• Investigative Magnetic Resonance Imaging
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• 제23권1호
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• pp.75-80
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• 2019

Metastasis of rhabdomysarcoma to the breast is a very rare manifestation in adult males. Herein, we report a case of metastasis from embryonal rhabdomyosarcoma in the left hypothenar muscle that presented as a breast mass in a 38-year-old man, who four months later expired because of multiple bone metastases related to pancytopenia. We describe the various imaging findings, including mammograms, ultrasonography, computerized tomography (CT), positron emission tomography-computed tomography (PET-CT), and magnetic resonance imaging (MRI) of this rare disease. The various imaging findings of this lesion could be helpful for future diagnosis of male breast lesions.

• The Korean Journal of Pain
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• 제27권1호
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• pp.49-53
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• 2014

Background: The carpal tunnel syndrome (CTS) is the most common cause of severe hand pain. In this study we treated acute pain in CTS patients by means of local intradermal injections of anti-inflammatory drugs (mesotherapy). Methods: In twenty-five patients (forty-five hands), CTS diagnosis was confirmed by clinical and neurophysiological examination prior to mesotherapy. A mixture containing lidocaine 10 mg, ketoprophen lysine-acetylsalycilate 80 mg, xantinol nicotinate 100 mg, cyanocobalamine 1,000 mcg plus injectable water was used. Sites of injection were three parallel lines above the transverse carpal ligament and two v-shaped lines, one at the base of the thenar eminence, and the other at the base of the hypothenar eminence. Results: The day after the treatment, all but four patients reported a significant reduction in pain and paresthesias. After 12 months, 17 patients had a complete pain relief, eight patients reported recurrence of pain and sensory symptoms and four out of them underwent surgical treatment. Conclusions: With the obvious limits of a small-size open-label study, our results suggest that mesotherapy can temporary relieve pain and paresthesias in most CTS patients and in some cases its effect seems to be long-lasting. Further controlled studies are needed to confirm our preliminary findings and to compare mesotherapy to conventional approaches for the treatment of CTS.

• 대한물리치료과학회지
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• 제10권1호
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• pp.102-108
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• 2003

The purpose of this study was to determine the changes of skin temperature and subjective fatigue of the thoracic vertebrae by the chiropractic adjustments. Stimulation of the sympathetic nervous system will cause the changes in the skin blood flow which can be detected by measuring the skin surface temperature. This study was to see whether chiropractic adjustments could affect the activity of the sympathetic nervous system as reflected by changes in skin temperature of the thoracic. Skin temperature and subjective fatigue on 16 subjects was measured before, within 10 sec, 10min, 20min and 30 min after a thoracic adjustment with Digital Infrared Thermal Imaging(DITI) and Visual Analogue Scale(VAS). The adjustments consisted of a straight posterior-to-anterior high-speed, low-amplitude thrust to the transverse process of T3-T10 using a reinforced hypothenar contact. The average temperature and fatigue changed when the spine was considered as an entire unit. These results illustrate that the blood flow through the soft tissue can be affected by specific adjustments to the spine. This study might be served as an useful baseline data for the changes of the circulation and fatigue after the chiropractic adjustments.

• Clinical Pain
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• 제18권2호
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• pp.97-101
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• 2019

Tardy ulnar nerve palsy is ulnar neuropathy at or around elbow and commonly evaluated in the electromyography laboratory. However, ulnar neuropathy at the elbow due to neurofibroma is rare. Neurofibromas are tumors that arise within nerve fasciculi and anywhere along a nerve from dorsal root ganglion to the terminal nerve branch. We report one case of ulnar neuropathy at the elbow due to neurofibroma. Patient had paresthesia on the left 5th finger and there had been left hypothenar atrophy since 2 months ago. Tinel's sign was positive at left elbow. As a result of electromyography, there were suggestive of right ulnar neuropathy at or around elbow, referred to as tardy ulnar nerve palsy. Ultrasonography showed a diffuse tortuous thickening with multiple neurofibromas arising from individual fascicles of the ulnar nerve in cubital tunnel area. Surgery was then performed to release cubital tunnel of left elbow, then the patient's symptoms improved.

• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.332-338
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• 2015

