• Title/Summary/Keyword: 동시치료

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The Concurrent Validity of the Korean Occupational Balance Assessment(OBA) Tool (한국형 작업균형 평가(Occupational Balance Assessment)의 동시타당도 연구)

  • Hong, So-Young;Hong, Deok-Gi
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.2
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    • pp.1-9
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    • 2020
  • Objective : The purpose of this study was to establish the concurrent validity of the Korean Occupational Balance Assessment(OBA) tool. Methods : This study was conducted on 1016 people from October 1 to October 25, 2019. Data collection was performed using OBA and Occupational Balance Questionnaire11(OBQ11). The data were analyzed by descriptive statistics, Pearson correlation. Results : There was a significant correlation between the scores of the three areas of OBA and the total score of OBQ11(p<.01). All three areas were analyzed with positive correlations. The time use area (r = .554) and occupation frequency area (r = .574) were found to be correlated. Most of the sub-factors in the occupation characteristics area (importance r = .582, goal achievement r = .633, enjoyment r = .649, health r = .650) were analyzed with high correlation. Conclusion : OBA has proven to be a valid and reliable assessment tool for measuring occupational balance. Further research needs to provide guideline on occupational balance for usefulness in clinical area.

Management of Neuropathic Pain (신경병성 통증의 치료)

  • Kim, Yeong-In
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.274-280
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    • 1999
  • A variety of mechanism may generate pain resulting from injury to the central and peripheral nervous system. None of these mechanism is disease-specific, and several different pain mechanism may be simultaneously present in anyone patient, independent of diagnosis. Diagnosis of neuropathic pain is often easily made from information gathered on neurologic examination and from patient history. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if the neurologist has a complete understanding of therapeutic options, the mainstay of which is pharmacotherapy. Selection of an appropriate rharmacologic agent is by trial and error since individual responses to different agents, doses, and serum levels are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuropathic pain. Tricyclic antidepressants are first-line agents, although other drugs, including anticonvulsants, local anesthetic antiarrhythmics, clonidine, opiates, and certain topical agents, also offer pain relief in some patient populations. The novel antidepressants venlafaxine and nefazodone are potentially useful new drugs that are better tolerated than tricyclic antidepressants. Also Gabapentine seems an interesting and promising drug for the treatment of neuropathic pain.

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Application and therapeutic effects of sickle red blood cells for targeted cancer therapy (표적항암치료를 위한 겸형적혈구의 응용 및 치료 효과)

  • Choe, Se-woon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.12
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    • pp.2395-2400
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    • 2016
  • Conventional drug carriers such as liposomes, nanoparticles, polymer micelles, polymeric conjugate and lipid microemulsion for cancer chemotherapy shield normal tissues from toxic drugs to treat cancer cells in tumors. However, inaccurate tumor targeting uncontrolled drug release from the carriers and unwanted accumulation in healthy sites can limit treatment efficacy with current conventional drug carriers with insufficient concentrations of drugs in the tumors and unexpected side effects as a result. Sickle red blood cells show natural tumor preferential accumulation without any manipulation due to the adhesive interaction between molecular receptors on the membrane surface and counter-receptor on endothelial cells. In addition, structural changes of microvascular in tumor sites enhances polymerization of sickle red blood cells. In this research, we examined the use of sickle red blood cells as a new drug carrier with novel tumor targeting and controlled release properties to quantify its therapeutic effects.

Radiation Therapy for T2N0 Glottic Cancer (T2N0 병기 성문암의 방사선치료)

  • Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.217-222
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    • 2006
  • $\underline{Purpose}$: This study evaluated the results of definitive radiation therapy and the prognostic factors that affect survival rates for T2N0 glottic cancer patients. $\underline{Materials\;and\;Methods}$: Thirty patients with T2N0 glottic cancer who were treated with definitive radiation therapy at our institution between September 1986 and June 2004 were retrospectively reviewed. All patients were pathologically confirmed as having squamous cell carcinoma and were staged as AJCC T2N0. The age of the patients ranged from 39 to 79 (median 62) years and all were male. A total dose of $66{\sim}70\;Gy$ (median 66 Gy) was delivered with a 6-MV linear accelerator in $6.5{\sim}7$ weeks. The median follow-up period was 63 months. $\underline{Results}$: The actuarial disease-free survival rate for the entire group of the patients was 79% at 5 years. The five-year disease-free survival rates for patients without and with subglottic extension were 90% and 56%, respectively (p=0.03). However, anterior commissure involvement, supraglottic extension, and impaired cord mobility were not statistically significant prognostic factors. The five-year disease-free survival rates for patients with and without concurrent chemotherapy were 86% and 69%, respectively (p=0.47). $\underline{Conclusion}$: Subglottic extension can be considered a poor prognostic factor for T2N0 glottic cancer.

REPAIR OF BILATERAL CLEFT LIP AND NOSE: PRINCIPLES AND METHODS OF MULLIKEN (양측 구순열비의 교정술: Mulliken의 원칙과 방법)

  • Jung, Young-Soo;Mulliken, John B.;Sullivan, Stephen R.;Padwa, Bonnie L.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.353-360
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    • 2009
  • The principles for repair of bilateral cleft lip and nasal deformity are 1) symmetry, 2) primary muscular continuity, 3) proper philtral size and shape, 4) formation of the median tubercle and vermilion-cutaneous ridge from lateral labial elements, and 5) primary positioning of the alar cartilages to construct the nasal tip and columella. The authors underscore the essential role of preoperative premaxillary positioning for the synchronous closure of the cleft lip and primary palate, and describe Mulliken's operative technique. We discuss three-dimensional adjustments based on predicted fourth-dimensional changes. In a consecutive series of 50 patients, no revisions were necessary for philtral size or columellar length. Preoperative premaxillary positioning and primary repair of bilateral cleft lip and nasal deformity may impair maxillary growth. Nevertheless, a symmetric nasolabial appearance, rather than emphasis on maxillary growth, is the priority for the child with bilateral cleft lip.

Occupational Therapy Student's Experience of Interruption of Fieldwork Practice due to COVID19 : Phenomenological Study (작업치료 전공 학생들의 코로나19로 인한 실습 중단 경험: 현상학적 연구)

  • Jung, Nam-Hae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.473-479
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    • 2020
  • This study examined the meaning of the experiences of university students majoring in occupational therapy, where their practice was discontinued due to COVID-19, and to provide basic data for future measures. This study was a phenomenological study. The subjects of this study were seven students. Interviews were analyzed according to Colaizzi data analysis. As a result of an interview, it was organized into 17 themes, six themes clusters, and two categories. The themes clusters were indifference, problem recognition, wandering, coping, aftermath, and anticipation for coping. The students experienced a confused and frustrating situation after recognizing the problem of COVID-19 and experienced anxiety and regret as they experienced the interruption of their fieldwork. The students expected all universities to implement a batch and quick response at the same time. In the future, a systematic communication and delivery system is needed to quickly prepare and implement countermeasures at the same time as institutions, associations, and universities.

Analysis on Characteristics of Therapeutic Factors of VRAT(Virtual Reality Art Therapy) Contents (가상현실 미술치료 (VRAT) 콘텐츠의 치료적 요인 특성에 대한 분석)

  • Rim, Sung-Ryun
    • The Journal of the Korea Contents Association
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    • v.22 no.4
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    • pp.1-12
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    • 2022
  • Since the early 20th century, along with the interest and development of alternative psychotherapy, the field of art therapy has also been developed and expanded. In particular, the recent development of technology and the untact era brought about by the COVID-19 Pandemic is accelerating the development of new digital art therapy contents. Among them, the hot interest in virtual reality is raising expectations and questions about the effectiveness of psychotherapy given by new media beyond traditional art therapy. In this study, the characteristics of VRAT (Virtual Reality Art Therapy) content therapeutic factors were investigated through qualitative literature analysis based on the conceptual framework and therapeutic components of ETC (Expressive Therapies Continumm), an integrated art therapy theory. As a result of the study, VRAT contents showed mostly therapeutic factors in the left hemisphere that triggered the user's dynamic, perceptual, and cognitive factors, and the therapeutic factors in the right hemisphere, which focused on sensory, emotional, and symbolic factors, were relatively few. The reason seems to be due to the nature of the experimental stage, the absence of active intervention by the therapist and long-term session composition, and the fear, clumsiness, and unfamiliarity of users about VRAT in addition to the characteristics and technical limitations of the VRAT medium. The limitations of the study include the small number of documents to be analyzed and the insufficient form of current VRAT to be called art therapy. It is expected that the characteristics of the therapeutic factors of VRAT content media and environment derived as a result of this study will be usefully used for the appropriate development of VRAT content in the future.

