• 제목/요약/키워드: 모의환자

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Therapeutic Effect of Low Level Laser Therapy on the Trigger Points (발통점에 대한 저출력 레이저의 치료효과)

  • Cho, Soo-Hyun;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.25 no.3
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    • pp.331-343
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    • 2000
  • 구강안면통증환자에서 저출력 레이저의 임상 효과는 많은 임상가에 의해 연구되었으나 그 결과에 대해서는 아직도 논란중이다. 이에 본 연구는 두 가지 방법으로 시행하여 구강안면부위의 발통점에 대한 저출력 레이저의 효과를 평가하였다. 첫 번째 방법은 저작근 중 교근, 측두근과 경부근육 중 승모근에 발통점을 가진 부산대학교 치과대학생 69명중 37명은 레이저 조사군, 32명은 레이저 모의 조사군으로 무작위로 분류하여 저출력 레이저의 치료효과를 평가하였다. 둘째 방법으로 동일 근육에 발통점이 있는 19명의 환자와 발통점이 전혀 없는 20명의 정상인을 무작위로 환자군과 정상 대조군으로 분류하고, 각 군을 다시 레이저 조사군과 모의 조사군으로 나누어 실제 저출력 레이저의 치료효과와 위약효과를 평가하였다. 50mW, 820nm의 GaAlAs 반도체 레이저를 이용하여 4주 동안 첫 주는 2회, 이후 3주 동안 각 1회씩 총 5회를 조사하였고, 레이저 모의 조사군에서도 동일한 방법으로 시행하였다. 치료반응은 전자통각계를 이용하여 압력통각역치를 치료 전, 치료 2주 및 4주에 측정하여 이를 비교한 바 다음과 같은 결과를 얻었다. 1. 레이저 조사군의 각 근육에서 측정한 압력통각역치는 치료 2주 후부터 유의하게 높아졌으며(P<0.05), 모의 조사군과의 차이는 이후 점점 더 증가하였다(P<0.001). 모의 조사군에서는 압력통각역치의 유의한 변화가 없었다. 2. 레이저 조사-환자군에서 측정한 압력통각역치는 레이저 모의조사-환자군의 압력통각역치보다 그 증가폭이 더 크게 나타났다(P<0.05). 정상 대조군은 레이저 조사와 관계없이 압력통각역치에 유의성이 없었다. 3. 약간의 위약 반응이 레이저 모의조사 환자군과 정상 대조군에서 관찰되나, 레이저 조사 환자군의 실제 레이저 치료효과가 위약 반응보다 우세하였다.

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Analysis on Vowel and Consonant Sounds of Patent's Speech with Velopharyngeal Insufficiency (VPI) and Simulated Speech (구개인두부전증 환자와 모의 음성의 모음과 자음 분석)

  • Sung, Mee Young;Kim, Heejin;Kwon, Tack-Kyun;Sung, Myung-Whun;Kim, Wooil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.18 no.7
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    • pp.1740-1748
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    • 2014
  • This paper focuses on listening test and acoustic analysis of patients' speech with velopharyngeal insufficiency (VPI) and normal speakers' simulation speech. In this research, a set consisting of 50-words, vowels and single syllables is determined for speech database construction. A web-based listening evaluation system is developed for a convenient/automated evaluation procedure. The analysis results show the trend of incorrect recognition for VPI speech and the one for simulation speech are similar. Such similarity is also confirmed by comparing the formant locations of vowel and spectrum of consonant sounds. These results show that the simulation method for VPI speech is effective at generating the speech signals similar to actual VPI patient's speech. It is expected that the simulation speech data can be effectively employed for our future work such as acoustic model adaptation.

Effects of Psychiatric Nursing Practicum using Simulated Patients on Self-Directed Learning Readiness, Learning Self-Efficacy, Satisfaction of Learning (모의환자를 활용한 정신간호 시뮬레이션 교육이 자기주도적 학습, 학습 자기효능감, 교육만족도에 미치는 효과)

  • Kim, Soon-Ok;Kim, Hyun-Sook
    • The Journal of the Korea Contents Association
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    • v.14 no.2
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    • pp.396-408
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    • 2014
  • The purpose of this study is to examine the effect of the psychiatric nursing simulation practicum, which was developed for the therapeutic relationship forming and communication, psychiatric nursing assessment training utilizing simulated patients, on self-directed learning, learning self-efficacy and learning satisfaction. As a one group pre-test and post-test design, this test conducted 8 hours of intervention on 119 senior nursing students as study subjects. As a result, self-directed learning and learning self-efficacy were seen to be significantly improved after the program compared to before the program, and these variables displayed a moderate-level static correlation with learning satisfaction. These results can be deemed representative of the fact that, concerning psychiatric nursing practicum, a simulation teaching using simulated patients is effective. The results of this study are expected to contribute to improving field-centered psychiatric nursing practicum and the quality of psychiatric clinical work.

