• 제목/요약/키워드: Interventional Therapy

검색결과 119건 처리시간 0.028초

The Blood Neutrophil-to-lymphocyte Ratio Predicts Survival in Patients with Advanced Hepatocellular Carcinoma Receiving Sorafenib

  • Zheng, You-Bing;Zhao, Wei;Liu, Bing;Lu, Li-Gong;He, Xu;Huang, Jian-Wen;Li, Yong;Hu, Bao-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5527-5531
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    • 2013
  • Background and Aim: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the prognostic significance of the blood neutrophil-to-lymphocyte ratio (NLR) in patients with advanced HCC who received sorafenib monotherapy. Methods: A total of sixty-five patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib were enrolled. Potential prognostic factors such as age, gender, tumoral characteristics, performance status and NLR were analyzed. Results: Median OS and TTP for the entire cohort were 10.0 months (95%CI, 7.6-12.3 months) and 4.5 months (95% CI, 4.0-4.9 months). The mean NLR at baseline was 2.89. The median OS of patients with a high NLR (>4) was 6.5 months (95%CI, 5.2-7.7 months) compared with 12.5 months (95%CI, 9.9-15.0) for patients with a normal NLR (${\leq}4$) (P=0.01). Age ${\leq}65$, NLR>4, extrahepatic metastases and vascular invasion were all predictors of poorer overall survival. Multivariate analysis showed that NLR > 4, vascular invasion and extrahepatic metastases were independent predictors of poorer overall survival. The median TTP of patients with a high NLR was 2.5 months (95%CI, 1.4-3.6 months) compared with 4.5 months (95%CI, 3.9-5.1 months) for patients with a normal NLR (P=0.012). Conclusions: High baseline NLR was associated with worse OS and TTP for patients with advanced HCC treated with sorafenib.

Pumpless extracorporeal interventional lung assist for bronchiolitis obliterans after allogenic peripheral blood stem cell transplantation for acute lymphocytic leukemia

  • Park, Yeon-Hee;Chung, Chae-Uk;Choi, Jae-Woo;Jung, Sang-Ok;Jung, Sung-Soo;Lee, Jeong-Eun;Kim, Ju-Ock;Moon, Jae-Young
    • Journal of Yeungnam Medical Science
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    • 제32권2호
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    • pp.98-101
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    • 2015
  • Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate $CO_2$ effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

허리엉치 안정화운동이 만성허리통증환자의 허리통증장애지수와 보행속도에 미치는 영향 (The Effect of Lumbosacral Stabilization Exercise on Oswestry Disability Index and Gait Velocity of Patients with Chronic Low Back Pain)

  • 강정일;정대근
    • 디지털융복합연구
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    • 제11권8호
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    • pp.243-250
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    • 2013
  • 본 연구는 허리엉치 안정화 운동프로그램이 만성 허리통증환자의 허리통증장애와 보행속도에 미치는 영향을 알아보고자 만성 허리통증환자 34명을 대상으로 실험군 18명과 대조군 16명을 무작위 추출 하였다. 실험 전 오스웨스트리-허리통증장애지수(Oswestry disability index) 검사와 보행속도 분석을 한 후, 실험군은 허리엉치 안정화 운동과 함께 물리치료의 전통적 중재 기법을 시행하고 대조군은 전통적 중재 기법만을 주 4회, 하루 30분, 4주간 시행하여 사후검사를 한 후, 집단별 실험 전과 실험 후의 허리통증장애지수와 보행속도를 비교하였다. 허리통증장애지수는 실험군과 대조군의 집단 내에서 유의한 차이가 있었고(p>.01)(p>.05), 보행속도는 실험군 집단 내와 집단간에서 유의한 차이가 있었다(p>.001)(p>.05).

