• Title/Summary/Keyword: Fluoroscopic guidance

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Ingested Foreign Body Trapped in the Appendix: A Case Report (충수에서 발견된 섭취된 이물질 1예)

  • Ahn, Young-Jae;Park, Yoon-Joon;Kim, Myung-Joon;Han, Seok-Joo;Oh, Jung-Tak
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.217-221
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    • 2007
  • Foreign body ingestion is a frequent event in the pediatric age group, but the incidence of foreign bodies in the appendix is very low. The authors report a case of ingested foreign body trapped in the appendix in a 7-year-old girl. The foreign body was successfully treated by laparoscopic appendectomy under fluoroscopic guidance.

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Epidural Catheter Malposition in a Failed Epidural Anesthesia Confirmed by Computed Tomography

  • Lee, Se-Jin;Kim, Sang-Ho;Park, Sun-Young;Kim, Mun-Gyu;Jung, Bo-Il;Ok, Si-Young
    • The Korean Journal of Pain
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    • v.24 no.1
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    • pp.44-47
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    • 2011
  • We report a case of failed epidural anesthesia despite successful identification of the epidural space, loss of resistance technique, hanging drop method and drip infusion. This case evaluated the use of computed tomography to confirm epidural catheter position, which showed the catheter accidentally positioned at the T2 lamina. Because epidural anesthesia can even after successful procedure using standardized techniques such as loss of resistance, we recommend performing the procedure under fluoroscopic guidance to improve success rate and patient safety.

Flexible covered stent ; development and clinic application (Flexible covered stent의 개발과 임상응용)

  • Suh, S.W.;Kim, I.Y.;Hong, T.M.;Kim, W.K.;Choo, S.W.;Do, Y.S.;Choo, I.W.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.335-336
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    • 1996
  • Flexible, self-expanding metallic stent were developed using igzag wire bend and segmented polyurethane. Mechanical properties of these stents were tested using INSTRON. These stents were used for palliative treatment of mallignant esophagogastric strictures(3 case) and bawl preparation of collorectal obstruction(10 case). All stents were inserted with fluoroscopic guidance without techinal failures. According to the results, these stents are easy to insert, safe, and very effective for dilation of strictures in curved GI tract.

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Patient Dose for Diagnostic Radiological Procedures in Korea (일반 X-선 촬영에서의 환자피폭선량에 관한 조사연구)

  • Kim, You-Hyun;Choi, Jong-Hak;Kim, Sung-Soo;Lee, Chanh-Yeup;Lee, Young-Bae;Kim, Chel-Min
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.59-63
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    • 2004
  • IAEA's Guidance Levels have been provided for Western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of korean people's proportions. Therefore, We need to develope the standard doses for korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in korea. 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. The results were as follows; 1) General radiographic equipments were 43%, fluoroscopic equipments 29%, dental equipments 13%, CT units 8% and mamographic units 7%. 2) According to classification by rectification way, three-phase equipments were 30%, inverter-type generators 29%, single- phase equipments 26%, unknown units 6%. 3) According to classification by receptor system, film-screen types were 46%, CR types 27%, OR types18% and unknown types 9%. 4) The number of examinations were chest 48%, spine 17% and abdomen 13%. 5) Patient doses were head AP 3.1 mGy, abdomen AP 3.5 mGy and chest PA 0.4 mGy.

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Ultrasound-guided Distance Measurements of Vertebral Structures for Lumbar Medial Branch Block (초음파 유도하에서의 요추부 후관절 내측지 차단술을 위한 주요 척추 구조물의 거리 측정)

  • Moon, Jin Cheon;Shim, Jae Kwang;Jo, Kwang Yun;Yoon, Kyung Bong;Kim, Won Oak;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.111-115
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    • 2007
  • Background: Selective diagnostic blocks of the medial branches of the dorsal primary ramus are usually performed under the guidance of fluoroscopic or computed tomography. Recently, however, ultrasound guidance has been suggested as an altemative method. In this study, the distances between the vertebral structures were measured and compared with the values measured using magnetic resonance imaging (MRI) to assess the clinical feasibility of using ultrasound-guided block in Korean patients. Methods: Five male and 15 female patients were enrolled in this study. The target point of the medial branch block in our study was the groove at the base of the superior articular process, We measured the depth from the skin to the target point at the transverse process (d-TP) and to the most superficial point of the superior articular process (d-AP). Results: The d-TP and d-AP values measured under ultrasound guidance were concordant with the values measured using MRI. Conclusions: The images of the bony landmarks obtained under ultrasound examination could be useful for ultrasound-guided lumbar medial branch block.

Analysis of Intravascular Flow Patterns following Cervical Transforaminal Epidural Injection (경부 경추간공 경막외 차단술 시 혈관 내 조영에 대한 분석)

