• Title/Summary/Keyword: 치료단계

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Fighting hiteen~ - 여드름의 단계별 치료방법

  • Choe, Yu-Jin
    • 건강소식
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    • v.39 no.7
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    • pp.16-17
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    • 2015
  • 여드름은 나이와 계절을 가리지 않고 발생하는 피부 최대의 적이다. 사계절 내내 스트레스를 불러오는 여드름의 치료에는 많은 방법이 있지만, 많은 사람들이 여드름 치료 방법을 찾을 뿐 단계에 따른 치료 방법을 찾지는 않는다. 여드름은 잘못 치료하게 되면 흉터가 남거나 오히려 피부트러블이 증기하게 되므로 단계별, 증상별로 치료를 달리하는 것이 중요하다.

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Digital Medicine Taken by Eye and Ear : rehabilitation treatment for chronic brain disease using VR/AR technology (눈과 귀로 복용하는 디지털 치료제 : VR/AR 공감 반응을 활용한 만성 뇌 질환 재활치료방법 개발)

  • Lee, Jong-Hyun;Kwon, Young-Sung
    • Trans-
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    • v.12
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    • pp.21-49
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    • 2022
  • This study examines the possibility of chronic brain disease rehabilitation treatment using VR/AR technology and raises the research need for the development of digital therapeutics. In addition, by proposing a digital therapeutic research and development process this study intends to contribute to the development of VR/AR rehabilitation treatment. To this end, this study identified research trends of VR/AR technology, neurophysiology, and chronic brain disease and proposed a method for applying VR/AR technology to treat chronic brain disease patients in three stages. The first stage is to prepare a neurophysiological basis for rehabilitation treatment of brain disease patients using VR technology. The second stage is to provide a treatment method using VR/AR technology and systematize the contents characteristics. The third stage is to conduct clinical trails and validate that the treatment method and contents utilization is effective for the patient. It is hope that this study serves as a guide for developing media production base technology for treating patient with a chronic brain disease.

Study of Failure Mode and Effect Analysis in Brachytherapy (근접방사선치료에 관한 사고유형과 영향분석 연구)

  • Lee, Soon Sung;Park, Dong Wook;Shin, Dong Oh;Kim, Dong Wook;Kim, Kum Bae;Oh, Yoon-Jin;Kim, Juhye;Kwon, Na Hye;Kim, Kyeong Min;Choi, Sang Hyoun
    • Journal of the Korean Society of Radiology
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    • v.11 no.7
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    • pp.627-635
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    • 2017
  • Brachytherapy is generally performed in conjunction with external radiation therapy, and the treatment course is very complicated, which can lead to radiation accidents. In order to solve this problem, we designed the process map by applying the failure mode and effects analysis (FMEA) method to the Brachytherapy and scored the risk priority number (RPN) for each treatment course based on this process map. The process map consisted of five steps, Patient consulting", "Brachytherapy simulation", "CT simulation", "Brachytherapy treatment planning" and "Treatment". In order to calculate the RPN, doctor, medical physicist, dose planners, therapist, and nurse participated in the study and evaluated occurrence, severity, and lack of detectability at each detail step. Overall, the process map is preceded by a patient identification procedure at each treatment stage, which can be mistaken for another patient, and a different treatment plan may be established to cause a radiation accident. As a result of evaluating the RPN for the detailed steps based on the process map, overall "Patient consulting" and "Brachytherapy treatment planning" step were evaluated as high risk. The nurses showed a tendency to be different from each other, and the nurses had a risk of 55 points or more for all the procedures except "Treatment", and the "Brachytherapy simulation" step was the highest with 88.8 points. Since the treatment stage differs somewhat for each medical institution performing radiotherapy, it is thought that the risk management should be performed intensively by preparing the process map for each institution and calculating the risk RPN.

