• Title/Summary/Keyword: SOFT TISSUE

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Myxofibrosarcoma Originating from Chest Wall (흉벽에서 발생한 점액성섬유육종)

  • Cha, Byung-Ki;Lee, Mi-Kyung;Lee, Sam-Youn;Choi, Chong-Bum;Choi, Soon-Ho
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.166-170
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    • 2006
  • Myxofibrosarcoma represents one of the most common soft tissue sarcomas of the extremities in adult and elderly patients. However, it only rarely occurs in the chest wall. A 58 years old woman presented with a huge painless lump (8 ${\times}$ 6.5 cm) in the right lower parasternal area which recurred a few months following excision from General surgery of our hospital. Histology showed an infiltrative deep seated dermal and subcutaneous tumor. It had a distinctive lobular growth pattern with prominent myxoid change and moderate cellularity. Tumor cells were spindleshaped with varying degrees of pleomorphism and frequent mitotic figures. Numerous blood vessels with curvilinear growth pattern were also seen. Immunostains for S-100, CD68, Mac 387, and FX IIIa were all negative, but positive for Vimentin. The histologic feature was of an intermediate grade myxofibrosarcoma. Wide excision was performed and recovered in good condition without any physical disabilities and was discharged at one month later. Currently she is waiting for the skin graft without chemotherapy and radiotherapy.

Type I immune-mediated polyarthritis with azathioprine therapy in a Shih-tzu dog

  • Jung, Dong-In;Park, Chul;Kang, Byeong-Teck;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Ko, Ki-Jin;Lee, So-Young;Cho, Sue-Kyung;GU, Su-Hyun;Heo, Ra-Young;Park, Hyo-Jin;Jeon, Hyo-Won;Kim, Jung-Hyun;Han, Sung-Kuk;Yoon, Ah-Ram;Sung, Ju-Heon;Yoo, Jong-Hyun;Park, Hee-Myung
    • Korean Journal of Veterinary Research
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    • v.46 no.4
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    • pp.395-398
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    • 2006
  • A 2-month-old female Shih-tzu dog was referred because of lameness, exercise intolerance, depression, elbow and stifle joint swelling. Physical examination, complete blood counts, serum-chemistry, radiography, synovial fluid analysis, antinuclear antibody test, and rheumatoid factor measurement were initiated. On radiography, soft tissue swelling of elbow and stifle joints without erosiveness were founded. The results of synovial fluid analysis revealed severe neutrophilic pleocytosis (nondegenerative), decreased viscosity, increased turbidity, positive on mucin-clot test, and negative on bacterial culture. The results of rheumatoid factor measurement and antinuclear antibody test were negative and below 1 : 40, respectively. Based on all tests, we diagnosed this case as juvenile onset type I immune-mediated polyarthritis. Azathioprine (1 mg/kg body weight, per os q 24 h, for 4 weeks) was then administered and clinical signs improved gradually. Four weeks after azathioprine administration, clinical signs were disappeared. This report describes the clinical findings, imaging characteristics, synovial fluid findings, and other laboratory results of type I immune-mediated polyarthritis and successful management with azathioprine therapy.

Quantitative Analyses of Cells using Photoshop after the H&E Staining of the Synovia of Osteoarthritis and Rheumatoid Arthritis Patients (H&E 염색 이미지의 포토샵 분석을 이용한 골관절염과 류마티스 관절염 활막 세포의 정량 분석)

  • Park, Jin-Ah;Kim, Keun-Cheol
    • Journal of Life Science
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    • v.22 no.8
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    • pp.1034-1040
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    • 2012
  • Synovium is the soft tissue that lines the non-cartilaginous surfaces within joints. It has been reported that synovial cells are activated during the pathogenesis of rheumatoid arthritis. In this study, we quantitate and compare the cellular composition of synovia derived from individuals with non-inflammatory osteoarthritis (OA) and those with inflammatory rheumatoid arthritis (RA). Synovia from OA (n=8) and RA (n=5) patients were used for hematoxylin and eosin (H&E) staining. A light microscopic examination has shown that RA synovia were morphologically thickened and hypertrophied as compared to OA synovia. We also performed an immunohistochemistry (IHC) analysis to classify cell types in the synovia using CD68, CD90, or PGP9.5 markers. As a result, we obtained quantitative data regarding the cell populations, which are macrophages in the lining layer and FLSs in the subintimal layer of the synovium. Further Photoshop analyses of the H&E images could allow the counting of the number and layer of the cells in the synovium. The number and layers of the macrophage cells were increased in the lining layer of the RA synovia as compared to the OA synovia. FLS cells also were increased in the subintimal layer of RA synovia. Therefore, quantification of the H&E stained images via Photoshop is a possible analysis protocol for synovium study. This quantitation also supports the idea that the increases in cell number and cell activation are important processes for RA pathogenesis.

