• Title/Summary/Keyword: 치료실

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A Clinical Study of Congenital Infant Muscular Torticollis (선천성 유아 사경의 임상 물리치료 연구)

  • Huh, Choon-Bok
    • Journal of Korean Physical Therapy Science
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    • v.3 no.1
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    • pp.863-870
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    • 1996
  • The 46 patients were investigated with the congenital infant muscular torticollis referred Dept. of physical therapy in Dong San Medical Center from January in 1995 to January in 1996. 1. The ratio between males and females was scaled to 1.5 : 1.23 cases(50.0 %) were involved with left side and 22 cases(47.8 %) involved with right side, and one case was of bilaterality. 2. Sequence of birth, the first bone babys were the most distributed with 34cases(73.9 %), the second bone babys were followed with 11cases(23.9 %). 3. There were normal deliveries 60.8 %, Cearean section deliveries 23.9 %, difficulty deliveries .0 % and breech presentation was 2.2 %. 4. The case of cephalic asymmetry consisted 60.0 % of all congenital torticollis and most frequently found at the age of all $5\sim8$ weeks(45.7 %). In 26.1 % of all congenital torticollis cases, facial asymmetry was found and these cases were most frequently in the age of $5\sim8$ weeks(26.1 %), also in the age group of $9\sim12$ weeks and $17\sim20$ weeks consecutively(each 3 %).(P<0.05) 5. The duration of therapy required differently according to the severity of the torticollis, in mild cases, it took $1\sim2$ weeks cases(30.4 %) revealed high therapeutic effect in 54.3 % of the cases. In moderately involved cases(30.4 %), therapy required $3\sim4$ weeks in 13 % of the cases showed improvements. In the most severely involved cases, (7 %) it took more than $9\sim10$ weeks of therapy and showed improvement in 6.5 % only.(P<0.005) 6. The result of this study showed the best therapeutic effects were noticed in the mild cases of congenital torticollis(24 cases 45.6 %) and excellent improvement in moderately involved cases (28.1 %) and 13.1 % of the most severely involved cases(P<0.05).

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A Clinical Study of Pulmonary Tuberculosis in Diabetics (당뇨병에 동반된 폐결핵의 임상적 연구)

  • Jeong, In-Kyung;Yoo, Jee-Hong;Lee, Seon-Mee;Koh, Kwan-Pyo;Han, Min-Soo;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.705-713
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    • 1998
  • Background: An association between diabetes and tuberculosis has long been implied. The severity of diabetes appears to correlate with the degree of tuberculous activity. Methods: A retrospective chart review of 82 patients with active pulmonary tuberculosis in diabetics (DMTB) and 83 patients with active pulmonary tuberculosis in nondiabetics (Non-DMTB) admitted to the Kyung Hee Medical Center between January 1995 and December 1996 was underiaken. Results: The sex ratio of DMTB was 58 : 24, and that of Non-DMTB was 62 : 21. Male patients predominated in both groups. The highest incidence of DMTB was 6th and 7th decades and that of Non-DMTB was 3rd and 4th decades. In case which the tuberculosis developed after diagnosis of diabetes, the prevalence of pulmonary tuberculosis was the highest in diabetes for 5-10 years. On chest X-ray findings, the moderate advanced tuberculosis cases were the most common (60.9% in DMTTB and 50.6% in Non-DMTB). There was no relation between the degree of tuberculosis activity on chest x-ray(minimal, moderate, and far advanced tuberculosis) and presence of diabetes. The incidence of lower lung field tuberculosis in DMTB was significantly higher than Non-DMTB(p<0.05). The multiple lobe involvement was the predominant chest roentgenographic finding in both groups. There was no significant difference of treatment response between DMTB and Non-DMTB. There was no relationship between initial HbA1c and the severity of pulmonary tuberculosis on chest X-ray. During treatment of pulmonary tuberculosis in excellently and well controlled diabetes, the cure rate of pulmonary tuberculosis was significantly higher than the poorly controlled diabetes and the rate of treatment failure was significantly lower than poorly controlled diabetes. (p<0.05). Conclusion: Poor control of blood glucose is related with increased rate of treatment failure in pulmonary tuberculosis with diabetes mellitus. Further investigation will be needed to study the mechanisms of treatment failure in poorly controlled diabetics with pulmonary tuberculosis.

