Background: Open lung biopsy is used for diagnosis of diffuse infiltrative lung diseases (DILD), but it is invasive and relatively expensive procedure. Fluoroscopy-guided cutting needle lung biopsy (FCNLB) has merits of avoidance of admission and rapid diagnosis. But diagnostic accuracy and safety were not well known in the diagnosis of DILD. Methods: We included 52 patients (37 men, 15 women) having DILD on HRCT with dyspnea, except the patients who could be confidently diagnosed with clinical and HRCT findings. FCNLB was performed using 16G Ace cut needle (length 1.5 cm, diameter 2 mm) at the area of most active lesion on HRCT. Final diagnoses were made by the consensus. Results: The mean interval between the HRCT and FCNLB was 4.5 days. Most cases were performed one biopsy during 5~10 minutes. Specific diagnosis was obtained in 43 of 52 biopsies (83%). The most common diagnosis was nonspecific interstitial pneumonia (11 cases) and followed by cryptogenic organizing pneumonia (7 cases), diffuse alveolar hemorrhage and usual interstitial pneumonia (5 cases in each), hypersensitivity pneumonitis (3 cases), tuberculosis and drug induced interstitial pneumonitis (2 cases in each), the others are in one respectively. Mild complication was developed in 9 patients (8 pneumothorax, 1 hemoptysis). Most of complications were regressed without treatment except one case with chest tube insertion for pneumothorax. Conclusion: Fluoroscopy-guided 16 G cutting needle lung biopsy was an useful method for the diagnosis of DILD.
TMPRSS2:ERG gene fusions in prostate cancer have a dominant prevalence of approximately 50.0%, but infomration is limited on differences among ethnic and geographical groups. Some studies focusing on Japanese and Korean patients reported a lower incidence. Investigations concerning Chinese revealed controversial results. We evaluated TMPRSS2:ERG, TMPRSS2:ETV1 and TMPRSS2:ETV4 fusions in more than 100 Eastern Chinese prostate cancer patients. Paraffin blocks of needle biopsy and radical prostatectomy were collected from 91 and 18 patients respectively. All patients' clinicopathologic factors were gathered. TMPRSS2:ERG, TMPRSS2:ETV1 and TMPRSS2:ETV4 fusions were tested by multi-probe fluorescence in situ hybridization (FISH) assay. TMPRSS2:ERG fusions was present in 14.3% biopsy specimens and 11.1% radical prostatectomy patients. Neither TMPRSS2:ETV1 nor TMPRSS2:ETV4 fusion was found in any case. Altogether, 13 (86.7%) TMPRSS2:ERG fusion positive cases possessed deletion pattern and 7 (46.6%) and insertion pattern. Some 5 cases had both deletion and insertion patterns. While 38.5% (5/13) patients with deletion pattern had distant metastasis, except for one metastatic case harboring both deletion and insertion, there were no patients with insertion pattern accompanied with metastasis. There were no differences between fusion positive and negative cases in the distribution of age, PSA, Gleason score and TNM stage. Eastern Chinese prostate cancer patients have a significantly low incidence of TMPRSS2:ERG fusion. They also lack TMPRSS2:ETV1 and TMPRSS2:ETV4 fusion. There are more deletion pattern than insertion pattern in TMPRSS2:ERG positive cases. Fusion positive and negative patients have no clinicopathologic factor differences.
