• Title/Summary/Keyword: 치료지침서

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A Comparison of Two Procedures to Assess Visual Perceptual Skills of Children With Cerebral Palsy (뇌성마비의 시 지각 검사를 위한 평가도구의 비교)

  • Kim, Kyeong-Mi;Yu, Byong-Kyu
    • Physical Therapy Korea
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    • v.6 no.4
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    • pp.15-21
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    • 1999
  • 이 연구의 목적은 Motor-Free Visual Perception Test (MVPT)와 Mariannene Frostig Developmental Test of Visual Perception (DTVP)을 사용하여 뇌성마비 아동과 정상아동의 시 지각 능력의 차이를 알아보고, 뇌성마비의 사지마비군과 양하지마비군, 그리고 정상아동군에서 두 평가도구의 결과에서 제시한 시 지각능력의 차이를 비교하기 위한 것이다. 뇌성마비 아동 21명(사지마비 11명, 양하지마비 10명)과 정상아동 8명을 대상으로 하였다. 대상의 연령범위는 4세에서 8.5세이었다. 시 지각 능력을 평가하기 위하여 운동기능을 포함하지 않은 MVPT와 운동기능을 포함한 DTVT를 사용하였다. 평가과정과 방법은 표준화된 지침서에 따라 수행하였다. 자료분석은 SPSS를 사용하여 Wilcoxon signed rank test와 Mann-Whitney, Kruskal-Wallis를 하였다. MVPT와 DTVP의 지각지수를 뇌성마비 아동과 정상아동을 비교한 결과 뇌성마비 아동의 지각지수가 정상 아동보다 유의하게 낮았다. 아동의 교정연령과 MVPT와 DTVP의 지각연령의 차(CA-PA)를 사지마비군, 양하지마비군, 그리고 정상군과 비교한 결과 정상군에서는 두 평가도구 간의 차이가 없었으나, 사지마비군에서는 두 평가도구 사이에 유의한 차이가 있었다. 이 연구의 결과는 뇌성마비 아동의 시 지각능력을 평가하기 위한 도구로 MVPT의 사용을 제시하였다.

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Dental Treatment of Child with Hemophilia (혈우병을 가진 어린이의 치과치료)

  • Lim, Ji Eun;Lee, Soo Eon;Ahn, Hyo Jung;Park, Jae-Hong;Choi, Sung Chul
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.4
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    • pp.229-233
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    • 2012
  • Hemophilia, the most common of the inherited bleeding disorder, is the result of a deficiency of clotting factor. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. We report on the diagnosis and treatment of a 9-year-old boy having severe hemophilia visited our department with the chief complaints of pus discharge on the left lower molar region. In the clinical and radiographic examination, periapical abscess and dental caries were diagnosed. Considering complexity of the treatment and complication in the coagulation, it was decided to carry on the treatment under general anesthesia. Clotting factor IX concentrates were intended to provide 50-70% plasma level. Pulpectomy, resin restoration and Stainless steel crown were given under general anesthesia. Several teeth were extracted and the sockets were packed with Surgicel$^{(R)}$ (Oxidized Regenerated Cellulose, Johnson and Johnson Co. Neuchatel, Switzerland) under general anesthesia. Transpalatal arch and lingual arch were given for maintaining the extracted space before discharged. For people with severe hemophilia, factor replacement is necessary before scaling, surgery or regional block injections. Therefore, if several extractions are needed, dental care under general anesthesia would be effective and efficient management.

Characteristics of Physiological Variables(EDR, EMG) in Biofeedback Treatment (바이오피이드백 치료에서 나타나는 신체변수(EDR, EMG)의 특성)

  • Seo, Man-Kil;Han, Woo-Sang;Lee, Kyung-Kyu;Yu, Bum-Hee;Lee, Yu-Ri;Kim, E-Yong;Kim, Hyun-Woo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.1
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    • pp.38-45
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    • 1999
  • Objectives: We explored the characteristics of physiological variables such as electrodermal response(EDR) and electromyography(EMG) in patients with insomnia, panic disorder, and other anxiety disorders. we aimed to decide the minimum sessions in biofeedback treatment to make the treatment effective and examine the effects of long-term biofeedback treatment by measuring the physiological variables. Methods: Thirty seven outpatients who received biofeedback treatment were divided into 3 groups according to the number of biofeedback sessions(patients who received 4-5 sessions, who received 6-9 sessions, and who received more than 10 sessions). We measured mean and delta values of EDR and EMG levels, and the Hamilton Anxiety Rating Scale(HARS), and Slef-Relaxation Inventory(SRI) in all patients. Data were analyzed by t-test and repeated measures analysis of variance. Results: The mean and delta values of EDR and EMG levels were not different among the 3 groups during the first 4 biofeedback sessions. However, patients who received more than 10 biofeedback sessions had higher baseline mean EDR value(F=2.233, p=0.036) in the first session, compared with other patients. In patients who received more than 10 biofeedback sessions, mean EDR was significantly reduced after $5^{th}$ session(F=10.41, p<0.01). They showed significant improvement in SRI scores at 12th biofeedback session(t=2.726, p<0.05) and in HARS scores at $6^{th}$(t=3.10, p<0.05) and $12^{th}$ biofeedback session(t=10.93, p<0.001). Conclusions: Wesuggest that patients should receive more than 5 biofeedback sessions to experience internal cues and get a good clinical response to biofeedback treatment.

