We investigated the pathway of differentiation in a case of mucinous carcinoma of the skin (MCS) arising on the right temple of a 70-year-old man. Histopathologic findings of the tumor showed evidence of apocrine-type differentiation such as distinctive decapitation secretion. Additionally, by employing a panel of antibodies, the immunohistochemical staining pattern of tumor cells was shown to be compatible with that of apocrine glands. Although the differentiation of this neoplasm remains controversial, the findings in our case suggest apocrine differentiation.

Because poor skin wound healing associated with diabetes is thought to be partly a result from impaired angiogenesis, treatments that improve angiogenesis could have important clinical applications. We herein report the effects of novel developed material, collagen-poly glycolic acid fiber hybrid matrix, being used together with basic fibroblast growth factor to promote wound healing of full-thickness skin defects on the back of type 2 diabetic Lepr(db) mice. Our data indicates that this therapeutic approach markedly promotes angiogenesis and granulation tissue formation in comparison with other conditions 14 days after wounding.

We report 4 cases of an infundibular cyst that histopathologically showed small papillary projections of follicular germinative cells emanating from the basal layer of the cyst wall. Some of these projections branched and formed a reticulated pattern. This cystic lesion is histopathologically distinctive. We propose to designate it as a trichoblastic infundibular cyst because its lining resembles that of an infundibular cyst, yet it has cells that resemble those of the follicular germ in its wall.

One of the most frequently requested facial contour improvement procedures in the Orient is reduction malarplasty. However, until recently, osteotomies in the malar region have been performed by means of a coronal incision that required a larger incision and more invasive procedure than many patients are comfortable with when considering an elective cosmetic surgical procedure. We have developed a reduction malarplasty method to improve facial contours that circumvents the drawbacks inherent in the conventional method. In our method, the protrusion in the cheekbone area is corrected by performing an osteotomy of the zygoma through an intraoral incision and an osteotomy of the zygomatic arch through a small preauricular incision.

A case of double linear scleroderma of the forehead (coup de sabre) is described. The histopathology of this rare lesion is now well known with a normal epidermis and a sclerotic dermis. The correction was done with an original two-stage procedure: the lesion with alopecia was first treated by excision-suture and a transfer of the involved subcutaneous tissue along the right inner canthus; 1 year later, by a hemicoronal incision, we transferred a galeal-pericranial flap beneath the wider forehead lesion. We think that the use of a filling flap to correct wide coup de sabre lesions without cutaneous excision can be a simple alternative to the classic treatment by complete excision and flap reconstruction. The subcutaneous fascial system of the scalp can provide a good donor site with minimal morbidity.

We used an ultrasonic surgical aspirator on the epidermal surface to perform dermabrasion instead of the conventional motor-driven grinder. It was determined on histologic examination that it is possible to fragment the epidermis with greater selectively using the ultrasonic surgical aspirator. Abrasion also can be performed safely on spotty lesions and intricate, problematic regions with the ultrasonic surgical aspirator. We feel that the ultrasonic surgical aspirator is a promising device for use in dermabrasion.

Loss of voice after total laryngectomy is a major concern that has prompted much effort to develop methods of surgical voice restoration. In 1992, Kawahara described a tracheocolic shunt for voice restoration using a revascularized ileocolic graft. With this method, aspiration through the phonatory shunt is prevented by the ileocolic valve (Bauhin's valve), while vocalization is allowed. The purpose of this study was to use sound spectrogram analysis to evaluate voices surgically restored in that way. Between 2002 and 2005, 10 consecutive patients underwent laryngopharyngoesophagectomy with Kawahara's surgical voice restoration for advanced carcinoma of the hypopharynx and/or cervical esophagus at Akita University Hospital, Japan. We then used sound spectrography to analyze and compare the voices of patients receiving Kawahara's voice restoration, against healthy volunteers and patients who underwent the same surgery without voice restoration and spoke using an electronic larynx. We also evaluated the intelligibility of conversation and performed a listening test. The sound spectrograms showed that when produced by the electronic larynx, consonant sounds and voice frequencies below 300 Hz were not clearly recognized. By contrast, in patients who received Kawahara's surgical voice restoration, consonant and vowel sounds at frequencies above and below 300 Hz were clearly recognized. Although conversation was intelligible with both Kawahara's surgical voice restoration and the electronic device, listeners judged the voice produced by the former to be superior. Thus, the voice produced by Kawahara's surgical voice restoration is superior to that produced by the electronic larynx.

We report two unusual cases of rectus sheath hematoma. This condition usually presents with acute onset and is generally treated through the general surgery or emergency service department. However, if the hematoma grows slowly it may be diagnosed as an abdominal tumor and the patient may then be referred to the plastic surgery department.