Retroperitoneal Hematoma as a Serious Complication of Endovascular Aneurysmal Coiling

  • Murai, Yasuo;Adachi, Koji;Yoshida, Yoichi;Takei, Mao;Teramoto, Akira
    • Journal of Korean Neurosurgical Society
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    • 제48권1호
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    • pp.88-90
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    • 2010
  • Retroperitoneal hematoma (RH) due to radiologic intervention for an intracranial lesion is relatively rare, difficult to diagnose, and can be lifethreatening. We report a case of RH that developed in a patient on anticoagulant therapy following endovascular coiling of a ruptured anterior communicating artery (AcoA) aneurysm. An 82-year-old man presented with a 12-day history of headache. Computed tomography (CT) on admission demonstrated slight subarachnoid hemorrhage, and left carotid angiography revealed an AcoA aneurysm. The next day, the aneurysm was occluded with coils via the femoral approach under general anesthesia. The patient received a bolus of 5,000 units of heparin immediately following the procedure, and an infusion rate of 10,000 units/day was initiated. The patient gradually became hypotensive 25 hours after coiling. Abdominal CT showed a huge, high-density soft-tissue mass filling the right side of the retroperitoneum space. The patient eventually died of multiple organ failure five days after coiling. RH after interventional radiology for neurological disease is relatively rare and can be difficult to diagnose if consciousness is disturbed. This case demonstrates the importance of performing routine physical examinations, sequentially measuring the hematocrit and closely monitoring systemic blood pressures following interventional radiologic procedures in patients with abnormal mental status.

Berberine suppresses in vitro migration of human aortic smooth muscle cells through the inhibitions of MMP-2/9, u-PA, AP-1, and NF-κB

  • Liu, Su-Jian;Yin, Cai-Xia;Ding, Ming-Chao;Xia, Shao-You;Shen, Qin-Min;Wu, Ji-Dong
    • BMB Reports
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    • 제47권7호
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    • pp.388-392
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    • 2014
  • Berberine, a type of isoquinoline alkaloid isolated from Chinese medicinal herbs, has been reported to have various pharmacological activities. Studies have demonstrated that berberine has beneficial effects on vascular remodeling and alleviates restenosis after vascular injury. However, its mechanism of action on vascular smooth muscle cell migration is not fully understood. We therefore investigated the effect of berberine on human aortic smooth muscle cell (HASMC) migration. Boyden chamber assay was performed to show that berberine inhibited HASMC migration dose-dependently. Real-time PCR and Western blotting analyses showed that levels of matrix metalloproteinase (MMP)-2, MMP-9, and urokinase-type plasminogen activator (u-PA) were reduced by berberine at both the mRNA and protein levels. Western blotting assay further confirmed that activities of c-Fos, c-Jun, and NF-${\kappa}B$ were significantly attenuated. These results suggest that berberine effectively inhibited HASMC migration, possibly by down-regulating MMP-2, MMP-9, and u-PA; and interrupting AP-1 and NF-${\kappa}B$ mediated signaling pathways.

Current Topics on Quality Assurance of X-ray Diagnosis in Japan

  • Katoh, Tuguhisa;Imamura, Keiko;Matumoto, Toru
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.13-16
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    • 2002
  • Recent topics on quality assurance (QA) of X-ray diagnosis in Japan were reported in this presentation. These were related to mass screening mammography (MMG), lung screening CT (LSCT), skin injury caused by interventional radiology (IVR) and traceable system of dosimeters for x-ray diagnosis. In these successful stories, the author would like to stress the cooperation of all the medical am: clinical staff including medical doctors, radiological technologists, medical physicists, manufacturers of medical devices and others.

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고양이 심근비대증에 병발한 안장색전증의 중재치료 증례 (Interventional Approaches for Treatment of Saddle Embolus in Two Cats with Hypertrophic Cardiomyopathy)

  • 강민희;박희명
    • 한국임상수의학회지
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    • 제31권4호
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    • pp.298-302
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    • 2014
  • 8년령의 중성화된 잡종 수컷 고양이 (증례 1)와 3년령의 중성화된 샴 수컷 고양이 (증례 2)가 뒷다리 마비, 지속적인 개구호흡, 그리고 객혈 등을 주증으로 내원하였다. 심잡음 (증례 1)과 분마성심음 (증례 2)이 좌측 심저부에서 청진되었으며, 방사선 검사상 증례 1의 경우 폐포패턴을 동반한 심한 공기연하증이, 증례 2에서는 확연한 심비대가 확인되었다. 심초음파 검사에서 두 마리 고양이 모두에서 좌심실과 심실중격의 구심성 비대와 좌심방의 확장이 확인되었다. 심장 초음파를 포함한 검사를 바탕으로 본 환축은 고양이 심근비대증으로 진단되었으며, 신체검사와 복부 초음파 검사를 통하여 병발한 안장색전증을 확인하였다. 일반적인 치료를 통한 환축의 예후가 불량한 점을 감안하여, 직접적인 혈관내 혈전용해술이 시도되었다. 혈관조영술을 통하여 혈전의 위치와 크기를 확인 할 수 있었으나, 광범위한 색전증으로 인하여 중재적 시술을 이용한 혈전용해는 성공적이지 못했다.

