• Title/Summary/Keyword: 치료단계

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Strategy of Multistage Gamma Knife Radiosurgery for Large Lesions (큰 병변에 대한 다단계 감마나이프 방사선수술의 전략)

  • Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.801-809
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    • 2019
  • Existing Gamma Knife Radiosurgery(GKRS) for large lesions is often conducted in stages with volume or dose partitions. Often in case of volume division the target used to be divided into sub-volumes which are irradiated under the determined prescription dose in multi-sessions separated by a day or two, 3~6 months. For the entire course of treatment, treatment informations of the previous stages needs to be reflected to subsequent sessions on the newly mounted stereotactic frame through coordinate transformation between sessions. However, it is practically difficult to implement the previous dose distributions with existing Gamma Knife system except in the same stereotactic space. The treatment area is expanding because it is possible to perform the multistage treatment using the latest Gamma Knife Platform(GKP). The purpose of this study is to introduce the image-coregistration based on the stereotactic spaces and the strategy of multistage GKRS such as the determination of prescription dose at each stage using new GKP. Usually in image-coregistration either surgically-embedded fiducials or internal anatomical landmarks are used to determine the transformation relationship. Author compared the accuracy of coordinate transformation between multi-sessions using four or six anatomical landmarks as an example using internal anatomical landmarks. Transformation matrix between two stereotactic spaces was determined using PseudoInverse or Singular Value Decomposition to minimize the discrepancy between measured and calculated coordinates. To evaluate the transformation accuracy, the difference between measured and transformed coordinates, i.e., ${\Delta}r$, was calculated using 10 landmarks. Four or six points among 10 landmarks were used to determine the coordinate transformation, and the rest were used to evaluate the approaching method. Each of the values of ${\Delta}r$ in two approaching methods ranged from 0.6 mm to 2.4 mm, from 0.17 mm to 0.57 mm. In addition, a method of determining the prescription dose to give the same effect as the treatment of the total lesion once in case of lesion splitting was suggested. The strategy of multistage treatment in the same stereotactic space is to design the treatment for the whole lesion first, and the whole treatment design shots are divided into shots of each stage treatment to construct shots of each stage and determine the appropriate prescription dose at each stage. In conclusion, author confirmed the accuracy of prescribing dose determination as a multistage treatment strategy and found that using as many internal landmarks as possible than using small landmarks to determine coordinate transformation between multi-sessions yielded better results. In the future, the proposed multistage treatment strategy will be a great contributor to the frameless fractionated treatment of several Gamma Knife Centers.

Facial Expression Training Digital Therapeutics for Autistic Children (자폐아를 위한 표정 훈련 디지털 치료제)

  • Jiyeon Park;Kyoung Won Lee;Seong Yong Ohm
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.1
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    • pp.581-586
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    • 2023
  • Recently a drama that features a lawyer with autism spectrum disorder has attracted a lot of attention, raising interest in the difficulties faced by people with autism spectrum disorders. If the Autism spectrum gets detected early and proper education and treatment, the prognosis can be improved, so the development of the treatment is urgently needed. Drugs currently used to treat autism spectrum often have side effects, so Digital Therapeutics that have no side effects and can be supplied in large quantities are drawing attention. In this paper, we introduce 'AEmotion', an application and a Digital Therapeutic that provides emotion and facial expression learning for toddlers with an autism spectrum disorder. This system is developed as an application for smartphones to increase interest in training autistic children and to test easily. Using machine learning, this system consists of three main stages: an 'emotion learning' step to learn emotions with facial expression cards, an 'emotion identification' step to check if the user understood emotions and facial expressions properly, and an 'expression training' step to make appropriate facial expressions. Through this system, it is expected that it will help autistic toddlers who have difficulties with social interactions by having problems recognizing facial expressions and emotions.

Design and Implementation of a Simple 3D-Orthodontia Simulation System for Malocclusion Treatment (부정교합 치료를 위한 간단한 3D 치열교정 시스템의 설계 및 구현)

