• 대한정형외과 초음파학회지
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• 제2권2호
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• pp.99-106
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• 2009

상지의 말초신경 압박 병증의 진단은 환자의 병력 및 이학적 검사로 이환된 신경 및 부위를 임상적으로 짐작할 수 있지만 신경 압박 부위를 정확히 확인하기 위해서는 전기진단적 검사가 큰 도움이 된다. 대부분 증상의 초기에는 비 수술적 치료가 선행되지만 보존적 치료의 실패로 수술적 치료가 필요할 경우는 각 신경의 가능한 압박 부위 중 정확한 위치를 추정하는 것이 성공적인 수술의 시작이 된다. 또한 전기진단적 검사와 더불어 시행되는 근골격계 초음파 검사는 전기진단적 검사만으로는 진단이 어려운 공간 점유 병소(space occupying lesion; SOL)에 의한 말초신경 압박병증의 진단 및 신경의 해부학적 변화, 신경 내부 병변의 진단에 유용한 것으로 보고되고 있다. 성공적인 말초신경 압박병증의 치료를 위해서는 이러한 다양한 진단 방법을 동원하여 정확한 부위를 확인 후 효과적인 수술을 시행하는 것이 중요하다.

• 대한족부족관절학회지
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• 제11권2호
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• pp.187-191
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• 2007

Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.

• 대한핵의학회지
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• 제28권3호
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• pp.397-401
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• 1994

저자들은 간 스캔상 간 우엽 전반에 걸친 냉소를 보여 공간점유병소로 생각되었던 Budd-Chiari증후군 1예를 경험하였다. 본례는 복부팽만을 주소로 본원 내원하여 시행한 간 스캔상 간 우엽 전반에 걸친 집적감소를 보여 만성 간 질환에 동반된 간 종괴로 생각하였으나 복부 전산화 단층촬영과 자기공명촬영에서 간우엽의 경색이 의심되었다. 자기공명혈관촬영과 초음파 도플러를 시행하였으며 우측 간정맥과 중앙 간정맥폐쇄를 보여 Budd-Chiari증후군으로 진단된 경우이다. 하대정맥의 폐쇄소견은 보이지 않았다. 이를 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.26-32
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• 2001

Objective : The increasing use of sensitive neuroimaging techniques has demonstrated that significant percentage of patients with intractable complex partial seizures have brain masses, especially in temporal lobe. The optimal surgical solution for these patients is still open to debate. The purpose of our investigation is to evaluate the surgical outcome of patient with lesion-related temporal lobe epilepsy with respect to the types of surgery and the location of lesion. Patients and Methods : From DEC. 1993 to Dec. 1997, 35 patients with intractable epilepsy and space occupying temporal lobe lesion identified in preoperative MRI were included in this study. The types of surgery were lesionectomy, anterior temporal lobectomy with or without hippocampectomy. The location of lesion was divided as anteromedial group and lateral cortical group. The postoperative seizure outcomes according to the type of surgery and location of the lesion were compared. Results : Twenty-six of 34 patients(76.5%) were seizure-free after surgery. The Engel's class was favorable after anterior temporal lobectomy with or without hippocampectomy(p=.044) Conclusion : It is favorable to perform anterior temporal lobectomy for the treatment of intractable epilepsy with space-occipying lesion in temporal lobe. The resection of the hippocampus can be individualized.

• Journal of Korean Neurosurgical Society
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• 제45권1호
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• pp.53-56
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• 2009

The authors present a case of subdural empyema in a macrocephalic patient. A 23-year-old male was admitted due to headache and fever. One month ago, he had mild head injury by his coworkers. Physical examination showed a macrocephaly and laboratory findings suggested purulent meningitis. Neuroimaging studies revealed a huge size of epidural space-occupying lesion. Under the impression of epidural abscess, operation was performed. Eventually, the lesion was located at subdural space and was proven to be subdural empyema. Later, histological examination of the specimen obtained by surgery demonstrated finings consistent with the capsule of the chronic subdural hematoma. Two weeks after operation, Propionibacterium acnes was isolated. The intravenous antibiotics were used for total of eight weeks under monitoring of the serum level of the C-reactive protein. Follow-up brain computed tomography (CT) scan showed the presence of significant amount of remaining subdural lesion. However, he has complained of minimal discomfort. It is suggested that the subdural empyema occurred with preexisting chronic subdural hematoma after head injury about one month prior to admission and it took a long time to treat Propionibacterium acnes subdural empyema with systemic antibiotics, at least over eight weeks.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.252-254
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• 2006

