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Increase of Spoken Number of Syllables Using MIT(Melody Intonation Therapy) : Case Studies on older adult with stroke and aphasia (MIT(Melodic Intonation Therapy) 중심의 음악활동을 이용한 실어증을 가진 뇌졸중 노인의 음절 수 증가에 대한 사례 연구)

  • Hong, Do Kyoung
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.57-67
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    • 2005
  • Most of stroke patients have not only physical difficulty but speech and neurological disorder because of hemiplegia and such unexpected changes cause psychologic disadaptability and absent-mindedness. Particularly, lowering of physical ability can lead to serious emotional problem from failure or frustration in daily life. Generally, treatment of patient with stroke put emphasis on physical rehabilitation but actually this patient had considerable speech disorder such as aphasia or articulation disorder. Moreover, failing of recognition function, mental disorder as hypochondria, and even visual and auditory disorder are represented. So it is effective to integrate verbal remediation and other treatments in medical care environment. In particular, patients with language disorder very often wither psychologically therefore it is efficient to use of music therapy that gives opulent emotion to aphasia patients. And primarily to investigate the effects of 10 sessions treatments; change in spoken total number of syllables, to confirm their own value by success of given task and reassure about themselves ability. All of 10 sessions stages were scored by MIT manual and its improvement were measured, that is, accomplishment was analyzed within each level in order to prove detail change of spoken total number of syllables. The result of this program organized from 2 syllables to 4 syllables is summarized as follows. Subject A completed in preliminary stage Level I, in 2 syllables case advanced to Level III in fifth session and to Level IV in seventh session, in 3 syllables case advanced to Level III in seventh session and to Level IV in ninth session, and in 4 syllables case showed 8% low success rate in first session but after repeated practice increased considerably in sixth session and in advanced to Level III in eighth session to Level IV in tenth session. Subject B also completed in preliminary stage Level I, in 2 syllables case advanced to Level III in forth session and to Level IV in sixth session, in 3 syllables case advanced to Level III in fifth session and to Level IV in seventh session, and in 4 syllables case showed 10% low success rate in first session and increased considerably in fifth session and in advanced to Level III in seventh session but could not reach to Level IV until tenth session. As a result, it was shown that music therapy using MIT was not statistically meaningful but improved spoken total number of syllables and success rate of task had improved as a whole. Therefore, music intervention using MIT it has positive affect on verbal ability of patients with Broca's Aphasia and their language rehabilitation.

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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Performance Status of Sanitary Management of School Food Service in the Jeonnam Area (전남지역 학교급식의 위생관리 실태)

  • 고무석;정난희;이전옥
    • Korean Journal of Human Ecology
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    • v.7 no.1
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    • pp.51-67
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    • 2004
  • This study analyzed the effects of nutrition technicians' hygiene education on cooking workers' performance of hygiene management in order to ensure the security of school meals. The situation of cooking workers' disposition in subject schools was elementary school(51.1%) and middle school(48.9%) and the type of meals was rural area type(54.2%), urban type(36.5%). and island and isolated area type(9.3%). The methods of meals management were single cooking(88.2%) and joint cooking and management(11.8%). The type of distributing meals was distributing in a dining room(93.5%), in a classroom(3.7%), and in both dining room and classroom(2.8%). Nutrition technicians' employment form included regular(53.5%) and daily(88.2%). Their education was junior college graduate(50.2%), university graduate(44.8%). and graduate school students(5.0%). Cooking workers' employment form included daily(88.2%) and regular (11.1%). suggesting that most were regular. Most cooking workers(77.4%) had at least high school certificate. Regarding the situation of cooking workers' disposition in subject schools, the number of student per one cooking worker was found as 91-120(37.2%), 61-90(22.6%). 60 and under(21.l %). 121-15006.7%). and 151 and over(2.5%). Cooking workers' level of performance of hygiene management was post-working stage(66.37/75 marks), pre-working stage(64.22/75 marks). and working stage(20.34/25 marks), The counting of meals articles in a pre-working stage(20.34/25 marks). temperature and required time in a working stage(18.78/25 marks), and machinery equipment and hygiene in a pre-working stage(21.40/25 marks) showed lowest of performance, which suggest poor service of hygiene. Cooking workers' performance of hygiene management by working stage showed the significant difference with school class(p<.001), type of schools with meals(p<.05). state of cooking workers' employment(p<.001), and cooking worker's disposition(p<.05). A working stage showed the significant difference with type of schools with meals(p<.05). A post-working stage showed the significant difference according to type of schools with meals(p<.05), and the methods of meals management(p<.05), and cooking workers' disposition(p<.05). In the execution of hygiene education, individual hygiene was highest(94.8%), followed by the management of machinery equipment and tools(89.7%), food poisoning and microorganism(94.7%), and the method of food treatment(76.4%). A yearly plan of hygiene education included established(83.9%) and not established(l6.1%). Regular education included not executed(25.1%), 2-3 times a month(l6.1%), and more than 4 a month(4.0%) and occasional education was not executed(57.0%), 1-3 times a month(26.3%), and more than 4 a month(l5.7%). In the methods for hygiene education, oral education(95.7%) was used most, followed by demonstration(10.5%), poster/photo(10.5%), video/slide(3.7%), and computer(3.7%). Frequency of improvement and complement of hygiene education included once a month(56.3%), once a year(20.7%), by quarter(l1.5%), and every six months(1l.5%). Newspaper was used most in materials of hygiene education, followed by internet, TV, nutrition technician's reeducation, information exchange between members, educational office's training, and reference book, and educational office's material. and symposium. Cooking workers' assessment of the effect of hygiene education was conducted through observation(56.8%), check table(l5.2%), question(l4.0%), and examination(14.0%). The reason of cooking workers' low level of performance included habitual custom(53.9%), lack of understanding(20.4%), overwork(l4.6%), and lack of knowledge(l1.l%) and the reason of difficulty in hygiene education included lack of time(55.3%), lack of understanding(27.6%), lack of knowledge and information(8.7%), and lack of budget(48.0%).

