• 제목/요약/키워드: treatment approach

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비인강암의 수술적 치료 (Surgical Treatment of the Nasopharyngeal Carcinoma)

  • 이원상;전영명;최흥식
    • 대한두경부종양학회지
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    • 제12권1호
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    • pp.92-99
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    • 1996
  • The primary treatment of the nasopharyngeal carcinoma is at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate choice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the outcome of treatment of nasopharyngeal carcinoma. The purpose of this papaer is to report our surgical experience of the nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

  • Im, Joon;Kang, Sang Hoon;Lee, Ji Yeon;Kim, Moon Key;Kim, Jung Hoon
    • 대한치과교정학회지
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    • 제44권6호
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    • pp.330-341
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    • 2014
  • A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

국부변형률 방법을 이용한 용접후열처리 전후 시편의 피로수명 해석 (Fatigue Life Analysis of Butt-welded Joint with and without Postweld Heat Treatment by Local Strain Approach)

  • 이동형;서정원;구병춘;석창성
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2003년도 추계학술대회
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    • pp.1086-1091
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    • 2003
  • The problem of residual stresses and fatigue behavior in welded structures is the main concern of welding research fields. The residual stresses and distortions of structures by welding exert negative effect on the safety of mechanical structures. Postweld heat treatment is usually carried out to relieve this residual stresses of welded joints. In this paper the influence of postweld heat treatment on fatigue life of butt-welded joint was investigated. To predict the effect of PWHT, an analytical model is developed by finite element and local strain approach and the result of fatigue life analysis is compared to experimental results. It is demonstrated that fatigue life estimates closely approximate the experimental results and PWHT provides some increase of fatigue lives in long-life fatigue region and no increase in short-life fatigue region because of the residual stress relaxation under tensile loads.

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Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram

  • Chae, Ki-Hwan;Ju, Chang-Il;Lee, Seung-Myung;Kim, Byoung-Wook;Kim, Saeng-Youp;Kim, Hyeun-Sung
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.312-316
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    • 2009
  • Objective : The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. Methods : The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. Results : The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. Conclusion : In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.

The Effects of a Trauma Team Approach on the Management of Open Extremity Fractures in Polytrauma Patients: A Retrospective Comparative Study

  • Sakong, Seungyeob;Lim, Eic Ju;Cho, Jun-Min;Choi, Nak-Jun;Cho, Jae-Woo;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • 제34권2호
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    • pp.105-111
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    • 2021
  • Purpose: Open extremity fractures require prompt antibiotic medication and initial debridement surgery to reduce the infection rate and restore functional stabilization. We aimed to report the effects and positive outcomes of a trauma team approach on the management of open extremity fractures in polytrauma patients. Methods: This retrospective review included all polytrauma patients with open extremity fractures admitted between March 2009 and December 2019. Patients were divided into two groups according to whether they were treated before or after the implementation of the trauma team approach (March 2014). We analyzed the outcomes in each group with respect to the time interval until the doctor's arrival, total length of stay in the emergency department, the time interval until initial antibiotic treatment and operation, whether the initial operation was performed within 24 hours, and the rate of deep infections. Results: A total of 123 patients met the inclusion criteria. There were no statistically significant differences in demographic characteristics. The time interval until the doctor's arrival (64.12±49.2 minutes vs. 19.82±15.23 minutes; p=0.035) and initial antibiotic treatment (115.47±72.12 minutes vs. 48.78±30.12 minutes; p=0.023) significantly improved after implementing the trauma team approach. The union rate was not significantly different. However, the time interval until initial debridement, opportunity for initial debridement within 24 hours, and the rate of deep infections demonstrated better results. Conclusions: The reduced time interval until initial antibiotic treatment and debridement could be attributed to the positive effect of the trauma team approach on the management of open extremity fractures in polytrauma patients.

Treatment of Thoracolumbar and Lumbar Unstable Burst Fractures by Using Combined and Posterior Surgery

  • Shin, Jong Ki;Goh, Tae Sik;Son, Seung Min;Lee, Jung Sub
    • Journal of Trauma and Injury
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    • 제29권1호
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    • pp.14-21
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    • 2016
  • Purpose: The purpose of this research was to analyze the results of the combined and posterior approaches for treating thoracolumbar and lumbar burst fractures and to find an adequate method of treatment. Methods: We retrospectively analyzed the cases of 46 patients with unstable thoracolumbar and lumbar burst fractures who had been surgically treated. All cases were divided into two groups based on the operation method used. Eleven patients had undergone the combined approach, while 35 patients had undergone the posterior approach. Radiological and clinical evaluations were performed before surgery, after surgery, and at the final follow-up. Results: The stenotic ratios of the area occupied by the retropulsed bony fragments to the estimated area of the original spinal canal were 68.2% and 45.6% for the combined and the posterior approaches, respectively. No significant differences in the neurological improvement or the corrected state of the sagittal index were noted, but the patients who had been treated with the combined approach group had better results than those who had been treated with the posterior approach group in terms of correction and maintenance of the sagittal index. The average kyphosis corrections at the final follow-up were 15.3 degrees for the patients in the combined approach group and 10.0 degrees for those in the posterior approach group. Surgical time and estimated blood loss were all significantly higher for patients in the combined approach group. Conclusion: The combined and the posterior approaches showed similar results in the improvements of the neurologic state and the corrected state of the sagittal index. However, use of the combined approach is recommended for patients with severe kyphosis and with severe canal encroachment.

