• 제목/요약/키워드: Interventional treatment

검색결과 223건 처리시간 0.029초

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).

TACE의 중재적 시술시 환자의 피폭선량 평가 (The Evaluation of Patients' Radiation Dose During TACE of Interventional Radiology)

  • 이승열;임현수;한만석
    • 대한방사선기술학회지:방사선기술과학
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    • 제34권3호
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    • pp.209-214
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    • 2011
  • TACE의 중재적 시술시 환자와 시술자가 받는 피폭선량을 평가하고, 환자의 피폭선량을 최소화하기 위한 방안을 모색하기 위함이다. 2010년 6월부터 9월까지 중재적 시술의 빈도와 방사선 피폭의 양이 비교적 큰 TACE 시술환자를 대상으로 혈관조영장비(Philips Allura Xper FD 20)와 장비내 장착된 Ionization chamber에 의해 나타나는 DAP(Dose area product)값에 교정상수를 적용시켜 시술시 환자가 받는 유효선량을 근사적으로 얻어냈으며 환자와 시술자의 갑상선과 생식선 주위에 TLD를 부착하여 피폭선량을 산출하고 SPSS 통계에 의한 분석과 평가를 하였다. DAP값에 의해 산출된 TACE 시술시 1인당 ED(Effective Dose)는 평균 18.43${\pm}$6.63 mSv로 나타났으며 이는 전국 평균값의 75%에 해당한다. 또한 TLD에 의해 측정된 환자의 갑상선과 생식선부위의 1인당 평균피폭선량은 각각 0.37 mSv, 0.77 mSv로 나타났으며 보호용구를 착용한 시술자는 환자 1인당 각각 0.07 mSv, 0.01 mSv의 평균피폭선량을 받았다. 시술에 참여하는 모든 의료진들은 법적 선량한도의 적용을 받지 않는 방사선의료피폭에 대해 경각심을 가져야하며, 영상모니터에 실시간으로 표시되는 DAP값을 이용하여 환자의 피폭선량을 고려하며 시술에 임해야하며 시술에 방해가 되지 않는 한도 내에서 환자에게 차폐용구를 적절히 활용해야 한다.

Survival and Prognostic Factors for Hepatocellular Carcinoma: an Egyptian Multidisciplinary Clinic Experience

  • Abdelaziz, Ashraf Omar;Elbaz, Tamer Mahmoud;Shousha, Hend Ibrahim;Ibrahim, Mostafa Mohamed;El-Shazli, Mostafa Abdel Rahman;Abdelmaksoud, Ahmed Hosni;Aziz, Omar Abdel;Zaki, Hisham Atef;Elattar, Inas Anwar;Nabeel, Mohamed Mahmoud
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권9호
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    • pp.3915-3920
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    • 2014
  • Background: Hepatocellular carcinoma (HCC) is a dismal tumor with a high incidence, prevalence and poor prognosis and survival. Management of HCC necessitates multidisciplinary clinics due to the wide heterogeneity in its presentation, different therapeutic options, variable biologic behavior and background presence of chronic liver disease. We studied the different prognostic factors that affected survival of our patients to improve future HCC management and patient survival. Materials and Methods: This study is performed in a specialized multidisciplinary clinic for HCC in Kasr El Eini Hospital, Cairo University, Egypt. We retrospectively analyzed the different patient and tumor characteristics and the primary mode of management applied to our patients. Further analysis was performed using univariate and multivariate statistics. Results: During the period February 2009 till February 2013, 290 HCC patients presented to our multidisciplinary clinic. They were predominantly males and the mean age was $56.5{\pm}7.7years$. All cases developed HCC on top of cirrhosis that was mainly due to HCV (71%). Most of our patients were Child-Pugh A (50%) or B (36.9%) and commonly presented with small single lesions. Transarterial chemoembolization was the most common line of treatment used (32.4%). The overall survival was 79.9% at 6 months, 54.5% at 1 year and 22.4% at 2 years. Serum bilirubin, site of the tumor and type of treatment were the significant independent prognostic factors for survival. Conclusions: Our main prognostic variables are the bilirubin level, the bilobar hepatic affection and the application of specific treatment (either curative or palliative). Multidisciplinary clinics enhance better HCC management.

말티스 견에서 시술된 미니코브라 카테터와 코일을 이용한 동맥관 개존증의 치료 2 증례 (Transarterial Coil Embolization in Two Maltese Dogs with Patent Ductus Arteriosus Using a Mini Cobra-tip Angiocatheter)

  • 한동현;안효진;현창백
    • 한국임상수의학회지
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    • 제27권6호
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    • pp.740-745
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    • 2010
  • 동맥관개존증은 출생 후에도 폐동맥과 하행대동맥 사이에 동맥관이 지속적으로 열려 있는 선천성 심장질환이다. 동맥관개존증은 외과적인 결찰술로 폐쇄할 수 있지만, 다양한 도구를 이용한 동맥관개존증의 중재적 치료술은 비침습적인 치료과정과 시술 후 관리의 최소화의 이유로 빠르게 대체되고 있다. 소형품종에서의 중재적인 치료술은 동맥의 크기가 작기 때문에 혈관으로의 접근성이 주요한 문제점이 된다. 비록 경정맥을 이용한 정맥 접근법이 개발되었으나 이 기술은 동맥관에 폐색장치를 장착시키기 위해서 숙달된 기술이 필요하며, 폐색 장치 (색전 코일이나 혈관폐색장치)가 예기치 않게 잘못 장착될 위험성을 가지고 있다. 따라서, 우리는 이번 연구에서 소형품종 (체중3 kg미만)에서 대퇴동맥 접근을 통한 미니 혈관카테타를 이용한 변형된 코일 색전법을 개발하였다. 이러한 변형된 방법을 통하여 우리는 좌우 단락된 동맥관개존증을 가진 두마리의 소형품종 (말티즈)을 성공적으로 치료하였다.

Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia

  • Rahman, F Abdul;Naidu, J;Ngiu, CS;Yaakob, Y;Mohamed, Z;Othman, H;Jarmin, R;Elias, MH;Hamid, N Abdul;Mokhtar, N Mohd;Ali, RA Raja
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.4037-4041
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    • 2016
  • Background: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre. Materials and Methods: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups. Results: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were $4.9{\pm}3.2$ months and $8.3{\pm}2.0$ months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria. Conclusions: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.

Extended duration pulsed radiofrequency for the management of refractory meralgia paresthetica: a series of five cases

  • Ghai, Babita;Dhiman, Deepanshu;Loganathan, Sekar
    • The Korean Journal of Pain
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    • 제31권3호
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    • pp.215-220
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    • 2018
  • Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1-2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.

인공판막 혈전에 의한 좌전하행지 폐쇄 후 급성심근경색 -1예 보고- (Acute Myocardial Infarction after Embolic Occlusion of Left Anterior Descending Artery by Prosthetic Valve Thrombosis - Report of 1 case -)

  • 김재현;임달수;오삼세;백만종;김종환;나찬영
    • Journal of Chest Surgery
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    • 제37권4호
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    • pp.369-372
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    • 2004
  • 인공판막 혈전에 의한 관상동맥 폐쇄 후 발생하는 급성심근경색은 드물지만 치명적인 질환으로 환자들의 생존율을 높이기 위해서는 빠른 진단과 적절한 치료가 중요하다 본원에서는 기계승모판막 혈전에 의한 좌전하행지의 폐쇄로 급성심근경색이 발생한 환자 1예에서 중재시술 및 항혈전요법 후 승모판 재치환술을 성공적으로 시행하였기에 증례 보고하는 바이다.

동맥경화증의 발생에 관한 혈류역학적 가설들에 대한 비교연구 (A Comparative Study of the Hemodynamic Hypotheses for the Generation of Atherosclerosis)

  • 서상호;조민태;노형운;권혁문
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2003년도 춘계학술대회
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    • pp.1915-1918
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    • 2003
  • Atherosclerosis, which is a degenerate disease, is believed to occur in the vascular system due to deposition of cholesterol and low density lipoprotein(LDL) or thrombosis on the blood vessel. Atherosclerosis narrows arterial lumen, which is known as stenosis phenomenon of blood vessel. Pathogenesis of atherosclerosis is thought to occur mainly by aging. Restenosis phenomenon is observed in the same site of insertion of a stent and balloon angioplasty after treatment of interventional theraphy. Several hypothetical theories related to the generation of atherosclerosis have been reported: high shear stress theory, low shear stress theory, high shear stress gradient theory, flow separation and turbulence theory and high pressure theory. However, no one theory clearly explains the causes of atherosclerosis. In the present study the generation of atherosclerosis in the left coronary artery is investigated. The hypotheses are verified by using the computer simulation.

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불안정형 협심증 환자의 고위 흉부 경막외 진통 효과 -증례보고- (High Thoracic Epidural Analgesia for the Control of Pain in Unstable Angina Pectoris -A case report-)

  • 이봉재
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.271-274
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    • 2006
  • Unstable angina is a critical phase of coronary heart disease, with widely variable symptoms and prognoses. Recently, despite the advances in surgical revascularization, catheter-based revascularization and medical treatment, an increasing number of patients with angina pectoris are refractory to medical therapy and; therefore, can not be considered as candidates for coronary artery bypass grafting or interventional angioplasty. These patients are often treated with narcotics for pain relief, and forced to severely reduce their levels of activity and productivity. It has become clear that alleviating the pain caused by myocardial ischemia may be possible by altering the sympathetic afferent nerve fibers. Sympathetic blockade can be produced using high thoracic epidural analgesia. Herein, the case of a patient with intractable angina and poor ventricular function, who received high thoracic epidural analgesia to relieve ischemic chest pain, is reported.

Curcumin의 신경병증성 통증 억제효과 (Curcumin Attenuates Chronic Constriction Nerve Injury-Induced Neuropathic Pain in Rats)

  • 김채은;박은성;전영훈
    • 한국약용작물학회지
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    • 제16권3호
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    • pp.183-187
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    • 2008
  • Nerve injury can lead to neuropathic pain, which is often resistant to current analgesics and interventional therapeutic methods. Extracellular signal-regulated kinase (ERK) plays important role in the induction of neuropathic pain. We explored the antinociceptive effect of curcumin and its effect on ERK in the spinal cord in the neuropathic pain model of rats induced by chronic constriction injury (CCI) of the sciatic nerve. In injured rats, mechanical allodynia, which is one of characteristics of neuropathic pain developed and the activation of ERK in spinal cord significantly increased compared with control group. However, administration of curcumin (50 mg/kg/day p.o) for 7 days started from one day before the injury prevented the development of mechanical allodynia and increase of ERK phosphorylation. These results indicate that curcumin can be a new therapeutic agent in the treatment of neuropathic pain.