1.A Rare Case of Malignant Solitary Fibrous Tumor on the Scalp
Keimyung Medical Journal 2023;42(2):107-113
Solitary fibrous tumor (SFT) is an uncommon tumor that typically originates in the pleural cavity but may also be found in extra-pleura sites like the head and neck, spine, lungs, mediastinum, peritoneum, and pelvis. There are few reports of SFT of the scalp, and malignant SFT of the scalp appears to be so rare that only two cases of it were reported previously. A 47-year-old woman was admitted to our institution with a large, rapidly growing mass on the left parietal scalp. An analysis of her scalp condition and imaging findings of the mass revealed two different appearances between the superior and inferior halves; the scalp of the inferior half looked normal, but that of the superior half did not. Also, computed tomography findings of the mass confirmed different patterns between the superior and inferior halves. The mass with the abnormal superior half scalp was removed totally. The pathological diagnosis was malignant SFT, but the inferior mass was revealed to have a benign nature. The patient underwent prophylactic radiotherapy and experienced no local recurrence or distant metastasis at the final follow-up at 12 months. We present a third case of malignant SFT originating on the scalp and describe our clinical and surgical experience managing malignant SFT of the scalp.
2.Endoscopic Treatment of Chronic Subdural Hematoma Combined with Inner Subdural Hygroma
Yoon Hwan PARK ; Kwang-Ryeol KIM ; Ki Hong KIM
Journal of Korean Neurosurgical Society 2023;66(5):552-561
Objective:
: A chronic subdural hematoma (CSDH) is a collection of bloody fluid located in the subdural space and encapsulated by neo-membranes. An inner subdural hygroma (ISH) is observed between the inner membrane of a CSDH and the brain surface. We present six cases of CSDH combined with ISH treated via endoscopy.
Methods:
: Between 2011 and 2022, among the 107 patients diagnosed with CSDH in our institute, six patients were identified as presenting with CSDH combined with ISH and were included in this study. Preoperative computerized tomography (CT) and magnetic resonance imaging (MRI) were performed simultaneously, and endoscopic surgery for aspiration of the hematoma was performed in all cases of CSDH combined with ISH.
Results:
: The mean age of patients was 71 years (range, 66 to 79). The patients were all male. In two cases, the ISH was not identified on CT, but was clearly seen on MRI in all patients. The inner membrane of the CSDH was tense and bulging after draining of the CSDH in endoscopic view due to the high pressure of the ISH. After fenestration of the inner membrane of the CSDH and aspiration of the ISH, the membrane was sunken down due to the decreasing pressure of the ISH. There was one recurrence in post-operative 2-month follow up. The symptoms improved in all patients after surgery, and there were no surgery-related complications.
Conclusion
: CSDH combined with ISH can be diagnosed on imaging, and endoscopic surgery facilitates safe and effective treatment.
3.Vascular Variations in the Anterolateral Thigh Flap.
So Min HWANG ; Min Wook KIM ; Kwang Ryeol LIM ; Yong Hui JUNG ; Hyung Do KIM ; Hong Il KIM
Journal of the Korean Microsurgical Society 2013;22(1):13-17
PURPOSE: Although a fasciocutaneous perforator artery as a vascular pedicle has previously been shown to be predominant in the anterolateral thigh (ALT) flap, recent studies have shown that a myocutaneous perforator artery is predominant. We have attempted to attain a clinical understanding of the vascular variations in the ALT flap. MATERIALS AND METHODS: We confirmed the origin of a perforator artery in 11 cases of ALT flap. We then reviewed the variations of the descending branch of the lateral femoral circumflex artery, known as the major origin of the flap, and the overall variations associated with an ALT flap. RESULTS: In a total of 11 cases, there were 18 perforator arteries of the ALT flaps. In addition, there were 9 fasciocutaneous perforator arteries and another 9 myocutaneous ones. However, depending on the origin, there was great variability in the perforator artery. That is, there were unique variants in the descending branches of the lateral femoral circumflex artery, the major origin of the perforator artery, in 3 of the total 11 cases. CONCLUSION: Our results showed that (1) a perforator artery accounts for the high proportion of fasciocutaneous ones, (2) a perforator artery might not originate from the descending branch of the lateral femoral circumflex artery and (3) there might be unique variants in the descending branch. If considering this, surgeons would successfully elevate an ALT flap.
Arteries
;
Perforator Flap
;
Thigh
4.Risk Factors Associated with Germinal Matrix-Intraventricular Hemorrhage in Preterm Neonates.
Kwang Ryeol KIM ; Sang Won JUNG ; Dong Won KIM
Journal of Korean Neurosurgical Society 2014;56(4):334-337
OBJECTIVE: The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. METHODS: A total of 168 premature neonates whose birth weight < or =1500 g or gestational age < or =34 weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. RESULTS: In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). CONCLUSION: Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.
Birth Weight
;
Ductus Arteriosus, Patent
;
Gestational Age
;
Glucose
;
Hemorrhage*
;
Humans
;
Infant, Newborn*
;
Intensive Care, Neonatal
;
Logistic Models
;
Membranes
;
Precipitating Factors
;
Risk Factors*
;
Rupture
;
Sodium
;
Ultrasonography
5.Aberrant CpG Islands Hypermethylation Profiles in Malignant Gliomas.
