• Title/Summary/Keyword: interventional

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Recent advances in transcatheter treatment of congenital heart disease (선천성 심질환에 대한 중재적 치료술의 최근 진전)

  • Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.917-929
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    • 2006
  • Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.

Bertolotti Syndrome: A Diagnostic and Management Dilemma for Pain Physicians

  • Jain, Anuj;Agarwal, Anil;Jain, Suruchi;Shamshery, Chetna
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.368-373
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    • 2013
  • Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy

  • Na, Eun Duc;Cha, Dong Hyun;Cho, Jung Hyun;Kim, Mi Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.4
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    • pp.182-186
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    • 2012
  • Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

Rule Weight-Based Fuzzy Classification Model for Analyzing Admission-Discharge of Dyspnea Patients (호흡곤란환자의 입-퇴원 분석을 위한 규칙가중치 기반 퍼지 분류모델)

  • Son, Chang-Sik;Shin, A-Mi;Lee, Young-Dong;Park, Hyoung-Seob;Park, Hee-Joon;Kim, Yoon-Nyun
    • Journal of Biomedical Engineering Research
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    • v.31 no.1
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    • pp.40-49
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    • 2010
  • A rule weight -based fuzzy classification model is proposed to analyze the patterns of admission-discharge of patients as a previous research for differential diagnosis of dyspnea. The proposed model is automatically generated from a labeled data set, supervised learning strategy, using three procedure methodology: i) select fuzzy partition regions from spatial distribution of data; ii) generate fuzzy membership functions from the selected partition regions; and iii) extract a set of candidate rules and resolve a conflict problem among the candidate rules. The effectiveness of the proposed fuzzy classification model was demonstrated by comparing the experimental results for the dyspnea patients' data set with 11 features selected from 55 features by clinicians with those obtained using the conventional classification methods, such as standard fuzzy classifier without rule weights, C4.5, QDA, kNN, and SVMs.

The Experience in Dose Measurement of IVR with Glass Dosimeter System

  • Nishizawa, Kanae;Moritake, Takashi;Iwai, Kazuo;Matsumaru, Yuji;Tsuboi, Koji;Maruyama, Takashi
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.269-271
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    • 2002
  • It is reported that exposure for the patient and the medical staff from IVR is large. Direct measurement of patient exposure is difficult, since the measurement disturbs reading of images. The fluorescence glass-dosimeter system consisting of small-size glass chips is developed in recent years. Owing to its small size and physical characteristics, direct monitoring of surface dose may be feasible. The dose measurement for patient and medical staff during head interventional radiology (IVR) examinations was tried by using the fluorescence glass-dosimeter system. A dose response of the glass dosimeter is almost linear in large dose range but its energy dependency is high. About 20% variation of sensitivity was observed in the effective energy of 45-60keV which was used in IVR. In spite of this shortcoming, the fluorescence glass-dosimeter system is a convenient means for a dose monitoring during IVR performance.

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Options in Intracoronary Radiation Therapy (관동맥혈관 내 방사선 근접 치료: 치료 방법의 비교와 선택)

  • Moon, Dae-Hyuk;Oh, Seung-Jun;Lee, Hee-Kyung;Yi, Byong-Yong;Kim, Eun-Hee;Park, Seong-Wook
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.209-221
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    • 1999
  • Coronary restenosis is still regarded as Achilles' Hill of interventional cardiology despite relentless efforts of many investigators. Recent experimental and clinical studies have suggested that both gamma and beta radiation can reduce restenosis after angioplasty. Currently, intracoronary brachytherapy for the prevention of restenosis has become a new evolving treatment modality in interventional cardiology. This report discusses a physical aspect of gamma and beta radiation, initial clinical results and delivery systems used in intracoronary brachytherapy. We shall take a brief overview of methods and their advantages in intra-coronary brachytherapy. Future work should provide further insight for the best way of treating restenosis.

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Interventional Therapy for Renal Artery Pseudoaneurysms

  • Ji, Wen-Bin;Wang, Wei-Zheng;Sun, Song;Mi, Yu-Cheng;Xu, Qiong;Chen, Yi-Er;Yang, Song;Tao, Dan;Xu, Wei;Xu, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1595-1598
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    • 2012
  • The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the kidney surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.

Embolization of the Device to the Left Pulmonary Artery after the Interventional Closure of Ruptured Sinus of Valsalva Aneurysm

  • Choudhry, Lalit Kumar;Rao, Vinay M;Gnanamuthu, Birla Roy;Agrawal, Vishal;Shankar, Ravi;Prasath, Ram
    • Journal of Chest Surgery
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    • v.48 no.3
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    • pp.202-205
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    • 2015
  • Formation of an aneurysm in the sinus of Valsalva of the aortic root is usually due to an area of congenital weakness in its wall. This aneurysm may progressively dilate and rupture into any of the cardiac chambers or into the pericardial cavity. Though this is conventionally treated by surgery, interventional therapy using various closure devices is becoming more common. Embolization of these closure devices may occur. We report a case of embolization of such a device into the left pulmonary artery which during surgical retrieval, unmasked the hidden ventricular septal defect (VSD). Therefore one has to be cautious while making a diagnosis of rupture of the sinus of Valsalva of right coronary sinus without VSD.

Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration

  • Yu, Hyun Jeong;Park, Chan Jin;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.129-135
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    • 2016
  • Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.