Evaluation and Comparison of Myocardial Perfusion Defects in Patients with Early Breast Cancer Subjected to Different Radiation Simulation Techniques (조기유방암 환자에서 방사선 모의치료 방법의 차이에 따른 심근관류결손의 비교 평가)

  • Nam, Ji-Ho;Ki, Yong-Kan;Kim, Dong-Won;Kim, Won-Taek
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.26-33
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    • 2007
  • [ $\underline{Purpose}$ ]: The aim of this study is to evaluate and compare the incidence and aspects of myocardial perfusion defects in patients who were subjected to either two-dimensional or three-dimensional simulation techniques for early left-sided breast cancer. The myocardial perfusion defects were determined from using single photon emitted computerized tomography (SPECT) myocardial perfusion images. $\underline{Materials\;and\;Methods}$: Between January 2002 and August 2003, 32 patients were enrolled in this study. The patients were diagnosed as having early (AJCC stage T1-T2N0M0) left-sided breast cancer and were treated with tangential irradiation after breast-conserving surgery and systemic chemotherapy. The patients were divided into two groups according to the type of simulation received: two-dimensional simulation using an X-ray fluoroscope simulator or three-dimensional simulation with a CT simulator. All patients underwent technetium-99m-sestamibi gated perfusion SPECT at least 3 years after radiotherapy. The incidence and area of myocardial perfusion defects were evaluated and were compared in the two groups, and at the same time left ventricular ejection fraction and cardiac wall motion were also analyzed. The cardiac volume included in the radiation fields was calculated and evaluated to check for a correlation between the amount of irradiated cardiac volume and aspects of myocardial perfusion defects. $\underline{Results}$: A myocardial perfusion defect was detected in 11 of 32 patients (34.4%). There were 7 (46.7%) perfusion defect cases in 15 patients who underwent the two-dimensional simulation technique and 4 (23.5%) patients with perfusion defects in the three-dimensional simulation group (p=0.0312). In 10 of 11 patients who had myocardial perfusion changes, the perfusion defects were observed in the cardiac apex. The left ventricular ejection fraction was within the normal range and cardiac wall motion was normal in all patients. The irradiated cardiac volume of patients in the three-dimensional simulation group was less than that of patients who received the two-dimensional simulation technique, but there was no statistical significance as compared to the incidence of perfusion defects. $\underline{Conclusion}$: Radiotherapy with a CT simulator (three-dimensional simulation technique) for early left-sided breast cancer may reduce the size of the irradiated cardiac volume and the incidence of myocardial perfusion defects. Further investigation and a longer follow-up duration are needed to analyze the relationship between myocardial perfusion defects and clinical ischemic heart disease.

CT Simulation Technique for Craniospinal Irradiation in Supine Position (전산화단층촬영모의치료장치를 이용한 배와위 두개척수 방사선치료 계획)

  • Lee, Suk;Kim, Yong-Bae;Kwon, Soo-Il;Chu, Sung-Sil;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.165-171
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    • 2002
  • Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

The Development and Effect of the Patient Safety Education Program Using Simulated situation (모의 상황을 활용한 환자안전 교육 프로그램 개발 및 효과)

  • Jung, Hyo-Sun;Kim, Sung hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.398-409
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    • 2019
  • As the prevention of patient safety accidents has been strengthened in the accreditation process of medical institutions, patient safety, which is the maintenance of patient safety by managing medical accidents around the patients, is considered a subject that is important as a disease cure. The purpose of this study is to develop a Patient Safety Program using simulated situations for inpatients at a general hospital ward and to understand the effects on knowledge, performance, and perception of patient safety before and after the programs. In addition, the satisfaction of patient safety education is verified after application of the program. The participants were 30 inpatients at a general hospital. Data were collected from April 15 to 30, 2019 and analyzed using IBM SPSS Version 23.0. The results of the preand post-education revealed a statistically significantly improvement of patient safety knowledge, performance, perception and educational satisfaction. The Patient Safety Education Program using simulated situation was an effective educational program for the inpatients to improve patient safety knowledge, performance, perception, and educational satisfaction. Therefore, this program demonstrated a positive effect of patient safety and it is expected that it can be used as the basis of an education program in patient safety education in a clinical setting.

