• Title/Summary/Keyword: 치료 protocol

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A Rehabilitation protocol for Arthroscopic Bankart repair in Korean Medicine : A Case Report (Bankart 병변의 관절경적 복원술 후 한방 재활치료 프로토콜을 적용하여 호전된 증례 보고)

  • Geum, Ji-Hye;Baek, Dong-gi;Lee, Jung-Han
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.177-187
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    • 2019
  • Objectives: The aim of this study was to report the clinical improvement of a patient who underwent arthroscopic Bankart repair using a rehabilitation protocol involving Korean medicine. Methods: The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy, and Doin exercise therapy during the admission period. To estimate the patient's status, we used the Numeric Rating Scale (NRS), Pain Disability Index (PDI), assessments of the range of motion (ROM) and Muscle Manual Test (MMT) for the shoulder joint. Results: After administering the abovementioned treatments, we found that the patient's NRS, PDI, and ROM and MMT for the shoulder joint were improved. Conclusions: The rehabilitation protocol involving Korean medicine can be applied to and produce good results for patients who undergo arthroscopic repair for Bankart lesions. The limitation of the study was that the number of cases we studied was insufficient to prove the effectiveness. Hence, further studies are needed for designing the rehabilitation protocol involving Korean medicine.

Economic Evaluation of Gemcitabine-cisplatin Chemotherapy for Non Small-Cell Lung Cancer Patient in an Outpatient Setting (비용-효과 분석 기법을 이용한 Gemcitabine 외래 항암 치료의 경제성 평가)

  • Min, Su-Hyun;Ko, Su-Kyoung;Lim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.3
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    • pp.363-371
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    • 2008
  • Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

Comparison of mean airflow rate before and after treatment in patients with sulcus vocalis according to aerodynamic analysis methods (성대구증 환자의 공기역학적 검사 방법에 따른 치료 전과 후의 평균호기류율 비교)

  • Seung Yeon Lee;Hong-Shik Choi;Jaeock Kim
    • Phonetics and Speech Sciences
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    • v.15 no.4
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    • pp.61-69
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    • 2023
  • Sulcus vocalis is characterized by incomplete closure of the vocal folds, with a high mean airflow rate (MFR) as a distinctive feature. The MFR is measured using two aerodynamic analysis methods [the maximum sustained phonation protocol (MXPH) and voicing efficiency protocol (VOEF)] of the phonatory aerodynamic system (PAS), and the results may vary depending on the method. This study compared the differences in MFR before and after treatment (microsurgery and voice therapy) according to the MXPH and VOEF of the PAS in 30 patients with sulcus vocalis. Additionally, we examined whether there were differences in the subjective voice evaluation (voice handicap index, VHI), perceptual voice evaluation (GRBS), and fundamental frequency (F0) before and after treatment. The results showed significant differences between the two methods, both before and after treatment, in patients with sulcus vocalis. However, there were no significant differences by methods in the changes before and after treatment. The VHI and GRBS scores significantly decreased after treatment; however, F0 showed no significant differences before and after treatment. This study indicates that when evaluating MFR changes in patients with sulcus vocalis, it is acceptable to use either aerodynamic analysis (MXPH or VOEF).

A Design of Realtime Virus Interception System via File Transfer Protocol (파일 전송 프로토콜을 경유하는 실시간 바이러스 차단 시스템 설계)

  • 김두현;정종근;정일용
    • Proceedings of the Korean Information Science Society Conference
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    • 2000.10c
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    • pp.597-599
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    • 2000
  • 이제는 인터넷이 우리의 생활 깊숙히 들어와 온라인 쇼핑, 웹 기반 메일, 소프트웨어 업/다운로드 등 인터넷을 서핑하는 것이 하루 세끼 밥을 먹고, TV를 보는 것처럼 생활화되었다. 이런 인터넷을 통해 하루에도 수많은 파일들이 FTP를 통해 들어오고 나가고 있으나 현재로서는 클라이언트 단위에서 사용자가 직업 바이러스를 점검, 치료하고 있을 뿐이다. 따라서, 본 논문에서는 클라이언트에 유입되기 전 단계인 게이트웨이에서 FTP의 인터넷 트래픽을 조사형 들어오는 파일들 중 바이러스에 감염된 파일을 체크함으로써 클라이언트에 유입되기 전에 치료 및 사용자에게 재전송하는 바이러스 탐지 시스템을 제안한다.

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The Implementation & design of a WAP based Remote Medical System (WAP기반의 모바일 원격진료시스템의 설계 및 구현)

  • 구제영;김경주;오근탁;이윤배;이성태;이영신
    • Proceedings of the Korean Information Science Society Conference
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    • 2003.04d
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    • pp.238-240
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    • 2003
  • 기존의 원격진료시스템은 직접 PC를 통해 Server에 접속하여 환자의 신상명세 및 치료 처방을 수행하고 있다. 그러나 무선 인터넷이 보급됨에 따라 PC가 아닌 휴대용 단말 장치만으로도 Server에 접속할 수 있게 되었다. 실제 임상에서 무선 인터넷의 PDA나 휴대폰을 이용하여 환자에 대한 처방이나 치료를 의사가 즉각적으로 할 수 있게 되었다. 그러나 PDA나 휴대폰의 경우 처리 속도 및 화면 크기에 한계가 있다. 그러므로 본 논문은 이런 문제를 개선하기 위해서 WAP(Wireless Application Protocol)을 이용하여 빠르고 정확한 최적의 원격진료시스템을 제안하고 구현한다.

