• Title/Summary/Keyword: Interventional Radiology

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Association Between Insulin-like Growth Factor-2 Expression and Prognosis after Transcatheter Arterial Chemoembolization and Octreotide in Patients with Hepatocellar Carcinoma

  • Xiong, Zheng-Ping;Huang, Fang;Lu, Meng-Hou
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3191-3194
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    • 2012
  • Objective: To investigate the association between the change of IGF-2 level in serum after transcatheter arterial chemoembolization (TACE) and hepatocellular carcinoma (HCC) progression, especially in relation to metastasis. Methods: IGF-2 in serum was measured by quantitative sandwich enzyme-linked immunosorbent assaybefore, 3 days and 4 weeks after TACE in 60 patients with HCC. The occurrence of HCC metastasis was also evaluated, 3 months after TACE. Results: (1) The average serum level of IGF-2 in the 60 patients with HCC was $136.5{\pm}87.3$ pg/ml; (2) A tendency for increase was observed with heterogenous uptake of octreotide and portal vein thrombosis. Metastatic foci were found in 37/38 patients in the group with IGF-2 increasing (97.0%), in contrast to 3/22 (13.6%) patients with IGF-2 decrease. Conclusion: The increase of IGF-2 level in serum appears to be associated with the occurrence of metastatic HCC after TACE and chemotherapy.

A Study on Evaluation of Portal Vein by Utilizing MIP Reconstruction in the PC Environment after Abdomen CT of Hepatic Artery Embolization Patients (간동맥 색전술 환자의 복부단층촬영 후 PC 환경에서 MIP재구성영상을 이용한 간문맥평가에 관한 고찰)

  • Kim, Young-Keun;Jang, Young-Ill;Heo, Young-Nam
    • Journal of radiological science and technology
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    • v.24 no.2
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    • pp.13-17
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    • 2001
  • When most patients are diagnosed with the quiet progressed hepatoma which often would make the operation impossible, the Interventional Radiology hepatic artery embolization is an extremely useful method for such patients. An existence of the malfunction is evaluated by gaining a portal vein image as a delayed phase image after injecting a contrast media into the superior mesenteric artery. However, it is difficult to make a definite judgement due to the extended exposure time with the peristalsis and the intestine gas obstructing the sharpness of the image when the Patient exposure time increases and due to the increased usage of contrast media and its side effect. The portal vein can be evaluated by obtaining the MIP image after reconstructing a 3-dimensional personal computer setting using the 2-dimensional from an enhancement abdomen CT image that is almost a requisite in operation to a hepatoma patient. Such method nay prevent a decrease in the quality of image based upon the time delay and intestine gas; also, because the patient exposure dose and contrast media usage may be reduced, it is a new, valuable way to decide the operational matter of hepatic artery embolization on a pre-angiography.

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Factors Affecting the Radiation Protection Behavior of Nurses Using the Educational Diagnostic Stage of the PRECEDE Model (PRECEDE모형의 교육적 진단단계를 활용한 간호사의 방사선 방어행위 수행도 영향요인)

  • Kim, Sang Hwa;Lee, Eun Nam
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.278-288
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    • 2020
  • Purpose: This study aimed to identify the influencing factors that affect the radiation protection behavior of nurses, by applying the educational diagnostic stage of the PRECEDE Model. Methods: Participants were 167 nurses working in interventional procedure rooms and operating rooms in general hospitals and university hospitals in Korea. Data were collected from August 30 to September 25, 2019, through self-reporting questionnaires and analyzed with t-test, ANOVA, Pearson's correlation coefficients, and hierarchical multiple regression analysis using the SPSS/WIN 25.0 program. Results: The influencing factor that affects nurses' radiation protection behavior was the radiation protection environment (β=.41, p<.001), accounting for 59.6% of the radiation protection behavior (F=17.34, p<.001). Conclusion: Administrative and financial efforts to create a safe organizational atmosphere and establish a safe radiation protection environment are needed. Moreover, it is necessary to develop guidelines for nursing work in radiology to improve radiation protection behavior and reduce nurses' radiation exposure.

A Study on Die Design Optimization for Microcatheter Extrusion Processes (마이크로 카테터 압출 공정을 위한 다이 설계 최적화에 관한 연구)

  • Jo, Seunggi;Lee, Euntaek
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.20 no.1
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    • pp.34-41
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    • 2021
  • Interventional radiology and minimally invasive surgery both require a precisely shaped microcatheter. Microcatheters are manufactured using polymer extrusion processes with a die and puller. The manufacturing parameters and die geometry greatly influence the profile of the extrudate and designing dies using a trial-and-error process is expensive and requires a lot of time. Therefore, predicting the profile of the extrudate is important for manufacturing microcatheters. This study investigates the effects of die design and geometry on the profile of the extrudate. The profiles of the extrudate are predicted using ANSYS Polyflow with respect to the different die geometries. The outer and inner diameters and wall thickness of the predicted extrudate are compared to those of a target extrudate. The die swell of melt polymer and the effect of the pulling are both examined. Optimized die designs are suggested for manufacturing the target extrudate.

Ruptured uterus in a 36-week pregnant patient with hemorrhagic shock after blunt trauma in Korea: a case report

  • Sebeom Jeon;Suyoung Park;Soohyun Oh;Jayun Cho
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.281-285
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    • 2023
  • Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 35-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.

