• Title/Summary/Keyword: C-Arm

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Once vs. Twice Daily Thoracic Irradiation in Limited Stage Small Cell Lung Cancer (국한성 병기 소세포폐암의 방사선치료시 분할 조사방식에 따른 치료성적)

  • Kim, Jun-Sang;Kim, Jae-Sung;Kim, Ju-Ock;Kim, Sun-Young;Cho, Moon-June
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.291-301
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    • 1998
  • Purpose : A retrospective study was conducted comparing single daily fraction (SDF) thoracic radiotherapy (TRT) with twice daily (BID) TRT to determine the potential benefit of BID TRT in limited-stage small cell lung cancer (SCLC). Endpoints of the study were response. survival, pattern of failure, and acute toxicity. Materials and Methods : Between November 1989 to December 1996, 78 patients with histologically proven limited-stage SCLC were treated at the Department of Therapeutic Radiology, Chungnam National University Hospital. Of these, 9 were irradiated for palliative intent, and 1 had recurrent disease. Remaining 68 patients were enrolled in this study. There were 26 patients with a median age of 58 years, and 22 (85$\%$) ECOG performance score of less than 1 in SDF TRT. There were 42 patients with a median age of 57 years, and 36 (86$\%$) ECOG performance score of less than 1 in BID TRT By radiation fractionation regimen, there were 26 in SDF TRT and 42 in BID TRT. SDF TRT consisted of 180 cGy, 5 days a week. BID TRT consisted of 150 cGy BID, 5 days a week in 13 of 42 and 120 cGy BID, in 29 of 42. And the twice daily fractions were separated by at least 4 hours. Total radiotherapy doses were between 5040 and 6940 cGy (median, 5040 cGy) in SDF TRT and was between 4320 and 5100 cGy (median, 4560 cGy) in BID TRT. Prophylactic cranial irradiation (PCI) was recommended for patients who achieved a CR. The recommended PCI dose was 2500 cGy/10 fractions. Chemotherapy consisted of CAV (cytoxan 1000 mg/$m^2$, adriamycin 40 mg/$m^2$, vincristine 1 mg/$m^2$) alternating with VPP (cisplatin 60 mg/$m^2$, etoposide 100 mg/$m^2$) every 3 weeks in 25 (96$\%$) of SDF TRT and in 40 (95$\%$) of BID TRT. Median cycle of chemotherapy was six in both group. Timing for chemotherapy was sequential in 23 of SDF TRT and in 3 BID TRT, and concurrent in 3 of SDF TRT and in 39 of BID TRT Follow-up ranged from 2 to 99 months (median, 14 months) in both groups. Results : Of the 26 SDF TRT, 9 (35$\%$) achieved a complete response (CR) and 14 (54$\%$) experienced a partial response (PR). Of the 42 BID TRT, 18 (43$\%$) achieved a CR and 23 (55$\%$) experienced a PR. There was no significant response difference between the two arms (p=0.119). Overall median and 2-year survival were 15 months and 26.8$\%$, respectively. The 2-year survivals were 26.9$\%$ and 28$\%$ in both arm, respectively (p=0.51). The 2-rear survivals were 35$\%$ in CR and 24.2$\%$ in PR, respectively. The grade 2 to 3 esophageal toxicities and grade 2 to 4 neutropenias were more common in BID TRT (p=0.028 0.003). There was no difference in locoregional and distant metastasis between the two arms (p=0 125 and 0.335, respectively). The most common site of distant metastasis was the brain. Conclusion : The median survival and 2-year survival were 17 months and 20.9$\%$ in SDF TRT with sequential chemotherapy, and 15 months and 28$\%$ in BID TRT with concurrent chemotherapy, respectively. We did not observe a substantial improvement of long-term survival in the BID TRT with concurrent chemotherapy compared with standard schedules of SDF TRT with sequential chemotherapy. The grade 2 to 3 esophageal toxicities and glade 2 to 4 neutropenias were more common in BID TRT with concurrent chemotherapy. Although the acute toxicities were more common in BID TRT with concurrent chemotherapy than SDF TRT with sequential chemotherapy, a concurrent chemotherapy and twice daily TRT was feasible. However further patient accrual and long-term follow up are needed to determine the potential benefits of BID TRT in limited-stage SCLC.

