• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.830-833
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• 2010

Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.84-88
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• 2014

Traditional method of pulpectomy for a necrotic primary anterior tooth was done on lingual side. But it could not recover the discoloration of crown effectively. For the purpose of treating the discoloration of crown after lingual pulpectomy, additional methods of crown restoration were needed like : celluloid crown, open-faced crown, rasin-faced crown. Neverthless, these kinds of complete coverage methods had some disadvantages such as possibility of tooth fracture by increased tooth preparation. In order to overcome the shortcomings of lingual pulpectomy, labial treatment could be considered as an alternative. It is a method that treats necrotic pulp through the labial access opening. After finishing the pulp treatment, discolored labial tooth structure was removed extending from access opening. Discoloration of deep area could be masked effectively using opaque sealant. Cavity on labial side was restored with composite resin. This labial approach method has several advantages. First, it gives a direct vision for effective pulp treatment which is also very useful for children with poor behavior. Second, most of lingual tooth structure could be saved and occlusal contact of lingual surface remains undisrupted. Only nonfunctional discolored labial surface may removed. Third, complete removal of discolored part of a labial tooth and immediate resin restoration could be done effectively after pulp treatment. Moreover, it also could be used for pulp treatment having serious dental caries on labial surface with sound lingual tooth structure. This report presents cases with discolored upper anteior primary tooth, approaching labial side with successful restoration.

• Journal of Korean Physical Therapy Science
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• v.2 no.2
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• pp.517-531
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• 1995

This article reviews the concepts of motor ability and motor skill and the models, theories, and treatment approaches of motor contorl. Reflex, hierarchical, and systems models of motor control are discussed. And muscle reeducation, neurodevelopment, motor relearning program, and contemporary task-oriented approach is also discussed. We consider that the concept of motor control is being changed and the treatment approach also is being changed. There are a number of reasons, the first is traditional trteatment approach has limitation. Second is theories of motor control is contineously developed. Third is new approach is coming to us. therefore, the therapists shoulder strive for acquisition of motor skill and motor ability. This article hope the successful integration of models and treatment approaches and its application in physical therapy practice.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.1
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• pp.9-17
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• 2017

Objectives : Comparative review was rendered to evaluate strengths and weaknesses of two common treatment approaches of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. A typical symptom of headache from hypertension was chosen for substantial approach of this review. Methods : Pros and cons of two different approaches to disease were evaluated based on literatures and texts focusing treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. Headache can be correlated with hypertension yet it can be induced by multiple other factors, and headache may/may not accompany hypertension. Hypertension is an example of treatment based on syndrome differentiation from disease and headache can be an example of treatment based on syndrome differentiation. Results : Treatment based on syndrome differentiation can give more autonomy and flexibility in approach to the disease, Intuition, experience, and traditional medical theory can be applied with ease. However, management and eradication of diseases are difficult and standardization of treatment is not easy among practitioners. Treatment based on syndrome differentiation from disease incorporated merits of both eastern and western medicines, achieving more evidence based diagnosis and treatment. Eradication and standardization of disorders are possible with the latter approach. Conclusions : Comparing two systems of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease with emphasis on hypertension and headache yielded medical values. Treatment based on syndrome differentiation from disease appears to be superior in medical values and effectiveness, but further evaluation and interest are needed to make advancement in Korean traditional medicine.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.52-59
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• 2013

