• Title/Summary/Keyword: 보조적치료

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Neoadjuvant Chemotherapy and Radiation Therapy in Advanced Stage Nasopharyngeal Carcinoma (진행된 병기의 비인강암에서의 선행보조 항암화학요법과 방사선치료)

  • Hong Semie;Wu Hong-Gyun;Park Charn II
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.275-280
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    • 1999
  • Purpose : To assess the feasibility and the toxicity of the neoadjuvant chemotherapy on the treatment of patients with locoregionally advanced nasopharyngeal carcinoma. Methods and Materials : We analyzed 77 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with neoadjuvant chemotherapy followed by radiation therapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows : AJCC stage III-2, stage IV-75. Sixty-six patients received infusion of 5-FU (1000 mg/m$^2$, on Day 1$\~$5) and cisplatin (100 mg/m$^2$, on Day 1), eleven patients received infusion of 5-FU (1000 mg/m$^2$, on Day 1 $\~$5) and carboplatin (300 mg/m$^2$, on Day 1) as neoadjuvant chemotherapy Prior to radiation therapy. The median follow-up for surviving patients was 44 months. Results : The overall chemotherapy response rates were 87$\%$. The toxicities of chemotherapy were mild. Only 3 patients experienced Grade 3 toxicities (1 for cytopenia, 2 for nause/vomiting). The degree of radiation induced mucositis was not severe, and ten patients developed Grade 2 mucositis. The 5-year overall survival rates were 68$\%$ and the 5-year disease free survival rates were 65$\%$. The 5-year freedom from distant metastasis rates were 82$\%$ and 5-year locoregional control rates were 75$\%$. Conclusion : This single institution experience suggests that neoadjuvant chemotherapy improves overall survival and disease free survival for patients with advanced stage nasopharyngeal carcinoma without increase of toxicity.

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The Usefulness of a Percutaneous Cardiopulmonary Support Device for the Treatment of Fulminant Myocarditis (전격성 심근염의 치료에 있어 경피적 순환 보조 장치의 유용성)

  • Lim, Juyoug;Jung, Sung Ho;Je, Hyoung-Gon;Lee, Taek Yeon;Choo, Suk Jung;Lee, Jae Won;Chung, Cheol Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.20-24
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    • 2010
  • Background: Fulminant myocarditis is a rare, but life threatening condition. Its prognosis is related with proper management in the acute phase. A cardiopulmonary support device can be very useful in this phase. We report on our experiences with managing acute fulminant myocarditis with a cardiopulmonary support (CPS) device. Material and Method: We reviewed retrospectively 9 patients who had a CPS device used for their fulminant myocarditis between September, 2006 and October, 2008. A Capiox emergency bypass system (Terumo Inc, Tokyo, Japan) was percutaneously inserted in all the patients. Upon implantation, all the patients were in cardiogenic shock because of ventricular arrhythmia or severe left ventricular dysfunction. The mean left ventricular ejection fraction (EF) was $20{\pm}6%$ according to transthoracic echocardiography. Result: 3 patients died despite CPS. The CPS was bridged to a transplanted heart in one patient. The rest were successfully explanted after a mean time of $107{\pm}70$ hours of running. The mean EF after discharge was $56{\pm}7%$ without dilated cardiomyopathy. Conclusion: Fulminant myocarditis can be fatal, but its prognosis is excellent if these patients receive proper, timely treatment. A cardiopulmonary support device can be very useful in this acute period. However, the implantation and management protocol of cardiopulmonary support are not yet settled. Further study is necessary to lower the complications of cardiopulmonary support for patients with fulminant myocarditis.

