• Title/Summary/Keyword: 치료 protocol

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RECONSIDERATION OF TREATMENT PROTOCOL ON THE REDUCTION OF ENTEROCOCCUS FAECALIS ASSOCIATED WITH FAILED ROOT CANAL TREATMENT (근관치료 실패와 관련된 Enterococcus faecalis 제거를 위한 치료 protocol의 재고찰)

  • Lee, Woo-Cheol;Hong, Seong-Tae;Shon, Won-Jun
    • Restorative Dentistry and Endodontics
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    • v.33 no.6
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    • pp.560-569
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    • 2008
  • Microorganism survived in the root canal after root canal cleaning and shaping procedure is a main cause of root canal treatment failure. There are several mechanisms for the bacteria to survive in the root canal after chemomechanical preparation and root canal irrigation. Bacteria organized as biofilm has been suggested as an etiology of persistent periapical lesion. Recent studies were focus on removal of Enterococcus faecalis biofilm due to the report that the persistence of this bacteria after root canal treatment may be associated with its ability to form biofilm. Several investigations demonstrated that current root canal treatment protocol including use of NaOCl, EDTA and Chlorhexidine as irrigants is quite effective in eliminating E. faecalis biofilm. However, this microorganism still can survive in inaccessible areas of root canal system and evade host immune response, suppress immune activity and produce biofilm. Up to date, there is no possible clinical method to completely get rid of bacteria from the root canal. Once the root canal treatment failure occurred, and conventional treatment incorporating current therapeutic protocol has failed, periapical surgery or extraction should be considered rather than prolong the in effected retreatment procedure.

The Study for Establishment of Protocol with Quality Assurance (QA) of Hyperthermia Cancer Therapy System in Korea (국내 온열 암 치료 시스템의 품질관리 프로토콜 확립에 대한 연구)

  • Hwang, Jinho;Kay, Chul-Seung
    • The Journal of the Korea Contents Association
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    • v.20 no.1
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    • pp.668-674
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    • 2020
  • Quality Assurance (QA) is essential to provide effective hyperthermia, but in the case of a problem with a hyperthermia cancer therapy system in Korea, the manufacturers or venders are repairing and maintaining the system. In Korea, if an error occurs in the hyperthermia system, the manufacturer and sales agent are repairing and maintaining it. There is no QA protocol suitable for the domestic situation. This study is based on the QA guidelines recommended by institutions such as European Society for Hyperthermia Oncology (ESHO), Hellenic Society of Oncologic Hyperthermia (HSOH), and the results of questionnaires to hospitals that have hyperthermia cancer therapy systems in Korea. By developing an optimized QA protocol, we aim to reduce the errors and inaccuracies that can occur in during hyperthermia such as measurement of temperature, instrumentation, and heat transfer. In addition, we will visit a hospital with a hyperthermia cancer therapy system in Korea to perform a QA based on this study, and study to specify tolerances and accurate QA set-up parameters using the measured QA results.

Preliminary Study on Developing Protocol for Music Therapy Assessment for Cognitive and Emotional-Behavioral Domain using Rhythm (MACED-Rhythm) (인지 및 정서행동 영역에서의 음악치료 사정을 위한 리듬 프로토콜(MACED-Rhythm) 개발 예비 연구)

  • Duerksen, George;Chong, Hyun Ju
    • Journal of Music and Human Behavior
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    • v.10 no.1
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    • pp.67-83
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    • 2013
  • Assessment in music therapy is a vital part for both the therapist and client in the process of therapy. Based on what is assessed, objectives are identified to formulate specific action procedures and strategies. The existing assessment tools involve lists of skills and behaviors in developmental domains without the music assessment protocol. In this study, the authors attempted to develop an assessment protocol using rhythm production for assessing skills in cognitive and emotional-behavior domain, namely Music Therapy Assessment for Cognitive and Emotional Behaviors (MACEB). The test items of the MACEB-Rhythm were developed using rhythmic patterns varying in terms of item difficulty, which are based on the various degree of clarity in the grouping/gestalt, saliency in part-whole relationship, and complexity in repetition vs. variability. Also the developed tool purported to examine one's level of emotional behavior trait by analyzing performance of musical parameters such as tempo, pacing, and loudness in the reproduced output. In order to verify the logical sequencing of test items, firstly 61 subjects participated in verifying the item difficulty for the selected 15 pilot items. The test items were revised and re-sequenced based on the gathered scores of item difficulty. In the second procedure, seven experts in the fields of music education, music therapy and music psychology whose research interest lie in music cognition revised the developed rhythm protocol items focusing on learning sequence, cognitive process and feasibility for skills assessment. The study attempted to provide foundations for using rhythm as an assessment protocol prior to its verification of assessment validity and reliability.

