• 제목/요약/키워드: treatment approach

검색결과 3,135건 처리시간 0.037초

요추 추간판탈출증의 자연적 흡수 -증례 보고- (The Spontaneous Resorption of Herniated Lumbar Disc -A case report-)

  • 김영훈;문동언;박종민;윤재원
    • The Korean Journal of Pain
    • /
    • 제18권1호
    • /
    • pp.56-59
    • /
    • 2005
  • The most effective treatment methods for a herniated lumbar disc remain questionable. This report follows the patients course, from the onset of pain through the completion of the non-surgical treatment, and shows that a lumbar herniated disc, with radiculopathy, can be successfully treated with a non-surgical approach. This report discusses the possible explanations for disc resorption: retraction into the intervertebral space, dehydration/shrinkage and resorption due to an inflammatory reaction. A non-surgical approach can be an effective treatment option for a herniated lumbar disc.

An Unusual Complication of Colonic Perforation Following Percutaneous Nephrostomy in a Grade IV Blunt Renal Injury Patient

  • Yan, Joan Gan Cheau;Huei, Tan Jih;Lip, Henry Tan Chor;Mohamad, Yuzaidi;Alwi, Rizal Imran
    • Journal of Trauma and Injury
    • /
    • 제32권2호
    • /
    • pp.118-121
    • /
    • 2019
  • Percutaneous nephrostomy is relatively safe for temporary urinary diversion. However, colonic perforation due to percutaneous nephrostomy can happen with an incidence of 0.2% as reported in the English literatures. To our knowledge, this is the first case being reported as a complication following treatment for traumatic renal injury. This paper is to share our treatment approach which differs from the usual approach according to existing literatures. We report on a young man who sustained grade IV renal injury due to blunt trauma and was managed conservatively. The treatment of traumatic renal injury via urinary diversion was complicated with an iatrogenic colonic perforation. The management and subsequent treatment of this patient is discussed in this case report.

Surgical Treatment of Acetabular Posterior Wall Fracture with Hip Arthroscopy: A Case Report

  • Joao Vale;Sara Diniz;Pedro Santos Leite;Daniel Soares
    • Hip & pelvis
    • /
    • 제34권1호
    • /
    • pp.62-67
    • /
    • 2022
  • Posterior wall fractures are the most common type of acetabular fractures. Treatment can be conservative or surgical. Operative treatment is indicated for acetabular fractures that result in hip joint instability and/or incongruity, as well injuries with incarceration of fragments of bone or soft tissue within the hip joint. Surgical treatment can range from open reduction and osteosynthesis to hip arthroplasty. Arthroscopy has recently been used as the main surgical technique or as a reduction aid. In this case a 26-year-old male with a fracture of the posterior wall who underwent a posterior miniinvasive approach, followed by hip arthroscopy. This allowed joint wash, removal of the loose body, confirmation of reduction and absence of intra-articular hardware. Excellent clinical and radiological results were obtained. This case demonstrates the advantage of using hip arthroscopy in assessment of fracture reduction, the absence of intra-articular hardware or fragments, as well as a less invasive approach.

소아폐렴(小兒肺炎)의 한의학적(韓醫學的) 연구(硏究)에 대한 고찰(考察) -중의학(中醫學) 문헌(文獻)을 중심(中心)으로- (A literature study of pediatric pneumonia in traditional chinese medicine)

  • 김장현;권혁란
    • 대한한방소아과학회지
    • /
    • 제17권1호
    • /
    • pp.99-115
    • /
    • 2003
  • Pneumonia is an acute or recurrent infection of the parenchyma of the lung causing cough, fever, and respiratory distress. Pneumonia was named 'Feiyanchuansou(肺炎喘嗽)' in chinese medicine. This study was progressed for oriental medical treatment for pediatric pneumonia in china. The purpose of this study is current oriental medical approach to pediatric pneumonia In this study, the authors tried to figure out the cause of the pediatric pneumonia and its treatment and came to the conclusion as follows: 1. The study for pediatric pneumonia consists of basic, clinical and experimental study. 2. Basic study consists of etiology and pathogenesis(病因病耭), the rule of treatment(治療原則) and method of treatment(治法). 3. Clinical study consists of symptoms-based treatment(辨證論治), adequate prescription treatment(專病專方), acupuncture(鍼灸治療), and western diagnosis based treatment. 4. The majority of experimental study was pharmacology that consists of antiviral and antibacterial effect, removing heat(淸熱), releasing pulmonary qi(宣肺), dissipating phlegm(化痰).

  • PDF

Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist's Perspective

  • Sehhoon Park
    • Journal of Chest Surgery
    • /
    • 제56권2호
    • /
    • pp.67-74
    • /
    • 2023
  • Perioperative treatment with conventional cytotoxic chemotherapy for resectable non-small cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune checkpoint blockade (ICB) has now become an essential component of treatment, even as neoadjuvant or adjuvant therapy in patients with operable NSCLC. Both pre- and post-surgery ICB applications have proven clinical efficacy in preventing disease recurrence. In addition, neoadjuvant ICB combined with cytotoxic chemotherapy has shown a significantly higher rate of pathologic regression of viable tumors compared with cytotoxic chemotherapy alone. To confirm this, an early signal of OS benefit has been shown in a selected population, with programmed death ligand 1 expression ≥50%. Furthermore, applying ICB both pre- and post-surgery enhances its clinical benefits, as is currently under evaluation in ongoing phase III trials. Simultaneously, as the number of available perioperative treatment options increases, the variables to be considered for making treatment decisions become more complex. Thus, the role of a multidisciplinary team-based treatment approach has not been fully emphasized. This review presents up-to-date pivotal data that lead to practical changes in managing resectable NSCLC. From the medical oncologist's perspective, it is time to dance with surgeons to decide on the sequence of systemic treatment, particularly the ICB-based approach, accompanying surgery for operable NSCLC.

