• The Korean Journal of Pain
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• 제22권1호
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• pp.52-57
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• 2009

Background: Transforaminal epidural injection (TEI) may be useful to treat unilateral pain that has a dermatomal distribution. In this approach, the needle tip can be placed closer to the dorsal root ganglion and ventral aspect of the nerve root. However many studies have reported that serious complications following TEI occurred more frequently when it was conducted at the cervical level. One of the presumptive mechanisms of the complication is intravascular injection. Therefore this study was conducted to identify the incidence of complications in response to intravascular injections at cervical segments. Methods: This study included all patients, who visited our pain clinic and had radicular symptoms or herpes zoster associated pain. All procedures were conducted under fluoroscopic guidance with contrast enhancement by one of the authors. After the ideal needle position was confirmed by biplanar fluoroscopy, the blood aspiration through the needle hub was evaluated, and a 3 ml mixture of nonionic contrast (2 ml) with normal saline (1 ml) was injected at a rate of 0.3-0.5 ml/sec continuously under real time fluoroscopic visualization. We then classified the contrast spreading pattern as neural, simultaneous neural and vascular, or vascular. Results: A total 71 cervical TEIs were performed. In 26 cases (36.6%), the contrast only spread to the nerve sheath. However, 45 cases (63.4%) showed an intravascular spreading pattern, 37 (52.1%) of which showed a neural and vascular pattern and 8 (11.3%) of which showed only a vascular pattern. Conclusions: Approximately two thirds of the cases of cervical TEI were found to lead to intravascular spreading, which is much higher than the incidence reported in previous studies.

• The Korean Journal of Pain
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• 제12권1호
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• pp.87-94
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• 1999

Backgroud: We have performed the CT-guided celiac plexus block (CPB) using anterior approach to evaluate the safety and efficacy of the procedure and to determine the role of CT. Methods: CPB were done in 10 patients (5 men and 5 women: mean age, 58.1 years) with intractable upper abdominal pain due to terminal malignancy of the stomach (n=3), pancreas (n=4), gallbladder (n=2), and liver (n=1). To permit an anterior approach, patients lay supine on the CT scan table during the procedure. One 21-guage Chiba needle was placed just anterior to the diaphragmatic crus between the celiac and superior mesenteric arteries and 10~12 ml of dehydrated alcohol was injected. Degree of pain relief following the procedure was assessed and pain was graded on a numeric rating scale (NRS) from 0 to 10. Results: The results suggest a direct relation between the degree of celiac invasion and the response to the CPB. With CT guidance, it is possible for us to direct the needle into more accurate region, allowing alcohol to be deposited in specific ganglion area. Conclusions: CT-guided CPB using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT-guidance allowed precise needle placement and safe procedure. Careful classification of cases is important to predict the degree of pain relief using the grading system based on the degree of involvement of the celiac plexus.

• 대한기관식도과학회지
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• 제5권1호
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2008년도 추계학술대회A
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• pp.1547-1552
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• 2008

The tip of these catheter with straight needles is not able to reach in the vicinity of the disc bulging, which are the cause of the low back pain and because the far indirect radio-frequency treatment results in the decompression, the nucleoplasty has the limit. Many incurable diseases has not been solved due to the unexistence of the advanced technique for the MIS human body catheter device. To increase the possibility of nucleoplasty, the needle tip should be located at the closest area of the lesion. For this reason, the best way to increase the success rate of the operation is that the needle tip should access 3-dimensionally to the operating field as soon as possible. To achieve this aim, our studies are restricted as follows: 1) the SMA catheter design to control the 3-dimensional direction, 2) the security of the immediate response by the positive control of the SMA element thermal distribution using Peltier thermoelectric elements, 3) the aquisition of the control data by monitoring the relationship between the temperature of SMA element and the displacement, and 4) the design of the controller to guarantee the accurate location.

• 대한정형외과 초음파학회지
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• 제2권2호
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• pp.94-98
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• 2009

침술은 중국에서 3,000년 이상의 기원을 가진 가장 대중적인 보완대체의학 치료 방법으로 전세계적에서 널리 시행되고 있다. 초음파는 교육과 연구목적, 신경과 늑막과 같은 위험한 구조 주위 경혈에 침술을 시행할 때 도움이 된다. 또한 초음파는 조직에서 침 수기의 생 기계적 효과를 평가하는 데 이상적인 영상 검사로 조직 형태와 생 기계적 정보의 영상을 제공하는 특징적 장점을 가지고 있다. 탄성영상은 내부 혹은 외부에서 발생하는 기계적 자극에 의한 조직의 기계적 성질 혹은 반응을 정량화 할 수 있다. 그러므로 초음파와 탄성영상의 결합은 침술에 의한 인체 결합조직 구조의 동적변화를 정량적으로 평가할 수 있다.

• 전기학회논문지
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• 제56권2호
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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.

