• The Journal of Korean Physical Therapy
• /
• 제12권3호
• /
• pp.497-507
• /
• 2000

This study was performed to understanding on guidelines for using therapeutic modalities according to injury phases of soft tissue. Clinical decisions on how and when therapeutic modalities may be used should be based on recognition of signs and symptoms. as well as some awareness of the time frames associated with the various phases of the Healing process. The physical therapist must have a sound understanding of that process in terms of the sequence of the various process of healing stage. The results of this study are as follows: 1. Once an acute injury has occured, the healing process consists of the imflammatory response phase, the fibroblastic-repair phase, and the maturation-remodeling phase and can impede by various pathologic factors. 2. Modality use in the initial acute injury phase and the inflammatory response phase should be directed toward limiting the amount of swelling and reducing pain. 3. Modality use in the Fibroblastic repair phase may be change from cold to heat. The purpose of heat is to increase circulation to the injured area to promote healing. 4. During the Maturation-Remodeling phase, some type of heating modalities, ultrasound, or short wave and microwave diathermy should be used to increase circulation to the deeper tissue. In this phases, physical therapists must control training and conditioning habits to allow the injury to heal sufficiently.

• Journal of the Korean Society of Radiology
• /
• 제9권7호
• /
• pp.523-528
• /
• 2015

In this study, we evaluated the heating characteristics of single sonication and superposed two low-intensity ultrasonic sonication. Compare the results, the superposed sonication was showed a superior thermal effect than single sonication. And the maximum temperature was increased as 120-150%. The starting time of temperature rising has been shortened in superposed sonication. In addition, the time up to the maximum temperature has been shortened, too. In generally, as the ultrasonic intensity is higher, the more surface damage is occurred. However, in the case of superposed sonication, the same thermal effect had be confirmed without surface damage. Through the results of the study, we thought that the superposed sonication will be able to reduce the intensity of the ultrasonic treatment. And, by using the low-intensity, the more safe and more effect therapy will be possible in therapeutic ultrasound application.

• Korean Journal of Radiology
• /
• 제25권2호
• /
• pp.199-209
• /
• 2024

Objective: This study aimed to compare therapeutic efficacy and technical outcomes between adjustable electrode (AE) and conventional fixed electrode (FE) for radiofrequency ablation (RFA) of benign thyroid nodules. Materials and Methods: Between 2013 and 2021, RFA was performed on histologically proven benign thyroid nodules. For the AE method, AE length ≥ 1 cm with higher power and < 1 cm with lower power were utilized for ablating feeding vessels and nodules, especially those near anatomical structures, respectively. The therapeutic efficacy (volume reduction rate [VRR], complication rate, and regrowth rate) and technical outcomes (total energy delivery, ablated volume/energy, RFA time, and ablated volume/time) of FE and AE were compared. Continuous parameters were compared using a two-sample t-test or Mann-Whitney U test, and categorical parameters were compared using a chi-squared test or Fisher's exact test. Results: A total of 182 nodules (FE: 92 vs. AE: 90) in 173 patients (mean age ± standard deviation, 47.0 ± 14.7 years; female, 90.8% [157/173]; median follow-up, 726 days [interquartile range, 441-1075 days]) were analyzed. The therapeutic efficacy was comparable, whereas technical outcomes were more favorable for AE. Both electrodes demonstrated comparable overall median VRR (FE: 92.4% vs. AE: 84.9%, P = 0.240) without immediate major complications. Overall regrowth rates were comparable between the two groups (FE: 2.2% [2/90] vs. AE: 1.1% [1/90], P > 0.99). AE demonstrated a shorter median RFA time (FE: 811 vs. AE: 627 seconds, P = 0.009). Both delivered comparable median energy (FE: 42.8 vs. AE: 29.2 kJ, P = 0.069), but AE demonstrated higher median ablated volume/energy and median ablated volume/time (FE: 0.2 vs. AE: 0.3 cc/kJ, P < 0.001; and FE: 0.7 vs. AE: 1.0 cc/min, P < 0.001, respectively). Conclusion: Therapeutic efficacy between FE and AE was comparable. AE demonstrated better technical outcomes than FE in terms of RFA time, ablated volume/energy, and ablated volume/time.

• Journal of the Korean Chemical Society
• /
• 제58권6호
• /
• pp.575-579
• /
• 2014

Development of liposomes has been actively studied for effective delivery of drug at tumor site. However, despite their preferential accumulation at tumor site, the therapeutic efficacy of such liposomal drug has been limited because of low drug release. Therefore, we developed a temperature-sensitive liposome (TSL), which can be made to maximize release of drug by external stimulation such as ultrasound. Doxorubicin (DOX) as a model drug was encapsulated into TSL by a pH gradient method. The particle size of the TSL was $142.0{\pm}6.24nm$. Surface charge was $-10.55{\pm}1.12mV$. Release of drug from TSLs was up to 80% within 15 min at over $42^{\circ}C$ measured by fluorescence intensity. Cytotoxicity of released DOX from TSLs with ultrasound was highly increased compared to TSLs without ultrasound. Taken together, we demonstrate that temperature sensitive drug release from TSLs with ultrasound, which may be useful for cancer therapy to increase drug concentration at tumor site by external stimulation.

