• Title/Summary/Keyword: Treatment option

Search Result 1,238, Processing Time 0.027 seconds

Current Concepts and Recent Trends in Arthroscopic Treatment of Large to Massive Rotator Cuff Tears: A Review

  • Rho, Joseph Y.;Kwon, Yong suk;Choi, Sungwook
    • Clinics in Shoulder and Elbow
    • /
    • v.22 no.1
    • /
    • pp.50-57
    • /
    • 2019
  • Rotator cuff tear is a common cause of shoulder pain and disability in adults. Due to the various nature of progression of rotator cuff tears and the complex biomechanics of the shoulder joint, repair and treatment of large-to-massive tears are challenging for many surgeons. Despite the recent popularity of reverse total shoulder arthroplasty as a treatment option for large-to-massive irreparable rotator cuff tears, biological and mechanical repair augmentation has also shown promise as a viable treatment option. The purpose of this study was to briefly summarize and review current studies on the assessment and arthroscopic treatment of large-to-massive rotator cuff tears, whether repairable or irreparable, to aid in developing a consensus on future treatment directions.

Operative Treatment for Osteochondral Lesions of the Talus: Bone Marrow Aspirate Concentrate and Matrix-induced Chondrogenesis (거골 골연골병변에 대한 수술적 치료: 골수 흡인물 농축액 및 기질 유래 연골 형성)

  • Kim, Bom Soo;Na, Yeop;Kwon, Won-Hwan
    • Journal of Korean Foot and Ankle Society
    • /
    • v.24 no.2
    • /
    • pp.61-68
    • /
    • 2020
  • Bone marrow aspirate concentrate and matrix-induced chondrogenesis (BMIC) is an interesting treatment option for osteochondral lesions of the talus with promising short- to mid-term results. The various terminologies used to describe this surgical method need to be addressed. These include bone marrow-derived cell transplantation, matrix-induced bone marrow aspirate concentrate, and matrix-associated stem cell transplantation. BMIC is a one-stage, minimally invasive surgery performed arthroscopically or using a mini-open arthrotomy approach without a malleolar osteotomy in most cases. The lesion is replaced with hyaline-like cartilage, and treatmentrelated complications are rare. BMIC is a safe and effective treatment option and should be considered in large lesions or lesions with a prior treatment history.

Burr Hole Drainage : Could Be Another Treatment Option for Cerebrospinal Fluid Leakage after Unidentified Dural Tear during Spinal Surgery?

  • Huh, Jisoon
    • Journal of Korean Neurosurgical Society
    • /
    • v.53 no.1
    • /
    • pp.59-61
    • /
    • 2013
  • Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.

Thromboexclusion Treatment for Recurrent Aortic Aneurysm: Still an Option in Select Cases

  • Choi, Jung Suk;Kim, Hwan Wook
    • Journal of Chest Surgery
    • /
    • v.52 no.6
    • /
    • pp.416-419
    • /
    • 2019
  • Flow reversal and thromboexclusion constitute a valuable alternative for aortic surgeons to have within their technical armamentarium for the treatment of aortic aneurysmal disease. Although not usually a preferred treatment for general aortic pathologies, this technique can be considered as a treatment option in select situations, such as mycotic aneurysm, a hostile surgical field, and a poor condition of the patient. Here, we present a case of extra-anatomic bypass and thromboexclusion for recurrent aortic aneurysm after previous extra-anatomic bypass and thromboexclusion surgery.