Development of Individually Adapted Electromagnetic Therapy System in Incontinence (환자 맞춤형 전자기장 요실금 치료 시스템 개발)

  • Noh, Si-Cheol;Kang, Kyu-Hong;Lee, Jeong-Seok;Min, Kwon-Sik;Kwon, Jang-Woo;Choi, Heung-Ho
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.4
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    • pp.51-59
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    • 2008
  • Incontinence is the urination disorder as the leakage of urine without her own volition and the woman's representative disease which reduce the life quality. The electromagnetic therapy has high possibility of development cause it has no needs of operant exercise, no arousing of shame and impossibility of infection. But, it has improvement points such as uniformity of the treatment protocol, patient dependance and absent of patient monitoring system. With these demands, the system which stimulate the pelvic flaw muscle with electromagnetic and monitoring the patient status during the therapy is proposed, in this study. And individually adapted electromagnetic therapy system for incontinence patient is also suggested. The proposed system consisted of electromagnetic generation device, cooling device, treating chair, patient monitoring device with pulsation and control software. The simulation for high power system and evaluation confirm was performed. With the development of control software, the convenience of using and maintenance are ensured and the patient adapted therapy protocol is applied. The developed patient adapted electromagnetic therapy system with monitoring device is regarded as the patient affinitive treating method by reducing the riskiness, improving the efficiency with patterned protocol and pre/post therapy. These results, in this study, can bring the safe and organized treatment method to incontinence patients and can lead the variable study for electromagnetic therapy in incontinence.

A Rehabilitation Protocol for High Tibial Osteotomy in Korean Medicine: A Report of 3 Cases (근위 경골 절골술 후 한방 재활치료 프로토콜을 적용한 재활치료의 임상적 효과: 증례 보고)

  • Geum, Ji-Hye;Ha, Won-Bae;Koh, Nak-Yong;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.3
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    • pp.107-118
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    • 2018
  • In this study, we propose a rehabilitation protocol involving Korean medicine for patients after high tibial osteotomy (HTO) and report its effectiveness. Three patients underwent HTO using the rehabilitation protocol involving Korean medicine. We estimated the outcome evaluating physical examination findings of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state. After the treatment, we observed that knee movement and muscular strength were improved. In addition, the numeric rating scale, pain disability index, Lysholm knee score, and walking state of patients were improved. Therefore, a rehabilitation protocol involving Korean medicine can be effectively used for patients after HTO. The limitation of this study was the insufficient number of cases and the difficulty of follow-up because of the characteristics of this operation and the long periods of time that are needed for each phase of the protocol. Further studies are needed to design a rehabilitation protocol involving Korean medicine.

Accuracy evaluation of treatment plan according to CT scan range in Head and Neck Tomotherapy (두경부 토모테라피 치료 시 CT scan range에 따른 치료계획의 정확성 평가)

  • Kwon, Dong Yeol;Kim, Jin Man;Chae, Moon Ki;Park, Tae Yang;Seo, Sung Gook;Kim, Jong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.13-24
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    • 2019
  • Purpose: CT scan range is insufficient for various reasons in head and neck Tomotherapy®. To solve that problem, Re-CT simulation is good because CT scan range affects accurate dose calculations, but there are problems such as increased exposure dose, inconvenience, and a change in treatment schedule. We would like to evaluate the minimum CT scan range required by changing the plan setup parameter of the existing CT scan range. Materials and methods: CT Simulator(Discovery CT590 RT, GE, USA) and In House Head & Neck Phantom are used, CT image was acquired by increasing the image range from 0.25cm to 3.0cm at the end of the target. The target and normal organs were registered in the Head & Neck Phantom and the treatment plan was designed using ACCURAY Precision®. Prescription doses are Daily 2.2Gy, 27 Fxs, Total Dose 59.4Gy. Target is designed to 95%~107% of prescription dose and normal organ dose is designed according to SMC Protocol. Under the same treatment plan conditions, Treatment plans were designed by using five methods(Fixed-1cm, Fixed-2.5cm, Fixed-5cm, Dynamic-2.5cm Dynamic-5cm) and two pitches(0.43, 0.287). The accuracy of dose delivery for each treatment plan was analyzed by using EBT3 film and RIT(Complete Version 6.7, RIT, USA). Results: The accurate treatment plan that satisfying the prescribed dose of Target and the tolerance dose in normal organs(SMC Protocol) require scan range of at least 0.25cm for Fixed-1cm, 0.75cm for Fixed-2.5cm, 1cm for Dynamic-2.5cm, and 1.75cm for Fixed-5cm and Dynamic-5cm. As a result of AnalysisAnalysis by RIT. The accuracy of dose delivery was less than 3% error in the treatment plan that satisfied the SMC Protocol. Conclusion: In case of insufficient CT scan range in head and neck Tomotherapy®, It was possible to make an accurate treatment plan by adjusting the FW among the setup parameter. If the parameter recommended by this author is applied according to CT scan range and is decide whether to re-CT or not, the efficiency of the task and the exposure dose of the patient are reduced.

