Yun Seok Suh;Jae Won Choi;Jeong Hee Yoon;Dong Ho Lee;Yoon Jun Kim;Jeong Hoon Lee;Su Jong Yu;Eun Ju Cho;Jung Hwan Yoon;Jeong Min Lee
Korean Journal of Radiology
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제22권12호
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pp.1974-1984
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2021
Objective: This study aimed to compare the efficacy between no-touch (NT) radiofrequency ablation (RFA) and conventional RFA using twin internally cooled wet (TICW) electrodes in the bipolar mode for the treatment of small hepatocellular carcinomas (HCC). Materials and Methods: In this single-center, two-arm, parallel-group, prospective randomized controlled study, we performed a 1:1 random allocation of eligible patients with HCCs to receive NT-RFA or conventional RFA between October 2016 and September 2018. The primary endpoint was the cumulative local tumor progression (LTP) rate after RFA. Secondary endpoints included technical conversion rates of NT-RFA, intrahepatic distance recurrence, extrahepatic metastasis, technical parameters, technical efficacy, and rates of complications. Cumulative LTP rates were analyzed using Kaplan-Meier analysis and the Cox proportional hazard regression model. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat and as-treated analyses were performed. Results: Enrolled patients were randomly assigned to the NT-RFA group (37 patients with 38 HCCs) or the conventional RFA group (36 patients with 38 HCCs). Among the NT-RFA group patients, conversion to conventional RFA occurred in four patients (10.8%, 4/37). According to intention-to-treat analysis, both 1- and 3-year cumulative LTP rates were 5.6%, in the NT-RFA group, and they were 11.8% and 21.3%, respectively, in the conventional RFA group (p = 0.073, log-rank). In the as-treated analysis, LTP rates at 1 year and 3 years were 0% and 0%, respectively, in the NT-RFA group sand 15.6% and 24.5%, respectively, in the conventional RFA group (p = 0.004, log-rank). In as-treated analysis using multivariable Cox regression analysis, RFA type was the only significant predictive factor for LTP (hazard ratio = 0.061 with conventional RFA as the reference, 95% confidence interval = 0.000-0.497; p = 0.004). There were no significant differences in the procedure characteristics between the two groups. No procedure-related deaths or major complications were observed. Conclusion: NT-RFA using TICW electrodes in bipolar mode demonstrated significantly lower cumulative LTP rates than conventional RFA for small HCCs, which warrants a larger study for further confirmation.
Kim, Su-kyung;Kang, Tae-woo;Park, Dong-hwan;Lee, Ji-hyun;Cynn, Heon-seock
한국전문물리치료학회지
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제24권3호
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pp.10-20
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2017
Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM ($n_1=10$) and DBM ($n_2=9$) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.
Purpose: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. Results: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). Conclusions: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.
Background: Behavior guidance is a technique used to subdue inappropriate behavior by establishing communication that meets the needs of a child. This study aimed to measure the effectiveness of a mobile app (Little Lovely Dentist) compared to the tell-show-do (TSD) technique in managing anxious children during their first dental visit. Methods: Fifty children (30 boys and 20 girls) without any past dental experience, aged from 7 to 11 years, were randomly allocated into either the dental app group or the TSD group. The pre- and post-operative anxiety of children who underwent prophylactic cleaning was assessed both physiologically and subjectively using a heart rate measurement and the RMS pictorial scale, respectively. Results: The intragroup comparison of heart rate and RMS scores for children allocated to the dental app group was statistically significant (P value ≤ 0.001). However, a significant reduction only occurred in the RMS scores, but not the heart rate measurements, in the TSD group. Conversely, there was an increase in heart rates in the TSD group. Conclusion: Educating the child prior to a dental procedure using a smartphone application such as Little Lovely Dentist can significantly alleviate the anticipatory anxiety and engage children in dental treatment during their first visit.