Effect of 1Hz Motor Nerve Electrical Stimulation on Joint Range of Motion

  • Jong Ho Kang
    • Physical Therapy Rehabilitation Science
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    • 제11권4호
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    • pp.409-413
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    • 2022
  • Objective: This study aims to compare the range of motion of the joints by applying the contraction and relaxation techniques used in manual therapy as electrical stimulation treatment. Based on this, we would like to propose the possibility of using motor nerve electrical stimulation therapy for musculoskeletal physical therapy. Design: Single-arm interventional study Methods: Active and passive straight leg raising tests were performed on 20 healthy men and women in their 20s to measure the angle of hip joint flexion. Then, the electrical stimulation time was set to 10 seconds and 5 seconds of rest, and motor nerve electrical stimulation of 1 Hz was applied with the maximum strength that could withstand the hamstring muscles for 10 minutes. After electrical stimulation, straight leg raising tests again to confirm the range of motion of the hip joint flexion. Results: As a result of this study, it was confirmed that the joint range of motion was significantly improved for both active and passive straight leg raising tests after application of motor nerve electrical stimulation(p<.05). Conclusions: With a strong electrical stimulation treatment of 1 Hz, the effect similar to the contraction and relaxation technique used in manual therapy was confirmed through the joint range of motion. In the future, motor nerve electrical stimulation therapy can be used for musculoskeletal physical therapy to provide a new approach for patients with reduced pain and joint range of motion due to muscle tension.

체외충격파 치료기(Extracorporeal Shockwave Therapy)의 성능평가 및 보완사항에 관한 연구 (Study on the Performance Evaluation and Supplementations of Extracorporeal Shockwave Therapy)

  • 오찬우;박상건;박홍규
    • 전기학회논문지P
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    • 제67권1호
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    • pp.52-56
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    • 2018
  • Extracorporeal shockwave therapy has been widely spread out showing an excellent efficacy compared to traditional medicinal treatments, interventional procedures or surgeries for diseases of tendons and musculoskeletal system. Major performance tests of extracorporeal shockwave therapy consist of pressure, energy flux, concentration, and effective amount of energy on the focus area of shockwave according to IEC 61846. Shockwave should be irradiated accurately to the lesion area to improve the performance of extracorporeal shockwave therapy, which makes it necessary to add the relevant section, IEC 60601-2-36 (12.1.101. Precision of Target Markers and Target Locations). International standards of extracorporeal shockwave therapy have been prepared based on European and western people. Thus, we need to conduct many studies on Korean patients to improve the quality of extracorporeal shockwave therapy and to develop the medical industry. In addition, the performance evaluation of extracorporeal shockwave therapy which has been prepared according to international standards should be additionally modified and supplemented corresponding to the Korean circumstances.

Barbiturate 혼수 요법(Coma Therapy)을 이용한 제1형 복합부위통증증후군 치험 -증례보고- (Management of Complex Regional Pain Syndrome Type 1 with Barbiturate Coma Therapy -A case report-)

  • 박태규;한경림;신동욱;이영주;김찬
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.213-217
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    • 2006
  • Although various treatments for complex regional pain syndrome (CRPS) have been proposed, no well recognized treatment for CRPS has been established. Herein, a case using barbiturate coma therapy for the refractory pain management of a 24-year-old male patient, who suffered from constant stabbing and burning pain, with severe touch allodynia in the left upper extremity following blunt trauma on his forearm is described. Interventional treatments, including permanent spinal cord stimulation and large doses of oral medications, were performed. However, the pain could not be controlled, which lead to frequent emergency room treatment for about 1 month prior to his therapy. He then underwent barbiturate coma therapy due to the uncontrollable pain, with repeated sedation therapy due to his outrageous behavior. His pain became increasingly tolerable and the allodynia was markedly decreased after 5 days of coma therapy.