The aim of the study is to analyze incidence and risk factors for air embolism during computed tomography (CT) fluoroscopy-guided lung biopsies using noncoaxial automatic needle.Materials and Methods: Between February 2014 and December 2019, 204 CT fluoroscopy-guided lung biopsies (127 men; mean age, 70.6 years) using noncoaxial automatic needle under inspiratory breath holding were performed. We retrospectively evaluated the incidence of air embolism as presence of air in the systemic circulation on whole-chest CT images obtained immediately after biopsy. Risk factors of the patient, tumor and procedural factors (size, location and type of nodule, distance from the pleura, the level of the lesion relative to the left atrium, emphysema, patient position, penetration of a pulmonary vein, etc) were analyzed.
Results:The technical success rate was 97.1%. Air embolism was radiologically identified in 8 cases (3.92%, 7 males; size, 21.6 ± 18.2 mm; distance to pleura, 11.9 ± 14.5 mm). Two patients showed overt symptoms and the others were asymptomatic. Independent risk factors were needle penetration of the pulmonary vein ( P = 0.0478) and higher location relative to left atrium ( P = 0.0353). Size, location and type of nodule, distance from the pleura, emphysema, patient position, and other variables were not significant risk factors. As other complications, pneumothorax and alveolar hemorrhage were observed in 57.4% and 77.5%, respectively.
Conclusions:In CT fluoroscopy-guided lung biopsy using the noncoaxial automatic needles, radiological incidence of air embolism was 3.92%. Given the frequency of air embolism, it is necessary to incorporate this into postprocedure imaging and clinical evaluation.
The idea of Society 5.0 initiative has been proposed to solve various social problems by connecting virtual cyberspace and real physical space through information technology. When applying the idea to improve the work-life balance of physicians in the medical field, we must consider the increased stress owing to their long continuous working hours. Estimating the stress of physicians in their daily lives by the questionnaires is insufficient, because of the difficulty of accurate their activity recalling. By using bio-metric information such as heart rate, physical activity, and sleeping information, it was expected that the daily stress state of physicians with high accuracy. In this paper, we propose a method for estimating physician stress by analyzing bio-metric information acquired by wearing a wearable sensor device. The proposed method estimates the state of stress during daily activities by acquiring data on heart rate variability (HRV) during wakefulness as well as sleep depth during rapid eye movement (REM) and non-REM sleep. Up to seven physicians wore the wearable sensor device for the maximum of eight weeks and the sleep depth and low-/high-frequency (LF/HF) components of HRV were obtained. Our observation showed that physicians' root mean square of successive differences (rMSSDs) were constantly high in their healthy state. Therefore, the decreasing of this index can be used as an indicator of fatigue and stress. In addition, by combining LF/HF components to the rMSSDs, we may estimate the stress state of physicians and find personal stressors.
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