• Title/Summary/Keyword: Tibial Mass

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Tarsal Tunnel Syndrome Induced by a Ganglionic Mass: A Case Report (족근관에 발생한 결절종으로 인한 족근관 증후군의 치험 1례)

  • Seul, Chul Hwan;Nam, Sang Hyun;Chung, Yoon Kyu
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.648-651
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    • 2006
  • Purpose: Tarsal tunnel syndrome is characterized by pain and paresthesia of the entire posterior tibial nerve and its branches of the lower extremity. The cause of the tarsal tunnel syndrome is usually unknown but, rare case of space occupying benign tumors such as a ganglion may be one of the causes. We report our experiences of surgical treatment of the tarsal tunnel syndrome caused by ganglion we have encountered recently. Methods: A 54-year-old male patient presented with paresthesia, burning pain, positive Tinnel's sign without preceeding trauma, infection or any other causes of event. With surgical intervention, we completely removed the space occupying ganglion and with performed surgical release of the posterior tibial nerve and its branches. Results: At a 14-month follow up examination, the symptoms of paresthesia, burning pain, sensory disturbance was much improved compared to the preoperative conditions. Takakura's rating scale was elevated from 4(Poor) to 8(Good). Conclusion: We report our surgical experience of a rare case of tarsal tunnel syndrome caused by a ganglion, with a review of literature.

How to Avoid Graft-Tunnel Length Mismatch in Modified Transtibial Technique for Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft

  • Ko, Dukhwan;Kim, Hyeung-June;Oh, Seong-Hak;Kim, Byung-June;Kim, Sung-Jae
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.407-412
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    • 2018
  • Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels - the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

BONE METASTASIS MODEL OF ORAL SQUAMOUS CELL CARCINOMA (구강 편평상피세포암의 골전이 모델)

  • Park, Young-Wook;Oh, Yu-Jin;Lee, Hee-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.118-125
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    • 2010
  • Background and Purpose: Bone metastases rarely occur in patients with oral squamous cell carcinoma (OSCC), so the molecular mechanisms of bone metastasis of OSCC remains unclear. Studies with animal models allow progresses in understanding the molecular events for bone metastasis and provide new targets for therapy. So we tried to establish a murine model for bone metastasis of oral squamous cell carcinoma. Materials and Methods: Human OSCC cells (KB cell line) were xenografted to nude mice via direct inoculation into the tibial marrow. Mice with tibial tumors were sacrificed once a week, until seven weeks after the injection of human tumor cells. Growth of tibial tumors were observed by histology. Expression of TGF-$\beta$ and CXCR-4 in bone OSCC (experimental) and subcutaneous tumor (control) was also evaluated by immunohistochemical staining. Results: Bone OSCC was successfully induced by intra-tibial injection of KB cells. Tumor mass was developed in the marrow tissues of tibia and finally invade the endosteum of tibia. Immunohistochemical staining showed higher expression of TGF-$\beta$ in bone tumors than in subcutaneous tumors. Conclusion: A murine model of bone metastasis of OSCC was suggested that imitated the clinical findings of distant vascular metastasis. This bone tumor model should facilitate understanding of the molecular pathogenesis of OSCC bone metastasis, and aid in the developement of treatment strategies against OSCC bone metastasis.

CCR5 deficiency in aged mice causes a decrease in bone mass

  • Oh, Eun-Ji;Zang, Yaran;Kim, Jung-Woo;Lee, Mi Nam;Song, Ju Han;Oh, Sin-Hye;Kwon, Seung Hee;Yang, Jin-Woo;Koh, Jeong-Tae
    • International Journal of Oral Biology
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    • v.44 no.4
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    • pp.173-181
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    • 2019
  • The CC chemokine receptor 5 (CCR5) is a G protein-coupled receptor that regulates chemotaxis and effector functions of immune cells. It also serves as the major co-receptor for the entry of human immunodeficiency virus (HIV). Recently, CCR5 inhibitors have been developed and used for the treatment or prevention of HIV infections. Additionally, it has been identified that CCR5 controls bone homeostasis by regulating osteoclastogenesis and the communication between osteoblasts and osteoclasts. However, the effects of CCR5 inhibition on bone tissue in elderly patients are unknown. This study aimed to examine the bone phenotype of aged CCR5 knockout (KO) mice. Femoral and tibial bones were isolated from 12-month and 18-month old wild-type (WT) and CCR5 KO mice, and microcomputed tomography and histology analyses were performed. Twelve-month-old CCR5 KO mice exhibited a decreased trabecular bone mass and cortical bone thickness in both femoral and tibial bones compared with age-matched WT mice. Eighteen-month-old mice also showed a decreased trabecular bone mass in femurs compared with control WT mice, but not in tibial bones. Unlike in 12-month-old mice, the cortical margin of femurs and tibias in 18-month-old mice were rough, likely because they were aggravated by the deficiency of CCR5. Overall, our data suggest that the deficiency of CCR5 with aging can cause severe bone loss. When CCR5 inhibitors or CCR5 inactivating technologies are used in elderly patients, a preventive strategy for bone loss should be considered.