Endovascular Treatment of Cerebral Aneurysms: Technical Options in Coil Embolization (뇌동맥류의 혈관 내 치료: 코일색전술의 기술적 선택)

  • Moon Hee Han
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.549-561
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    • 2020
  • Since the endosaccular coil embolization technique was introduced as an alternative for treating selected patients with aneurysms, it has become a mainstay of treatment for cerebral aneurysms. In lesions with a neck larger than the aneurysmal body, an irregular shape, or arterial branches incorporated within the sac, endovascular treatment using detachable coils are traditionally contraindicated because of technical difficulties. Coil embolization has evolved as a result of both the development of related devices and the introduction of technical improvements using various devices. Use of various technical and device options can make endovascular treatment of cerebral aneurysms safer and can widen the treatment indications. Various technical options, including the technical modification of device-assisted techniques, will be presented, and the related practical points will be discussed in this issue.

Effects of Robot-assisted Therapy on Lower Limb in Patients with Subacute Stroke (아급성기 뇌졸중 환자에서의 로봇 보조 보행훈련 효과)

  • Kim, Ji Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.459-466
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    • 2016
  • This study examined the effects of robot-assisted therapy on the motor and functional recovery of the lower limbs in 53 subacute stroke patients. Robot-assisted therapy was performed using Lokomat? (Hocoma AG, Zurich, Switzerland) for thirty minutes per day, five times a week for four weeks. The outcome measures used were the Fugl-Meyer assessment, Motricity index(MI), Functional ambulation category(FAC), Berg balance scale(BBS) for gait function and balance ability, 10m walking test, K-Modified Barthel Index(K-MBI) for the activities of daily living and Mini mental state examination (MMSE), and Beck's depression inventory(BDI) for depression. All patients recruited underwent these evaluations before and after the four week robot-assisted therapy. For the evaluation, the somatosensory evoked potentials were used to assess the functional recovery. Robot-assisted therapy on the lower limb after subacute stroke showed improvement in motor strength, gait function, and the activities of daily living. All changes in terms of MI, FAC, BBS, and K-MBI exhibited a statistically significant difference after the four weeks robot-assisted therapy. The somatosensory evoked potential result showed a correlation with the MI and K-MBI. Robot-assisted therapy is believed to facilitate the motor and functional recovery of the lower limb in subacute stroke patients.

Analysis of Electrohydraulic Left Ventricular Asistant Device using Recursive Parameter Estimation Algorithm (파라메타 추정 알고리듬을 이용한 전기유압식 좌심실 보조 장치의 해석)

  • Lee, Dong-Joon;Lee, Sang-Woo;Kim, Hee-Chan;Min, Byung-Goo
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.05
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    • pp.117-119
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    • 1995
  • 서울대학교 의공학과에서는 부분적인 심부전 판자의 보조 및 치료장비로 전기유압식 좌심실 보조 장치를 개발하고 있다. 이 장비의 경우 인체의 좌심방 및 대동맥에 직접 연결되므로 실제적으로 좌심실 보조 장치의 박출량을 센서를 통하여 알아내는 데에는 여러가지 어려움이 따른다. 이러한 필요성에 비추어 전기유압식 좌심실 보조 장치의 박출량을 시스템을 ARX모델로 모델링하여 RLS(Recursive Least Square) 알고리듬을 이용하여 추정하였다. 그 결과 비교적 높은 정착도로 박출량이 추정됨을 볼 수 있었다. 하지만, ARX모델의 특성상 원래 본 연구의 시작과정에서 분석한 시스템의 동적 특성을 완전하게 반영할 수 없었다. 앞으로 시스템의 파라미터 추정 과정에서 이미 주어진 동적 특성은 고정시키고 나머지 파라미터들만을 추정하는 알고리듬을 개발하는 것도 흥미로운 과제라 할 수 있다.

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Application of Cardiac Electromechanical FE Model for Predicting Pumping Efficacy of LVAD According to Heart Failure Severity (심부전 정도에 따른 좌심실보조장치의 박동효율예측을 위한 심장의 전기역학적 유한요소 모델의 응용)

