• Title/Summary/Keyword: Blind injection

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INTERNATIONAL STANDARD PROBLEM 50: THE UNIVERSITY OF PISA CONTRIBUTION

  • Cherubini, Marco;Lazzerini, Davide;Giannotti, Walter;D'auria, Francesco
    • Nuclear Engineering and Technology
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    • v.44 no.6
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    • pp.587-596
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    • 2012
  • The present paper deals with the participation of the University of Pisa in the last International Standard Problem (ISP) focused on system thermal hydraulic, which was led by the Korean Atomic Energy Research Institution (KAERI). The selected test was a Direct Vessel Injection (DVI) line break carried out at the ATLAS facility. University of Pisa participated, together with other eighteen institutions, in both blind and open phase of the analytical exercise pursuing its methodology for developing and qualifying a nodalization. Qualitative and quantitative analysis of the code results have been performed for both ISP-50 phases, the latter adopting the Fast Fourier Transfer Based Method (FFTBM). The experiment has been characterized by three-dimensional behavior in downcomer and core region. Even though an attempt to reproduce these phenomena, by developing a fictitious three-dimensional nodalization has been realized, the obtained results were generally acceptable but not fully satisfactory in replicating 3D behavior.

Study on Image Quality Assessment in Whole Body Bone Scan (전신 뼈검사에서의 영상 평가 연구)

  • Kwon, Oh Jun;Hur, Jae;Lee, Han Wool;Kim, Joo Yeon;Park, Min Soo;Roo, Dong Ook;Kang, Chun Goo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.30-36
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    • 2015
  • Purpose Whole body bone scan, which makes up a largest percentage of nuclear medicine tests, has high sensitivity and resolution about bone lesion like osteomyelitis, fracture and the early detection of primary cancer. However, any standard for valuation has not yet been created except minimum factor. Therefore, in this study, we will analysis the method which show a quantitative evaluation index in whole body bone scan. Materials and Methods This study is conducted among 30 call patients, who visited the hospital from April to September 2014 with no special point of view about bone lesion, using GE INFINIA equipment. Enumerated data is measured mainly with patient's whole body count and lumbar vertabrae, and the things which include CNR (Contrast to Noise ratio), SNR (Signal to Noise ratio) are calculated according to the mean value signal and standard deviation of each lumbar vertabrae. In addition, the numerical value with the abdominal thickness is compared to each value by the change of scan speed and tissue equivalent material throughout the phantom examination, and compared with 1hours deleyed value. Completely, on the scale of ten, 2 reading doctors and 5 skilled radiologists with 5-years experience analysis the correlation between visual analysis with blind test and quantitative calculation. Results The whole body count and interest region count of patients have no significant correlation with visual analysis value throughout the blind test(P<0.05). There is definite correlation among CNR and SNR. In phantom examination, Value of the change was caused by the thickness of the abdomen and the scan speed. And The poor value of the image in the subject as a delay test patient could be confirmed that the increase tendency. Conclusion Now, a standard for valuation has not been created in whole body bone scan except minimum factor. In this study, we can verify the significant correlation with blind test using CNR and SNR and also assure that the scan speed is a important factor to influence the imagine quality from the value. It is possible to be some limit depending on the physiology function and fluid intake of patient even if we progress the evaluation in same condition include same injection amount, same scan speed and so on. However, that we prove the significant evaluation index by presenting quantitative calculation objectively could be considered academic value.