The Availability of the step optimization in Monaco Planning system (모나코 치료계획 시스템에서 단계적 최적화 조건 실현의 유용성)

  • Kim, Dae Sup
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.207-216
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    • 2014
  • Purpose : We present a method to reduce this gap and complete the treatment plan, to be made by the re-optimization is performed in the same conditions as the initial treatment plan different from Monaco treatment planning system. Materials and Methods : The optimization is carried in two steps when performing the inverse calculation for volumetric modulated radiation therapy or intensity modulated radiation therapy in Monaco treatment planning system. This study was the first plan with a complete optimization in two steps by performing all of the treatment plan, without changing the optimized condition from Step 1 to Step 2, a typical sequential optimization performed. At this time, the experiment was carried out with a pencil beam and Monte Carlo algorithm is applied In step 2. We compared initial plan and re-optimized plan with the same optimized conditions. And then evaluated the planning dose by measurement. When performing a re-optimization for the initial treatment plan, the second plan applied the step optimization. Results : When the common optimization again carried out in the same conditions in the initial treatment plan was completed, the result is not the same. From a comparison of the treatment planning system, similar to the dose-volume the histogram showed a similar trend, but exhibit different values that do not satisfy the conditions best optimized dose, dose homogeneity and dose limits. Also showed more than 20% different in comparison dosimetry. If different dose algorithms, this measure is not the same out. Conclusion : The process of performing a number of trial and error, and you get to the ultimate goal of treatment planning optimization process. If carried out to optimize the completion of the initial trust only the treatment plan, we could be made of another treatment plan. The similar treatment plan could not satisfy to optimization results. When you perform re-optimization process, you will need to apply the step optimized conditions, making sure the dose distribution through the optimization process.

A Study on Functional Structure in Conversation of Family Therapy (가족치료 대화의 구조와 기능에 대한 대화분석적 연구)

  • Cho, Yong-Gil;Yu, Myung-Yee;Park, Tai-Young
    • Korean Journal of Social Welfare
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    • v.60 no.4
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    • pp.253-276
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    • 2008
  • This study investigated dialog sequence prototype that was the structure of communication, which could be shown in family counseling conversation between therapists and clients. The study was intended to review the process stages of family counseling through literature review, and divided functional phases into 'atmosphere formation phase', 'family evaluation phase', 'persuasion phase of cognitive change', 'confirmation phase of change experience', and 'termination phase'. The study selected two family therapists and 30 clients for research objects. They allowed data collections for the study after the explanation about the research objects. The transcribers were trained by the consent of transcription, which used particular symbol for verbal and nonverbal contents in conversation. The transcribed data were analyzed by dialog grammar, one of the linguistic dialog analysis method developed by Hundsnurscher(1994). This study described and explained dialog sequence prototype that displayed in conversation between family therapist and client through the total sessions in family therapy. The study found three types of dialog sequence prototype in 'atmosphere formation phase', eight types in 'family evaluation phase', nine types in 'persuasion phase of cognitive change', eight types in 'confirmation phase of change experience', and eight types of 'termination phase'. Even if the dialog sequence prototype mentioned above cannot be applied to the process of family therapy at its face value, these findings may contribute to beginners in counseling and graduate students majoring family therapy to do practice in counseling. The research has a limitation in which the study investigated dialog sequence prototype of conversation in two persons. Future research needs to include dialog sequence prototype of conversation among more than three persons. Specifically, when a family therapist do family counseling, he/she treats more than three family members as usual. Therefore, the researchers hope that future study investigates dialog sequence prototype between therapist and client, client and client, among therapist, client and other family members.