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Effects of Educational Programs Utilizing Forests on Maladjusted Behavior of Mentally Retarded Students (숲을 활용한 교육이 정신지체학생의 부적응행동에 미치는 영향)

  • Park, Kyoung-Lee;Sim, Woo-Kyung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.5
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    • pp.64-79
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    • 2010
  • Students with intellectual disabilities typically have great difficulties communicating their needs and wants and may get frustrated, anxious or show signs of aggressive behaviour. They are often unable to understand the concept of relationships with other people as well. This lack of social communication and interaction leads to poor motivation which increases other areas of difficulty in their lives. Therefore, to teach students with intellectual disabilities, it is essential to find special teaching methods to support their positive behavior. This paper proposes that special educational curriculum for students with intellectual impairments utilize natural environments(forests) and materials. The purpose of this study was to investigate the effects of Educational Programs Utilizing Forests on maladjusted behavior of students with mental retardation and to examine the positive effects of such planning practices. The subjects were middle school students who attended a special school for mentally-retarded students. They were divided into two separate groups- an experimental group and a control group. All subjects received the pre and post test using the same method. This program was applied to the formal educational process of middle school from March 1st to October 30th, 2009. In this experiment the results indicate that the effect of using a natural environment(forest) and the materials within a formal educational curriculum was positive as a type of horticultural therapy and that it supports positive behavior strategies in students with intellectual impairments. The usage of various natural materials including plants and flowers within the natural environments provide students with increased opportunities to participate. Teaching methods including natural materials help teachers engage with their students more easily during routine activities as their interest is already stimulated. This project will help students with intellectual impairments to build skills which enable effective participation and increase independence throughout their lives. This should be embedded into both routine and planned activities of the classroom Also, it offers a needed interior plan for the treatment space through an analysis of psychological factors of how the environment affects students.

A Study on the Major Issues and Legislative Considerations of CCTV Installation in an Operating Room (수술실 CCTV 설치의 쟁점과 입법방향에 관한 소고(小考))

  • Kim, Sungeun;Choe, A Reum;Bae, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.111-138
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    • 2021
  • 'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

A Study on Effective Information Delivery of Digital Sign Systems in General Hospitals (종합병원 디지털 정보안내사인의 효과적 정보전달을 위한 연구)

  • Kim, Hwa Sil;Paik, Jin Kyung
    • Korea Science and Art Forum
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    • v.19
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    • pp.281-292
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    • 2015
  • For this study, I conducted a survey investigating current situation, user preference, and field experiment. Hospitals utilizing digital sign systems at least five years were selected, which are connected with visual elements (layout, typo, color) used in waiting areas and elements of the systems (time, video time line). The results obtained from the field survey showed that digital sign systems used the color of typo and background contrasted to one another to increase explicitness and to ensure easy understanding of contents. In addition, the Gothic typo with relatively high legibility was adopted. Time and video timeline, which characterize digital sign systems, showed the advertising screens of the hospitals and the guidance of medical treatment at regular intervals. Moreover, survey results on user satisfaction showed that a majority of respondents indicated they had difficulty in understanding digital information conveyed from digital sign systems due to time setting for rotational speed or the small size of typo although most of the users had previous experience with digital sign systems. The highest proportion of respondents (n=86, 86%) answered that information related to medical departments was what they sought most frequently and that this kind of information should be importantly considered in digital sign systems. For the experiment, new samples with restructured contents of current digital sign systems were created and tested while keeping its design unchanged as well as applying these new samples. Study participants were in their 20s through 50s. When the size of typo was larger under the same conditions for all age groups, study participants found the desired information approximately 3.5 seconds faster. In addition, those in their 20-30s and 40-50s showed the time difference of 4.7 seconds for small typo and 6 seconds for large typo, which suggested that there was a difference by age in the amount of time taken in the experiment to find the desired information from the rotating digital sign system regardless of age and the size of typo.

