• Title/Summary/Keyword: A protocol for follow-up

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A Study on the Organization of Department for the Education of Telecommunications (통신교육을 위한 학과편제에 관한 연구)

  • Jhow, Jeong-Hyon;Shin, Sang-Gak;Wang, Jee-Kyoon;Lee, Jin
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.7 no.3
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    • pp.87-111
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    • 1982
  • The education system is the communication field should be based on the characteristics of communication science and the function of manpower. However, the current education system at the level of college is insufficient and irrational to meet the requirements of the telecommunication field in our country. The main reasons are as follows: 1. Misunderstanding the characteristics of communication science. 2. Indiscretion of the categories of communication manpower due to lack of coordination between academic circles and communication industrial field. Telecommunication function could be performed only by combining the engineering and the suitable operational control. The communication engineering is similar to the electronic engineering, but the former should follow the miscellaneous international protocol and the domestic regulations, being only a means for the telecommunication function. In order to improve the education system of communiation, we aim to identify the principle of communication science, orthodoxy of the education, the categories of communication industrial field and manpower. The present system has been formed on the basis of ignoring the attributes of manpower and historical background of communication science. Therefore, this paper proposes to set up new departmental organizations for educating communication manpower as the following: In addition, this paper proposes a new curriculum model of the above twodept, and we believe that it well turn out more scientific, effective and reasonable education for the communication science. 1. Modification of the present formation, designated Electronic Communication Department. 2. New formation model: A. The best future model such as establishing ad independent telecommunication college which is composed of : Dept. of Radiocommunication Dept. of Telecommunication Enginnering Dept. of Communication Industrial management Dept. of Transmission Engineering Dept. of Telecommunication Law B. An immediately practicable proposal model instead of the existin Dept.. which is composed of the first two Dept. of the above five Dept. In addition, this paper proposes a new curriculum model of the above two dept. and we believe that it will turn out the education for the communication science to be more scientific, effective and reasonable.

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Comparison of real-time ultrasound imaging for manual lymphatic drainage on breast cancer-related lymphedema in individuals with breast cancer: a preliminary study

  • Seo, Dongkwon;Lee, Seungwon;Choi, Wonjae
    • Physical Therapy Rehabilitation Science
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    • v.9 no.1
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    • pp.43-48
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    • 2020
  • Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.

A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System (미국 임상영양치료(MNT)의 법제화 과정 및 수가 체계)

  • 박은철;김현아;이해영;이영은;양일선
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.852-862
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    • 2002
  • The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States

  • Victoria J. Nedder;Mary A. Breslin;Vanessa P. Ho;Heather A. Vallier
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.67-73
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    • 2024
  • Purpose: Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD Checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Methods: Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2). Results: Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 154 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P>0.999); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06). Conclusions: The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health.

Radiopharmaceuticals for the Therapy of Metastatic Bone Pain (뼈전이의 방사성동위원소 통증치료)

  • Ahn, Byeong-Cheol
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.82-89
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    • 2006
  • Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.

A Study for the Development of Neurofeedback Biosignal Index for Tic Response Supression Test of Tourette's Syndrome (투렛증후군의 틱 반응 억제 시험을 통한 뉴로피드백 생체신호 지표 개발 시론)

  • Woo, Jeong-Gueon;Kim, Wuon-Sik
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.861-869
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    • 2022
  • In patients with Tourette's syndrome, a tic occurs when Mu wave synchronization is broken. Conversely, when Mu wave synchronization is achieved, a tick does not occur. When the tic is suppressed, the cognitive control response process is changed, and if the neurofeedback training that adjusts the EEG frequency power is performed with the changed, the patient will be treated autonomously without artificially suppressing the tic. The results of the research test suggest that if the tic patient does not artificially synchronize mu waves in the premotor cortex (Frontal Cortical 3 site), and if EEG control is performed autonomously like neurofeedback training, as a result, tics do not occur. Cognitive control response processes are altered when a subject is inhibited from tics. By training the altered cognitive control with neurofeedback that modulates EEG frequency power, the patient can be treated autonomously without artificially suppressing the tic.Mu-wave synchronizationcan now be added to existing neurofeedback treatment protocols such as SMR reinforcement, theta-beta-wave imbalance correction, and alpha-wave reinforcement. This study will be used in follow-up studies and clinical trials to more scientifically verify the neurofeedback treatment protocol, a treatment for patients with Tourette's syndrome.

Individualized Traditional Korean Acupuncture for Knee Osteoarthritis : a Protocol for a Randomized Controlled Trial

  • Byun, Hyuk;Baek, Seung-Tae;Park, In-Shik;Kim, Kap-Sung;Kim, Sun-Woong;Choi, Sun-Mi;Lee, Seung-Deok
    • The Journal of Korean Medicine
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    • v.27 no.4
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    • pp.225-232
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    • 2006
  • Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

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Gemcitabine And Cisplatin Followed by Chemo-Radiation for Advanced Nasopharyngeal Carcinoma