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The feasibility evaluation of Respiratory Gated radiation therapy simulation according to the Respiratory Training with lung cancer (폐암 환자의 호흡훈련에 의한 호흡동조 방사선치료계획의 유용성 평가)

  • Hong, mi ran;Kim, cheol jong;Park, soo yeon;Choi, jae won;Pyo, hong ryeol
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.149-159
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    • 2016
  • Purpose : To evaluate the usefulness of the breathing exercise,we analyzed the change in the RPM signal and the diaphragm imagebefore 4D respiratory gated radiation therapy planning of lung cancer patients. Materials and Methods : The breathing training was enforced on 11 patients getting the 4D respiratory gated radiation therapy from April, 2016 until August. At the same time, RPM signal and diaphragm image was obtained respiration training total three steps in step 1 signal acquisition of free-breathing state, 2 steps respiratory signal acquisition through the guide of the respiratory signal, 3 steps, won the regular respiration signal to the description and repeat training. And then, acquired the minimum value, maximum value, average value, and a standard deviation of the inspiration and expiration in RPM signal and diaphragm image in each steps. Were normalized by the value of the step 1, to convert the 2,3 steps to the other distribution ratio (%), by evaluating the change in the interior of the respiratory motion of the patient, it was evaluated breathing exercise usefulness of each patient. Results : The mean value and the standard deviation of each step were obtained with the procedure 1 of the RPM signal and the diaphragm amplitude as a 100% reference. In the RPM signal, the amplitudes and standard deviations of four patients (36.4%, eleven) decreased by 18.1%, 27.6% on average in 3 steps, and 2 patients (18.2%, 11 people) had standard deviation, It decreased by an average of 36.5%. Meanwhile, the other four patients (36.4%, eleven) decreased by an average of only amplitude 13.1%. In Step 3, the amplitude of the diaphragm image decreased by 30% on average of 9 patients (81.8%, 11 people), and the average of 2 patients (18.2%, 11 people) increased by 7.3%. However, the amplitudes of RPM signals and diaphragm image in 3steps were reduced by 52.6% and 42.1% on average from all patients, respectively, compared to the 2 steps. Relationship between RPM signal and diaphragm image amplitude difference was consistent with patterns of movement 1, 2 and 3steps, respectively, except for No. 2 No. 10 patients. Conclusion : It is possible to induce an optimized respiratory cycle when respiratory training is done. By conducting respiratory training before treatment, it was possible to expect the effect of predicting the movement of the lung which could control the patient's respiration. Ultimately, it can be said that breathing exercises are useful because it is possible to minimize the systematic error of radiotherapy, expect more accurate treatment. In this study, it is limited to research analyzed based on data on respiratory training before treatment, and it will be necessary to verify with the actual CT plan and the data acquired during treatment in the future.

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호흡을 고려한 고정밀 방사선치료를 위한 임상적 고려

  • Park, Hui-Cheol;Jo, Byeong-Cheol;Kim, Su-San;O, Do-Hun;Bae, Hun-Sik
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2005.04a
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    • pp.16-21
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    • 2005
  • 방사선치료를 하는데 호흡을 다루는 문제는 매우 중요하다. 호흡으로 인한 인체의 움직임은 종양, 정상조직의 위치 등을 변화시킴으로써 표적체적 설정을 다루는 ICRU definition에 영향을 미칠 뿐만 아니라 일반적인 방사선치료의 단계별 과정에 큰 영향을 끼친다. 본 연제에서는 방사선치료의 과정 중 호흡을 고려한 영상획득, 방사선치료계획, 정도보증 등 주로 의학 물리적 관점에서 세부적으로 다루어야 할 문제들은 논외로 하고, 환자의 호흡을 모니터하고 다루어 호흡에 따른 맞춤치료를 하는 방법들을 개관해 보고자 한다. 또한, 호흡을 다루는 각각의 방법에 따른 임상적 고려사항들에 대해서도 언급하고자 한다. 각각의 기관에서 호흡을 고려한 고정밀 방사선치료를 시행하는데 있어 적절한 전략 및 프로토콜을 세우고, 이를 환자를 대상으로 정확하게 수행하기 위해서는 호흡이 방사선치료 전반에 미치는 영향을 각각의 단계별로 정확하게 이해하는 것이 선행되어야 할 것이다.

