• Title/Summary/Keyword: 백병원

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Persistent Primitive Olfactory Artery Type 4 with Fusiform Aneurysm: A Case Report (방추형동맥류를 동반한 제4형 잔류 원시 후각동맥의 영상 소견: 증례 보고)

  • Heecheol Park;Jin Wook Baek;Hae Woong Jeong;Young Jin Heo;Suyoung Yun;Ji-Yeon Han
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1361-1366
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    • 2023
  • The persistent primitive olfactory artery (PPOA) is a rare variant of the anterior cerebral artery, first reported in 1979. It reportedly has a high correlation with the development of aneurysms, owing to the hemodynamic stress induced by the structural characteristics of the hairpin turn. Herein, we present a rare case of PPOA type 4 with a fusiform aneurysm at the hairpin turn segment in a 46-year-old female with occasional headaches. Time-of-flight MR angiography and transfemoral cerebral angiography revealed an unusual branch arising from the left A1 segment, running anteromedially along the ipsilateral olfactory tract, and turning the hairpin posterior to the olfactory bulb. This branch continued into the left accessory middle cerebral artery, and a fusiform aneurysm was observed at the hairpin segment. No further treatment was performed, and follow-up imaging was recommended. Nevertheless, it is essential to recognize and diagnose these rare variations.

Two-Stage Operation Over a Period of 7 Years for a Patient with Macrodactyly: A Case Report (발가락 거대지 환자에게 7년에 걸쳐 시행한 단계적 수술: 증례 보고)

  • Yong-Uk Kwon;Young-Chae Seo;Ga-Won Jeon;Hyo-Young Lee
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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    • pp.24-29
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    • 2023
  • Macrodactyly of the toe is a rare congenital anomaly characterized by the overgrowth of a digit/digits in the foot and is one of the most difficult conditions to treat. Since the condition alters functionality and appearance, the treatment goal is to restore function and cosmetically enhance the appearance. Various surgical techniques are used for toe macrodactyly, including amputation, debulking, and epiphysiodesis. Herein, we present a case of a six-year-old patient with a second toe macrodactyly who was successfully treated with a two-stage operation over a seven-year period. We initially performed an ostectomy of the middle phalanx with a fusion of the proximal and distal phalanges and then performed a soft tissue debulking procedure.

Comparing the "pre-COVID-19 period" and the "COVID-19 early-stage period" for emergency medical services (COVID-19 발현 초기 119 구급대를 경유해 응급실로 내원하는 환자들의 이송 시간과 호소하는 증상의 변화 : 부산지역 일개 응급의료센터로 이송된 환자의 구급활동일지를 중심으로)

  • Kang, Ji-Hun;Ji, Jae-Gu;Jang, Yun-Deok;Lee, Si-Won;Kim, Seong-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.161-169
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    • 2020
  • Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

Hindfoot Alignment Change after High Tibial Valgization Osteotomy in a Patient with an Ipsilateral Fused Ankle: A Case Report (족관절이 유합되어 있는 상태에서 동측 슬관절 고위경골외반절골술을 시행한 이후 후족부 정렬의 변화: 증례 보고)

  • Sung Sahn Lee;Jin Soo Suh;Kyeong Woo Park;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.75-79
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    • 2024
  • Ankle arthrodesis was performed on a 55-year-old male patient with an active lifestyle who developed severe arthritis in the left ankle. Over the follow-up period, high tibial valgization osteotomy was conducted for painful medial knee joint arthritis with genu varum deformity to correct overall lower limb alignment from varus to valgus with respect to the fused ankle. This study was conducted to investigate how hindfoot alignment would change when the overall alignment of the lower limb shifted from varus to valgus with the ipsilateral ankle in a fused state. Conclusively, while no intrinsic changes in the hindfoot alignment were observed following the alteration of lower limb alignment, the hindfoot naturally adjusted to valgus deviation in response to limb valgus realignment. Moreover, symptoms changed in line with this adjustment. Given the absence of similar case studies or reports, a review of relevant literature is included to contribute to knowledge of this subject.