The Heel Reconstruction by Microsurgery (미세수술을 이용한 발뒤꿈치 재건)

  • Lee, Kwang-Suk;Huh, Chang-Young;Kim, Hak-Yoon;Suh, Jeong-Dae
    • Archives of Reconstructive Microsurgery
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    • v.3 no.1
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    • pp.24-31
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    • 1994
  • The heel, with its specialized fat for shock absorption at heel strike and large surface area for balance and weight bearing, is a important component of normal ambulation. Despite of distinguished improvement in the field of microsurgical free flaps, the choice of reconstruction of the heel has been remained controversial. We reviewed 22 cases of the heel reconstruction using vascularized free flaps from January, 1980 through May, 1993 at the Department of Orthopedic Surgery of Korea University Hospital. The results were as follows: 1. The etiology was traumatic in 21 cases, and chronic ulceration due to burn in 1. 2. The arteries used in free flaps were 11 dorsalis pedis arteries, 2 deep circumflex iliac arteries, 2 supeficial iliac arteries, 2 branches of lateral femoral circumflex iliac arteries, 2 radial arteries, and 3 thorcodorsal arteries. 3. The mean size of the vascularized bone was $4.5cm{\times}3.5cm$, and that of skin flap was $12.1cm{\times}9.2cm$. 4. Of the 22 cases, 19 had a successful outcome and 3 in failure, the causes of failure were thrombosis and infection.

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Augmentation of Pyriform Margin Using Porous High-Density Polyethylene Sheet In Unilateral Cleft Lip Nasal Deformity (일측성 구순열비변형에서 다공성 폴리에틸렌 판을 이용한 상악골이상구증대술)

  • Han, Ki Hwan;Kim, Jin Han;Choi, Tae Hyun;Kim, Jun Hyung;Son, Dae Gu
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.431-438
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    • 2008
  • Purpose: The common deformity after the correction of unilateral cleft lip nasal deformity is nasal asymmetry, and it is caused by the hypoplasia of the pyriform aperture. To correct this, many procedures have been applied, but still many problems are present. Authors performed the inlay and onlay insertion of porous high density polyethylene sheet(1 mm thickness $Medpor{(R)}$ sheet) in the hypoplastic pyriform margin of cleft side and obtained satisfactory results. Methods: 11 cases were performed and the mean follow up period was 15.1 months. Their mean age was 23.6 years. Under general anesthesia, bilateral pyriform margin was exposed. $Medpor{(R)}$ sheets in "match stick" like shaped were inlay inserted, and kidney shaped were onlay inserted fixating with two 6 mm titanium screws. After the surgery, the results was evaluated by photogrammetric analysis. On the basal view, the distance from the subalare and labiale superius' to the transverse baseline connecting the both cheilions was measured from the cleft side and the non-cleft side. Then, the postoperative symmetry was assessed by obtaining the cleft side against the non-cleft side as proportion index, defined as lateral and medial upper lip contour index. Results: There were 2 infections. The cause was because the inserted implant was too long and thus protruded to the base of nasal cavity. The lateral upper lip contour index was from 95.49 to 103.27, and medial upper lip contour index was from 90.92 to 100.49, it was statistically increased, and thus the symmetry was improved. However clinically mild depression remained at nostril floor. Conclusion: Authors performed porous high density polyethylene sheet inlay and onlay insertion for the hypoplasia of the pyriform margin in unilateral cleft lip nasal deformity. It was found that depressed pyriform margin and upper lip were corrected effectively except for the nostril floor, for which an additional soft tissue augmentation would be necessary. The inlay insertion has risk of protrusion, thus the guideline of the use of artificial prosthesis should be observed strictly.