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Oral-Motor Facilitation Technique (OMFT): Part II-Conceptual Hierarchy and Key Point Technique (구강운동촉진기술: 2 부-개념적 위계 및 핵심 기법)

  • Min, Kyoung Chul;Seo, Sang Min;Woo, Hee-soon
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.53-61
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    • 2021
  • Introduction : OMFT is a therapeutic technique based on sensorimotor, motor control and motor learning, and its major goal is to improve oral motor function. The oral motor conceptual hierarchical development is divided into 5 steps: 1) sensorimotor, 2) movement integration, 3) structural movement, 4) functional oral motor, and 5) comprehensive oral motor. Discussion : The OMFT consists of 3 techniques, 10 categories, and 50 sub-item. 1) Warming up technique: 2 categories, 12 sub-item, warming up by sensory awareness and adaptation, therapy situation adaptation, neck movement; 2) Key point technique: 7 categories, 30 sub-item, oral motor facilitation and increasing chewing skill by direct stroke of oral structures such as the face, lips, cheeks, gum, jaws, and tongue; 3) Application technique: 1 category, 8 sub-item, facilitate food intake and swallowing. Conclusion : The goal of this article is to introduce 3 techniques, 50 sub-item of OMFT, as a comprehensive oral motor therapy method, for application to clients. This article provides information that will help oral motor specialists in treating clients with oral motor problems more effectively and professionally.

Glottic and subglottic airway obtruction

  • 김영모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.113-113
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    • 2003
  • 성문과 성문하부의 기도 폐쇄는 위치 정도 원인 기간 등은 환자에 따라 다르고 그 치료방법 역시 다양하다. 주 원인으로는 기관내 삽관, 각종 외상 및 화상 등 을 들 수 있다. 이러한 질환의 치료 목적은, 기관내 튜브나 기관 캐뉼러 를 통하지 않고 비강을 통하여 자연스럽게 호흡할 수 있도록 기도를 유지 하면서 발성이 가능하고 기고 흡인 없이 연하가 가능하도록 하며 기침 반사가 원활하게 되도록 하는데 있다. 치료목적의 달성을 위하여 협착의 경우, 단계 즉 초기 단계 또는 성숙단계 여부, 위치, 정도, 범위 환자의 연령 전신상태 등을 술전에 잘 평가하고 수술도중의 소견과 술자의 경험이나 기호에 따라 적절한 치료법을 선택하여 치료해야 한다. 후두 외상에 의한 기도 문제는 다른 외상에 비해 흔하지 않은데 이는 연골의 유연성과 후두의 가동성 그리고 후두가 하악과 흉골사이에 위치하여 외상시 보호받게 되는 해부학적 특성에 기인한다. 여러 요인으로 인하여 진단이 늦어질 수도 있는데 이러한 경우 심각한 증상이 초래 되거나 치료가 의 시기가 지나 후두 또는 기관 협착, 발성장애등의 후유증이 유발 될 수 있다.

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중서의결합치료소아백혈병사로(中西醫結合治療小兒白血病思路) -중서의 결합으로 소아백혈병 치료에 대한 접근-