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Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: Effects on the vital signs and onset, and duration of anesthesia

  • Lasemi, Esshagh;Sezavar, Mehdi;Habibi, Leyla;Hemmat, Seyfollah;Sarkarat, Farzin;Nematollahi, Zahra
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.4
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    • pp.201-205
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    • 2015
  • Background: This prospective, randomized, double-blind, clinical study was conducted to compare the effects of 4% articaine with 1:100,000 epinephrine (A100) and 4% articaine with 1:200,000 epinephrine (A200) on the vital signs and onset and duration of anesthesia in an inferior alveolar nerve block (IANB). Methods: In the first appointment, an IANB was performed by injecting A100 or A200 in 1 side of the mouth (right or left) randomly in patients referred for extraction of both their first mandibular molars. In the second appointment, the protocol was repeated and the other anesthetic solution was injected in the side that had not received the block in the previous session. Systolic and diastolic blood pressures (SBP and DBP) and pulse rate were measured during and 5 min after the injection. The onset and duration of anesthesia were also evaluated. Data were analyzed using t-test and Mann-Whitney U-test, and p-value was set at 0.05. Results: SBP and pulse rate changes were slightly more with A100; however, DBP changes were more with A200, although the differences were not significant (P > 0.05). There were no statistically significant differences in the parameters evaluated in this study. The onset and duration of anesthesia, and the changes in SBP, DBP, and pulse rate during and 5 min after the injection were the same in both the groups. Conclusions: For an IANB, A200 and A100 were equally efficient and successful in producing the block. Epinephrine concentration did not influence the effects of 4% articaine.

Effects of Preemptive Analgesia by Epidural Bupivacaine and Fentanyl on Postoperative Pain Control in Lower Abdominal Surgery (하복부 수술에서 경막외 Bupivacaine과 Fentanyl에 의한 선행진통법이 술후 통증관리에 미치는 효과)

  • Lee, Jun-Hak;Kim, In-Ryeong;Yoon, Chae-Sik;Chung, Eun-Bae;Lee, Ki-Nam;Moon, Jun-Il
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.185-190
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    • 1997
  • Background: Preemptive analgesia is an antinociceptive treatment that prevents the establishment of altered central processing which amplifies postoperative pain. A controversy exists over the effectiveness and clinical value of preemptive analgesia. We studied whether epidural bupivacaine and fentanyl prior to surgery could possibly affect postoperative pain and analgesic demands, as compared to administration of same at end of surgery. Methods: Forty patients scheduled for lower abdominal surgery were randomly assigned to one of two groups and prospectively studied in a double-blind method. Group 1(n=20) received epidural injection of 15 ml bupivacaine 0.25% with fentanyl 100 y g before surgery while group 2(n=20) received the same injection at the end of their surgery respectively. Postoperative analgesia consisted of basal plus patient-controlled mode of epidural bupivacaine and fentanyl from PCA system. Postoperative visual analog pain scores(VAPS), analgesics consumption, supplementary analgesics requirement and side effects were assessed for 3 postoperative days. Results: There were no significant difference in analgesics requirement and pain scores, at any time, during rest or after movement, in measurement between the groups. Conclusions: We conclude no clinical value of effectiveness in administering epidural bupivacaine-fentanyl before surgery as compared to administration after surgery.

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Description of a novel ultrasound guided peribulbar block in horses: a cadaveric study

  • Leigh, Hannah;Gozalo-Marcilla, Miguel;Esteve, Vicente;Bautista, Alvaro Jesus Gutierrez;Gimenez, Tamara Martin;Viscasillas, Jaime
    • Journal of Veterinary Science
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    • v.22 no.2
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    • pp.22.1-22.9
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    • 2021
  • Background: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naive to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.

Comparison the Soyeom Pharmacopuncture Therapy Effects of Ultrasound Guided Group and Unguided Group on the Patients' Facet Joint with Acute Low Back Pain Caused by Traffic Accidents: A Retrospective Study (교통사고로 유발된 급성 요통 환자의 후관절 소염약침 치료에 대한 초음파 유도하군과 비유도군의 효과 비교: 후향적 연구)

