• 제목/요약/키워드: conservative management

검색결과 797건 처리시간 0.031초

Freiberg병의 수술적 치료 (Surgical Treatment of Freiberg's Disease)

  • 정덕환;이용욱;이상훈
    • 대한족부족관절학회지
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    • 제1권1호
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    • pp.23-29
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    • 1997
  • Freiberg's disease is a pathologic condition of the second or third metatarsal head, rarely the forth or fifth metatarsal head, and it becomes abnormally enlarge due to avascular necrosis of subchondral cancellous bone. From Nov. 1982 to Sep. 1994, we treated surgically 10 cases of the disease who complained the continuous symptoms inspite of proper conservative management. Metatarsal head excision was done in 8 cases and resurfacing of the cartilagenous portion of the metatarsal head in 2 cases. During the average follow up of 55 months, the pain was relieved in all patients who were underwent surgical intervention but the stiffness of the metatarsophalangeal joint was remained in most of cases. It seems to be a logical treatment of choice in younger and active patients that conservative management is the initial treatment but more ablative procedure is needed for the continued symptoms. We can propose the metatarsal head excision or resurfacing of the involved joint is effective treatment method with simple procedure and minimize morbid period than other procedures such as corrective osteotomy.

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Retirement For Cause 개념에 의한 가스터빈 디스크 수명의 평가 (Life Evaluation of Gas Turbine Engine Disk based on Retirement for Cause Concept)

  • 남승훈;박종화;김종엽
    • 대한기계학회논문집A
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    • 제26권2호
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    • pp.365-373
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    • 2002
  • For gas turbine engines, the safe life methodology has historically been used fur fatigue life management of failure critical engine components. The safe retirement limit is necessarily determined by a conservative life evaluation procedure, thereby many components which have a long residual life are discarded. The objective of this study is to introduce the damage tolerant design concept into the life management for aircraft engine component instead of conservative fatigue life methodology which has been used for both design and maintenance. Crack growth data were collected on a nickel base superalloy which have been subjected to combined static and cyclic loading at elevated temperatures. Stress analysis fur turbine disk was carried out. The program for computing creep-fatigue crack growth was developed. The residual lifes of turbine disk component under various temperatures and conditions using creep-fatigue crack growth data were estimated. As the result of analysis, it was confirmed that retirement fur cause concept was applicable to the evaluation of residual life of retired turbine disk which had been designed based on the conventional fatigue life methodology.

급성 마비성 장폐색 환자의 한방치험 증례보고 (A Case Report of Oriental Medical Treatment for a Patient with Acute Paralytic Ileus)

  • 송창훈;조현석;김정철;이재은;하장;백태현;박정한
    • 대한한방내과학회지
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    • 제26권4호
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    • pp.946-953
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    • 2005
  • Ileus is blockage of the intestine that prevents the contents of the intestine from passing to the lower bowel. In western medical treatment, surgery is mandatory for severe cases such as strangulation ileus. However more generally, conservative management is used for treatment. Examples of conservative management are decompression with tube, fluid treatment, enema and fasting cure. Until now, many oriental medical studies have been conducted on chronic ileus, but almost none on acute ileus. The results for the case in this report suggest that oriental medical treatment such as acupuncture, moxibustion, herbal medicine is effective in treating acute ileus. We think that further studies should be conducted on a combination therapy with other oriental medical treatment such as retention enema.

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선천성 피부결손증의 치험 1례 (The Treatment of Congenital Cutis Aplasia)

  • 김용하;차규호;정재호;이경호;설정현
    • Journal of Yeungnam Medical Science
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    • 제9권2호
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    • pp.422-426
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    • 1992
  • 저자들은 회귀하고도 사망율이 높은 선천성 피부결손증 1례를 경험하고 국소피판과 피부이식으로써 치료하고 비교적 만족한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

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Benefits of the Various Pain Procedures as Therapeutic Option in Low Back Pain