Lens shielding block 제작시 업무개선에 관한 고찰

  • 차우정;조현상;김영곤;김종식;박영환
    • The Journal of Korean Society for Radiation Therapy
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    • v.14 no.1
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    • pp.95-99
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    • 2002
  • I. 목적 : 결막 림프종 환자의 전자선 치료를 위해 Lens shielding block의 제작시 외부 의뢰 제작과 SMC 자체 제작의 장${\cdot}$단점을 비교해보고 제작 과정에 있어 업무의 효율성을 평가하고자 한다. II. 대상 및 방법: Lens shielding block의 제작시 외부의뢰제작과정과 자체 제작 과정을 비교하여 업무의 효율성, 인력의 변화 및 두방법의 장?단점을 분석하였다. 모의치료후 두 방법의 제작 시간을 비교하였으며, 재료의 차이점과 이용방법을 비교하여 개선된 사항을 알아보았다. III. 결과 : Lens shielding block의 자체 제작시 치료 시작시기는 모의치료 실시 후 7일에서 3일로 단축되어 업무의 효율성과 그에 따른 환자의 불편함이 줄어들게 되었다. 또한, 외부의뢰 제작 과정에서 실시되었던 치과와 치과 기공실에 의뢰하던 과정이 없어지고 과내 모의치료실과 공작실에서 작업하게 되어 모든 작업을 과내에서 일률적으로 실시할 수 있게 되었다. 또한, 모의치료를 실시하면서 실시간으로 shielding block을 수정 할 수 있어 정확성이 재고되었고, 반복되는 제작 작업으로 인해 제작 공정이 보편화되고, 손쉬어졌으며, 재료 활용의 효율성이 증대되었다. IV. 결론 : Lens shieiding block의 자체 제작으로 시간이 단축되어 업무의 효율성이 증대되었고 그에 따른 인력소모와 환자의 불편함이 줄어들게 되었으며, 제작자가 모의치료를 통해 바로 block의 오차를 수정할 수 있어 치료의 안정성 및 정확성이 높아졌으므로 결론적으로 의료의 질 개선과 서비스 향상이 이루어졌다.

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Effective Recognition of Velopharyngeal Insufficiency (VPI) Patient's Speech Using Simulated Speech Model (모의 음성 모델을 이용한 효과적인 구개인두부전증 환자 음성 인식)

  • Sung, Mee Young;Kwon, Tack-Kyun;Sung, Myung-Whun;Kim, Wooil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.19 no.5
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    • pp.1243-1250
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    • 2015
  • This paper presents an effective recognition method of VPI patient's speech for a VPI speech reconstruction system. Speaker adaptation technique is employed to improve VPI speech recognition. This paper proposes to use simulated speech for generating an initial model for speaker adaptation, in order to effectively utilize the small size of VPI speech for model adaptation. We obtain 83.60% in average word accuracy by applying MLLR for speaker adaptation. The proposed speaker adaptation method using simulated speech model brings 6.38% improvement in average accuracy. The experimental results demonstrate that the proposed speaker adaptation method is highly effective for developing recognition system of VPI speech which is not suitable for constructing large-size speech database.

Analysis of Body Mass Index on Set Up Errors Rectal Cancer in Radiotherapy (체질량지수(BMI)와 방사선 치료 시 직장암 환자의 자세 오차 분석)

  • Shim, Jae-Goo;Jung, Hong-Ryang;Seo, Jung-Min;Park, Byoung Suk;Jang, Joon-Young
    • Proceedings of the Korea Contents Association Conference
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    • 2013.05a
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    • pp.211-212
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    • 2013
  • 방사선 치료를 받는 모든 환자의 경우 먼저 모의 치료를 시행한 후에 동일한 자세로 방사선 치료를 실시한다. 이 때 무엇보다도 중요한 사항은 정확한 자세의 재현성이다. 직장암 환자의 방사선 치료를 시행하는 경우에도 모의 치료와 동일한 자세 유지가 요구되어진다. 하지만 호흡 및 환자의 여러 가지 요소에 의해 자세의 오차가 발생할 수 있다. 이에 본 논문은 직장암 환자의 방사선 치료를 시행하는 경우 오차가 발생할 수 있는 요소 중에 환자의 체지량 지수 차이에 의한 자세 재현성에 대해 알아보고 향후 자세 오차를 줄일 수 있는 방법을 모색하고자 한다.

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A New Fitness Index for Simulated Implantation System of Artificial Hip Joint based on 3D Medical Images (3차원 의료영상에 기반한 인공고관절 모의시술 시스템 개발 및 새로운 정합도 측정 방법에 관한 연구)

  • 김용호;김중규;최귀원
    • Journal of Biomedical Engineering Research
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    • v.21 no.2
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    • pp.201-212
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    • 2000
  • 본 논문에서는 인공고관절과 환자의 고관절 부위를 각각 3차원 영상화한 후에 이들의 정합도 (fitness)를 측정하여 수치적인 정보로 제공함으로써 환자의 체형에 적합한 인공고관절을 선택하고, 더 나아가 정확한 시술방향과 시술깊이를 제공할 수 있는 모의시술시스템을 제시하였다. 이를 위해 region growing 기법등을 이용하여 환자의 CT 영상을 3차원화하고, 또한 인공고관절을 projection 기법 등을 통해 3차원 영상화하였으며, 지금까지 인공고관절 정합도 측정에 사용했던 단순한 단면적 비교방식과는 달리 삽입의 균일성도 가늠할 수 있는 새로운 정합도 측정 방식을 고안하여 적용하였다. 다양한 실험과 분석을 통하여 새로 제안한 정합도 측정 방법의 정확성과 우수함을 확인할 수 있었으며, 본 논문에서 제시하는 모의 시술시스템은 향후 정형외과 분야에서 인공무릎과 같은 다른 영역에서의 시술 보조 시스템으로도 응용될 수 있을 뿐만 아니라, 인공관절의 국산화 및 주문제작 등에성도 많은 활용을 할 수 있을 것으로 기대된다.

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