• Title/Summary/Keyword: 서울대학교병원

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Status of Interchange of Medical Imaging in Korea: A Questionnaire Survey of Physicians (영상정보교류 실태 파악을 위한 의사 설문조사)

  • Choi, Moon Hyung;Jung, Seung Eun;Kim, Sungjun;Shin, Na-Young;Yong, Hwan Seok;Woo, Hyunsik;Jeong, Woo Kyoung;Jin, Kwang Nam;Choi, SeonHyeong
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.247-253
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    • 2018
  • The purpose of this study was to summarize the results of a survey for physicians with specialties other than radiology about imaging studies of patients referred from other institutions. The survey was promoted through individual contacts or social network service and physicians who voluntarily responded to the survey were the subjects of the study. The questionnaire consisted of 11 questions about basic information and referrals about medical imaging. A total of 160 physicians from 30 specialties participated in the survey and 95.6% of the respondents worked in tertiary care center or general hospital. Patients were frequently referred with outside medical images. The most frequently referred imaging modalities were computed tomography and magnetic resonance imaging. However, radiological reports from outside institutions were rarely referred. Most physicians thought that reinterpretation for outside imaging is necessary to acquire a secondary opinion. In conclusion, considering that outside radiological reports are frequently missing and there are high demands on reinterpretation for outside imaging, guidelines for referral of radiological reports with medical imaging, basic elements of radiological reports, and reinterpretation need to be developed.

Concurrent Use of Nefopam vs. Ketorolac with Opioid Analgesic for Post-operative Pain Management (수술 후 통증조절 목적으로 펜타닐과 병용되는 네포팜 vs. 케토롤락의 사용현황)

  • Kim, Yoon Hee;Kim, Young Won;Choi, Kyung Suk;Lee, Jung Hwa;Lee, Eunsook;Kim, Seungyeon;Choi, YoungRok;Lee, Euni
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.4
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    • pp.279-284
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    • 2018
  • Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer (조기위장관암 내시경 치료 임상진료지침)

  • Park, Chan Hyuk;Yang, Dong-Hoon;Kim, Jong Wook;Kim, Jie-Hyun;Kim, Ji Hyun;Min, Yang Won;Lee, Si Hyung;Bae, Jung Ho;Chung, Hyunsoo;Choi, Kee Don;Park, Jun Chul;Lee, Hyuk;Kwak, Min-Seob;Kim, Bun;Lee, Hyun Jung;Lee, Hye Seung;Choi, Miyoung;Park, Dong-Ah;Lee, Jong Yeul;Byeon, Jeong-Sik;Park, Chan Guk;Cho, Joo Young;Lee, Soo Teik;Chun, Hoon Jai
    • Journal of Digestive Cancer Reports
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    • v.8 no.1
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    • pp.1-50
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    • 2020
  • Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

A Case of Aggravation of Thyroid Goiter after Treatment with PD-1 Inhibitor for Breast Cancer in Patients with Underlying Hashimoto's Thyroiditis (기저 하시모토 갑상선염이 있던 유방암 환자에서 PD-1 억제제 투약 후 악화된 갑상선 종대의 증례)

  • Kim, Hana;Kim, Min Joo;Song, Young Shin;Cho, Sun Wook
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.172-175
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    • 2018
  • Anti-programmed cell death-1 (PD-1) humanized monoclonal antibody inhibits PD-1 activity by binding to the PD-1 receptor on T-cells and blocking PD-1 ligands and induces immune tolerance of cancer cells. It has been widely used for various kinds of cancer treatment. However, many immune-related adverse events (irAEs) have been reported because it modulates our immune system. In this case study, we reported a case of 42-year-old woman with Hashimoto's thyroiditis who showed rapid aggravation of thyroid goiter and acute hyperventilation syndrome after treatment with PD-1 inhibitor as a neoadjuvant chemotherapy for breast cancer.

Recalcitrant Low Back Pain Diagnosed as Hypophosphatemic Osteomalacia Induced by Antiviral Medication (항바이러스제에 의한 저인산성 골연화증으로 진단된 난치성 요통)

  • Chae, Hyun Jun;Won, Jun Hee;Lee, Won Kyung;Kim, Keewon
    • Clinical Pain
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    • v.20 no.2
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    • pp.131-134
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    • 2021
  • We report a rare case of anti-viral agent induced hypophosphatemic osteomalacia presented with localized and radicular pain. A 51-year-old man, who had been taking adefovir for chronic hepatitis, had experienced low back pain radiating to his right thigh for 2 years. With impression of lumbar disc herniation, he underwent magnetic resonance imaging and found multi-level disc herniation with facet joint synovial cysts. He received transforaminal epidural steroid injections, however, symptoms did not improve. To find other possible causes, additional tests were performed. Blood tests revealed hypophosphatemia and increased serum alkaline phosphatase, and osteoporosis was noted in dual-energy X-ray absorptiometry with multiple hot uptakes in bone scan. After replacement of adefovir to entecavir and supplement of phosphate and vitamin D, phosphate level and the clinical symptoms were improved. This is the first to report the presentation of osteomalacia due to anti-viral agent as radicular low back pain with facet synovial cysts.