  • Kim, Jung-Hee;Kong, Min-Ho;Hong, Hyun-Jong;Song, Kwan-Young;Kang, Dong-Soo
    • Journal of Korean Neurosurgical Society
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    • 제39권3호
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    • pp.204-209
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    • 2006
  • Objective : The authors retrospectively evaluate the benefits of the various pain procedures for the treatment of low back pain unresponsive to conservative management. Methods : Over a period of 2 years from May 2002 and June 2004, the authors had performed various pain procedures on 106 patients with low back pain. Epidural block, facet joint block, sacroiliac joint block, and myofascial block were included among various pain procedures. The pain improvement, period of analgesic use, and degree of satisfaction were evaluated 1 day, 4 weeks, and 6 months after injections. The outcome of pain procedures was analyzed by using a modified Macnab criteria. Results : Sixty-four patients had a single procedure with no combination and 42 patients [39.6%] received the combination of the various pain procedure. Regardless of the single or combination cases of procedure, combination of appropriate spinal level on each procedure was conducted in 104 [98.1%]. Mean follow up period was 12.2 months. Eighty-two patients [77.4%] experienced significant pain relief and overall analgesic medication was reduced in 91 patients [85.8%] at 6 months after procedure. Unfavorable results were demonstrated in 10 patients. Permanent procedural complications did not occur. Conclusion : The various pain procedures are the possible therapeutic option for low back pain unresponsive to conservative management including medication or physical therapy.

A Basic Research for Preservation of Works Exhibited in the Outdoor Sculpture Park - A Scientific Analysis of Painted Work 'Conversion' Exhibited in the Cheonmasan Sculpture Park -

  • Oh, Seung-Jun;Wi, Koang-Chul
    • 보존과학회지
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    • 제37권4호
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    • pp.391-401
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    • 2021
  • Outdoor sculptures of modern art works are being damaged and deteriorated as they are exposed to the outdoor environment due to the nature of exhibition in the outdoor environment, but secure of basic data through the measures for conservation and advanced researches still remain in the early stage. The surface of "Conversion" which is exhibited in the Busan Cheonmasan Sculpture Park has been exfoliated and deteriorated due to outdoor exhibition for a long time, so systematic conservation and management of works are considered necessary. Prior to the conservation and management, this study conducted observation of cross section, analysis of inorganic components, FT-IR, Raman and Py-GC/Mass analysis to examine the nature and type of paints used for the work through a scientific analysis. As a result of analysis, paints used for the "Conversion" include paint mixed with silvery aluminium powder and white pigment, reddish paint mixed with toluidine red, bluish paint that mixed prussian blue and titanium white and mixture of phthalocyanine blue and titanium white. The result is expected to be used as basic data for selecting materials necessary for conservative treatment of and establishing a plan for conservative treatment of the "Conversion".

2세 유아에서 발생한 고도 전위성 치상돌기 골절의 보존적 치료 (Conservative Management for a Highly Displaced Dens Fracture in a Two-Year-Old Child)

  • 임성준;김건중;김용민
    • 대한정형외과학회지
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    • 제56권6호
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    • pp.530-534
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    • 2021
  • 소아, 특히 유아의 치상돌기 골절은 매우 드물고, 따라서 그 진단 및 치료에 대하여 정립된 기술을 쉽게 볼 수 없다. 특히 전위가 심한 경우 보존적 혹은 수술적 치료 중 무엇을 적용해야 할지 결정하기가 어렵다. 이론적으로 수술적 고정을 통해 골절의 조기 정복과 견고한 유지가 가능할 것으로 보이나, 작고 연약한 소아에서 안전하게 수행되기가 쉽지 않고, 환축추 관절의 영구적 고정이라는 문제가 남는다. 저자들은 교통사고로 발생한 2세 여아의 고도 굴곡 전위된 치상돌기 골절 1예를 보존적으로 치료하여 양호한 결과를 얻었기에 이 체험을 문헌 고찰과 함께 보고하는 바이다.

