Purpose: Besides scar shape and aesthetics, achieving a suitable color match is crucial for the postoperative cosmetic outcome in autologous tissue breast reconstruction. Herein, we assessed color matching between breast and flap skin quantitatively, focusing on the deep inferior epigastric artery perforator flap (DIEP) and latissimus dorsi flap (LD), using luminance measurements.
 Methods: From 2017-2020, 34 patients with DIEP and 15 with LD who underwent primary or secondary one-stage reconstruction after unilateral total mastectomy were included. Luminance measurements were taken from AB areas of both unaffected and reconstructed skin, symmetrically located in photographs taken > 1-year post-operation.
 Results: DIEP showed no significant difference between unaffected and reconstructed sides. However, LD showed a significant difference between the unaffected (176.8, SD 9.5) and reconstructed sides (168.9, SD 8.8) (p < 0.001), resulting in lower reconstructed skin luminance than the unaffected side in all LD cases. The absolute luminance difference between unaffected and reconstructed skin was significantly smaller in the DIEP group (3.9, SD 3.0) than the LD group (7.9, SD 5.4) (p = 0.002).
 Conclusion: LD had a larger luminance difference than DIEP, making the reconstructed side appear darker. This supports the clinical impression that comparing luminance differences serves as a measure of color matching.

 Reforms in the way physicians work will take effect on April 1, 2024. These reforms will require an increase in labor productivity within a limited time frame. In this study, we implemented digital transformation (DX) using a voice recognition system and task shifting to medical administrative assistants to reduce the time required for medical record entry.
 Smartphones equipped with a speech recognition system were used to record the details of consultations and surgeries during rounds on the ward, as well as to prepare referral letters and return letters, to investigate how much time could be saved by charting compared to the traditional manual input method.
 Our findings suggest that chart entry time was reduced by an average of approximately 5 min per patient for initial consultations and approximately 1 min for follow-up consultations.
 Using DX and shifting tasks to medical assistants significantly reduced charting time and improved worker productivity.

 In cases of severe lower eyelid ectropion, the bulbar and palpebral conjunctivae become dry and thickened, undergoing histological changes that resemble the skin. This process is sometimes referred to as 'conjunctival metaplasia.' In this study, we present a case of severe lower eyelid ectropion and report on histological findings related to skin-like changes and the treatment.
 Surgery was performed to remove the hard, skin-like surface of the palpebral conjunctivae to prevent corneal damage. Tarsal plate shortening and orbicularis oculi muscle shortening surgeries were performed to improve the horizontal laxity of the lower eyelid. Moreover, fixation of the lower eyelid retractors to the tarsal plate was performed to improve vertical tension.
 The surgeries were effective in correcting ectropion, and corneal damage was prevented. Histologically, skin-like changes in the palpebral conjunctiva are different from those observed in conjunctival metaplasia.

 Ehlers-Danlos syndrome (EDS) is a genetic disorder involving genetic mutations related to collagen, which is clinically characterized by skin extensibility, joint hypermobility, and vascular fragility. EDS is classified into 13 disease types according to genetic mutations. The mechanism and detailed pathogenesis leading to multisystem complications remain to be elucidated. The tissue fragility associated with collagen abnormalities may lead to lethal complications such as vascular and organ ruptures.
 Herein, we report a case of a 51-year-old EDS patient who presented with a minor head injury and was discharged with a small subcutaneous hematoma in the left occipital region. The patient was admitted to the hospital 6 days post-injury for increased subcutaneous hematoma and anemia, which required emergency hematoma removal and hemostasis. Even if the trauma is minor, careful observation is needed in EDS patients, as they have a higher risk of developing severe complications.

 Reconstruction of large defects in the glabella and forehead area poses a surgical challenge due to the need to consider the facial aesthetic units during the procedure. Herein, we present a case of a 78-year-old woman who underwent reconstruction of a large defect in the glabella and forehead area after excision of basal cell carcinoma using bilateral forehead V-Y advancement flaps within a single subunit. A favorable aesthetic outcome was achieved without complications such as dysesthesia or scar contracture. The use of bilateral forehead V-Y advancement flaps enabled effective reconstruction of the glabella and forehead defect while ensuring appropriate aesthetic subunits.