Hyoid Bone Fracture Associated with Hypoglossal Nerve Palsy: A Case Report (설하신경마비를 동반한 설골골절: 증례보고)

  • Kim, Sin-Rak;Park, Jin-Hyung;Han, Yea-Sik
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.199-202
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    • 2011
  • Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

Anterolateral thigh flap for 1st web contracture release (전외측 대퇴부 유리피판술 이용한 제1 수지간 반흔구축 재건)

  • Kim, Ki Wan;Lee, Dong Chul;Kim, Jin Soo;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.147-152
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    • 2009
  • Purpose: First web space contracture of the hand has been treated with various surgical techniques such as Z - plasty, local flap, pedicled flap, distant free flap, and anterolateral thigh free flap. Among those surgical techniques, anterolateral thigh free flap provide a thin and pliable flap, which is a useful method for correction of first web space contracture. Methods: From August 2003 to September 2007, authors selected 9 patients who had first web space contracture with limitation of thumb abduction within 30 degrees. All of patients had received first web contracture release with anterolateral thigh free flap. Age ranged from 24 to 51, and all the patients were male. Average follow up period was 12 months and authors performed photographic analysis of the thumb abduction angle of postoperative increase. Result: All the flaps were survived. Donor site was closed with primary closure in 8 cases and covered with split - thickness skin graft in 1 case. Average flap size was $8{\times}9cm$ and average thickness was 0.6 cm in suprafascial flap. The procedure resulted in increased thumb abduction angle of $34.7^{\circ}$ in average and showed concave shape of first web space in suprafascial flap. Additional operations were performed with Z - plasty in 3 cases, local flap in 5 cases, and opponensplasty in 3 cases. Conclusion: In suprafascial flap, we obtained relatively thin flap thickness and were able to make natural concave shape of first web space. In releasing severe contracture of the first web space, anterolateral thigh free flap provided a good coverage of appropriate thickness and pliable soft tissue and allowed limited donor site morbidity.

The Clinical Role of $^{99m}Tc$-(V)-DMSA Imaging in Patients with Head and Neck Cancer (두경부 종양에서 $^{99m}Tc$-(V)-DMSA 영상술의 진단적 유용성)

  • Bae, Sun-Kun;Lee, Jae-Tae;Park, June-Sik;Park, In-Kyu;Hyun, Dong-Woo;Lee, Young-Hak;Kim, Jeong-Gyun;Ahn, Byeong-Cheal;Choi, Ji-Yong;Sohn, Sang-Gyun;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.526-532
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    • 1995
  • Introduction : $^{99m}Tc$-(V)-DMSA is a tumor seeking agent that has been used to image medullary carcinoma of thyroid, soft tissue sarcoma and lung cancer. This study was designed to assess the clinical role of $^{99m}Tc$-(V)-DMSA in the diagnosis of head and neck cancers. We has evaluated the diagnostic efficacy of planar and SPECT imaging using $^{99m}Tc$-(V)-DMSA. Patients and Method : Sixty-eight patients with head and neck mass were included in this study. All subjects were diagnosed by biopsy or surgery. Planar and SPECT images were obtained at 2 or 3 hour after intravenous injection of 740 MBq(20 mCi) $^{99m}Tc$-(V)-DMSA. Seventeen patients also underwent SPECT in aging using dual head camera. Result : The diagnostic sensitivity of $^{99m}Tc$-(V)-DMSA planar and SPECT imaging was 65% and 90%, and specificity was 80% and 66%, respectively. The sensitivity of planar imaging in squamous cell carcinoma was similar to overall sensitivity Six metastatic lesion were first diagnosed by scintigraphy. But benign lesions such as Kikuchi syndrome, tuberculous lymphadenitis also revealed increased uptake. Conclusion : $^{99m}Tc$-(V)-DMSA imaging seems to be a promising method in the evaluation of patients with head and neck mass. We recommend SPECT imaging to delineate anatomic localization of the lesion.