  • Park, Jeong-Wook;Kim, Sang Woo;Jeon, Dong-Hwi;Kim, Byung-Jun;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.3
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    • pp.85-93
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    • 2021
  • Objectives This study aims to compare the effect of an ultrasound on a guided group and an unguided group on Soyeom pharmacopuncture therapy on the facet joint in patients with acute low back pain caused by traffic accidents. Methods 21 patients with acute low back pain caused by traffic accidents from March 1, 2021 to May 31, 2021 were included in this study. The study was conducted as a retrospective study which analyzes the patient's medical records. 11 patients (Group A) received ultrasound guided Soyeom pharmacopuncture therapy and 10 patients (Group B) received unguided Soyeom pharmacopuncture therapy on the facet joint. Visual analogue scale (VAS) and Oswestry disability index (ODI) was used to evaluate improvements in functions and pain, and five point Likert scale to evaluate patient's satisfaction. Results Both groups showed a statistically significant decrease in the VAS and ODI on the 5th day of hospitalization. However, there was no statistically significant difference between the groups. Difference in the Likert scale between the groups was not statistically significant either. Conclusions We found that ultrasound guided Soyeom pharmacopuncture therapy on the facet joint showed similar efficacy compared with unguided Soyeom pharmacopuncture therapy at facet joint on acute low back pain patients caused by traffic accidents.

Evaluation of the efficacy and safety of epidural steroid injection using a nonparticulate steroid, dexamethasone or betamethasone: a double-blind, randomized, crossover, clinical trial

  • Lee, Guen Young;Lee, Joon Woo;Lee, Eugene;Yeom, Jin S.;Kim, Ki-Jeong;Shin, Hyung-Ik;Kang, Heung Sik
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.336-344
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    • 2022
  • Background: The U.S. Food and Drug Administration has prohibited epidural steroid injection (ESI) with particulate steroids. Thus, this study aimed to compare the efficacy and safety of ESI with two nonparticulate steroids, dexamethasone and betamethasone. Methods: The eligible patients (n = 600) who received ESI (0 week) with dexamethasone (ESI-dexa) or betamethasone (ESI-beta) had follow-up visits at 2, 4, and 8 weeks with a phone interview at 12 weeks. The primary endpoint was the proportion of effective responders without pain or who were much improved at 2 weeks. The secondary endpoints were the proportion of crossover injections at 2 weeks; changes in the visual analog scale (VAS) and disability index scores at 2, 4, and 8 weeks; the number of additional ESIs in 12 weeks; the number of participants having spinal surgery, as well as the incidence of adverse events over the 12 weeks. Results: The proportion of effective responders at 2 weeks was not different between ESI-beta (72/216, 33.3%) and ESI-dexa (63/200, 31.5%; P = 0.670). Adverse events were more common with ESI-dexa (40/200, 20.0%) than with ESI-beta (24/216, 11.1%; P = 0.012). VAS scores decreased more with ESI-beta than with ESI-dexa at 2 weeks (difference, 0.35; P = 0.023) and 4 weeks (difference, 0.42; P = 0.011). The disability score improved significantly more with ESI-beta compared with ESI-dexa at 2 weeks (difference, 3.37; P = 0.009), 4 weeks (difference, 4.01; P = 0.002), and 8 weeks (difference, 3.54; P = 0.007). Conclusions: Betamethasone would be more appropriate for ESI.

The Effects of distilled Rehmannia glutinosa Herbal Acupuncture on the Heart Rate Variability(HRV) (생지황 약침이 정상인의 심박변이도(HRV)에 미치는 영향)