Objectives : To observe the changes in the expression of neurotransmitters NO and enzymes that create NO, such as nNOS, iNOS and eNOS, upon the needle insertion on river point, one of the five transport points of three yang meridians on the forefoot. Methods : Based on rats, needle was inserted on both sides of LI5, SI5 and TE6, which are river points of three yang meridians on the forefoot, and were retained for five minutes. After the retention, blood was drawn via cardiac puncture and tissues from each point around meridian vessels were extracted to be examined on the changes of the expression of NO, as well as of nNOS, iNOS and eNOS. Results : In terms of the effect on NO creation in tissues, none of the experimental groups showed any significant change compared to the Normal group. In terms of the effect on expression of nNOS within tissues, LI5 and SI5 showed significant increase based on the results of immunohistochemistry. In iNOS within tissues, LI5 and SI5 showed significant increase based on the results of immunohistochemistry. In eNOS within tissues, SI5 showed significant increase based on the results of immunohistochemistry. Conclusions : The effect on the function of NO, nNOS, iNOS and eNOS of needle insertion on the river points of three yang meridians on the forefoot could be observed, and based on this study, it is considered that the effect of needle stimulation on the changes of nervous system could be found out through additional research.
Objectives : To observe the changes in the expression of nNOS, iNOS, eNOS and NO by the needle insertion on river points, one of the five transport points of three yang meridians of the foot. Methods : Based on rats, needle was inserted on both left and right sides of ST41, BL60 and GB38 and retained for five minutes. After the retention, blood was drawn via cardiac puncture and tissues from each point around meridian vessels were extracted to observe the changes in the expression of nNOS, iNOS, eNOS and NO. Results : In terms of the effect on expression of nNOS within tissues, ST41 showed significant decrease based on the results of immunohistochemistry. In terms of the effect on expression of iNOS within tissues, none of the experimental groups showed any significant change compared to the Normal group. Regarding expression of eNOS within tissues, GB38 showed significant increase based on the results of immunohistochemistry. In terms of the effect on NO creation in tissues, none of the experimental groups showed any significant change compared to the Normal group. Conclusions : The effect of needle insertion on the river points of three yang meridians of the foot on the function of nNOS, iNOS, eNOS and NO could be observed, and based on this study, it is considered that the effect of needle stimulation on the changes of nervous system could be found out through additional research.
Objectives : This study was performed to investigate the effect of invasive laser acupuncture therapy with green light (LAT-G) at HT7(Sinmun), SP3(Taebaek) on the blood pressure in hypertensive rat induced by two kidney one clip. Methods : The experiments were performed on Sprague Dawley rats. 2K1C hypertension model was prepared by constricting the left renal artery with a sliver clip. Animals were divided into four groups, which were simple acupuncture treatment group with straight needle insertion on the square(AT-SS), acupuncture treatment group with reducing manipulation in the opposite channel direction(AT-RD), laser acupuncture treatment group with green light 532 nm, 10mW power in the opposite channel direction(LAT-G10) and laser acupuncture treatment group with green light 532 nm, 20mW power in the opposite channel direction(LAT-G20). The treatments were performed once per two days for 10 days. Results : Body weight was increased significantly in LAT-G20 group compared with AT-RD group. The blood pressure was significantly decreased in LAT-G20 and LAT-G10 groups compared with AT-SS group. Conclusions : These results suggest that green laser acupuncture therapy at SP3 ${\cdot}$ HT7 is more effective than straight needle insertion on the square for controlling hypertension. It is possible that invasive green laser acupuncture therapy (532 nm) can be used as a reducing method of the traditional acupuncture techniques.
Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.