Image quality and usefulness evaluaton of 3D-CBCT and Gated-CBCT according to baseline changes for SBRT of Lung Cancer (폐암 환자의 정위체부방사선치료 시 기준선 변화에 따른 3D-CBCT(Cone Beam Computed-Tomography)와 Gated-CBCT의 영상 품질 및 유용성 평가)

  • Han Kuk Hee;Shin Chung Hun;Lee Chung Hwan;Yoo Soon Mi;Park Ja Ram;Kim Jin Su;Yun In Ha
    • The Journal of Korean Society for Radiation Therapy
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    • v.35
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    • pp.41-51
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    • 2023
  • Purpose: This study compares and analyzes the image quality of 3D-CBCT(Cone Beam Computed-Tomography) and Gated CBCT according to baseline changes during SBRT(Stereotactic Body RadioTherapy) in lung cancer patients to find a useful CBCT method for correcting movement due to breathing Materials and methods : Insert a solid tumor material with a diameter of 3 cm into the QUASARTM phantom. 4-Dimentional Computed-Tomography(4DCT) images were taken with a speed of the phantom at period 3 sec and a maximum amplitude of 20 mm. Using the contouring menu of the computerized treatment planning system EclipseTM Gross Tumor Volume was outlined on solid tumor material. Set-up the same as when acquiring a 4DCT image using Truebeam STxTM, breathing patterns with baseline changes of 1 mm, 3 mm, and 5 mm were input into the phantom to obtain 3D-CBCT (Spotlight, Full) and Gated-CBCT (Spotlight, Full) images five times repeatedly. The acquired images were compared with the Signal-to-Noise Ratio(SNR), Contrast-to-Noise Ratio(CNR), Tumor Volume Length, and Motion Blurring Ratio(MBR) based on the 4DCT image. Results: The average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Spotlight Gated CBCT images were 13.30±0.10%, 7.78±0.16%, 3.55±0.17%, 1.18±0.06%. As a result, Spotlight Gated-CBCT images according to baseline change showed better values than Spotligtht 3D-CBCT images. Also, the average Signal-to-Noise Ratio, Contrast-to-Noise Ratio, Tumor Volume Length and Motion Blurring Ratio of Full Gated CBCT images were 12.80±0.11%, 7.60±0.11%, 3.54±0.16%, 1.18±0.05%. As a result Full GatedCBCT images according to baseline change showed better values than Full 3D-CBCT images. Conclusion : Compared to 3D-CBCT images, Gated-CBCT images had better image quality according to the baseline change, and the effect of Motion Blurring Artifacts caused by breathing was small. Therefore, it is considered useful to image guided using Gated-CBCT when a baseline change occurs due to difficulty in regular breathing during SBRT that exposes high doses in a short period of time

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Effect of Bronchial Artery Embolization(BAE) in Management of Massive Hemoptysis (대량 객혈환자에서 기관지 동맥색전술의 효과)

  • Yeo, Dong-Seung;Lee, Suk-Young;Hyun, Dae-Seong;Lee, Sang-Haak;Kim, Seok-Chan;Choi, Young-Mee;Suh, Ji-Won;Ahn, Joong-Hyun;Song, So-Hyang;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Kim, Ki-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.53-64
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    • 1999
  • Background : Massive and untreated hemoptysis is associated with a mortality of greater than 50 percent. Since the bleeding is from a bronchial arterial source in the vast majority of patients, embolization of the bronchial arteries(BAE) has become an accepted treatment in the management of massive hemoptysis because it achieves immediate control of bleeding in 75 to 90 percent of the patients. Methods: Between 1990 and 1996, we treated 146 patients with hemoptysis by bronchial artery embolization. Catheters(4, 5, or 7F) and gelfoam, ivalon, and/or microcoil were used for embolization. Results: Pulmonary tuberculosis and related disorders were the most common underlying disease of hemoptysis(72.6%). Immediate success rate to control bleeding within 24hours was 95%, and recurrence rate was 24.7%. The recurrence rate occured within 6 months after embolization was 63.9%. Initial angiographic findings such as bilaterality, systemic-pulmonary artery shunt, neovascularity, aneurysm were not statistically correlated with rebleeding tendency(P>0.05). Among Initial radiographic findings, only pleural lesions were significantly correlated with rebleeding tendency(P<0.05). At additional bronchial artery angiograpy done due to rebleeding, recanalization of previous embolized arteries were 63.9%, and the presence of new feeding arteries were 16.7%, and 19.4% of patients with rebleeding showed both The complications such as fever, chest pain, headache, nausea and vomiting, arrhythmia, paralylytic ileus, transient sensory loss (lower extremities), hypotension, urination difficulty were noticed at 40 patients(27.4%). Conclusion: We conclude that bronchial artery embolization is relatively safe method achieving immediate control of massive hemoptysis. At initial angiographic findings, we could not find any predictive factors for subsequent rebleeding. It may warrant further study whether patients with pleural disease have definetely increased rebleeding tendency.

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Clinical Efficacy of Erdosteine in Patients with Acute or Chronic Bronchitis -A Randomized, Double Blind, Comparative Study vs. Ambroxol- (급.만성 기관지염 환자에서 엘도스$^{(R)}$(Erdosteine)의 임상효과 -염산 암브록솔과의 무작위 이중맹검 비교시험-)

  • Kim, Seok-Chan;Lee, Sang-Hoak;Song, So-Hyang;Kim, Young-Kyoon;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1296-1307
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    • 1997
  • Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

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