• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.120-123
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• 2012

Objective : Percutaneous vertebroplasty (PVP) is usually carried out under three-dimensional (2D) fluoroscopic guidance. However, operative complications or bone cement distribution might be difficult to assess on the basis of only 2D radiographic projection images. We evaluated the feasibility of performing an intraoperative and postoperative examination in patients undergoing PVP by using three-dimensional (3D) reconstructive C-arm. Methods : Standard PVP procedures were performed on 14 consecutive patients by using a Siremobil Iso-$C^{3D}$ and a multidetector computed tomography machine. Post-processing of acquired volumetric datasets included multiplanar reconstruction (MPR) and surface shaded display (SSD). We analyzed intraoperative and immediate postoperative evaluation of the needle trajectory and bone cement distribution. Results : The male : female ratio was 2 : 12; mean age of patients, 70 (range, 77-54) years; and mean T score, -3.4. The mean operation time was 52.14 min, but the time required to perform and post-process the rotational acquisitions was 7.76 min. The detection of bone cement distribution and leakage after PVP by using MPR and SSD was possible in all patients. However, detection of the safe trajectory for needle insertion was not possible. Conclusion : 3D rotational image acquisition can enable intra- or post-procedural assessment of vertebroplasty procedures for the detection of bone cement distribution and leakage. However, it is difficult to assess the safe trajectory for needle insertion.

• Restorative Dentistry and Endodontics
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• 제43권1호
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• pp.2.1-2.10
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• 2018

Objectives: To determine the effect of size and insertion depth of irrigation needle on the amount of apical extruded debris and the amount of penetration depth of sealer using a confocal laser scanning microscope (CLSM). Materials and Methods: Twenty maxillary premolars were assigned to 2 groups (n = 10), according to the size of needle tip, 28 G or 30 G. Buccal roots of samples were irrigated with respective needle type inserted 1 mm short of the working length (WL), while palatal roots were irrigated with respective needle type inserted 3 mm short of the WL. Prepared teeth were removed from the pre-weighed Eppendorf tubes. Canals were filled with F3 gutta-percha cone and rhodamine B dye-labeled AH 26 sealer. Teeth were transversally sectioned at 1 and 3 mm levels from the apex and observed under a CLSM. Eppendorf tubes were incubated to evaporate the irrigant and were weighed again. The difference between pre- and post-weights was calculated, and statistical evaluation was performed. Results: Inserting needles closer to the apex and using needles with wider diameters were associated with significantly more debris extrusion (p < 0.05). The position of needles and level of sections had statistically significant effects on sealer penetration depth (p < 0.05 for both). Conclusions: Following preparation, inserting narrower needles compatible with the final apical diameter of the prepared root canal at 3 mm short of WL during final irrigation might prevent debris extrusion and improve sealer penetration in the apical third.

• Journal of Acupuncture Research
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• 제28권1호
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• pp.15-28
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• 2011

Objectives : To understand the strength and weakness of traditional warm needle acupuncture based on existing research outcomes in Korea mostly and to suggest how to build the desirable warm needle acupuncture apparatus by overcoming demerits of traditional and currently existing ones. Methods : We searched warm needle relating papers in Korean with the key words of '온침, 화침, 열자극' by using DBpia, Journal of Korean Oriental Medical Society, Journal of Korean Acupuncture & Moxibustion Society and Journal of Society for Meridian and Acupoint. Degree dissertations in Korean were also searched with the same words through the search engine of Library of Kyung Hee University. We also searched with words of 'warm, thermal, heat, needle, acupuncture, temperature' via Pubmed and found a small number of English written papers and large number of Chinese written ones. To find english translated version of those papers, we googled with the same words with no success. Results : About 20 papers on warm needle acupuncture written in Korean were found and analyzed with respect to experimental factors that affected the thermal properties or the amount of heat stimulus of the acupuncture. More rigorous descriptions seemed to be required on the insertion depth, duration and manipulation of warm needle treatment. A basic heat transfer model was presented for the clarification of heat loss through the needle of warm needle acupuncture. Environmental factors such as air flow on the properties seems to be considered for the warm needle acupuncture. Conclusions : Papers on warm needle acupuncture were reviewed and analyzed based on their thermal properties and tools such as needles and moxa cones. Several suggestions were made on the descriptions relating the properties. Necessary specifications were introduced to aim modernized warm needle systems.

