In adult congenital muscular torticollis (CMT) patients, physical therapy is not as effective because the development of sternocleidomastoid muscle (SCM) muscle is complete. While surgical release can address CMT in adult patients, the risk of general anesthesia and visible postoperative scar is a concern, expecially in patients with mild symptoms. In this paper, we report our experience in treating such patients with minimal-incision myotomy under local anesthesia. A review was performed for all adult patients who had undergone the simple myotomy procedure. Surgical indication was reserved for patients with mild fibrotic band in the SCM muscle with minimal lengthdiscrepancybetween the muscles. All patients had recognizable head tiltand palpation of fibrotic band on affected side of the neck. Surgical details are described in the main body of text. Three female patients had undergone the procedure. Torticollis was resolve in all patients with complete restoration of ranage of motion. There were no postoperative complications, and patient satisfaction was high. We have reported three cases of mild CMT in adult female patients, who had undergone minimal-incision myotomy under local anesthesia. Outcomes were satisafactory with no morbidity to report. With careful patient selection, this method offers an alternate treatment option for adult CMT patients with mild symptoms.
Adult* ; Anesthesia, General ; Anesthesia, Local* ; Cicatrix ; Female ; Head ; Humans ; Muscles ; Neck ; Palpation ; Patient Satisfaction ; Patient Selection ; Postoperative Complications ; Torticollis*

BACKGROUND: Keloid management can be difficult and frustrating, and the mechanisms underlying keloid formation are only partially understood. Despite many studies of the pathogenesis and cause, little is known of the predisposing factors or the diathesis. Therefore, we evaluated patients with keloid for 13 years clinical experience, with the goal of considering the causative factors and physical disposition of keloid. METHODS: We evaluated 107 patients (38 males, 69 females; median age 22.31 years, range 7-58 years) who visited the department of plastic and reconstructive surgery from March 1998 to December 2010. The patients' chart and clinical photo were reviewed for the study. RESULTS: Etiologies were an intended wound like piercing or surgical wound (n=39), avulsion flap injury (n=30), laceration (n=29) and burn (n=9). The location were the head and neck (n=38), trunk (n=23), upper extremity (n=21), lower extremity (n=16) and face (n=9). Patients with more than overweight (>23 kg/m2, Body mass index) were 84 in 107 patients (78.5%) with keloids. CONCLUSIONS: In the care of the keloids, patient information, particularly sex, age and body mass index, it may be useful indicators for expecting prognosis of the patients and treating with proper management. Particularly, large-scale accurate follow-up observations on obese patients will be critical.
Body Mass Index ; Burns ; Causality ; Disease Susceptibility ; Epidemiology ; Female ; Head ; Humans ; Keloid* ; Lacerations ; Lower Extremity ; Male ; Neck ; Overweight ; Prognosis ; Upper Extremity ; Wounds and Injuries

Hepatocellular carcinoma (HCC) in the caudate lobe remains one of the most intricate locations where various treatments tend to pose problems with regard to the optimal approach. Surgical resection has been regarded as the most effective treatment; however, isolated resection of the caudate lobe is strenuous and associated with a high rate of early recurrence. Percutaneous ablation might be technically difficult or impossible to perform due to the deep location of tumors and adjacent large vessels. Treatment with drug-eluting beads (DEB) can potentially enhance the therapeutic efficacy for patients with unresectable HCC by drawing on the slower, more consistent drug delivery process. We described a case of a 62-year-old man with HCC in the caudate lobe who was successfully treated by DEB.
Carcinoma, Hepatocellular/*therapy ; Chemoembolization, Therapeutic ; Doxorubicin/administration & dosage ; Drug-Eluting Stents ; Humans ; Liver Neoplasms/*therapy ; Magnetic Resonance Imaging ; Male ; Neoplasm Staging ; Tomography, X-Ray Computed

A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Abdominal Wall ; Actinomycosis ; Biopsy ; Diabetes Mellitus ; Gastrectomy ; Humans ; Hydrazines ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; Penicillin G ; Recurrence

A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus.
Abdominal Wall ; Actinomycosis ; Biopsy ; Diabetes Mellitus ; Gastrectomy ; Humans ; Hydrazines ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; Penicillin G ; Recurrence