Background: As breast tissue expanders consist of metallic materials in the needle guard and ferromagnetic injection port, irradiation can produce radioactivation. Materials and Methods: A CPX4 (Mentor Worldwide LLD) breast tissue expander was exposed using the Versa HD (Elekta) linear accelerator. Two photon energies of 6 and 10 MV-flattening filter free (FFF) beams with 5,000 monitor units (MU) were irradiated to identify the types of radiation. Furthermore, 300 MU with 10 MV-FFF beam was exposed to the CPX4 breast tissue expander by varying the machine dose rates (MDRs) 600, 1,200, and 2,200 MU/min. To assess the instantaneous dose rates (IDRs) solely from the CPX4, a tissue expander was placed outside the treatment room after beam irradiation, and a portable radioisotope identification device was used to identify the types of radiation and measure IDR. Results and Discussion: After 5,000 MU delivery to the CPX4 breast tissue expander, the energy spectrum whose peak energy of 511 keV was found with 10 MV-FFF, while there was no resultant one with 6 MV-FFF. The time of each measurement was 1 minute, and the mean IDRs from the 10 MV-FFF were 0.407, 0.231, and 0.180 μSv/hr for the three successive measurements. Following 10 MV-FFF beam irradiation with 300 MU indicated around the background level from the first measurement regardless of MDRs. Conclusion: As each institute room entry time protocol varies according to the working hours and occupational doses, we suggest an addition of 1 minute from the institutes' own room entry time protocol in patients with CPX4 tissue expander and the case of radiotherapy vaults equipped with a maximum energy of 10 MV photon beams.
Purpose: Most of the patients who underwent surgery feels variable kinds of fear or anxiety; an uncomfortable mood state that happens without specific object affects patient's satisfaction before and after the surgery. As music therapy is rather noninvasive method generally used in reducing patient's anxiety, the authors researched about the extent of anxiety with the change of vital sign before the operation while comparing with the cases of patients who took the music therapy at closed reduction under general anesthesia. Method: We divided the patients in 4 groups; A with the premedication (Midazolam, Dormicum$^{(R)}$) before the operation, B with the premedication and music therapy, C with only music therapy, D with no premedication or therapy. And we measured the vital signs after the arrival at the operation room, after induction and 20 minutes after the operation. Also we observed the changes of anxiety index with the STAI (State Trait Anxiety Inventory)-K (Korea)YZ 1 hour before and 8 hours after the surgery. Result: The group B showed the least changes in blood pressure as the group D showed the highest change. Both group C and A showed increase in blood pressure but the upswing in group A was lower than group C. At the change of pulse rate group B showed the lowest upswing also group D showing the highest. Group B showed quite a few upswing but lower than group D, but, at the same time, group A showed lower upswing when comparing two cases. After analysis of STAI-KYZ score, the anxiety relatively decreased in group B and C in comparison with group D. And the index of anxiety state of group A showed just as much to group D. Conclusion: The music therapy is better healthcare method compared to other therapies in reducing anxiety also with satisfying effect who underwent operation. The authors recommend music therapy assisted with use of premedication for better relief of anxiety.
The scatter photons and photoneutrons from high energy photon beams (more than 10 MV) will increase the undesired dose to the patient and the staff working in linear accelerator room. This undesired dose which is found at out-of-field area can increase the probability of secondary malignancy. The purpose of this study is to determine the equivalent dose of scatter photons and neutrons generated by 3 different treatment techniques: 3D-conformal, intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). The measurement was performed using two types of the optically stimulation luminescence detectors (OSL and OSLN) in the Alderson Rando phantom that was irradiated by 3 different treatment techniques following the actual prostate cancer treatment plans. The scatter photon and neutron equivalent dose were compared among the 3 treatments techniques at the surface in the out-of-field area and the critical organs. Maximum equivalent dose of scatter photons and neutrons was found when using the IMRT technique. The scatter neutrons showed average equivalent doses of 0.26, 0.63 and $0.31mSv{\cdot}Gy^{-1}$ at abdominal surface region which was 20 cm from isocenter for 3D, IMRT and VMAT, respectively. The scattered photons equivalent doses were 6.94, 10.17 and $6.56mSv{\cdot}Gy^{-1}$ for 3D, IMRT and VMAT, respectively. For the 5 organ dose measurements, the scattered neutron and photon equivalent doses in out of field from the IMRT plan were highest. The result revealed that the scatter equivalent doses for neutron and photon were higher for IMRT. So the suitable treatment techniques should be selected to benefit the patient and the treatment room staff.