Purpose: The purpose of this study was to examine the effect of postural control and locomotion on improvement of two point discrimination (TPD), stereognosis (ST) through somatosensory training (SST) on the upper limb (UL). Methods: The subjects were 20 hemiplegia patients who have problems with unilateral neglect after stroke. The patients were divided into two groups, the experimental group (EG) and the control group (CG). In the EG, SST for TPD, ST was performed 18 times, three times a week for six weeks, together with physical therapy (PT) and occupational therapy (OT). In the CG conventional PT and OT without SST was performed for six weeks. Several assessment tools were used in comparison of groups; two point discrimination test (TPDT) on forearm (F), thenar (T), hypothenar (TH), thumb tip (TH-T), index finger tip (IN-T), stereognosis test (ST), postural assessment scale for stroke (PASS), and clinical test of sensory interaction on balance (CTSIB) and timed up and go test (TUG). Results: In the CG, conventional PT and OT resulted in statistically improved TPDT (F), ST, PASS, and TUG. In the EG, SST resulted in statistically improved TPDT (F, T, HT, TH-T, IN-T), ST, PASS, and TUG. TPDT-T, ST, and CTSIB with length of displacement with eye open (LDEO) also showed significant improvement between the groups. Conclusion: In both groups TPDT ST, PASS and TUG, and SST had effects on the UL and TPDT, ST and static postural control had greater effects compared with the PG. Therefore, we could assume that TPD and ST are very important in performing human activities including postural control and locomotion.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.780-783
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• 2006

Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

• 대한물리의학회지
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• 제7권4호
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• pp.481-491
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• 2012

PURPOSE: This study find out the effect of improved two point discrimination (TPD), hand function and activities of daily living (ADL) performance through tactile stimulus of upper limb (U/L) in impaired characteristics of stroke METHODS: We selected 26 stroke patients in BMH who has problems with neglect, sensory and motor deficits. Patients were divided into 3 group with neglect group (NG), sensorimotor deficits group (SMG) and motor deficit group (MG). To compare each group we used assessment tools such as two point discrimination on affected side (TPDas) and unaffected side (TPDus), Manual functional test on affected side (MFTas) and unaffected side (MFTus) and Korean version modified barthel index (K-MBI). RESULTS: 1) In the NG, tactile stimulus on U/L was statistically important for TPDas (forearm, index finger tip) also SMG and MDG was statistically important for TPDas. 2) In the NG, SMG, there was statistically important for MFTas, MFTus and in the MG. K-MBI also was statistically importance. Among three group, there was an statistically important difference for TPTus (forearm, thenar, hypothenar), MFTas and MFTus. We analyzed the relationship among TPD, MFT and K-MBI and There was negative relationship between TPD, MFT and There was positive relationship between TPD and K-MBI CONCLUSION: In impaired characteristics of stroke patients, tactile stimulus on U/L influenced on two point discrimination, hand function and ADL's. And we also found relationship among somatosensory, hand function, and ADL performance.

• Archives of Plastic Surgery
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• 제34권1호
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• pp.111-114
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• 2007

Purpose: Dystrophic calcification occurs in damaged or devitalized tissues in the presence of a normal calcium and phosphorus metabolism. There are many reports on dystrophic calcification caused by injections of various types of drugs. The aim of this report is to highlight the fact that dystrophic calcification can be caused by the injection of a foreign body for aesthetic augmentation. Methods: This case report describes a patient presenting with dystrophic calcification caused by an injection of an unknown foreign body approximately 50 years ago. An 80-year-old man had localized cellulitis with swelling and ulceration on the dorsum of the left hand. The radiographs demonstrated a $5{\times}3.5{\times}1.7cm$ lesion between the first and second metacarpal bones and a $5{\times}2.5{\times}1.5cm$ lesion in the hypothenar region. The laboratory data and physical examinations were generally within the normal limits. The microscopic examination revealed dead bone fragments and dense collagenous tissue with dystrophic calcification. Results: After surgically removing the masses, the resulting defects were treated with an abdominal flap. The result was satisfactory in terms of symptoms and appearance. Conclusion: This case suggests that dystrophic calcification can be caused by an injection of a foreign body for aesthetic augmentation.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.61-69
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• 2022

Background Single free flaps are a commonly used reconstructive method for multiple soft tissue defects in digits. We analyzed the flap size, division timing, and degree of necrosis in cases with various types of flap division. Methods We conducted a retrospective review of the medical charts of patients who had undergone single free flap reconstruction for multiple soft tissue defects across their digits from 2011 to 2020. The flap types included were the lateral arm free flap, venous forearm free flap, thenar free flap, hypothenar free flap, anterolateral thigh free flap, medial plantar free flap, and second toe pulp free flap. Flap size, anastomosed vessels, division timing, and occurrence of flap necrosis were retrospectively investigated and then analyzed using the t-test. Results In total, 75 patients were included in the analysis. The success rate of the free flaps was 97.3%. All flaps were successfully divided after at least 17 days, with a mean of 47.17 days (range, 17-243 days) for large flaps and 42.81 days (range, 20-130 days) for the medium and small flaps (P=0.596). The mean area of flap necrosis was 2.38% in the large flaps and 2.58% in the medium and small flaps (P=0.935). Severe necrosis of the divided flap developed in two patients who had undergone flap division at week 6 and week 34. Conclusions In cases where blood flow to the flap has been stable for more than 3 weeks, flap division can be safely attempted regardless of the flap size.

• Annals of Clinical Neurophysiology
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• 제23권2호
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• pp.99-107
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• 2021

Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.