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A Clinical Evaluation of Splanchnic Nerve Block (내장신경차단에 관한 임상적 연구)

  • Kim, Soo-Yeoun;Oh, Hung-Kun;Yoon, Duek-Mi;Shin, Yang-Sik;Lee, Youn-Woo;Kim, Jong-Rae
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.34-46
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    • 1988
  • Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was $6.60{\pm}0.61\;cm$ on the left side and $6.60{\pm}0.83\;cm$ on the right side in group 2, and $5.46{\pm}0.76\;cm$ on the left side and $5.49{\pm}0.69\;cm$ on the right side in group 3. The average depth to which the needle was inserted was $8.60{\pm}0.52\;cm$ on the left side and $8.74{\pm}0.60\;cm$ on the right side in group 2, and $8.96{\pm}0.63\;cm$ on the left side and $9.18{\pm}0.57\;cm$ on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly, 51.8% on the left side and 54.4% n the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6won the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows, the spread upward along the anterior mal gin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, $39.17{\pm}6.69\;ml$ of 0.5% -l% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block $40.00{\pm}4.26\;ml$ of 50% alcohol was injected for the semipermanent block. In group 2, $13.75{\pm}4.88\;ml$ of 1% lidocaine were used as the test block and followed by $46.17{\pm}4.37\;ml$ of 50% alcohol was injected as the semipermanent block. In group 3, $15.63{\pm}1.19\;ml$ of 1% lidocaine for test block followed by $15.62{\pm}1.20\;ml$ of pure alcohol and $16.05{\pm}2.58\;ml$ of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanent block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narcotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But, in some cases it was 3 to i months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerve block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.

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Development of Micro Thermal Image Acquisition System (마이크로 열화상 계측 시스템의 IOT 모듈화 개발)

