• Title/Summary/Keyword: Guided mass

Search Result 163, Processing Time 0.025 seconds

Caudal and epidural blocks in infants and small children: historical perspective and ultrasound-guided approaches

  • Kil, Hae Keum
    • Korean Journal of Anesthesiology
    • /
    • v.71 no.6
    • /
    • pp.430-439
    • /
    • 2018
  • In infants and small children, ultrasound (US) guidance provides ample anatomical information to perform neuraxial blocks. We can measure the distance from the skin to the epidural space in the US image and can refer to it during needle insertion. We may also visualize the needle or a catheter during real-time US-guided epidural catheterization. In cases where direct needle or catheter visualization is difficult, US allows predicting successful puncture and catheterization using surrogate markers, such as dura mater displacement, epidural space widening due to drug injection, or mass movement of the drug within the caudal space. Although many experienced anesthesiologists still prefer to use conventional techniques, prospective randomized controlled trials using US guidance are providing increasing evidence of its advantages. The use of US-guided regional block will gradually become widespread in infants and children.

Percutaneous Ultrasound-Guided Fine-Needle Aspiration Cytology and Core-Needle Biopsy for Laryngeal and Hypopharyngeal Masses

  • Dongbin Ahn;Gil Joon Lee;Jin Ho Sohn;Jeong Eun Lee
    • Korean Journal of Radiology
    • /
    • v.22 no.4
    • /
    • pp.596-603
    • /
    • 2021
  • Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

MRI-guided Wire Localization Open Biopsy is Safe and Effective for Suspicious Cancer on Breast MRI

  • Wang, Hai-Yi;Zhao, Yu-Nian;Wu, Jian-Zhong;Wang, Zheng;Tang, Jing-Hai
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.5
    • /
    • pp.1715-1718
    • /
    • 2015
  • Background: Magnetic resonance imaging of breast, reported to be a high sensitivity of 94% to 100%, is the most sensitive method for detection of breast cancer. The purpose of this study was to investigate our clinical experience in MRI-guided breast lesion wire localization in Chinese women. Materials and Methods: A total of 44 patients with 46 lesions undergoing MRI-guided breast lesion localization were prospectively entered into this study between November 2013 and September 2014. Samples were collected using a 1.5-T magnet with a special MR biopsy positioning frame device. We evaluated clinical lesion characteristics on pre-biopsy MRI, pathologic results, and dynamic curve type baseline analysis. Results: Of the total of 46 wire localization excision biopsied lesions carried out in 44 female patients, pathology revealed fourteen malignancies (14/46, 30.4%) and thirty-two benign lesions (32/46, 69.6%). All lesions were successfully localized followed by excision biopsy and assessed for morphologic features highly suggestive of malignancy according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category of MRI (C4a=18, C4b=17, C4c=8,C5=3). Of 46 lesions, 37 were masses and 9 were non-mass enhancement lesions. Thirty-two lesions showed a continuous kinetics curve, 11 were plateau and 3 were washout. Conclusions: Our study showed success in MRI-guided breast lesion wire localization with a satisfactory cancer diagnosis rate of 30.4%. MRI-guided wire localization breast lesion open biopsy is a safe and effective tool for the workup of suspicious lesions seen on breast MRI alone without major complications. This may contribute to increasing the diagnosis rate of early breast cancer and improve the prognosis in Chinese women.

Histopathologic Diagnosis of Pleural Metastasis of Renal Cell Carcinoma Using Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

  • Kang, Yeh-Rim;Jhun, Byung-Woo;Jeon, Kyeong-Man;Koh, Won-Jung;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Han, Joung-Ho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
    • /
    • v.71 no.5
    • /
    • pp.355-358
    • /
    • 2011
  • Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful, safe diagnostic modality for evaluating mediastinal and hilar lymphadenopathy. We report a 51-year-old male who presented with a left renal mass and multiple pleural masses without lung parenchymal lesions. The pleural masses were thought to be metastatic tumors or malignant mesothelioma. The patient underwent two percutaneous needle biopsies of the pleural mass, but the specimens were insufficient for a histopathological diagnosis. Because one pleural mass was adjacent to the right main bronchus, we decided to perform EBUS-TBNA for the pleural mass. As a result, sufficient core tissue was obtained with no complications, and the histopathological findings were consistent with metastatic papillary renal cell carcinoma. To our knowledge, this is the first case of using EBUS-TBNA for a pleural mass.

