• Title/Summary/Keyword: axilla

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Morphometric Study of the Nerve Roots Around the Lateral Mass for Posterior Foraminotomy

  • Hwang, Jae-Chan;Bae, Hak-Geun;Cho, Sung-Won;Cho, Sung-Jin;Park, Hyung-Ki;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.358-364
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    • 2010
  • Objective : Morphometric data on dorsal cervical anatomy were examined in an effort to protect the nerve root near the lateral mass during posterior foraminotomy. Methods : Using 25 adult formalin-fixed cadaveric cervical spines, measurements were taken at the lateral mass from C3 to C7 via a total laminectomy and a medial one-half facetectomy. The morphometric relationship between the nerve roots and structures of the lateral mass was investigated. Results from both genders were compared. Results : Following the total laminectomy, from C3 to C7, the mean of the vertical distance from the medial point of the facet (MPF) of the lateral mass to the axilla of the root origin was 3.2-4.7 mm. The whole length of the exposed root had a mean of 4.2-5.8 mm. Following a medial onehalf facetectomy, from C3 to C7, the mean of the vertical distance to the axilla of the root origin was 2.1-3.4 mm, based on the MPF. Mean vertical distances from the MPF to the medial point of the root that crossed the inferior margin of the intervertebral disc were 1.2-2.7 mm. The mean distance of the exposed root was 8.2-9.0 mm, and the mean angle between the dura and the nerve root was significantly different between males and females, at $53.4-68.4^{\circ}$. Conclusion : These data will aid in reducing root injuries during posterior cervical foraminotomy.

Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

Comparison of Tympanic and Axillary Temperatures (고막체온과 액와체온의 비교 연구 - 성인대상자를 중심으로 -)

  • Yea, Jae-Hee;Jo, Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.2
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    • pp.162-170
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    • 2009
  • Purpose: To verify the usability of tympanic temperature measurement for adults, a comparison of tympanic and axillary temperatures was done. Method: The study was conducted during October 2008, and participants were 110 female nursing students. Axillary temperatures were taken with glass mercury thermometers for 5, 7 and 10 minutes. Tympanic temperatures were taken with Infrared Thermometer IRT 4520 on both ears, twice at a 5-second interval. The data were analyzed using the SPSS 12.0 program. Results: In the 1st measurement, the mean for right tympanic temperatures ($0.06^{\circ}C$) and for left ($0.03^{\circ}C$) were significantly higher than the 2nd. A comparison of mean temperatures for right and left, showed that the mean for the left side on the 1st measurement was significantly higher ($0.01^{\circ}C$) than the right. Also the temperature on left side in the 2nd measurement was higher ($0.04^{\circ}C$) than the right 2nd, but not significantly higher. The mean temperature for right and left tympanic on 1 st and 2nd measurements were significantly higher than axilla for 5 minutes ($0.58^{\circ}C$), for 7 minutes ($0.52^{\circ}C$), and for 10 minutes ($0.43^{\circ}C$). The tympanic temperature was the most closely correlated with the axillary temperature at 10 minutes. Conclusion: Findings indicate that measurement of tympanic temperature is a useful alternative to axillary temperature taken for 10 minutes.

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An Ergonomic Study of the Sleeve Pattern According to Arm Movement -on Expansion and Contraction of the Skin Surface of the Arm- (팔의 동작에 따른 소매 원형의 인간공학적 연구 -팔의 피부면 신축을 중심으로-)

  • 함옥상
    • Journal of the Korean Home Economics Association
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    • v.19 no.3
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    • pp.21-32
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    • 1981
  • Clothing must have the individual beauty and the function that one can do one's body movement freely. therefore, from the human engineering view point, the exact measurement of the human body and the analysis of it's results must be applied to clothing because the arm works most. In this study, the skin surface of arm was investigated by shell made of Alginate of each movement. And by sometic method the rate of expansion and contraction of each section, inter-relation among the bust girth, axillary arm girth and scye girth and between the shoulder length right and the under axilla waist length were calculate4d. With these results, cap height, breadth of a sleeve and arm hole girth of existing sleeve pattern have been compared and analysed. The results are as follows; 1) According to the developmental figures of shell, the whole area change was small but that of shape was remarkable in M 4, 9, 13. The change of the Block 1 was particular. 2) Over arm length was contracted in all movements except M6 and under arm length expanded. The changes of sections a, b, c are large, while those of sections d, e are small. 3) In terms of latitudes, change of fore-arm region was small. The rate of scye girth varied from 14.3% of M13 to-5.6% of M2. The breadth of a sleeve expanded in all movements, and especially the front region expanded more than the back. 4) The relation between the shoulder length right and under axilla waist length, in all occasions, was contracted mutually, and one contracted, the other expanded. Therefore, in clothing construction when we consider the function of the arm it is better to widen the arm hole and the breadth of a sleeve at the same time than no widen the shoulder length by lowering the upper part of the upper side seam line.

