• Title/Summary/Keyword: 동시치료

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A Survey of Physical Therapy Clinical Progress Note in Korea (한국 물리치료사의 임상기록에 대한 조사연구)

  • Kim, Seung-Joon
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.485-492
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    • 2005
  • 환자에 대한 기록은 일정한 형식을 가지고 환자 내원 초기부터 환자 및 의료진의 요구와 관리목적에 부합한 효과적인 평가, 치료계획, 치료적 중재를 수립할 수 있게 만드는 필수적인 일련의 상호관련학적 의사소통 도구임과 동시에 치료사가 환자관리에 포함된 사고 과정을 분석하는 데 도움을 주며 문제해결에 대한 사고를 체계화하는데 있어 중요한 역할을 한다. 본 연구의 목적은 물리치료사의 일반적 특성과 임상기록의 실태, 임상기록의 중요성을 인식하고 임상활동의 문제점을 개선하며 기록의 체계화를 이루어 임상기록의 활성화와 나아가 물리치료의 질적 향상과 물리치료 서비스에 대한 효율성을 높이는데 있다. 이 연구는 전국 의료기관이나 보건관련기관에서 근무하는 물리치료사를 선정하였다. 2005년 7월1일부터 8월30일 사이에 구조화된 설문지 320매를 직접 전달해 치료사가 작성한 설문지 314매를 직접 수거하였다. 분석 방법으로는 백분율과 빈도, Kuskal-Wallis Test. Pearson Chi-Square, Mann-Whitney U로 검정하였다. 잘못 표기한 응답자 1명을 제외한 응답자 총 313명 중 남자 142명 (45.2%), 여자 171명 (54.5%) 이었으며, 25세 이상 29세 이하 연령층이 119명 (37.9%)으로 가장 많이 분포하였다. 근무처에 따른 근무 개월, 일일 평균 환자수는 통계학적 검정으로 유의한 차이가 있는 것으로 나타났다(p<.05). 근무처에 따른 임상기록 작성에서도 통계학적 검정이 유의하였다(p<.05) 임상기록 작성이 효율적인 치료. 치료사 만족도에도 통계학적으로 유의한 결과가 나타났다(p<.05).

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Simultaneous Bilateral Clavicle Fractures - A Case Report - (외상으로 동시에 발생한 양측 쇄골 골절 - 증례 보고 -)

  • Chang, Kee-Young;Roh, Kwon-Jae;Yun, Geon-Ung;Shin, Sang-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.125-128
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    • 2009
  • Bilateral clavicle fractures caused by a strong external force acting at the same time is a rare case. While unilateral clavicle fracture with conservative treatment shows satisfactory clinical outcome, bilateral clavicle fractures with it has drawbacks such as severe pain, difficulty in rehabilitation and breathing. We experienced a rare case of bilateral clavicle fractures with multiple rib fractures, hemo-thorax and transverse process fracture of thoracic vertebra treated with surgical intervention promoted functional recovery and comfortable breathing. So, we report this case with article review.

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EMR Management system for the patient management (환자관리를 위한 EMR 관리 System)

  • Youn, Sek-Koun;Song, Jeong-Young
    • The Journal of Engineering Research
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    • v.8 no.1
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    • pp.79-85
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    • 2006
  • 일반적으로 Electronic Medical Record(EMR) 과 OCS를 통해 환자의 계속적인 치료와 결과, 향후 치료방향 등을 결정한다. EMR 내용은 각개 병원소유 양식으로, 소유권을 인정 함과 동시에 장려 정책을 통해 확산 발전시켜야 할 필요가 있다. 여기에서 유의 해야 할 점은, EMR이 작성되고, 전자서명이 끝난 Data는 그 내용이 임의로 변경 또는 훼손 되어서는 안된다. 현재는 각 병원에서만 환자정보를 제어, 관리하고 있으므로, 의료 분쟁 또는 Data의 손실로 인한 몇 가지 문제가 발생할 소지가 있다. 본 논문에서는, 각 병원에서 사용하고 있는 EMR의 내용을 전자서명을 통해 객관적인 인증과 동시에 환자 개인의 정보보호에도 문제가 없는 system 구축에 대하여 논하고, 실제로 검증해 본다.

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Muscle Function and Cognitive Enhancement Program for Parkinson's Patients (파킨슨 환자를 위한 근 기능 및 인지능력 통합 향상 프로그램)

  • Jeung, ye-chan;Choi, Hyun-hee
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2019.07a
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    • pp.145-146
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    • 2019
  • 본 논문에서는 파킨슨병이 우리 사회에서 증가하고 있고 노인들 만이 아니라 젊은 사람들에게도 나타날 수 있기 때문에 환자들을 위해 근 기능 및 인지능력을 향상 시키는게 목표이다. 파킨슨병은 현재까지 원인이 알려지지 않았지만 도파민 세포가 손상되는 것으로 알려져 있기 때문에 아직은 약물치료와 식이요법 치료를 통해 질환의 증상을 중지시키거나 느리게 할 수 없다. 파킨슨병의 증강 중 가장 중심이 되는 근 기능 문제와 인지능력을 동시에 향상 시킬 수 있는 기대를 할 수 있으며 이것을 통해 다른 증상들도 느려 질 수 있도록 하는 기대를 할 수 있다. 프로그램을 통한 근 기능 능력이나 인지능력을 동시에 향상하고 대상자 개개인의 능력에 맞게 운동을 할 수 있는 프로그램을 개발하는데 목적이 있는 연구이다.

