Alternative Method of Retrocrural Approach during Celiac Plexus Block Using a Bent Tip Needle

BACKGROUND: This study sought to determine safe ranges of oblique angle, skin entry point and needle length by reviewing computed tomography (CT) scans and to evaluate the usefulness of a bent tip needle during celiac plexus block (CPB). METHODS: CT scans of 60 CPB patients were reviewed. Image of the uppermost margin of L2 vertebral body was used to measure the minimal and maximal oblique angles and the distances from the midline to skin puncture point. The imaginary needle trajectory distance was calculated by three-dimensional measurement. When the procedure was performed by using a 10° bent tip needle under a 20° oblique X-ray fluoroscopic view, the distance (GF/G'F) from the midline to the actual puncture site was measured. RESULTS: The imaginary safe oblique angle range was 26.4-34.2° and 27.7-36.0° on the right and left, respectively. The distance from the midline to skin puncture point was 6.1-7.6 cm on the right and 6.3-7.6 cm on the left. The needle trajectory distance at minimal angle was 9.6-11.6 cm on the right and 9.5-11.5 cm on the left. The distance of GF/G'F was 5.1-6.5 cm and 5.0-6.4 cm on the right and left, respectively. All imaginary parameters were correlated with BMI except for GF/G'F. All complications were mild and transient. CONCLUSIONS: We identified safe values of angles and distances using a straight needle. Furthermore, using a bent tip needle under a 20° oblique fluoroscopic view, we could safely perform CPB with smaller parameter values.ope

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가치투자는 종목의 주가와 기업의 내재가치의 괴리를 이용해 매매하는 장기적인 투자전략의 하나이다. 주식 투자자들의 공통적인 관심사인 높은 투자성과를 위해 우량한 종목을 선별해내는 방법과 적절한 시점에 매매하는 방법이 모두 중요하다. 이 중 장기적인 투자를 가정하는 가치투자 관점에서는 우량한 종목을 선별해내는 방법이 더욱 중요한 과제라고 볼 수 있다. 본 논문에서는 이러한 가치투자 관점에서의 우량종목 선별방법을 의사결정나무 알고리즘과 재무정보의 업종 특성을 연계한 분석을 통해 포트폴리오를 구성하는 방법을 제안하였다. 실험을 통해 의사결정나무와 주가순자산비율(PBR)의 업종 특성을 반영하여 포트폴리오를 구성할 경우 실험에 적용된 전 기간에 대하여 임의 투자방식보다 정확률은 약 38%, 평균 수익률은 약 3.2배 상승하는 것을 확인하였다