Renal Biopsy (신장의 조직 검사)

  • Taek Min Kim;Jeong Yeon Cho;Sang Youn Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1198-1210
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    • 2023
  • The extent of renal biopsy indication is being widened because of the increasing incidence of incidental renal masses; the increasing treatment options for renal cell carcinoma, including ablation therapy and novel targeted treatment; and the increasing incidence of kidney transplantation. However, percutaneous renal biopsy is technically difficult, particularly for beginners, because the skin-to-organ distance is relatively longer than those associated with other organs. In the present review, we will discuss the indications, technical considerations, efficacy, and complications of renal biopsy. Furthermore, we share practical tips of renal biopsy through many examples to help radiologists perform renal biopsy safely and effectively in various situations.

Infiltrating Angiolipoma of the Cheek : A Case Report (볼에 발생한 혈관지방종: 증례 보고)

  • Kim, Jin Su;Lee, Seung Joon;Choi, Min Ho;Kim, Chang Hyen;Park, Je Uk
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.5
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    • pp.119-123
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    • 2018
  • Lipomas are the most common benign mesenchymal tumors composed of mature adipocytes. They are usually slow-growing, soft and asymptomatic masses. Angiolipomas are rare benign soft tissue tumors that are distinguished from common lipomas by a marked degree of vascularization. The diagnosis and prognosis of angiolipomas are based entirely on the findings of histological evaluations. Angiolipoma, showing characteristics of both lipoma and hemangioma, usually develop in the trunk and extremities, and rarely arise in the head and neck region. Angiolipoma of the cheek is very rare. This report presents the clinical and histopathological features of infiltrating angiolipoma excised from the cheek.

A Case of Squamous Cell Carcinoma arising from an Odontogenic Keratocyst (우측 하악의 치성 각화성 낭종 수술 후 발견된 암으로 내원한 63세 환자 1예)

  • Jae Eun, Oh;Chan Yeong, Lee;Kyeong Min, Kim;Min Sung, Tak;Hyung Kwon, Byeon
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.2
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    • pp.37-41
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    • 2022
  • Odontogenic keratocyst (OKC) accounts for 3-11% of all odontogenic cysts. OKC is a benign intra-osseous odontogenic tumor, but what makes this cyst special is its aggressive behavior and high recurrence rate. OKC is relatively aggressive compared to other odontogenic cysts, but its malignant transformation is considered extremely rare. Squamous cell carcinoma associated with odontogenic keratocysts have rarely been reported in the medical literature. We recently experienced a case of a 63-year-old man finally confirmed with squamous cell carcinoma of the mandible, which was initially diagnosed as a benign odontogenic keratocyst. Surgical resection was performed as definitive treatment. Therefore, we present this unique case with a review of the literature.

Six Cases of Diabetic Foot Wounds with Concomitant Skin Malignancies (당뇨발 창상에 동반되는 피부 악성종양 6예)

  • Tae Hun Kwon;Taeseung Lee;Changsik John Park;Yoon Hyo Choi;Kyoung Min Lee
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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    • pp.30-34
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    • 2023
  • Diabetic foot wounds have a significant effect on the health-related quality of life of patients. As diabetic foot wounds are usually chronic and recurrent, it is possible that they can lead to skin malignancies. Several factors can make it difficult to make an early and accurate diagnosis of skin malignancies of the foot in patients with diabetes mellitus. Even though the prevalence of diabetes mellitus and diabetic foot wounds is increasing, currently there are no guidelines for the biopsy of diabetic foot wounds. We have evolved a criterion for the above based on six cases of diabetic foot wounds with concomitant skin malignancies. We recommend that clinicians should broadly consider implementing this criterion when managing patients with diabetic foot wounds.

Pediatric Hip Disorders (소아 고관절 질환)

  • Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon;Seul Bi Lee;Yeon Jin Cho
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.531-548
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    • 2024
  • Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.