Juan Luis Gomez-Amador;Cristopher G Valencia-Ramos;Marcos Vinicius Sangrador-Deitos;Aldo Eguiluz-Melendez;Gerardo Y Guinto-Nishimura;Alan Hernandez-Hernandez;Samuel Romano-Feinholz;Luis Alberto Ortega-Porcayo;Sebastian Velasco-Torres;Jose J Martinez-Manrique;Juan Jose Ramirez-Andrade;Marco Zenteno-Castellanos
Journal of Cerebrovascular and Endovascular Neurosurgery
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제25권1호
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pp.50-61
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2023
Objective: To describe the roadmapping technique and our three-year experience in the management of intracranial aneurysms in the hybrid operating room. Methods: We analyzed all patients who underwent surgical clipping for cerebral aneurysms with the roadmapping technique from January 2017 to September 2019. We report demographic, clinical, and morphological variables, as well as clinical and radiological outcomes. We further describe three illustrative cases of the technique. Results: A total of 13 patients were included, 9 of which (69.2%) presented with subarachnoid hemorrhage, with a total of 23 treated aneurysms. All patients were female, with a mean age of 47.7 years (range 31-63). All cases were anterior circulation aneurysms, the most frequent location being the ophthalmic segment of the internal carotid artery (ICA) in 11 cases (48%), followed by posterior communicating in 8 (36%), and ICA bifurcation in 2 (8%). Intraoperative clip repositioning was required in 9 aneurysms (36%) as a result of the roadmapping technique in the hybrid operating room. There were no residual aneurysms in our series, nor reported mortality. Conclusions: The roadmapping technique in the hybrid operating room offers a complementary tool for the adequate occlusion of complex intracranial aneurysms, as it provides a real time fluoroscopic-guided clipping technique, and clip repositioning is possible in a single surgical stage, whenever a residual portion of the aneurysm is identified. This technique also provides some advantages, such as immediate vasospasm identification and treatment with intra-arterial vasodilators, balloon proximal control for certain paraclinoid aneurysms, and simultaneous endovascular treatment in selected cases during a single stage.
Low back Pain(LBP) is a common problem, and the resulting disability frequently contains nonorganic, psycho-logical and social elements that are difficult for the physical therapists to manage. The physical therapist-patient relationship is the most important factors in the management of low back pain as chronic disease. The purpose of this study was to evaluate and to identify factors that had influenced low, back pain patients satisfaction with physical therapist The subjects of this study were 223 out-patients(116 males and 107 females) who had been visited to physical therapy room of medical institutions in Seoul and Uijgngbu city. They were examined by the questionaire of Dimatteo and Hays which was amended to serve the purpose of this study by author. The collected data was analyzed by ANOVA according to the purpose of this study. There was no difference with statistic value in LBP patient's satisfaction according to occupation, sex, schooling, religion, marital status, medical security, duration of disease, the tine required, recurrence, but was a difference according to age, income, period of treatment, cost, diagnosis, waiting time, the number of physical therpy's sort, sex ane age of physical therapists (p<.05). LBP patients was satisfied with physical therapist's communicative behavior, but was dissatisfied with physical therapist's competence.
The trigger point phenomenon is an extremely common syndrome in physical therapy room. The symptoms created by these syndromes may be interpreted as originating in discogneic disease, nerve entrapment syndromes, viscerosomatic pain, and certain myalgic pain of unknown etiology. Injuries, viral or bacterial infections, immobilization, psychogenic stress, and other environment factors can preciptate and perpetuate these syndromes, which may occur in any of the voluntary muscles of the human body and thus lead to a multitude of myofascial pain syndromes. Obviously symptomatic treatment can meet with only partial success. Knowledge of the trigger point phenomenon will aid the diagnostician in understanding otherwise in explicable symptom. The trigger point are $2{\sim}5mm$ in diameter, hyperirritable palpable taut in a tissue, when compressed, is locally tender, if sufficiently hypersensitive, give rise to referred pain and tenderness, and sometimes to referred automatic phenomena and distortion of proprioception. The treatment of myofascial trigger point pain syndrome is not difficult once the source of the problem has been determined. Where as many modalities may be used, two of the most effective are spray-and stretch and TP injection. These can be followed by deep massage, specific, manual resistive exercise, and an exercise program which the patient can follow at home. The goal of management is to inactivate the TPs and to restore shortened and stretch resistent muscles to their full range of motion. The purpose of this case study was to know about the pathophysiologic mechanism of the trigger point and will enable to physical therapist to direct his treatment to the real source of trouble.
