• Title/Summary/Keyword: Therapeutic Ultrasound

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Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography

  • Shin Haba;Kazuo Hara;Nobumasa Mizuno;Takamichi Kuwahara;Nozomi Okuno;Akira Miyano;Daiki Fumihara;Moaz Elshair
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.458-462
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    • 2022
  • Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to prevent bleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old male patient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle, and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coils were placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumen cannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next day revealed no complications.

The Effect of Ultrasound Treatment on Regeneration Nerve and Muscle on Injured Peripheral Nerve of Rats Model (말초신경 손상 백서모델에서 초음파 치료의 신경 및 근육 재생효과)

  • Cheong, Mee-Sun;Kim, Kyoung-Yoon
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.589-600
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    • 2005
  • The purposes of this study is to discuss and analyze the effect on the recovery from cut in sciatic nerve. This study used 9 weeks male rats of Sprague-Dawley family. Rat in groups 4 were treated with pulsed therapeutic ultrasound for 3 minutes. 3 times weekly at 3MHz respectively (intensity; $0.2W/cm^2,\;0.5W/Cm^2,\;10W/cm^2$); rat in group 1 received placebo ultrasound. In addition, changes of serum aspartate amino-transferase(AST) and creatine phosphokinase(CPK) levels were also demonstrated with diameter of individual muscle fasciculate and number of muscle fiber in each of three types of muscles located in gastrocnemius, soles. The results of comparing the changes in groups are as follows; 1. We found out that hypertrophic epineurium was present in sciatic nerve injured ultrasound treatment of groups. 2. In the gastrocnemius morphological investigation of the group I (control group), severe muscle atrophy were observed at the 7th days of the sciatic nerve injury. however, muscle atrophy of the group IV ($1.0W/cm^2$) were slightly recovered at the 14th days after treatment ultrasound. At the 28th days, muscular fibers were formed in polygon and were significantly recovered. 3. C-fos immunoreactive of the group II ($0.2W/cm^2$), III ($0.5W/cm^2$) were remarkably increased at the 1th day after treatment of ultrasound. Group IV were markedly deceased. 4. Brain-Derived Neurotrophic Factor(BDNF) immunoreactive of the group II, III were increased after 7 days of the sciatic nerve injury. Group IV were markedly increased from 14th days to 28th days after treatment of ultrasound. 5. A significant increase of serum AST levels were demonstrated in control group. However, serum AST levels of massage groups were significantly decreased compared to that of control group in followed order ; ($0.2W/cm^2<0.5W/cm^2<1.0W/cm^2$). 6. A significant increase of serum CK levels were demonstrated in control of group. However, serum CK levels of massage groups were significantly decreased compared to that of control group in followed order ; ($0.2W/cm^2<0.5W/cm^2<1.0W/cm^2$). The above results suggest that ultrasound treatment after peripheral nerve injury might reduce noxious stimuli, facilitate nerve recovery and effective in the functional improvement delaying muscle atrophy or degeneration.

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A Study on the Efficiency Evaluation of Ultrasound Therapy Using Varicose Vein Simulated Tissue Phantom and Tissue Equivalent Phantom (하지정맥류 모사 생체조직 팬텀과 조직등가 팬텀을 이용한 초음파 치료효과 평가에 관한 연구)

  • Kim, Ju-Young;Jung, Tae-Woong;Shin, Kyoung-Won;Noh, Si-Cheol;Choi, Heung-Ho
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.427-433
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    • 2018
  • Because of the expectation of the non-invasive treatment effect, Various studies on the treatment of varicose veins using focused ultrasound are reported. In this study, the bio-tissue phantom and tissue equivalent phantom that can be applied to estimation of ultrasonic varicose veins treatment effect. Each phantom was evaluated for its usefulness by evaluating the acoustic characteristics and the shrinkage rate according to the ultrasonic irradiation. A multi-layer structure phantom with three layers of skin, fat, and muscle was constructed considering the structure of the tissue where the varicose veins occurred. The materials constituting each layer were made to have characteristics similar to human body. In addition, the multi-layered phantoms with blood vessel mimic tube, with bovine blood vessel, and with animal tissue were fabricated. The degree of shrinkage of blood vessel mimic material and vascular tissue according to ultrasonic irradiation was evaluated using B-mode image. As the results of this study, it was thought that the proposed phantom could be used effectively in the evaluation of ultrasonic varicose veins treatment. In addition, it is thought that these phantoms could be applied to the development of varicose vein treatment device using the focused ultrasound and the verification of the therapeutic effect.

