• Title/Summary/Keyword: Aponeurosis

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Radiologic Findings of Mediastinal Fibromatosis (종격동섬유종증의 방사선학적 소견)

  • Chang, You-Song;Cho, Jae-Ho;Cho, Kil-Ho;Hwang, Mee-Soo;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.217-221
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    • 1991
  • The fibromatosis is a rare tumorous with local invasion, but is not metastasized distantly. This term should not be applied to nonspecific reactive fibrous proliferations that are part of an inflammatory process of are secondary to injury of hemorrhage and have no tendency toward growth or recurrence. It arises principally from the connnective tissue of muscle and overlying fascia or aponeurosis(musculaponeurotic fibromatosis), and chiefly affects the muscle of shoulder, pelvic girdle, and extremity. The term 'aggressive fibromatosis' is also employed to describe this disease, but it is impossible to predict the clinical course in the individual case. The fibromatosis arising in the mediastinum is very rare, and the report about it is nearly absent. The plain radiography shows merely mass with soft tissue density. The CT demonstrates a poorly defined homogenous or heterogenous mass, isodense with skeletal muscle on precontrast-images, and slightly hyperdense to muscle on postcontrast-scan. Accurate delineation between the tumor & surrounding tissue is vague or frequently impossible. The authors experienced one case of the mediastinal fibromatosis recently and report the case with review of concerned literature.

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Clinical anatomic consideration of the superficial layer of the masseter muscle for botulinum toxin injection (보툴리눔 톡신 주사를 위한 깨물근 얕은층의 임상해부학적 고찰)

  • Lee, Hyung-Jin;Kim, Hee-Jin
    • The Journal of the Korean dental association
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    • v.55 no.5
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    • pp.365-369
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    • 2017
  • In clinical dentistry, botulinum toxin is generally used to treat the square jaw, bruxism, and temporomandibular joint diseases. Recently, this procedure has been expanded and applied for cosmetic purposes, and it is becoming a key task to be aware of the precise anatomical structure of the target muscles to be cautious during treatment and how to prevent side effects. Therefore, the purpose of this study is to observe the anatomical structure of the superficial layer of masseter muscle and to provide a most effective botulinum toxin injection method through clinical anatomical consideration. It was observed that the muscle belly of superficial part of the superficial layer was originated from the deep to the aponeurosis of masseter muscle and descend, then changed gradually into the tendon structure attaching to the inferior border of the mandible. In this study, we named this structure deep inferior tendon. This structure was observed in all specimens. We conclude that the use of superficial layer and deep layer injection should be considered to prevent paradoxical masseteric bulging in consideration of the deep inferior tendon of superficial part of superficial layer of masseter muscle.

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Anatomical Study on Hand Gworeum Skin in Human

  • Park, Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.41 no.4
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    • pp.72-77
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    • 2020
  • Objectives: This study was carried out to concrete the concept of Hand Gworeum Skin referred in Suwen of Huangdi Neijing. Methods: The Hand Gworeum Meridian was labeled with latex in the body surface of the cadaver, subsequently dissecting a superficial fascia and muscular layer in order to observe internal structures. Results: Skin histologically encompasses a common integument and a immediately below superficial fascia, this study established the skin boundary with adjacent structures such as relative muscle, tendon as its compass. The realm of the Hand Gworeum Skin is as follows: The skin close to the nipple on the 4th intercostal space, the interceps of biceps brachii muscle, the cubital surface at ulnad of bicipital aponeurosis, the anterior surface of the forearm, between flexor carpi radialis and palmaris longus(from wrist crease to 5chon above), the palm between the 3rd and 4th metacarpals on the cross part with the palm crease, the radiod from the middle finger nail(or the end of middle finger). The realm of the Hand Gworeum Skin is situated on between Hand Taeeum Skin and Hand Soeum Skin in front of arm. Conclusion: The realm of Hand Gworeum Skin from the anatomical viewpoint seems to be the skin area outside the superficial fascia or the muscle involved in the pathway of the Hand Gworeum Meridian vessel, Collateral Meridian vessel, and Meridian muscle, being considered adjacent vessels or nerves at the same time.