  • Lee, Jun-Yeob;Oh, Jong-woo;Lee, DongHoon
    • Proceedings of the Korean Society for Agricultural Machinery Conference
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    • 2017.04a
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    • pp.169-169
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    • 2017
  • 스마트 돈사 내의 열환경 분석에 필수적으로 고려되어야 인자는 가축의 복사 에너지 변화로 볼 수 있다. 열환경 제어의 대상이기도 하지만 회귀적으로 열환경 변화의 인자이기도 하다. 이러한 가축의 복사 에너지 분석을 위하여 시설 내에 용이하게 배포가 가능한 열화상 계측 시스템을 개발하였다. 초소형 마이크로 열화상 계측 시스템에 부가적으로 IOT(Internet of Thing) 기반 기술을 이용한 모듈화 개발을 병행하였다. 열화상 계측 센서로 LWIR(Longwave infrared)영역에 해당하는 $8{\mu}m{\sim}4{\mu}m$의 영역에서 $0.05^{\circ}C$의 분해능을 보이는 $Lepton^{TM}$ (500-0690-00, FLIR, Goleta, CA)모델을 사용하였다. SPI(Serial Peripheral Interface) 속도 2 Mhz로 마이크로프로세서(NanoPi NEO Air, FrendlyArm, CA, USA)와 고속 통신을 수행하여 9 Hz의 계측이 가능하다. 열화상 센서와 마이컴으로 구성되는 단위 계측 시스템의 통신 기능 확장을 위하여 다음과 같이 세 단계의 정보 전달 시나리오를 설계하였다. 1) 단독적으로 열화상을 계측 하고 내장된 메모리에 저장하는 형식 2) 인접한 사용자 인터페이스에서 1번 단독 모듈에 접속하여 열화상을 실시간으로 전송하여 화면에 도시하는 형식 3) 2번 사용자 도시모듈과 병행적으로 Local WI-FI 통신을 이용한 모바일 기기에 화면을 도시하는 형식. 이와 같은 계층적이며 모듈화된 계측 시스템을 구성하기 위해서 1번 모듈에 공개 소프트웨어인 Hostapd 2.5(http://w1.fi/hostapd)버전을 설치하였다. 외부 인터넷 환경이 없는 상황에 1번 모듈 단독으로 AP(Access Point) 기능을 제공하여 지근 거리에 있는 2번 모듈과 3번 모바일 기기의 접속을 관리할 수 있다. 2번 모듈의 경우 화면 다수의 1번 모듈에 접속을 교차적으로 수행하는 방식과 2번 모듈 자체가 AP가 되어 1번 모듈의 접속을 허용하는 형태로 구성되어 있다. 계측 시스템의 계측 매트릭스 구성에 따라 선택적으로 결정할 수 있다. 1번 2번 모듈 공통적으로 TCP/IP Listener와 Client 서비스를 병렬적으로 수행할 수 있도록 개발을 하였다. 3번 모바일 기기에서 사용자 인터페이스 구현을 위하여 범용 Android 기반 GUI 프로그램과 Socket 통신을 연동시켰다. 1개의 열화상 Frame의 전송량은 9,600 Byte ($=80{\times}60{\times}2Byte$) 로 WI-FI 통신 전송 시 2회 ~ 6회 정도 내외로 가변적인 통신 수행 횟수를 나타내었다. 센서 계측 시스템과 정보 전송 시스템을 병렬적으로 구성한 모듈화 된 계측시스템의 전 요소에서 센서에서 제공하는 최대 계측 주기인 9 Hz 구현이 일반적으로 가능하였다. 이를 이용한 추후 연구를 통해 가축 객체의 열복사 정보와 돈사 내 열환경 간의 역학성을 연구할 것이다.

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COMPARISON OF THE PHYSICAL PROPERTIES OF FOUR KINDS OF ACRYLIC RESIN DENTURE TEETH (4종 아크릴릭 레진 인공치의 물리적 성질에 관한 비교)

  • Hwang, Jong-Woo;Chung, Chae-Heon;Ko, Yeong-Mu
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.2
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    • pp.210-230
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    • 1995
  • To compare the wear resistance of four kinds of commercial acrylic resin teeth [SR-Orthosit PosterioresR(Ivoclar Co., Liechtenstein), Endura PosteriorR(Shofu Inc. Japan), trubyte IPN teethR(Dentsply International Inc., York,), Trubyte BiotoneR(dentsply Inermational Inc. Brazil) by means of the toothbrush abrasion method, the artificial resin teeth were embedded in epoxy resin with the occlusal surfaces aligned in one plane for a total of 40 blocks. There after, each lock was mounted in the arm of the toothbrush abrasion machine(K 236, Japan). Wear measurements were made on the three preconditioned states. Those were as follows : no treatment specimens, thermocycled specimens, and thermocycled specimens which were immeresed applied load of 400g during the buring the brushing cycle. At the end of the 30,000-stroke cycle, each specimen was removed, and weighed. The microhardness of four kinds of commercial resin teeth were determined by means of microhardness tester. Microhardness tests were performed on te no treatment specimens, thermocycled specimens, and thermocycled specimens with immersion in the denture cleansing solution. Finally, the comparison of thermal properties were perfomed using differential scanning calorimeter(DSC-1500). The following results were obtained : 1. In the case of no treatment teeth, the wear amount of endura Posterior(EN) was the greatest among the others(p<0.01), and the wear amount of three kinds of artificial resin teeth was increased in the order of Trubyte IPN teeth(IN), Trubyte Biotone(BN), SR-Orthosit Posteriores(SN) but there was no statistic significance(p>0.01). 2. The wear amount of Trubyte IPN teeth(IT) and Trubyte Biotone(BT), was increased due to thermocycling effect, but that of Endura Posteriores(ET) was decreased conversely(p<0.01). 3. Except for the SR-Orthosit Posteriores(STC), the wear amount of three kinds of artificial resing teeth(that is, ETC, ITC, BTC) was increased due to denture cleansing solution$(Cledent^R)$, but there was no statistic significance(p>0.01). But the wear amount of the SR-Orthosit Posteriores(STC) was the greatest among the others(p<0.01). 4. The wear amount of toothbrush was the greatest in case of contact with occlusal surface of SROrthosit Posteriores resin teeth(p<0.01). 5. the microhardness values(KHN) of the SR-Orthosit Posteriores was the highest among the experimental artificial resin teeth(p<0.01). 6. There was no relationship between microhardness valuse(KHN) and wear amount of four kinds of experimental artificial resin teeth(p<0.01). 7. The differential canning calorimetric property of four kinds of artificial resin teeth did not show endothermal or exothermal peak in the range of $100^{\circ}C$

