• Title/Summary/Keyword: anatomical site

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Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography (안진검사에서 단속운동검사, 시추적검사, 시운동성 안진검사의 임상적 의의)

  • Choi, Yoon Seok;Na, Hyung Gyun;Song, Si-Youn;Kim, Yong-Dae;Bae, Chang Hoon
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.29-36
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    • 2017
  • Background: Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. Methods: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. Results: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. Conclusion: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

Chest Wall Giant Malignant Peripheral Nerve Sheath Tumor -One case report (흉벽에 발생한 거대 악성 말초신경초종-치험 1례-)

  • Park, Jin-Gyu;Kim, Min-Ho;Jo, Jung-Gu
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.729-732
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    • 1997
  • A case of chest wall malignant peripheral nerve sheath tumor(MPNST) was reported in the U.S.A by Mark and coworkers6)(1991), but none in korea. MPNST accounts for approximately 10% of all soft tissue sarcoma, mostly in patients between 20 and 50 years of age. MPNST arises in association with a major nerve trunk, including the sciatic nerve, brachial plexus, and sacral plexus and the most common anatomical site is the proximal portion of the upper and lower extremity and trunk. Surgical treatment is local excision of mass in low grade sarcoma but unblock resection is necessary in high grade sarcoma. We experienced multiple huge low grade MPNST on left chest wall of a 50 years old man. The tumor and invalved chest wall were removed, and the chest wall defect(15$\times$8 cm) was reconstructed with Teflon. Postoperative course was unevenful.

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INTRAORAL OPEN REDUCTION OF MANDIBULAR SUBCONDYLAR FRACTURES USING KIRSCHNER WIRE (Kirschner wire를 사용한 과두하 골절의 구강내 접근법)

  • Kim, Seong-Il;Kim, Seung-Ryong;Baik, Jin-Ah;Ko, Seung-O;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.270-276
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    • 2001
  • The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.

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Tumors Involving Skin, Soft Tissue and Skeletal Muscle: Benign, Primary Malignant or Metastatic?

  • Hsieh, Chi-Ying;Tsai, Huang-Wen;Chang, Chih-Chun;Lin, Tsuo-Wu;Chang, Ke-Chung;Chen, Yo-Shen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6681-6684
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    • 2015
  • Background: Metastatic cancer with invasion of skin, soft tissue and skeletal muscle is not common. Examples presenting as soft tissue masses could sometimes lead to misdiagnosis with delayed or inappropriate management. The purpose of current study was to investigate clinical characteristics in the involvement of metastatic cancer. Materials and Methods: A total of 1,097 patients complaining of skin or soft tissue masses and/or lesions were retrospectively reviewed from January 2012 to June 2013. Tumors involving skin, soft tissue and skeletal muscle of head and neck, chest wall, abdominal wall, pelvic region, back, upper and lower extremities were included in the study. Results: Fifty-seven (5.2%) patients were recognized as having malignancies on histopathological examination. The most common involvement of malignancy was basal cell carcinoma, followed by cutaneous squamous cell carcinoma, sarcoma and melanoma. The most common anatomical location in skin and soft tissue malignancies was head and neck (52.6% of the malignancies). Four (0.36%) of the malignant group were identified as metastatic cancer with the primary cancer source from lung, liver and tonsil and the most common site was upper extremities. One of them unexpectedly expired during the operation of metastatic tumor excision at the scalp. Conclusions: Discrimination between benign and malignant soft tissue tumors is crucial. Performance of imaging study could assist in the differential diagnosis and the pre-operative risk evaluation of metastatic tumors involving skin, soft tissue and skeletal muscle.