Measurement of Ground Reaction Force and Energy Consumption for Ankle Assembly (Fixed-axis , Single-axis , Multi-axis Type) of Trans-Tibial Amputee (하퇴의지착용자에 대한 인공족관절 유형(고정형, 단축형, 다축형)에 따른 지면반발력 및 에너지 소모의 측정)

  • 김성민;배하석;박창일
    • Journal of Biomedical Engineering Research
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    • v.22 no.6
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    • pp.543-550
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    • 2001
  • In this study, ground reaction force(GRF) and energy consumption of fixed. single-axis and multi-axis Prosthetic ankle assemblies were investigated to show the biomechanical evaluation for trans-tibial amputees. In the experiments. two male and two female trans-tibial amputees were tested with fixed, sin91e-axis and multi-axis Prosthetic ankle assembly. A three-dimensional gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance Phase for nine Points Energy consumption of each Prosthetic ankle assembly was measured while subjects walked at 2km/h. 3km/h and the most comfortable walking speed on the treadmill The results showed that multi-axis ankle was superior to the other two ankle assemblies for the characteristic of forwarding and breaking forces. Fixed ankle was relatively superior to the other two ankle assemblies for gait balancing and movement of the center fur mass Compared to the other ankle assembly. sing1e-axis type showed lower energy consumption over 2.3km/h walking speed .

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Relationship between Impact and Shear Forces, and Shock during Running (달리기 시 충격력과 충격 쇼크 변인들과의 관계)

  • Park, Sang-Kyoon;Ryu, Ji-Seon
    • Korean Journal of Applied Biomechanics
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    • v.30 no.2
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    • pp.145-154
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    • 2020
  • Objective: The purpose of this study was to determine the relationship between impact and shear peak force, and tibia-accelerometer variables during running. Method: Twenty-five male heel strike runners (mean age: 23.5±3.6 yrs, mean height: 176.3±3.3 m/s, mean mass: 71.8±9.7 kg) were recruited in this study. The peak impact and anteroposterior shear forces during treadmill running (Bertec, USA) were collected, and impact shock variables were computed by using a triaxial accelerometer (Noraxon, USA). One-way ANOVA was used to test the influence of the running speed on the parameters. Pearson's partial correlation was used to investigate the relationship between the peak impact and shear force, and accelerometer variables. Results: The running speed affected the peak impact and posterior shear force, time, slope, and peak vertical and resultant tibial acceleration, slope at heel contact. Significant correlations were noticed between the peak impact force and peak vertical and resultant tibia acceleration, and between peak impact average slope and peak vertical and resultant tibia acceleration average slope, and between posterior peak (FyP) and peak vertical tibia acceleration, and between posterior peak instantaneous slop and peak vertical tibial acceleration during running at 3 m/s. However, it was observed that correlations between peak impact average slope and peak vertical tibia acceleration average slope, between posterior peak time and peak vertical and resultant tibia acceleration time, between posterior peak instantaneous slope and peak vertical tibial acceleration instantaneous slope during running at 4 m/s. Conclusion: Careful analysis is required when investigating the linear relationship between the impact and shear force, and tibia accelerometer components during relatively fast running speed.

Tarsal Tunnel Syndrome due to Varicose Veins Misdiagnosed as Ganglion Cyst: A Case Report (결절종으로 오인된 하지정맥류로 인한 족근관 증후군: 증례 보고)

  • Young Kwan Moon;Hyun June Lee;Yu Mi Kim
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.158-161
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    • 2023
  • Tarsal tunnel syndrome is a nerve entrapment syndrome of posterior tibial nerve as it passes through the tarsal tunnel. The patient presented posteromedial malleolar swelling, palpable mass and pain, and was misdiagnosed as ganglion cyst in the other clinic. Aspiration and steroid injection were done for years, which had no significant effect on symptom relief. As skin lesion and pigmentation abruptly appeared around the palpable mass, MRI and physical exam were done in our hospital. The patient was diagnosed as varicose veininduced tarsal tunnel syndrome and therefore tarsal tunnel decompression following dilatated varicose vein resection was done. The patient's symptom was improved after the surgery. Therefore, herein we report this case.

