• 대한족부족관절학회지
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• 제18권1호
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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 $4.3{\times}2.7{\times}2.7cm^3$.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1966년도 제5회 학술대회
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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 $^{198}Au$.

• 대한족부족관절학회지
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• 제20권2호
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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.

• Journal of Trauma and Injury
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• 제34권1호
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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.

• 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.

• Journal of Chest Surgery
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• 제42권3호
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• pp.350-354
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• 2009

배경: 복잡한 흉막강내 공간차지병소(complicated pleural space occupying lesions, SOL)의 치료는 그 병의 진행정도와 상태에 따라 흉막천자, 폐쇄식흉강삽관술, 섬유소용해제의 주입, 그리고 흉강경이나 개흉술을 이용한 수술적 치료 등이 선택될 수 있다. 특히 비디오 흉강경 수술이 발달함에 따라 개흉술의 단점을 극복하여 보다 적극적으로 비디오 흉강경을 이용한 수술(VATS)을 시행하여 좋은 결과를 보고하고 있다. 이에 저자들은 비디오 흉강경을 이용한 흉막 유착박리술과 박피술의 유용성과 조기수술의 효과에 대해 알아보고자 의무기록과 방사선 기록을 후향적으로 조사, 분석하였다. 대상 및 방법: 1996년 5월부터 2006년 4월까지 complicated plerual SOL 환자 64명(평균연령 $41.8{\pm}19.8$세)에서 시행한 65예의 VATS 흉막 박피술과 흉막 유착박리 술을 분석하였다. 결과 분석을 위해 수술후 단순흉부방사선 소견을 임의로 4군(Class)으로 나누었다. Class I: no or minimal pleural lesion, class II: blunting of costophrenic angle and mild pleural thickening, class III: elevated diaphgram or persistent lung collapse, class IV complicated or recurrent effusion. 결과: 수술전 환자들은 진단적, 치료적 시술로 41예에서 흉막천자술, 10예에서 pigtail catheter 삽입술, 11예에서 폐쇄식흉강삽관술, 그리고 10예에서 섬유소용해제 주입을 받았다. 증상발현 후부터 수술까지의 기간이(증상발현기간)평균 18.4일이었고, 심각한 합병증이나 사망예는 없었다. 수술결과 Class I 28예, II 13예, III 19예, IV 5예였으며, 증상발현기간과 수술시간과의 관계에서 통계적으로 유의한 차이를 보였다. 또한 증상발현기간 18일을 기준으로 조기수술군과 지연수술군으로 나누어 비교하면 단순흉부방사선 소견 class별로 빈도수에서 두군간에 유의한 차이를 보였다. 결론: 비디오 흉강경을 이용한 흉막 유착제거 술과 박피술은 Complicated pleural SOL 치료를 위한 안전하고 효과적인 방법이고, 보다 좋은 결과를 위해서 조기에 적극적인 수술이 필요하다.

• 대한한방내과학회지
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• 제21권3호
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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.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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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.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.301-305
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• 2018

혈관종은 내피세포로부터 기원한 양성종양의 일종으로, 수부에서는 드물게 발생하는 것으로 알려져 있다. 62세 여자환자로 우측 2수지 요골측의 통증을 주소로 내원하였으며, 시행한 자기공명영상에서 수지신경을 압박하는 것으로 보이는 혈관종이 의심되었다. 수술을 시행하여 요골측 수지신경 및 수지혈관을 압박하고 있는 혈관종을 확인하였으며, 수지신경 및 혈관을 가능한 보존하기 위하여 미세수술을 통해 혈관종을 제거하였다. 공간점유성 병변에 의한 압박성 신경병증은 드문 일로, 정확한 진단에 어려움이 있으나, 본 증례와 같이 자기공명영상을 통한 술 전 평가와 및 미세수술을 이용한 병변 제거 및 신경 보존을 통하여 신경병성 통증을 성공적으로 호전시킬 수 있을 것으로 생각한다.