Malignant peripheral nerve sheath tumor (MPNST), a rare soft-tissue sarcoma, is most commonly located in the trunk, extremities, and head and neck, but rare in the breast. We report a metastatic breast MPNST in a 27-year-old woman with neurofibromatosis type 1 (NF-1). Chest computed tomography revealed a well-defined, oval, mildly enhancing nodule in the right breast. US revealed a circumscribed, oval, heterogeneous echoic mass with vascularity and intermediate elasticity in the right upper outer breast. The breast mass was excised and diagnosed as MPNST on histopathology evaluation. Although rare, it should be included in the differential diagnosis of breast mass in NF-1 patient.
Journal of The Korean Society of Integrative Medicine
/
v.7
no.2
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pp.165-179
/
2019
Purpose : The purpose of this study is to improve the stroke patient's gait ability by applying a closed or kinetic chain lower limb exercise Methods : The study subjects were 48 hospitalized hemiplegic patients who agreed to participate in the study. 48 subjects went through the intervention: 24 in the experimental group and 24 in the control group. One set consisted of 10 repeats of the exercise. The subjects performed three sets of the exercise once a day, 5 times a week, for 6 weeks. Results : TUG and FGA were significantly improved in the experimental group. The spatio-temporal gait variables in the experimental group all showed significant improvement. In the control group, velocity, cadence, and double limb support showed significant improvement, Trunk sway angle showed significant improvement in all three axes in both groups. Conclusion : The results of this study indicate that a more positive effect in terms of improvement of the stroke patient's gait ability will be seen for closed rather than open kinetic chain lower limb resistance exercise.
Clear cell hidradenoma (CCH) is a rare tumor of the sweat glands of eccrine or apocrine differentiation. It can occur anywhere in the body, but common sites of involvement are the head, face, trunk, and extremities. Although several reports have described sonographic findings of CCH, only one study on the axilla mentioned its strain elastographic findings. Here, we present a case of CCH in the right calf with its sonographic and strain elastographic findings in a tumor that looked like an epidermoid tumor.
After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.
The purpose of this study is to compare 4 different body punch types(type 1: a punch using a shoulder, type 2: a punch using a waist, type 3: a punch using lower extremities, and type 4: a punch with elbows by your side at chest level) in horseback-riding stance and establish suitable teaching theory and method, which would be a useful reference to Taekwondo instructors on the spot(in Taekwondo dojangs all around Korea). Five exhibition players from Korean national Taekwondo exhibition team participated in this study. Each participant was asked to perform the four different types of punches and their kinematic and kinetic data were recorded with 7 vicon cameras(125Hz) and two force plates(AMTI, 1200Hz). We analyzed displacement, time, resultant center of body mass trajectory, velocity, trunk angular velocity, and ground reaction force(GRF) from each body segment in body punch and the result. I performed 1-way ANOVA(RM) for average values of each player after standardization and statistical significance was set as p<.05. was as the following ; First, they showed a tendency to take the body punch posture with the biggest motion at a shoulder and on descending order a waist and a knee. Second, a mean time for each body punch on ascending order 0.46sec. for type 2, 0.49sec for type 3, 0.50sec. for type 4, and 0.56sec. for type 1. Third, a mean resultant center of body mass trajectory for each body punch the longest 4.07cm for type 3 and the shortest 2.458cm for type 1. Fourth, a mean of maximal velocity of a fist strike was the fastest 5.99m/s for type 3, 5.93m/s for type 4, 5.67m/s for type 2, and 5.01m/s for type 1 on the descending order. Fifth, a mean of maximal trunk angular velocity of the fastest 495.6deg./sec. for type 4 and 337.7deg./sec. for type 1 on the descending order. Sixth, strongest value was type 3, 2 for anterior-posterior ground reaction force(left -54.89N, right 60.58N), type 4 for medial-lateral GRF(left 83.59N, right -80.12N), and type 3 for vertical GRF(left 341.79N, right 426.11N).
Kim, Kyoung-Hoon;Bae, Yong-Chan;Nam, Su-Bong;Choi, Soo-Jong;Kang, Cheol-Uk
Archives of Plastic Surgery
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v.36
no.4
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pp.417-421
/
2009
Purpose: Dermatofibrosarcoma protuberans(DFSP) is a moderate - degree malignant tumor of soft tissue from dermis to fat layer with high recurrences(11% to 73%) due to its local infiltrative characteristic. Many debates and controversies in deciding accurate surgical margin were presented before, but references about depth of invasion and appropriate surgical excision level were not properly made out. Therefore, we tried to identify the degree of tissue invasion of DFSP. Methods: Twenty patients, including 8 patients with recurrent lesions, over last 10 years were reviewed retrospectively. Different surgical margins were applied according to the location and based on histopathologic result, we have defined as a 'deep tissue invasion' if there were infiltration of tumor cell into fascia or underlying muscle layer was present. All invaded tissue including dermis, fat, fascia and muscle were excised until no tumor cell was found during intraoperative frozen section biopsy. And comparative analysis of deep tissue invasion according to age, primary site, duration of disease and recurrence was done. Results: Thirteen patients(65%) showed deep tissue invasion and incidence was found to be increasing with age(over 30 years old). All patients with DFSP on head and neck region revealed deep tissue invasion followed by trunk(54%) and lower extremities(50%). There was no relationship between duration of disease and deep tissue invasion. Conclusions: It is clear that many cases of DFSP had a deep tissue invasion. And high prevalence of deep tissue invasion with age, primary site was intimately associated. So, underlying deep tissue must be completely examined and excised sufficiently throughout the operation for clear resection of DFSP with no recurrences, especially when age is over 30s and on head and neck region.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.32
no.6
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pp.598-602
/
2006
The lipoma is the neoplasm of mesenchymal origin. Although most lipomas occur on the trunk and the proximal portion of the extremities, lipomas of the oral and maxillofacial regions are relatively rare, approximately 13% of all cases. Lipomas have been found in all age, but usually found between 40 and 60 years of age. Clinically the lipoma is a painless, slowly growing, nearly always benign soft mass. The treatment of choice is a surgical excision, and the recurrence is rare. But the infiltrating lipoma originated from muscle has high recurrence rate. It has ill-defined border and little or no evidence of encapsulation. Histologically there is a consistent infiltration with dissociation of the surrounding muscle fiber. The infiltrating lipoma should be excised with surrounding normal muscle and tissue to prevent the recurrence. This case was a 57-year-old female with a painless swelling of the right cervical and parotid areas which was diagnosed as large infiltrating lipoma by clinical examination and radiographic findings. The patient was treated by surgical excision and showed good functional and esthetic results. Histologically the tumor was diagnosed as infiltrating lipoma with no evidence of malignancy.