Endoscopic Management of Anastomotic Leakage after Esophageal Surgery: Ten Year Analysis in a Tertiary University Center

  • Nader El-Sourani;Sorin Miftode;Maximilian Bockhorn;Alexander Arlt;Christian Meinhardt
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.58-66
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    • 2022
  • Background/Aims: Anastomotic leakage after esophageal surgery remains a feared complication. During the last decade, management of this complication changed from surgical revision to a more conservative and endoscopic approach. However, the treatment remains controversial as the indications for conservative, endoscopic, and surgical approaches remain non-standardized. Methods: Between 2010 and 2020, all patients who underwent Ivor Lewis esophagectomy for underlying malignancy were included in this study. The data of 28 patients diagnosed with anastomotic leak were further analyzed. Results: Among 141 patients who underwent resection, 28 (19.9%) developed an anastomotic leak, eight (28.6%) of whom died. Thirteen patients were treated with endoluminal vacuum therapy (EVT), seven patients with self-expanding metal stents (SEMS) four patients with primary surgery, one patient with a hemoclip, and three patients were treated conservatively. EVT achieved closure in 92.3% of the patients with a large defect and no EVT-related complications. SEMS therapy was successful in clinically stable patients with small defect sizes. Conclusions: EVT can be successfully applied in the treatment of anastomotic leakage in critically ill patients, while SEMS should be limited to clinically stable patients with a small defect size. Surgery is only warranted in patients with sepsis with graft necrosis.

Evaluation of Factors Impacting Cosmetic Outcome of Breast Conservative Surgery - a Study in Iran

  • Olfatbakhsh, Asiie;Mehrdad, Neda;Ebrahimi, Mandana;Alavi, Nasrin;Hashemi, Esmat;Kaviani, Ahmad;Najafi, Masoume;Haghighat, Shahpar;Arefanian, Saeed
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2203-2207
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    • 2015
  • Background: Breast conservative surgery (BCS) followed by radiotherapy is the standard approach in management of stage I-II breast cancer. Several factors can affect cosmetic outcomes. The aim of this study was to evaluate the cosmetic results of BCS and influencing factors in the Iranian Breast Cancer Research Center. Materials and Methods: Patients who had undergone BCS were included. Photographs were taken of both breasts of the patients in three aspects and were evaluated by three specialists. The cosmetic scores were calculated based on a standard questionnaire. The data were analyzed using univariate and multivariate regression for relationships between cosmetic scores and clinical data. Results: A total number of 103 patients were included in the study. Mean age and BMI of the patients were $46.8{\pm}8.9$ and $28.1{\pm}3.9$, respectively. Breast cup sizes C and D accounted for 74.7% of the study group. The mean cosmetic score obtained from three referees was 5.72+2.06, consisting of 35.9% excellent-good, 35% moderate, and 29.1% unsatisfactory results. Patient BMI, volume of the resected tissue and breast cup size (D) showed significant correlation with the cosmetic score. On multivariate regression analysis, cosmetic score and BMI (p=0.022,) as well as breast cup size (p=0.040), remained significant. Conclusions: Immediate or delayed symmetrization of the breasts is suggested during breast conservative surgery, meanwhile performing oncoplastic techniques to improve the results significantly. Also it is suggested to discuss anticipation of less satisfactory results with patients having higher BMI and large breast cup size.

요통으로 한방병원에 입원한 환자의 병력기간별 호전도에 관한 연구 (The Study on History Period and Treatment Outcomes of Patients Admitted to a Korean Medicine Hospital for Low Back Pain)

  • 조창영;김원우;성익현;이갑수;정재훈;박상원;이진호;하인혁
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.137-143
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    • 2014
  • Objectives Low back pain causes disability and incurs large socioeconomic burden. Many cases of acute low back pain progress into chronic conditions. As the treatment period extends, burden of socioeconomic expenses also rises. Thus this study is to investigate whether history period influences improvement rate of pain and disability in the patients who receive conservative Korean medicine treatment. Methods 447 inpatients who received conservative Korean Medicine treatment for the management of low back pain have been grouped into acute, sub-acute and chronic according to the length of history period. NRS, ODI and improvement rate of each group were investigated. Treatment every patient has received as follow; acupuncture, herbal medicine, Chuna manipulation, bee venom, and physical treatment. Results Acute patients showed improvement with NRS of $3.98{\pm}2.50$ and ODI of $28.04{\pm}21.54$. The NRS of sub-acute patients showed improvement with NRS of $2.81{\pm}2.07$, ODI also showed improvement with $11.64{\pm}13.94$. Statistically significant difference was observed in NRS, ODI and improvement for acute patients. Improvement in pain and disability was observed to be larger. Conclusions It demonstrated that receiving valid conservative Korean medicine treatment is beneficial for low back pain patients in improvement of their pain and disability.