SummaryInterventional radiology (IVR) is a technique using image guidance such as X-ray fluoroscopy to perform diagnostic and therapeutic procedures. It is widespread, and its use continues to increase. Radiofrequency catheter ablation (RFCA) has a long fluoroscopy time, and ablation procedures may be repeated in a single session. The entrance skin dose may reach several Gy, but information on radiation dose of actual procedures is limited. We conducted a survey on RFCA to acquire general information on how the procedures are performed in local institutions, including patient radiation dose in the Kanto area. 43% (33/77 institutions) of institutions to which we sent written questionnaires returned completed forms. Ablation for atrial fibrillation had the longest average fluoroscopy times (100.8 min) and average procedure times (228 min), and average air kerma at the interventional reference point (1173.6 mGy). Percutaneous coronary intervention and RFCA may cause skin injury, which suggests the continued need for radiation safety management.
This article introduces treatment of Mechanical low back pain using McKenzie Approach. McKenzie classifies low back pain into three diagnostic categories on the basis of clinical symptoms and responses to examination movements; Postural syndrome, Dysfunction syndrome and Derangement syndrome. Dysfunction syndrome and Derangement syndrome are further classified into several subcategories. Appropriate mechanical diagnosises are decided an integral part in McKenzie Approach. McKenzie Approach consists basically of 17 treatment techniques, most of which are self-treatments by patients. McKenzie points out that 70% of low back pain can be treated without mobilization and manipulation, and claims that intervention by a therapist not only makes patients passive but also results in an elongation of treatment period. He also emphasizes that treatment techniques by a therapist should be given only when self-treatment by a patient does not appear to exert an effect.
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