• 제목/요약/키워드: Interventional treatment

검색결과 231건 처리시간 0.021초

Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Kim, Myung-Hwan;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.165-167
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    • 2009
  • Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

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.

Epidural Injection시술시 투시율 변화에 따른 선량비교연구 (Comparative study of dose due to the change of fluoroscopy pulse rate of Epidural Injection treatment time)

  • 서정범;오동훈;이정범;이종웅
    • 대한디지털의료영상학회논문지
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    • 제15권1호
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    • pp.21-26
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    • 2013
  • To be investigated and measures to reduce the medical exposure of patients to change the Epidural Injection time Fluoroscopy Pulse Rate in this study. Was conducted in 50 patients who underwent surgery Epidural Injection performed by interventional care of Konkuk University Hospital from January to April 2013. The treatment time with the change of Pulse rate, is measured in minutes fluoroscopy time, and measured the area dose (${\mu}Gym^2$) and depth dose (mGy). Using the Image J program, to measure the PSNR and SNR. The fluoroscopy time as a result surgery, there was no significance in the statistical analysis, and depth dose is 34.3 to 34.9%, was reduced from 35.8 to 38.7% the area dose. It is possible to reduce the appropriate Pulse rate, to reduce the dose without statistical analysis significance fluoroscopy time.

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척추수술후증후군 환자에서 단일 전극을 이용한 경부와 흉부 척수자극술 - 증례보고 - (Cervical and Thoracic Spinal Cord Stimulation with Single Electrodes for Failed Back Surgery Syndrome - A case report -)

  • 이재준;엄태범;홍성준;황성미;임소영;신근만
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.199-202
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    • 2007
  • Failed back surgery syndrome (FBSS) is a condition characterized by extreme pain after spinal surgery. Treatment of FBSS is aimed at improving function, using interdisciplinary approaches that encompass rehabilitation, psychological therapy, and pain management. If no response to conventional treatment is noted, a more interventional technique such as spinal cord stimulation (SCS) should be used. SCS is a well-established method of managing a variety of chronic neuropathic pain conditions. A 32 year-old male patient afflicted by FBSS that was irresponsive to both medication and several repeated nerve blocks showed improvement of symptoms after cervical and thoracic SCS with a single electrode. Centered on the midline of the spinal cord, single-electrode SCS can be an effective method for relieving pain and improving function.

Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

  • Han, Sanghoon;Han, Kyoung Hee
    • Childhood Kidney Diseases
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    • 제23권2호
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    • pp.116-120
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    • 2019
  • Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

Biomarkers for Evaluating the Inflammation Status in Patients with Cancer

  • Guner, Ali;Kim, Hyoung-Il
    • Journal of Gastric Cancer
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    • 제19권3호
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    • pp.254-277
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    • 2019
  • Inflammation can be a causative factor for carcinogenesis or can result from a consequence of cancer progression. Moreover, cancer therapeutic interventions can also induce an inflammatory response. Various inflammatory parameters are used to assess the inflammatory status during cancer treatment. It is important to select the most optimal biomarker among these parameters. Additionally, suitable biomarkers must be examined if there are no known parameters. We briefly reviewed the published literature for the use of inflammatory parameters in the treatment of patients with cancer. Most studies on inflammation evaluated the correlation between host characteristics, effect of interventions, and clinical outcomes. Additionally, the levels of C-reactive protein, albumin, lymphocytes, and platelets were the most commonly used laboratory parameters, either independently or in combination with other laboratory parameters and clinical characteristics. Furthermore, the immune parameters are classically examined using flow cytometry, immunohistochemical staining, and enzyme-linked immunosorbent assay techniques. However, gene expression profiling can aid in assessing the overall peri-interventional immune status. The checklists of guidelines, such as STAndards for Reporting of Diagnostic accuracy and REporting recommendations for tumor MARKer prognostic studies should be considered when designing studies to investigate the inflammatory parameters. Finally, the data should be interpreted after adjusting for clinically important variables, such as age and cancer stage.

New opportunities for nanoparticles in cancer immunotherapy

  • Park, Wooram;Heo, Young-Jae;Han, Dong Keun
    • 생체재료학회지
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    • 제22권4호
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    • pp.211-220
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    • 2018
  • Background: Recently, cancer immunotherapy has become standard for cancer treatment. Immunotherapy not only treats primary tumors, but also prevents metastasis and recurrence, representing a major advantage over conventional cancer treatments. However, existing cancer immunotherapies have limited clinical benefits because cancer antigens are often not effectively delivered to immune cells. Furthermore, unlike lymphoma, solid tumors evade anti-cancer immunity by forming an immune-suppressive tumor microenvironment (TME). One approach for overcoming these limitations of cancer immunotherapy involves nanoparticles based on biomaterials. Main body: Here, we review in detail recent trends in the use of nanoparticles in cancer immunotherapy. First, to illustrate the unmet needs for nanoparticles in this field, we describe the mechanisms underlying cancer immunotherapy. We then explain the role of nanoparticles in the delivery of cancer antigens and adjuvants. Next, we discuss how nanoparticles can be helpful within the immune-suppressive TME. Finally, we summarize current and future uses of nanoparticles with image-guided interventional techniques in cancer immunotherapy. Conclusion: Recently developed approaches for using nanoparticles in cancer immunotherapy have enormous potential for improving cancer treatment. Cancer immunotherapy based on nanoparticles is anticipated not only to overcome the limitations of existing immunotherapy, but also to generate synergistic effects via cooperation between nanoparticles and immune cells.

Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention

  • Lim, Hanseul;Hwang, Shin;Ko, Gi-Young;Han, Hyejin
    • Journal of Yeungnam Medical Science
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    • 제39권2호
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    • pp.161-167
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    • 2022
  • Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

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.

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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    • 제36권3호
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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.