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Clinical Trial Protocol Development of Acupuncture for Disaster Survivors: Results from an Expert Survey (전문가 설문조사에 기반한 재난 경험자에 대한 침치료 임상연구 프로토콜 개발)

  • Huiyong Kwak;Chanyoung Kwon;Jungtae Leem;Sang-Ho Kim
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.1
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    • pp.15-26
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    • 2024
  • Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.

The effects of knee joint position sense following local and general load protocols (국소적 부하와 전신적 부하가 슬관절 위치 감각에 미치는 영향)

  • Hwang, Yoon-Tae;Park, Rae-Joon;Choi, Jin-Ho
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.429-440
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    • 2005
  • The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

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A Systematic Review of Modified Constraint- Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy (뇌성마비 유형 중 편마비 아동을 위한 수정된 강제유도 운동치료의 효과에 대한 체계적 고찰)

  • Hong, So-Young;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.10 no.2
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    • pp.11-22
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    • 2012
  • Objective : This research investigated the intervention effects, protocol of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Methods : For the key words of a database search, "Cerebral Palsy", "Hemiplegia", "Constraint Induced Movement Therapy", "modified Constraint Induced Movement Therapy" were used. We examined papers published in journals from January 2001, when the modified Constraint Induced Movement Therapy was first suggested, to May 2011, using PubMed, Medline. Ovid. Results : A total of 10 papers were analyzed and results of modified Constraint Induced Movement Therapy were an effective therapeutic method to improve motor function, quality of movement and that they also increased the frequency of functional use of the affected hands of hemiplegic cerebral palsy. Conclusion : This paper conducted a systematic review of the research literature reporting on the effects of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Analysis of the fewer number of papers, there was limitation that we consider studies at all levels of evidence. However the restraint methods should be decided according to the characteristics of the individually and apply a variety of therapeutic activities, there is positive support for the use of modified constraint-induced movement therapy to improve the recovery of the paretic upper extremity with cerebral palsy.

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Single Case Study: The Positive Impact of the Intensive Sensory Integration Intervention for the Sensory Defensiveness (감각통합기능장애에 대한 집중치료프로그램의 효과 : 사례보고)

  • Park, Ji-Hun;Noh, Jong-Su;Lee, Hyang-Sook;Cha, Jung-Jin
    • The Journal of Korean Academy of Sensory Integration
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    • v.7 no.2
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    • pp.63-76
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    • 2009
  • Objective : The purpose of this study was to identify effects of intensive sensory integration (SI) treatment and home-program for a child who has a sensory integration disorder. This study also examined whether the positive effect is long-lasting by a follow-up test. Method : A boy with sensory integration dysfunction underwent an intensive SI treatment for 2 weeks. The intervention was consisted of 9 sessions and duration of the each session was 40 minutes. Sensory diet and Wilbarger protocol was provided as home program. The child's sensory function was evaluated before and after the SI intervention. Five month later, re-evaluation was executed for follow-up purpose. Results : In the evaluation after the Si intervention, the child's sensory defensiveness was decreased. Praxis, visual perception, sensory regulation dysfunction (sleep function), affective stabilization and performance of activities of daily living are also improved. In the re-evaluation after the 5 month later, the self-regulation ability, especially sleep function, has been maintained and the visual perception was developing continually. However, the child showed some affective regulation such as bothering his mother and losing his temper. Conclusions : The intensive SI intervention showed positive effects in terms of SI function improvement and the effect lasted long without any additional therapeutic intervention.

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Impact of Transcranial Direct Current Stimulation Combined With Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Systematic Review (뇌졸중 환자의 상지기능 향상을 위한 경두개 직류 자극과 강제 유도 운동 치료의 결합 중재 효과에 대한 체계적 고찰)

  • Kim, Sun-Ho
    • Therapeutic Science for Rehabilitation
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    • v.8 no.4
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    • pp.7-18
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    • 2019
  • Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and December 2018. The main search terms were "Transcranial direct current stimulation" or "tDCS," "Constraint-induced movement therapy" or "CIMT," "Upper extremity function," "Upper limb," and "Stroke." Based on the inclusion and exclusion criteria, 6 articles were selected. Furthermore, intervention effects on upper extremity function, activities of daily living, and cortical activity were assessed. Results : The current intensity, application time, and protocol of the CIMT varied the between studies. However, the intervention procedures to perform CIMT immediately after transcranial direct current stimulation was the same. Transcranial direct current stimulation combined with CIMT was effective in improving upper limb function and activities of daily living in patients with stoke and had a significant effect on cerebral cortex activation. Conclusions : This study provides information on transcranial direct current stimulation combined with CIMT for use by clinical therapists. Further studies are needed to standardize the stimulation time, current intensity, and electrode attachment position. Furthermore, randomized controlled trials, including long-term follow up, are needed for larger populations using the most appropriate CIMT protocol.