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Purpose@#The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. @*Methods@#The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEE DLW ) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEE Youth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. @*Results@#In the first part of this study, there were no significant differences between theTEE DLW and the TEE Youth-PACT. The TEE Youth-PACT accurately predicted TEE DLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE Youth-PACT and overestimated TEE Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. @*Conclusion@#The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEE Youth-PACT and to set the EER for children and adolescents.
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Background@#Osteomas are benign, slow-growing bone tumors that can be classified as central, peripheral, or extraskeletal. Central osteomas arise from the endosteum, peripheral osteomas from the periosteum, and extraskeletal osteomas within the muscle. Frontal peripheral osteomas are mainly encountered in plastic surgery. In this study, we retrospectively analyzed the clinical data of patients with frontal peripheral osteomas. @*Methods@#We retrospectively reviewed the medical records of patients who visited our hospital with frontal peripheral osteomas between January 2014 and June 2022. We analyzed the following variables: age, sex, tumor type (sessile or pedunculated), single or multiple, size, history of head trauma, operation, and recurrence. @*Results@#A total of 39 patients and 41 osteomas were analyzed, of which 29 osteomas (71%) were sessile and 12 osteomas (29%) were pedunculated. The size of the osteomas ranged from 4 to 30 mm, with an average size of 10 mm. The age of patients ranged from 4 to 78 years with a mean age of 52 years. There were seven men (18%) and 32 women (82%), and the man-to-woman ratio was 1:4.6. Two patients (5%) had multiple masses, with two osteomas in each, while only two patients (5%) had a history of head trauma. Twenty-nine patients (74%) underwent ostectomy by a direct approach, and none of the patients experienced recurrence. @*Conclusion@#The epidemiologic data of our study will help plastic surgeons encounter frontal peripheral osteomas in the field to provide proper management for their patients.
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Purpose@#This study evaluated the validity of a physical activity classification table (PACT) based on total energy expenditure (TEE) and physical activity level (PAL) measured using the doubly labeled water (DLW) method in Korean adults and the elderly. @*Methods@#A total of 141 (male 70, female 71) adults and elderly were included. The reference standards TEEDLW , PALDLW were measured over a 14-day period using DLW. A 24-hour physical activity diary was kept for three days (two days during the week and one day on the weekend). PALPACT was calculated by classifying the activity type and intensity using the PACT. PALPACT was multiplied by resting energy expenditure measured by indirect calorimetry to estimate TEEPACT . @*Results@#The mean age of the study participants was 50.5 ± 18.8 years, and the mean body mass index was 23.4 ± 3.3 kg/m2 . A comparison of TEEDLW and TEEPACT by sex and age showed no significant differences. The bias, the difference between TEEDLW and TEEPACT , was male 17.3 kcal/day and female −4.5 kcal/day. The percentage of accurate predictions (values within ± 10% of the TEEDLW ) of TEEPACT was 58.6% in males and 54.9% in females, with the highest prediction values in the age group 40–64 years (70.9%) in males and over 65 years (73.9%) in females. The spearman correlation coefficient (r) between TEEPACT and TEEDLW was 0.769, indicating a significant positive correlation (p < 0.001). @*Conclusion@#In this study, the use of a new PACT for calculating TEE and PAL was evaluated as valid. A web version of the software program and a smartphone application need to be developed using PACT to make it easier to apply for research purposes.
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Research articles were reviewed to validate the estimated energy requirements (EERs) equations developed by the Institute of Medicine of the National Academies (IOM). These equations are based on total energy expenditure (TEE) measured by the doubly labeled water (DLW) method. We subsequently aimed to provide the basis for the suitability to apply the IOM equations as EER equations for Koreans, and develop relevant equations for EER in the Dietary Reference Intake for Koreans (KDRI). Additionally, besides the EER(IOM) equations, other equations were examined for EER estimation. Research papers demonstrating the validation of the EER(IOM) equations based on TEE(DLW) were searched through PubMed (up to September 2019). Of the 637 potentially relevant articles identified, duplicates and unsuitable titles and abstracts were excluded. Furthermore, papers with irrelevant subject and inappropriate study design were also excluded. Finally, 11 papers were included in the review. Among the reviewed papers, 8 papers validated the application of the EER(IOM) equations for EER based on TEE(DLW). These included 3 studies for children (USA 1, Korea 2), 1 for adolescents (Portugal), 2 for adults (Korean), and 2 for the elderly (Korea, USA).EER(IOM) equations were found to be generally acceptable for determining EER by using the DLW method, except for Korean boys at 9–11 yrs (overestimated) and female athletes at 19–24 yrs (underestimated). Additionally, 5 papers include the validation of other EER equations, beside EER(IOM) for EER based on TEE(DLW). In Japanese dietary reference intake and recommended dietary allowance, EER equations are acceptable for determining EER based on TEE(DLW). The EER(IOM) equations is generally acceptable for determining EER using the DLW method in Koreans as well as several populations, although certain defined groups were found to be unfit for the estimation. Additionally, the concept of healthy body mass index of Koreans and physical activity levels need to be considered, thereby providing the basis for developing relevant equations of EER in KDRI.
