• 제목/요약/키워드: Post-treatment imaging

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Surveillance for metachronous cancers after endoscopic resection of esophageal squamous cell carcinoma

  • Ryu Ishihara
    • Clinical Endoscopy
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    • 제57권5호
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    • pp.559-570
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    • 2024
  • The literature pertaining to surveillance following treatment for esophageal squamous cell carcinoma (SCC) was reviewed and summarized, encompassing the current status and future perspectives. Analysis of the standardized mortality and incidence ratios for these cancers indicates an elevated risk of cancer in the oral cavity, pharynx, larynx, and lungs among patients with esophageal SCC compared to the general population. To enhance the efficacy of surveillance for these metachronous cancers, risk stratification is needed. Various factors, including multiple Lugol-voiding lesions, multiple foci of dilated vascular areas, young age, and high mean corpuscular volume, have been identified as predictors of metachronous SCCs. Current practice involves stratifying the risk of metachronous esophageal and head/neck SCCs based on the presence of multiple Lugol-voiding lesions. Endoscopic surveillance, scheduled 6-12 months post-endoscopic resection, has demonstrated effectiveness, with over 90% of metachronous esophageal SCCs treatable through minimally invasive modalities. Narrow-band imaging emerges as the preferred surveillance method for esophageal and head/neck SCC based on comparative studies of various imaging techniques. Innovative approaches, such as artificial intelligence-assisted detection systems and radiofrequency ablation of high-risk background mucosa, may improve outcomes in patients following endoscopic resection.

외상 후 스트레스 장애에 대한 옥시토신의 역할: 체계적 문헌 고찰 (Role of Oxytocin in Post-traumatic Stress Disorder: A Systematic Review)

  • 오재욱;김민수;추상희
    • Journal of Korean Biological Nursing Science
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    • 제24권1호
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    • pp.1-16
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    • 2022
  • Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

술전ㆍ후 상악동염환자와 정상인의 상악동 크기 및 골벽두께에 관한 전산화단층방사선학적 연구 (A Computed Tomographic Study on the Size and Bone Wall Thickness of the Maxillary Sinus in Normal, Preoperative and Postoperative Maxillary Sinusitis Patients)

  • 최선영;이상래;고광준
    • Imaging Science in Dentistry
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    • 제30권2호
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    • pp.109-116
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    • 2000
  • Purpose : To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. Materials and Methods : The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. Results: The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). Conclusion : The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

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Endoscopic Treatment of Chronic Subdural Hematoma Combined with Inner Subdural Hygroma

  • Yoon Hwan Park;Kwang-Ryeol Kim;Ki Hong Kim
    • Journal of Korean Neurosurgical Society
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    • 제66권5호
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    • pp.552-561
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    • 2023
  • Objective : A chronic subdural hematoma (CSDH) is a collection of bloody fluid located in the subdural space and encapsulated by neo-membranes. An inner subdural hygroma (ISH) is observed between the inner membrane of a CSDH and the brain surface. We present six cases of CSDH combined with ISH treated via endoscopy. Methods : Between 2011 and 2022, among the 107 patients diagnosed with CSDH in our institute, six patients were identified as presenting with CSDH combined with ISH and were included in this study. Preoperative computerized tomography (CT) and magnetic resonance imaging (MRI) were performed simultaneously, and endoscopic surgery for aspiration of the hematoma was performed in all cases of CSDH combined with ISH. Results : The mean age of patients was 71 years (range, 66 to 79). The patients were all male. In two cases, the ISH was not identified on CT, but was clearly seen on MRI in all patients. The inner membrane of the CSDH was tense and bulging after draining of the CSDH in endoscopic view due to the high pressure of the ISH. After fenestration of the inner membrane of the CSDH and aspiration of the ISH, the membrane was sunken down due to the decreasing pressure of the ISH. There was one recurrence in post-operative 2-month follow up. The symptoms improved in all patients after surgery, and there were no surgery-related complications. Conclusion : CSDH combined with ISH can be diagnosed on imaging, and endoscopic surgery facilitates safe and effective treatment.