Once vs. Twice Daily Thoracic Irradiation in Limited Stage Small Cell Lung Cancer (국한성 병기 소세포폐암의 방사선치료시 분할 조사방식에 따른 치료성적)

  • Kim, Jun-Sang;Kim, Jae-Sung;Kim, Ju-Ock;Kim, Sun-Young;Cho, Moon-June
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.291-301
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    • 1998
  • Purpose : A retrospective study was conducted comparing single daily fraction (SDF) thoracic radiotherapy (TRT) with twice daily (BID) TRT to determine the potential benefit of BID TRT in limited-stage small cell lung cancer (SCLC). Endpoints of the study were response. survival, pattern of failure, and acute toxicity. Materials and Methods : Between November 1989 to December 1996, 78 patients with histologically proven limited-stage SCLC were treated at the Department of Therapeutic Radiology, Chungnam National University Hospital. Of these, 9 were irradiated for palliative intent, and 1 had recurrent disease. Remaining 68 patients were enrolled in this study. There were 26 patients with a median age of 58 years, and 22 (85$\%$) ECOG performance score of less than 1 in SDF TRT. There were 42 patients with a median age of 57 years, and 36 (86$\%$) ECOG performance score of less than 1 in BID TRT By radiation fractionation regimen, there were 26 in SDF TRT and 42 in BID TRT. SDF TRT consisted of 180 cGy, 5 days a week. BID TRT consisted of 150 cGy BID, 5 days a week in 13 of 42 and 120 cGy BID, in 29 of 42. And the twice daily fractions were separated by at least 4 hours. Total radiotherapy doses were between 5040 and 6940 cGy (median, 5040 cGy) in SDF TRT and was between 4320 and 5100 cGy (median, 4560 cGy) in BID TRT. Prophylactic cranial irradiation (PCI) was recommended for patients who achieved a CR. The recommended PCI dose was 2500 cGy/10 fractions. Chemotherapy consisted of CAV (cytoxan 1000 mg/$m^2$, adriamycin 40 mg/$m^2$, vincristine 1 mg/$m^2$) alternating with VPP (cisplatin 60 mg/$m^2$, etoposide 100 mg/$m^2$) every 3 weeks in 25 (96$\%$) of SDF TRT and in 40 (95$\%$) of BID TRT. Median cycle of chemotherapy was six in both group. Timing for chemotherapy was sequential in 23 of SDF TRT and in 3 BID TRT, and concurrent in 3 of SDF TRT and in 39 of BID TRT Follow-up ranged from 2 to 99 months (median, 14 months) in both groups. Results : Of the 26 SDF TRT, 9 (35$\%$) achieved a complete response (CR) and 14 (54$\%$) experienced a partial response (PR). Of the 42 BID TRT, 18 (43$\%$) achieved a CR and 23 (55$\%$) experienced a PR. There was no significant response difference between the two arms (p=0.119). Overall median and 2-year survival were 15 months and 26.8$\%$, respectively. The 2-year survivals were 26.9$\%$ and 28$\%$ in both arm, respectively (p=0.51). The 2-rear survivals were 35$\%$ in CR and 24.2$\%$ in PR, respectively. The grade 2 to 3 esophageal toxicities and grade 2 to 4 neutropenias were more common in BID TRT (p=0.028 0.003). There was no difference in locoregional and distant metastasis between the two arms (p=0 125 and 0.335, respectively). The most common site of distant metastasis was the brain. Conclusion : The median survival and 2-year survival were 17 months and 20.9$\%$ in SDF TRT with sequential chemotherapy, and 15 months and 28$\%$ in BID TRT with concurrent chemotherapy, respectively. We did not observe a substantial improvement of long-term survival in the BID TRT with concurrent chemotherapy compared with standard schedules of SDF TRT with sequential chemotherapy. The grade 2 to 3 esophageal toxicities and glade 2 to 4 neutropenias were more common in BID TRT with concurrent chemotherapy. Although the acute toxicities were more common in BID TRT with concurrent chemotherapy than SDF TRT with sequential chemotherapy, a concurrent chemotherapy and twice daily TRT was feasible. However further patient accrual and long-term follow up are needed to determine the potential benefits of BID TRT in limited-stage SCLC.