A case report on a patient with Dupuytren's contracture improved by acupuncture, moxibustion and bee venom pharmacopuncture (침, 뜸, 봉약침으로 호전된 듀피트렌 구축 환자 증례 보고)

  • Bang, Chan Hyuck;Sohn, Soo Ah;Lee, Kyung Yun;Ok, So Yoon;Choi, Yu Na
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.173-180
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    • 2016
  • Objectives : To treat the progression of fibroproliferative disease that affects the flexion contracture of the fingers for patients with Dupuytren's contracture, the purpose of this study is to report a case of a patient with Dupuytren's contracture after complex Korean medical treatment. Methods : A patient was treated with acupuncture, moxibustion and bee venom pharmacopuncture on their left palmar aponeurosis. Six rounds of acupuncture and moxibustion were administered from November 30, 2015 through to January 2, 2016. Three rounds of bee venom pharmacopuncture was administered from December 14, 2015 through to January 2, 2016. The degree of flexion contracture and the Tubiana's stage were measured to evaluate the clinical improvement. Results : After 30 treatment sessions the flexion contracture degrees of the 4th finger's metacarpophalangeal joint and proximal interphalangeal joint improved as much as $25^{\circ}$, $15^{\circ}$, respectively. And the flexion contracture degrees of the 5th finger's metacarpophalangeal joint, proximal interphalangeal joint and distal interphalangeal joint improved as much as $15^{\circ}$, $10^{\circ}$, $5^{\circ}$, respectively. The Tubiana's stage of each finger decreased from 4 to 3. Conclusion : This study suggests that acupuncture, moxibustion and bee venom pharmacopuncture could be effective for patients with Dupuytren's contracture.

Schwannoma of the Foot: A Case Report (족부 신경초종의 치험례)

  • Song, Woo-Jin;Kim, Chul-Han;Kang, Sang-Gue;Tark, Min-Seong;Choi, In-Ho
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.890-893
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    • 2011
  • Purpose: Schwannoma is a slow-growing, encapsulated benign peripheral nerve tumor that originates from the Schwann cell of the nerve sheath. Schwannoma most frequently involves the major nerve. Schwannoma of the foot is rare. This is a report of our experience with a small, deep-seated, and non-palpable schwannoma occurring in the foot. Methods: A 42-year-old woman presented with the plantar pain of the right foot during 2 years. Physical examination did not identified a palpable mass. She made a clinical diagnosis of plantar fasciitis and was conservatively treated 2 years ago. Since her plantar foot pain was aggravated, she was recently visited again. For the evaluation of her plantar foot pain, sonographic examination of the whole right foot was performed, and it revealed a small hypoechoic hetergenous, deep-seated mass beneath the plantar aponeurosis. At operation, a $0.7{\times}0.6{\times}0.4$ cm sized, ovoid, yellowish grey mass was removed. Results: Histology was confirmed that the mass was a benign schwannoma. There were no postoperative complications. Conclusion: Unsusual case of a schwannoma with the plantar foot pain during 2 years is presented. It should be recognized a small, deep-seated, non-palpable

Classification of Blepharoptosis by Etiology (눈꺼풀처짐의 원인에 따른 분류)