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BACKGROUND/OBJECTIVES@#Benign prostatic hyperplasia (BPH) is the most common prostate disease and one of the most common chronic diseases caused by aging in men. On the other hand, there has been no research on BPH using Abeliophyllum distichum Nakai (A.distichum). Therefore, this study investigated the effects of A. distichum on BPH.MATERIALS/METHODS: A. distichum leaves were extracted with distilled water, 70% ethanol, and 95% hexane as solvents. Subsequently, the inhibitory effects of each A. distichum extract on androgen receptor (AR) signaling were evaluated in vitro. The testosterone-induced BPH model was then used to confirm the efficacy of A. distichum leaves in 70% ethanol extract (ADLE). @*RESULTS@#ADLE had the strongest inhibitory effect on AR signaling. A comparison of the activity of ADLE by harvest time showed that the leaves of A. distichum harvested in autumn had a superior inhibitory effect on AR signaling to those harvested at other times. In the BPH rat model, the administration of ADLE reduced the prostate size and prostate epithelial cell thickness significantly and inhibited AR signaling. Subsequently, the administration of ADLE also reduced the expression of growth factors, thereby inactivating the PI3K/AKT pathway. @*CONCLUSIONS@#An analysis of the efficacy of ADLE to relieve BPH showed that the ethanol extract grown in autumn exhibited the highest inhibitory ability of the androgen-signaling related factors in vitro. ADLE also inhibited the expression of growth factors by inhibiting the expression of the androgen-signaling related factors in vivo. Overall, ADLE is proposed as a functional food that is effective in preventing BPH.
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BACKGROUND/OBJECTIVES@#The increased consumers’ interests in health and food safety have increased the demand for organic foods. Many studies have been performed on consumers’ purchase intentions for organic foods and their influencing factors, and various studies have shown that the prices of organic foods and the consumers’ willingness to pay are important influencing factors. This study examined the payment value of organic foods and agrifood consumer competency index according to the food-related lifestyles in South Korean consumers. @*SUBJECTS/METHODS@#A cross-sectional analysis was performed using the 2019 Consumer Behavior Survey for Food. A total of 6,176 participants aged 19 to 74 years (male: 2,783, female: 3,393) were included in the analysis. @*RESULTS@#Three factors were extracted by factor analysis (rational consumption-seeking type, convenience-seeking type, and health, and safety-seeking type) to explain the consumers’ food-related lifestyles. The results of cluster analysis suggested that consumers were classified into 3 food-related lifestyles as the ‘exploratory consumers’ (n = 2,485), ‘safetyseeking consumers’ (n = 1,544), and ‘passive consumers’ (n = 2,147). Exploratory consumers showed a significantly higher willingness to pay for imported organic foods (P < 0.05). Safety-seeking consumers had a significantly higher willingness to pay for domestic organic foods (P < 0.05). For the agrifood consumer competency index, exploratory consumers had the highest score, followed in order by safety-seeking consumers and passive consumers. @*CONCLUSIONS@#These results provide basic data in understanding consumption tendency for organic foods and agrifoods based on food-related lifestyles of South Korean consumers.
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Purpose@#This study evaluated how artificial intelligence-based computer-assisted diagnosis (AICAD) for breast ultrasonography (US) influences diagnostic performance and agreement between radiologists with varying experience levels in different workflows. @*Methods@#Images of 492 breast lesions (200 malignant and 292 benign masses) in 472 women taken from April 2017 to June 2018 were included. Six radiologists (three inexperienced [<1 year of experience] and three experienced [10-15 years of experience]) individually reviewed US images with and without the aid of AI-CAD, first sequentially and then simultaneously. Diagnostic performance and interobserver agreement were calculated and compared between radiologists and AI-CAD. @*Results@#After implementing AI-CAD, the specificity, positive predictive value (PPV), and accuracy significantly improved, regardless of experience and workflow (all P<0.001, respectively). The overall area under the receiver operating characteristic curve significantly increased in simultaneous reading, but only for inexperienced radiologists. The agreement for Breast Imaging Reporting and Database System (BI-RADS) descriptors generally increased when AI-CAD was used (κ=0.29-0.63 to 0.35-0.73). Inexperienced radiologists tended to concede to AI-CAD results more easily than experienced radiologists, especially in simultaneous reading (P<0.001). The conversion rates for final assessment changes from BI-RADS 2 or 3 to BI-RADS higher than 4a or vice versa were also significantly higher in simultaneous reading than sequential reading (overall, 15.8% and 6.2%, respectively; P<0.001) for both inexperienced and experienced radiologists. @*Conclusion@#Using AI-CAD to interpret breast US improved the specificity, PPV, and accuracy of radiologists regardless of experience level. AI-CAD may work better in simultaneous reading to improve diagnostic performance and agreement between radiologists, especially for inexperienced radiologists.