  • Seok Hyo-Pyeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.71-75
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    • 2001
  • 백혈병은 조혈계통의 악성 증식성 질환으로서 현재까지 주로 화학약물요법에 의존하고 있는 실정이다. 화학약물요법은 백혈병 세포를 소멸시킬 수 있지만 또한 인체에 여러 가지 독성 반응 및 부작용을 일으키기도 한다. 따라서 중서의결합으로 백혈병 치료에 접근하는 것은 중요한 의미를 갖는다. 중의학에서 소아 백혈병을 치료하는 경우 청열해독법(淸熱解毒法), 부정보허법(扶正補虛法), 활혈화어법(活血化瘀法)을 주로 사용한다. 청열해독법은 백혈병의 조기치료에 주로 활용되는데, 인체의 저항력을 증강시켜 화학약물요법을 실시하는 동안 흔히 나타날 수 있는 감염증상을 예방하는 효과를 얻을 수 있다. 부정보허법(扶正補虛法)은 주로 화학약물요법의 유도 완화기 및 치료효과의 유지를 위하여 활용되는데, 이는 인체의 면역력을 향상시켜 화학약물요법이 인체에 미치는 손상을 경감시킬 수 있다. 활혈화어법(活血化瘀法)은 미세순환을 개선시키는 작용을 하며 골수의 조혈기능을 촉진하고 면역기능을 조절하며 또한 일부 활혈화어제(活血化瘀劑)는 백혈병 세포에 직접적인 억제효과를 보인다. 소아백혈병에 대하여 화학약물요법을 진행하는 동안 중약을 같이 병행하는 경우 다음과 같은 과정으로 나누어 실시할 수 있다. 1. 유도완화치료(화학요법)단계: 이와 같은 치료과정은 대개 화학약물요법으로 인한 극심한 독성반응이나 주작용을 나타내게 되는데, 이 과정에서 중약치료를 병행하면 신속하게 증상을 개선시킬 수 있다. 만약 구토나 설사와 같은 소화계 부작용이 나타나면 화위강역법(和胃降逆法)을 활용하고, 감염 증상이 나타나면 부정(扶正)과 거사법(祛邪法)을 병행할 수 있다. 화학약물요법을 진행한 후 신체가 극도로 허약해지고 골수의 기능이 심하게 억제되는 경우는 주로 부정(扶正)시키는 중약을 사용하면서 익기양혈제(益氣養血劑)를 곁들이고 보조적으로 단삼(丹蔘), 당귀(當歸), 천궁(川芎), 계혈등(鷄血藤) 등과 같은 활혈화어제(活血化瘀劑)를 사용하여 골수의 조혈기능을 회복시킨다. 2. 치료효과의 유지단계: 본 과정에서는 중약치료에 있어서 부정(扶正)과 거사법(祛邪法)을 병행한다. 화학약물요법을 실시하는 동시에 거사제(祛邪劑)를 중용(重用)함으로써 화학약물요법의 효과를 강화시킨다. 화학약물요법이 끝난 뒤 부정(扶正)시키는 약물을 중용(重用)하여 인체의 면역기능을 증강시키고 백혈병세포를 억제시킨다. 3. 치료효과의 유지 및 강화단계: 치료효과의 유지단계에서는 변증논치(辨證論治)의 원칙에 입각하여 항암효과가 있는 중약을 활용할 수 있는데, 예를 들어 백화사설초(白花蛇舌草), 산자고(山慈?), 청대(靑黛), 용규(龍葵) 등을 사용할 수 있고, 육신환(六神丸)을 장기적으로 복용하여도 된다. 소아백혈병 치료에 있어서 중서의결합의 치료법을 활용하는 경우 다음과 같은 내용에 주안점을 둘 수 있다. 화학약물요법을 진행하는 과정에서 중약을 병행하여 투여하는 경우 사진합삼(四診合參)을 근간으로 종합적인 분석을 통하여 병인(病因)을 살피어 치료에 임하도록 한다. 약물의 선택과 처방의 구성은 반드시 변증논치(辨證論治)의 원칙하에 이루어져야 한다. 화학약물요법과 중약치료를 병행하는 과정에서 변증(辨證)과 변병(辨病)이 서로 결합되고 부정(扶正)과 거사법(祛邪法)을 병행하여 활용한다. 정체관(整體觀)에서 출발하여 환자를 관찰하는 동시에 특징적인 증후(證候)에 대한 변증논치(辨證論治)도 중요하며, 또한 백혈병 환자의 유형(類型)이나 임상 혈액검사 소견, 골수의 양상, 화학요법의 진행단계 및 환자의 연령과 체질 등을 충분히 가만하여 종합적인 분석을 토대로 치료법을 선택하여야 중약요법과 화학약물요법의 협동적인 효과를 증폭시키고 백혈병치료에 새로운 전기를 마련할 수 있을 것이다.

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