• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.94-98
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• 2009

Acupuncture is a treatment method that originated more than 3,000 years ago in China and is practiced in most of the world. Acupuncture became the most popular complementary and alternative medicine modality. Ultrasound is useful for research and educational purposes, visualizing needle insertion at acupuncture points, especially next to vulnerable structures such as nerves or the pleura. Additionally, ultrasound is an ideal imaging method for evaluation the biomechanical effects of needle manipulation on tissue and has the distinctive advantage of yielding both images of tissue morphology and biomechanical information. Elastography take aim at quantifying a mechanical response or the mechanical property of tissues from a mechanical stimulus, generated internally or externally. Therefore, the combination of ultrasound and elastography analyses allows quantitative assessment of dynamic changes in the structure of human connective tissue.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.276-280
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• 2015

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.56 no.2
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• pp.436-441
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• 2007

Background: As patients are positioned at insulated bed and practitioner are positioned at insulated floor or shoes, it could be a cause of lessening effect in acupuncture practice. We investigated how Ground connection could influence on the electrical meridian potential between practitioner and patient during acupuncture practice. Method: We treated 30 normal healthy subjects with acupuncture and measured changes in the electrical potential between the stomach meridian points ST-39 and ST-37 in response to light touch after insertion of a needle at ST-36. At first, we stimulated needle and measured electrical potentials for non ground, patient ground only, practitioner ground only, all ground, respectively. Result: All ground subject elicited positive mean potential $44.6{\pm}19.2{\mu}V$ and showed $181.4{\pm}59.7{\mu}V$ peak to peak potential. practitioner ground only showed negative mean potential $-51.5{\pm}9.3{\mu}V\;and\;367.4{\pm}27.8{\mu}V$ of peak to peak potential. Patient ground only revealed no mean potential as $2.9{\pm}1.3{\mu}V,\;16.4{\pm}11.9{\mu}V$ of peak to peak potential. All ground showed no mean potential as $1.6{\pm}0.7{\mu}V,\;3.3{\pm}1.9{\mu}V$ of peak to peak potential. respectively.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.55-59
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• 2005

Purpose: To evaluate the drainage effect of silk suture material following aspiration of the bursa as an early treatment of chronic prepatellar bursitis. Materials and Methods: Twelve cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 18.3 months. The average symptom duration before introduction into this study was 2.2 months. With an aseptic technique, the aspiration of the bursa was done with spinal needle or injection needle and syringe and then the insertion of silk suture material through the aspiration needle was performed. 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 material was found in all cases, but there was no development of active infection in eleven cases. At five days after procedure, a supprative infection was developed in one case. The results were considered satisfactory in 92% of cases and the average duration of treatment is 14.5 days. Conclusion: The drainage with silk suture material following aspiration of the bursa is effective and less invasive method in the early treatment of chronic prepatellar bursitis.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.208-221
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• 2000

The objective of this research was to compare the flushing effects using 1:1,000 diluted heparin or 0.9% normal saline in relation to needle gauge and frequency of IV medications. The comparative categories were clotting, duration of patency, and incidence of phlebitis. The design of research was a Nonequivalent Control group, Post test, Nonsynchrorized Design. The independent variable was 0.9% normal saline flushing the IV locks and the dependent variables were clotting, duration of patency, and incidence of phlebitis. Subjects were medical-surgical inpatients over 15 years old and with peripherally placed IVs who were hospitalized in a university medical center. Exclusion criteria included foreigners and those who were rejected for this research. The final sample for data analysis included 295 IV sites in 194 patients; 154 were in the saline group and 141 were in the heparin group. Subjects were assigned to have IV locks is flushed with 0.9% normal saline in the experimental group and to have IV lock flushed with 1:1,000 diluted heparin(100 units) in the control group. In order to increase reliability, the nurses who were assigned to the units involved in the study received an explanation on the standard method for locking an IV, recording method for observational data and criteria for the detection of phlebitis. Data were collected for a period of 2 weeks, from March 16, 2000 to March 29, 2000. Total duration of IV was defined the time of IV insertion to the time of discontinuation. Phlebitis was defined as the presence of the following : pain, swelling. erythema at the insertion site. Chi-square was used to determine the association between the degree of clotting, duration of patency, and incidence of phlebitis for the diluted heparin or the normal saline and needle gauge and frequency of IV medications. The results are summarized as follows : (a) There was difference in the degree of clotting between two groups($X^2=5.882$, p=.015). (b) There was no difference in the degree of duration of patency between two groups($X^2=2.439$, p=.295). (c) There was no difference in the incidence of phlebitis between two groups($X^2=0.190$, p=.663). (d) There was difference in the degree of clotting($X^2=6.209$, p=.013) and in the degree of duration of patency($X^2=6.978$, p=.031) according the needle guage between the two groups. (e) There was difference in the incidence of phlebitis($X^2=5.008$, p=.025) according to the frequencies of IV injection between two groups.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.183-189
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• 2013