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Background@#The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. @*Methods@#In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients’ satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. @*Results@#Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients’ satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. @*Conclusions@#VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.
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The accuracy and convenience of continuous glucose monitoring (CGM), which efficiently evaluates glycemic variability and hypoglycemia, are improving. There are two types of CGM: professional CGM and personal CGM. Personal CGM is subdivided into real-time CGM (rt-CGM) and intermittently scanned CGM (isCGM). CGM is being emphasized in both domestic and foreign diabetes management guidelines. Regardless of age or type of diabetes, CGM is useful for diabetic patients undergoing multiple insulin injection therapy or using an insulin pump. rt-CGM is recommended for all adults with type 1 diabetes (T1D), and can also be used in type 2 diabetes (T2D) treatments using multiple insulin injections. In some cases, short-term or intermittent use of CGM may be helpful for patients with T2D who use insulin therapy other than multiple insulin injections and/or oral hypoglycemic agents. CGM can help to achieve A1C targets in diabetes patients during pregnancy. CGM is a safe and cost-effective alternative to self-monitoring blood glucose in T1D and some T2D patients. CGM used in diabetes management works optimally with proper education, training, and follow up. To achieve the activation of CGM and its associated benefits, it is necessary to secure sufficient repetitive training and time for data analysis, management, and education. Various supports such as compensation, insurance coverage expansion, and reimbursement are required to increase the effectiveness of CGM while considering the scale of benefit recipients, policy priorities, and financial requirements.
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Background@#Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic reproducibility of PBLs in core needle biopsy (CNB) specimens with World Health Organization (WHO) classification. @*Methods@#Diagnostic reproducibility was assessed using interobserver variability (kappa value, κ) and agreement rate in the pathologic diagnosis of 60 PBL cases on CNB among 20 breast pathologists affiliated with 20 medical institutions in Korea. This analysis was performed using hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for cytokeratin 5 (CK5) and p63. The pathologic diagnosis of PBLs was based on WHO classification, which was used to establish simple classifications (4-tier, 3-tier, and 2-tier). @*Results@#On WHO classification, H&E staining exhibited ‘fair agreement’ (κ = 0.21) with a 47.0% agreement rate. Simple classifications presented improvement in interobserver variability and agreement rate. IHC staining increased the kappa value and agreement rate in all the classifications. Despite IHC staining, the encapsulated/solid papillary carcinoma (EPC/SPC) subgroup (κ = 0.16) exhibited lower agreement compared to the non-EPC/SPC subgroup (κ = 0.35) with WHO classification, which was similar to the results of any other classification systems. @*Conclusions@#Although the use of IHC staining for CK5 and p63 increased the diagnostic agreement of PBLs in CNB specimens, WHO classification exhibited a higher discordance rate compared to any other classifications. Therefore, this result warrants further intensive consensus studies to improve the diagnostic reproducibility of PBLs with WHO classification.
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Energy requirement is defined as energy expenditure in an energy equilibrium state.The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to ‘low active’ was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with ‘active’ and ‘very active’ PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.
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Purpose@#This study investigated the food consumption behaviors in Korean adults, according to the agrifood consumer competency index (ACCI). @*Methods@#Data obtained from the 2019 Consumption Behaviors Survey for Food were analyzed. A total of 6,176 adults (2,783 males, 3,393 females) aged ≥ 19 years, were included in the study. Based on the score of agrifood consumer competency index, the subjects were classified into three groups. The dietary habits, eating-out and food-delivery/take-out behaviors, opinion of food labeling, and concerns for domestic products were compared among the 3 groups. @*Results@#The ACCI scores of the male and female subjects were 63.6 and 64.8, respectively. Subjects of both genders in the highest tertile of the ACCI were more likely to have a higher education level and higher health concerns, as compared to subjects in the lowest tertile (p < 0.05). Male subjects having highest tertile of the ACCI reported significantly more exercise and alcohol consumption, as compared to subjects in the lowest tertile (p < 0.05). A higher score of the ACCI also portrayed a higher satisfaction in own diet and greater checking of the food label. Moreover, subjects with a higher score of the ACCI showed greater satisfaction and reliability in the food label, as well as increased concerns for domestic agrifoods, local foods, and eco-friendly foods. Subjects in the lowest tertile of the ACCI acquired their dietary information from acquaintances, whereas subjects in the highest tertile of the ACCI learnt the information from food labels themselves. @*Conclusion@#These results are indicative of the food consumption and behaviors of Koreanadults according to their ACCI scores, and provide basic data that will be useful for implementing an effective food policy.