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Radiotherapy Incidents Analysis Based on ROSIS: Tendency and Frequency (ROSIS 자료 기반 방사선 사고 사례 분석 : 경향과 빈도)

  • Koo, Jihye;Yoon, MyongGeun;Chung, Won Kuu;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.298-303
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    • 2014
  • In this study, we examine the trends and types of incidents frequently occur during radiation therapy by using the data from the radiation oncology safety information system (ROSIS), according to discovery method explores the development direction of future research accident cause factor control method. This study was carried out analysis of incident data in ROSIS nearly 1163 cases in last 11 years from 2003 to 2013. We categorized into treatment methods, found the time, discoverer of occupations and finding ways to analyze the data. Then, we calculate the percentage and the classification for each item. About 1163 cases of incident cases including the near miss cases, external radiation therapy, brachytherapy and other were 97%, 2% and 1%. In the case was improperly planned dose delivery was 44% (497 cases) which 429 cases (86%) was found before 3 fractions and 13 cases were found after 11 fractions. The investigation was found to be distributed in various a found times. Approximately 42% of found time was during treatment and 29% of patients were found the problem during inspection chart. Occupation to discover the most radiation accidents was the radiation therapist (53%) who works in treatment room. Among 1163 incidence cases, 24% cases were found the accident before the treatment, therefore most of accident were found after of during the treatment (70%, 813 cases). This trend is acquired through ROSIS analysis, is expected to be not significantly different in the case of Korea, so it is necessary more diverse and systematic research for the prevention and early detection by using the ROSIS data.

COMPARISON OF DEVELOPMENTAL AND PSYCHOPATHOLOGlCAL CHARACTERISTICS FOR RAD AND PDD CHILDREN (반응성 애착장애 아동과 전반적 발달장애 아동의 발달 및 정신병리학적 특징의 비교연구)

  • Yoon, Hyun-Sook;Choi, Jin-Sook;Kim, Tae-Ryeon;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.3-13
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    • 1992
  • For the purpose of better understanding of RAD children, comparisons were performed about the developmental and psychopathological characteristics between RAD and PDD children. Study subjects were the children between the ages 2 and 6. who visitied SNUCH Child and Adolescent Psychiatry OPD or treated in Day Treatment Center during May, 1989 and Sep., 1991, diagnosed by the child psychiatrist as RAD or PDD according to DSM-III-R diagnostic criteria. A total of 40 children were included in the study. 20 were RAD(18 boys, 2 girls). 20 were PDD(20 boys). PEP was performed to all study subjects, by the raters blind to psychiatric diagnosis of each. And analysis was done about the level of developmental functioning score and psychopathological scores between RAD and PDD children. The results are as follows 'There were retardation on the general developmental functioning in RAD children, and the severity of retardation were lined up as perceptual ability>imitation>gross motor>cogitive language>eye-hand coordination>fine motor. Characteristics of psychopathology in RAD children were lined up by severity as language>play>relationship>affection >sensory. Group differences of the two shows on PDD group rejection score was significantly higher on the perception item. while RAD was superior on the perception emerging response. Differences of the psychopathology between two groups were on such areas as ; Affection, which was significantly higher on 'Absent' in RAD, while significantly higher on 'severe' in PDD children. On the interest for the play and materials. sensory and language areas, RAD children were significantly higher ratings on 'Absent' than PDD children.

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Radiation Therapy for Pituitary Adenoma -Changes in Endocrine Function after Treatment- (뇌하수체선종의 방사선치료후 혈중 호르몬치의 변화)

  • Yoon Sei Chul;Jang Hong Suck;Kim Song Hwan;Shinn Kyung Sub;Bahk Yong Whee;Son Ho Young;Kang Joon Ki
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.185-195
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    • 1991
  • Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

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A Study on Accuracy and Usefulness of In-vivo Dosimetry in Proton Therapy (양성자 치료에서 생체 내 선량측정 검출기(In-vivo dosimety)의 정확성과 유용성에 관한 연구)