The dermoid cyst is the one of common space occupying orbital lesion. This lesion is regarded as a non-invasive tumor, but infrequently causes destruction of adjacent bony structure and displacement of adjacent tissue. We experienced a characteristic ovoid orbital dermoid cyst that occupied in the frontal sinus and causes displacement of the eyeball with well-defined lining. This 55-year-old male presented a mass in left orbit, which rapidly increased in size for past 12 months, and patient could not open left eyelid. We removed this tumor totally then reconstructed the orbital roof and frontal sinus with an iliac bone graft and polyethylene sheet(Medpor Newnan, USA). This patient was followed up for 12 months and patient obtained satisfactory result without any complication suck as recurrence or infection.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.114-118
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• 2002

Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

• Clinics in Shoulder and Elbow
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• 제15권2호
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• pp.109-116
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• 2012

목적: 주관절부 척골 신경병증에서 술 전에 시행한 초음파 소견과 그 유용성에 대하여 알아보고자 하였다. 대상 및 방법: 척골 신경병증을 진단 받고 술 전 초음파 검사를 시행한 22예를 대상으로 하였다. 장축 영상을 통해 척골 신경의 주행 경로, 위치, 굵기와 신경 주위 공간 점유 병소 등을 확인하였고, 단축 영상을 통해 내상과 근위부 3 cm, 후방, 원위부 3 cm에서의 단면적 및 척골 신경 부종비를 측정하여 전기 생리학적 검사 및 술 전 임상적 평가와의 연관성을 파악하였다. 결과: 초음파 검사상 총 22예 중 21예 (95.5%)에서 주관절 내상과 후방부에 척골 신경의 미만성 부종 소견이 관찰되었다. 이 중 공간 점유 병소는 4예로, 결절성 낭종이 3예, 이소성 골화가 1예 있었다. 내상과 부위 척골 신경의 평균 단면적이 근위부 및 원위부의 평균 단면적보다 통계학적으로 유의하게 컸다 (p<0.05). 척골 신경 부종 비는 전기 생리학적 검사 및 술 전 임상적 평가와 통계학적 유의성을 가지지 않았다 (p>0.05). 결론: 주관절부 척골 신경병증에서의 초음파 검사로 신경의 형태학적 변화를 알 수 있을 뿐만 아니라 공간 점유 병소 또는 신경 탈구 등의 원인을 파악하는데 도움이 되었다. 초음파 검사는 전기 생리학적 검사와 더불어 척골 신경병증의 정확한 진단 및 치료 방법의 선택에 유용한 방법으로 판단된다.

• Imaging Science in Dentistry
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• 제34권2호
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• pp.111-116
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• 2004

Rhabdomyosarcoma, when it occurs in the head and neck, is primarily found in children. Alveolar rhabdomyosarcoma is rarely seen in the oral lesion, comparing to the embryonal and the pleomorphic variants. This is a report of a case of alveolar rhabdomyosarcoma in the mandible in a ten-year old girl who complained of a non-painful swelling on the right cheek. The right lower 1st molar was mobile. Her radiographs revealed an extensive radiolucency with somewhat irregular border on the right mandibular ramus. The right mandibular 1st and 2nd molars lost their lamina dura and were floating. CT images revealed smooth-outlined soft tissue mass occupying the pterygomandibular space, the infratemporal space, and the masseteric muscle with thinning and perforation of the right mandibular angle and ramus. Histopathological and immunohistochemical findings established the final diagnosis of alveolar rhabdomyosarcoma.

• 대한핵의학회지
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• 제39권4호
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• pp.266-267
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• 2005

Hepatic hemangioma is the most common benign liver tumor and must be considered in the differential diagnosis of other space occupying hepatic masses. A 54-year-old man was referred to evaluate bone metastases of lung adenocarcinoma. In our case, we thought that a focal hepatic uptake in the bore scan was a metastatic lesion, because of underlying lung adenocarcinoma. However, the findings of abdominal CT and Tc-99m RBC scan results were deemed to be characteristic of hepatic hemangioma. The biopsy of the lesion was not performed.