• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.99-106
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• 2009

Compressive neuropathy in the upper extremity can be clinically diagnosed by careful history taking, physical examination of the involved nerve. Electrodiagnosis for the suspected nerve informs severity of compression of the involved nerve and indicates specific site of the lesion. In the early stage of the disease, non-operative treatment generally cures the symptom, however, if the conservative treatment fails, confirmation of the exact site of the lesion should be preceded before the operation. Recently, ultrasonography, as a supportive tool for the diagnosis of compressive neuropathy has increasing popularity for its ability to find space occupying lesion, anatomical change of the nerve, and the pathologic change in the nerve itself. For the successful treatment of the compressive neuropathy, these various diagnostic tools have to be introduced in the orthopaedic clinic.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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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.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.397-401
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• 1994

A twenty-one-year-old man visited our hospital due to abdominal distension for a month. On the physical examination, there was severe abdominal distension with fluctuation and shifting dullness. The routine laboratory results were within normal range. On the Magnetic Resonace angiography, there wasn't any blood flow within the right and middle hepatic vein. So we concluded that the etiologic disease was Budd-Chiari syndrome. On the liver scan, there was cold area(absence of radiouptake) on entire right lobe of the liver, increased uptake on the bone marrow and showed splenomegaly. This finding was similar to the liver mass occupying right lobe with underlying chronic liver disease. On the previous reports, it is quite uncommon finding that Budd-Chirari syndrome shows lesion like space occupying one on the liver scan. So we report this case with a review of the literature.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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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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• v.45 no.1
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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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• v.33 no.2
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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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• v.4 no.2
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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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• v.15 no.2
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• pp.109-116
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• 2012

Purpose: The aim of this study was to evaluate preoperative ultrasonographic findings and usefulness in ulnar neuropathy around elbow. Materials and Methods: Twenty-two patients with ulnar neuropathy were performed preoperative ultrasonogram. The route, location, thickness of the ulnar nerve and space occupying lesion through longitudinal scan were evaluated. Cross-sectional areas of the ulnar nerve were measured at the level of medial epicondyle and 3 cm proximal and distal to the medial epicondyle through axial scan. Correlations between swelling ratio of ulnar nerve and eletrophysiologic study and preoperative Dellon's assessment were checked. Results: In 21 cases (95.6%) of total 22 cases, diffuse swelling of the ulnar nerve around elbow were identified. 4 cases had space occupying lesions including 3 ganglionic cysts and 1 heterotopic ossification. Cross sectional areas at the level of medial epicondyle were significantly larger than at the level of 3 cm proximal and distal to the medial epicondyle (p<0.05). There were no statistically significant correlations between swelling ratio of ulnar nerve and eletrophysiologic study and preoperative clinical assessment (p>0.05). Conclusion: This study showed that ultrasonography was helpful to detect etiology of ulnar neuropathy around elbow such as space occupying lesion, morphological change or dislocation of ulnar nerve. It could be useful tool for diagnosis and treatment in patients with ulnar neuropathy at elbow.

• Imaging Science in Dentistry
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• v.34 no.2
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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.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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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.