Short-Wave Infrared Fluorescence-Guided Surgery Using Indocyanine Green in a Dog with a Cutaneous Mast Cell Tumor

  • Su-Hyeon Kim;Sungin Lee
    • Journal of Veterinary Clinics
    • /
    • v.39 no.6
    • /
    • pp.395-399
    • /
    • 2022
  • A 6-year-old spayed, female golden retriever dog was presented with a skin mass on the dorsal region of the right carpus. The cytology result of the region revealed characteristics of mast cell tumors (MCTs). Short wave-infrared fluorescence-guided surgery using Indocyanine green (ICG) was performed to determine the surgical margin of the tumor. ICG was injected intravenously 24 hours before the surgery and the patient was hospitalized and carefully monitored. During the surgery, ICG fluorescence-based surgery was performed to identify the tumor and the surgical margin. The tumor was visible, and the skin mass was resected using NIR device for the guidance of the surgical margin of the tumor. Once the resection was complete, the surgical site was again inspected with SWIR fluorescence imaging to identify residual tumor cells. The resected tumor, using ICG navigation, was classified as low-grade cutaneous MCT and the margin was complete on the histopathological result. We report herein a case of resection of a cutaneous MCT in a dog using SWIR fluorescence imaging ICG which can be potentially used for the identification of tumors and evaluation of the surgical margin for complete resection.

A Software Update Technique for Aircraft Missiles based on MIL-STD-1760 (MIL-STD-1760 기반 항공기용 유도탄 소프트웨어 업데이트 기법)

  • Lee, Seungyoun;Kim, Sungkwon;Lee, Hyunah;Cho, Dongsik
    • Journal of the Korea Institute of Military Science and Technology
    • /
    • v.21 no.5
    • /
    • pp.649-657
    • /
    • 2018
  • It is essential that weapons which are mounted on aircraft need to prove its reliability and safety during its developments. A guided missile should have high reliability and safety throughout various tests which are including ground tests, captive flight tests, detailed technical tests and operational tests. In these various tests, it is vital that software of each component in the guided missile should be easily updated in order to correct algorithms or errors. In this paper, we propose a software update technique based on MDTP(mass data transfer protocol) which are defined in MIL-STD-1760. The proposed techniques have the following advantages: First, software of each unit in a weapon can be updated through a test equipment without disassemble a guided missile. Second, development periods for a software update can be reduced by reusing MDTP. Third, we can easily maintenance of the software because it is based on standard. We proved its efficiency and validity through experiments. Therefore, the proposed technique should be effectively utilized for software update of a weapon mounted on an aircraft during development processes.

Percutaneous Ultrasound Guided Ethanol Ablation of Primary Hyperparathyroidism in a Dog (초음파 유도 에탄올 주입법을 이용한 개의 원발성 부갑상선항진증 치료)

  • Choi, Ji-Hye;Kim, Jin-Kyung;Kim, Hyun-Wook;Kim, Hak-Sang;Kim, Jun-Young;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
    • /
    • v.24 no.3
    • /
    • pp.457-460
    • /
    • 2007
  • Primary hyperparathyroidism (PHP) is rare in dogs. Mainly functional solitary parathyroid adenoma causes hypercalcemia due to excessive autonomous secretion of parathyroid hormone (PTH). PHP can be diagnosed based on serum calcium phosphorus, ionized calcium and PTH, and cervical ultrasound provides important information about the number size and location of parathyroidal lesion. Ultrasound guided intralesional ethanol injection has been used as an alternative to surgical treatment of PHP. In this case, PHP was diagnosed in 12 year-old Pug with clinicopathologic examination and cervical ultrasound, and the parathyroidal mass was ablated successfully through ultrasound guided ethanol injection.