컴퓨터 적외선(赤外線) 전신체열촬영(全身體熱撮影)으로 본 경추추간판(頸椎椎間板) 탈출증(脫出症)의 침구치료효과(鍼灸治療效果) (Clinical evaluation of Acupuncture on Herniated of Cervical Intervertebral Disc by DITI)

  • 이건목
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.132-140
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    • 1995
  • Object : This study is designed to evaluate the correlation between the data of DITI(Digital Infrared Thermographic Imaging)examination and the changes of clinical symptom after the therapy of acupuncture in the patients with herniated cervical intervertebral disc. Content : The conservative therapy with acupuncture was performed during $4{\sim}5$ weeks, The acupuncture points of SI3, B62, TE3, G34, LI4, S36, GV26, G21, SII5 were used. In the pre- and post therapy, DITI examinations were performed in patients who had HIVD and were treated by acupuncture simultaneously, and then tried to correlate the results of clinical symptoms with the difference of thermographic findings at pre-acupuncture and post-acupuncture. Setting : The standard routine thermoghaphic examinations were performed with thermography(DITI) in the 15 patients with lumbar disc herniations at pre- and post acupuncture. Patient : Thermographic imaging of 15 cases were analyzed. They has disc herniations in X-ray, CT scan and MRI and they were treated by acupuncture theraphy in our hospital from March, 1994 to January, 1995. Result : 1) The causes were trauma(60%), retention of phlegm and fluid(8.7%) and cold & moisture(33.3%) 2) Levels of herniated cervical disc are C2/3(1 case). C3/4(2 cases), C5/6 & C6/7 (2 cases), C6/7(4 cases), Normal(6 cases). 3) Classifications of thermographic pattern are radiculopathy(80%), spot(13.3%), and nonspecific(6.7%) in order. 4) In evaluation Results of clinical symptom are Excellent(80%), Good(6.7%), and Poor(6.7%). Data of DITI are Excellent(80%), Good(6.7%), Fair(6.7%), and Poor(6.7%). Conclusion ; Acupuncture showed good results over 86.7% in clinical evaluation and 86.7% in DITI. Thermographic examination was valuable in the evaluation of therapeutic effect of acupuncture treatment.

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Finite element analysis of stabilization splint pressure distribution in a patient with disc displacement without reduction: A preliminary study

  • Acing Habibie Mude;Muhammad Ikbal;Mukhsan Putra Hatta;Irfan Sugianto;Edy Machmud;Fadhlil Ulum A Rahman;Imran Irsal;Eka Fibrianti;Muthia Mutmainnah Bachtiar;Thalib Rifky Samdany Abdullah Syeban Attamimi
    • Imaging Science in Dentistry
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    • 제54권3호
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    • pp.251-256
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    • 2024
  • Purpose: This study was performed to investigate the pattern of condylar pressure distribution in the discs of a patient diagnosed with disc displacement without reduction. Materials and Methods: This research consisted of a pre- and post-test observational clinical study. A patient diagnosed with disc displacement without reduction underwent treatment with an occlusal splint for 3 months. Finite element analysis employed a 3-dimensional model constructed from magnetic resonance images of the patient, taken both before the application of the splint and 3 months after its use. Results: The post-test model demonstrated a decrease in condylar pressure on the disc, with measurements dropping to 72 MPa from the pre-test level of 143 MPa. In the pre-test, the pressure distribution pattern was concentrated on the lateral posterior border, whereas in the post-test, it shifted toward the intermediate zone of the disc. Conclusion: Utilization of a stabilization splint for 3 months resulted in decreased pressure and a marked change in the pressure distribution pattern on the temporomandibular disc.

Syringo-Subarachnoid-Peritoneal Shunt Using T-Tube for Treatment of Post-Traumatic Syringomyelia

  • Kim, Seon-Hwan;Choi, Seung-Won;Youm, Jin-Young;Kwon, Hyon-Jo
    • Journal of Korean Neurosurgical Society
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    • 제52권1호
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    • pp.58-61
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    • 2012
  • Various surgical procedures for the treatment of post-traumatic syringomyelia have been introduced recently, but most surgical strategies have been unreliable. We introduce the concept and technique of a new shunting procedure, syringo-subarachnoid-peritoneal shunt. A 54-year-old patient presented to our hospital with a progressive impairment of motion and position sense on the right side. Sixteen years before this admission, he had been treated by decompressive laminectomy for a burst fracture of L1. On his recent admission, magnetic resonance (MR) imaging studies of the whole spine revealed the presence of a huge syrinx extending from the medulla to the L1 vertebral level. We performed a syringo-subarachnoid-peritoneal shunt, including insertion of a T-tube into the syrinx, subarachnoid space and peritoneal cavity. Clinical manifestations and radiological findings improved after the operation. The syringo-subarachnoid-peritoneal shunt has several advantages. First, fluid can communicate freely between the syrinx, the subarachnoid space, and the peritoneal cavity. Secondly, we can prevent shunt catheter from migrating because dural anchoring of the T-tube is easy. Finally, we can perform shunt revision easily, because only one arm of the T-tube is inserted into the intraspinal syringx cavity. We think that this procedure is the most beneficial method among the various shunting procedures.

