• Title/Summary/Keyword: Treatment selection

Search Result 1,215, Processing Time 0.026 seconds

Paradigm Shift in Intra-Arterial Mechanical Thrombectomy for Acute Ischemic Stroke : A Review of Randomized Controlled Trials after 2015

  • Sheen, Jae Jon;Kim, Young Woo
    • Journal of Korean Neurosurgical Society
    • /
    • v.63 no.4
    • /
    • pp.427-432
    • /
    • 2020
  • Three randomized control trials (RCTs), published in 2013, investigated efficacy of mechanical thrombectomy in large vessel occlusions and did not show better results compared to intravenous (IV) recombinant tissue-type plasminogen activator (tPA) alone. However, most clinicians treating stroke consider mechanical thrombectomy as the standard treatment rather than using IV tPA alone. This paradigm shift was based on five RCTs investigating efficacy of mechanical thrombectomy in acute ischemic stroke conducted from 2010 to 2015. They demonstrated that mechanical thrombectomy was effective and safe in acute ischemic stroke with anterior circulation occlusion when performed within 6 hours of stroke onset. There are four reasons underlying the different results observed between the trials conducted in 2013 and 2015. First, the three RCTs of 2013 used low-efficiency thrombectomy devices. Second, the three RCTs used insufficient image selection criteria. Third, following the initial presentation at the hospital, reperfusion treatment required a long time. Fourth, the three RCTs showed a low rate of successful recanalization. Time is the most important factor in the treatment of acute ischemic stroke. However, current trends utilize advanced imaging techniques, such as diffusion-weighted imaging and multi-channel computer tomographic perfusion, to facilitate the detection of core infarction, penumbra, and collateral flows. These efforts demonstrate that patient selection may overcome the barriers of time in specific cases.

Economical selection of optimum pressurized hollow fiber membrane modules in water purification system using RbLCC

  • Lee, Chul-sung;Nam, Young-wook;Kim, Doo-il
    • Membrane and Water Treatment
    • /
    • v.8 no.2
    • /
    • pp.137-147
    • /
    • 2017
  • A water treatment utility in South Korea operates a large system of pressurized hollow fiber membrane (PHFM) modules. The optimal selection of membrane module for the full scale plant was critical issue and carried out using Risk-based Life Cycle Cost (RbLCC) analysis based on the historical data of operation and maintenance. The RbLCC analysis was used in the process of decision-making for replacing aged modules. The initial purchasing cost and the value at risk during operation were considered together. The failure of modules occurs stochastically depending on the physical deterioration with usage over time. The life span of module was used as a factor for the failure of Poisson's probability model, which was used to obtain the probability of failure during the operation. The RbLCC was calculated by combining the initial cost and the value at risk without its warranty term. Additionally, the properties of membrane were considered to select the optimum product. Results showed that the module's life span in the system was ten years (120 month) with safety factor. The optimum product was selected from six candidates membrane for a full scale water treatment facility. This method could be used to make the optimum and rational decision for the operation of membrane water purification facility.

Treatment of Femoral Neck Fractures in the Elderly: A Survey of the Korean Hip Society Surgeons

  • Hong Seok Kim;Je-Hyun Yoo;Young-Kyun Lee;Jong-Seok Park;Ye-Yeon Won
    • Hip & pelvis
    • /
    • v.35 no.3
    • /
    • pp.157-163
    • /
    • 2023
  • Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.

Selection of Glyphosate-Resistant Clones form MNNG-treated Mesophyll Protoplasts of Haploid Tobacco Plants (반수체 담배의 엽육 원형질체로부터 MNNG 처리에 의한 Glyphosate 저항성 클론의 선별)

  • 성순기
    • Journal of Plant Biology
    • /
    • v.36 no.1
    • /
    • pp.105-112
    • /
    • 1993
  • Selection of glyphosate-resistant clones from MNNG-treated mesophyll protoplasts of haploid tobacco and their differentiation were studied. The protoplasts were treated with 0.1 to 100 $\mu\textrm{g}$/mL N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) for 30 min when they expanded to oval shapes. After the treatment, the protoplasts in 4-16 cell stages were transferred to the selective medium containing 1 mM glyphosate for the selection of the glyphosate-resistant colonies. The efficiency of the cell division of the protoplasts in the selective medium decreased as the MNNG concentrations in creased. Optimal MNNG concentration for induction of the glyphosate-resistant clones was 10$\mu\textrm{g}$/mL and mutation frequency was 2.66$\times$10-6. The stability of the glypohsate-resistance of the clones was examined by prolonged subculture in the medium with 1 mM glyphosate, and the resistant clones were survived more than 10 months. Among them one clone has been proliferating and greening and the others were proliferating without greening or greening with slower proliferating.

