• Title/Summary/Keyword: 인제의과대학

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Overlooked and Challenging Encounters-Inflammatory Pseudotumors in the Abdomen and Pelvis: A Pictorial Essay (놓치기 쉽고 진단이 어려운 복부골반강의 염증성 가성 종양: 임상화보)

  • Min Ha Kwag;Jin Young Park;Hae Woong Jeong;Ji Yeon Han;Jong Heon Lim;Young Seon Kim;Jung Won Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1121-1133
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    • 2020
  • Inflammatory pseudotumors (IPTs) are uncommon, mass-forming lesions, predominantly involving the lung and orbit. Although the incidence of IPTs is rare in the abdomen and pelvis, they can be encountered as enhancing, soft-tissue lesions, mimicking malignancy or fibrosclerosing disease. Generally, they exhibit a wide range of nonspecific imaging features in various organs. Preoperative imaging diagnosis of IPTs in appropriate clinical settings may help determine proper patient management. In this article, we review radiologic findings of IPTs in the abdominopelvic cavity, including the liver, spleen, kidney, gastrointestinal tract, mesentery, pelvis, and retroperitoneum.

CT Follow-Up of Postoperative Bronchopleural Fistula: Risk Factors for Progression to Chronic Complicated Infection (수술 후 기관지 흉막루의 전산화단층촬영 추적 검사: 만성 복합성 감염 진행의 위험인자 분석)

  • Ji-Yeon Han;Ki-Nam Lee;Yoo Sang Yoon;Jihyun Lee;Hongyeul Lee;Seok Jin Choi;Hye Jung Choo;Jin Wook Baek;Young Jin Heo;Gi Won Shin;Jinyoung Park;Dasom Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.128-138
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    • 2021
  • Purpose We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT. Materials and Methods We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis. Results The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2-33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1-545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1-73.5), only in the univariate analysis. Conclusion The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.

Classify the Acute Drug Intoxication Patients with Poisoning Severity Score(PSS) and Calculate the Optimal Cutoff Value of PSS, PSSsum to Predict Poor Prognosis (급성 약물 중독 환자에서 Poisoning Severity Score (PSS)를 이용한 중증도 분류와 중증도 분류에 있어 PSS 값과 PSSsum 값의 Optimal Cutoff Value)

  • Park, Hyun Woo;Park, Ha Young;Kim, Han Byeol;Park, Keon Woo;Lee, Sang Hun;Lee, Hyun Wook;Lee, Je Won;Hwang, Tae Sik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.75-85
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    • 2018
  • Purpose: This study examined the Poisoning Severity Score (PSS) from acute poisoning patients, to determine the relationships among the PSS, PSSsum, the primary outcome (prolonged stay at the ER over 24 hours, general ward and ICU admission and the application of intubation and mechanical ventilator, and the administration of inotropes). Methods: A retrospective study was conducted through the EMR for 15 months. The PSS grade was classified according to the evidence of symptoms and signs. The differences in the primary outcomes between the PSS of when a single organ was damaged, and the PSS, PSSsum combined with the grade of when multiple organs were damaged, were studied. The cutoff value was calculated using the receiving operating characteristics (ROC) curve. Results: Of the 284 patients; 85 (29.9%) were men with a mean age of 48.8 years, and their average arrival time to the ER was $4.4{\pm}6.7\;hours$. The most frequently used drug was hypnotics. The number of patients with PSS grade 0, 1, 2, 3, and 4 was 17, 129, 122, 24, and one, respectively. No ICU admissions, application of intubation and mechanical ventilators, administration of inotropes were observed among the patients with PSS grades 0 and 1 but only on patients with PSS grades 2 to 4. At PSS, when separating the patients according to the number of damaged organs, 17 had no symptoms, 133 had one organ damaged, 75 had two organs damaged, 36 had three organs damaged, and 23 had four organs damaged. Significant differences were observed between increasing number of damaged organs and the primary outcome. Conclusion: Among the acute poisoning patients, the PSS was higher in severity when the grade was higher. The number of damaged organs and the primary outcome showed meaningful statistical differences. This study confirmed that when the patients' PSS>2 and PSSsum>5, the frequency of ICU admission was higher, and they were considered to be severe with an increased prescription risk of application of intubation and mechanical ventilator, and the administration of inotropes.

Clinical Assessments and MRI Findings Suggesting Early Surgical Treatment for Patients with Medial Epicondylitis (내측상과염 환자의 임상항목과 자기공명영상 항목 중 조기 수술적 치료가 필요한 환자군이 갖는 인자에 관한 분석)

  • Hyungin Park;Seok Hahn;Jisook Yi;Jin-Young Bang;Youngbok Kim;Hyung Kyung Jung;Jiyeon Baik
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.613-623
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    • 2021
  • Purpose To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis. Materials and Methods Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients' demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment. Results Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio: 1.864; 95% confidence interval: 1.264-2.750) was correlated with surgical treatment. Conclusion Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.