  • Kim, Sunyoung;Choi, Jaehyock;Won, Huisu;Hong, Joowan;Cho, Jaehwan;Lee, Sunyeob;Park, Cheolsoo
    • Journal of the Korean Society of Radiology
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    • v.8 no.4
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    • pp.171-180
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    • 2014
  • In this study, the authors attempted to measure the skin dose by irradiating the actual dose on to the TLD(Thermo-Luminescence Dosimeter) and EBT3 Film used as the In-vivo dosimetry after planning the same treatment as the actual patient on a Phantom, because the erythema or dermatitis is frequently occurred on the patients' skin at the time of the proton therapy of medulloblastoma patient receiving the proton therapy. They intended to know whether there is the usefulness for the dosimetry of skin by the comparative analysis of the measured dose values with the treatment planned skin dose. The CT scan from the Brain to the Pelvis was done by placing a phantom on the CSI(Cranio-spinal irradiation) Set-up position of Medulloblastoma, and the treatment Isocenter point was aligned by using DIPS(Digital Image Positioning System) in the treatment room after planning a proton therapy. The treatment Isocenter point of 5 areas that the proton beam was entered into them, and Markers of 2 areas shown in the Phantom during CT scans, that is, in all 7 points, TLD and EBT3 Film pre-calibrated are alternatively attached, and the proton beam that the treatment was planned, was irradiated by 10 times, respectively. As a result of the comparative analysis of the average value calculated from the result values obtained by the repeated measurement of 10 times with the Skin Dose measured in the treatment planning system, the measured dose values of 6 points, except for one point that the accurate measurement was lacked due to the measurement position with a difficulty showed the distribution of the absolute dose value ${\pm}2%$ in both TLD and EBT Film. In conclusion, in this study, the clinical usefulness of the TLD and EBT3 Film for the Enterance skin dose measurement in the first proton therapy in Korea was confirmed.

Perinatal outcomes according To chorionicity in Twin Gestations (쌍생아 임신의 융모막과 주산기 결과)

  • Choi, Eun-Jin;Yun, Hyun-Jin;Hyh, Jae-Won;Hong, Yong-Hong
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.67-74
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    • 2008
  • Purpose : The purpose of this study was to assess the natural history and perinatal outcomes of twin gestations according to chorionicity. Methods : We retrospectively reviewed the medical records of 99 monochorionic (MC) and 206 dichorionic (DC) twin gestations delivered at Il Sin Christian Hospital in Busan between January 2002 and December 2007. The incidences of twin-to-twin transfusion syndrome (TTS) and selective intrauterine growth restriction (sIUGR), as well as perinatal morbidity and mortality, were evaluated. Results : MC twins had a lower gestational age (35.7 vs. 36.6 weeks, P=0.03) at birth and a higher incidence of intrauterine fetal loss (10% vs. 1.5%, P<0.001) than DC twins. The incidence of intrauterine fetal loss was higher in MC sIUGR than in DC sIUGR (19% vs. 2.5%, P=0.025) twins. The number of admissions to the neonatal intensive care unit (NICU; 31% vs. 16%, P=0.042), and the incidence of periventricular leukomalacia (7% vs. 0%, P=0.031), and respiratory distress syndrome with surfactant treatment (27% vs. 11%, P=0.049) were higher in MC than DC twins. The incidences of sIUGR and TTS were 21 and 9% among the MC twins. The incidences of intrauterine fetal loss were higher in MC twins with TTS [6 of 9 (67%)] or sIUGR [4 of 21 (19%)] than uncomplicated MC twins (P<0.001). The frequency of admission to the NICU (P=0.001), the length of hospital stay (P=0.033), the prevalence of periventricular leukomalacia (P=0.011), and intraventricular hemorrhage (P=0.007) were also higher in MC with TTS or sIUGR than in uncomplicated MC twins. Conclusion : The incidence of neonatal complications was higher in MC twins, especially those gestations complicated by TTS or sIUGR.

Effects of Vibration Stimulation Therapy on Neglect of Stroke Patients (진동감각 자극치료가 뇌졸중 환자의 편측무시에 미치는 영향)

  • Jeon, So-Hyun
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.87-95
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    • 2018
  • Objective : Vibration stimulators are easier to obtain in clinical settings than other treatment tools, and it is advantageous that the arm activation training can be performed passively. Despite the following advantages, recent studies on vibration sense have not been activated yet. The purpose of this study was to investigate the effect of vibration sensation on the hands of the affected upper limb on unilateral reduction of stroke patients. Method : Patients with unilateral neglect due to stroke were enrolled in this study for about 3 weeks from October 19, 2018 to November 7, The research design used ABA design among the single-subject experimental research design, and a total of 18 circuits (4 baseline, 6 intervention, 3 baseline regression) were performed once a day on weekdays Respectively. MMES-K was used to select the subjects. Line bisection test (LBT), Albert's test and Star Cancellation Test (SCT) were used as unilateral neglect test. For the analysis, the baseline and intervention period measurements were visually analyzed using graphs and mean values were used. Result : All three evaluations showed that the number of errors missed during the training period was lower than the baseline period, and this decrease remained after training. The error was reduced by an average of $2{\pm}1.2$ omissions and an average omissions of $0.6{\pm}0.5$ omitting an average of $4.5{\pm}1$ omissions in the line break test. As a result of the Albert test, the average error decreased by $22.5{\pm}1.9$ omissions and $8{\pm}7.3$ omissions and $0.3{\pm}0.5$ omissions, respectively. In the star clearance test, the average error decreased from $26{\pm}4.6$ to $21.8{\pm}1.7$ and $20{\pm}0$, respectively. Conclusion : In this study, vibrotactile stimulation therapy showed a continuous effect on improving unilateral neglect. Based on these findings, further research should be conducted in order to improve objectivity in future studies. Further research on various arbitration methods that maximize the effect of intervention will be needed.

