• Title/Summary/Keyword: lower extremities

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Eccrine porocarcinoma on the cheek

  • Seo, Bommie Florence;Choi, Hyuk Joon;Jung, Sung-No
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.48-50
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    • 2019
  • Eccrine porocarcinoma is a rare malignant tumor arising from the intraepidermal ductal portion of the eccrine sweat gland. It develops either spontaneously or from a long standing benign eccrine poroma. This entity usually affects older people and is commonly located on the lower extremities, the trunk, and the head. We report a case of eccrine porocarcinoma on the left cheek in an 85-year-old male. In our case, the tumor was treated with wide excision and postoperative adjuvant radiation therapy. The patient recovered well without local recurrence and distant metastasis during the 14-month follow-up period. Wide excision and postoperative adjuvant radiation therapy can be considered as a safe and effective treatment option in treating patients with eccrine porocarcinoma.

Methimazole-Induced Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in the Peripheral Nerves

  • Kang, Mi Il;Kim, Dohee
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.176-181
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    • 2018
  • Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been reported in Graves' disease patients treated with antithyroid drugs (ATDs), especially propylthiouracil. ATD-induced ANCA-associated vasculitis usually involved the kidneys followed by the respiratory organs and skin. The treatment of ANCA-associated vasculitis induced by ATDs is to stop ATD therapy immediately, which often leads to an overall good prognosis. We report a case of ANCA-associated vasculitis in the peripheral nerves of the lower extremities in a 66-year-old woman who was treated with methimazole (MMI) for Graves' disease. To our knowledge, this is the third case of peripheral nervous system (PNS) involvement of ATD-induced vasculitis and the first case of PNS vasculitis associated with MMI.

X-linked Charcot-Marie-Tooth disease case with a novel missense mutation in GJB1 gene

  • Lee, Jong-Mok;Shin, Jin-Hong
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.107-109
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    • 2018
  • X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.

Influence of Body Weight Support and Walking Speed in the Static Posture of Stroke Patients using Indirect PNF Treatment: A Case Report (PNF의 방산을 이용한 간접치료가 뇌졸중환자의 정적 자세에서의 체중지지 및 보행 속도에 미치는 영향 : 증례보고)

  • Lee, Byung-Ki;Yun, Jeung-Hyun
    • PNF and Movement
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    • v.10 no.4
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    • pp.71-76
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    • 2012
  • Purpose : The purpose of this study was to examine the effects of PNF of irradiation using an indirect treatment of the stroke patient's static weight support and walking speed. Methods : Was carried out a total of nine different the PNF method of treatment for patients with left hemiplegia stroke. PNF of treatment is not in the non-paralyzed side of the trunk and upper and lower extremities by applying resistance and increased strength of the affected side. Assessment of treatment weight support both feet measured and modified using the timed up and go test were compared before and after treatment. Results : Treatment of the paralyzed side of the quadriceps and hamstring, gluteus medius muscle strength increased, and both sides of the foot body weight support improved walking speed was increased. Conclusion : Irradiation using PNF indirect treatment improves the function of the gait of stroke patients.

Infectious Myositis of the Jaw Presenting as Trismus of Unknown Origin

  • Kim, Hee-Young;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.45 no.4
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    • pp.115-119
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    • 2020
  • Infectious myositis, an infection of the skeletal muscles, is a rare condition and potentially life-threatening if not detected and treated in the early stages. This clinical entity may arise from various pathogens, such as bacteria, fungi, parasites, and viruses. A propagation of contiguous infection, penetrating trauma, vascular insufficiency, or hematogenous spreading of microorganisms can cause infectious myositis. Though several cases have been reported in large muscle groups in the lower extremities, there are only a few reports on infectious myositis of the masticatory muscles. We report three cases of infectious myositis presenting jaw pain and trismus. Unlike a common head and neck infection caused by the spreading of odontogenic origin, the early diagnosis of infectious myositis was difficult because no specific lesion suspected to be the infection source was observed in the physical examination and the plain radiographs. Advanced imaging modalities such as computed tomography and magnetic resonance imaging, and laboratory evaluation is useful for the early detection of infectious myositis.

Lymphaticovenular Anastomosis: Superficial Venous Anatomical Approach

  • Winaikosol, Kengkart;Surakunprapha, Palakorn
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.689-695
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    • 2022
  • Background Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results.

Diagnosis of Benign Monomelic Amyotrophy (양성 국소 근위축증의 진단)

  • Byun, Justin;Bang, Meyong Hwan;Park, Jung Hyun
    • Clinical Pain
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    • v.19 no.2
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    • pp.101-105
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    • 2020
  • Benign monomelic amyotrophy (BMA) is a benign motor neuron disease in which amyotrophic change is confined to either the upper or the lower extremities. Numerous cases of BMA have been reported from Japan and India. However, only a few cases have been reported from other regions, including South Korea. Here we report a rare case of late-onset BMA in Korean male using conventional diagnostic approach with magnetic resonance imaging and electromyography. The patient received ten sessions of manual therapy, which focused on strengthening of the left ankle. At two-month follow up, weakness was still isolated to the patient's left ankle. There were no signs of disease progression.

Coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in an immunocompetent patient: a case report

  • Bae, Sang Woon;Lee, Jong Ho
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.67-71
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    • 2022
  • This report describes a case of coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in a 66-year-old immunocompetent female patient. The patient had undergone traditional procedures, including acupuncture, which possibly caused the coinfection. During treatment with susceptible antibiotics for bacterial meningitis, she developed hydrocephalus on the third day. Consequently, the patient recovered with a mild neurological deficit of grade 4 motor assessment in both upper and lower extremities at discharge. S. paucimobilis and L. monocytogenes are rare pathogens in developed countries, occurring only during environmental outbreaks. S. paucimobilis meningitis is rarely reported. Hence, the various presentations of S. paucimobilis meningitis and the antibiotic regimen for its treatment are hereby reported, in addition to a review of other similar reported cases. This case is a possible traditional procedure-related infection. Appropriate oversight and training should be emphasized regarding preventive measures of this kind of infection. A team approach with neurologists and neurosurgeons is imperative in treating patients with hydrocephalus-complicated meningitis.

Sex/gender differences in gastrointestinal endoscopy from the perspective of patients and gastroenterologists

  • Nayoung Kim
    • Clinical Endoscopy
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    • v.56 no.3
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    • pp.268-282
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    • 2023
  • The sex/gender of gastroenterologists impact patients' satisfaction, compliance, and clinical outcomes. For instance, female gastrointestinal (GI) endoscopist-patient gender concordance improves health-related outcomes. This finding suggests that it is important to increase the number of female GI endoscopists. While the number of women in the field of gastroenterology is increasing in the United States and Korea by over 28.3%, it is not enough to account for the gender preferences of female patients. GI endoscopists are at a high risk of endoscopy-related injuries. However, there is a different distribution of muscle and fat; male endoscopists are more affected in their back, while females are more affected in the upper extremities. Women are more susceptible to endoscopy-related injuries than men. There is a correlation between the number of colonoscopies performed and musculoskeletal pain. Job satisfaction is lower in young female gastroenterologists (30' and 40') than in the opposite gender and other ages. Thus, it is important to address these issues in the development of GI endoscopy.

The Signification of Anterolateral Thigh Free Flap for Reconstruction of Soft Tissue Defect in Malignant Soft Tissue Tumor of Lower Extremity (하지에 발생한 연부 조직 종양의 광범위 절제술 후 재건술에서 전외측 대퇴부 유리 피판술의 유용성)

  • Kwon, Young Ho;Lee, Gun Woo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.89-95
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    • 2011
  • Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

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