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Production of Sedum Extract Adding Jelly and Assessment of Its Physicochemical Properties (돌나물 즙을 첨가한 젤라틴 젤리의 제조 및 품질특성)

  • Mo, Eun-Kyoung;Kim, Hyun-Ho;Kim, Seung-Mi;Jo, Hyun-Ho;Sung, Chang-Keun
    • Korean Journal of Food Science and Technology
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    • v.39 no.6
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    • pp.619-624
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    • 2007
  • Sedum sarmentosum, also blown as stonecrop (dolnamul), is a widely consumed herb, and is used as an ingredient in salads in Korea. Unfortunately, sedum is perishable and vulnerable to tissue damage during preservation. Therefore, this feasibility study was performed in order to increase the availability of sedum and increase its value. Various concentrations of sedum extract (0.5-3%) were added to gelatin jelly, and their physicochemical properties were determined. The ascorbic acid content of the sedum jelly increased in proportion to the sedum extract concentration. Calcium content of the sedum jelly was 4 to 28 times higher than that of the control. Contrary to the control, iron was detected in the sedum jelly (0.023-1.031 mg/100 g dry weight). Furthermore, magnesium and potassium levels were higher in the sedum extract groups. There were significant differences (p < 0.05) in greenness (a value) and yellowness (b value) between the control and the sedum extract groups. However, significant differences between the 2% and 3% sedum extract groups were not detected. As sedum extract concentration increased, the pH level of soft jellies (solid state) decreased. Therefore, hardness and gumminess were decreased significantly. These results are in agreement with the sensory evaluation. According to sensory tests, the values for palatability, appearance, and color in the 2% sedum extract group were higher than those of the 0.5-1% and 3% sedum extract groups.

Usefulness estimating of Time of flight(TOF) during Carotid angio inspection including Aortic arch (Aortic arch를 포함한 Carotid angio 검사 시 Time of flight(TOF)의 유용성 평가)

  • Yoo, Yeong-Jun
    • Korean Journal of Digital Imaging in Medicine
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    • v.15 no.1
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    • pp.1-7
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    • 2013
  • Purpose : The Carotid Angio inspection including Aortic arch applied to wide area is conducted as the Contrast Enhance MR Angiography(CEA) which is using a contrast medium. However it is a burden not only for someone such as infants, pregnant women and patients suffering from kidney failure but continuous use of contrast medium also can be a burden for patients who has been taken follow up inspection since diagnose lesion already. The purpose of this study is to estimate a usefulness of the Time of Flight (TOF) by comparing with CEA. Materials and methods : 10 patients with an average age of 58 (from 45 to 75) who had MRA inspection in our hospital were studied using 3.0 Tesla Aachieva (Philips, Netherland) MRI system and Sense Neuro-Vascular 16 Channels Coil. The same patient was inspected both TOF and CEA simultaneously. The TOF inspection included from Aortic arch to Willis Circle by connecting 3 TOF stacks and so did CEA inspection. The quantitative analysis was conducted through signal to noise ratio(SNR) and contrast to noise ratio(CNR) with soft tissue by setting up an area of interest on CCA bifurcatoin, ICA, ECA, MCA and VA concerning obtained image. In case of qualitative analysis, 3 radiological technologists and 1 radiologist evaluated 4 items (1: Visibility of the blood vessel, 2: Image distortion measure, 3: Overlapping measure with vein, 4: Peripheral blood vessel description measure) into five points scale (1: Very bad, 2: Bad, 3: Normal 4: Good, 5: Very good). Results : Results for the quantitative analysis was obtained by calculating the average of 5 ROIs in case of SNR and CNR separately. Results of SNR, TOF were generally measured higher than CEA (In case of TOF were 166.1, 205.2, 154.39, 172.23, 161.95, and CEA were 92.05, 95.43, 84.76, 73.69, 88.3). But according to the result of CNR, both TOF and CEA were measured similarly as 67.62, 106.71, 55.9, 73.74, 63.46 for TOF and 67.82, 71.19, 60.52, 49.45, 64.07 for CEA. Throughout every results of each ROI, SNR showed statistically meaningful consequence (0.050.05). In case of qualitative analysis the average of each evaluated item was 4.2points and 4.28points in the item1, 2.93points and 4.55points in the item2, 4.6points and 3.13points in the item3, 2.88points and 4.6points in the item4. According to the results TOF was measured higher in the item3 while in the item2 and item4 CEA was higher and in case of the item1, both CEA and TOF were similar. To sum up statistically meaningful results (p<0.05) were shown in the item2, item3 and item4 but not in the item1 (p>0.05). Conclusions : Both TOF and CEA are complementary because each inspection has pros and cons, but when inspect wide area including Aortic arch normally CEA is conducted. But TOF inspection also can be considered as alternative in terms of patients who has difficulty in the contrast medium such as infants, pregnant women and patients suffering from kidney failure and patients during follow up.

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