운동조절이론과 중추신경계 손상환자를 위한 치료 접근법의 재검토 (Motor Control Models and Neurologic Rehabilitation Approaches: A Literature Review)

  • 김종만;신헌석
    • 한국전문물리치료학회지
    • /
    • 제8권1호
    • /
    • pp.97-106
    • /
    • 2001
  • Physical therapists should under stand motor control models and apply various models to evaluation and treatment of neurologically impaired patients. Thus, this paper reviews motor control models and applications in clinical settings. Assumptions and limitations of reflex models, hierarchical models, and systems models are presented. This paper also delineates goals and dissatisfaction of neurologic rehabilitation approaches for neurologically impaired patients. Muscle reeducation approach, neurotherapeutic facilitation approach, and contemporary task-oriented approach are explained.

  • PDF

하악골 과두하 골절의 이하선 경유 접근법을 통한 관혈적 정복술 증례보고 (Case Report of Transparotid Approach of Mandibular Subcondylar Fracture)

  • 문민철;오석준;고성훈
    • 대한두개안면성형외과학회지
    • /
    • 제10권1호
    • /
    • pp.33-36
    • /
    • 2009
  • Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

Aneurysm of the Posterior Inferior Cerebellar Artery: Clinical Features and Surgical Results

  • Rhim, Jong-Kook;Sheen, Seung-Hun;Oh, Sung-Han;Noh, Jae-Sub;Chung, Bong-Sub
    • Journal of Korean Neurosurgical Society
    • /
    • 제37권6호
    • /
    • pp.399-404
    • /
    • 2005
  • Objective: Aneurysms arising from the posterior inferior cerebellar artery(PICA) are uncommon. We review literature on that and surgical results on aneurysmal treatment by choice of surgical approach. Methods: On the basis of radiologic findings & charts, we review retrospectively the surgical results of 12 cases from Mar 1999 to Dec 2003. Results: The mean age of the 12 patients was 55.8(ranged from 36 to 71) and female was predominant (female:male = 8:4). Locations of PICA aneurysms revealed variously(vertebral artery - PICA junction: 8, lateral medullary segment: 2, PICA - anterior inferior cerebellar artery common trunk: 1, telovelomedullary : 1). Surgical approaches & treatments were attempted in 11 cases and embolization was done in 1 case(Far lateral transcondylar or supracondylar approach & clipping: 9, Far lateral transcondylar or supracondylar approach and trapping: 2, suboccipital approach & clipping: 1). The surgical result were 8 of 12 patients were good outcome, 1 of 12 was severely disabled and 3 of 12 were died. Conclusion: First, we choose surgical approach by the laterality of aneurysms and surgical or interventional treatment is attempted as soon as possible. The PICA aneurysm is regarded as having a relatively good surgical outcome without drilling of the posterior arch of the atlas.

A Comprehensive Approach to Posttraumatic Lymphedema Surgical Treatment

  • Nicolas Pereira;Vanessa Onate;Ricardo Roa
    • Archives of Plastic Surgery
    • /
    • 제50권4호
    • /
    • pp.422-431
    • /
    • 2023
  • Background Posttraumatic lymphedema (PTL) is sparsely described in the literature. The aim of this study is to propose a comprehensive approach for prevention and treatment of PTL using lymphovenous anastomosis (LVA) and lymphatic vessels free flap, reporting our experience in the management of early-stage lymphedema. Methods A retrospective observational study was performed between October 2017 and July 2022. Functional assessment with magnetic resonance lymphangiography and indocyanine green lymphography was performed. Patients with lymphedema and functional lymphatic channels were included. Cases with limited soft tissue damage were proposed for LVA, and those with acute or prior soft tissue damage needing skin reconstruction were proposed for superficial circumflex iliac artery perforator lymphatic vessels free flap (SCIP-LV) to treat or prevent lymphedema. Primary and secondary outcomes were limb volume reduction and quality of life (QoL) improvement, respectively. Follow-up was at least 1 year. Results Twenty-eight patients were operated using this approach during the study period. LVA were performed in 12 patients; mean reduction of excess volume (REV) was 58.82% and the improvement in QoL was 49.25%. SCIP-LV was performed in seven patients with no flap failure; mean REV was 58.77% and the improvement QoL was 50.9%. Nine patients with acute injury in lymphatic critical areas were reconstructed with SCIP-LV as a preventive approach and no lymphedema was detected. Conclusion Our comprehensive approach provides an organized way to treat patients with PTL, or at risk of developing it, to have satisfactory results and improve their QoL.