Childhood Brain Tumors (소아 뇌종양 - 항암화학요법을 중심으로 -)

  • Ghim, Thad T.
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1055-1058
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    • 2002
  • 뇌종양 치료성적은 점차 향상되고 있지만 백혈병 등 다른 소아암에 비해 향상 속도가 느리다. 하지만, 근래 MRI, PET scan 등 neuro-imaging 기술의 발달, 뇌종양의 분자유전학적 연구, 외과 수술 방법의 진전, 치료방사선요법의 다양화 등 많은 분야에서 꾸준한 발전을 보이고 있다. 그리고 여러 가지 신약개발에 의한 제 1, 제 2상의 약제시험, antiangiogenesis 약제의 임상시험, gene therapy 등의 연구가 활발하게 진행되고 있으므로, 이에 따른 환자의 치료 성적도 향상될 것으로 기대하고 있다. 외국에서는 여러 대학이 함께 참여하여 작성한 공동의 치료 protocol에 의한 치료가 활발하게 진행되어 생존율을 높이는데 반해, 우리나라에서는 아직까지 각 기관의 협조체제가 구축되지 못한 형편이다. 하지만 금년에 처음으로 여러 대학에서 임상각과가 참석하는 한국소아 뇌종양연구회가 탄생되어 우리나라 뇌종양 환아들의 치료 protocol 개발에 기여할 것을 기대하고 있다. 뇌종양 치료 후 생존하는 아이들을 위한 정밀한 추적관찰이 필수사항인데 여기에 소아과 의사들의 역할은 클 것으로 사료된다. 지능장애, 부적절한 대인관계, 사회적응의 어려움, 치료 후 발생한 내분비계통의 후유증 그리고 2차 암의 발생 등의 정확한 진단 및 치료가 소아과 의사들의 몫으로 남는다. 또한, 이러한 장애가 있는 환아들이 사회에 잘 적응하도록 하기 위해서는 재활교육에 대한 사회적인 관심과 그에 적절한 지원제도의 확립이 절실히 요구된다. 이 점에 있어서도 소아과 의사들의 관심과 지원이 필요하다.

The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome (일차성 및 이차성 신증후군에서 Mendoza Protocol에 의한 Intravenous Methylprednisolone Pulse Therapy의 효과)

  • Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.117-124
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    • 2001
  • Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

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Advances in Radiation Oncology in New Millennium in Korea (21세기 방사선종양학의 전망:최근의 진보와 한국에서의 발전)

  • Huh, Seung-Jae;Park, Chan-Il
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.167-176
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    • 2000
  • The objective of recent radiation therapy is to improve the quality of treatment and the after treatment quality of life. In Korea, sharing the same objective, significant advancement was made due to the gradual increase of patient number and rapid increase of treatment facilities. The advancement includes generalization of three-dimensional conformal radiotherapy (3D-CRT), application of linac-based stereotactic radiosurgery (SRS), and furthermore, the introduction of intensity modulated radiation therapy (IMRT). Authors in this paper prospectively review the followings: the advancement of radiation oncology in Korea, the recent status of four-dimensional radiation therapy, IMRT, the concept of the treatment with biological conformity, the trend of combined chemoradiotherapy, the importance of internet and radiation oncology information management system as influenced by the revolution of information technology, and finally the global trend of telemedicine in radiation oncology. Additionally, we suggest the methods to improve radiotherapy treatment, which include improvement of quality assurance (QA) measures by developing Koreanized QA protocol and system, regional study about clinical protocol development for phase three clinical trial, suggestion of unified treatment protocol and guideline by academic or research societies, domestic generation of treatment equipment's or system, establishment of nationwide data base of radiation-oncology-related information, and finally patterns-of-care study about major cancers.

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