• 제목/요약/키워드: Retrospective approach

검색결과 293건 처리시간 0.027초

10년간의 3차 의료기관 경험을 바탕으로 한 대동맥장골동맥 폐색 질환 혈관내 치료의 기술적 고찰: 후향적 연구 (Technical Consideration of Endovascular Treatment for Aortoiliac Occlusive Disease Based on a 10-Year Tertiary Hospital Experience: A Retrospective Study)

  • Panat Nisityotakul;Sorracha Rookkapan
    • 대한영상의학회지
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    • 제85권3호
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    • pp.596-606
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    • 2024
  • Purpose To examine the technical considerations of endovascular treatment for aortoiliac occlusive disease (AIOD) based on a 10-year experience in Songklanagarind Hospital. Materials and Methods This retrospective cohort study included 210 patients who underwent endovascular treatment for symptomatic AIOD between January 2010 and December 2020. The patients' clinical and lesion characteristics, including technical considerations of the procedure, were collected, analyzed, and stratified using the Transatlantic Inter-Society Consensus (TASC). Results Most patients (80%) in this study had chronic limb-threatening ischemia lesions, with an occlusion rate of 37%. The technical success rate of TASC C & D was lower than that of TASC A & B, 84.4% vs. 99.2% p ≤ 0.001. A technical success rate of 93.3% (14/15) was found for the femoral and brachial approach, compared with a success rate of 89.0% (57/64) for the unibifemoral approach in TASC C & D, without a statistically significant difference (p = 0.076). However, the puncture site complications in this route were up to 17.6%, which is the highest rate compared with other techniques. These complications could be treated either conservatively or minimally invasively. Conclusion In cases of failed femoral access, simultaneous femoral and brachial approaches improved the technical success rate of endovascular recanalization of TASC C & D aortoiliac occlusions.

구강내 접근법만을 통한 골절단술과 재위치술을 이용한 협골 축소술 (REDUCTION MALARPLASTY WITH BONE OSTECTOMY & REPOSITIONING ONLY USING INTRAORAL APPROACH)

  • 신상훈;허준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권1호
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    • pp.105-109
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    • 2000
  • The zygoma is protruded on both sides of the midface and plays an important part in determining the impression of face. There are much different esthetic consideration of zygomatic prominence between the oriental and western. Because slight prominent zygoma is thought to be esthetic in the western, there has been done many augmentation therapy. But, in the oriental, prominent zygoma, especially in the female, is thought to be aggresive and manlike image, there has been done many zygoma reduction therapy. There are two methods to reduce the prominent zygoma, one is shaving method and the other is zygoma repositioning with ostectomy. The approach to zygoma and zygomatic arch without surgical morbidity is very difficult, so this problem has been difficult subject to oral & maxillofacial surgeon in a long period. We report the treatment case of facial asymmetry with the unilateral zygoma reduction & genioplasty using only intraoral approach with the retrospective study.

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Derivation of a new dose constraint applicable to radioactive discharges from Korean nuclear power plants through retrospective dose assessment

  • Kim, Soyun;Cheong, Jae Hak
    • Nuclear Engineering and Technology
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    • 제54권10호
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    • pp.3660-3671
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    • 2022
  • A new methodology to derive a dose constraint for radioactive effluent from a unit of nuclear power plant (NPP) through retrospective assessment was developed to reflect operational flexibility in line with international standards. The new dose constraint can retain the safety margin between the offsite dose and the past dose constraints. As case studies, the new approach was applied to 24 Korean NPPs to address the limitations of the existing seven dose constraints that do not fully comply with current international radiation protection standards. Therefore, an effective dose constraint for Korean NPPs was proposed as no less than 0.15 mSv/y, which is comparable to the international practices and previous studies (0.05-0.3 mSv/y). Although the lower bound of the equivalent dose constraint was calculated as 0.17 mSv/y, it is not proposed in this study since the compliance with the derived effective dose constraint can prevent accompanied equivalent doses to any organs from exceeding equivalent dose limits. The new framework and the case studies are expected to contribute toward and support the revision of existing dose constraints for radioactive effluent from NPPs, ensuring better compliance with the current international safety standards as well as reflect the operational flexibility in practice.

하악과두부 골절 치료시 다양한 외과적 접근법에 대한 임상적 고찰 (CLINICAL REVIEW OF VARIOUS SURGICAL APPROACHES IN THE TREATMENT OF MANDIBULAR CONDYLE FRACTURE)

  • 김지혁;김성민;권광준;박영욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권1호
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    • pp.72-82
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    • 2008
  • Various surgical approaches in the mandibular condyle fracture have been reported and many advantages of intraoral reduction were also introduced. But there are still controversies about surgical method of condylar fractures up to date. To establish the surgical approach protocol of condylar fracture, from May 2001 to December 2004, total 65 patients with 74 fractures of the mandibular condyle were reviewed during 2 years, retrospectively. All cases were classified according to the treatment considering factors, such as the level of fracture, degree and direction of displacement of fractured segment, patient’s age and gender, surgical approach methods, and their complications. Especially, advantages and surgical limitations of extraoral surgical approach, such as direct reduction and fixation via submandibular approach, Nam’s method, and endaural approach, were compared with those of intraoral surgical approach, such as direct intraoral reduction with transbuccal fixation or right angle driver system, and intraoral reinsertional approach after extraoral fixation of fractured fragment. The guidelines of surgical approach of condylar fracture based on our clilnical retrospective experiences and literature reviews can be suggested.