Imaging Findings of Nodular Fasciitis in Breast including Artificial Intelligence Mammography and Shear Wave Elastography: A Case Report (유방의 결절성 근막염의 인공지능 유방촬영술과 탄성초음파를 포함한 영상 소견: 증례 보고)

  • So Hyeong Park;Ji Yeon Park;Mee Joo;Jae Il Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1397-1402
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    • 2023
  • Nodular fasciitis is a benign fibroblastic proliferation rarely reported in the breast. We report the case of a 55-year-old woman who presented with imaging findings that resembled a malignancy. Mammography revealed an isodense nodule with partially indistinct margin in the right breast, showing the abnormality score 75% on artificial intelligence. Ultrasonography revealed an oval hypoechoic nodule with microlobulated margin, echogenic halo, increased blood flow, and soft elasticity. After core needle biopsy and excision, nodular fasciitis was diagnosed. Although nodular fasciitis of the breast is rare, it may mimic malignancy; therefore, it should be considered as a differential diagnosis to prevent unnecessary intervention.

Imaging of Sequestered Lumbar Discs (요추 분리추간판의 영상 소견)

  • Gangwon Jeong;Heecheol Park;Sun Joo Lee;Dae-Hyun Park;Sung Hwa Paeng;Eugene Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.3-23
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    • 2024
  • Intervertebral disc herniation is frequently encountered in radiological practice. Sequestered disc herniation occurs when the disc material undergoes degeneration and completely loses continuity with the parent nucleus pulposus. Sequestered discs can reside within and outside the spinal canal, exerting a mass effect on adjacent structures, compressing nerve pathways, and eliciting a range of clinical symptoms. In particular, sequestered discs within the dura cannot be identified without durotomy. Therefore, precise preoperative localization is crucial for surgical planning. On MRI, the signal intensity of the sequestered disc may vary due to independent degeneration processes. Additionally, most sequestered disc fragments show varying degrees of peripheral enhancement depending on the degree of angiogenesis and granulation around the isolated tissue. In this article, we review various imaging findings and the location of the sequestered disc to provide patients with an accurate diagnosis and appropriate treatment direction.

Impact of Respiratory Phase during Pleural Puncture on Complications in CT-Guided Percutaneous Lung Biopsy (CT 유도 경피 폐생검에서 흉막 천자 시 호흡 시기가 합병증에 미치는 영향)

  • Ji Young Park;Ji-Yeon Han;Seok Jin Choi;Jin Wook Baek;Su Young Yun;Sung Kwang Lee;Ho Young Lee;SungMin Hong
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.566-578
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    • 2024
  • Purpose This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory-phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360-0.906; p = 0.017). Conclusion Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

Chondroblastoma of the Talus Mimicking an Aneurysmal Bone Cyst: A Case Report (동맥류성 골낭종으로 오인된 거골에 발생한 연골모세포종: 증례 보고)

  • Park, Ji Soo;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.31-34
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    • 2019
  • Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.

Ankle Arthrodesis for Severe Arthritis Induced by Diffuse-Type Pigmented Villonodular Synovitis: A Case Report (미만성 색소 융모 결절성 활액막염에 의해 발생한 고도의 발목 관절염에 대한 관절 유합술: 증례 보고)

  • Kim, Young Kyu;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.173-176
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    • 2018
  • Pigmented villonodular synovitis (PVNS) is a proliferative disease that affects the synovial joint, tendon and bursa. PVNS can form a nodular structure in any joint, but it most commonly affects the knee joint and is rare in the foot and ankle joint. PVNS is divided into two types. Localized-type PVNS exhibits focal involvement with a nodular mass, while diffuse-type PVNS involves the entire synovium. Synovitis of the affected joint can also destroy cartilage and bone. Diffuse type accounts for 75% of PVNS and has a reported recurrence rate of 12.2% to 46%; aggressive synovectomy is recommended as the most effective treatment. In localized-type PVNS, only arthroscopic partial synovectomy is effective with a lower recurrence rate. We report a patient with severe ankle joint arthritis induced by diffusetype PVNS. The patient was treated by lateral malleolar ostectomy and ankle arthrodesis with a plate and screws via a lateral approach.