  • Park, Soo Ho;Park, Dae Hwan;Shim, Jeong Su
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.455-460
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    • 2008
  • Purpose: We have classified blepharoptosis into the categories including pseudoptosis in Koreans and compared with other previous studies. Methods: Total of 250 patients(398 eyes) who underwent surgery for blepharoptosis from 1987 to 2006 were studied. By classification of Beard, patients were categorized into congenital, acquired and pseudo blepharoptosis and later they were reclassified by their etiologies. Also addition of pseudoptosis to the classification of Frueh, blepharoptosis were categorized into neurogenic type, myogenic type, aponeurotic type, mechanical type and pseudoptosis. And we divided these cases by the degree of blepharoptosis, levator function and the operation methods. Results: Out of the 250 patients, 175 patients were congenital type, 49 were acquired type and 26 were pseudoptosis. According to the mechanistic classification, 177 myogenic type, 30 aponeurotic, 7 mechanic, 8 neurogenic and 28 pseudoptosis were categorized. Regarding severity of blepharoptosis, there were 29.2% of mild, 40% of moderate, and 30.8% of severe cases. Out of the 398 cases, in terms of the operation methods, there were 39 aponeurosis plication, 184 levator resection, 5 Muller tucking, 60 Orbicularis oculi muscle flap, 66 frontalis transfer, and 21 blepharoplasty. Conclusion: The cause and degree of ptosis, and levator function are very important when considering the amount of resected muscle. There were only a few studies about blepharoptosis classification including pseudoptosis category. Therefore, through this study, we can investigate the relationship between the pseudoptosis and the others. This study could be useful for the making future management plans of blepharoptosis in Korean patients.

Anatomical Study on the Heart Meridian Muscle in Human

  • Park Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.26 no.1 s.61
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    • pp.11-17
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    • 2005
  • This study was carried out to identify the components of the human heart meridian muscle, the regional muscle group being divided into outer, middle, and inner layers. The inner parts of the body surface were opened widely to demonstrate muscles, nerves, blood vessels and to expose the inner structure of the heart meridian muscle in the order of layers. We obtained the following results; $\cdot$ The heart meridian muscle is composed of muscles, nerves and blood vessels. $\cdot$ In human anatomy, the difference between terms is present (that is, between nerves or blood vessels which control the meridian muscle and those which pass near by). $\cdot$ The inner composition of the heart meridian muscle in the human arm is as follows: 1) Muscle H-l: latissimus dorsi muscle tendon, teres major muscle, coracobrachialis muscle H-2: biceps brachialis muscle, triceps brachialis muscle, brachialis muscle H-3: pronator teres muscle and brachialis muscle H-4: palmar carpal ligament and flexor ulnaris tendon H-5: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficialis tendon, flexor digitorum profundus tendon H-6: palmar carpal ligament & flexor retinaculum, flexor carpi ulnaris tendon H-7: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficial is tendon, flexor digitorum profundus tendon H-8: palmar aponeurosis, 4th lumbrical muscle, dorsal & palmar interrosseous muscle H-9: dorsal fascia, radiad of extensor digiti minimi tendon & extensor digitorum tendon 2) Blood vessel H-1: axillary artery, posterior circumflex humeral artery H-2: basilic vein, brachial artery H-3: basilic vein, inferior ulnar collateral artery, brachial artery H-4: ulnar artery H-5: ulnar artery H-6: ulnar artery H-7: ulnar artery H-8: palmar digital artery H-9: dorsal digital vein, the dorsal branch of palmar digital artery 3) Nerve H-1: medial antebrachial cutaneous nerve, median n., ulnar n., radial n., musculocutaneous n., axillary nerve H-2: median nerve, ulnar n., medial antebrachial cutaneous n., the branch of muscular cutaneous nerve H-3: median nerve, medial antebrachial cutaneous nerve H-4: medial antebrachial cutaneous nerve, ulnar nerve H-5: ulnar nerve H-6: ulnar nerve H-7: ulnar nerve H-8: superficial branch of ulnar nerve H-9: dorsal digital branch of ulnar nerve.

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Myositis Ossificans Progressiva - Two Cases Report - (진행성 골화성 근염 - 2예 보고 -)

  • Park, Byeong-Mun;Kim, Dong-Soo;Ko, Young-Kwan;Song, Kyung-Sub;Jeon, Kwang-Pyo;Yoon, Hyung-Ku;Moon, Chan-Sam
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.2
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    • pp.63-67
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    • 2002
  • Myositis ossificans progressiva, also known as 'fibrodysplasia ossificans progressiva' is a rare disorder, most probably inherited as a mendelian dominant trait with irregular penetrance. It is characterized by congenital malformations of the great toes and progressive edema, calcification and ossification of the fasciae, aponeurosis, ligaments, tendons, and connective tissue in interstitial tissues of skeletal muscle. The basic defect is in the connective tissue, whereas the skeletal muscle remains fundamentally normal. We report two cases of a brother and sister whose the disorder is involved in a same family.