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Mass Reduction and Physicochemical Properties of the Produced Compost during Composting Domestic Food Wastes in a Small Composter (소형 퇴비화용기에서 가정 음식물쓰레기의 퇴비화 과정 중 감량화 및 생산 퇴비의 물리화학적 특성)

  • Park, Ju-Won;Seo, Jeoung-Yoon
    • Korean Journal of Environmental Agriculture
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    • v.20 no.4
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    • pp.238-243
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    • 2001
  • Mass reduction and physicochemical properties of the produced compost were investigated during composting domestic food wastes without additive. A small composter used in this study had the height of 15 cm from the center of bottom half circle (diameter 24 cm) up to under the lid, the side length of 50 cm and the horizontal lid angle of $50^{\circ}$ and was operated at the heating unit temperature of $85^{\circ}$. It was mixed by the rotating arm for two minutes in every half hour while supplied with air flow at 3 L/min for 10 minutes in every half hour. This condition was found in a preliminary experiment as optimal for keeping the water content of composting material in the optimal range without adding any bulking materials. The domestic food wastes were added into the composter at the rate of 1 kg/day without additives during composting. The results were as follows; during the composting process, water content maintained in the range of $51.0{\sim}53.5%$. Hemicellulose and lignin contents did not show any tendency, but cellulose content decreased. During the composting process, $NH_3-N$ and $NO_2-N$ were not detected due to nitrification. The contents of inorganic compounds did not increase during the composting process. They were in the range of $1.32{\sim}1.71%\;P_2O_5$, $1.29{\sim}1.48%\;CaO$, $0.41{\sim}0.49%\;MgO$, and $0.38{\sim}0.74%\;K_2O$. For 20 days, weight reduction rate was 67.5% in wet basis, and decomposition rate was 48% in dry basis. Concentration of heavy metals (Cu, Cr, Cd, Pb, Zn, Hg, As) was less than the limiting value of the compost. Maturity of the produced compost was 3 grade through reaching maximum temperature of $46{\sim}48^{\circ}C$.

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A Clinical Evaluation of Splanchnic Nerve Block with Absolute Ethanol (무수 알코올에 의한 내장신경차단에 관한 임상적 연구)