A Survey on Rehabilitation Therapists' Understandings about Traditional Korean Medicine Treatments for Developmentally Delayed Children (발달지연 아동의 한방치료에 대한 소아재활치료사들의 인식조사)

  • Kweon, Ji Hyeon;Yun, Young Ju;Oh, Tae Young;Kim, Bu Young;Lee, Mi Joo;Lee, Seung Yeon;Yu, Sun Ae
    • The Journal of Pediatrics of Korean Medicine
    • /
    • v.31 no.4
    • /
    • pp.61-70
    • /
    • 2017
  • Objectives The purpose of this survey is to know the rehabilitation therapists' awareness on the oriental medicine treatments for developmentally delayed children. Methods We distributed questionnaires to 370 rehabilitation therapists and collected 260 of them. We analyzed the data from the collected 260 questionnaires. Results 1. 60% of the participants didn't know what the oriental medicine treatment pertains. 2. 28% of the participants were aware the benefits of the oriental medicine treatment, especially in improving physical fitness and general health. 3. 30% of the participants worried about the side effect of the oriental medicine treatment such as increasing liver somatic index, changing of body weight, muscle stiffness or pain. 4. 53% of the participants said they refer to western medicine primary care doctor when parents of young patients ask rehabilitation therapists about the oriental medicine treatment option for their children. 5. Many participants think that the oriental treatment option should be widely recognized and understood. Conclusions This study shows that the rehabilitation therapists' low awareness about the oriental medicine treatment option for developmentally delayed children.

Cost-Minimization Analysis of Biologic Disease-Modifying Antirheumatic Drugs Administered by Subcutaneous Injections in Patients with Rheumatoid Arthritis (피하주사로 투여하는 생물학적 항류마티스 제제의 비용 최소화 연구)

  • Park, Seung-Hoo;Lee, Min-Young;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
    • /
    • v.26 no.1
    • /
    • pp.59-69
    • /
    • 2016
  • Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

A Case of Endovascular Treatment for Followed by Side to Side Bypass for Vertebral Artery Dissecting Aneurysms Involved Posterior Inferior Cerebellar Artery

  • Chung, Seung-Young;Yoon, Byul Hee;Park, Moon Sun;Kim, Seong Min
    • Journal of Korean Neurosurgical Society
    • /
    • v.55 no.1
    • /
    • pp.36-39
    • /
    • 2014
  • Treatment of complex aneurysms usually entails not only direct clipping but also alternative treatment modality. We recently experienced a case of vertebral artery dissecting aneurysm and obtained good treatment outcomes. Our case suggests that the endovascular segmental occlusion with posterior inferior cerebellar artery (PICA) to PICA side anastomosis might be a good treatment option in patients with complex vertebral artery dissecting aneurysms. A 45-year-old woman has a left vertebral dissecting aneurysm with dizziness. Based on the aneurysmal morphology and the involvement of PICA, the patient underwent side to side anastomosis of the PICA. This was followed by the endovascular segmental coil occlusion. The aneurysmal sac was completely obliterated. At a 2-year follow-up, the patient achieved a good patency of both PICA. In conclusion our case suggests that the endovascular segmental occlusion of the parent artery followed by PICA to PICA bypass surgery through a midline suboccipital approach is a reasonable multimodal treatment option in patients with complex vertebral artery dissecting aneurysms.

Camouflage treatment by backward rotation of the mandible for a severe skeletal Class III malocclusion with aplastic anemia: A case report

  • Choi, Dong-Soon;Lee, Dong-Hyun;Jang, Insan;Cha, Bong-Kuen
    • The korean journal of orthodontics
    • /
    • v.52 no.5
    • /
    • pp.362-371
    • /
    • 2022
  • Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

Stromal vascular fraction injection to treat intractable radiation-induced rectovaginal fistula

  • Kim, Mijung;Lew, Dae Hyun;Roh, Tai Suk;Song, Seung Yong
    • Archives of Plastic Surgery
    • /
    • v.48 no.1
    • /
    • pp.127-130
    • /
    • 2021
  • Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients' everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. In light of the angiogenic, regenerative characteristics of SVF, it was incorporated as a treatment option in two cases of rectovaginal fistula discussed here. As described in this report, irradiated rectovaginal fistulas in rectal cancer patients were successfully treated with SVF injection, and we suggest SVF as a feasible treatment option for cases of rectovaginal fistula that would otherwise be very difficult to cure.