Electrical Feeding Patterns and Stylet Movement of Rice Brown Planthopper, Nilaparvata lugens(Homoptera), in the Rice Tissues (벼멸구의 섭식 패턴과 벼 조직내에서 구침의 이동)

  • 윤영남;장영덕
    • Korean journal of applied entomology
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    • v.32 no.2
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    • pp.208-217
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    • 1993
  • Feeding behavior fo female brown planthoppers, Nilaparvata lugens Stal, was examined with an electrical recording technique using DC amplifier and through anatomical observation of stylet ovement in the rice plat with electrical recordings. There was six feeding patterns, type P, S, SB, O, X and Ph with the brown planthopper. Type P was a probing pattern during searching the proper feeding site. Type S appeared to be associated with the initial penetration and changing direction through the tissues, and from this type type SB pattern could be distinguished by the regularity of the large potential drops seen, and might be associated with penetration of the phloem sheath and/or salivation in the phloem sheath. The type O pattern shows none of the large voltage drops which were believed to occur when cell walls were being broken down and passes through a relatively thin layer of cells into an air space. The very constant waveform of the type X pattern could be seen during ingestion within the xylem bundle sheath area. The Ph pattern always followed an SB pattern and was associated with a marked negative voltage drop. When this pattern was seen, the brown planthopper might be ingested plant sap from phloem sheath area.

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Pull-in Suture Technique for the Disinsertion of the Phalangeal Tendon Distal Insertion (Pull-in 봉합술을 이용한 수지건 원위 부착부 파열의 치료)

  • Kim, Jae Won;Chung, Sung Mo
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.723-728
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    • 2008
  • Purpose: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. Methods: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. Results: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. Conclusion: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).

Clinical efficacy of intermittent magnetic pressure therapy for ear keloid treatment after excision

  • Jun, Dongkeun;Shin, Donghyeok;Choi, Hyungon;Lee, Myungchul
    • Archives of Craniofacial Surgery
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    • v.20 no.6
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    • pp.354-360
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    • 2019
  • Background: Keloids are benign fibro-proliferative lesion, related to excessive inflammatory reactions in certain anatomical areas, including the auricles. Their specific etiology remains unclear; nonetheless they exhibit tumor-like characteristics of significant recurrence and cause emotional distress, even with various treatment strategies. We applied intermittent magnetic pressure therapy on ear keloids in combination with surgical excision, and present its effectiveness herein. Methods: Ear keloid patients were treated with surgical excision followed by magnetic pressure therapy. The keloid tissues underwent excision and keloid marginal flaps were utilized for wound closure. Intermittent magnetic pressure therapy was applied 2 weeks after the surgical procedure. The pressure therapy consisted of a 3-hour application and 2-hour resting protocol (9 hr/day), and lasted for 6 months. The results were analyzed 6 months after the therapeutic procedures, using the scar assessment scale. Results: Twenty-two ear keloids from 20 patients were finally reviewed. Among the keloids that completed the therapeutic course, 20 ear keloids out of 22 in total (90.9%) were successfully eradicated. Two patients (2 keloids) exhibited slight under-correction. Postoperative complications such as wound dehiscence or surgical site infection were not noted. The scar assessment scale demonstrated a significant improvement in each index. The intermittent pressure therapy led to patient compliance, and avoided pressure-related pain and discomfort. Conclusion: Excision followed by intermittent pressure application using a magnet successfully reduced the burden of fibro-proliferative keloids, and had good patient compliance. The role of intermittent pressure application and resting should be studied with regard to keloid tissue remodeling.

Histopathological Features of Colorectal Cancer in Al-Madinah Region of Saudi Arabia: 8 Years Experience

  • Albasri, Abdulkader;Yosef, Hala;Hussainy, Akbar Shah;Sultan, Saud Ahmad;Alhujaily, Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3133-3137
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    • 2014
  • Background: To determine the histopathological pattern of colorectal cancer (CRC) among Saudi patients with a view to determine various epidemiological and histopathological features of the disease. Materials and Methods: We retrospectively collected and analyzed the demographic and histopathological data of all the patients with CRC diagnosed at King Fahad Hospital, Madinah, Saudi Arabia over a period of 8 years from January 2006 to December 2013. Results: Of 324 cases of CRC reviewed, 200 cases (61.7%) were males while 124 cases (38.3%) were females giving a male to female ratio of 1.6: 1. Age of the patients ranged from 20 to 100 years with a mean age 57.9 years. The rectosigmoid region was the most frequent anatomical site (13.6%) involved and adenocarcinoma (88.6%) was the most common histopathological type. The majority of adenocarcinomas (87.3%) were moderately differentiated. A total of 47.8% of patients were in stage B and 43.5% of patients were in stage C of the Aster-Coller classification. Most patients (75.7%) presented with large size tumors. Lymphovascular invasion and lymph node metastasis were recorded in 67.9% and 43.6% of cases, respectively. Conclusions: Colorectal cancer is common in our environment and the majority of patients present late with an advanced stage. Screening programs regarding CRC should be enhanced to improve the outcome of the patients.