  • Jung, Dae Hyun;Lim, Ki Moo
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.38 no.8
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    • pp.715-720
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    • 2014
  • In order to maximize the effect of left ventricular assist device (LVAD) on ventricular unloading, the therapy should be begun at appropriate level of heart failure severity. We predicted pumping efficacy of LVAD according to the severity of heart failure theoretically. We used 3 dimensional finite element model of ventricle coupled with 6 Wind-kessel compartmental model of vascular system. Using the computational model, we predicted cardiac responses such as contractile ATP consumption of ventricle, left ventricular pressure, cardiac output, ejection fraction, and stroke work according to the severity of ventricular systolic dysfunction under the treatments of continuous LVAD. Contractile ATP consumption, which indicates the ventricular energetic loading condition decreased maximally at the $5^{th}$ level heart-failure under LVAD therapy. We conclude that optimal timing for LVAD treatment is $5^{th}$ level heart-failure when considering LVAD treatment as "bridge to recovery".

Development of Device Management and Safety Diagnosis Manual for Electrical Stimulating Swallowing-Assist Equipments (전기적 자극방식 삼킴 보조 치료기의 장비관리/안전진단 매뉴얼 개발)

  • Heo, S.Y.;Choi, B.G.;Rhee, G.M.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.8 no.2
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    • pp.79-88
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    • 2014
  • In Republic of Korea, there are considerable vulnerability in electrical stimulating swallowing-assist equipments even though they are professional medical equipments and have high penetration rate with heavy frequency of use. Therefore, in this article, we developed Device Management and Safety Diagnosis Manual for Electrical Stimulating Swallowing-Assist Equipments system. For achieving this, we collected and analysed international standard data from international organizations like International Electrotechnical Commission(IEC). After literature reviews, we build maintenance worksheet and equipment procedure manual for electrical stimulating swallowing-assist equipments according to evidences we collected. These manual and protocol would be used as standard process and contribute to sustain accuracy, effectiveness of the devices, also decrease failure rate and assist to save medical documents.

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THE TRAINING OF DENTAL THERAPISTS IN N.S.W. (호주'뉴-사우스웨일즈주'에 있어서 치과보조원(치료사)교육)

  • Kim, Yung-Hai
    • The Journal of the Korean dental association
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    • v.16 no.3 s.106
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    • pp.223-234
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    • 1978
  • 성장기에 있어서 치아우식병발생은 특히 국민학교아동에게서 크게 나타나며 손쉬운 대책으로 발전된 것이' 치과치료사(dental therapist)혹은 치과간호원(dental nurse)제도이다. 이 제도는 약 50년전 Newzealand에서 시작되어 국민학교아동에 대한 간단한 치료와 구강위생교육급예방에 대한 제도를 주임무로 삼고 각학교에 배치되었다. 최근 이 제도는 대양주각국에 도입되어 유사업무에 임하고 있다. 한국에는 각종보조원학교가 있으나 이 제도와는 업무분야가 다르고 국민학교아동에 대한 전담제도가 확립되어 있지 않기에 '뉴-사우스웨일즈주'에 있는 학교를 예로 들어 학교의 행선적구조, 인력, 교과내용 훈련방법, 실사회활동, 급 본인들의 직업적 만족도등을 조사연구하였음.

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Design and Development of Interactive Therapy System for Children with Autism (발달장애아동을 위한 상호작용 치료시스템의 디자인 개발)

  • Choi, Min-Young;Lee, Hyun-Jhin;Lee, Jang-Han
    • Science of Emotion and Sensibility
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    • v.13 no.4
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    • pp.777-788
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    • 2010
  • Early diagnosis of autism and intervention of medical treatment are very significant to develop specific social communication skill for children with autistic spectrum disorders (ASDs). But they have difficulties in medical treatment because of lack of a public welfare institution and special medical system. In particular, few children can access such treatment and the existing single-therapist clinics are inefficient with regard to cost and time. Therefore, new methods should be studied for developing various products, services, and systems for autistic children. This study discusses the potential use of an interactive design as assistive technology for such children. We utilize the experience gained in the collaborative design of the interactive therapy system (ITS). The key methods include a collaborative design with rapid interactive prototyping, heuristic evaluation, user-centered process, VR technology, tangible interface, and scenario-based contents. We applied these methods to the ITS and proved the efficiency of interactive design as an assistive technology through clinical experimentation.

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