• 제목/요약/키워드: Treatment option

검색결과 1,254건 처리시간 0.032초

광범위 회전근 개 파열에서 관절 성형술 (Massive Rotator Cuff Tears: Arthroplasty)

  • 김명선;문은선
    • Clinics in Shoulder and Elbow
    • /
    • 제13권1호
    • /
    • pp.132-140
    • /
    • 2010
  • 목적: 광범위 회전근 개 파열에 대한 수술적 치료는 매우 어려우며, 다양한 수술 방법이 알려져 있다. 여러 수술 방법 중 광범위 회전근 개 파열에서 적용될 수 있는 관절 성형술에 대해 고찰하고자 한다. 대상 및 방법: 광범위 회전근 개 파열에 대한 수술 방법 중 하나인 관절 성형술에 관한 문헌들을 조사하여 요약하고 정리하였다. 결과: 봉합이 불가능한 광범위 회전근 개 파열 환자에서 관절 성형술은 일차적 치료법 또는 구제술로 사용될 수 있으며, 반관절 성형술은 오구 견봉 궁이 건재할 경우 Neer의 제한적 기준을 목표로 삼는다면 만족스런 결과를 얻을 수 있다. 또한, 역형 견관절 전 성형술은 가성 마비를 동반한 고령의 환자에서 동통 완화와 능동적 거상을 회복할 수 있는 구제술이다. 결론: 치료가 어려운 광범위 회전근 개 파열 환자에서 적절한 관절 성형술의 선택은 견관절의 동통 완화와 기능적 관절 운동 범위 회복을 가능케 할 수 있을 것으로 사료된다.

ACCURATE AND EFFICIENT COMPUTATIONS FOR THE GREEKS OF EUROPEAN MULTI-ASSET OPTIONS

  • Lee, Seunggyu;Li, Yibao;Choi, Yongho;Hwang, Hyoungseok;Kim, Junseok
    • Journal of the Korean Society for Industrial and Applied Mathematics
    • /
    • 제18권1호
    • /
    • pp.61-74
    • /
    • 2014
  • This paper presents accurate and efficient numerical methods for calculating the sensitivities of two-asset European options, the Greeks. The Greeks are important financial instruments in management of economic value at risk due to changing market conditions. The option pricing model is based on the Black-Scholes partial differential equation. The model is discretized by using a finite difference method and resulting discrete equations are solved by means of an operator splitting method. For Delta, Gamma, and Theta, we investigate the effect of high-order discretizations. For Rho and Vega, we develop an accurate and robust automatic algorithm for finding an optimal value. A cash-or-nothing option is taken to demonstrate the performance of the proposed algorithm for calculating the Greeks. The results show that the new treatment gives automatic and robust calculations for the Greeks.

Advances in surgical treatment of lymphedema

  • Beederman, Maureen;Chang, David W.
    • Archives of Plastic Surgery
    • /
    • 제48권6호
    • /
    • pp.670-677
    • /
    • 2021
  • An estimated 250 million people worldwide suffer from lymphedema. In the past, the first-line option for treatment was nonsurgical management, either in the form of compression garments or wrapping, or comprehensive decongestive therapy, with debulking surgery reserved for the more advanced cases. However, with improvements in microsurgical techniques and imaging modalities, surgical intervention is increasingly being utilized. This review highlights recent advancements in the surgical treatment of lymphedema, specifically focusing on improvements in imaging, surgical techniques, and prevention of lymphedema.

침습성 프로락틴 분비 뇌하수체 선종에서 Bromocriptine의 치료효과 (The Effect of Bromocriptine Treatment for Invasive Prolactinoma)

  • 양문술;김선호;임승길;이승구
    • Journal of Korean Neurosurgical Society
    • /
    • 제37권4호
    • /
    • pp.275-281
    • /
    • 2005
  • Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

Endovascular Treatment of Dural Arteriovenous Fistulas : Single Center Experience

  • Oh, Jae-Sang;Yoon, Seok-Mann;Oh, Hyuk-Jin;Shim, Jai-Joon;Bae, Hack-Gun;Lee, Kyeong-Seok
    • Journal of Korean Neurosurgical Society
    • /
    • 제59권1호
    • /
    • pp.17-25
    • /
    • 2016
  • Objective : Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods : Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results : All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ${\geq}2$ times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion : Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route.

하수처리시설의 T-N 방류수 수질기준 강화방안에 관한 연구 (A Study on Strengthening Option of T-N Effluent Water Quality Standards of Sewage Treatment Plants)

  • 김지태
    • 한국물환경학회지
    • /
    • 제34권2호
    • /
    • pp.216-225
    • /
    • 2018
  • Over the past 40 years, the public sector has continued to invest in the sewage treatment plants (STPs) in Korea. Currently, the domestic sewage treatment rate is over 90% with the enhancement of operating efficiency of the STPs, and water quality of major rivers has been continuously improved. However, COD and T-N indicators are stagnating or slightly worsening, and though advanced treatment facilities are installed in most of the STPs, there is a limit to the removal of nutrients. Since there are a lot of water pollution sources in the vicinity of the watershed because of high population density in Korea, it is essential to reduce the inflow of the nutrients in order to prevent the eutrophication of the rivers and lakes. While the effluent T-P standard in STPs has greatly strengthened since 2012, which results in the considerable investment for the improvement of treatment process in STPs for the last few years, it is necessary to strengthen the T-N standards, as the effluent standard of T-N has been maintained at 20 mg/L since 2002. In this study, based on the analysis of the effluent T-N standard status of major industrialized countries, and the domestic nitrogen load in public waters, the option of appropriate T-N standard level is reviewed, and the required investment costs and the effect of strengthening the standard are estimated.

In Vitro Evaluation of Antimicrobial Activity of Lactic Acid Bacteria against Clostridium difficile

  • Lee, Joong-Su;Chung, Myung-Jun;Seo, Jae-Gu
    • Toxicological Research
    • /
    • 제29권2호
    • /
    • pp.99-106
    • /
    • 2013
  • Clostridium difficile infection (CDI) has become a significant threat to public health. Although broad-spectrum antibiotic therapy is the primary treatment option for CDI, its use has evident limitations. Probiotics have been proved to be effective in the treatment of CDI and are a promising therapeutic option for CDI. In this study, 4 strains of lactic acid bacteria (LAB), namely, Lactobacillus rhamnosus (LR5), Lactococcuslactis (SL3), Bifidobacterium breve (BR3), and Bifidobacterium lactis (BL3) were evaluated for their anti-C. difficile activity. Co-culture incubation of C. difficile ($10^6$ and $10^{10}$ CFU/ml) with each strain of LAB indicated that SL3 possessed the highest antimicrobial activity over a 24-hr period. The cell-free supernatants of the 4 LAB strains exhibited $MIC_{50}$ values between 0.424 mg/ml (SL3) and 1.318 (BR3) mg/ml. These results may provide a basis for alternative therapies for the treatment of C. difficile-associated gut disorders.