자폐증 청소년에서 체중감소와 연관된 반추적 구토의 정신과적 치료 (Psychiatric Treatment of Ruminative Vomiting and the Associated Weight Loss in an Adolescent Boy with Autism : A Case Report)

  • 신윤오;이문성
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제20권1호
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    • pp.39-43
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    • 2009
  • We treated the persistent ruminative vomiting of a 13-year-old autistic boy by using a behavioral and psychopharmacological approach in a closed ward. Before the interventions, the patient had lost about 10kg of body weight due to very high-frequency ruminative vomiting. Together with psychopharmacological trials, the psychiatric treatment included a combination of a behavioral approach and food regulation that emphasized food restrictions, and we provided regular light meals. There was a considerable reduction of the ruminative vomiting and 2kg weight gain was achieved during the admission. These therapeutic gains were maintained at the 4-month follow-up assessment and the vomiting symptom reached a near-zero level and the weight loss were recovered by about 8kg. The issues related to the treatment approaches for ruminative vomiting with autism are discussed.

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Treatment of juvenile rheumatoid arthritis

  • Kim, Kwang-Nam
    • Clinical and Experimental Pediatrics
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    • 제53권11호
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    • pp.936-941
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    • 2010
  • The systematic approach to pharmacologic treatment is typically to begin with the safest, simplest, and most conservative measures. It has been realized that the more rapidly inflammation is under control, the less likely it is that there will be permanent sequelae. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of initial treatment for inflammation. In addition, the slow-acting antirheumatic drugs (SAARDs) and disease-modifying antirheumatic drugs (DMARDs) have efficacy of anti-inflammatory action in children with chronic arthritis. New therapeutic modalities for inflammation, such as etanercept and infliximab, promise even further improvements in the risk/benefit ratio of treatment. It is not typically possible at the onset of the disease to predict which children will recover and which will go on to have unremitting disease with lingering disability or enter adulthood with serious functional impairment. Therefore, the initial therapeutic approach must be vigorous in all children.

전염성 단핵구증의 중의학(中醫學) 연구(硏究)에 대한 고찰(考察) (A literature study of Infectious Mononucleosis in Traditional Chinese Medicine)

  • 장규태
    • 대한한방소아과학회지
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    • 제18권2호
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    • pp.233-249
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    • 2004
  • Objectives : Infectious mononucleosis is a clinical syndrome caused by Epstein-Barr virus that is particularly common in adolescents and children. This study was progressed for current oriental medical treatment of infectious mononucleosis in china. The purpose of this study is the opening oriental medical approach to infectious mononucleosis in Korea Methods : Authors conducted a literature search in data of Traditional Chinese Medical Journal. The data were extracted in a standardized, predefined manner and accessed critically. Results : The study for infectious mononucleosis consists of basic, clinical, experimental study. Basic study consists of etiology & pathogenesis and the rule of treatment. Clinical study consists of symptoms-based treatment and adequate prescription treatment. Experimental study consists of effective herbs and new traditional chinese medical injection. Conclusion : Traditional chinese medical approach using herbs works in children with infectious mononucleosis in Korea.

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Esthetic restorations of maxillary anterior teeth with orthodontic treatment and porcelain laminate veneers : a case report

  • Moon, Ji-Eun;Kim, Sung-Hun;Han, Jung-Suk;Yang, Jae-Ho;Lee, Jai-Bong
    • The Journal of Advanced Prosthodontics
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    • 제2권2호
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    • pp.61-63
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    • 2010
  • If orthodontists and restorative dentists establish the interdisciplinary approach to esthetic dentistry, the esthetic and functional outcome of their combined efforts will be greatly enhanced. This article describes satisfying esthetic results obtained by the distribution of space for restoration by orthodontic treatment and porcelain laminate veneers in uneven space between maxillary anterior teeth. It is proposed that the use of orthodontic treatment for re-distribution of the space and the use of porcelain laminate veneers to alter crown anatomy provide maximum esthetic and functional correction for patients with irregular interdental spacing.