• Medical Lasers
• /
• 제9권1호
• /
• pp.12-24
• /
• 2020

Human fibroblast-derived multi-peptide factors (MPFs) have been used during treatments with energy-delivering modalities to enhance energy-induced tissue reactions. Human fibroblast-derived MPFs, which include a range of growth factors and chemoattractive factors, activate and recruit fibroblasts and endothelial cells, as well as promote extracellular matrix deposition, all of which are crucial to wound repair. Interestingly, fibroblasts from different species or anatomical sites exhibit distinct transcriptional properties with high heterogeneity. In addition, the patterns of MPF secretion can differ under a range of experimental conditions. Therefore, the use of allogeneic fibroblasts and proper cultivation thereof are necessary to obtain MPFs that can enhance the epithelial-mesenchymal interactions during wound repair. Moreover, energy-delivering devices should be selected according to evidence demonstrating their therapeutic efficacy and safety on a pathological skin condition and the major target skin layers. This paper reviewed the histologic patterns of post-treatment tissue reactions elicited by several energy sources, including non-ablative and ablative fractional lasers, intense focused ultrasound, non-invasive and invasive radiofrequency, picosecond-domain lasers, and argon and nitrogen plasma. The possible role of the immediate application of human fibroblast-derived MPFs during wound repair was proposed.

• The Journal of the Acoustical Society of Korea
• /
• 제35권6호
• /
• pp.452-465
• /
• 2016

In this study, the structure of a concave annular array transducer was optimized to generate high intensity focused ultrasound for medical therapeutic application. The transducer has a phased array structure composed of several concentric channels that have 40 mm as the radius of curvature. We derived theoretical equations to analyze the sound field of the transducer and verified the validity of the equations by comparing the results calculated by the equations with those from finite element analyses. We also checked the possibility of dynamic focusing at around the geometric focal point. Further, the level of a grating lobe occurring at an unwanted position in the transducer sound field was confirmed to be reducible through the relation between the number of channels and the frequency of the transducer. Hence, the structure of the transducer was optimized to place the main lobe within a specific range from the zenith while systematically reducing the level of the maximum sidelobe including the grating lobe. The designed structure showed the performance better than that targeted at all the focal points.

• Clinical Endoscopy
• /
• 제56권1호
• /
• pp.100-106
• /
• 2023

Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

• Journal of Sensor Science and Technology
• /
• 제32권6호
• /
• pp.418-424
• /
• 2023

Natural killer (NK) cells play a crucial role in combating infections and tumors. However, their therapeutic application in solid tumors is hindered by challenges, such as limited lifespan, tumor penetration, and delivery precision. Our research introduces a novel ultrasonic actuation technique to navigate NK cells more effectively in the vascular system, particularly at vessel bifurcations where targeted delivery is most problematic. We use a hemispherical ultrasonic transducer array that generates phase-modulated traveling waves, focusing on an ultrasound beam to steer NK cells using blood-flow dynamics and a focused acoustic field. This method enables the precise obstruction of non-target vessels and efficiently directs NK cells toward the tumor site. The simulation results offer insights into the behavior of NK cells under various conditions of cell size, radiation pressure, and fluid velocity, which inform the optimization of their trajectories and increase targeting efficiency. The experimental results demonstrate the feasibility of this ultrasonic approach for enhancing NK cell targeting, suggesting a potential leap forward in solid tumor immunotherapy. This study represents a significant step in NK cell therapeutic strategies, offering a viable solution to the existing limitations and promising enhancement of the efficacy of cancer treatments.

• Journal of Trauma and Injury
• /
• 제36권3호
• /
• pp.165-171
• /
• 2023

Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

• Tuberculosis and Respiratory Diseases
• /
• 제73권4호
• /
• pp.197-203
• /
• 2012

Recent advances in bronchoscopy have led to changes in clinical diagnostics and therapeutics in pulmonary medicine. In diagnostic bronchoscopy, there have also been new developments in endobronchial ultrasound technology which may be incorporated into clinical practice in the near future. Functional bronchoscopy, which evaluates information such as airway pressure, airflow, or gas exchange, suggests promising clinical advances in the near future. In therapeutic bronchoscopy, bronchoscopic volume reduction is a novel approach for the treatment of severe emphysema. In this review, seven recently published articles representing current advances in bronchoscopy are summarized and discussed.