  • Lee, Hyo-Keun;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.111-121
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    • 1991
  • It has been well known that the splanchnic nerve block is effective for patients who suffer from intractable upper abdominal pain. However, it is unclear whether the effect of the splanchnic nerve block depends on varied alcoholic concentration. In this study, an attempt was made to use absolute ethanol on patients who recieved a splanchnic nerve block at Severance Hospital during the period from September l990 to April l991. The results are as follows; 1) Among the 33 patients, including 22 males and 1l females, the fifties and sixties were the major age groups. 2) Stomach cancer was the most common underlying disease(13 cases), with pancreatic can- cer next(9 cases). 3) The main locations of pain were the upper abdomen, epigastrium, and entire abdomen in decreasing order. 4) There were 17 cases who had had chemotherapy, and 1l cases of whom had had surgery before the splanchnic nerve block. 5) The volume of alcohol used was 12 ml bilaterally. 6) Among the 33 patients, 15.2% required a second block within two weeks of the first block. One case required a third block. 7) The most common complications of splanchnic nerve block were hypotension(33.3%), occasional transient sharp burning pain, flushing of face, pain on injection site, nausea, vomiting, dyspnea, chest discomfort and diarrhea. 8) The supplemental block most commonly used was a continuous epidural block. It was used both as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 9) The interval between the receiving the absolute ethanol block and discharge was within 2 weeks in l5 cases. But, in the patients with poor general health, the interval between the splanchnic nerve block and discharge prolonged. The above results suggest that bilateral splanchnic nerve block done with absolute ethanol after an effective test block with 1% lidocaine under C-arm fluroscopic control is satisfactory and reliable. Still, 26.6% of the patients received a repeat block within 2 weeks. Insufficient spread of ethanol due to its small volume seems to be a major factor in the repeat block. Minimizing the incidence of repeat block remains a problem to be solved.

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The Dietary Status of Kindergarten Child from a High Socioeconomic Apartment Compound in Seoul (일부(一部) 고소득(高所得) 아파트 단지내(團地內) 유치원(幼稚園) 어린이의 성장발육(成長發育) 및 영양(營養)에 관(關)한 연구(硏究))

  • Hyun,, Wha-Jin;Mo, Su-Mi
    • Journal of Nutrition and Health
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    • v.13 no.1
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    • pp.27-36
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    • 1980
  • A dietary survey of 100 children, aged 5 to 6, of Y.C. Kindergarten located in Yowido apartment compound of Seoul, was conducted July 18 to August 21, 1979. The results are summarized as follows: General family environment: Ninety four percent of the subjects were from families having two to three children, without grandparents in the home. One hundred percent of fathers were educated at or above the college level, while 83.9% of mothers had completed college. Mothers' ages ranged from 30 to 40 years, with 58% in the $31{\sim}35$ age bracket. Nearly 60% of the fathers were office and government employees, 10% were professors and teachers, 30% were engaged in businesses and other work, while 91.3% of mothers were unemployed. Anthropometric measurements: Mean values of standing height, body weight, girth of head and girth of chest, ranged from the 75th to the 90th percentile of Korean standards. None of the subjects had anthropometric indicators below the 5th percentile, representing the malnutrition borderline, of the Korean standards; while 12%, 24%, 17% and 14% of subjects supposed the 97th percentile in standing height, body weight, girth of head, and girth of chest, respectively. Furthermore, 58% of subjects exceeded Jelliffe's standard in arm circumferences; 60%, in triceps skinfold thickness; and 14.5% of subjects exceeded 120% of the latter standard. From this data, a certain number of these children were judged to he rather overweight. Dietary intake: Mean intake per day of energy and of nutrients, excluding iron, reached or exceeded Korean recommended dietary allowances. The energy input ratio of carbohydrate: protein: fat was 61.4 : 13.2 : 25.4, showing lower dependance on carbohydrates and higher dependance on fat for energy needs, compared with the average for Korean children of the same age group. Mean FAO-protein score of each subject's diet was shown to be as high as 90.6. Energy intake was divided among breakfast, lunch, and evening meal, on the average, in a ratio of 19.6 : 24.1 : 23.0. Approximately 33.3% of the daily caloric intake came from the snacks. Nutrition Knowledge of mothers: Nutrition knowledge of mothers was highly scored. Mothers' self-evaluations of their knowledge of nutrition was highly correlated with attitudes toward nutrition behavior.