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To set the estimated energy requirement (EER) in Dietary Reference Intakes for Koreans (KDRI), we need the coefficient by physical activity stage, as determined by the physical activity level(PAL). Thus, there has been demand for a tool to calculate PAL based on the physical activity diary. This study was undertaken to develop a physical activity (PA) classification table for Koreans, using the 2011 Compendium of physical activities in the United States. The PA classification table for Koreans contains 262 codes, and values of the metabolic equivalent of task (MET) for specific activities. Of these, 243 PAs which do not have Korean specific data or information, were selected from the 2011 Compendium of PAs that originated in the United States; another 19 PAs were selected from the previous research data of Koreans. The PA classification table is codified to facilitate the selection of energy values corresponding to each PA. The code for each PA consists of a single letter alphabet (activity category) and four numeric codes that display the activity type (2 digit number), activity intensity (1 digit number), and specific activities (1 digit number). In addition, the intensity (sedentary behavior, low, middle and high) of specific PA and its rate of energy expenditure in MET are presented together. The activity categories are divided into 4 areas: Daily Activity (A), Movement (B), Occupation (C), and Exercise and Sports (D). The developed PA classification table can be applied to quantify the energy cost of PA for adults in research or practice, and to assess energy expenditure and physical activity levels based on self-reported PA.
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The most common malignant tumors in the colon are adenocarcinomas, while leiomyosarcoma (LMS) are rare. Here, we report a case of LMS of the sigmoid colon in a 73-year-old man who presented with sigmoido-rectal intussusception, which was discovered by abdominal computed tomography. As LMS of the colon is uncommon and is rarely associated with intussusception, we have described the imaging features in this case report.
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Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.
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Objectives@#We have been providing psychotherapy training for medical students enrolled in the course of ‘Clinical Practice.’ The aim of this study is to introduce the psychotherapy education developed in this process, conceptualize objective education methods, and check the impact of educational applications of psychotherapy for medical students. @*Methods@#Psychotherapy was applied to the medical students during their clerkship in psychiatry. 221 medical students participated in this program from 2017–2019, which consisted of 2–3 people in a group. One was in charge of clients, and the other was an observer. Their clerkship was based on psychodynamic psychotherapy, especially Taopsychotherapy. Before and after the practice, participants completed a self-reporting questionnaire about ego identity, self-concealment, and professional help-seeking attitudes. Statistical analysis using a two-way repeated measure analysis of variance was conducted. @*Results@#Participants learned of the nuclear feelings associated with the current problem and were surprised to find a connection with past experiences, but accepted the connection. Selfidentity decreased in the client role students (p=0.001), and professional help-seeking attitude increased in both client and observer role students (p=0.001). @*Conclusion@#In the general course of psychotherapy, patients are reminded of their first interpersonal relationships, like parents, and in the beginning, they only think of positive aspects under repressed emotions. However, they gradually recalled negative emotions. The above practical course featured this same pattern. As they recognized negative emotions that were repressed, self-identity decreased in client role students.
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Objective@#We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique. @*Materials and Methods@#We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation. @*Results@#The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm2 , 0.82 ± 0.34 cm2 , and 0.80 ± 0.26 cm2 , respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94–0.97) and 0.87 (95% CI, 0.82–0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96–0.98) and 0.98 (95% CI, 0.97–0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89–0.94) and 0.91 (95% CI, 0.88–0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82–0.91) vs. 0.85 (95% CI, 0.79–0.89). @*Conclusion@#High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.
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During the past decade, researchers have investigated the use of computer-aided mammography interpretation. With the application of deep learning technology, artificial intelligence (AI)-based algorithms for mammography have shown promising results in the quantitative assessment of parenchymal density, detection and diagnosis of breast cancer, and prediction of breast cancer risk, enabling more precise patient management. AI-based algorithms may also enhance the efficiency of the interpretation workflow by reducing both the workload and interpretation time. However, more in-depth investigation is required to conclusively prove the effectiveness of AI-based algorithms. This review article discusses how AI algorithms can be applied to mammography interpretation as well as the current challenges in its implementation in real-world practice.
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Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.
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Background@#The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. @*Methods@#In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients’ satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. @*Results@#Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients’ satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. @*Conclusions@#VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.