  • PDF

Selection of Fusion Level for Adolescent Idiopathic Scoliosis Surgery : Selective Fusion versus Postoperative Decompensation

  • Kim, Do-Hyoung;Hyun, Seung-Jae;Kim, Ki-Jeong
    • Journal of Korean Neurosurgical Society
    • /
    • v.64 no.4
    • /
    • pp.473-485
    • /
    • 2021
  • Adolescent idiopathic scoliosis (AIS), which is associated with an extensive range of clinical and radiological presentations, is the one of the most challenging spinal disorders. The goals of surgery are to correct the deformity in 3 dimensions and to preserve motion segments while avoiding complications. Despite the ongoing evolution of classification systems and algorithms for the surgical treatment of AIS, there has been considerable debate regarding the selection of an appropriate fusion level in AIS. In addition, there is no consensus regarding the exact description, relationship, and risk factors of coronal decompensation following selective fusion. In this review, we summarize the current concepts of selection of the fusion level for AIS and review the available information about postoperative coronal decompensation.

A CASE REPORT OF TRAUMATIC NEUROPATHIC PAIN PATIENT (외상성 신경병증 환자의 치험례)

  • Choi, Moon-Gi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.34 no.2
    • /
    • pp.200-206
    • /
    • 2008
  • A variety of mechanisms may generate pain resulting from injury to the peripheral nervous system. None of these mechanisms is disease-specific, and several different pain mechanisms may be present simultaneously in any one patient. Diagnosis of neuropathic pain is often easily made from the information gathered on neurologic examination and from patient history. Evidence of sensory disturbances elicited by examination combined with laboratory tests confirming injury to peripheral nerve establishes the diagnosis of neuropathic pain. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if dentist has a complete understanding of the therapeutic options. Pharmacologic therapy has been the mainstay of treatment. Selection of an appropriate pharmacologic agent is by trial and error since individual response to different agents, doses, and serum level are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuripathic pain. If pharmacologic treatment is not effective, nerve block using lidocaine, steroid and alcohol and neurectomy must be considered for treatment option.

Conservative Treatment of the Knee Injury and Pain (슬관절 손상과 동통의 보존적 치료)

  • Bin Seoung-I1;Nam Tae-Seok;Ahn Ji-Hyun;Jung Kwang-Whan
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.3 no.2
    • /
    • pp.107-110
    • /
    • 2004
  • Treatment of knee injury and pain consists of conservative and surgical treatment. Although conservative treatment is suffice in many cases, surgical treatment is performed which is not necessary. Therefore, thorough knowledge of injury mechanism and selection of treatment modalities are required. Injury mechanism and conservative treatment of knee injury patients will be discussed.

  • PDF

Evaluation of Pharmacists' Intervention Activities in Community Pharmacy (지역약국 약사의 처방중재 활동 평가)

  • Hyunji Koo;Jong-Mi Seong;Sun-Young Jung;Kyeong Hye Jeong
    • Korean Journal of Clinical Pharmacy
    • /
    • v.34 no.1
    • /
    • pp.62-70
    • /
    • 2024
  • Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.

Foreign Students' Use of Dental Treatment and Dental Institutions Study on Selection Criteria (외국인 유학생의 치과진료 이용실태와 치과의료기관 선택기준에 관한 연구)

  • Shim, Youn-Soo;An, So-Youn;Park, So-Young
    • Journal of Convergence for Information Technology
    • /
    • v.11 no.7
    • /
    • pp.172-180
    • /
    • 2021
  • This study was carried out to provide basic data for improving oral health management plans by identifying the actual conditions of dental treatment use and criteria for selecting dental medical institutions for foreign students. The survey method was a survey of 145 foreign students at S University, and the collected data was conducted with the SPSS 24.0 program. As a result of the analysis, dental caries treatment was the most common among all nationalities in the dental experience. When the oral health education program was important, the will to use dental treatment in the future was positive. Therefore, in the future, it is required to revitalize oral health education programs and provide health care information for foreign students.

Trends of conscious sedation in the Department of Pediatric Dentistry at the Dankook University Dental Hospital for 11 Years

  • Sohyun Park;Jongbin Kim;Jongsoo Kim;Joonhaeng Lee;Miran Han;Jisun Shin
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.23 no.5
    • /
    • pp.265-271
    • /
    • 2023
  • Background: Anxiety and fear in children's dental care are major impediments to successful dental care. High-quality dental treatment can be achieved using various behavioral control methods; however, conscious sedation using drugs can be used if behavioral control is difficult, owing to excessive fear and anxiety. This study aimed to examine the trends in conscious sedation implemented in pediatric dentistry at the Dankook University Dental Hospital over the past 11 years. Methods: This study included 6,438 cases of dental treatment under conscious sedation conducted over 11 years between January 2011 and December 2021 in the Department of Pediatric Dentistry at Dankook University Dental Hospital. Results: Over the past 11 years, the number of dental treatments under sedation has increased. In the case of inhalation sedation using nitrous oxide, the rate of increase was approximately twice every year, and the use of midazolam gradually decreased. The average age of children who underwent sedation was 5.11 years, and the rate of sedation treatment in children aged <4 years tended to decrease, while that of children aged >5 years tended to increase. This is related to the trend of changes in drugs used. In a sex-based survey, sedation treatment rate was higher in males than that in females. Conclusion: Appropriate selection of sedatives can reduce the frequency of general anesthesia and minimize complications through efficient and safe dental treatments. Trend analysis of sedation by year will help provide guidelines for the appropriate selection of sedation for dental treatment of children and patients with disability.