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Telecanthus Associated with Blepharoptosis (눈꺼풀처짐을 수반한 눈구석벌어짐증)

  • Baik, Bong-Soo;Ji, So-Young;Choi, Jae-Il;Suhk, Jeong-Hoon;Yang, Wan-Suk
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.465-471
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    • 2011
  • Purpose: Blepharoptosis is often associated with telecanthus and the presence of epicanthal fold in telecanthus is one of unique features in Asian eyelids. The purpose of this article is to define telecanthus and pseudotelecanthus, and to determine optimal surgical procedure depending on classification of telecanthus. Methods: Among 187 patients with blepharoptosis who had the advancement procedure of the Muller's musclelevator aponeurosis composite flap for ptosis, 55 patients underwent Flowers' split V-W plasty concomitantly with shortening the medial canthal tendon for correction of telecanthus from September 2003 to January 2011. Among them, 52 patients were followed up for 16 months. We newly defined telecanthus because Mustarde ratio is inaccurate to measure in certain cases and then made a definition of pseudotelecanthus. Besides, we also classified telecanthus into mild, moderate and severe types based on its severity. Results: Telecanthus is defined when the ICD (inner canthal distance) is greater than 110% of normal ICD. Pseudotelecanthus is a telecanthus like a wide skin bridge formed between the eyes because of the epicanthal fold in the normal ICD. Flowers' split V-W plasty combined with shortening medial canthal tendon was very effective in mild and moderate telecanthus with almost invisible scar and no recurrence occurring. In severe types, however, it showed high incidence (28%) of incomplete correction of telecanthus. Conclusion: New definition of telecanthus can be easily applied to any case and we think the classification of telecanthus is useful to select an appropriate operative procedure. Split V-W plasty with shortening of medial canthal tendon is a very effective procedure in mild and moderate telecanthus. Besides, it is also effective in improving the treatment outcomes of ptosis in cases of blepharoptosis associated with telecanthus.

New insight into the vasto-adductor membrane for safer adductor canal blockade

  • Yanguk Heo;Miyoung Yang;Sung Min Nam;Hyun Seung Lee;Yeon-Dong Kim;Hyung-Sun Won
    • The Korean Journal of Pain
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    • v.37 no.2
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    • pp.132-140
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    • 2024
  • Background: This study aimed to identify exact anatomical landmarks and ideal injection volumes for safe adductor canal blocks (ACB). Methods: Fifty thighs from 25 embalmed adult Korean cadavers were used. The measurement baseline was the line connecting the anterior superior iliac spine (ASIS) to the midpoint of the patellar base. All target points were measured perpendicular to the baseline. The relevant cadaveric structures were observed using ultrasound (US) and confirmed in living individuals. US-guided dye injection was performed to determine the ideal volume. Results: The apex of the femoral triangle was 25.3 ± 2.2 cm distal to the ASIS on the baseline and 5.3 ± 1.0 cm perpendicular to that point. The midpoint of the superior border of the vasto-adductor membrane (VAM) was 27.4 ± 2.0 cm distal to the ASIS on the baseline and 5.0 ± 1.1 cm perpendicular to that point. The VAM had a trapezoidal shape and was connected as an aponeurosis between the medial edge of the vastus medialis muscle and lateral edge of the adductor magnus muscle. The nerve to the vastus medialis penetrated the muscle proximal to the superior border of the VAM in 70% of specimens. The VAM appeared on US as a hyperechoic area connecting the vastus medialis and adductor magnus muscles between the sartorius muscle and femoral artery. Conclusions: Confirming the crucial landmark, the VAM, is beneficial when performing ACB. It is advisable to insert the needle obliquely below the superior VAM border, and a 5 mL injection is considered sufficient.