A 77-year-old man presented with a huge protruding mass on the left anterior chest wall. The tumor was resected and diagnosed as dermatofibrosarcoma protuberans (DFSP). DFSP is an uncommon, intermediate-grade mesenchymal cutaneous tumor which extends deep into subcutaneous tissue and may invade through the fascial planes and into muscle but rarely metastasize. Histologically, DFSP is composed of spindle cells arranged in an irregularly whorled or storiform pattern. The histological diagnosis can be confirmed with immunohistochemical staining for CD34. We report a case of DFSP. The tumor was completely excised and the chest wall was reconstructed using latissimus dorsi muscle flap and skin graft.
Aged ; Dermatofibrosarcoma ; Humans ; Muscles ; Skin ; Subcutaneous Tissue ; Thoracic Wall ; Thorax ; Transplants

OBJECTIVE: To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). METHODS: Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). RESULTS: According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p < 0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. CONCLUSION: HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.
Humans ; Hypertrophy ; Low Back Pain* ; Muscle Strength ; Paraspinal Muscles ; Ultrasonography ; Vibration* ; Visual Analog Scale

Posterior epidural migration of a lumbar intervertebral disc fragment (PEMLIF) is uncommon because of anatomical barriers. It is difficult to diagnose PEMLIF definitively because of its relatively rare incidence and the ambiguity of radiological findings resembling spinal tumors. This case report describes a 76-year-old man with sudden-onset weakness and pain in both legs. Electromyography revealed bilateral lumbosacral polyradiculopathy with a mass-like lesion in L2-3 dorsal epidural space on lumbosacral magnetic resonance imaging (MRI). The lesion showed peripheral rim enhancement on T1-weighted MRI with gadolinium administration. The patient underwent decompressive L2-3 central laminectomy, to remove the mass-like lesion. The excised lesion was confirmed as an intervertebral disc. The possibility of PEMLIF should be considered when rim enhancement is observed in the epidural space on MRI scans and electrodiagnostic features of polyradiculopathy with sudden symptoms of cauda equina syndrome.
Aged ; Electromyography ; Epidural Space ; Gadolinium ; Humans ; Incidence ; Intervertebral Disc Displacement ; Intervertebral Disc* ; Laminectomy ; Leg ; Magnetic Resonance Imaging ; Polyradiculopathy

Pruritus (itching) is classically defined as an unpleasant cutaneous sensation that leads to scratching behavior. Although the scientific criteria of classification for pruritic diseases are not clear, it can be divided as acute or chronic by duration of symptoms. In this study, we investigated whether skin injury caused by chemical (contact hypersensitivity, CHS) or physical (skin-scratching stimulation, SSS) stimuli causes initial pruritus and analyzed gene expression profiles systemically to determine how changes in skin gene expression in the affected area are related to itching. In both CHS and SSS, we ranked the Gene Ontology Biological Process terms that are generally associated with changes. The factors associated with upregulation were keratinization, inflammatory response and neutrophil chemotaxis. The Kyoto Encyclopedia of Genes and Genomes pathway shows the difference of immune system, cell growth and death, signaling molecules and interactions, and signal transduction pathways. Il1a , Il1b and Il22 were upregulated in the CHS, and Tnf, Tnfrsf1b, Il1b, Il1r1 and Il6 were upregulated in the SSS. Trpc1 channel genes were observed in representative itching-related candidate genes. By comparing and analyzing RNA-sequencing data obtained from the skin tissue of each animal model in these characteristic stages, it is possible to find useful diagnostic markers for the treatment of itching, to diagnose itching causes and to apply customized treatment.
Animals ; Biological Processes ; Chemotaxis ; Classification ; Cytokines ; Dermatitis, Contact* ; Gene Expression ; Gene Ontology ; Genome ; Hypersensitivity ; Immune System ; Interleukin-6 ; Mice* ; Models, Animal ; Neutrophils ; Pruritus* ; RNA* ; Sensation ; Sequence Analysis, RNA* ; Signal Transduction ; Skin* ; Transcriptome ; Transient Receptor Potential Channels ; Up-Regulation ; Wound Healing