  • Hwang, Su Jin;Han, Kyung Ream;Kim, Sae Young;Kim, Nan Seol;Kim, Chan
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.52-57
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    • 2009
  • Background: Transforaminal epidural injection (TEI) may be useful to treat unilateral pain that has a dermatomal distribution. In this approach, the needle tip can be placed closer to the dorsal root ganglion and ventral aspect of the nerve root. However many studies have reported that serious complications following TEI occurred more frequently when it was conducted at the cervical level. One of the presumptive mechanisms of the complication is intravascular injection. Therefore this study was conducted to identify the incidence of complications in response to intravascular injections at cervical segments. Methods: This study included all patients, who visited our pain clinic and had radicular symptoms or herpes zoster associated pain. All procedures were conducted under fluoroscopic guidance with contrast enhancement by one of the authors. After the ideal needle position was confirmed by biplanar fluoroscopy, the blood aspiration through the needle hub was evaluated, and a 3 ml mixture of nonionic contrast (2 ml) with normal saline (1 ml) was injected at a rate of 0.3-0.5 ml/sec continuously under real time fluoroscopic visualization. We then classified the contrast spreading pattern as neural, simultaneous neural and vascular, or vascular. Results: A total 71 cervical TEIs were performed. In 26 cases (36.6%), the contrast only spread to the nerve sheath. However, 45 cases (63.4%) showed an intravascular spreading pattern, 37 (52.1%) of which showed a neural and vascular pattern and 8 (11.3%) of which showed only a vascular pattern. Conclusions: Approximately two thirds of the cases of cervical TEI were found to lead to intravascular spreading, which is much higher than the incidence reported in previous studies.

A Rat Pylorus Stricture Model to Create Stent-induced Granulation Tissue Formation (백서 날문부에서 스텐트 유도 조직 과증식 형성을 위한 전임상 모델에 관한 연구)

  • Kim, Min-Tae
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.559-565
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    • 2022
  • In this study, we intend to develop a granulation tissue formation model. As a pilot experiment, a contrast agent was injected into the pylorus in 3 rats, the normal pylorus lumen size was confirmed, and a stent was placed. Stent migration was confirmed in to the duodenum within 1 week. In this experiment, stent was sutured and fixed to induce granulation tissue formation after gastrostomy under a fluoroscopic guidance. Twenty rats were divided into Healthy Group / Gastrostomy Group. After anesthesia of the Gastrostomy Group, an abdominal incision was performed, and gastrostomy was performed under a fluoroscopic guidance, and a stent was placed into the pylorus. In order to prevent stent migration due to peristalsis, suture between the pylorus and the proximal end of the stent was performed. Postoperative behavior and weight changes were monitored daily. Four weeks after surgery, gastrointestinal fluoroscopy imaging was performed and rats were sacrifices. To evaluate the degree of granulation formation, the stent was sectioned transversely. Gastrostomy group was statistically significantly higher than Healthy Group in granulation area ratio (all p<.001). In conclusion, it is considered that the level of tissue overgrowth formation for preclinical evaluation of the pylorus stricture model through gastrostomy is appropriate as a research evaluation tool.

Transbronchial Lung Cryobiopsy for Diagnosing Interstitial Lung Disease: A Retrospective Single-Center Experience

  • Park, Jin Han;Jang, Ji Hoon;Kim, Hyun Kuk;Jang, Hang-Jea;Lee, Sunggun;Kim, SeongHo;Kim, Ji Yeon;Choi, Hee Eun;Han, Ji-yeon;Kim, Da Som;Kang, Min Kyun;Kang, Eunsu;Kim, Il Hwan;Lee, Jae Ha
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.341-348
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    • 2022
  • Background: An accurate diagnosis in patients with interstitial lung diseases (ILDs) by multidisciplinary discussion (MDD) based on histopathologic information is essential for optimal treatment. Transbronchial lung cryobiopsy (TBLC) has increasingly been used as a diagnostic alternative to surgical lung biopsy. This study aimed to evaluate the appropriate methods of TBLC in patients with ILD in Korea. Methods: A total of 27 patients who underwent TBLC were included. TBLC procedure details and clinical MDD diagnosis using TBLC histopathologic information were retrospectively analyzed. Results: All procedures were performed under general anesthesia with the fluoroscopic guidance in the operation room using flexible bronchoscopy and endobronchial balloon blocker. The median procedure duration was less than 30 minutes, and the median number of biopsies per participant was 2. Most of the bleeding after TBLC was not severe, and the rate of pneumothorax was 25.9%. The most common histopathologic pattern was alternative (48.2%), followed by indeterminate (33.3%) and usual interstitial pneumonia (UIP)/probable UIP (18.5%). In the MDD after TBLC, the most common diagnosis was idiopathic pulmonary fibrosis (33.3%), followed by smoking-related ILD (25.9%), nonspecific interstitial pneumonia (18.6%), unclassifiable-ILD (14.8%), and others (7.4%). Conclusion: This first single-center experience showed that TBLC using a flexible bronchoscopy and endobronchial balloon blocker with the fluoroscopic guidance under general anesthesia may be a safe and adequate diagnostic method for ILD patients in Korea. The diagnostic yield of MDD was 85.2%. Further studies are needed to evaluate the diagnostic yield and confidence of TBLC.

The Efficacy of Fluorograb for Paediatric Patients Dose Reduction during Pneumatic Reduction and Voiding Cystourethrography(VCUG) (영.유아의 배뇨성 방광-요도 조영술 및 방사선 공기 주입 정복술시 피폭선량 경감을 위한 fluorograb의 유용성)

  • Kim, Sang-Tae;Choi, Ji-Won
    • The Journal of the Korea Contents Association
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    • v.9 no.12
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    • pp.385-390
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    • 2009
  • The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.

The Efficacy of Fluorograb for Paediatric Patients Dose Reduction during Pneumatic Reduction and Voiding Cystourethrography (VCUG) (영아/유아의 공기 주입 정복술 및 방사선 배뇨성 방광요도 조영술시 피폭 선량 경감을 위한 FluroGrab의 유용성)

  • Kim, Sang-Tae;Choi, Ji Won;Han, Tae-Jong
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.1167-1172
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    • 2009
  • The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.

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