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Identification of Tumor Suppressor Genes on Chromosome 21 (제21번 염색체의 종양억제유전자 발굴)

  • Lee, Eung-Bae;Choi, Jin-Eun;Jang, Jin-Sung;Park, Jae-Yong
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.141-147
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    • 2009
  • Background: We performed this study to identify the tumor suppressor genes located in the long arm of chromosome 21 in non-small cell lung cancer. Material and Method: The genes of USP25 in 21q11.2, NCAM2, ADAMTS1 in 21q21.2, and Claudin-8 (CLDN8), Claudin-17 (CLDN17) and TIAM1 in 21q22.1 were investigated for their gene expressions, genetic alterations and promoter methylation. Result: The expressions of CLDN8 and CLDN17 were significantly decreased in 7 (L132, H157, H358, H522, H1299, H1703 and HCC2108) of 13 cell lines, and the expression of ADAMTS1 was also significantly reduced in 6 cell lines (A549, SW900, H1299, H1373, H1703 and H1793). There were no genetic alterations by PCR-SSCP and cDNA cloning in the cell lines with a decreased gene. In the cell lines with a decreased gene expression, the mRNA expression was increased significantly with treatment of 5-Aza-CdR. Conclusion: These results suggest that the ADMTS1, CLDN8 and CLDN17 may act as tumor suppressor genes.

The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome

  • Son, Jung-Hee;Kim, Sang-Dae;Kim, Se-Hoon;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.240-243
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    • 2010
  • Objective : Radiofrequency (RF) medial branch neurotomy is an effective management of lumbar facet syndrome. However, pain may recur after period of time. When pain recurs, it can be repeated, but the successful outcome and duration of relief from repeated procedures are not clearly known. The objective of this study was to determine the success rate and duration of pain relief from repeated radiofrequency medial branch neurotomy for lumbar facet syndrome. Methods : A retrospective review of medical records was done on 60 consecutive patients, from March of 2006 to February of 2009, who had an initial successful RF neurotomy but subsequently underwent repeated procedures due to recurrence of pain. All procedures were done in carefully selected patients after at least two responsive medial branch nerve blocks. C-arm fluoroscopic guide, impedance, sensory and motor threshold monitoring tools were used for the precise placement of electrodes. Responses of repeated procedures were compared with initial radiofrequency neurotomy for success rates and duration of pain relief. Results : There were 48 females and 12 males. Mean age was 52.4 years (range, 26-83). RF medial branch neurotomy was done on one side in 38 and both sides in 22 patients, each covering at least three segments. Average visual analog scale at last procedure was 6.8. Twelve patients had previous lumbar operations, including 4 patients with instrumentations. Fifty-five patients had two procedures and five patients had three procedures. Mean duration of successful pain relief (> 50% of previous pain for at least 3 months period) after initial radiofrequency neurotomy was 10.9 months (range, 3-28) in 51 (85%) patients. From repeated procedures, successful pain relief was seen in 50 (91%) patients with average duration of 10.2 months (range, 3-24). Five patients had third procedure, which was successful in 4 (80%) patients with mean duration of 9.8 months (range, 5-16). This was not statistically different from initial results. There were no permanent neurological complications from the procedures. Conclusion : Results of this study indicate that the frequency of success and durations of relief from repeated RF medial branch neurotomy for lumbar facet syndrome are similar to initial results that provided relatively prolonged period of pain relief without major side effects Each procedure seems to provide successful pain relief for about 10 months in more than 85% of carefully selected patients when properly done.

Correlations of Abnormal Involuntary Movements with Blood Glucose, Lipid Levels in Chronic Schizophrenics (만성정신분열병 환자들에서 비정상적 불수의 운동과 혈당, 지질과의 상관관계)

  • Kim, Hyeong-Seob;Kim, Eung-Jo;Lee, Joo-Ho;Ji, Seong-Hak
    • Korean Journal of Biological Psychiatry
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    • v.11 no.2
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    • pp.117-126
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    • 2004
  • Objects:It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. Methods:Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance- related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. Results:There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. Conclusion:In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of $HbA_1C$, waist, and weight are recommended for schizophrenics.

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