  • Jamshed, Arif;Hussain, Raza;Iqbal, Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.899-904
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    • 2014
  • Concurrent chemo-radiation (CRT) has been established as the standard of care for non-metastatic loco-regionally advanced nasopharyngeal carcinoma (NPC) but recently the addition of induction chemotherapy in the already established regimen has presented an attractive multidisciplinary approach. This retrospective study was carried out to evaluate the efficacy of induction chemotherapy (IC) followed by CRT for the management of loco-regionally advanced NPC. Between July 2005 and September 2010, 99 patients were treated with cisplatin based IC followed by CRT. Induction chemotherapy included a 2 drug combination; intravenous gemcitabine $1000mg/m^2$ on day 1 and 8 and cisplatin $75mg/m^2$ on day 1 only. Radiotherapy (RT) was given as a phase treatment to a total dose of 70 Gy in 35 fractions. Concurrent cisplatin ($75mg/m^2$) was administered to all patients on days 1, 22 and 43. All patients were evaluated for tumor response and adverse effects after IC and 6 weeks after the completion of the treatment protocol. Statistical analysis was performed using SPSS version 17 and Kaplan Meier estimates were applied to project survival. Median follow-up duration was 20 months. The 5-year overall survival (OS), loco regional control (LRC) and relapse free survival (RFS) rates were 71%, 73% and 50%respectively. Acute grade 4 toxicity related to induction chemotherapy and concurrent chemo-radiation was 4% and 2% respectively, with only 3 toxicity-related hospital admissions. We conclude that induction gemcitabine and cisplatin followed by chemo-radiation is a safe and effective regimen in management of nasopharyngeal carcinoma, meriting further investigation in randomized clinical trials.

Acupuncture for Chronic Fatigue Syndrome and Idiopathic Chronic Fatigue : a Protocol for a Pilot Randomized Controlled Trial (만성피로증후군과 특발성 만성피로에 대한 침 치료의 유효성 및 안전성 평가 : 무작위 대조 예비 임상연구 프로토콜)

  • Kim, Jung-Eun;Kang, Kyung-Won;Kim, Tae-Hun;Jung, So-Yong;Kim, Ae-Ran;Shin, Mi-Suk;Park, Hyo-Ju;Hong, Kwon-Eui;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.28 no.3
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    • pp.151-163
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    • 2011
  • Objectives : Our aim is to evaluate feasibility for massive clinical research and to make basic analysis of efficacy and safety of acupuncture treatment for chronic fatigue syndrome and idiopathic chronic fatigue. Methods : This study is a protocol for a pilot randomized controlled trial. It was developed through literature searches and discussions among researchers. Results : Forty participants allocated to acupuncture group and wait-list group. Participants allocated to acupuncture group will be treated three times per week for a total of 12 sessions over four weeks. Eight points (GV20; bilatral GB20, BL11, BL13, BL15, BL18, BL20, BL23) have been selected for the acupuncture group. Participants in the wait-list group will not receive acupuncture treatment during study period and follow-up will be made in the 5th and 9th weeks after random allocation. Then the same acupuncture treatment as that performed to the acupuncture group will be made to the wait-list group. Fatigue Severity Scale, a short form of Stress Response Inventory, Beck Depression Inventory, and Insomnia Severity Index will be used as outcome variables to evaluate the efficacy of acupuncture. Safety will be assessed at every visit. Conclusions : The trial based on this study will be performed. The results of the trial will provide basis for the efficacy and safety of acupuncture treatment for chronic fatigue syndrome and idiopathic chronic fatigue.

Initial Clinical Experience with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Signet-Ring Cell Gastric Cancer with Peritoneal Metastase

  • Konigsrainer, Ingmar;Horvath, Philipp;Struller, Florian;Konigsrainer, Alfred;Beckert, Stefan
    • Journal of Gastric Cancer
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    • v.14 no.2
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    • pp.117-122
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    • 2014
  • Purpose: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been shown to improve survival in select patients with gastric cancer and peritoneal metastases. It remains unclear, however, whether this multimodal treatment protocol is also beneficial for signet-ring cell gastric cancer (SRC) patients with peritoneal metastases. Materials and Methods: Clinical data of patients scheduled for upfront systemic chemotherapy consisting of 5-FU (2,600 $mg/m^2$), folinic acid (200 $mg/m^2$), docetaxel (50 $mg/m^2$), and oxaliplatin (85 $mg/m^2$) followed by CRS and HIPEC using cisplatin (50 $mg/m^2$) at the Comprehensive Cancer Center, University Hospital T$\ddot{u}$bingen, Germany were retrospectively analyzed. Results: Eighteen consecutive patients for whom irresectability has been ruled out by a computed tomography scan were enrolled. However, complete cytoreduction could only be achieved in 72% of patients. When categorizing patients with respect to the completeness of cytoreduction, we found no difference between both groups considering tumor- or patient-related factors. The overall complication rate following complete cytoreduction and HIPEC was 46%. Within a median follow-up of 6.6 (0.5~31) months, the median survival for CRS and HIPEC patients was 8.9 months as opposed to 1.1 months for patients where complete cytoreduction could not be achieved. Following complete cytoreduction and HIPEC, progression-free survival was 6.2 months. Conclusions: In SRC with peritoneal metastases, the prognosis appears to remain poor irrespective of complete CRS and HIPEC. Moreover, complete cytoreduction could not be achieved in a considerable percentage of patients. In SRC, CRS and HIPEC should be restricted to highly selective patients in order to avoid exploratory laparotomy.