Sayed, Jehan Ahmed;Elshafy, Sayed Kaoud Abd;Kamel, Emad Zareif;Riad, Mohamed Amir Fathy;Mahmoud, Amal Ahmed;Khalaf, Ghada Shalaby
The Korean Journal of Pain
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제31권3호
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pp.206-214
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2018
Background: Immune responses appear to be affected by anesthetics and analgesics. We investigated the effects of caudal tramadol on the postoperative immune response and pain management in pediatric patients. Methods: Sixty ASA-I pediatric patients aged 3-10 years undergoing lower abdominal surgery. Patients were randomly assigned either to a caudal bupivacaine (0.25%) group (group B), or a group that received caudal tramadol (1 mg/kg) added to the bupivacaine (0.25%) (group T). Both were diluted in a 0.9% NaCl solution to a total volume of 1ml/ kg. The systemic immune response was measured by collecting blood samples preoperatively, at the end of anesthesia, and at 24 and 72 hours postoperatively, and studied for interleukin IL-6, C-reactive proteins (CRP) cortisol levels, and leucocytes with its differential count. Postoperative pain was assessed along with sedation scales. Results: Postoperative production of IL-6 was significantly higher in group B at the end of anesthesia, than at the $24^{th}$ hour, and at the $72^{nd}$ hour in group B and group T, respectively. The immune response showed leukocytosis with increased percentages of neutrophil and monocytes, and a decreased lymphocyte response rate within both groups with no significant differences between the groups. Cortisol and CRP were significantly higher in group B. Conclusions: Adding tramadol to a caudal bupivacaine block can attenuate the pro-inflammatory cytokine response, Cortisol, and CRP in children undergoing lower abdominal surgery.
Objectives : To evaluate the evidence supporting the effectiveness of Chuna manual therapy for functional dyspepsia. Methods : We conducted search across the 3 electronic databases (Pubmed, CAJ and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy as a treatment for functional dyspepsia. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Thirteen RCTs met our inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy combined with medication treatments in terms of the efficacy rate when compared to medication treatments alone. Positive results were also obtained, in terms of the efficacy rate, when comparing Chuna manual therapy combined with medication plus specific electromagnetic therapy to medication treatments alone. Conclusions : Our systematic review found encouraging but limited evidence of Chuna manual therapy for functional dyspepsia. However, to obtain stronger evidence without the drawbacks of trial design and the quality of studies, we recommend sham-controlled RCTs or comparative effectiveness research to test the effectiveness of Chuna manual therapy.
Objectives : The purpose of this study is to compare the effect of Chuna manual treatment and Chuna manual treatment with self muscle energy techniques on patients with pelvic malposition Methods : Random allocation was done. We used Chuna manual treatment to control group and Chuna manual treatment with self muscle energy techniques to experimental group. These patient's pelvic malposition were checked by Leg length analysis, measuring Innominate measurement length, obturator foramen size and height of femur head. Results : 1)After the 3 weeks treatment, patients' inequality of leg length and Innominate measurement length were significantly reduced. 2)There was no significant difference between control group and experimental group. Conclusions : Chuna manual treatment and Chuna manual treatment with self muscle energy techniques are considered to be effective and useful in patients with pelvic malposition. But there was no significant difference between control group and experimental group.
Objectives : The aim of this study was to investigate difference of the effects of transcutaneous electrical nerve stimulation(TENS) with different frequencies in participants having delayed onset muscle soreness(DOMS). Methods : We recruited 36 healthy participants, but 3 of them were dropped out. They were randomly divided into 3groups : 3 Hz TENS(n=11), 100 Hz TENS(n=11) and sham TENS(n=11). DOMS of the both triceps surae muscle induced by repetitive concentric, ecentric exercise. The result measurements were pain perception(visual analogue scale, VAS), mechanical pain threshold(MPT) by pressure algometer, electrical contraction and fatigue by surface electromyography. The measurements were on first visit, before and after treatment except first. This study was prospective, randomized, controlled, single-blinded trial. Results : In 100 Hz TENS group, VAS was significantly decreased during whole session compared with 3 Hz and control group, and after each treatment, too. In 3 Hz TENS group, VAS was significantly decreased during whole session compared with control group, and after 2nd, 3rd treatment, too. In 100 Hz TENS group, MPT increased the most among 3 groups during whole session and after 1st treatment, but there were no statistical significances. Conclusions : Both 3 Hz and 100 Hz TENS improved delayed onset muscle soreness, but 100 Hz TENS group is more effective than 3 Hz TENS group.
Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P<.05). The muscle activation levels of the infraspinatus and posterior deltoid muscles were highest at the external rotation angles of 30° and 60°, respectively. The muscle activity ratio between the infraspinatus and posterior deltoid muscles also showed a significant difference (P<.05) and was highest at the shoulder external rotation angle of 30°. Conclusion: The findings of this study suggest that muscle activity is the highest at the shoulder external rotation angle of 30° in healthy individuals.
Lee, Jeong-Yol;Kim, Ha-Young;Shin, Sang-Wan;Bryant, S. Ross
The Journal of Advanced Prosthodontics
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제4권4호
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pp.204-209
/
2012
PURPOSE. The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction. MATERIALS AND METHODS. A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants. RESULTS. Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants. CONCLUSION. The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants.
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