• Title/Summary/Keyword: Therapeutic technique

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Detection Rate of Intravascular Injections during Cervical Medial Branch Blocks: A Comparison of Digital Subtraction Angiography and Static Images from Conventional Fluoroscopy

  • Jeon, Young Hoon;Kim, Sae Young
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.105-108
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    • 2015
  • Background: The most definitive diagnosis of neck pain caused by facet joints can be obtained through cervical medial branch blocks (CMBBs). However, intravascular injections need to be carefully monitored, as they can increase the risk of false-negative blocks when diagnosing cervical facet joint syndrome. In addition, intravascular injections can cause neurologic deficits such as spinal infarction or cerebral infarction. Digital subtraction angiography (DSA) is a radiological technique that can be used to clearly visualize the blood vessels from surrounding bones or dense soft tissues. The purpose of this study was to compare the rate of detection of intravascular injections during CMBBs using DSA and static images obtained through conventional fluoroscopy. Methods: Seventy-two patients were included, and a total of 178 CMBBs were performed. The respective incidences of intravascular injections during CMBBs using DSA and static images from conventional fluoroscopy were measured. Results: A total of 178 CMBBs were performed on 72 patients. All cases of intravascular injections evidenced by the static images were detected by the DSAs. The detection rate of intravascular injections was higher from DSA images than from static images (10.7% vs. 1.7%, P < 0.001). Conclusions: According to these findings, the use of DSA can improve the detection rate of intravascular injections during CMBBs. The use of DSA may therefore lead to an increase in the diagnostic and therapeutic value of CMBBs. In addition, it can decrease the incidence of potential side effects during CMBBs.

CORTICOTOMY IN PATIENT WITH NARROW PALATAL ARCH (피질골절단술을 이용한 상악협소증환자의 치험례)

  • Kim, Eun-Cheol;Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.371-374
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    • 1999
  • The treatment of adults with dentofacial deformities is frequently complicated by existence of discrepancies in transverse dimension. Control of the transverse dimension through surgical technique is now a valuable treatment consideration in non-growing patients. Proper diagnosis of relative and absolute maxillary transverse deficiency is imperative prior to surgical intervention. Therapeutic purpose should be implemented accordingly to facilitate correction of transverse discrepancies concomitant with treatment objectives in sagittal dimension in order to provide the patient with the most stable and functional result possible. Concomitant surgical correction of narrow palate require less treatment time, treatment cost and post-treatment relapse is less than to do only orthodontic therapy. This report is concerned with rapid palatal expansion by a combination of corticotomy and orthodontic treatment.

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Effects of Hamstring Flexibility and Dynamic Stability of Lower Lumbar according to Stretching and Massage Techniques (스트레칭과 마사지 기법이 넙다리뒤근의 유연성 및 아래 허리뼈의 동적 안정성에 미치는 영향)

  • Kim, Gi-Chul;Lee, Jeon-Hyeong;Kwon, Sang-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.4
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    • pp.609-617
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    • 2013
  • PURPOSE: This study aims to provide effects of therapeutic techniques as well as basic materials of safety by comparing and analyzing the effects of hamstring flexibility and dynamic stability of lower lumbar according to Stretching and Massage Techniques to adults with reduced the flexibility of hamstring. METHODS: This study conducted differential diagnosis through sit and reach test(SRT) and Schober test to select subjects who have shortened hamstring without any spinal problem. Selected subjects were divided into two groups randomly; HSG(Hamstring Stretching Group, n=8) and HMG(Hamstring Massage Group, n=8) and they received treatment for 2 weeks. To take statistics, SRT and dynamic view using x-ray were used. RESULTS: On SRT, HSG and HMG showed significant difference between pre and post test. A comparison of the difference value between HSG and HMG, HSG($9.73{\pm}1.78$) has more remarkable outcome than HMG($2.78{\pm}0.56$). Lower lumbar intervertebral disc length test for Intervertebral disc length(IDL)L45 and IDLL5S1 did not show significant differences between two groups and difference value. CONCLUSION: This study showed that stretching is more effective to improve hamstring flexibility than massage technique. Especially, flexibility increase of the hamstring in vertebral stabilization cannot affect improvement possibility will make a flexibility in order and the intervention and stabilization exercise of the spine.