Treatment of Ossifying Fibroma (화골성 섬유종의 치료)

  • Han, Chung-Soo;Lee, Yong-Girl;Bae, Eun-Hwan;Kim, Sung-Soo;Kim, Sung-Tae
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.94-100
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    • 1996
  • Ossifying fibroma is one of a group of fibro-osseous lesions which arises typically within the jaw bones and only rarely affects the long bones. Ossifying fibroma of the long bones almost involve exclusively the tibia but may also involve the fibula. Ossifying fibroma of the long bones is distinct from fibrous dysplasia, adamantinoma and nonossifying fibroma with regard to age of the patient, site, radiographic appearance, histological features, and clinical course. We are reporting the cases of seven patients with a tumor-like lesion that named osteofibrous dysplasia. It is most commonly found in the tibia and fibula of a child ten years of age or younger. Of the seven cases reported in this study, only one patient was younger than ten years. In all cases, the lesions were usually located in the tibial diaphysis. The average duration of clinical manifestation was 5.2 years. The clinical symptoms were anterior bowing of the tibia in 2 cases, buldging of the tibia in 2 cases, and mass overlying the tibia in 3 cases. On the roentgenography, it shows multiple radiolucent lesion with intervening sclerotic rim of the tibial diaphysis. In seven patients, 6 cases were confirmed with biopsy. We had done curettage and bone graft in three cases, VFG was done in one case. The other three cases underwent conservative management.

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Changes of the growth plate in children: 3-dimensional magnetic resonance imaging analysis

  • Yun, Hyung Ho;Kim, Hyun-Jung;Jeong, Min-Sun;Choi, Yun-Sun;Seo, Ji-Young
    • Clinical and Experimental Pediatrics
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    • v.61 no.7
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    • pp.226-230
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    • 2018
  • Purpose: This pilot study assessed changes in the growth plate and growth rates in children during a 6-month period. Methods: The study included 31 healthy children (17 boys, 14 girls) under evaluation for growth retardation. Height, weight, bone age, insulin like growth factor-1 (IGF-1), and insulin like growth factor binding protein 3 (IGF-BP3) were measured at baseline and after 6 months. In addition, the diameter, thickness, and volume of the femoral and tibial growth plates were measured using magnetic resonance imaging. Results: The mean bone age in boys and girls was 11.7 and 10.7 years, respectively. In boys, height (z score) (-0.2 vs. 0.0), weight (z score) (0.8 vs. 1.1), body mass index (BMI) (z score) (1.27 vs. 1.5), IGF-1 (ng/mL) (343.6 vs. 501.8), and IGF-BP3 (ng/mL) (5,088.5 vs. 5,620.0) were significantly higher after 6 months. In girls, height (z score) (-1.0 vs. -0.7), weight (z score) (-0.5 vs. 0.1), BMI (z score) (-0.02 vs. 0.3), IGF-1 (ng/mL) (329.3 vs. 524.6), and IGF-BP3 (ng/mL) (4,644.4 vs. 5,593.6) were also significantly higher after 6 months. In both sexes, the mean diameter and volume of the femoral and tibial growth plates were significantly increased 6 months later. Conclusion: No significant correlation was found between changes in the growth plate and clinical parameters in children with growth retardation in this study, other than correlations of change in femoral diameter with weight and BMI. A larger, long-term study is needed to precisely evaluate the correlation between change in the growth plate and growth.

Neurilemmoma of Deep Peroneal Nerve Sensory Branch : Thermographic Findings with Compression Test

  • Ryu, Seung Jun;Zhang, Ho Yeol
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.286-290
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    • 2015
  • We report a case of neurilemmoma of deep peroneal nerve sensory branch that triggered sensory change with compression test on lower extremity. After resection of tumor, there are evoked thermal changes on pre- and post-operative infrared (IR) thermographic images. A 52-year-old female presented with low back pain, sciatica, and sensory change on the dorsal side of the right foot and big toe that has lasted for 9 months. She also presented with right tibial mass sized 1.2 cm by 1.4 cm. Ultrasonographic imaging revealed a peripheral nerve sheath tumor arising from the peroneal nerve. IR thermographic image showed hyperthermia when the neurilemoma induced sensory change with compression test on the fibular area, dorsum of foot, and big toe. After surgery, the symptoms and thermographic changes were relieved and disappeared. The clinical, surgical, radiographic, and thermographic perspectives regarding this case are discussed.