• Title/Summary/Keyword: Interventional treatment

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Lobaplatin-TACE Combined with Radioactive 125I Seed Implantation for Treatment of Primary Hepatocellular Carcinoma

  • Peng, Sheng;Yang, Qiu-Xia;Zhang, Tao;Lu, Ming-Jian;Yang, Guang;Liu, Zhen-Yin;Zhang, Rong;Zhang, Fu-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5155-5160
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    • 2014
  • Aim: To investigate the efficacy and safety of lobaplatin-transcatheter arterial chemoembolization (TACE) combined with radioactive $^{125}I$ seed implantation in treatment of primary hepatocellular carcinoma (HCC). Methods: 75 patients with primary HCC were enrolled in the study, among them 43 receiving lobaplatin-TACE (TACE group) and 32 lobaplatin-TACE combined with $^{125}I$ seed implantation (TACE+$^{125}I$ group). After treatment, the local remission rates and postoperative complications of two groups were compared using the Pearson Chi-square test. Overall survival in the two groups was calculated using Kaplan-Meier survival curves and the differences were tested using Log-rank test. Results: There were 7 cases of complete response (CR), 13 of partial response (PR), 6 of stable disease (SD) and 17 of progressive disease (PD) in the TACE group, with 13 cases of CR, 9 of PR, 5 of SD and 5 of PD in the TACE+$^{125}I$ group. The disease control rates of TACE and TACE+$^{125}I$ group were 60.5% (26/43) and 84.4% (27/32), respectively, with a significant difference between them (P < 0.05). The survival rates at 6, 12 and 18 months in the TACE group were 100.0%, 81.8% and 50.0%, respectively, and those in TACE+$^{125}I$ group were 100.0%, 93.8% and 65.6%. The mean survival times in the TACE and TACE+$^{125}I$ groups were 19.5 and 22.9 months, respectively. There was a significant difference in the overall survival rate between two groups (P < 0.05). No serious complications were encountered in either group. Conclusion: Lobaplatin-TACE combined with $^{125}I$ seed implantation is favorable and safe for treatment of primary HCC.

Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: No (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 부정적인 입장에서)

  • Bae, Jong-Seok
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.7-10
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    • 2010
  • Chronic low back pain (CLBP) is a distinct disease entity in that its clinical course and response to the treatment are quite different from acute low back pain (ALBP). CLBP is also closely related with systemic or preexisting psychosocial factors rather than focal or localized factors. Since there has been little consensus in practice regarding the proper management of CLBP, clinicians tend to approach and manage patients with CLBP in an empirical manner rather than an evidence-based one. In this article, I will review the difficulties of therapeutic choice in CLBP and provide superior aspects of medical treatment over invasive interventional treatments.

Recent Interventional Procedures for Spinal Discogenic Pain for Life Care : Technical and Ethical Issues (라이프케어를 위한 추간판성 통증 치료의 최신중재기법 기술적 윤리적 문제들에 관하여)

  • Hong, Young-Ki
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.311-320
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    • 2019
  • Discogenic pain which develops during the degenerative process of intervertebral disc is an intractable disease of musculoskeletal system. Unlike other diseases in modern medical science, it is not clinically confirmed through objective imaging and clinicopathologic index. Moreover, current technology has been facing difficulties finding fundamental treatment. This study examined through reviewing literature whether the therapeutic rationales of interventional procedures for the discogenic pain, such as nerve block, intradiscal electrothermal therapy and nucleoplasty, are valid and whether safety reviews such as preclinical tests are carried out faithfully during the technology development process. As a result, it is presumed that there is not yet an interventional treatment for discogenic pain, whose therapeutic rationale has been objectively verified. And there are some cases of interventional treatment that have not been adequately equipped with the preclinical test steps necessary to review the safety of the procedure during the technology development process. In conclusion, since there is still no interventional treatment for discogenic pain which has clear therapeutic rationale, it is necessary to recognize that a more careful approach is needed to judge whether the procedure is performed in clinical settings. And medical ethical issues may arise for some interventional treatment that are deemed to have been carried out without a thorough review of safety.