• Journal of Acupuncture Research
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• 제17권4호
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• pp.113-119
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• 2000

Objectives : Wrist ganglion is one of the most common diseases on the wrist joint. So far acupuncture, medication, drainage and local anesthetic excision therapy have been used for this disease, but the development of more effective treatment method is being expected because of frequent recurrence and side effect. Considered that most ganglion is polycystic, on the basis of classic centro-square acupuncture, newly transformed centro-square acupuncture was applied to this report. Methods : All the patients with wrist ganglion was divided into two groups. Newly transformed centro-square acupuncture was app(ied to one group composed of 11 patients and classic centro-square acupuncture to the other group with 19 patients. Classic centro-square acupuncture is made up of slanting and straight insertion. the former is a method that tips of 4 needles are inserted from the outersurface of wrist ganglion oriented to the center of the ganglion, the latter is that tip of one needle is inserted on the center of the ganglion straightly. In the newly transformed centro-square acupuncture, straight insertion of dry needle was taken place of by syringe needle in order to drain phlegm. In this report, classic and newly transformed centro-square acupuncture were used somewhat differently from original ones. Moxibustion was applied after removing all the needles. In newly transformed centro-square acupuncture, moxibustion was also applied after drainage of phlegm and slanting insertion. Results : 1. Wrist ganglion was frequently developed around the acupoint of Tae-Yeon(Tai Yuan, LU9) and Yang-Ji(Yang Chi, TE4) and the difference between occurrence of development on the left and right hand had no significancy. 2. The mean number of treatment for recovery : The newly transformed centro-square acupuncture had fewer treatment than classic one. 3. The newly transformed centro-square acupuncture was more effective than classic one. 4. As a result of following up 6 to 72 months after wrist ganglion had been eliminated, there was no recurrence. Conclusion : In the treatment of wrist ganglion, newly transformed centro-square acupuncture can be regarded as more useful method in the clinical practice, because it has comparatiely shorter duration of treatment and is more effective.

• 한국한의학연구원논문집
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• 제2권1호
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• pp.84-103
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• 1996

The physiological signals measured by Oriental Medicine instruments have been analyzed quantitatively in the view of the rule of promoting and counteracting relation of five evolutive phases theory. We tried to reduce the physiological signals measured by EAV(Elec-tro-Acupuncture according to Voll) and IR thermography to the representation of five evelutive phases. The EAV index and local skin temperature on acupuncture points of each phases measured and normalized so that the total value of five phases became unity. We assumed that the normalized EAV index and local skin temperature mean the deficiency or excess of Qi for each phases. The state of Qi distribution for each phases were approximately agree with the diagnostic pattern of O. M. doctor. Taking account of the Qi distribution state of·or the five evolutive phases, we performed a proper needle insertion on acupuncture points to induce the distinct change of Qi for each phases. We compared the measured results with the predictions of Qi variation by the rule of pro- moting and counteracting relation over the five evolutive phases. For all cases, the variation of Qi in the own phase on which a needle insertion was performed were exactly same to the theoretical prediction and partial agreement was shown for the other four phases. The same analysis was carried to the results of skin temperature measurements at accupoints. We found that the local skin temperature at accupoints of each phases shelved a finite change by the needle insertion and the behavior- of its change were strongly correlated to the rule of promoting and counteracting relation of five evolutive phases.

• Journal of Acupuncture Research
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• 제23권1호
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• pp.135-143
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• 2006

Objectives : This study was performed to observe effect of acupuncture stimulation on heart rate variability in stroke patients. Methods : Data were obtained from heart rate variability of 29 stroke patients. Heart rate variability was measured total five times(before and after needle insertion, before and after needle removal, and 10 minutes after needle removal) for five minutes each time. Results : Heart rates were continuously decreased until 10 minutes after needle removal. SDNN, Total power, LF, and HF were increased until 5 minutes after needle removal, but deceased between 5 and 10 minutes after needle removal. There was no significant changes between male and female and among age groups. Conclusion : This study showed that acupuncture stimulation could effect on heart rate variability in stroke patients. Heart rate variability could be a objective tool to verify the mechanism of acupuncture effect in various condition.

