• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.109-113
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• 2010

Purpose: To evaluate the efficacy of ultrasound guided injection of prolotherapy and steroid mixture injection in patients with adhesive capsulitis. Materials and Methods: 53 patients with adhesive capsulitis were included in the study and in all the patients a mixture of steroid and prolotherapy agent was injected into the coracohumeral ligament under the sonographic guidance. The patients were evaluated using the VAS and ROM of the shoulder before the injection and at 8 weeks and at 1 year after the injection. Results: Forward flexion was 93.4 degrees before the injection and was 142, 153 degrees at 8weeks and 1 year after injection. Abduction was 79.2 degrees before the injection and was 125.4, 152.6 degrees at 8 weeks and 1 year after the injection. The VAS score was 6.7 before the injection and was 3.5, 3.7 at 8 weeks and 1 year after the injection. Conclusion: The ultrasound guided injection of prolotherapy and steroid mixture into the coracohumeral ligament in patients with adhesive capsulitis is allowing both tissue distension and inflammatory process controlling procedure. It is effective in improving the range of shoulder motion significantly and is also effective in decreasing the pain.

• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• 대한한약신문
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• s.122
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• pp.1-8
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• 2007

식약청장 "건의사항 합리적 방향 조화롭게 추진"/한방의료기관 한약 규격품 사용 의무화/'한약방' 의료비 연말정산자료 인터넷 제출 가능/서울지부, 긴급이사회.임시총회 개최/한약재 '주사' & '웅황' 사용 이렇게/한의학시장 개방시 중의학 잠식 우려/한의학연 최신 침구기술 공개/한약도매업무관리자 추가방안 철회 촉구/'한방 복합엑스산제' 보험급여 추진 논란/심천사혈요법 운영자 실형선고/부적합 판정을 받은 한약재/비증 이야기/신체의 일부 성형수술하면 전체 조화 깨져/명칭이 비슷하여 감별하기 어려운 한약재/지부탐방-제주지부장에게 듣는다/우리 약초를 찾아서-칡

• The Journal of the Korean dental association
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• v.57 no.4
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• pp.222-232
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• 2019

Injection therapy can be used to treat the refractory and chronic pain situations that are not well responded to conventional therapy in TMD-patients. The target of injection is the intra-articular- and peri-articular tissue of joint and adjacent tissue like muscle. For the success of injectional therapy, selection of injection solution and technique is essential, so discussion will be done about that and one of the promising techniques of intra-articular injection, US-guided TMJ Intrar-articular injection, is also discussed.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.85-89
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• 2009

Purpose: To analyze the clinical outcome after ultrasound guided multiple dry needlings and local steroid injection for acute calcific tendinitis of shoulder. Materials and Methods: Twenty patients with acute episode of pain by calcific tendinitis of shoulder with average age 58.2 (50~70 years) and follow-up of 18 months in average (range, 12~24) were included in study. There were 18 patients with right and 2 with left sided involvement. All patients had calcific deposits in the supraspinatus tendon. All patients underwent standardized nonoperative treatment protocol, consisting of 5~12 MHz high resolution ultrasound guided multiple dry needlings with 18 guage needle, followed by 2% lidocaine 1cc and 40 mg/ml depomedrol 1cc injection at site of calcific tendinitis. The outcome was assessed by UCLA shoulder score, range of motion and VAS score. A statistical analysis with ANOVA and Tukey's post-hoc test with the significance level at 5% was performed using SAS 9.1 software (SAS Institute, Cary, NC). Results: All patients got continuous relief of pain right after the procedures until final follow-up. Before the procedures, the UCLA scores were fair in 15 patients and poor in 5. After the procedures, the UCLA scores were excellent in 16 patients and good in 4. All cases revealed no limitation of shoulder function. The average VAS score decreased from 8.9 before the procedures to 0.5 at final follow-up (p<0.0001). No complication was encountered. Conclusion: An ultrasound guided local steroid injections following multiple dry needlings would be one of the useful treatment modality for the acute calcific tendinitis of shoulder.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.101-110
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• 2011

To describe the background, mechanism, clinical results and complications of prolotheapy based on the literature review. Prolotherapy is a minimally invasive injection-based treatment of chronic musculoskeletal pain, including ligament and joint laxity. The mechanism of this injection-based technique is to initiate a local inflammatory response with resultant tissue healing. The used proliferants are classified by bio-mechanism to act in three different ways as osmotic, irritants, and chemotatics. The most commonly used proliferant is hyperosmolar (10~25%) dextrose to act by osmotic rupture of cells. High resolution ultrasound imaging of musculoskeletal structure provide a more accurate diagnosis. Also ultrasound-guided intervention provides a more high efficacy and low rate of complications. The most common complication is local pain at the injected site, that is self-limited and good responsive to anti-inflammatory agents. Other complications are rare. It is reported that prolotherapy appears safe when performed by an experienced clinician. Prolotherapy has grown in popularity and has received significant recent attention. However there are limited evidence-based data supporting the indication and efficacy of prolotherapy in the treatment of chronic musculoskeletal pain or soft tissue injuries. Future studies are necessary to determine whether prolotherapy can play an independent and definitive role in a treatment for chronic musculoskeletal pain.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.976-982
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• 2006

