• The Korean Journal of Pain
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• v.36 no.2
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• pp.195-207
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• 2023

Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.229-236
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• 2020

Purpose: This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. Materials and Methods: As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. Results: At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). Conclusion: A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.81-85
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• 2021

Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.

• Clinical Endoscopy
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• v.56 no.2
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• pp.164-168
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• 2023

When diagnosing the nature of biliary strictures, it is sometimes difficult to perform non-invasive methods such as ultrasound, spiral computed imaging, magnetic resonance imaging, or endoscopic ultrasonography. Thus, treatment decisions are usually based on biopsy results. However, brush cytology or biopsy, which is widely used for biliary stenosis, has limitations owing to its low sensitivity and negative predictive value for malignancy. Currently, the most accurate method is bile duct tissue biopsy under direct cholangioscopy. On the other hand, intraductal ultrasonography administered under the guidance of a guidewire has the advantages of easy administration and being less invasive, allowing for adequate examination of the biliary tract and surrounding organs. This review discusses the usefulness and drawbacks of intraductal ultrasonography for biliary strictures.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.435-441
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• 2018

In this study, we performed to design an image guiding algorithm to improve the efficiency and safety of treatment of varicose vein by focused ultrasound. The algorithm was suggested by different guiding images according to the location of varicose veins. In the case of deep-seated varicose veins, the target area was marked on the surface of the blood vessel in the obtained cross-sectional blood vessel ultrasound image. In the case of the superficial varicose vein, A guiding system based on image segmentation algorithm of the vascular region was suggested and designed two different algorithms according to varicose veins progression degree. as a results, the algorithm based on ultrasound image show a small error with $830{\mu}m$ at maximum. However, the algorithm based on charge coupled device image has a maximum error of 8.3 mm in some data. Therefore, it is expected that additional study is needed for superficial varicose vein image guiding algorithm, and it is expected that the accuracy of blood vessel tracking should be evaluated by constructing simple system.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.109-113
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• 2010

Purpose: To evaluate the efficacy of ultrasound guided injection of prolotherapy and steroid mixture injection in patients with adhesive capsulitis. Materials and Methods: 53 patients with adhesive capsulitis were included in the study and in all the patients a mixture of steroid and prolotherapy agent was injected into the coracohumeral ligament under the sonographic guidance. The patients were evaluated using the VAS and ROM of the shoulder before the injection and at 8 weeks and at 1 year after the injection. Results: Forward flexion was 93.4 degrees before the injection and was 142, 153 degrees at 8weeks and 1 year after injection. Abduction was 79.2 degrees before the injection and was 125.4, 152.6 degrees at 8 weeks and 1 year after the injection. The VAS score was 6.7 before the injection and was 3.5, 3.7 at 8 weeks and 1 year after the injection. Conclusion: The ultrasound guided injection of prolotherapy and steroid mixture into the coracohumeral ligament in patients with adhesive capsulitis is allowing both tissue distension and inflammatory process controlling procedure. It is effective in improving the range of shoulder motion significantly and is also effective in decreasing the pain.

• Korean Journal of Acupuncture
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• v.41 no.3
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• pp.101-109
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• 2024