Photodynamic Therapy for Neoplasms in Intrathoracic Constructed Stomach (식도암 수술 후 흉곽 내 위장에 발생한 원발성 위암에 대한 광역동치료 -1예 보고 -)

  • Park, Ki-Sung;Ko, Moo-Sung;Kwon, Oh-Choon;Lee, Sub;Kim, Jong-Ki;Jheon, Sang-Hoon
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.794-797
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    • 2003
  • Photodynamic therapy (PDT) is a local, endoscopically controlled nonoperative therapeutic technique based on selective sensitization of mucosal, malignant and precancerous lesions of the esophagus, trachea and bronchus prior to light-induced tissue destruction in the department of thoracic and cardiovascular surgery. PDT is effective and safe for palliative treatment of neoplasms in the stomach, esophagus, and lung. But skin phototoxicity is unsatisfactory, therefore optimization of management of post-PDT is necessary for preventing phototoxic side effects of skin. Careful patient education in photoprotection techniques, close patient follow-up, early dermatologic referral and medical treatment are recommended. We performed PDT in a patient with intrathoracic constructed stomach. We report this case with a brief review of literatures, therefore.

Genome Wide Expression Analysis of the Restored Changes by Carthami Flos Extract Treatment on Rat Brain Injury (흰쥐의 손상된 뇌조직에서의 유전자 발현 변화에 대한 홍화(紅花) 추출물 투여의 작용)

  • Kim, Bu-Yeo;Limb, Se-Hyun;Lee, Guem-San;Kim, Hyung-Woo;Lim, Chi-Yeon;Cho, Su-In
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.706-713
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    • 2010
  • Objectives : The source is from the flower of Carthamus tinctorius L., family Compositae. It is used in clinical medicine to promote blood circulation, remove blood stasis, promote menstruation and alleviate pain. In the present study, we investigated the genome wide analysis of Carthami Flos on the intra-cranial hemorrhage(ICH) model. Methods : ICH in rat was induced by injection of collagenase type IV and Carthami Flos extract(CFe) was administered orally. The molecular profile of cerebral hemorrhage in rat brain tissue was measured using microarray technique to identify up- or down- regulated genes in brain tissue. Results : Expression profile showed that diverse genes were up- or down-regulated by ICH induction. Administration of CFe restored the expression level of some of altered genes by ICH to normal expressional level. Interestingly, these recovered genes by CFe were involved in the same biological pathways which were significantly activated or suppressed by ICH. Conclusion : The above results might explain the therapeutic mechanism of CFe on ICH. Further, by analyzing interaction network, core genes was identified which could be key molecular targets of CFe against ICH.

Effect of Stellate Ganglion Block Using 0.2% Ropivacaine (0.2% Ropivacaine을 이용한 성상신경절차단의 효과)

  • Cho, Young-Woo;Song, Sun-Ok;Jang, Ju-Hyen
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.182-186
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    • 2000
  • Background: Ropivacaine is a new amide local anesthetics, having therapeutic properties similar to those of bupivacaine but less cardiovascular toxicity and motor blockade. The aim of this study was to evaluate the effects of ropivacaine used in stellate ganglion block (SGB) compared with those of lidocaine or bupivacaine. Methods: This prospective and crossover study performed in twenty patients with sudden sensory neural hearing loss. All patients received three times SGB, in the paratracheal approach using 8 ml of 1% lidocaine, 0.2% bupivacaine, and 0.2% ropivacaine respectively without any orders. Onset time and action duration of Horner's syndrome were observed after each SGB. Results: Onset time of ropivacaine was the middle of the three agents; earlier lidocaine and slower bupivacaine. Lidocaine ($3.0{\pm}1.9$ min), bupivacaine ($4.1{\pm}2.9$ min) and ropivacaine ($3.3{\pm}1.3$ min). But there were no significant differences; Action duration of Horner's syndrome of ropivacaine (223.6?105.2 min) was longer than lidocaine ($134.6{\pm}77.3$ min) and shorter than bupivacaine ($241.2{\pm}115.8$ min). There were significant differences in the action duration of each local anesthetics (P<0.05). There was no critical side effects and temporary foreign body sensation was the most common side effect. Conclusions: We conclude that ropivacaine is a good alternative in SGB instead of lidocaine or bupivacaine. Ropivacaine is a long acting local anesthetic similar to those of bupivacaine with wide margin of safety. However, optimal concentration and volume of ropivacaine in SGB should be studied.