Purpose: The purpose of this study is to evaluate treatment results of multidisciplinary approach of critical ischemic limb with diabetic foot. Materials and Methods: From March 2005 to March 2012, 674 diabetic foot patients were analyzed. Among them, 85 patients were neuroarthropathic type, 383 patients were infectious type, and 206 patients were ischemic type. The subjects were 206 patients who had critical ischemic limbs and major or minor amputations were done. Various single or combined treatment method before amputation was performed. We investigated their ABI, HbA1c, main occlusion lesion, limb salvage and hospitalization period by various treatment method. Results: Major amputation was 27 cases, minor amputation was 179 cases. Mean HbA1c was 8.2%, and mean ABI was 0.66. Main occlusion lesion was 6 cases at common iliac artery, 13 cases at external iliac artery, 9 cases at internal iliac artery, 11 cases at common femoral artery, 23 cases at deep femoral artery, 52 cases at superficial femoral artery, 35 cases at popliteal artery, 40 cases at posterior tibia artery, 35 cases at anterior tibial artery, 28 cases at peroneal artery, and 13 cases at dorsalis pedis artery. Major amputations were decreased, minor amputations were increased, and hospitalization period was reduced by treatment of multidisciplinary approach. Conclusion: Treatment of multidisciplinary approach, which include preoperation percutaneus transluminal angioplasty, vascular surgery, and amputation, of critical ischemic limb with diabetic foot had advantages of limb salvage and hospitalization period reduction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.23.1-23.10
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• 2019

The choice of surgical technique in orthognathic surgery is based primarily on the surgical treatment objectives (STO), which is a fundamental component of the orthognathic treatment process. In the conventional orthodontics-first approach, presurgical planning can be performed twice, during the preorthodontic (initial STO) and presurgical phases (final STO). Recently, a surgery-first orthognathic approach (SFA) without presurgical orthodontic treatment has been introduced and combined initial and final STO at the same time. In contrast to the conventional surgical-orthodontic treatment protocol that includes preoperative orthodontics for dental decompensations to maximize stable postoperative occlusion, the SFA potentially shortens the treatment period and minimizes esthetic concerns during the decompensation period because skeletal problems are corrected from the beginning. The indications for the SFA have been proposed in the literature, but no consensus exists. Moreover, because dental occlusion of the pre-orthodontic arches cannot be used as a guide for establishing the surgical treatment plan, there are fundamental limitations in accurate prediction of postsurgical results in the SFA. Recently, the concepts of postsurgical orthodontic treatment are continuously changing and evolving to overcome this inherent limitation of the SFA. The elimination of presurgical orthodontics can change the paradigm of orthognathic surgery but still requires cautious case selection and thorough discussion and collaboration between orthodontists and surgeons regarding the goals and postoperative management of the orthognathic procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.10.1-10.8
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• 2019

The "surgery-first" approach, defined as a team approach between surgeons and orthodontists for orthognathic surgery without preoperative orthodontic treatment, is aimed at dental decompensation. A brief historical background and indications for the surgery-first approach are reviewed. Considering the complicated mechanism of postoperative orthodontic treatment, the proper selection of patients is a vital component of successful surgery-first approach.

• Coupled systems mechanics
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• v.11 no.2
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• pp.121-132
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• 2022

Wastewater treatment plants (WWTPs) are designed and built to remove contaminants from wastewater. WWTPs are composed of various facilities equipped with hydro-mechanical and electrical equipment. This paper presents a comparison of two different approaches for WWTPs modelling. Static modelling is suitable for determining the dimensions of facilities and equipment capacity. The special significance of this approach is for the design of new plants, i.e., when a very small number of input data on the quantities and composition of the influent wastewater is available. Dynamic modelling is expensive, time consuming and requires great expertise in the use of simulators, models and very good understanding of the treatment processes. Also, dynamic modelling is very important to use for optimization, consideration of future scenarios and also possible scenarios on the plant. The comparison of two approaches was made on the input data from the biggest and most important plant in Bosnia and Herzegovina (B&H)-WWTP Butila (Sarajevo). The main idea is to show the differences between two demanding accesses. It is important to know how to apply an adequate approach to research and solve the set task. The II phase of the plant Butila, which includes the removal of nutrients, is planned in several years and therefore the importance of research has increased.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.116-119
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• 2010

Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1677-1681
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• 2000

Microsurgical transthoracic extrapleural approach for thoracic discectomy in three cases were modified and simplified in order to achieve better exposure of ventral extradural space than posterolateral extrapleural(lateral extracavitary) approach and less pulmonary complications than transthoracic transpleural approach. These approaches were optimized by microscope and video-assistance. Surgery was followed by clinical improvement in all patients. The results of treatment seem to support the use of these modified techniques as adequate surgical treatment of thoracic disc herniations without any complications.