Introduction: The management of umbilical hernias is challenging due to varying opinions from different departments and institutions. To systematize the management of umbilical hernias from diagnosis to surgical technique, we retrospectively reviewed cases of umbilical lesions at our institution and extracted key points for practice.
 Methods: We reviewed diagnostic techniques, the ratio of umbilical hernias to other diseases, timing of surgery, choice of surgical technique, and postoperative umbilical shape in patients with umbilical lesions and hernias from 2018 to 2023.
 Results: Umbilical hernia was diagnosed in more than 85% of umbilical lesions, with differentiation primarily performed using ultrasound. The timing of surgery was determined after 2 years of age, focusing on the thickness of the abdominal subcutaneous fat. Patients with a large umbilical fossa circumference had a poor postoperative umbilical shape if surgery was performed without fossa reduction.
 Discussion: In the systematic management of umbilical hernias, it is important to use ultrasonography for diagnosis, perform surgery after 2 years of age when the thickness of abdominal subcutaneous fat is sufficient, and apply different surgical techniques according to the transverse diameter of the umbilical fossa.

 Introduction: To accurately evaluate surgical interventions, creating standardized and aesthetically pleasing images is critical. We describe the ideal equipment and settings to produce clinical photographs.
 Method: Clinical photographs were obtained using a mirrorless camera, single-focus lens, and strobe with a softbox. The camera-to-subject distance and camera settings were constant throughout.
 Results: Clinical photographs of a single patient are presented. The distortion was minimal, and almost all facial elements were in focus. The background was evenly lit, and the shadow edge was not noticeable.
 Discussion: Four key aspects are crucial for producing high-quality clinical photographs: (1) A mirrorless full-frame sensor camera with a 90-105 mm macro lens to maximize the resolution. (2) An appropriate camera-to-subject distance that prevents distortion. (3) Fixed settings to produce consistent images, including f-value, shutter speed, ISO sensitivity, exposure, and color temperature. (4) A strobe with a large softbox to create a natural, soft shadow.
 Conclusion: The information described in this article facilitates an understanding of the underlying mechanisms of the equipment and the adjustment of settings, forming the foundation for reproducing high-quality and comparable images.

 High-pressure injection injuries are rare instances of trauma resulting from accidental contact with the nozzle of a high-pressure sprayer. Due to the significant risks of necrosis from direct damage to soft tissue and exposure to toxic chemicals, urgent evaluation and treatment are crucial. In this report, we describe a case of high-pressure injection injury to the thumb. A 45-year-old man presented to our department three days after a spray gun injection injury. He was treated with aggressive debridement and hyperbaric oxygen therapy, resulting in healing by day 36. Hyperbaric oxygen therapy was effective despite the delayed treatment.

 Lipoma is a common type of benign tumor, mostly found on the back, neck, shoulders, and abdomen. They rarely appear on the face or limbs. Notably, other non-cancerous tumors, such as mucous cysts, inclusion body cysts, and synovial giant cell tumors, may affect the proper fingers; thus, lipomas are typically not considered a possible diagnosis for such tumors. We report two cases of lipomas on the proper fingers. We provide a comprehensive discussion of the diagnosis and surgical considerations for treating lipomas on the proper fingers, along with a review of the relevant literature. Although lipomas are usually asymptomatic, they can cause neurological symptoms, such as pain and movement disorders, when they develop on the proper fingers. We emphasize the importance of considering the possibility of lipomas when tumors appear on the proper fingers.

 We report a rare case of pleomorphic adenoma (PA) of the nasal cavity.
 A 71-year-old woman presented with a slow-growing mass in the nasal cavity that was initially diagnosed as epithelial-myoepithelial carcinoma (EMC) by fine-needle aspiration (FNA). Tumor resection with a 3-mm margin was performed. Reconstructive surgery was performed after diagnostic confirmation of PA. The defect was reconstructed using a cheek-based hinged flap for the nasal lining and a nasolabial V-Y advancement flap for outer skin coverage.
 The patient's postoperative course was uneventful, no tumor recurrence was seen over >2 years, and the aesthetic results were satisfactory.
 PA originating from the nasal cavity contains more epithelial tissue than PA originating from the major salivary glands; therefore, the tumor may be misdiagnosed as an epithelial malignancy. In the case of a preoperative diagnosis of suspected EMC by FNA, additional partial biopsy is recommended.