Schwannomas are neurogenic tumors that arise from Schwann cells of the neural sheath. They are most often benign and solitary. Ancient schwannoma is a rare variant of schwannoma with a typical characteristics of a slow growing benign tumor. A case of ancient schwannoma which originated from the lingual nerve has not been reported in the literature yet. The clinical and histological aspects of this tumor are discussed and the literature regarding this rare entity is reviewed.
Lingual Nerve* ; Neurilemmoma* ; Schwann Cells

BACKGROUND: Using biochemical and immunohistochemical studies, alterations of cytokeratin expression has been reported in seborrheic keratosis. OBJECTIVE: To further investigate the cytokeratin expression in seborrheic keratosis, we have done immunohistochemical staining using a panel of specific anti-keratin antibodies in this study. We also observed the cytokeratin expression in the hair, sebaceous gland and sweat gland of the some epidermis. METHODS: Twenty cases of seborrheic keratosis were collected from the pathologic files. The histological types included acanthotic type (13 cases), hyperkeratotic type (5 cases), and pigmented type (2 cases). All tissues had been fixed in formalin and then paraffin-embedded according to conventional procedures. Each section was mounted on a gelatin-coated glass slide, and incubated with various anti-keratin antibodies. The sections were then immunostained using the avidin-biotin-peroxidase complex system. The peroxidase reaction was visualized with diaminobenzidine (DAB). RESULTS: 1. Cytokeratin expression in seborrheic keratosis lesions On staining with 34βB4 (K1), several staining patterns in the suprabasal layers of the epidermis were observed in 10 out of 20 cases. Using the AE1 (K10,14,15), we observed focal staining in 2 cases. We observed several positive staining patterns in 5 cases with K13,16 antibody. On staining with K10 antibody, we observed focal or irregular staining patterns in 14 cases. Focal staining was also observed with K5,8 antibody in one case. 2. Cytokeratin expression in the hair, sebaceous gland and sweat gland On immunoperoxidase staining of hair, there were positive reactions with CAM5.2 (K8,18) in 2 cases. There were positive reaction with K13,16 antibody in one case, with 34βB4 (K1), and K10 antibody in 3 cases, and with K17 antibody in 2 cases. On immunoperoxidase staining of sebaceous glands, there was one positive reaction with CAM5.2 (K8,18) in the suprabasal cells of sebaceous glands and with K13,16 antibody in sebaceous ducts. There were positive reactions with K17 antibody in the sebaceous ducts in 2 cases, and with K1 antibody in the sebaceous glands in one case. Using 34βB4 (K1), 4 out of 20 cases showed positive reactions in sweat glands. On staining with AE1 (K10,14,15), positive reactions were observed in 8 cases. Staining with CAM5.2 (K8,18) showed positive reactions in 14 cases. There were positive reactions with K19 antibody in 9 cases. CONCLUSION: Our data suggests that the predominant keratin expression in the tumor cells of seborrheic keratosis is high molecular weight keratin (K1/K10) rather than other lower molecular weight keratin. Tumor cells show some proliferative activity and monoclonal antibody K19 could be a marker for eccrine sweat glands like CAM5.2 (K8,18).
Antibodies ; Epidermis ; Formaldehyde ; Glass ; Hair ; Keratins* ; Keratosis, Seborrheic* ; Molecular Weight ; Peroxidase ; Sebaceous Glands ; Sweat Glands

The presence and distribution of pan-neuroendocrine markers such as neuron-specific enolase (NSE), chromogranin (CG), and synaptophysin (SYP) were investigated by immunohistochemistry in 15 cases of neuroblastic tumors, including four cases of neuroblastomas, six cases of ganglioneuroblastomas, and five cases of ganglioneuromas. Three cases of normal sympathetic ganglion were used for the normal control group. NSE was observed in all cases and both in ganglion cells and in neuropils. NSE was detected not only in the majority of the neuroblasts showing signs of differentiation, but also in some poorly differentiated neuroblasts. All cases of neuroblastic tumors were positive for CG, however, some variability of staining intensity and distribution patterns were noted. CG was found mainly in differentiated neuroblasts with enlarged cytoplasm and nuclei along the periphery of the perikaria, and was also found in the perinuclear regions of some undifferentiated cells. SYP was positive in 9 of 11 cases. In all of the 9 cases, SYP was detected in some differentiating neuroblasts and differentiated neuroblasts, as well as the mature ganglion cells. However, it has scarcely stained in dot or granular pattern. Two CG-negative tumors were also negative for SYP. Our data indicate that antibodies against NSE and CG are helpful as a diagnostic aid for neuroblastic tumors.
Antibodies ; Cytoplasm ; Ganglia, Sympathetic ; Ganglion Cysts ; Ganglioneuroblastoma ; Ganglioneuroma ; Immunohistochemistry ; Neuroblastoma ; Neurons* ; Neuropil ; Phosphopyruvate Hydratase* ; Synaptophysin*