Stereotactic Vacuum-Assisted Core Biopsy Results for Non-Palpable Breast Lesions

  • Agacayak, Filiz;Ozturk, Alper;Bozdogan, Atilla;Selamoglu, Derya;Alco, Gul;Ordu, Cetin;Pilanci, Kezban Nur;Killi, Refik;Ozmen, Vahit
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5171-5174
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    • 2014
  • Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.

Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion (미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교)

  • Kim, Won Hyo;Kim, In Soo;Kong, Chang gi;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.319-336
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    • 2020
  • The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.

Usefuless of Multi-functional Gastroduodenal Coil Catheter with Phantom (팬텀을 이용한 다기능 위.십이지장관 코일 카테타의 유용성 평가)

  • Lim, Jin-Oh;Kim, Tae-Hyung;Jung, Yang-Hwa;Choi, Won-Chan;Shin, Ji-Hoon;Song, Ho-Young
    • Journal of radiological science and technology
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    • v.26 no.4
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    • pp.21-26
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    • 2003
  • To evaluate the newly designed gastroduodenal coil catheter:in-vitro test. The coil catheter that we made in our laboratory was 150 cm. The coil that is made of stainless steel wire was composed 1.3 mm inner diameter and this coil spring was covered with heat-shrinkable polyethylene tube. To measure the length under fluorocopy, 8 radiopaque marks were attached at 5 cm, 10 cm, 11 cm, 12 cm, 13 cm, 14 cm, 15 cm, 20 cm apart from distal end of the catheter and 6, 2, 1 pores were made at 7 cm, 13 cm, 19 cm apart from the distal end. Radio-opacity and the amount of injected contrast was investigated in formerly used 5 Fr. vessel catheter, which is possible in measuring length, and newly designed coil catheter. Film density was tested for radio-opacity with autodensitometer. For measuring the volume of injected salin, the catheter was located in the acryl box(26 cm, 3 cm, 16 cm) that divided into 4 chambers. After injection 50 cc of contrast with autoinjector, the contrast's quantity in each chamber was measured with and without over the guide wire. Radio-opacity was 0.51 in 5 Fr. vessel catheter, 0.31 in newly made catheter. The amount of injected contrast was measured. In case of 5 Fr. vessel catheter, the amount was 99.5% from the distal part, there was no difference between with and without the guide wire. Otherwise, using a coil catheter, the pacentage the ejected saline was 1.17%, 18.8%, 41.8%, 38.2% from the distal part with the guide wire, 19.5%, 32.6%, 27.7%, 20.3% without the guide wire. Compare with formerly established catheter, this new coil catheter is easy to measure the length thanks to easy confirming under fluoroscopy and excellent in injecting contrast. Therefore, newly designed gastrointestinal catheter seems to be useful in gastrointestinal intervention procedure.

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FAST Reappraisal: Cross-sectional Study (혈역학적으로 안정된 복부둔상환자에서 FAST의 유용성 평가)

  • Ha, Sang Hyun;Hong, Chong Kun;Lee, Jun Ho;Hwang, Seong Youn;Choi, Seong Hee
    • Journal of Trauma and Injury
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    • v.25 no.3
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    • pp.67-71
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    • 2012
  • Purpose: Focused Assessment with Sonography for Trauma (FAST) provides an important initial screening examination in adult trauma patients. However, due to its low sensitivity, FAST is not a replacement for computed tomography (CT) in hemodynamically stable trauma patients. The aim of this study was to determine the test characteristics of FAST in adult, hemodynamically stable, blunt abdominal trauma patients by using a critical action as a reference standard. Methods: The medical records for FAST examination at a single hospital from January 2009 to February 2011 were retrospectively reviewed. The inclusion criterion was isolated, hemodynamically stable, blunt abdominal trauma. Hemodynamically unstable patients or patients with penetrating injuries were excluded. The reference standard was the presence of a critical action, which was defined as one of the following: 1) operative intervention for a finding discovered on CT, 2) interventional radiology for bleeding, 3) transfusion of 2 or more packed RBCs, or 4) death at the emergency department. Results: There were 230 patients who met the inclusion criterion. There were 20 true positive, 206 true negative, 0 false positive, and 4 false negative results. The sensitivity and the specificity were 83% and 100%, respectively. Conclusion: Despite its low sensitivity for detecting any abnormal finding discovered on CT, negative FAST could aid to exclude critical action in hemodynamically stable, blunt abdominal trauma patients.

Successful Treatment of Lower Extremity Malperfusion Caused by Acute Aortic Dissection (급성 대동맥 박리증에 의한 하지 관류부전의 치료)

  • Lee, Jae-Hoon;Kim, Hyong-Tae;Kim, Young-Hwan;Choi, Sae-Young;Keum, Dong-Yoon;Park, Nam-Hee
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.934-938
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    • 2006
  • Organ malperfusion may mask the presence of aortic dissection and is one of major cause of death in patient with aortic dissection. Several key mechanism appear to contribute to the development of malperfusion, therefore optimal choosing of treatment is necessary to obtain better result. In cases of extremity malperfusion, open bypass procedures have been used for primary treatment, but noninvasive interventional procedures are also recommended as good alternatives in some cases. Here in, we report a case of successful aortic replacement followed by stent insertion in patient with extremity malperfusion caused by acute aortic dissection.