Objectives : Cervical myofascial pain syndrome (C-MPS), a key aspect of Visual Display Terminals (VDT) Syndrome, leads to acute and chronic pain due to muscle shortening, potentially causing headaches and movement disorders. This study examines the effectiveness of Pharmacoacupuncture at the intersection of the Splenius Capitis (SC), Levator Scapulae (LS), and Serratus Posterior Superior(SPS) muscles under ultrasound guidance, known as the "SLS triangle" in treating C-MPS. Methods : Three patients (aged 30 to 37) with acute C-MPS presented at two Korean medicine clinics with severe neck pain and restricted cervical rotation. The evaluation of symptoms before treatment, immediately after treatment, and one day after treatment was conducted using the cervical rotation Range of motion (ROM) and the Numeric Rating Scale (NRS) for cervical pain. Treatments included Acupuncture, Cupping therapy, Chuna manipulation, Physical Therapy, and Pharmacopuncture (Jaha-geo extract, 2cc at the SLS triangle). Results : All three patients showed significant improvement post-treatment. Immediately after treatment, Patient 1's NRS improved from 7 to 2, Patient 2's NRS improved from 4 to 1, and Patient 3's NRS improved from 6 to 2. Directly after the procedure, there were no significant adverse reactions except for one patient experiencing temporary dizziness. When the patients were followed up by phone 24 hours later, no adverse reactions were reported. Conclusions : This study demonstrates that ultrasound-guided pharmacopuncture can significantly reduce pain and improve cervical rotation in patients with cervical myofascial pain syndrome. The findings suggest this non-invasive treatment is both safe and effective, warranting further research through larger-scale clinical trials to validate its efficacy and establish standardized protocols.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.103-112
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• 2019

Objectives The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - thoracic paravertebral space (TPVS), and also compare to the patients with non-guided pharmacoacupuncture. Methods We studied medical records of 6 patients hospitalized with rib fractures were analyzed retrospectively at department of Korean Medicine Rehabilitation from March 1, 2019 to May 31, 2019, The 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance with Korean Medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc) and the other 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS through non-guided. We used numeric rating scale to assess improvements in pain and the five-point likert scale was used to assess treatment satisfaction. Statistical analysis was carried out using the IBM SPSS Statistics 24 program. Results The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - TPVS, and also compare to the patients with non-guided pharmacoacupuncture. Conclusions After analyzing 6 studies, we could imply that the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance could be more effective on pain reduction and improvement of treatment satisfaction with rib fracture compared to those who were treated with non-guided pharmacoacupuncture.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.94-100
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• 2017

Purpose: The American Academy of Pediatrics provides guidelines for managing febrile urinary tract infection (UTI) in infants and children 2-24 months old, but little guidance is offered regarding UTIs in those younger than 8 weeks of age. The definition of UTI is unclear and whether to proceed with micturating cystourethrography (MCUG) or $^{99m}$technetium-dimercaptosuccinic acid (DMSA) scintigraphy scan in this age group is controversial. Methods: We retrospectively analyzed 29 neonates and infants younger than 2 months of age who underwent late DMSA scans 9 months following the first episode of febrile or symptomatic UTI between July 2009 and June 2016. Results: In total, 192 children aged 0-24 months underwent ultrasound and DMSA scans (MCUG in 174/192). Neonates and infants younger than 2 months of age were significantly less likely to develop fever, and had a lower fever peak, shorter duration of fever before admission and after starting antibiotics, longer hospitalization period, lower C-reactive protein, and greater incidence of nonEscherichia coli infection. There was no difference in pyuria response at diagnosis. The prevalence rates of an ultrasound abnormality (28%), vesicoureteral reflux (28%), UTI recurrence (38%), and renal scarring (10%) in infants younger than 8 weeks of age were similar to those in children 2-24 months old. Conclusion: Neonates and infants younger than 2 months of age with UTI warrant special consideration because the fever response used for diagnosis in older children may be absent or blunted. Clinical guideline is needed for the diagnosis and management of UTI in this age group.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.118-122
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• 2012

Taking history and ultrasonography is important to detect foreign body which might be located in the soft tissue. We encountered a case of soft tissue foreign body (transobturator tape) in a patient who had been treated with the impression of adductor myositis resulting from vagina fistula. The foreign body was found through ultrasonographic examination and the patient's symptom was relieved after removal of the foreign body from the ultrasonography-guided operation. Clinicians should keep in mind the fact that foreign bodies may exist when the inflammation persists without appreciable cause and ultrasonography can be useful tool in case of small fibrous band not detected with magnetic resonance imaging due to inflammatory change of the surrounding tissues.