Imaging Findings of Metaplastic Breast Carcinoma with Chondroid Differentiation: A Case Reports (연골성 분화를 보이는 화생성 유방암의 영상의학적 소견: 증례 보고)

  • Ji-Young Kim;Soung Hee Kim;Myeong Ja Jeong;Ji Hae Lee;Mi-Jin Kang;Geumhee Gwak;Su Hyun Yoo
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1385-1393
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    • 2022
  • Metaplastic carcinoma of the breast is a heterogeneous group of neoplasms with mixed epithelial and mesenchymal differentiation. Metaplastic carcinoma of the breast is a rare and aggressive malignancy, with high recurrence and metastasis. Metaplastic carcinoma with chondroid differentiation is an uncommon subtype that tends to have a relatively good prognosis than that of other subtypes. We report the imaging features of three cases of pathologically proven metaplastic carcinoma with chondroid differentiation as follows: a high-density mass with amorphous or coarse heterogeneous calcifications on mammography; a microlobulated or partially indistinct, complex cystic, and solid mass on sonography; and a relatively circumscribed or partially indistinct, irregular mass with heterogeneous T2 high-signal intensity and heterogeneous or rim enhancement with initial fast enhancement and delayed washout on MRI.

Postpartum Galactocele in Augmented Breast after Using Breast Pump Mimicking Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report (유방확대술 받은 수유 중인 여성에서 유축기를 사용한 뒤 발생한 유방 보형물 관련 역형성 거대 세포 림프종 모방 산후 젖낭종: 증례 보고)

  • Ga Young Lee;Gi Won Shin;Young Mi Park;Anbok Lee;Ha Young Park;Yoo Jin Lee;Ji-Yeon Han
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1570-1574
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    • 2021
  • Post-partum galactocele is a common benign disease among breastfeeding women, whereas retromammary and peri-implant galactocele are relatively rare conditions. Herein, a 34-year-old, 1 month-postpartum female, who had augmentation mammoplasty and a 1-month history of breast pump use, presented with left breast enlargement for 2 weeks. An initial left breast US revealed hyperechoic peri-implant fluid collection. Additional US-guided fine needle aspiration was done using a 21G-needle, draining the milk component in the process, and cytologic results revealed numerous crystals, suggestive of galactocele. Various diseases, especially breast implant-associated anaplastic large cell lymphoma, can cause peri-implant fluid collection in an augmented breast. Thus, correlating imaging features with clinical information and cytologic analysis plays an important role in appropriate management.

A Case of Columnar Cell Variant of Papillary Thyroid Carcinoma (갑상선 유두암 원주세포변형 1예)

  • Choe, Si Hong;Lee, Donghoo;Jung, Soo Jin;Kim, Do Hun
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.281-285
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    • 2018
  • Columnar cell variant of papillary thyroid carcinoma (CCV-PTC) is a rare variant representing 0.15-0.2% of all PTCs. The CCV is aggressive, due to its rapid growth, high local recurrence rate, and frequent lung, brain and bone metastasis. Aggressive surgical and medical management are recommended for these neoplasias. The authors experienced a case of CCV-PTC in a 45-year-old man. We performed total thyroidectomy with neck dissection. The patient received radiation and radioactive iodine therapy. There were no recurrences or complications in the following 24 months after the operation. The patient will closely undergo continuous follow up. We present the clinical characteristics, pathology, treatment, and prognosis of the tumor with a review of the literature.

Surgical Treatment of Talar Chondroblastoma via Partial Posterior Medial Malleolar Osteotomy: A Case Report (내과의 부분후방절골술을 통한 거골연골모세포종의 수술적 치료: 증례 보고)

  • Oh Jun Yu;Jin Soo Suh;Han Sung Kim;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.2
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    • pp.75-78
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    • 2023
  • During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixation when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

Effect of Severe Limb Purpura Following the Administration of COVID-19 Vaccination on a Diabetic Foot Requiring Amputation: A Case Report (COVID-19 백신 투여 이후 발생한 심한 사지 자반증이 절단을 요하는 당뇨발에 미치는 영향: 증례 보고)

  • Kim, Byung Ho;Suh, Jin Soo;Chang, Sun Hee;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.48-53
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    • 2022
  • The current SARS-CoV-2 coronavirus disease 2019 (COVID-19) pandemic has been a particular challenge for diabetes patients. Since these patients are at a higher risk of COVID-19, they have been prioritized for vaccination. In this report, we describe the case of a patient scheduled for diabetic foot amputation who received the first dose of ChAdOx1 nCov-19 vaccine and subsequently developed severe purpura in his genitalia and both of his hands and feet, accompanied by acute renal failure. The operation had to be postponed as severe limb purpura appeared just before the operation. With adequate management for acute renal failure and topical steroid application for the severe purpura lesions, a successful outcome could be obtained after the delayed first ray amputation. We recommend that COVID-19 vaccination should be carefully administered in patients with a diabetic foot requiring amputation.