Kim, Ki-Choul;Lee, Hyung-Jun;Lee, Kil-Yong;Park, Hee-Gon
Clinical Pain
/
v.20
no.2
/
pp.105-121
/
2021
Objective: Physiologically, the vastus medialis muscle is the first muscle to undergo muscle atrophy, and it was thought that pain in patients with knee osteoarthritis could be reduced if this muscle could be strengthened and stabilized. The purpose of this study was to prove the effectiveness in knee osteoarthritis using polydioxanone sutures that have been tried in other musculoskeletal areas. Method: Forty knee osteoarthritis patients voluntarily participated in the study, and divided into 30 polydioxanone suture needle (MEST-B2375 produced by Ovmedi Co.) and 10 sham needle (without suture). And the needles were inserted into the vastus medialis muscle. In all patients, safety evaluation including blood tests and ultrasonography as well as efficacy evaluation including isometric maximal contractile strength of quadriceps muscle, weight bearing pain, impression of change, quadriceps angle, rescue drug intake were evaluated up to 30 weeks after the procedure. Results: Isometric maximal contractile strength showed a significant improvement at 4 weeks after the procedure in the polydioxanone suture group, and the weight-bearing pain showed a significant improvement at every visit in the polydioxanone suture group compared with baseline values. Patient global impression of change score showed significant improvement at 20 and 30 weeks, and clinical score showed improvement at every visit. Conclusion: Insertion of polydioxanone sutures showed improvement in muscle strength and knee pain by supporting and fixation of the vastus medialis muscle in patients with degenerative knee osteoarthritis. Insertion of polydioxanone sutures is considered to have a therapeutic effect in knee osteoarthritis patients.
The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.
Objectives : This study was performed to observe the effects of acupuncture at right Nae-jong$(ST_{44})$ on the temperature and humidity changes of Sa-baek$(ST_2)$ area according to the meridian and Keo-ja(巨刺) of oriental medicine's theory. Methods : A clinical study was done on 13 females who didn't have my disease. We used LT-8B to observe the effects of acupuncture at right Nae-jong$(ST_{44})$ on the temperature and humidity changes of Sa-baek$(ST_2)$ area. Skin temperature and humidity on right and left Sa-baek$(ST_2)$ were measured by LT-8B at 1 minute before acupuncture stimulation, 1 minute and 2 minutes after acupuncture stimulation of right Nae-jong$(ST_{44})$. Results : 1. After inserting the needle at the right Nae-jong$(ST_{44})$ point, the temperature at the left Sa-baek$(ST_2)$ area rised from $31.60{\pm}1.13^{\circ}C$ 1 minute before to $32.24{\pm}1.19^{\circ}C$ 1 minute after the insertion and to $32.34{\pm}1.23^{\circ}C$ 2 minutes after insertion, what means an elevation by (P<0.05) between the temperature before and 2 minutes after the insertion and still an elevation by (P<0.01) between 1 minute and 2 minutes after insertion. The humidity at the same area decreased by (P<0.01) between 1 minute and 2 minutes after insertion. 2.After stimulating the right Nae-jong$(ST_{44})$ point the temperature change at the right Sa-baek$(ST_2)$ area between before and after the insertion was unremarkable, however the temperature rised by (P<0.05) between 1 minute and 2 minutes after insertion and the humidity decreased by (P<0.05) between 1 minute and 2 minutes after stimulation. 3. Comparing the temperature change between 1 minute and 2 minutes after stimulating the right Nae-jong$(ST_{44})$ point, we could find a significant difference by (P<0.05) at both Sa-baek$(ST_2)$ areas. Concerning the humidity change, there were some average differences but too small for statistic significance.
In PET/CT, the injection volume of 18F-FDG directly affects the SUV(standard uptake value), which can affect the reading results. Therefore, it is important to inject the correct dose value of 18F-FDG. In this study, we performed the correlation between the residual radioactivity remaining in the syringe and catheter insertion device according to the number of flushing during 18F-FDG injection. CRC-25R dose calibrator, catheter insertion devices, 3 cc syringes and 50 cc physiological saline were used in this study, and the results were statistically analyzed. As a result, the total residual radioactivity of the syringe and catheter insertion device remained the highest at 5.84% after two flushing, and the least remained at 1.49% after five flushing. The correlation analysis results showed that the number of flushing had a negative correlation with the residual radioactivity of the syringe at -0.436 and the catheter insertion device at -0.300. As a result of one-way distributed analysis of the average according to the number of flushing, the syringe showed a significant decrease at 4 times, and the catheter insertion device showed a significant decrease at 5 times. However, considering that an average of 0.8% remains in the case of catheter insertion devices, four time flushing seems to be the most appropriate.
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