Purpose: The purpose of this study was to compare the feeling state guided imagery(FSGI) and end state guided imagery(ESGI) on stress and performance of an intramuscular injection of nursing students. Method: The design was a time series with a nonequivalent control group pretest-posttest study. Data was collected from the 23 rd to the 25th of Nov. 2004. The subjects of this study were 40 female sophomores (21 for the ESGI, 19 for the FSGI). The instruments used in this study were the Visual Analogue Scale for Stress and the Nursing Skill Performance Check-list on Intramuscular Injection developed by the researchers(10 items). Guided imagery was provided through audiotapes for 8 minutes. A pretest was given before applying the guided imagery, posttest 1 was performed after the intervention, posttest 2 was performed before the intramuscular injection and then evaluation of the performance of the intramuscular injection was done. Data was analyzed using t-test, and Repeated Measures ANOVA. Result: The level of stress for those who received the ESGI and FEGI was not significant and the level of the nursing skill performance for those who received the ESGI was significantly higher than that of students who received the FEGI. Conclusion: The use of ESGI has an effect on learning psychomotor nursing skills and further research is needed on stress.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.15 no.6
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• pp.463-470
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• 2022

Intravenous injection is widely used for patient treatment, including injection drugs, fluids, parenteral nutrition, and blood products, and is the most frequently performed invasive treatment for inpatients, including blood collection, peripheral catheter insertion, and other IV therapy, and more than 1 billion cases per year. Intravenous injection is one of the difficult procedures performed only by experienced nurses who have been trained in intravenous injection, and failure can lead to thrombosis and hematoma or nerve damage to the vein. Nurses who frequently perform intravenous injections may also make mistakes because it is not easy to detect veins due to factors such as obesity, skin color, and age. Accordingly, studies on auxiliary equipment capable of visualizing the venous structure of the back of the hand or arm have been published to reduce mistakes during intravenous injection. This paper is about the development of venous detection equipment that visualizes venous structure during intravenous injection, and the optimal combination was selected by comparing the brightness of acquired images according to the combination of near-infrared (NIR) LED and Filter with different wavelength bands. In addition, an image processing algorithm was derived to threshehold and making blood vessel part to green through grayscale conversion, histogram equilzation, and sharpening filters for clarity of vein images obtained through the implemented venous detection experimental module.

• Journal of Korean Academy of Nursing
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• v.32 no.6
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• pp.784-791
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• 2002

The anxiety and stress of nursing students on performance intramuscular injection diminished nursing skill performance. The purpose of this study was to identify the effects of the guided imagery program on anxiety, stress and nursing skill performance of nursing students. Method: The study design was time series with a nonequivalent control group pretest- posttest study. The Data were collected from the 30th of Oct. to the 6th of Nov. 2001. The objects of this study were 36 sophomores of university(18 for the experimental group, 18 for the control group). The Instruments used in this study were State Trait Anxiety Inventory developed by Spielberger (1972), Visual Analogue Scale for Stress and Nursing skill performance developed by the researcher. The guided imagery was provided through audiotapes to the subjects for 8 minutes. The pretest was given before the therapy to measure variables for both groups and the posttests were performed after intervention. The data were analyzed by the SAS program using t-test and paired t-test. Result: The results of this study are as follows. The level of anxiety of students who received the guided imagery were significantly lower than that of control group. the level of stress had a deeling tendency and the nursing skill performance level was significantly higher than that of control group. Conclusion: The guided imagery suggested as an effective nursing intervention did reduce the anxiety and promoted nursing skill performance of nursing students.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.245-250
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• 2005

The syndrome of reversible posterior leukoencephalopathy syndrome(RPLS) is characterized clinically by acute neurologic signs such as headache, vomiting, confusion, seizures, and visual abnormalities. Radiologically, abnormalities consistent with reversible white matter edema in the occipital and parietal lobes are characteristic. RPLS has often been associated with various systemic disorders, such as hypertensive encefhalopathy, eclampsia, and the use of intravenous or intrathecal immunosuppressive drugs. We report a case of RPLS that occurred after intravenous steroid pulse therapy and treatment with oral cyclophosphamide in a child with nephrotic syndrome, and we emphasize the importance of early recognition of RPLS in the treatment of nephrotic syndrome and appropriate management tn prevent Permanent neurologic disability. (J Korean Soc Pediatr Nephrol 2005;9:245-250)