• 제목/요약/키워드: Interventional treatment

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Lifestyle Behaviors and Early Diagnosis Practices of Cancer Patients

  • Yilmaz, Medine;Sanli, Deniz;Ucgun, Mujde;Kaya, Nur Sahin;Tokem, Yasemin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3269-3274
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    • 2013
  • Background: The aim was to determine the lifestyle behaviors and the practices for early diagnosis of cancer of cancer patients. Materials and Methods: A descriptive cross-sectional design was used for this study. The sample consisted of 222 patients with a diagnosis of cancer (non-random sample method). Ethical permission was obtained of the Non-interventional Research Ethics Committee of our Institution. Values of p<0.05 were accepted as statistically significant. Results: It was observed that 54.4% of the patients had never performed breast self-examination, 60.8% had never had a mammography, and 71.2% had never had a Pap smear. Sixty-six point two percent of patients had never had screening for colon cancer within the past ten years. GIS cancers were higher in smokers and ex-smokers (p=0.005), in drinkers and in ex-drinkers (p=0.000). The breast cancer rate was higher in obese people (p=0.019). Conclusions: The results of this study provide information on the healthy lifestyle behavior of cancer patients before their diagnosis, and their use of early diagnosis practices. The important aspect of this study is to extend cancer patients' period of life after the diagnosis and treatment process, to make them conscious of risky lifestyle and nutritional behavior so that they can maintain a high quality of life, and to start initiatives in this direction that would ensure changes in behavior.

수정된 강제 유도 운동치료와 결합된 이중 반구 경두개 직류 자극이 만성 뇌졸중의 팔 기능에 미치는 영향 : 단일 맹검 무작위 통제 시험 (Impact of Dual-Hemisphere Transcranial Direct Current Stimulation Combined with Modified Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Single Blinded Randomized Controlled Trial)

  • 김선호
    • 대한통합의학회지
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    • 제8권2호
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    • pp.11-20
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    • 2020
  • Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

Comparison between Basic and Inverse Dual Drug and Peptide-coated Stents in a Porcine Restenosis Model

  • Jang, Eun-Jae;Lee, So-Youn;Bae, In-Ho;Park, Dae Sung;Jeong, Myung Ho;Park, Jun-Kyu
    • 공업화학
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    • 제31권5호
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    • pp.502-508
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    • 2020
  • Dual drug-eluting stents (DES) is a primary treatment method for coronary arterial diseases in current interventional cardiology practice. However, their pathological results according to the sequence of coating of drugs have not been reported yet. The peptide-dopamine dissolved in acetonitrile was coated onto the Chonnam National University Hospital (CNUH) stent using an electrospinning coating machine. For secondary coating (e.g., sirolimus coating, designated as SPS), sirolimus (SRL) and poly lactic-glycolic acid (PLGA) were mixed in tetrahydrofuran (THF), and the solution was then coated on the CNUH stent that had underwent the primary peptide coating using an electrospinning and spray technique. Next, the peptide-dopamine was coated on the SRL-PLGA coated stent (PSS). In this study, it was confirmed that endothelialization was promoted without being significantly affected by the coating order (SPS or PSS). The sequence of drug and peptide coating may affect the development of restenosis and PSS was effective in the prevention of restenosis compared to that of using SPS.

Non-Operative Management with Angioembolization of Grade IV and V Renal Injuries in a Hybrid Emergency Room System

  • Ahn, So Ra;Seo, Sang Hyun;Lee, Joo Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • 제34권3호
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    • pp.191-197
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    • 2021
  • Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I-III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient's arrival, angiography was performed within 8 minutes of the patient's arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.

Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

  • Kim, Su Cheol;Lee, Sang Min;Park, Gun Tae;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • 제24권2호
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    • pp.55-65
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    • 2021
  • Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain

  • Ghai, Babita;Kumar, Muthu;Makkar, Jeetinder Kaur;Goni, Vijay
    • The Korean Journal of Pain
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    • 제35권2호
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    • pp.183-190
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    • 2022
  • Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

삼차원 뇌혈관조영술에서 테이블 높이와 확대율 조절에 따른 수정체 선량 감소에 대한 연구 (Radiation Dose Reduction of Lens by Adjusting Table Height and Magnification Ratio in 3D Cerebral Angiography)

  • 윤종태;이기백
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권4호
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    • pp.313-320
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    • 2022
  • Both angiography and interventional procedures accompanied by angiography provide many diagnostic and therapeutic benefits to patients and are rapidly increasing. However, unlike general radiography or computed tomography using the same X-ray, the amount of radiation is quite high, but the dose range can vary considerably for each patient and operator. The high sensitivity of the lens to radiation during cerebral angiography and neurointervention is already well known, and although there are many related studies, it is insufficient to easily reduce radiation in diagnosis and treatment. In this situation, in particular, by adding three-dimensional rotational angiography (3D-RA) to the existing two-dimensional (2D) angiography, it is now possible to make an accurate diagnosis. However, since this 3D-RA acquires images through projection of more radiation than before, the exposure dose of the lens may be higher. Therefore, we tried to analyze whether the radiation dose of the lens can be reduced by moving the lens out of the field range by adjusting the table height and magnification ratio during the examination using 3D-RA. The surface dose was measured using a rando phantom and a radiophotoluminescent glass dosimeter (PLD) and the radiation dose was compared by adjusting the table height and magnification ratio based on the central point. As a result, it was found that the radiation dose of the lens decreased as the table height increased from the central point, that is, as the lens was out of the field of view. In conclusion, in 3D-RA, moving the table position of about 2 cm in height will make a significant contribution to the dose reduction of the lens, and it was confirmed that adjusting the magnification ratio can also reduce the surface dose of the lens.