The Deep Dry Needling Techniques, and Interventional Muscle & Nerve Stimulation (IMS) for the Treatment of Chronic Pain (만성통증 치료에서 Deep Dry Needling의 모델들과 중재적 근육 및 신경자극 요법)

  • Lee, Young Jin;Ahn, Kang;Lee, Sang Chul
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.1-7
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    • 2006
  • Chronic pain can cause disability, mild to severe suffering and high medical costs. Some unfortunate patient do not improve despite administering conservative treatment and then the various interventional therapies, including oriental medical treatment and/or surgery, and they find themselves in search of a more effective pain relief. Deep dry needling is one of the newer treatment modalities for these patients. The last 10 years have seen a lot of progress in understanding the neural pathways and the type and extent of tissue involvement during chronic pain. This in turn has stimulated the development of new treatment techniques, and deep dry needling is one of them. So, the authors of this paper discuss the individual theories, the characteristics and future directions of several deep dry needling techniques, and we examine the new dry needling technique that has been recently developed in Korea.

A Study on Usefulness of Balloon Cholangiography in Operating ERCP (ERCP 시술중 Balloon Cholangiography의 유용성에 관한 고찰)

  • Son, Soon-Yong
    • Journal of radiological science and technology
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    • v.20 no.1
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    • pp.43-49
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    • 1997
  • Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

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Efficacy of Transarterial Chemoembolization Combined with Radiofrequency Ablation in Treatment of Hepatocellular Carcinoma

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6159-6162
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    • 2015
  • Purpose: To evaluate efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of patients with hepatocellular carcinoma. Materials and Methods: During January 2009 to March 2012, 80 patients with hepatocellular carcinoma underwent TACE, with or without RFA. Alfafetoprotein (AFP) was checked before and after procedure. CT scans were obtained one month after TACE or RFA for all patients to evaluate tumor changes. Complete response+partial response+stable disease (CR+PR+SD)/n were used to assess the disease control rate (DCR). Survival at 3, 6 and 12 months was compared in both groups. Results: AFP levels in TACE + RFA group dropped rapidly, becoming obviously lower than that of the TACE group. In the TACE + RFA group DCR was 93.8%, while only 76.8% in the TACE group. The treatment effect between the two groups was statistically significant (P<0.05) by Ridit analysis. 1 year survival rate in the TACE + RFA group was 92.5%, significantly higher than that of the TACE group at 77.5% (P<0.05). Conclusions: TACE and RFA as combined therapy method for patients with middle and terminal stage HCC gives full play to synergy between the two and improves the therapeutic effect.

Interventional Radiology Treatment for Postoperative Chylothorax

  • Jun, Hoyong;Hur, Saebeom
    • Journal of Chest Surgery
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    • v.53 no.4
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    • pp.200-204
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    • 2020
  • Postoperative chylothorax is a rare occurrence after various thoracic surgical procedures, but it poses a substantial risk of morbidity and mortality. Thoracic duct embolization (TDE) is currently deemed the optimal treatment due to its safety and efficacy. This review offers an introduction to interventional options in this setting, detailing the steps of TDE for the edification of those engaged in postoperative care.

Pulmonary Arteriovenous Malformation and Its Vascular Mimickers

  • Hyoung Nam Lee;Dongho Hyun
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.202-217
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    • 2022
  • Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.

Microwave Ablation Treatment of Liver Cancer with a 2,450-MHz Cooled-shaft Antenna: Pilot Study on Safety and Efficacy

  • Jiao, De-Chao;Zhou, Qi;Han, Xin-Wei;Wang, Ya-Feng;Wu, Gang;Ren, Jian-Zhuang;Wang, Yan-Li;Ding, Peng-Xu;Ma, Ji;Fu, Ming-Ti
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.737-742
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    • 2012
  • To evaluate efficacy of microwave ablation in a primary clinical study, sixty patients (44 men, 16 women; mean age 53 years) with 96, 1-8 cm (mean $3.20{\pm}0.17$ cm) liver cancers were treated with 2,450-MHz internally cooled-shaft antenna. Complete ablation (CA) and local tumor progression (LTP) rates as well as complications were determined. CA rates in small (< 3.0 cm), intermediate (3.1-5.0 cm) and large (5.1-8.0 cm) liver cancers were 96.4% (54/56), 92.3% (24/26) and 78.6% (11/14), respectively. During a mean follow-up period of $17.17{\pm}6.52$ months, LTP occurred in five (5.21%) treated cases. There was no significant difference in the CA and LTP rates between the HCC and liver metastasis patient subgroups (P<0.05). Microwave ablation provides a reliable, efficient, and safe technique to perform hepatic tumor ablation.

Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

  • Kim, Yeon Dong;Moon, Hyun Seog
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.254-264
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    • 2015
  • Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.