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Preoperative Concurrent Radio-chemotherapy for Rectal Cancer: Report of Early Results (직장암에 대한 수술 전 동시병용 방사선-항암 화학요법: 초기 치료결과 보고)

  • Shin, Seong-Soo;Ahn, Yong-Chan;Chun, Ho-Kyung;Lee, Woo-Yong;Kang, Won-Ki;Park, Young-Suk;Park, Joon-Oh;Song, Sang-Yong;Lim-Do-Hoon;Park, Won;Lee, Jung, Eun;Kang, Min-Kyu;Park, Yung-Je
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.125-134
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    • 2003
  • Purpose: To report the early results of preopeartive concurrent radio-chemotherapy (CRCT) for treating rectal cancer. Materials and Methods: From June 1999 to April 2002, 40 rectal cancer patients who either had lesions with a questionable resectability or were candidates for sphincter-sacrificing surgery received preoperative CRCT. Thirty-seven patients completed the planned CRCT course. 45 Gy by 1.8 Gy daily fraction over 5 weeks was delivered to the whole pelvis in the prone position. The chemotherapy regimens were oral UFT plus oral leucovorin (LV) in 12 patients, intravenous bolus 5-FU plus LV in 10 patients, and intravenous 5-FU alone in 15 patients (bolus infusion in 10, continuous infusion in 5). Surgery was planned in 4$\~$6 weeks of the completion of the preoperative CRCT course, and surgery was attempted in 35 patients. Results: The compliance to the current preoperative CRCT protocol was excellent, where 92.5$\%$ (37/40) completed the planned treatment. Among 35 patients, in whom surgery was attempted after excluding two patients with new metastatic lesions in the liver and the lung, sphincter-preservation was achieved in 22 patients (62.9$\%$), while resection was abandoned during laparotomy in two patients (5.7$\%$). Gross complete resection was peformed in 30 patients, gross incomplete resection was peformed in one patient, and no detailed information on the extent of surgery was available in two patients. Based on the surgical and pathological findings, the down-staging rate was 45.5$\%$ (15/33), and the complete resection rate with the negative resection margin 78.8$\%$ (26/33). During the CRCT course, grade 3 $\~$4 neutropenia developed in four patients (10.8$\%$). Local recurrence after surgical resection developed in 12.1$\%$ (4/33), and distant metastases after the preoperative CRCT start developed in 21.6$\%$ (8/37). The overall 3-years survival rate was 87$\%$. Conclusion: Preoperative CRCT in locally advanced rectal cancer is well tolerated and can lead to high resection rate, down-staging rate, sphincter preservation rate, however, longer term follow-up will be necessary to confirm these results.

Development of Medical Examination and Treatment System for Dental Clinic (치과병원 전산화를 위한 통합 진료 시스템 구축)

  • 채옥삼;강승훈
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.40 no.2
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    • pp.26-37
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    • 2003
  • Unlike a medical doctor, a dentist performs all the tasks necessary for diagnosis and treatment of a disease all by himself. To increase the diagnostic accuracy, dentists need an efficient working environment providing much more integrated information of clinical data and radiographic image. In this paper, we propose an integrated environment for the dental hospital. It provides paperless and filmless hospital environment by integrating seamlessly three major operations for the dental hospital including patient record generation and management, clinical image acquisition and analysis, and treatment planning and simulation. This system also allows clinicians to provide more predictable dental care for the patients by supporting instant access to all the clinical data and quantitative data analysis.