Development of smartphone-based voice therapy program (스마트폰기반 음성치료 프로그램 개발연구)

  • Lee, Ha-Na;Park, Jun-Hee;Yoo, Jae-Yeon
    • Phonetics and Speech Sciences
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    • v.11 no.1
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    • pp.51-61
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    • 2019
  • The purpose of this study was to develop a smartphone based voice therapy program for patients with voice disorders. Contents of voice therapy were collected through analysis of mobile contents related to voice therapy in Korea, experts and users' demand survey, and the program was developed using Android Studio. Content needed for voice therapy was collected through analysis of mobile contents related to voice therapy. The user satisfaction evaluation for application was conducted for five patient with functional voice disorders. The results showed that the mobile contents related to voice therapy in Korea were mostly related to breathing, followed by voice and singing, but only 13 applications were practically practiced for voice therapy. Expert and user demand surveys showed that the patients and therapists both had a high need for content that could provide voice training in places other than the treatment room. Based on this analysis, 'Home Voice Trainer', an smartphone based voice therapy program, was developed. Home Voice Trainer is an application for voice therapy and management based on Android smartphones. It is designed to train voice therapy activities at home that have been trained offline. In addition, the records of voice training of patients were managed online so that patients can maintain voice improvement through continuous voice consulting even after the end of voice therapy. User evaluations show that patients are satisfied with the difficulty and content of voice therapy programs provided by home voice trainers, but lack of a portion of user interface, such as the portion of home button and interface between screens. Further study suggests the clinical application of home voice trainer to the patients with voice disorders. It is expected that the development study and the clinical application of smart contents related to voice therapy will be actively conducted.

Job Characteristics and Status of Community Occupational Therapist : Focus on OTs in Public Health Centers (지역사회 작업치료사의 업무 특성 및 실태 조사 : 보건소 근무 작업치료사를 중심으로)

  • Min, Kyoung-chul;Kim, Eun-hee;Woo, Hee-soon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.37-52
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    • 2020
  • Objective : This study was conducted to identify occupational therapists working in public health centers, the characteristics and actual conditions of occupational therapists in the community, and use them as basic data on occupational therapists in the community as of 2020. Methods : 77 questionnaires were replied by e-mail from OTs work at nationwide health public centers. Job characteristics and status were analysed by descriptive statistics and check correlation between job satisfaction and other factors. Results : Most survey respondents were female(77.9%) and 20-30(96.1%).. Some occupational therapists worked for dementia related team(72.7%) and others worked for like visiting care, health care, and rehabilitation center etc. Rate of experiences of public health center was 1-2 years(67.5%), the most common type of contract was flexible part-time worker(61%) and work intensity(94.8%) and satisfaction of work was very high(85.7%). The highest difficulty of their job was budget administrative work(26.7%) and of non-work difficulty was inequality under contracts(27.2%). They usually participated at dementia shelter, visiting OT, group OT. Difficulty of their job was high in budget administration, dementia shelters, and visiting work treatments. Goals of treatment were high in improvement of cognitive ability and, family support. Frequency of treatment was high in improvement of cognitive therapy, family support, and evaluation. Occupational therapy targets for health centers were dementia, the general elderly, and adult brain lesions, including those for ordinary people, psychiatric disorders and children. It was found that the primary occupations for evaluation were nurses (35.7%) and occupational therapists (33.7%), and that MMSE-DS, SGDS, and SMCQ were used a lot. Conclusion : This study could identify the job characteristics and status of community OTs. We hope that this result could be basic data for building expertise and role for community OTs in changing situations like community cares.