• Title/Summary/Keyword: Space occupying lesions

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Tarsal Tunnel Syndrome Secondary to Recurred Schwannoma Arising from the Posterior Tibial Nerve (후경골 신경에서 기인한 신경초종의 재발로 발생한 족근관 증후군)

  • Kim, Jae Young;Lee, Hye Kyung;Cho, Jaeho
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.36-39
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    • 2014
  • Tarsal tunnel syndrome is defined as a compressive neuropathy of the posterior tibial nerve in the tarsal canal. Schwannoma is a benign tumor that arises from the peripheral nerve sheath. It presents as a discrete, often tender, and palpable nodule associated with neurogenic pain or paresthesia when compressed or traumatized. The growth rate is usually slow, and these lesions seldom exceed 2 cm in diameter. In addition, local recurrence occurs less than 5%. We report on a case of tarsal tunnel syndrome caused by a large recurred space-occupying lesion measuring $4.3{\times}2.7{\times}2.7cm^3$.

An Application of Blood Clearance Rate of Colloidal $^{198}Au$ to the Interpretation of Photoscan of Liver (교양(膠樣) $^{198}$금(金) 혈액제거율검사(血液除去率檢査)의 간주사판독(肝走査判讀)에의 응용(應用))

  • Bahk, Yong-Whee
    • 대한핵의학회:학술대회논문집
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    • 1966.11a
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    • pp.93.3-94
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    • 1966
  • The fact that colloidal particulates of rdaiogold are mainly and effectively eliminated from the blood stream by phagocytic activity of Kupffer's cells of the liver has been successfully adopted to the diagnosis if certain liver diseases and the same principle has opened a new avenue to the study of the organ by obtaining scan. Indeed, the latter procedure has been widely used for the detection of space-occupying lesions of cirrhosis of the liver. Nevertheless problem of differential diagnosis of monochromatic "cold" areas or "mottling" of the internal structure on the scan limited the value of this diagnostic modality. The present investigation is aimed at improving intepretation of photoscan findings with the aid of blood clearance rate of the intravenously injected colloidal $^{198}Au$.

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Tarsal Tunnel Syndrome Associated with Gout Tophi: A Case Report

  • Park, Sam Guk;Park, Chul Hyun;Ahn, Hyo Se
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.2
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    • pp.84-87
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    • 2016
  • Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or its branches in the fibro-osseous tunnel beneath the flexor retinaculum. This pathology is associated with multiple etiologies, including trauma, space-occupying lesions, and impaired biomechanics. We report a case of tarsal tunnel syndrome associated with gout tophi in a patient with untreated gout along with a review of the relevant literature on tarsal tunnel syndrome.

Iatrogenic Duodenal Obstruction due to Acupuncture Therapy Trauma

  • Chung, Jae Hun;Lee, Si-Hak
    • Journal of Trauma and Injury
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    • v.34 no.1
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    • pp.70-74
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    • 2021
  • There are many possible causes of duodenal obstruction, such as congenital anomalies and various acquired conditions associated with space-occupying lesions. However, hemorrhage or retroperitoneal hematoma is a rare cause of duodenal obstruction. Here, we report the case of a 55-year-old man who developed duodenal obstruction due to a large retroperitoneal hematoma after acupuncture therapy. The patient experienced abdominal discomfort along with vomiting and nausea. Considering the size of the hematoma, emergency surgery could have been performed, but conservative treatment was continued because the patient's vital signs were stable. With spontaneous resolution of the hematoma, the symptoms of duodenal obstruction improved. The patient was eventually discharged without any complications associated with the hematoma. Our findings suggest that even when a hematoma is large, a conservative approach can be maintained until improvement of the symptoms of duodenal obstruction if the vital signs of the patient remain stable.

MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)

  • Lee, Kyu-Yong;Lee, Young Joo;Kim, Seung Hyun;Song, Hyoung Gon;Kim, Juhan
    • 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.

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Ultrasonographic Findings and Usefulness in Ulnar Neuropathy at the Elbow (주관절부 척골 신경병증에서의 초음파 소견 및 유용성)

  • Kim, Dong-Hu;Cho, Chul-Hyun;Lee, Kyung-Rak
    • 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.

