• Journal of radiological science and technology
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• v.46 no.2
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• pp.123-129
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• 2023

Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm² and 37.47 Gy·cm² , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm² and 117.51 Gy·cm² respectively. In PCI 43 case, those values were 198.73 Gy·cm² and 120.13 Gy·cm² respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1132-1141
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• 2021

Objective: To investigate changes in the median nerve, retinaculum, and carpal tunnel on ultrasound after successful endoscopic carpal tunnel release (ECTR). Materials and Methods: This prospective study involved 37 wrists in 35 patients (5 male, 30 female; mean age ± standard deviation [SD], 56.9 ± 6.7 years) with primary carpal tunnel syndrome (CTS). An in-house developed scoring system (0-3) was used to gauge the clinical improvement after ECTR. Ultrasound was performed before ECTR, and at 1, 3, and 12 months post-ECTR. Changes in the median nerve, flexor retinaculum, and carpal tunnel morphology on ultrasound after ECTR were analyzed. Ultrasound parameters for different clinical improvement groups were compared. Results: All patients improved clinically after ECTR. The average clinical improvement score ± SD at 12 months post-ECTR was 2.2 ± 0.7. The median nerve cross-sectional area proximal and distal to the tunnel decreased at all time intervals post-ECTR but remained swollen compared to normal values. Serial changes in the median nerve caliber and retinacular bowing after ECTR were more pronounced at the tunnel outlet than at the tunnel inlet. The flexor retinaculum had reformed in 25 (68%) of 37 wrists after 12 months. Conclusion: Postoperative changes in median nerve and retinaculum parameters were most pronounced at the tunnel outlet. Even in patients with clinical improvement after ECTR, nearly all ultrasound parameters remain abnormal at one year post-ECTR. These ultrasound parameters should not necessarily be relied upon to diagnose persistent CTS after ECTR.

• Journal of the Korean Society of Radiology
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• v.82 no.2
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• pp.347-358
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• 2021

Acute trauma is a common cause of mortality in individuals aged < 40 years. As organ preservation has become important in treating trauma patients, the treatment is shifting from surgical management to non-operative management. A multidisciplinary team approach, including interventional radiology (IR), is essential for the optimal management of trauma patients, as IR plays an important role in injury evaluation and management. IR also contributes significantly to achieving the best clinical outcomes in critically ill trauma patients. This pictorial essay aims to present and summarize various interventional treatments in trauma patients requiring critical care.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.307-312
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• 2023

Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.

• Journal of Radiation Protection and Research
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• v.49 no.2
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• pp.78-84
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• 2024

Background: As the quantity and complexity of radiological interventions are constantly increasing, gear that offers optimal protection while maintaining mobility and a low weight burden is becoming more important. A newly developed exoskeleton radiation protection system (ERPS) (StemRad MD; StemRad Ltd.) can carry the weight of the shielding. The aim of our study was to analyze initial experience, especially in terms of advantages and disadvantages, with this new ERPS in interventional radiology. Materials and Methods: Forty-six interventions utilizing the ERPS were analyzed. The interventional radiologists completed a 15-question survey evaluating various aspects of the protective system, including weight, mobility, comfort, and radiation protection adequacy. Results and Discussion: In 98% of procedures, interventionalists reported being very satisfied (89%) or slightly satisfied (9%) and would recommend the system to colleagues. The exoskeleton system was rated as 100% comfortable, not too heavy, and did not restrict mobility in 98% of cases. Conclusion: The ERPS is a recommendable alternative to standard lead aprons, providing flexibility, comfort, and effective weight distribution without restricting mobility.

• Journal of radiological science and technology
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• v.40 no.1
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• pp.27-34
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• 2017

The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8429-8433
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• 2014

Circulating tumor cells (CTCs) are believed to be particularly important and a reliable marker of malignancy. However, the prognostic significance of CTCs detected in patients with small cell lung cancer (SCLC) is still unclear. We therefore aimed to assess the prognostic relevance of CTCs using a meta-analysis. We searched PubMed for relevant studies and statistical analyses were conducted to calculate the hazard ratio (HR) and 95% confidence intervals (CIs) using fixed or random-effect models according to the heterogeneity of included studies. A total of 7 papers covering 440 SCLC patients were combined in the final analysis. The meta-analysis revealed that CTCs were significantly associated with shorter overall survival (HR=1.9; 95%CI: 1.19-3.04; Z=2.67; P<0.0001) and progression-free survival (HR=2.6; 95%CI: 1.9-3.54; Z=6.04; P<0.0001). The results thus suggest that the presence of CTCs indicates a poor prognosis in patients with SCLC. Further well-designed prospective studies are required to explore the clinical applications of CTCs in SCLC.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.1-7
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• 2006

Chronic pain can cause disability, mild to severe suffering and high medical costs. Some unfortunate patient do not improve despite administering conservative treatment and then the various interventional therapies, including oriental medical treatment and/or surgery, and they find themselves in search of a more effective pain relief. Deep dry needling is one of the newer treatment modalities for these patients. The last 10 years have seen a lot of progress in understanding the neural pathways and the type and extent of tissue involvement during chronic pain. This in turn has stimulated the development of new treatment techniques, and deep dry needling is one of them. So, the authors of this paper discuss the individual theories, the characteristics and future directions of several deep dry needling techniques, and we examine the new dry needling technique that has been recently developed in Korea.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.254-264
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• 2015

Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.88-90
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• 2010

Retroperitoneal hematoma (RH) due to radiologic intervention for an intracranial lesion is relatively rare, difficult to diagnose, and can be lifethreatening. We report a case of RH that developed in a patient on anticoagulant therapy following endovascular coiling of a ruptured anterior communicating artery (AcoA) aneurysm. An 82-year-old man presented with a 12-day history of headache. Computed tomography (CT) on admission demonstrated slight subarachnoid hemorrhage, and left carotid angiography revealed an AcoA aneurysm. The next day, the aneurysm was occluded with coils via the femoral approach under general anesthesia. The patient received a bolus of 5,000 units of heparin immediately following the procedure, and an infusion rate of 10,000 units/day was initiated. The patient gradually became hypotensive 25 hours after coiling. Abdominal CT showed a huge, high-density soft-tissue mass filling the right side of the retroperitoneum space. The patient eventually died of multiple organ failure five days after coiling. RH after interventional radiology for neurological disease is relatively rare and can be difficult to diagnose if consciousness is disturbed. This case demonstrates the importance of performing routine physical examinations, sequentially measuring the hematocrit and closely monitoring systemic blood pressures following interventional radiologic procedures in patients with abnormal mental status.