  • Shin, Jin-Cheol;Kim, Lak-Hyung;Song, Beom-Yong;Yook, Tae-Han
    • Journal of Pharmacopuncture
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    • v.11 no.1
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    • pp.83-97
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    • 2008
  • Objectives : We investigated the effects of distilled Rehmannia glutinosa Herbal Acupuncture on autonomic nervous system with the Heart Rate Variability(HRV) in adult man. as well as we tried to observe how distilled Rehmannia glutinosa Herbal Acupuncture on the balance of the autonomic nervous system. Methods : We investigated on 58 healthy volunteers consisted of 28 subjects in experiment(distilled Rehmannia glutinosa Herbal Acupuncture) group and 30 subjects in control(Normal Saline) group. Study form was a randomized, placebo-controlled, double-blind clinical trial. 28 subjects in experiment group were injected distilled Rehmannia glutinosa Herbal Acupuncture at $GB_{21}$(Kyonjong) and 30 subjects in control group were injected Normal Saline at $G_{21}$(Kyonjong). except of 2 subjects(in control group) who can't be measured and 6 subjects(2 in experiment group and 4 in control group) who move or make unforceable error during measuring. Finally 26 subject in experiment group and 24 subject in control group are studied. We measured HRV by PolyG-I on 7 times : before and after injection per 5 minutes during 30 minutes. The SPSS 10.0 for windows was used to analyze the data and the paired t-test(in group) and Student t-test(between two groups) were used to verify the result. Results : 1. After distilled Rehmannia glutinosa Herbal Acupuncture injection, Mean HRV is significantly low only for first 5 minute, SDNN is significantly high after 5 minute, Complexity is significantly low only from 20 minute to 25 minute. HRV index is significantly high for first 5minute and from 10 minute to after 10 minute. 2. HRV index of distilled Rehmannia glutinosa Herbal Acupuncture Group significantly increased from 25 minute to 30 minute, and pNN50 of Rehmannia glutinosa Herbal Acupuncture Group significantly decreased from 20 minute to 30 minute compared with those of Normal Saline group. 3. After distilled Rehmannia glutinosa Herbal Acupuncture injection, Ln(TP) and Ln(VLF) are significantly high after injection. Normalized LF is significantly high from 5 minute to 20 minute and from 25 minute and 30 minute. Normalized HF is significantly low from 5minute to 20 minute and from 25 minute and 30 minute. 4. Ln(TP) and Ln(VLF) of distilled Rehmannia glutinosa Herbal Acupuncture Group significantly increased from 20 minute to 25 minute compared with those of Normal Saline group. Conclusions : The results suggest that Rehmannia glutinosa Herbal Acupuncture in healthy adult man tend to activate the autonomic nervous system and parasympathetic nervous system compared to Normal Saline within normal range.

Efficacy of intraosseous saline injection for pain management during surgical removal of impacted mandibular third molars: a randomized double-blinded clinical trial

  • Jawahar Babu. S;Naveen Kumar Jayakumar;Pearlcid Siroraj
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.3
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    • pp.163-171
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    • 2023
  • Background: Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. Methods: This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. Results: Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group) Conclusion: The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.

The Effect of Auricular Acupuncture on the Pulse Rate (이침 요법이 맥박의 변화에 미치는 영향)

  • Jang, Jun-hyouk;Kim, Ji-young
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.97-103
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    • 2003
  • Objective : Auricular acupuncture is a method of treatment that involves needling the ear in order to produce relief of symptoms. This concept was first developed by P.Nogier, french doctor and referred to as somatotopic representation. Many authors have commented the fact that the vagus nerve supplies the external auditory and the concha. The aim of this randomised, single blind study was to investigate whether auricular acupuncture of the ear produced changes in the pulse rate, an indicator of vagal tone. Methods: 10 healthy man volunteers were divided into normal and epinephrine stimulation group. Then each group was divided into vagus area acupuncture and control area acupuncture group again. Epinephrine stimulation group was injected by epinephrine 0.3cc twice, first. All of them were needled in either the vagus area or control area of the ear, and pulse rate changes were measured by patient monitor over 1 hour. Results : In the epinephrine stimulation group, there was significant differences in the pulse rate change between vagus area acupuncture and control area acupuncture group. After injection of epinephrine, the basal pulse rate was increased 1.3~1.4 times in the control group. However, in the vagus area acupuncture group the basal pulse rate was increased only 1.1~1.2 times.

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