Video-Assisted Thoracoscopic Pleural Adhesiotomy and Decortication for Complicated Pleural Space Occupying Lesions (복잡한 흉막강내 공간차지병소의 흉강경적 흉막 유착박리술 및 박피술)

  • Jo, Min-Seop;Cho, Deog-Gon;Moon, Seok-Whan;Moon, Young-Kyu;Kang, Chul-Ung;Cho, Kyu-Do;Jo, Keon-Hyeon
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.350-354
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    • 2009
  • Background: Complicated pleural space occupying lesions (SOL) have been treated by thoracentesis, closed thoracotomy drainage (CTD) or surgical intervention with using a video thoracosocpe or open thoracotomy depending on the extent of the disease. With the development of video assisted thoracoscopic surgery (VATS), VATS pleural adhesiolysis and decortication have revealed good results as compared to those for open thorcotomy. To assess the effectiveness of VATS pleural adhesiolysis and decortication, we retrospectively analyzed the medical record and radiologic findings of the patients with complicated pleural SOL and who were treated by this surgery. Material and Method: From May 1996 to April 2006, 64 patients (mean age: 41.8 years) with complicated pleural SOL underwent 65 VATS. To analyze the surgical outcome, we classified the postoperative findings on the simple chest X-rays into 4 classes as Class I: no or minimal pleural lesion, Class II: blunting of the cardiophrenic angle and mild pleural thickening, Class III: an elevated diaphgram or persistent lung collapse and Class IV: complicated or recurrent effusion. Result: Before VATS, the patients underwent the diagnostic or therapeutic procedures: single or repeat diagnostic tapping for 41, thoracoscotomy drainage for 11, pigtail catheter drainage for 10 and intrapleural fibrinolytics for 10. The mean duration between the onset of symptom and surgery was 18.4 days. There was neither mortality nor severe complications. The surgical outcomes were class 1 for 28, class 2 for 13, class 3 for 19 and class 4 for 5. There were statistically significant differences between the symptom duration and the classes, and between the operation time and the classes. Conclusion: VATS pleural adhesiolysis and decortication are effective, safe treatments for managing complicated pleural SOL, and an earlier operation is needed for obtaining a better surgical outcome.

A Case of Tugerculoma in Cerebrum with Brain Edema (뇌부종(腦浮腫)을 동반한 대뇌(大腦)의 결핵종(結核腫) 1례(例))

  • Son, Dong-Hyug;Yu, Kyung-Suk;Jang, In-Soo;Lee, Young-Goo;Yun, Hee-Sik;Byun, Duck-Si;Lee, Jin-Goo
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.529-533
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    • 2000
  • Intracranial tuberculoma is very rare nowadays. It is very difficult to differentiate tuberculoma from other space-occupying lesions. CT and MRI and intensive systemic review is very useful to diagnose intracranial tuberculoma. This case of patient had several symptoms of hemiparesis, headache. And we supposed that his symptoms were due to cerebrovascular accident at entry. But he was diagnosed as tuberculoma with brain edema in cerebrum. After treating him with mannitolization, acupuncture and herb medicine, his symptoms were remarkably improved. So we report this case of tuberculoma in cerebrum.

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Nontraumatic Intracystic Hemorrhage of Arachnoid Cyst: CT and MR Findings

  • Kim, Seung Jin;Baek, Hye Jin;Moon, Jin Il;Cho, Soo Buem;Choi, Bo Hwa;Bae, Kyungsoo;Jeon, Kyung Nyeo;Choi, Dae Seob
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.120-122
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    • 2016
  • Arachnoid cysts (AC) are intraarachnoidal cerebrospinal fluid collections, and account for 1% of all intracranial space-occupying lesions. Intracystic hemorrhage of the AC can occur spontaneously, but this is an extremely rare event. Herein, we present a case of hemorrhagic AC in a nontraumatic patient in the left middle cranial fossa. We also performed relevant literature review on this disease.

Microscopic Decompression of Digital Nerve Surrounded by Hemangioma: A Case Report (미세수술을 통하여 수지신경을 압박하는 혈관종을 성공적으로 제거한 증례 보고)

  • Ko, Jun Gul;Kim, Jun Hyeok;Rha, Eun Young;Lee, Jun Yong;Yoo, Gyeol;Baek, Sang Oon
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.301-305
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    • 2018
  • Hemangiomas are benign neoplasms of endothelial cells origin, rarely found in hand region. Authors report a 62-year-old female with capillary hemangioma of right index finger causing a neuropathic symptom via nerve compression. A space-occupying vascular lesion surrounding the radial digital nerve was revealed in magnetic resonance imaging (MRI), which was removed under microscopic assist. The digital nerve was decompressed consequently. The mass was firmly attached to both the digital nerve and digital artery, requiring a meticulous microscopic dissection to preserve the nerve and artery. Compression neuropathy caused by space-occupying lesions is rare and its diagnosis is often difficult. A microscopic surgical approach can be used to successfully relieve neuropathic pain after proper diagnosis established by diagnostic tools such as MRI as in this case.