법률정보시스템의 색인에 관한 연구 -특히 2차 법률정보를 중심으로- (A Study on the Index Model for Secondary Legal Information Databases)

  • 노정란
    • 한국비블리아학회지
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    • 제8권1호
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    • pp.117-134
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    • 1997
  • This study proves that the quoted legal text functions as the index which represents the contents of the text because of the characteristics of legal information, the automatic indexing in the secondary legal full-text databases can be possible without the assitance of the experts. In case of the establishment, amendment or repealing of law, change of words of index can be possible through revising the legal text quoted in the secondary legal full-text databases. Even when we dont input the full-text about retrospective documents, automatic indexing is also possible, and the establihment and the practice of expert knowledge and integrated databases are possible in case of the retrospective documents. This study indicates that it is necessary to have characteristic information the information experts recognize - that is to say, experimental and inherent knowledge only human being can have - built-in into the system rather than to approach the information system by the linguistic, statistic or structuralistic way, and it can be more essential and intelligent information system.

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Review for Retrospective Exposure Assessment Methods Used in Epidemiologic Cancer Risk Studies of Semiconductor Workers: Limitations and Recommendations

  • Park, Donguk
    • Safety and Health at Work
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    • 제9권3호
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    • pp.249-256
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    • 2018
  • This article aims to provide a systematic review of the exposure assessment methods used to assign wafer fabrication (fab) workers in epidemiologic cohort studies of mortality from all causes and various cancers. Epidemiologic and exposure-assessment studies of silicon wafer fab operations in the semiconductor industry were collected through an extensive literature review of articles reported until 2017. The studies found various outcomes possibly linked to fab operations, but a clear association with the chemicals in the process was not found, possibly because of exposure assessment methodology. No study used a tiered assessment approach to identify similar exposure groups that incorporated manufacturing era, facility, fab environment, operation, job and level of exposure to individual hazardous agents. Further epidemiologic studies of fab workers are warranted with more refined exposure assessment methods incorporating both operation and job title and hazardous agents to examine the associations with cancer risk or mortality.

Retrospective analysis of 79 patients with orbital floor fracture: outcomes and patient-reported satisfaction

  • Senese, Olivier;Boutremans, Edward;Gossiaux, Caroline;Loeb, Isabelle;Dequanter, Didier
    • 대한두개안면성형외과학회지
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    • 제19권2호
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    • pp.108-113
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    • 2018
  • Background: The aim of our retrospective study is to evaluate the management of isolated orbital floor fractures considering the clinical, functional and aesthetic results according to the surgical approach and the type of materials used. Methods: Retrospectively, clinical, radiological, surgical, and ophthalmological data from 79 patients were collected from January 2010 to December 2016. Furthermore, included patients were interrogated on functional and aesthetic satisfaction. Results: The main causes of trauma were physical aggression followed by accidents. The median time between trauma and surgery was 4 days. The most common surgical approaches were the subciliary and the transconjunctival ones. Alloplastic materials were used in 75 patients. In two patients, we used a combination of two grafts. Patients experienced minor immediate complications. On follow-ups, none of our patients suffered from ocular movement restrictions. Patients treated by subciliary approach had higher risk of retractile scaring compared to other surgical approaches. In our study, patients agreed to complete a questionnaire assessing functional and aesthetic outcomes with a high satisfaction score. No association between the implant material used and the results has been assessed. Conclusion: This study describes the results of orbital floor reconstructions. Despite a variety of materials used and surgical approaches performed, we believe that the transconjunctival approach is the most suitable option with a high satisfaction score.

L1-2 Disc Herniations : Clinical Characteristics and Surgical Results

  • Lee, Sang-Ho;Choi, Seok-Min
    • Journal of Korean Neurosurgical Society
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    • 제38권3호
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    • pp.196-201
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    • 2005
  • Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

Lymphaticovenular Anastomosis: Superficial Venous Anatomical Approach

  • Winaikosol, Kengkart;Surakunprapha, Palakorn
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.689-695
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    • 2022
  • Background Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results.

The Effect of Trauma Team Approach on the Management of Hemodynamically Unstable Pelvic Bone Fracture: Retrospective Comparative study

  • Cho, Won-Tae;Cho, Jae-Woo;Kim, Jinil;Kim, Jin-Kak;Oh, Jong-Keon;Kim, Hak Jun;Kim, Namryeol;Cho, Jun-Min
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.139-145
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    • 2016
  • Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.