Review on Intraperitoneal Acupuncture and Needling Depth (복강내침술과 관련 혈위의 자침 깊이에 대한 고찰)

  • Soyeon Kim
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.55-61
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    • 2023
  • Objectives : To review the needling depth, therapeutic and adverse effects of intraperitoneal acupuncture and related acupoints. Methods : Studies and reports from the literature, Korean medical health insurance data and databases were searched and selected. Results : The depth of needle insertion for acupoints related to intraperitoneal acupuncture has been documented to range from 0.9 to 10.5 cm depending on the acupoints and literature. In studies of safe needling depth, the justice of safe needling depth varied from study to study, but was generally based on the peritoneum, and the depth varies by patient age, sex, body type, and weight. Clinical studies in China have shown good efficacy and no side effects of abdominal long needle acupuncture, but there have been case reports of adverse events following abdominal acupuncture. Conclusions : To ensure both therapeutic effectiveness and safety of intraperitoneal acupuncture, It is necessary to utilize the ultrasound in clinical practice and conduct related research.

Perspectives : Understanding the Pathophysiology of Intraventricular Hemorrhage in Preterm Infants and Considering of the Future Direction for Treatment

  • Young Soo Park
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.298-307
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    • 2023
  • Remarkable advances in neonatal care have significantly improved the survival of extremely low birth weight infants in recent years. However, intraventricular hemorrhage (IVH) continues to be a major complication in preterm infants, leading to a high incidence of cerebral palsy and cognitive impairment. IVH is primarily caused by disruption of the fragile vascular network of the subependymal germinal matrix, and subsequent ventricular dilatation adversely affects the developing infant brain. Based on recent research, periventricular white matter injury is caused not only by ischemia and morphological distortion due to ventricular dilatation but also by free iron and inflammatory cytokines derived from hematoma and its lysates. The current guidelines for the treatment of posthemorrhagic hydrocephalus (PHH) in preterm infants do not provide strong recommendations, but initiating treatment intervention based on ultrasound measurement values before the appearance of clinical symptoms of PHH has been proposed. Moreover, in the past decade, therapeutic interventions that actively remove hematomas and lysates have been introduced. The era is moving beyond cerebrospinal fluid shunt toward therapeutic goals aimed at improving neurodevelopmental outcomes.

The Effect of Therapeutic Ultrasound and Static Stretching of the Hamstring Muscle on Flexibility and Static Balance Ability (초음파 치료와 정적 스트레칭이 뒤넙다리근의 유연성과 정적균형에 미치는 영향)

  • Cho, Seung-bong;Park, Mi-young;Won, Ji-sun;Kim, Ye-lin;Hong, Joon-taek;Kim, Seong-ho
    • Journal of Korean Physical Therapy Science
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    • v.26 no.1
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    • pp.45-53
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    • 2019
  • Background: The purpose of present study was to examine the effect of ultrasound therapy and static stretching on hamstring length and balance. Design: Randomized Controlled Trial. Methods: A total of 30 adults in S college, Seongnam city, Gyeonggi-do, between the ages of 20-30 were randomly assigned to two groups. Group 1 (n=15) had ultrasound therapy, called US group. Group 2 (n=15) had static stretching, called SS group. Measurements were taken prior to starting the program and after completing the experiment using Finger to floor test and Active knee extension test to get the results of hamstring flexibility and the ability of static balance. Paired t-test was used to compare each group pre-test values to post-test values and to compare US post-test values to SS post-test values on PASW 18.0. Results: 1) Both hamstring SS group and US group had significant increase (p<.05) in Finger to floor test and Active knee extension test. 2) Dominant leg standing had significant change (p<.05) only in US group. 3) There was no significant difference between US group and SS group. Conclusion: Results showed that US group and SS group had an effect on changes in hamstring length (p<.05). However, they did not show a significant increase in static balance. Further effective studies on hamstring SS group and US group were needed based on this examination.