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Outcome of Locally Advanced Esophageal Cancer Treated with Concurrent Chemo-radiotherapy (국소진행된 식도암에서 동시적 항암화학방사선요법의 결과)

  • Jang, Hyun-Soo;Kang, Seung-Hee;Lee, Sun-Young;Jo, Sun-Mi;Oh, Young-Taek;Chun, Mi-Son;Choi, Jin-Hyuk;Kang, Seok-Yun
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.71-77
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    • 2009
  • Purpose: We investigated the outcome and the prognostic factors of patients with locally advanced esophageal cancer who were treated with concurrent chemo-radiotherapy. Materials and Methods: Two hundred forty six patients with esophageal cancer that were treated by radiotherapy between January 1994 and July 2007. Of these, 78 patients who received radiotherapy of $\geq$45 Gy with concurrent chemotherapy were retrospectively enrolled in this study. We included patients stages IIA, IIB, III, IVA, and IVB with supraclavicular metastasis in the middle/lower esophageal cancer or celiac node metastasis in cervical or upper/middle thoracic esophageal cancer. The median radiation dose was 54 Gy and the combination chemotherapy with 5-FU and cisplatin (FP chemotherapy) was given concurrently with radiotherapy in most patients (88%). Results: The follow-up period ranged from 2 to 117 months (median 14 months). The treatment response of the 54 patients could be evaluated by computerized tomography or endoscopy. A complete response (CR) was observed in 17 patients, whereas a partial response was observed in 18 patients. In patients with a CR, the median recurrence time was 20 months and the first relapse sites constituted a locoregional failure in 3 patients and a distant failure in 7 patients. The 1-, 2-, and 5-year overall survival (OS) rates were 58.9%, 21.7%, and 12.2%, respectively. The median survival period was 14 months. A univariate analysis indicated that the treatment response and cycles of FP chemotherapy were significant prognostic factors for OS. Daily or weekly administration of cisplatin as a radiosensitizer showed a better treatment response than FP chemotherapy. Conclusion: This study has shown that results of concurrent chemo-radiotherapy in patients with locally advanced esophageal cancer is comparable to those of other studies. Daily or weekly cisplatin administration may be considered as an alternative treatment in patients that are medically unfit for FP chemotherapy.

The Results of Radiotherapy in Locally Advanced, Unresectable Pancreatic Cancer (절제 불가능한 국소 진행된 췌장암에서 방사선치료의 결과분석)

  • Jang, Hyun-Soo;Kang, Seung-Hee;Kim, Sang-Won;Chun, Mi-Son;Jo, Sun-Mi;Lim, Jun-Chul;Oh, Young-Taek;Kang, Seok-Yun
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.145-152
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    • 2009
  • Purpose: We retrospectively studied the outcomes and prognostic factors of patients with locally advanced, unresectable pancreatic cancer who were treated with concurrent chemoradiotherapy (CCRT) or radiotherapy only. Materials and Methods: Fifty-one patients with locally advanced, unresectable pancreatic cancer (stage IIA~III) who recevied radiotherapy ($\geq$30 Gy) between January 1994 and August 2008 were reviewed retrospectively. The median radiation dose was 39 Gy. Chemotherapy consisted of gemcitabine, cisplatin, or 5-FU alone or in various combinations, and was administered concurrently with radiotherapy in 38 patients. Results: The follow-up period ranged from 2~40 months (median, 8 months). The median survival, and the 1-and 2-year overall survival (OS) rates were 7 months, 15.7%, and 5.9%, respectively. Based on univariate analysis, the baseline CA19-9, performance status, and chemotherapy regimen were significant prognostic factors. The median survival was 8 months for CCRT, and 6 months for radiotherapy alone. The patients treated with gemcitabine-containing regimens had longer survival (median, 10 months) than the patients treated with radiotherapy alone (p=0.027). Twenty-three patients were available to evaluate the patterns of failure. Distant metastases (DM) occured in 18 patients and regional recurrences were demonstrated in 4 patients. Local progression developed in 14 patients. We analyzed the association between the time-to-DM and the baseline CA19-9 levels for 18 evaluable patients. The median time-to-DM was 20 months for patients with normal baseline CA19-9 levels and 2 months for patients with baseline CA19-9 levels $\geq$200 U/ml. Conclusion: CCRT with gemcitabine-based regimens was effective in improving OS in patients with locally advanced, unresectable pancreatic cancer. We suggest that the baseline CA19-9 level is valuable in determining the treatment strategy for patients with locally advanced, unresectable pancreatic cancer.