Lee, Kyeong Bong;Kim, Jong Geun;Park, Han Gi;Kim, Ji Eun;Kim, Hye Sun;Lee, Wan Hee
Physical Therapy Rehabilitation Science
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v.4
no.1
/
pp.11-16
/
2015
Objective: Prone bridge exercise is one of the core strengthening exercise for improving abdominal, lower and upper extremity muscles. In addition, coactivation of the trunk muscles and extremities is important for treatment of low back pain. This study aimed to investigate the correlation between the thickness, cross-sectional area of the target muscle, and endurance during prone bridge exercise. Our hypothesis was that an increase in muscle thickness is positively related to the hold time for the static prone bridge exercise. Design: Cross-sectional study. Methods: Fourteen healthy university students (8 men and 6 women) voluntarily participated in the study at Sahmyook University. Hold time for the prone bridge with one and both legs was measured. The resting and contracted thickness of the lateral abdominal, rectus femoris, and triceps muscles was measured using rehabilitative ultrasound imaging. The correlation between muscle thickness and endurance for maintenance time was evaluated. Results: The prone bridge with both legs and the contraction thickness of the triceps muscle showed a positive correlation (r=0.692, p<0.05); the prone bridge with one leg and the contraction thickness of the internal oblique and transversus abdominis muscles showed a positive correlation (r=0.545, 0.574, p<0.05, 0.05, respectively). Conclusions: Endurance for the prone bridge exercise with a stable support surface is correlated with the contraction thickness of arm muscles; the prone bridge exercise with an unstable support surface is correlated with the contraction thickness of the deep abdominal muscles.
Necrotizing fascitis is a severe soft tissue infection characterized by extensive necrosis of superficial fascia, suppurative fascitis, vascular thrombosis, widespread undermining of surrounding tissues. Associated systemic problems are widespread undermining of surrounding tissues, Associated systemic problems are common, with chronic alcoholism and diabetes being most prominent. Most commonly this disease presents in the extremities, trunk, and perineum. Necrotizing fascitis of dental origing is rare and its fulminating clinical course is not well documented in the dental literature. The present report is a case of necrotizing fascitis following vital extirpation of the pulp in a patient with uncontrolled diabetes mellitus and liver cirrhosis. Originally throught to be caused by hemolytic streptococcus organism or stphylococcus aureus, advances in anaerobic culturing have shown it to be a synergistic bacterial infection involving aerobic and ovligate anaerobes. it is relatively rare in relatively rare in haea and neck regions. If it was not diagnosed and treated in early stages, necrotizing fascitis can be potentially fetal, with a mortality rate approaching 40%. It's treatment requires early recognition, prompt and aggressive surgical debriment and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. Recently, we experienced two cases of necrotizing fascitis in cervicofacial region, One patient was 60 years old male with uncontrolled Diabetes Mellitus and other patient was 48 years old with steroid therapy during 30 years. Local surgical wound healing was successful but, patients were died after admission, because of lung abscess, gastrointestinal bleeding, septic shock and respiration hold.
The purpose of this study is to investigate if there is a higher rate of free flap failure in cases of vein grafts compared to non-vein graft, and to analyze the clinical usefulness and necessity in elective free flap surgery. We have used 24 vein grafts in 208 free flaps from May, 1986 until August, 1995. Vein grafts were from 2cm to 50cm in length between the recipient and donor vessels. Reconstructed sites were 10 lower extremities, 8 head and neck, 4 hand, and 2 trunk. Vein grafts were used 14 for arterial, 6 venous, 4 in both arterial and venous anastomoses. We intentionally used long vein grafts longer than 5cm for improved blood flow in cases of peripheral vascular disease, radionecrotic wounds, lower leg trauma. Short vein grafts of about 3cm in length were used to overcome the shortage of vascular length in cases of unexpected vessel anomaly, short donor vessel, and difficult access to recipient vessels after radical neck dissection. All veins were carefully handled with ligation of very small branches and were transferred to the recipient site without irrigation. 8 flaps were failed out of a total of 208 free flaps, however there was no failure among the 24 cases that needed vein grafts between the donor and recipient vessels. Success rates between non-vein grafts free flaps and vein graft free flaps were 95.6%(8/184) and 100%(0/24). Even though the vein grafts increase the operation time and the number of anastomoses, they do not result in any increased failure rate of free flap surgery(4.4% versus 0%). In addition to the reducing tension between recipient and donor vessels, the surgeon can select better recipient vessels with excellent blood flow so that vein grfats in microsurgery can provide a high success rate of free flaps.
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