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Odontogenic cutaneous fistula of dental origin at the alar-facial groove is rarely reported. As many patients present with only skin lesions without dental problems, it is often confused with a cyst, abscess or pyogenic granuloma. We report the case of a 52-year-old man who presented with a relapsing cutaneous ulcer in the left alar-facial groove area. Ultrasonography findings suggested a ruptured epidermal cyst, and an excisional biopsy was performed. At 10 days after the surgery, wound dehiscence and pus discharge were observed. Computed tomography revealed a sinus tract, and a diagnosis of odontogenic cutaneous fistula was made. After consultation with the dental department, endodontic treatment was performed. During reoperation, a remnant fistula from the left alar-facial groove area to the left upper central incisor was observed, for which fistulectomy was performed. The patient remained disease-free postoperatively. With early accurate diagnosis, patients with odontogenic cutaneous fistula can be protected from unnecessary surgical intervention and ineffective antibiotic therapy.

Crohn’s disease is difficult to diagnose owing to its varied symptoms, among which fistulae are a late-stage symptom that appears mainly in the form of a perianal fistula. A patient who was previously healthy without clinical history visited our hospital with an ulcer of unknown cause at the right flank and gluteal region. Using computed tomography (CT) and colonoscopy, we diagnosed the ulcer as an enterocutaneous fistula caused by Crohn’s disease and successfully treated it with general surgery. In young, lean men with skin lesions of unknown cause, a CT or colonoscopy test may be useful for diagnosing underlying gastrointestinal problems.

Summary:. Costochondritis after breast reconstruction and radiation therapy is rarely reported. Moreover, it is difficult to diagnose using computed tomography and magnetic resonance imaging; as such, wound debridement and reconstruction must be performed in several stages. A 51-year-old woman was diagnosed with invasive cancer of the right breast, and she underwent nipple sparing mastectomy and direct-to-implant breast reconstruction in November 2007. Thirteen years later, in September 2020, she experienced pain and swelling on her right breast. Incisional drainage and implant removal were performed in another clinic; however, the infection was not controlled. An implant-induced infection was suspected, and debridement was performed to a level where fresh tissue appeared in the upper layer of the intercostal muscle. Antibiotics and open dressing were used for 10 days; however, yellowish debris was noted, and third to fifth ribs and costal cartilages turned dark brown. Radiation-induced costochondritis was diagnosed based on clinical findings from the intraoperative field, wound course, and cartilage biopsy. Radical chest wall resection and reconstruction was performed using Teflon (Dupont/Chemours, Wilmington, Del.) and latissimus dorsi musculocutaneous flap. The patient was discharged 2 weeks after surgery without any complications. Costochondritis should be clinically diagnosed while performing the first debridement in staged operation. Radical chest wall resection is essential with chest wall reconstruction using Teflon and a latissimus dorsi musculocutaneous flap.

Background:. Upper blepharoplasty in elderly patients has characteristics that differ from those of younger patients. Blepharoptosis in elderly patients causes not only aesthetic problems but also functional problems such as entropion, visual disturbance, and sore eyes. We hypothesized that factors influencing patient satisfaction with upper blepharoplasty in elderly patients include aesthetic outcomes, functional outcomes, and personal factors. Methods:. This study included 57 patients aged >65 years who underwent upper blepharoplasty between April 2018 and March 2019. All surgeries were performed through the “Upper Blepharoplasty Service Project” of the public health center in Geoje City. To evaluate the individual characteristics of the patients, a preoperative questionnaire (including sociodemographic characteristics, main symptoms of discomfort in the upper eyelid, and degree of expectation of surgical results) was administered to the patients. After 6 months, a satisfaction survey was conducted accordingly. Results:. The main symptoms of discomfort were sagging of the skin of the upper eyelid. The mean score for patient satisfaction was 3.84 ± 0.40, and satisfaction with the results of surgery relative to the cost was 4.53 ± 0.63, which was the highest score. Significant verification of the regression coefficients showed that functional improvement and cognitive degree of postsurgery precautions had a significant effect on patient satisfaction, whereas aesthetic outcomes and expectations of surgical results were not correlated with patient satisfaction. Conclusion:. The findings indicated that elderly patients tended to be satisfied with functional improvement that resolved their symptoms of discomfort and personal factors such as cost and cognitive degree of precautions after upper blepharoplasty.