Absorbed and effective dose from periapical radiography by portable intraoral x-ray machine (이동형 구내 방사선촬영기로 촬영한 치근단 방사선사진의 흡수선량 및 유효선량 평가)

  • Cho, Jeong-Yeon;Han, Won-Jeong;Kim, Eun-Kyung
    • Imaging Science in Dentistry
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    • v.37 no.3
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    • pp.149-156
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    • 2007
  • Purpose: The purpose of this study was to measure the absorbed dose and to calculate the effective dose for periapical radiography done by portable intraoral x-ray machines. Materials and Methods: 14 full mouth, upper posterior and lower posterior periapical radiographs were taken by wall-type 1 and portable type 3 intraoral x-ray machines. Thermoluminescent dosemeters were placed at 23 sites at the layers of the tissue-equivalent ART woman phantom for dosimetry. Average tissue absorbed dose and radiation weighted dose were calculated for each major anatomical site. Effective dose was calculated using 2005 ICRP tissue weighted factors. Results: On 14 full mouth periapical radiographs, the effective dose for wall-type x-ray machine was 30 Sv; for portable x-ray machines were 30 Sv, 22 Sv, 36 Sv. On upper posterior radiograph, the effective dose for wall-type x-ray machine was 4 Sv; for portable x-ray machines doses were 4 Sv, 3 Sv, 5 Sv. On lower posterior radiograph, the effective dose for wall type x-ray machine was 5 Sv; for portable x-ray machines doses were 4 Sv, 4 Sv, 5 Sv. Conclusion: Effective doses for periapical radiographs performed by portable intraoral x-ray machines were similar to doses for periapical radiographs taken by wall type intraoral x-ray machines.

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Subacute Osteomyelitis on Phalangeal Bone Resulting from Multiple Kirschner Pin Fixation: Case Report (원위지 골절에 K-강선을 이용한 비관혈적 정복술 후 생긴 아급성 골수염 1례)

  • Kim, Jae Woo;Choi, Hwan Jun;Kim, Mi Sun;Kim, Jun Hyuk
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.409-412
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    • 2007
  • Purpose: Percutaneous Kirschner wire fixation is common method for hand fracture. It is simple but has risk of ascending infection through the pin and bony injury by multiple drilling. Ascending infection through pin tract is mostly superficial and can be treated with antibiotics and aseptic dressing. This is a case review of subacute osteomyelitis on phalangeal bones after Kirschner wire fixation with literature review. Methods: A 40-years-old man with distal phalangeal fracture on right second finger is presented. He went to a local clinic and had percutaneous Kirschner wire fixation under local anesthesia. He was transferred to our hospital for ulcerative wound on DIP joint at 4 weeks after operation. Radiography showed osteolytic change around medulla of middle and distal phalanges, leading to diagnosis of a subacute osteomyelitis. We treated it with amputation at the level of shaft of middle phalanx. Results: The postoperative course was uneventful. We thought several possible reasons for osteomyelitis in our case. First, it could resulted from ascending infection through the wire. Second, it could be resulted from a bony burn by repeated drilling. And bony necrosis could be a consequence of arterial insufficiency caused by 2 pin insertion. Conclusion: We suggest that a precise pinning based on accurate anatomical understanding is required for a percutaneous Kirschner wire fixation. The frequency of drilling should be minimized. Careful observation and patient education for pin site care are essential.