Resistive therapeutic exercise prescription goal is to improve functional performance and capabilities through the development of increased muscular strengh endurance or power. Resistance can be applied to either dynamic or static muscle contractions. Resistive therapeutic exorcise can be carried nut concentrically, eccentrically, isometrically, isokinetically. Neurodevelopmental treatment has not resistive therapeutic exercise concept. But proprioceptive neuromuscular facilitate techniques have resistive therapeutic exercise concept with pattens and techniques. It is aid muscle contraction, motor control and increase strength. Manual muscle testing will help the therapist establish a qualitative and quantitative baseline level of strength. Manual resistance maybe applied a against controlled lengthening contraction re static contraction of a muscle. A repetition maximum is not easy to calculate and is not the most accurate method available today to measure strength before of after a resistive therapeutic exercise program. Oddvar Holten Diagram is essy to calculate and is the most accurate method available today to measure strength before of after a resistive therapeutic exercise program. Plyometric training emphasize the development of muscular power and coordination. Quick bursts of force in functional movement patterns are often necessary of a patient is to return to high-demand occupational, recreational or sports related activities.
Purpose: The aim of this study was to evaluate the effects of favorite music therapy on the stress response of hysterectomy patients undergoing general anesthesia. Methods: Date were collected from June 29, 2015 to January 18, 2016 and the participants were 79 hysterectomy patients (experimental group 40 and control group 39). The experimental group listened to their favorite music through earphones from the moment they entered the surgical waiting room until they exited from the post anesthesia care unit. Results: There were statistically significant differences in anxiety (F=15.92, p<.001), systolic blood pressure (F=4.23, p=.008), diastolic blood pressure (F=3.07, p=.033), and heart rate (F=19.93, p<.001) between participants in the experimental group and the control group according to measurement times. Conclusion: The study results show that favorite music therapy considering patients' preferences is effective in reducing anxiety among patients undergoing a hysterectomy under general anesthesia, thus leading to a stable change in their blood pressure and heart rate.
Journal of Korean Academy of Fundamentals of Nursing
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제19권3호
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pp.292-301
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2012
Purpose: The purpose of the study was to evaluate the effects of postoperative oral care using cold therapy on nausea, vomiting and oral discomfort after laparoscopic myomectomy. Method: The study was conducted with an experimental group (n=29) and a control group (n=35) sampled from patients admitted to a women's hospital in a metropolitan city in Korea. Data were collected between October 10, 2011 and January 31, 2012 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANCOVA with SPSS/WIN 19.0. Results: After the intervention, postoperative nausea (p<.001) and oral discomfort for patients in the experimental group were significantly lower than in the control group. There were significant differences in the presence of vomiting between both groups at 12 hours (p<.001) and 24 hours (p=.003) after leaving the recovery room. Conclusion: Oral care using cold therapy was found to be an effective nursing intervention for reducing postoperative nausea, vomiting and oral discomfort up to 24 hours after recovery in patients with laparoscopic myomectomy.
Journal of the Korean Society of Physical Medicine
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제10권2호
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pp.95-98
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2015
PURPOSE: This study was conducted to devise a method of preventing water infiltration into the surface electrodes during EMG measurements underwater and on the ground and to check the reliability of Electromyography (EMG) measurements when underwater. METHODS: Six healthy adults were selected as subjects in this study. The measurements in this study were conducted in pool dedicated to underwater exercise and physical therapy room in the hospital building. An MP150 (Biopac Systems, US, 2010) and a BioNomadix 2-channel wireless EMG transmitter (Biopac Systems, US, 2012) was used to examine the muscle activity of rectus femoris, biceps femoris, tibialis anterior, gastrocnemius of dominant side. The subjects repeated circulation tasks on the ground for more than 10 min for enough surface electrode attachment movement. After a 15-min break, subjects performed the circulation task underwater(water depth 1.1m, water temperature $33.5^{\circ}C$, air temperature $27^{\circ}C$), as on the ground, for more than 10 min, and the MVIC of each muscle was measured again. SPSS v20.0 was used for all statistical computations. RESULTS: The maximum voluntary isometric contraction (MVIC) values between the underwater and on the ground measurements showed no significant differences in all four muscles and showed a high intraclass correlation coefficient (ICC) of >0.80. CONCLUSION: We determined that EMG measurements obtained underwater could be used with high reliability, comparable to ground measurements.
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