Effects of Combined Therapeutic Exercise on Improvement of Respiratory Function and Trunk Posture in Elderly Patients with Restrictive Lung Disease (치료적 복합운동이 제한성 폐질환 노인의 호흡기능과 체간자세 개선에 미치는 효과)

  • Wang, Joong-San
    • Journal of Digital Convergence
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    • v.13 no.9
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    • pp.333-339
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    • 2015
  • The purpose of this study was to examine the effects of trunk mobilization and stretching activities on respiratory function, trunk posture, and physical fatigue for elderlies with restrictive lung diseases and related respiratory impairment. The present study was conducted with ten subjects, participating for eight weeks between January and November 2014. Subjects performed trunk mobilization and stretching routines for 30 minutes per day for three days each week. The study results showed that there were significant improvements in FVC and FEV1, trunk posture, trunk movement and physical fatigue(p<.05). The study results verified that trunk mobilization and stretching activities can be used as respiratory orthopedic manual therapy to improve respiratory function, trunk posture, trunk movement and physical fatigue simultaneously for elderly with respiratory impairment. Continuous studies through therapeutic convergence with the exercise field along with the respiratory orthopedic manual therapy that used in this study for elderly people with restrictive lung diseases will be necessary for the future.

Visualization of Variation Analysis for Multi-time Dynamic Cardiac Model (시간대별 동적 심장 모델의 변이 분석 가시화`)

  • 김민정;최유주;김명희
    • Proceedings of the Korean Information Science Society Conference
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    • 2002.04a
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    • pp.751-753
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    • 2002
  • 본 논문에서는 여러 시간대에 걸쳐 획득한 영상 데이터 집합에 대하여 동적 모델을 이용한 데이터들의 동시 가시화를 수행하고, 각 모델들 간의 변이를 분석하여 객관적인 영상 분석결과를 가시화해주는 연구를 수행하였다. 먼저 동적 모델의 동시 가시화를 위하여 동적 모델 데이터의 저장 및 로딩 모듈을 설계하였고, 동적 모델들간의 변이 분석은 체적, 속도를 비교 가시화함으로써 이루어졌다. 이를 한 환자에대하여 치료기간 중 일정 시간대별로 획득된 심장영상 집합들에 적용함으로써 기존의 영상분석의 한계점을 극복하고 심장 질환의 진단을 효율적으로 도울 수 있도록 하였다.

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Phase II Study of Induction Irinotecan + Cisplatin Chemotherapy Followed by Concurrent Irinotecan + Cisplatin Plus Twice-Daily Thoracic Radiotherapy (유제한성 병기의 소세포 폐암에서 3주 간격으로 시행된 irinotecan과 cisplatin을 이용한 과다분할 방사선 동시 요법)

  • Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Cho, Moon June;Kim, Jin Hwan;Lee, Choong Sik;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.154-164
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    • 2007
  • Background: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. Irinotecan also can act as a potential radiation sensitizer along with cisplatin. To evaluate efficacy and toxicity of irinotecan plus cisplatin (IP) with concurrent thoracic radiotherapy, we conducted a phase II study of IP followed by concurrent IP plus hyperfractionated thoracic radiotherapy in patients with previously untreated limited-stage small-cell lung cancer. Methods: Twenty-four patients with previously untreated small-cell lung cancer were enrolled onto the study since November 2004. Irinotecan $60mg/m^2$ was administered intravenously on days 1 and 8 in combination with cisplatin $60mg/m^2$ on day1 every 21 days. From the first day of third cycle, twice-daily thoracic irradiation (total 45 Gy) was given. Prophylactic cranial irradiation was given to the patients who showed complete remission after concurrent chemoradiotherapy. Restaging was done after second and sixth cycle with chest CT and/or bronchosocpy. Results: Up to November 2004, 19 patients were assessable. The median follow-up time was 12.5 months. A total of 99 cycles (median 5.2 cycles per patient) were administered. The actual dose intensity values were cisplatin $19.6mg/m^2$/week and irinotecan $38.2mg/m^2$/week. Among the 19 patients, the objective response rate was 95% (19 patients), with 9 patients (47%) having a complete response (CR). The major grade 3/4 hematological toxicities were neutropenia (35% of cycles), anemia (7% of cycles), thrombocytopenia (7% of cycles). Febrile neutropenia was 4% of cycles. The predominant grade 3/4 non-hematological toxicities was diarrhea (5% of cycles). Toxicities was not significantly different with concurrent administration of irinotecan and cisplatin with radiotherapy, except grade 3/4 radiation esophagitis (10% of patients). No treatment-related deaths were observed. The 1-year and 2-year survival rate of eligible patients was 89% (16/18) and 47% (9/18), respectively. Conclusion: Three-week schedule of irinotecan plus cisplatin followed by concurrent IP plus hyperfractionated thoracic radiotherapy is an effective treatment for limited disease small-cell lung cancer, with acceptable toxicity.