Comparison of Ultrasound Guided Soyeom Pharmacopuncture Therapy Effect and Unguided Soyeom Pharmacopuncture Therapy Effect on Cervical Facet Joint of Acute Cervical Pain Patient Caused by Traffic Accidents: A Retrospective Study (교통사고로 유발된 급성 경추통 환자의 경추 후관절에 시행한 초음파 유도하 치료군과 비유도 치료군의 소염 약침 치료 효과 비교: 후향적 관찰 연구)

  • Yang, JaeEun;Oh, Min Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.109-117
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    • 2022
  • Objectives To compare the therapeutic effect of ultrasound guided soyeom pharmacopuncture therapy and unguided soyeom pharmacopuncture therapy on cervical facet joint of patient who have cervical pain caused by traffic accidents. Methods The study was planned as a retrospective study that analyzes the patient's medical records. We analyzed medical records of 20 patients with acute cervical pain caused by traffic accidents from April 1, 2022 to May 31, 2022. 10 patients (Group A) were treated ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint, 10 patients (Group B) were treated unguided soyeom pharmacopuncture therapy on cervical facet joint. We used visual analogue scale (VAS) and neck disability index (NDI) to evaluate improvements in cervical functions and pain, five point Likert scale to estimate patient's satisfaction. We used the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA) for statistical analysis. Results Group A showed a significant decrease in the VAS on the 5th day of the soyeom pharmacopuncture therapy (p=0.001). However, there was no statistically significant difference of VAS between two groups (p=0.142). Group A showed significant decrease in the NDI on the 5th day of the therapy (p=0.002). Also, there was statistically significant difference on NDI between two groups (p=0.018). Difference of five point Likert scale between two groups was not statistically significant (p=0.407). Conclusions In patients of acute cervical pain caused by traffic accidents, ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint showed significant efficacy on reduction of neck disability compared with unguided therapy.

Benefit of Ultrasound-guided Therapeutic Medial Branch Blocks after Percutaneous Epidural Neuroplasty (신경 성형술 후 초음파 유도하 내측 분지 차단술의 유용성)

  • Moon, Sang Ho;Lee, Song;Jung, Jae-Hyun;Shin, Won Shik
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.33-38
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    • 2014
  • Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

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Clinical Effect of Therapeutic Exercise in Women Suffering From Chronic Neck Pain (여성 만성 경통 환자에 대한 등척성 운동과 안정화 운동치료의 효과 비교)

  • Oh, Duck-Won;Kim, Suhn-Yeop
    • Physical Therapy Korea
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    • v.15 no.2
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    • pp.1-10
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    • 2008
  • This study compared the effect of therapeutic exercise with conservative treatment in women with chronic neck pain. Subjects were allocated to control, neck isometric exercise, and cervical stabilization exercise groups consisting of 29, 32, and 31 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound, interferential current therapy, and intermittent cervical traction. The neck isometric exercise group performed a neck isometric exercise and the cervical stabilization exercise group performed a cervical stabilization exercise. To compare the three groups, the levels of perceived pain, neck disability, and psychological depression were assessed on admission, at discharge, and one month after discharge. On admission and at discharge, the pain and neck disability scores did not differ significantly among the groups. However, one month after discharge, both the neck isometric and cervical stabilization exercise groups had significantly improved perceived pain levels as compared to control (p<.05). The improvement in the degree of neck disability was most significant in the cervical stabilization exercise group (p<.05). On comparing the changes in the variables at the three assessments for each group, there was a significant difference between the control and cervical stabilization exercise groups (p<.05). The findings indicate that therapeutic exercises, especially cervical stabilization exercises, are more effective for improving pain and neck disability than conservative treatment.

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