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Korean Guidelines for the Treatment of Panic Disorder 2018 : Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Panic Disorder (2018 한국형 공황장애 치료지침서 : 초기 및 유지 약물치료 전략)

  • Kim, Min-Kyoung;Lee, Jae-Hon;Gim, Minsook;Kim, Won;Moon, Eunsoo;Seo, Ho-Jun;Koo, Bon-Hoon;Yang, Jong-Chul;Lee, Kang Soo;Lee, Sang-Hyuk;Kim, Chan-Hyung;Yu, Bum-Hee;Suh, Ho-Suk
    • Anxiety and mood
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    • v.14 no.2
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    • pp.53-62
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    • 2018
  • Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

Korean Guidelines for the Treatment of Panic Disorder 2018 : Psychosocial Treatment Strategies (2018 한국형 공황장애 치료지침서 : 정신사회적 치료전략)

  • Gim, Minsook;Kim, Min-Kyoung;Lee, Jae-Hon;Kim, Won;Moon, Eunsoo;Seo, Ho-Jun;Koo, Bon-Hoon;Yang, Jong-Chul;Lee, Kang Soo;Lee, Sang-Hyuk;Kim, Chan-Hyung;Yu, Bum-Hee;Suh, Ho-Suk
    • Anxiety and mood
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    • v.15 no.1
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    • pp.13-19
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    • 2019
  • Objective : The purpose of this study was to investigate consensus relative to treatment strategies for psychosocial treatment in panic disorder, that represents one subject addressed by the Korean guidelines for treatment of panic disorder 2018. Methods : The executive committee developed questionnaires relative to treatment strategies for patients with panic disorder based on guidelines, algorithms, and clinical trials previously published in foreign countries and Korea. Seventy-two (61.0%) of 112 experts on a committee reviewing panic disorder responded to the questionnaires. We classified the consensus of expert opinions into three categories (first-line, second-line, and third-line treatment strategies), and identified treatment of choice using the Chi-square test and 95% confidence intervals. Results : For psychosocial treatment of panic disorder, individual and group cognitive behavior therapy (CBT) were recommended treatments of choice, and mindfulness based cognitive therapy (MBCT) was recommended as first line strategy. There was statistically significant consensus among experts regarding usefulness of each component of CBT and MBCT, for treatment of patients with panic disorder. Conclusion : Results, that reflect recent studies and clinical experiences, may provide the guideline for psychosocial treatment strategies for panic disorder.

Korean Guidelines for the Treatment of Generalized Anxiety Disorder 2024: Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Generalized Anxiety Disorder (2024 한국형 범불안장애 치료지침: 초기 및 유지 약물치료 전략)

  • Min-Kyoung Kim;Jun Ho Seo;Chun Il Park;Myung Hee Ahn;Hyeon-Ah Lee;Yoon Young Chang;Eunsoo Moon;Ho-Suk Suh;Won Kim;Kyoung-Uk Lee
    • Anxiety and mood
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    • v.20 no.2
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    • pp.54-64
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    • 2024
  • Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for the treatment of generalized anxiety disorder (GAD) 2024. In this paper, we discussed the consensus among psychiatrists specializing in anxiety disorders, regarding initial and maintenance treatment strategies for pharmacological treatment of GAD in Korea. Methods : The executive committee developed questionnaires on treatment strategies for patients with GAD, based on previous treatment guidelines and academic articles published internationally and in Korea. Sixty-two experts responded to the questionnaires. The consensus of expert opinions was classified into three categories (first-line, second-line, and third-line choices) using the chi-square test and 95% confidence intervals. Results : Combination of antidepressants and anxiolytics was recommended as treatments of choice (ToC), and antidepressant single pharmacotherapy as first-line strategies for initial treatment of GAD. Several SSRI, SNRI, and mirtazapine were preferred from among many antidepressants, and, among anti-anxiety drugs, clonazepam, alprazolam, buspirone, and lorazepam were first preferred. In the case of maintenance treatment of GAD, antidepressant single pharmacotherapy was selected as ToC and first-line strategies. In addition, it was reported that the preference for atypical antipsychotics was high not only in the initial but also in the maintenance treatment stage as antidepressants and atypical antipsychotics combination treatment maintained the top second-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study is based on the clinical experience of Korean experts regarding pharmacological treatment strategies for patients with GAD, and and it is expected to be helpful in presenting the basis and plan for GAD treatment in clinical practice.