• 한국분무공학회지
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• 제9권1호
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• pp.8-14
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• 2004

future exhaust emission limits for diesel-driven passenger cars will force the automotive company to significantly develop of the new technologies of diesel engine respectively of the drive assemblies. As we know, the contributions of soot and nitrogen oxide is the main problems in diesel engine. Recently, as a result, the pilot injection of common-rail fuel injection system recognizes an alternative function to solve an environmental problem. This study describes the effect of the nozzle structure and driven characteristic of injector on pilot injection fur a passenger car common-rail system. The pilot spray structure such as spray tip penetration, spray speed and spray angle were obtained by high speed images, which is measured by the Mie scattering method with optical system fur high-speed temporal photography. Also the CFD analysis was carried out for fuel behavior under high pressure in between needle and nozzle of injector for common-rail system to know the condition of initial injection at experiment test. It was found that solenoid-driven injector with 5-hole was faster than 6-hole injector in spray speed at same conditions and piezo-driven injector showed faster response than solenoid injector.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.125-134
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• 2006

Among the various physiological factors that affect nerve conduction velocity (NCV), temperature is the most important. Because the influence of temperature is the most important source of error. It is known from animal experiments that conduction is eventually completely blocked at low temperatures, the myelinated A fibers being the first affected and the thin fibers of group C the last. Many studies showed that the NCV decreases linearly with lowering temperature within the physiological range. The distal motor latency increased by $0.2msec/^{\circ}C$ drop in temperature between $25^{\circ}C$and $35^{\circ}C$ in the median, ulnar and peroneal nerves. The temperature affect the neuromuscular transmission; The miniature endplate potential (MEPP) and endplate potential (EPP) are increase with increasing temperature. In myasthenia gravis, the reduction in the decremental response is observed following cooling. The lowering temperature make increase the amplitude of sensory compound action potential; make enlarge the surface area of compound muscle action potential with very little increase in amplitude; make diminish the fibrillation potential and increase the myotonia in needle electromyography (EMG). Because of these findings mentioned above, the skin temperature should be routinely monitored and controlled during nerve conduction tests and needle EMG and should be taken into account when interpreting the findings.

• Korean Journal of Acupuncture
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• 제36권4호
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• pp.300-307
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• 2019

Objectives : This study details on a case of acupotomy for relapsed lateral malleolar bursitis. Methods : A 71-year-old woman with lateral malleolar bursitis was treated with acupotomy twice in an outpatient setting. A sterilized, disposable, blade width 0.5 mm × needle length 50 mm sized acupotomy was administered on GB40 and BL62 on each visit. Pain intensity assessment using Numeric Rating Scale (NRS) and the response evaluation criteria was conducted right after each treatment. Results : Pain on NRS declined from 5 to less than 1 after twice of acupotomy treatment. This result was regarded as 'Complete Response' using the response evaluation criteria. There were no side effects during whole treatment procedure at all. Conclusions : It is turned out that acupotomy can have a positive clinical effect on lateral malleolar bursitis in this case without any adverse effect. Further controlled studies on acupotomy for lateral malleolar bursitis are required for clinical application.

• 대한방사선치료학회:학술대회논문집
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• 대한방사선치료학회 2005년도 춘계학술대회 초록집
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• pp.23-26
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• 2005

재발한 vulva tumor의 근접 치료에 있어서 정상조직의 장애와 tumor volume내의 dose uniformity는 치료성적에 매우 중요한 요인이다. 이를 개선하기 위하여 modified MUPIT applicator를 제작하여 modified MUPIT applicator의 적용에 대한 유용성을 평가하고자 한다. modified MUPIT applicator는 template, cylinder, interstitial needle로 구성되었으며, tumor volume을 정하기 위하여 CT를 시행하였다. CT image를 이용하여 interstitial needle의 삽입 위치를 확인하고 수술실에서 template 를 치료 부위에 고정을 시키고 cylinder를 vaginal cavity에 삽입한 후 interstitial needle을 tumor volume 내에 삽입 하였다. tumor volume내에서 interstitial needle의 정확한 위치를 확인하기 위하여 CT를 시행하였으며 orthogonal film을 이용하여 computer planning을 실시하였다. daily tumor dose는 600 cGy, BID로 3000 cGy를 조사하였으며 치료 시 rectal dose를 평가하기 위하여 TLD를 이용하여 anal verge를 기준으로 5개 지점에서 rectal dose를 측정하였다. rectal dose는 34.1 cGy, 57.1 cGy, 103.8 cGy, 162.7 cGy, 165.7 cGy로 측정되었으며 EBRT(whole pelvis RT), ICR과 overlap되는 지점은 34.1 cGy, 57.1 cGy로 매우 우수하게 평가되었다. 결론적으로 자체 제작한 modified MUPIT applicator 사용하여 interstitial brachytherapy를 시행함으로써 EBRT로 cover하기 어려운 환자의 tumor volume내에서 irregularity를 효율적으로 극복할 수 있었고 우수한 rectal dose 분포를 통하여 rectal complication의 발생 확률을 현저히 감소시킬 수 있었다.