Purpose: The aim of this study was to identify the optimal insertion angle between the skin and the needle in ultrasound-guided internal jugular vein (IJV) catheterization with trauma patients. Methods: From March 2012 to December 2012, consecutive trauma patients who were planned to receive IJV catheterization were prospectively enrolled. We measured the distances from the skin to IJV's anterior-posterior (AP) vessel wall on the longitudinal scan's midline in supine-positioned patients. We calculated the AP diameter of IJV and the angle between skin and the imaginary line from the puncture site to the IJV's internal center on screen's midline (defined as optimal angle which is considered as the safest approach) on the longitudinal scan. We divided the patients into 3 groups based on the CVP (low CVP <5 $cmH_2O$, $5{\leq}$ middle CVP ${\leq}10\;cmH_2O$, and high CVP>10 $cmH_2O$) and compared their mean anterior posterior (AP) diameters and optimal angles. Results: A total of 56 patients were enrolled. Of these 21 were women(35.4%). The mean AP diameter of low CVP group was significantly lower than middle and high CVP groups($0.68{\pm}0.30$, $1.06{\pm}0.31$, and $1.23{\pm}0.49$ cm respectively, p=0.003 vs. 0.002). There was no significant difference among 3 groups' mean optimal angles ($28.1{\pm}6.1$, $30.1{\pm}4.5$, and $28.0{\pm}5.0$ degree respectively). Conclusion: The optimal angle between the skin and the needle in ultrasound-guided IJV catheterization with trauma patients is not changed as about 30 degrees regardless of CVP even though IJV's diameter is altered in proportion to the CVP.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.396-400
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• 2013

Conventional transcrural CPB via the "walking off" the vertebra technique may injure vital organs while attempting to proximally spread injectate around the celiac plexus. Therefore, we attempted the CT-simulated fluoroscopy-guided transdiscal approach to carry out transcrural CPB in a safer manner, spreading the injectate more completely and closely within the celiac plexus area. A 54-year-old male patient with pancreatic cancer suffered from severe epigastric pain. The conventional transcrural approach was simulated, but the needle pathway was impeded by the kidney on the right side and by the aorta on the left side. After simulating the transdiscal pathway through the T11-12 intervertebral disc, we predetermined the optimal insertion point (3.6 cm from the midline), insertion angle (18 degrees), and advancement plane, as well as the proper depth. With the transdiscal approach, we successfully performed transcrural CPB within a narrow angle, and the bilateral approach was not necessary as we were able to achieve the bilateral spread of the injectate with the single approach.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.409-412
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• 1999

To establish the electroacupuncture anesthesia for pigs, 6 piglets (Landrace mixed, 1 month old, 3.7~5.3 kg, female: 3 heads and male: 3 heads) were examined. The acupoints used for porcine electroacupuncture anesthesia were An-shen, and Tian-ping and Bai-hui. After horizontal insertion of needle to left and right An-shen, and perpendicular insertion to Tian-ping and Bai-hui, respectively, positive electrode was connected at right An-shen and Tian-ping, and negative electrode was connected at left An-shen and Bai-hui using veterinary electroacupuncture anesthesia apparatus, respectively. Electric condition was 3 V and 30 Hz. To examine the effect of electroacupuncture anesthesia, laparotomy (4 heads) and castration (2 heads)were applied. The induction time of electroacupuncture anesthesia was very rapid and about 1 minute, and pain of the body surface including the extremities was not detected. As for the reactions with electroacupuncture anesthesia, the head was directed to backward, nasal part was curved to one side, and blepharum was closed in part of changed nasal part. In addition, consciousness was vivid, and muscle tension and lift of the tail were observed in early stage but was relaxated afterwards. The pain was not found during incision and suture, bleeding was comparatively small volume and the class of anesthesia effect was excellent.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.98-105
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• 2023

Background: Ultrasound-guided first sacral transforaminal epidural steroid injection (S1 TFESI) is a useful and easily applicable alternative to fluoroscopy or computed tomography (CT) in lumbosacral radiculopathy. When a needle approach is used, poor visualization of the needle tip reduces the accuracy of the procedure, increasing its difficulty. This study aimed to improve ultrasound-guided S1 TFESI by evaluating radiological S1 posterior foramen data obtained using three-dimensional CT (3D-CT). Methods: Axial 3D-CT images of the pelvis were retrospectively analyzed. The radiological measurements obtained from the images included 1st posterior sacral foramen depth (S1D, mm), 1st posterior sacral foramen width (S1W, mm), the angle of the 1st posterior sacral foramen (S1A, °), and 1st posterior sacral foramen distance (S1ds, mm). The relationship between the demographic factors and measured values were then analyzed. Results: A total of 632 patients (287 male and 345 female) were examined. The mean S1D values for males and females were 11.9 ± 1.9 mm and 10.6 ± 1.8 mm, respectively (P < 0.001); the mean S1A 28.2 ± 4.8° and 30.1 ± 4.9°, respectively (P < 0.001); and the mean S1ds, 24.1 ± 2.9 mm and 22.9 ± 2.6 mm, respectively (P < 0.001); however, the mean S1W values were not significantly different. Height was the only significant predictor of S1D (β = 0.318, P = 0.004). Conclusions: Ultrasound-guided S1 TFESI performance and safety may be improved with adjustment of needle insertion depth congruent with the patient's height.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.641-648
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• 2018

Objective: This study examined the incidence and amount of air inflow during central venous catheter (CVC) insertion. Methods: This study was an experimental study aimed at designing an apparatus to implement blood vessel and blood flow in the human body. A 1.5-m long core tube with a Teflon tube, suction rubber tube, and polyvinyl chloride tube were made. This core tube was assumed to be the blood vessel of the human body. Blood was replaced with a saline solution. The saline solution was placed higher than the core tube and flowed into the inside of the tube by gravity. The CVC was injected 15-cm deep into the core tube. The air was collected through a 3-way valve into the upper tube. The experiments were carried out by differentiating the pressure in the tube, CVC insertion step, and diameter of the end of the catheter. The experiment was repeated 10 times under the same conditions. Results: The amount of air decreased with increasing pressure applied to the tube. Air was not generated when the syringe needle was injected, and the amount of air increased with increasing size of the distal end catheter. Conclusion: To minimize the possibility of air embolism, it is necessary to close the distal end catheter at the earliest point as soon as possible.