Outcome analysis of biplanar mandibular distraction in adults

  • Chattopadhyay, Debarati;Vathulya, Madhubari;Jayaprakash, Praveen Ambadivalappil;Kapoor, Akshay
    • 대한두개안면성형외과학회지
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    • 제22권1호
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    • pp.45-51
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    • 2021
  • Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.

통증에 대한 지시적 심상요법의 효과 - 대학생을 중심으로 - (An Effect of Guided Imagery on Pain)

  • 김주현
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.20-38
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    • 1999
  • This study is conducted to test an effect of the guided Imagery program on artificially induced pain and to develop an effective nursing intervention for patients with pain. The subjects of this study were 37 normal female university students. The data were collected from September 1998 to December 1998. And two group non-equal quasi -experimental research with pre and post design was used in this study, The data were analyzed with the SPSS $PC^+$ program with percentage, t-test, paired t-test and ANCOVA. The results of this study were as follows : 1. There are no significant differences of systolic blood pressure between groups. 2. The experimental group showed significantly lower diastolic blood pressure than control group after treatment. 3. There are no significant differences of pulse rate between groups. 4. The experimental group showed significantly higher body temperature than control group after treatment. 5. There are no significant differences of pain intensity between groups. 6. There are no significant differences of pain sensation between groups. 7. There are no significant differences of perceived pain tolerance time between groups. 8. The experimental group showed significantly longer real pain tolerance time than control group after treatment. 9. There are no significant differences of anxiety scores between groups. 10. There are no significant differences of Self-esteem scores between groups. 11. There are no significant differences of Self-esteem scores between groups. 12. There are no significant differences of imagability scores between groups. 13. The post-experimental group showed significantly higher relaxation rate than pre -experimental group. 14. There are no significant differences of imaging depth degree between pre-experimental group and post-experimental group. From the above results, it can be concluded that 1. This guided imagery program could be recommenced as an effective nursing intervention to relieve pain. 2. A follow up study is needed to identify long-term effects.

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골격성 III급 부정교합을 가진 양악 수술 환자의 술후 측모 예측을 위한 Video imaging (Power $Ceph^{\circledR}$ Ver 3.3)의 정확도에 관한 연구 (A study on the accuracy of profile change Prediction by video imaging (Power Ceph $^{\circledR}Ver$ 3.3) in Class III two jaw surgery patients)

  • 권미정;백형선;이원유
    • 대한치과교정학회지
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    • 제29권3호
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    • pp.285-301
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    • 1999
  • 악교정 수술의 계획에 있어서 수술 후 경조직의 이동에 따른 연조직 변화 양상을 보다 정확히 예측하는 것은 매우 중요하다. 최근에는 측모 두부 규격 방사선 사진과 실제 측모 사진을 병합하여 수술 후 측모 변화에 대한 가시성을 높인 여러 종류의 video imaging 프로그램들이 개발되어 널리 사용되고 있다. 그러나 이들 프로그램의 정확도를 판단하는 연구는 아직 미비한 실정이며 특히 국내에서 많이 시행되고 있는 골격성 III급 부정교합 환자의 수술 후 변화 양상에 대한 연구가 임상적인 활용에 앞서 선행되는 것이 필요하다. 이에 저자는 video imaging프로그램의 하나인 Power $Ceph^{\circledR}$ (Power Soft Co. Ver 3.3)을 이용하여 국내에서 양악수술을 시행 받은 골격성 III급 부정교합 환자 30명(남 14명, 여 16명)을 대상으로 예측도와 실제 술후의 측모를 비교하여 정확도를 평가하였으며 정확도에 영향을 미치는 요인을 분석하기 위해 이동량 및 술식별로 분류 비교하여 다음과 같은 결론을 얻었다. 1. 예측치와 실제 계측치의 비교에서 24개의 계측항목 중 14개 항목에서 유의성 있는 차이를 보였다. 2. 계측항목 중 유의성 있는 차이를 보이는 항목은 대부분 상악에 관련된 연조직으로 하악에 관련된 연조직에 비해 다양한 차이를 나타내었다. 3.상악 및 하악의 이동량에 따른 비교에서 이동량이 적은 군이 이동량이 많은 군에 비하여 예측치와 실제 계측치 비교에서 유의성 있는 차이를 보인 항목이 적게 나타났다. 4. 이부 성형술 여부에 따른 비교에서 이부 성형술을 시행하지 않은 군에서 이부 성형술을 시행한 군에 비하여 예측치와 실제 계측치 비교에서 유의성 있는 차이를 보인 항목이 적게 나타났다. Video imaging(Power $Ceph^{\circledR}$ Ver 3.3)프로그램에 의한 예측치와 실제 계측치 비교시 그 차이는 대부분 2mm 이내로써 임상적으로 수용할 수 있는 수준이었다.

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