Effectiveness of hyaluronic acid in the management of oral lichen planus: a systematic review and meta-analysis

  • Manjushri, Waingade;Raghavendra S, Medikeri;Shamali, Gaikwad
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권6호
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    • pp.405-417
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    • 2022
  • Oral lichen planus (OLP) is a chronic inflammatory immune-mediated condition that has been identified as a potentially malignant oral disorder. Various therapies have been proposed for its management as alternative to corticosteroids. However, no definitive treatment has been identified that can result in complete remission or minimal recurrence. Hyaluronic acid has recently been used as an alternative therapy for the management of OLP. This study aimed to systematically review the effectiveness of Hyaluronic acid in the management of symptomatic OLP. Online electronic databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and April 2022. RCTs were identified that compared the efficacy of hyaluronic acid and other interventional therapies at baseline and during follow-up. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, degree of erythema, clinical severity, and disease severity were assessed both quantitatively and qualitatively. Seven studies were analyzed. Five studies reported a high risk of bias while the remaining two studies reported an unclear risk of bias. The overall quantitative assessment of size, symptoms, degree of erythema, and sign score in OLP lesions treated with HA was not statistically significant compared to that in the control group (P > 0.05). In addition, subgroup analysis comparing HA with placebo or corticosteroids did not yield statistically significant (P > 0.05) results. Qualitatively, both HA and tacrolimus resulted in an effective reduction in signs and symptoms. Clinical/disease severity index/scores were inconsistent. A high degree of heterogeneity was observed among the included studies. None of the included studies reported the side effects of HA. These findings suggest that corticosteroids, tacrolimus, placebo, and HA could be equally effective in OLP management. The clinical/disease severity index or score reduction cannot be determined with certainty. Thus, OLP can be treated with HA as an alternative therapy. Owing to limited clinical trials on HA, high heterogeneity, and high risk of bias in the included studies, definitive conclusions cannot be derived.

인터벤션실의 오염실태 분석 및 평가 (Analysis and Evaluation of Pathogen Contamination Status in Interventional Angiography Room)

  • 김경완;임인철
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권3호
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    • pp.233-239
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    • 2022
  • In the radiology department, where radiation is used in medical institutions to perform examinations with various equipment, the field of surgical treatment is the intervention angiography room. Accordingly, strict infection control is required. The purpose of this study was to determine the contamination status by detecting pathogens before and after disinfection in the intervention angiography room, and to determine the degree of death by using a disinfectant, sodium dichloride isocyanurate, which is mainly used in the intervention angiography room. The subjects were 10 medical institutions of general hospital level or higher with an intervention angiography room in the P city, and 12 places with high contact frequency during examinations and procedures were sampled and requested to an analysis institution. As for the sample collection method, up/down, left/right directions were used to increase precision. Before disinfection, all procedures were completed, and after disinfection, exposure was performed using a disinfectant for at least 10 minutes, and detection was performed using a transport medium. As a result, in the pathogen analysis, most pathogens were detected in a humid environment or in a place with high contact frequency for microorganisms to thrive. The detected pathogens were found in the general environment or were human flora. It is a pathogen that does not cause disease under normal healthy host conditions. However, it was found to be an opportunistic infection that causes opportunistic infection depending on the case or situation in which the body's resistance is weakened. In addition, as a result of using the disinfectant mainly used in the intervention angiography room, it was found that more than 93.3% of them died. Therefore, the data of this study will be used as good basic data for the evaluation of pathogens in the intervention angiography room and will be of great help in infection control.

원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조 (Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings)

  • 최형인;최민정;김봉만;남궁환;최승규
    • 대한영상의학회지
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    • 제83권2호
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    • pp.400-405
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    • 2022
  • 위장관기질종양(gastrointestinal tumor; 이하 GIST)은 종종 위장관 출혈의 원인이 되는 드물지 않은 질환이지만 소장에 생기는 경우 내시경 및 전산화단층촬영(이하 CT)에서 발견이 어려울 수 있다. 본 증례에서 환자는 수술 전 총 3회의 CT를 시행 받았으나, 병변은 매번 복강의 다른 부위에 위치해 있었고, 허탈된 소장과 구분이 어려워 처음 2번의 CT에서는 발견하지 못했다. 혈관조영술에서 병변이 보였지만, 고령의 환자에서 원인불명 위장관 출혈의 가장 흔한 원인인 혈관기형으로 잘못 해석되어 올바른 진단과 치료가 3년간 지연되었다. 본 증례를 통해, GIST의 정확한 진단 및 치료 전략 수립을 위해 혈관조영술 소견을 강조하고자 한다.