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Upper Arm Contouring with Brachioplasty after Massive Weight Loss

  • Han, Hyun Ho;Lee, Min Cheol;Kim, Sang Hwa;Lee, Jung Ho;Ahn, Sang Tae;Rhie, Jong Won
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.271-276
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    • 2014
  • Background As the obese population increases in Korea, the number of patients who are trying to lose weight has been increasing steadily. In these patients, skin laxity and deformation of the body contour occurs, which could possibly be corrected by various body contouring surgeries. Here, we introduce the brachioplasty method and our experience of various body contouring surgeries performed in our center. Methods From November 2009 to August 2011, five cases of brachioplasty were performed. When the patient presented with sagging of the lateral inframammary crease and bat wing deformity in the axilla, extended brachioplasty was performed; in this case, the deformation of the axilla and lateral chest was corrected at the same time. A traditional brachioplasty was performed when contouring was needed only for skin laxity in the upper arm. Results Complications, such as hematomas or nerve injuries, were not evident. Some patients experienced partial wound dehiscence due to tension or hypertrophic scars found during the follow-up. In general, all of the patients were satisfied with the improvement in their upper arm contour. Conclusions Given the demands for body contouring surgery, the number of brachioplasty surgical procedures is expected to increase significantly, with abdominoplasty comprising a large portion of these surgeries. For the brachioplasty procedure, preparation and preoperative consultation regarding design of the surgery by experienced surgeons was important to prevent complications such as nerve damage or hematoma formation.

Clinical Evaluation of Thoracoscopic Sympathectomy in Hyperhidrosis (흉강경하 흉부 교감신경간 절제술을 시행한 본태성 다한증 환자의 임상적 고찰)

  • Oh, Wan-Soo;Kang, Jeong-Kweon;Yon, Jun-Heum;Kim, Jeong-Won;Hong, Ki-Hyuk
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.81-86
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    • 1999
  • Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.

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Thoracic Outlet Syndrome(TOS) (흉곽출구증후군)

  • Kang, Jeom-Deok;Park, Youn-Ki
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.9 no.2
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    • pp.5-11
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    • 2003
  • Thoracic outlet syndrome is actually a collection of syndromes brought about by abnormal compression of the neurovascular bundle by bony, ligamentous or muscular obstacles between the cervical spine and the lower border of the axilla. First of all a syndrome is defined as a group of signs and symptoms that collectively characterize or indicate a particular disease or abnormal condition. The neurovascular bundle which can suffer compression consists of the brachial plexus plus the C8 and T1 nerve roots and the subclavian artery and vein. The brachial plexus is the network of motor and sensory nerves which innervate the arm, the hand, and the region of the shoulder girdle. The vascular component of the bundle, the subclavian artery and vein transport blood to and from the arm. the hand. the shoulder girdle and the regions of the neck and head. The bony, ligamentous, and muscular obstacles all define the cervicoaxillary canal or the thoracic outlet and its course from the base of the neck to the axilla or arm pit. Look at the scheme of this region and it all becomes more easily understood. Compression occurs when the size and shape of the thoracic outlet is altered. The outlet can be altered by exercise, trauma, pregnancy, a congenital anomaly, an exostosis, postural weakness or changes. Thoracic outlet syndrome has been described as occurring in a diverse population. It is most often the result of poor or strenuous posture but can also result from trauma or constant muscle tension in the shoulder girdle. The first step to beginning any treatment begins with a trip to the doctor. Make a list of all of the symptoms which seem to be present even if the sensations are vague. Make a note of what activities and positions produce or alleviate the symptoms and the time of day when symptoms are worst. Also, note when the symptoms first appeared. This list is important and should also include any questions one may have.

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Diagnostic value of magnetic resonance imaging using superparamagnetic iron oxide for axillary node metastasis in patients with breast cancer: a meta-analysis

  • Lee, Ru Da;Park, Jung Gu;Ryu, Dong Won;Kim, Yoon Seok
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.297-306
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    • 2018
  • Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

Sonographic Features of Palpable Breast and Axillary Lesions in Adult Male Patients: A Pictorial Essay (만져지는 유방과 액와부 병변을 주소로 내원한 성인 남성의 초음파 소견: 임상화보)

  • Hyun Kyung Jung;Yun-Jung Lim
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.830-845
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    • 2022
  • The male breast is a non-functional and rudimentary organ, but similarly to the female breast, it can be affected by various diseases. In contrast to female breast cancer, male breast cancer has a low incidence, and there is no established breast cancer screening program for male patients. Therefore, the diagnostic evaluation is usually performed in male patients with symptoms such as palpability or pain in the breasts. Furthermore, most adult male patients who visit breast clinics sometimes present with not only breast symptoms but also axillary symptoms, and both the breast and axilla are usually examined during breast ultrasonography in daily clinical practice. The purpose of this pictorial essay was to present the sonographic features of various palpable breast and axillary lesions in adult male patients.