Chest Wall Lipogranuloma after Hydrogel Implant Rupture: Case Report

  • Park, So Yoon;Han, Boo-Kyung;Cho, Eun Yoon;Bang, Sa-Ik
    • Investigative Magnetic Resonance Imaging
    • /
    • v.19 no.3
    • /
    • pp.191-195
    • /
    • 2015
  • We present a 53-year-old woman with a large chest wall mass in the interpectoral space, which was eventually confirmed as a lipogranuloma resulting from hydrogel implant rupture. Ultrasonography (US) showed reduced implant volume with surrounding peri-implant fluid collection, suggesting the possibility of implant rupture. A heterogeneously hypoechoic mass was found between the pectoralis major and minor muscles adjacent to the ruptured implant. On magnetic resonance imaging (MRI), there was a large mass in the left interpectoral space of the upper inner chest wall. The mass showed slightly high signal intensity (SI) on pre-contrast T1-weighted image (WI) with mixed iso and high SI on T2-WI. The signal of the mass was suppressed using the water suppression technique but not with the fat suppression technique on T2-WI. The mass showed diffuse enhancement upon contrast enhancement. The enhancing kinetics showed persistent enhancement pattern. US-guided core needle biopsy revealed a lipogranuloma and removal confirmed a ruptured PIP hydrogel implant.

Immunoglobulin G4-Related Disease Masquerading Anaplastic Thyroid Carcinoma

  • Kim, Ji-a;Jo, Min-gyu;Kim, Seok-hyun;Kim, Young Geum;Cha, Wonjae
    • Journal of Clinical Otolaryngology Head and Neck Surgery
    • /
    • v.29 no.2
    • /
    • pp.301-306
    • /
    • 2018
  • Immunoglobulin G4-related disease (IgG4RD) is a chronic inflammatory condition characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, as well as varying degrees of fibrosis. We report a case of a 70-year-old man with a rapid-growing cervical mass for several months. Computed tomography and positron emission tomography showed a huge, ill-defined mass involving left thyroid lobe and encasing the common carotid artery, which was clinically and radiologically suspicious for anaplastic thyroid carcinoma. Ultrasonography-guided core needle biopsy was performed and histopathology examination revealed to be consistent with IgG4RD, and the IgG4/IgG ratio was 0.6. After oral corticosteroid was administered, the mass was dramatically resolved. Because IgG4RD often presents as a single localized and infiltrated mass lesion, it can be confused and misdiagnosed as a malignancy. Thus, clinicians should consider IgG4RD as a differential diagnosis in a rapid-growing neck mass to prevent unnecessary and excessive treatments.

AN EXPERIMENTAL STUDY OF GUIDED BONE REGENERATION OF BONE DEFECTS IN RABBIT USING RUBBER DAM (가토에서 러버댐을 이용한 골결손부의 골조직 유도 재생술에 관한 실험적 연구)

  • Jang, Chang-Dug;Whang, Hie-Seong;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.21 no.2
    • /
    • pp.110-119
    • /
    • 1999
  • The principle of guided tissue regeneration (GTR), as applied to bone healing, is based on the prevention of connective tissue from entering the bony defect during the healing phase. This allows the slower bone producing cells to migrate into and reproduce bone within the defect. The principle of guided tissue regeneration has demonstrated a level of success in regenerating bone defect. Several types of membrane barrier, each one with distinct properties, have been utilized to apply this principle in bone regeneration. The purpose of this study is to introduce and discuss the attributes of rubber dam as a barrier membrane and evaluate whether improved bone regeneration can be achieved by GTR using rubber dam. In the 15 New Zealand white rabbits, full-thickness bone defects on three sites of each rabbit calvaria were made. Non membrane group served as a control and experimental group 1 was covered with rubber dam and group 2 covered with Gore-Tex$^{TM}$ membrane. Macroscopic, radiographic, microscopic examinations were made serially on 1, 2, 3, 6, 12 weeks after operation. The results were as follows: 1. Macroscopically, the control site was collapsed and filled with connective tissue throughout the experimental period. But the defects of experimental groups 1 and 2 were filled with bone-like mass and showed the hard consistency on palpation. 2. Radiographically, the early new bone formation appeared similarly from the host bone in groups 1 and 2. 3. Microscopically, there were much connective tissue at the central part of control site but the defect of group 1 and 2 was filled with the mature bony trabeculae on the 12th week. This results suggest that rubber dam can be effectively used as a barrier membrane for guided bone regeneration.

  • PDF