A Study on the Priorities in the Roles of Community Pharmacists in Aged Society Using AHP (AHP를 이용한 고령사회 약국약사의 역할에 대한 우선순위 연구)

  • Kang, Eunjeong;Jang, Sunmee;Kil, Tae Soo
    • The Journal of the Korea Contents Association
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    • v.19 no.6
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    • pp.402-411
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    • 2019
  • This study aimed to identify priorities in community pharmacist's roles in aged society using Analytic Hierarchy Process. We developed a survey questionnaire for AHP, which consisted of 19 pharmacist's roles selected from the FIP/WHO guidelines. The AHP survey questionnaire was self-administered by 127 pharmacists. The results showed that pharmacists put medication therapy management at the highest priority, preparation, dispense, distribution of medication at the second priority, and efficient healthcare system at the lowest priority. Among the 19 roles, new roles such as monitoring of medication therapy results, team-based health care, and transitions of care obtained relatively high priority.

The study of awareness and practice of infection control on dental practitioners during the prosthodontic treatment (치과 보철물 제작 과정에서 감염 관리에 관한 치과 종사자의 인지도 및 실천도에 대한 연구)

  • Jeon, Han-Sol;Lee, Jin-Han
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.3
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    • pp.189-197
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    • 2015
  • Purpose: The aim of this study was to assess the degree of awareness and actual practice of dental practitioners regarding infection control during prosthodontic treatment. Materials and methods: Study participants were composed of dentists, dental hygienists, dental technicians working at dental university hospital, general hospital, dental hospital and dental clinics in Daejeon, Korea (n=126). The questionnaires included the data on general characteristics, education, awareness and practice of infection control procedures during prosthodontic treatment through personal self-administration survey. Awareness and practice were measured by Likert scale ranging from 1 to 5. Statistical analysis was done by one-way ANOVA. Influence of awareness on practice was estimated by regression analysis. Results: 27.7% of the respondents answered that the infection control education regarding prosthodontic treatment is insufficient. The mean value of awareness and practice of infection control during the prosthodontic treatment were $2.72{\pm}0.80$, $1.58{\pm}0.88$, respectively. The mean value of practice who answered that had education curriculum at college was $1.62{\pm}0.9$, and $1.31{\pm}0.49$ who did not. The mean value of awareness who equipped guideline was $3.01{\pm}0.9$, and $2.56{\pm}0.70$ who did not. Conclusion: 1. The respondents who received the infection control education by college curriculum showed higher degree of practice than the respondents who did not. 2. The respondents who have appropriate infection control guidebook in their workplace showed higher degree of awareness than the respondents who did not. 3. There was a correlation between the awareness and practice of infection control during prosthodontic treatment; the degree of awareness becomes higher, so does the degree of practice. 4. During the prosthodontic treatment, the degree of practice was lower than the degree of awareness on infection control.

The Structure of Korean Radiation Oncology in 1997 (국내 병원 별 방사선치료의 진료 구조 현황(1997년 현황을 중심으로 한 선진국과의 비교 구))

  • Kim Mi Sook;Yoo Seoung Yul;Cho Chul Koo;Yoo Hyung Jun;Yang Kwang Mo;Je Young Hoon;Lee Dong Hun;Lee Dong Han;Kim Do Jun
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.172-178
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    • 1999
  • Purpose : To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipments and patient loads between Korea and developed countries. Methods and Materials : Mail serveys we conducted in 1998 and data on treatment machines, personnel and peformed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole country were summarized using Microsoft Excel program. Results: In Korea during 1997, 42 facilities delivered megavoltage radiation theraphy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelators at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator, Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. Conclusions : The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there were a lot of hospitals which did not employ medical physicists.

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Current Status of Imaging Physics & Instrumentation In Nuclear Medicine (핵의학 영상 물리 및 기기의 최신 동향)

  • Kim, Hee-Joung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.83-87
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    • 2008
  • Diagnostic and functional imaging device have been developed independently. The recognition that combining of these two devices can provide better diagnostic outcomes by fusing anatomical and functional images. The representative examples of combining devices would be PET/CT and SPECT/CT. Development and their applications of animal imaging and instrumentation have been very active, as new drug development with advanced imaging device has been increased. The development of advanced imaging device resulted in researching and developing for detector technology and imaging systems. It also contributed to develop a new software, reconstruction algorithm, correction methods for physical factors, image quantitation, computer simulation, kinetic modeling, dosimetry, and correction for motion artifacts. Recently, development of MRI and PET by combining them together was reported. True integration of MRI and PET has been making the progress and their results were reported. The recent status of imaging and instrumentation in nuclear medicine is reported in this paper.