PURPOSE: The purpose of this study was to assess the intra-rater and inter-rater reliability and validity of pelvic tilting angle measurements using a smart phone-based inclinometer (Clino) compared to a palpation meter (PALM) in the standing and sitting position. This study used an interchangeable method with Clino to measure the pelvic tilting angle in the standing and sitting positions. METHODS: Twenty healthy subjects were recruited. Measurements of the pelvic tilting angle in the standing and sitting positions were obtained by two examiners using the Clino and PALM. A resting session was conducted 10 minutes later to assess the intra and inter rater reliability. To assess validity of the measurement using Clino, a PALM was used as the gold standard. The intra-class correlation coefficient (ICC) was used to determine the intra and inter rater reliability of Clino and a PALM. To assess the validity, the Pearson correlation coefficients were used for two measurement techniques to measure the pelvic tilting angle in the standing and sitting positions. The statistical significance was set to α=0.05. RESULTS: Measurements of the pelvic tilt had high inter-rater reliability in the standing (ICC=0.82) and sitting (ICC=0.88) positions using Clino and intra-rater reliability in the standing (ICC=0.87) and sitting (ICC=0.91) positions using Clino. Measurements of the pelvic tilt had high validity by a comparison of PALM and Clino in the standing (r=0.83) and sitting (r=0.89) positions (p<0.05). CONCLUSION: The use of Clino can be recommended as a tool to replace the PALM and measure the pelvic tilt angle in the standing and sitting positions while maintaining the clinical reliability and validity.
Healthy Volunteers ; Methods ; Palpation ; Reproducibility of Results

Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual’s ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.

As a new concept of resistive exercise, isokinetic exercise was developed during the early 1950's. In isokinetic exercise, the subject works at a fixed speed against variable and totally accommodating resistance. The isokinetic equipment has been used widely as a therapeutic modality in clinical setting, as a training and testing device for sports practicians, and as a method for scientific examination of postoperative status of muscles and joint function for orthopedists. In order to acquire the isokinetic normative data of the knee for clinical use, we examined the flexor and extensor muscle force of the knee joint in 160 subjects with Cybex II. The results were as follows; 1. Mean values of extensor strength were 76.04 ft.-1bs in right knee 75.45 ft.-lbs in left knee, 78.42 ft.-1bs in dominent hand side leg 73.84 ft.-1bs in non-dominent hand side leg, and 82.52 ft.-1bs in dominent leg 71.93 ft.-lbs in non-dominent leg. 2. Sex difference of extensor strength were 95.13 ft.-lbs in male 55.98 ft.-1bs in female, and that of flexor strength were 54.90 ft.-1bs in male 33.68 ft.-1bs in female. 3. Mean of position angle of maximal torque were between 58° and 65° for extensors, 35° and 45° for flexors. 4. Mean of total range of motion at working isokinetically with 60°/sec speed was 99°. 5. Mean values of extensor power were 54.43 ft.-1bs in male 30.63 ft.-lbs in female, and that of flexor power were 35.99 ft.-1bs in male 22.42 ft.-1bs in female. 6. Strength and power decreased as ages getting old, and there was significant diminish between 4th decade and 5th decade. 7. Power endurance had more difference when it was compared with occupation. Mean value of power endurance was between 12 times and 18 times.
Female ; Hand ; Humans ; Joints ; Knee Joint ; Knee ; Leg ; Male ; Methods ; Muscles ; Occupations ; Range of Motion, Articular ; Sex Characteristics ; Sports ; Torque

Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual’s ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.

BACKGROUND: CYFRA 21-1 is a tumor marker which measures a fragment of cytokeratin 19 expressed by epithelial cells in bronchus. It is known that cytokeratin 19 is abundant in squamous epithelial cell cancer of the lung. However, if the incidence of elevated serum CYFRA 21-1 level in patients with benign lung diseases or pulmonary tuberculosis with severe parenchymal damage is high the specificity of CYFRA 21-1 could be decreased. The purpose of this study is to investigate the changes of serum CYFRA 21-1 according to the degree of parenchymal damage and the usefulness of CYFRA 21-1 for diagnosing possibly combined lung cancer in patients with pulmonary tuberculosis. METHOD: We studied the changes of serum CYFRA 21-1 according to the sputum AFB stain, radiologic manifestation and history of treatment in 81 patients with pulmonary tuberculosis, and 20 healthy persons, 25 patients with lung cancer, as a control group. CYFRA 21-1 concentration in serum was quantified by the immunoradiometry assay(Centocor (R)) RESULT: The results were as follow; Serum CYFRA 21-1 level was significantly lower in patients with pulmonary tuberculosis(1.54+/-1.19ng/mL, p<0.01) as compared to patients with lung cancer( 12.25+/-15.97ng/mL), and was slightly higher than the level in heathy persons(0.90+/-0.49ng/mL) but there was no significant difference. Serum CYFRA 21-1 level was below the cut-off value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis but it was above the cut-off value in 64 percent of patients with lung cancer. Serum CYFRA 21-1 level was significantly higher in the initial treatment group(1.91+/-1.55ng/mL, p<0.05) as compared to the treatment failure group (0.92+/-0.30ng/mL). According to the sputum AFB smear, serum CYFRA 21-1 level in patients with negative result was slightly higher than the level in patients with positive result but there was no significant difference. According to the radiologic manifestation, serum CYFRA 21-1 level was significantly higher in patients with infiltrative lesion (2.15+/-1.63ng/mL, p<0.01) as compared to patients with destructive lesion (1.04+/-0.54ng/mL). As the size of cavity or destructive lesion was larger, the level was significantly lower(p<0.05). CONCLUSION: As serum CYFRA 21-1 level was significantly higher in the initial treatment group and patients with infiltrative lesion, it suppose to be closely related with the degree of parenchymal damage of the lung of the pulmonary tuberculosis. However CYFRA 21-1 could be useful method for diagnosing lung cancer even in patients with pulmonary tuberculosis combined with lung cancer because of the fact that it was below the cutoff value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis.
Bronchi ; Epithelial Cells ; Humans ; Incidence ; Keratin-19 ; Lung ; Lung Diseases ; Lung Neoplasms ; Sensitivity and Specificity* ; Sputum ; Treatment Failure ; Tuberculosis ; Tuberculosis, Pulmonary*

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.