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The Study on the Thyroid Disease (갑상선질환(甲狀腺疾患)에 관(關)한 연구(硏究) -20여년간(餘年間)의 핵의학교실업적(核醫學敎室業績)을 중심(中心)으로-)

  • Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.1-24
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    • 1982
  • Several recent advances in our knowledge of thyroid physiology have broad application to the diagnosis and management of thyroid disorders. For in the thyroid, more than other endocrine organs, pathophysiology can be translated directly into the diagnosis and management of thyroid disease. Graves' disease is a syndrome including goiter with hyperthyroidism, exophthalmos and dermopathy. The pathogenesis of Graves' disease is not yet clearly identified, but various autoantibodies to the thyroid gland and immunopathologic studies indicate that autoimmune processes are involved in the pathogenesis of the disease. The diagnosis and management of Graves' disease are largely dependent on radionuclide techniques as radioimmunoassay, radioactive iodine therapy and so on. Several laboratory tests are also developed to determine the remission of this disase including TRH stimulation test, $T_3$ suppression test and detection of thyroid stimulating immunoglobulins. Autoimmune thyroiditis is almost certainly a primary immunologic disease and the incidence tends to increase recently, mainly due to the application of biopsy technique in thyroid diseases. Thyroid nodules have been a great challenge to physicians because of the possibility of malignancy. But recently, cytologic examination of thyroid aspirate provides a very simple and also reliable diagnostic method in patients with thyroid nodules. In 163 patients with thyroid nodules, only 19.3% was revealed to be malignant. Therefore cytologic examination of thyroid aspirate and thyroid biopsy should be included in the diagnosis of nodular patients prior to surgical intervention. In this paper, a comprehensive review is presented on the pathogenesis, clinical features, laboratory findings and therapeutic modalities of various thyroid diseases on the basis of over 80 researches performed during the past 20 years at radioisotope clinic, Seoul National University Hospital.

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Use of Myocutaneous Flap for the Surgical Treatment of Bronchopleural Fistula (근피판술을 이용한 기관지 -늑막루의 외과적 치료 -치험 1례 보고-)

  • 김철환;박성동
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.107-111
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    • 1996
  • Persistent bronchopleural fistula (BPF) still presents a troublesome therapeutic challenge and demands an aggressive approach when conventional measures fail. A 50-year-old man had a rigtlt pneumonectomy for far-advanced pulmonary tuberculosis with the development of postopneumonectomy empyema and BPF 1 month postoperatively in October 1 81. The condition was managed with BPF closure and the Clagett procedure, which failed with the recurrence of BPF and empyema, followed by a spontaneous open window at about 1 year port:operatively. The BPF, which had been aggravated to a large size, was managed by the closure and obliteration of the empyema cavity using a Pectoralis-skin pedicled flap 13 years postoper atively on Jul, 1994. The BPF was controlled by the procedure, and the patient, with improved respiratory symptom, was discharged 43 days postoperatively. We conclude that the use of myocutaneous flap Is an effective procedure for the closure of a large BPF. The surgical technique of the pedicled flap operation is described and the case is reported.

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Embryo Aggregation Promotes Derivation Efficiency of Outgrowths from Porcine Blastocysts

  • Lee, Sang-Goo;Park, Jin-Kyu;Choi, Kwang-Hwan;Son, Hye-Young;Lee, Chang-Kyu
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.11
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    • pp.1565-1572
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    • 2015
  • Porcine embryonic stem cells (pESCs) have become an advantageous experimental tool for developing therapeutic applications and producing transgenic animals. However, despite numerous reports of putative pESC lines, deriving validated pESC lines from embryos produced in vitro remains difficult. Here, we report that embryo aggregation was useful for deriving pESCs from in vitro-produced embryos. Blastocysts derived from embryo aggregation formed a larger number of colonies and maintained cell culture stability. Our derived cell lines demonstrated expression of pluripotent markers (alkaline phosphatase, Oct4, Sox2, and Nanog), an ability to form embryoid bodies, and the capacity to differentiate into the three germ layers. A cytogenetic analysis of these cells revealed that all lines derived from aggregated blastocysts had normal female and male karyotypes. These results demonstrate that embryo aggregation could be a useful technique to improve the efficiency of deriving ESCs from in vitro-fertilized pig embryos, studying early development, and deriving pluripotent ESCs in vitro in other mammals.

Relationship between paravertebral muscle twitching and long-term effects of radiofrequency medial branch neurotomy

  • Koh, Jae Chul;Kim, Do Hyeong;Lee, Youn Woo;Choi, Jong Bum;Ha, Dong Hun;An, Ji Won
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.296-303
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    • 2017
  • Background: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. Methods: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: 'Complete', when twitching was observed at all needles; 'Partial', when twitching was present at 1 or 2 needles; and 'None', when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. Results: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). Conclusions: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.