• Journal of Acupuncture Research
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• 제20권2호
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• pp.145-160
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• 2003

Objective : This study was designed to find out whether placebo auricular acupuncture is able to be constituted as an appropriate control group for needle insertion to Korean. Methods : We performed a randomized controlled, single-blind study(n=48) comparing subjective evaluations of needles insertion and avoidance of needles insertion. Both ears were needled concurrently, one real acupuncture(needle insertion) and the other placebo acupuncture(avoidance of needle insertion with blunt tip). Subjects then completed a questionnaire rating the intensity of five sensations in each ear, and also attempted to identity which ear received placebo and which ear received real acupuncture. Results : As for the effects of real and placebo acupuncture on each item(Warmth, Fullness, Pain, Activity, Radiating), real acupuncture was significantly warmer, fuller, more painful than placebo acupuncture. In particular, the real acupuncture only in experienced acupuncture recipients was significantly warmer, fuller, more painful than placebo acupuncture. About the ability to differentiate real and placebo acupuncture, 54.2 percent correctly identified which ear received real acupuncture and which ear received placebo acupuncture. However, the ability to differentiate real and placebo acupuncture for naive and experienced acupuncture recipients was not significantly different. Conclusions : Most of the subjects(Korean) identified which ear received placebo and which ear received real acupuncture. We found that this placebo auricular acupuncture is not able to be applied to Korean, in particular for experienced acupuncture recipients. Further study is needed for new placebo auricular acupuncture or racial difference between American.

• The Korean Journal of Pain
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• 제20권1호
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• pp.40-45
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• 2007

Background: Caudal block is useful when anesthesia for surgery or treatment for chronic pain is needed, but this procedure has a failure rate of up to 25% even when it performed byan experienced physician. This high failure rate is usually due to improper needle placement. Methods: After gaining approval of the ethics committee, 46 patients received caudal blocks under ultrasound guidance; these were performed after the anatomical structures in the sacral hiatus had been measured with ultrasound. All these procedures were performed by the same anesthesiologist. The position and direction of the needle were identified using fluoroscopy by injecting a radio-opaque contrast through the needle. The time taken from thelidocaine injection to verification of the needle was measured and the planned nerve block was then carried out. Results: All cases of needle insertion into the sacral canal under ultrasound guidance were successful. The average duration of the procedure and the trial count were $134.1{\pm}10.1seconds$ and $1.2{\pm}0.1$, respectively. In 12 of the 46 cases (26%), the needle deviated either left or right in the sacral canal, so the direction of the needle had to be adjusted. The distance between two cornua, the depth of the sacral hiatus and the thickness and length of the sacrococcygeal ligament were $17.1{\pm}0.4$, $3.9{\pm}0.3$, $2.3{\pm}0.1$ and $24.9{\pm}0.9mm$, respectively. Conclusions: Ultrasound guidance can increase the success rate of inserting a needle into the sacral canal. However, even when ultrasound is used, the needle can deviate either left or right in the sacral canal.

• Korean Journal of Anesthesiology
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• 제71권6호
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• pp.430-439
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• 2018

In infants and small children, ultrasound (US) guidance provides ample anatomical information to perform neuraxial blocks. We can measure the distance from the skin to the epidural space in the US image and can refer to it during needle insertion. We may also visualize the needle or a catheter during real-time US-guided epidural catheterization. In cases where direct needle or catheter visualization is difficult, US allows predicting successful puncture and catheterization using surrogate markers, such as dura mater displacement, epidural space widening due to drug injection, or mass movement of the drug within the caudal space. Although many experienced anesthesiologists still prefer to use conventional techniques, prospective randomized controlled trials using US guidance are providing increasing evidence of its advantages. The use of US-guided regional block will gradually become widespread in infants and children.

• 대한족부족관절학회지
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• 제9권1호
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• pp.38-41
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• 2005

Purpose: To evaluate the drainage effect of silk suture following aspiration of the bursa as an early treatment of chronic lateral malleolar bursitis. Materials and Methods: Thirteen cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 16.4 months. The average symptom duration before introduction into this study was 7.8 weeks. With an aseptic technique, the aspiration of the bursa was done with 18G needle and syringe and then the insertion of silk suture through the aspiration needle was performed. The amount of drainage was identified two or three times in a week and stitch out was done at the cessation of drainage. Over one year follow-up, recurrence, infection, pain, and limitation of range of motion were investigated by telephone interview. Results: Redness around the insertion site of silk suture was found in all cases, but there was no development of active infection or recurrence. The average duration of treatment is 10.4 days. Conclusion: The drainage with silk suture following aspiration of the bursa is less invasive and very effective method in the early treatment of chronic lateral malleolar bursitis.