Kwang Ryeol KIM ; Ealmaan KIM ; Eun Ik SON
Brain Tumor Research and Treatment 2014;2(1):29-35
BACKGROUND: The authors analyzed whether the promoter hypermethylation of cancer-related genes was involved in the tumorigenesis of malignant gliomas. METHODS: A total of 29 patients received surgery and histologically confirmed to have malignant gliomas from January 2000 to December 2006. The promoter methylation status of several genes, which were reported to be frequently methylated in malignant gliomas, was investigated using methylation-specific polymerase chain reaction. RESULTS: All cases of malignant gliomas represented the promoter hypermethylation in at least 2 or more genes tested. Of 29 tumors, 28 (96.55%) showed concurrent hypermethylation of 3 or more genes. Ras association domain family member 1, epithelial cadherin, O-6 methyl guanine DNA methyltransferase, thrombospondin 1, p14 and adenomatous polyposis coli were frequently methylated in high grade gliomas including glioblastomas, anaplastic astrocytomas, and anaplastic oligodendrogliomas. CONCLUSION: Aberrant hypermethylation profile was closely related with malignant gliomas suggesting that epigenetic change may play a role in the development of malignant gliomas. Two or three target genes may provide useful clues to the development of the useful prognostic as well as diagnostic assays for malignant gliomas.
Adenomatous Polyposis Coli
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Astrocytoma
;
Brain Neoplasms
;
Carcinogenesis
;
CpG Islands*
;
DNA
;
Epigenomics
;
Glioblastoma
;
Glioma*
;
Guanine
;
Humans
;
Methylation
;
Oligodendroglioma
;
Polymerase Chain Reaction
;
Thrombospondin 1
6.A Clinical Experience of Total Scalp Avulsion in a Male.
Jennifer Kim SONG ; Min Wook KIM ; So Min HWANG ; Kwang Ryeol LIM ; Yong Hui JUNG ; Sung Min AHN
Journal of the Korean Microsurgical Society 2011;20(1):74-77
Total scalp avulsion is rare but a devastating injury. This condition burdens the patient with disfigured cosmetic appearance and permanent psychosocial trauma. Throughout history, this condition has been favored in women working with mechanics since the long hair function as a vector appliance for oblique pull of the hair into a stationary torque. We present our experience of the replantation of the total avulsed scalp in male, first to be reported in Korea. Warm ischemic time was exceeding 16 hours along with severe crushed condition of the detached margin, a relatively satisfactory result was obtained.
Cosmetics
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Female
;
Hair
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Humans
;
Korea
;
Male
;
Mechanics
;
Replantation
;
Scalp
;
Torque
;
Warm Ischemia
8.Modified Seven-flap Web Plasty for Incomplete Syndactyly.
So Min HWANG ; Hong Il KIM ; Sung Min AHN ; Kwang Ryeol LIM ; Yong Hui JUNG ; Jennifer K SONG
Journal of the Korean Society for Surgery of the Hand 2012;17(2):53-59
PURPOSE: Incomplete syndactyly, due to either congenital or acquired, is uncommon. Many different surgical methods have been descirbed. We introduce the modification of seven flap-plasty for incomplete syndactyly and report functional improvement after correction by modified seven flap-plasty without skin graft. MATERIALS AND METHODS: Twelve patients with an incomplete syndactyly who underwent modified seven flap-plasty were analyzed. Age ranged from one to 40-year-old (average age 21). There were 8 males and 4 females, and the degree of syndactyly was near proximal interphalangeal joint. Two different operative methods were performed. Modification I modified two half-Z flaps in parallelogram shape, and modification II modified V flap of V-M flap in Y-V flap. Functional improvements was measured by maximal abduction distance and maximal abduction angle change. RESULTS: All cases were corrected by using the modified seven flap plasty. Flap tip necrosis was found in two cases of severe burn scar patients, but did not require additional surgery. There was no specific complications. Maximal abduction distance was increased in 6 mm, and maximal abduction angle was increased in 5.8degrees. CONCLUSION: Incomplete syndactyly near proximal interphalangeal joint was corrected by modified seven flap plasty and was able to get a satisfactory result.
Adult
;
Burns
;
Cicatrix
;
Female
;
Humans
;
Joints
;
Male
;
Necrosis
;
Skin
;
Syndactyly
9.Basal Cell Carcinoma Presenting as a Hypertrophic Scar.
Kwang Ryeol LIM ; Ka Hyung CHO ; So Min HWANG ; Yong Hui JUNG ; Jennifer KIM SONG
Archives of Plastic Surgery 2013;40(3):289-291
No abstract available.
Carcinoma, Basal Cell
;
Cicatrix, Hypertrophic
10.Basal Cell Carcinoma Presenting as a Hypertrophic Scar.
Kwang Ryeol LIM ; Ka Hyung CHO ; So Min HWANG ; Yong Hui JUNG ; Jennifer KIM SONG
Archives of Plastic Surgery 2013;40(3):289-291
No abstract available.
Carcinoma, Basal Cell
;
Cicatrix, Hypertrophic