Purpose: Elderly men are often troubled by lower urinary tract symptoms (LUTS), including frequency, urgency, incontinence and nocturia. Especially, nocturia is one of the frequently complained about urologic symptoms and this can be combined with sleep disorders. We investigated the prevalence and risk factors for nocturia in males who participated in a prostate examination survey. Materials and Methods: A total of 7,299 men participated in a prostate examination survey from March 2003 to December 2006; these men were given an International Prostate Symptom Score (IPSS) and they underwent transrectal ultrasonography of the prostate. The prevalence of nocturia and its associated factors, which included age, the IPSS severity, the prostate volume and the place of residence, were evaluated. Results: Among the men who were evaluated, 23.4% reported voiding once per night and 68% reported voiding twice or more per night. The severe IPSS group revealed a significantly higher nocturia score compared to the mild and moderate IPSS group. While the nocturia score and the other LUTS score increased significantly with age, only the nocturia score increased significantly with age in each of the IPSS severity groups. The nocturia score increased significantly with a prostate volume ≥30g. Men living in Seoul showed a significantly lower nocturia score than that for men living in other areas. Multiple logistic regression analysis also indicated that an older age, a severe IPSS score, the country of residence were the independent risk factors. Multiple regression analysis revealed the nocturia score to have the highest correlation with the quality of life. Conclusions: For Korean males, the prevalence of nocturia ≥2 is 68% and the incidence of nocturia increased significantly according to age, the IPSS severity, the prostate volume and the place of residence. (Korean J Urol 2008;49:818-825) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose: Dihydrotestosterone (DHT) is key to the initiation and maintenance of abnormal prostatic growth in benign prostatic hyperplasia (BPH). Five α-reductase inhibitor reduces prostatic growth and serum prostate-specific antigen (PSA) by blocking the conversion of testosterone to DHT. Dutasteride is a dual (type 1 and 2) 5α-reductase inhibitor. We evaluated the effects of dutasteride on prostate volume, PSA, and PSA density in men with BPH. Materials and Methods: A total of 83 men with a clinical diagnosis of BPH were treated with dutasteride and an alpha-blocker. We investigated the change in prostate volume, PSA, and PSA density 6 and 12 months after initiation of dutasteride therapy. Results: After 6 months of dutasteride therapy, the total prostate volume was reduced from baseline by a mean of 15.46%, the PSA was reduced by a mean of 48.24%, and the PSA density was reduced by a mean of 37.97% (p

Byeong Seok Kim, Young Woo Son, Seoung Jin Lee, Si Hyong Jang, Yong Wook Park, Young Ha Oh, Hong Yong Choi, Hong Sang Moon From the Departments of Urology and Pathology, College of Medicine, Hanyang University, Seoul, Korea Schwannoma is a tumor that arises from neural sheath Schwann cells of peripheral nerves. Schwannoma is mostly solitary, except when it occurs in association with Von Recklinghausen's disease. Solitary schwannoma can occur in association with a nerve anywhere within the body, but rarely occurs in the pelvis. Microscopically, the tumors can be divided into hypercellular bundles of spindle-shaped cells (Antoni A area) and areas of lower cellularity, with loose myxomatous arrangement of cells and fibers (Antoni B area). Complete resection of pelvic schwannoma is a curative treatment. We report a case of benign presacral cystic schwannoma that caused recurrent acute urinary retention in a 79-year-old woman, along with a review of the literature. (Korean J Urol 2007;48: 663-666) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