• Title/Summary/Keyword: Interventional Procedures

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A Criticism Regarding the Medical Rationale of Nucleoplasty Studies for Internal Disc Disruption (수핵성형술(Nucleoplasty)을 이용한 디스크 내장증(Internal Disc Disruption)의 치료 연구들의 의학적 논거에 대한 비판)

  • Hong, Youngki
    • The Journal of the Korea Contents Association
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    • v.22 no.9
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    • pp.570-582
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    • 2022
  • Nucleoplasty is a type of percutaneous disc decompression that has been developed to treat herniated intervertebral discs. Currently, in some clinics, researchers have also applied this procedure to patients with internal disc disruption, apart from the originally intended usage on herniated intervertebral discs. The purpose of this study is to evaluate the feasibility of this extended use based on medical logic. To achieve this, the author analyzed case studies on performing nucleoplasty on patients with internal disc disruption. The main points of the analysis are, first, the validity of the treatment evidence presented by the researchers and, second, the relevance of the patient selection criteria. As a result, it is judged that the therapeutic rationale of existing papers applying nucleoplasty to the treatment of internal disc disruption is unclear or inconsistent with general medical logic, and in the process of patient screening, discs that may be deemed inappropriate for percutaneous decompression are included. Therefore, the author believes that existing studies applying nucleoplasty to the treatment of internal disc disruption have the nature of somewhat adventurous experiments that are unnecessary or can cause potential side effects. In order to uphold patients' rights and improve the completeness of the study in the research process on this topic, the author thinks that it is essential to establish clearer therapeutic evidence than the current level of understanding and to have an elaborate patient screening process based on it.

Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

Evaluating the Impact of Attenuation Correction Difference According to the Lipiodol in PET/CT after TACE (간동맥 화학 색전술에 사용하는 Lipiodol에 의한 감쇠 오차가 PET/CT검사에서 영상에 미치는 영향 평가)

  • Cha, Eun Sun;Hong, Gun chul;Park, Hoon;Choi, Choon Ki;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.67-70
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    • 2013
  • Purpose: Surge in patients with hepatocellular carcinoma, hepatic artery chemical embolization is one of the effective interventional procedures. The PET/CT examination plays an important role in determining the presence of residual cancer cells and metastasis, and prognosis after embolization. The other hand, the hepatic artery chemical embolization of embolic material used lipiodol produced artifacts in the PET/CT examination, and these artifacts results in quantitative evaluation influence. This study, the radioactivity density and the percentage error was evaluated by the extent of the impact of lipiodol in the image of PET/CT. Materials and Methods: 1994 NEMA Phantom was acquired for 2 minutes and 30 seconds per bed after the Teflon, water and lipiodol filled, and these three inserts into the enough to mix the rest behind radioactive injection with $20{\pm}10MBq$. Phantom reconfigure with the iterative reconstruction method the number of iterations for two times by law, a subset of 20 errors. We set up region of interest at each area of the Teflon, water, lipiodol, insert artifact occurs between regions, and background and it was calculated and compared by the radioactivity density(kBq/ml) and the% Difference. Results: Radioactivity density of the each region of interest area with the teflon, water, lipiodol, insert artifact occurs between regions, background activity was $0.09{\pm}0.04$, $0.40{\pm}0.17$, $1.55{\pm}0.75$, $2.5{\pm}1.09$, $2.65{\pm}1.16 kBq/ml$ (P <0.05) and it was statistically significant results. Percentage error of lipiodol in each area was 118%, compared to the water compared with the background activity 52%, compared with a teflon was 180% of the difference. Conclusion: We found that the error due to under the influence of the attenuation correction when PET/CT scans after lipiodol injection performed, and the radioactivity density is higher than compared to other implants, lower than background. Applying the nonattenuation correction images, and after hepatic artery chemical embolization who underwent PET/CT imaging so that the test should be take the consideration to the extent of the impact of lipiodol be.

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