  • Kim, Chul-Hun;Lee, Shin-Ku;Shin, Jung-Hoon;Lee, Sang-Jun
    • Proceedings of the Korean Information Science Society Conference
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    • 2012.06c
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    • pp.350-352
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    • 2012
  • 최근 의료 분야 소프트웨어가 발전함에 따라 3차원 가상 모델을 이용한 의료 소프트웨어의 개발도 꾸준히 증가하는 추세이다. 치열 교정 분야는 이러한 3차원 가상 모델을 적용할 수 있는 분야 중 하나이다. 치열교정 분야에서는 3차원 가상 모델을 이용하여 부정 교합 환자의 치료 초기부터 끝까지 여러 단계의 치아이동 과정을 제공한다. 치아 이동의 각 단계별로 Stereolithographic Model이 만들어지는데, 이는 투명하고 얇은 Overlay 장치를 제작하는 기초가 된다. 투명한 재질의 Overlay 장치는 심미적이고 사용이 간편하여 많은 환자들이 선호하고 있다. Overlay 장치를 제작하는 시스템을 구축한 회사로는 Invisalign System이 가장 대표적이다. Invisalign System은 미국에 본사를 둔 회사로 한국에 지사를 두고 적극적인 마케팅을 통해 3D 치열 교정 분야의 국내시장을 거의 독점하고 있다. 독점적이다 보니 비용이 다른 교정 치료보다 2배 가까이 들고 있지만, 현재 한국에서는 개발이 적극적으로 이루어지지 않는 실정이다. 이에 본 논문에서는 환자 치아의 정확하고 과학적인 진단자료를 얻어 높은 치료비용에 대한 개선과 치료 전 과정에 대한 시뮬레이션 및 Stereolithographic Model을 미리 환자에게 제공하여 만족도를 높일 수 있는 3D치열 교정 시스템을 제안한다.

The Role of Occupational Therapist in Disaster Management (재난상황에서 작업치료사의 역할에 대한 고찰)

  • Kim, Jung-Hun
    • The Journal of Korean society of community based occupational therapy
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    • v.6 no.2
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    • pp.21-30
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    • 2016
  • Objective : In October 2016, the most powerful earthquake, magnitude 5.1 and 5.8 struck the city of Gyeongju in Korea. Although it did not take a toll, this implicates potential disaster in the future. Taking this earthquake, this paper considers the healthcare system responding to disaster in non-government organization and other countries, and investigates the roles of occupational therapist in disaster management. Methods : This paper reviews literature related to healthcare system and roles of occupational therapist in disaster response. Results : Humanitarian recovery mission of Red Cross impacted and facilitated the recovery of vulnerable population including children, elderly and people with disabilities in disaster response. It was also emphasized by occurring large population with disabilities after disasters so that the concept of rehabilitation and occupational therapist's role was required. Occupational therapy practitioners play an important role in the stage of disaster preparedness, response and recovery and their target population is children, elderly and people with disabilities. Conclusion : The most of NGO and counties take the concept of rehabilitation into healthcare system responding to disaster. However, the system in Korea stays in emergency level. It is important to take the humanitarian recovery and rehabilitation concept to disaster relief. the survivors would be able to return to their normalcy and health life.

Skeletal Age Assessment of SMI and MP3 Stages to Predict the Pubertal Growth Spurt (사춘기 최대 성장 단계 예측을 위한 SMI 및 MP3 단계별 골연령 평가)

  • Lee, Yeonju;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.3
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    • pp.233-238
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    • 2019
  • This study aimed to assess the skeletal age of skeletal maturational indicator (SMI) and middle phalanx of the middle finger (MP3) stages and to predict the SMI and MP3 stages corresponding to pubertal growth spurt in boys and girls respectively. The skeletal age was assessed from hand-wrist radiographs of 363 children (182 boys, 181 girls) aged 7 to 16 years by radiologists using the Korean standard bone age chart. Also, SMI and MP3 stages were evaluated from the radiographs. From these records, the mean skeletal age of SMI and MP3 stages was calculated. The stages including pubertal growth spurt were SMI 4 - 5, MP3 FG - G stages in boys and SMI 3 - 4, MP3 F - FG stages in girls.

PULSE RATE AND OXYGEN SATURATION IN CHILDREN DURING ROUTINE RESTORATIVE DENTISTRY (소아 치과치료시 심박동과 동맥혈 산소포화도의 변화)

  • Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Park, Jeong-Yeol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.65-72
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    • 2008
  • Pulse oximeter to monitor oxygen saturation during pediatric dental sedations enables early detection of hypoxemia. The purpose of this study was to monitor the hemoglobin oxygen saturation level and pulse rate of nonmedicated pediatric patients during routine restorative procedures to study the effect of procedure and treated jaw. We obtained data from 53 children treated at the Department of Pediatric Dentistry, Chonbuk national university hospital. Pulse rate and oxygen saturation were measured and recorded using pulse oximetry at each step of treatment. The results are as follows: 1. In non-anesthesia group, steep increase of pulse rate was observed during rubber dam application in the maxilla and during cavity preparation in the mandible. 2. In anesthesia group, pulse rate started to decrease after the rubber dam application in the maxilla, while its decrease observed since cavity preparation step in the mandible. 3. In non-anesthesia group, oxygen saturation level was relatively constant during all steps in the maxilla, but in mandible, it was higher during operation compared to its pre and post operation baseline. 4. In anesthesia group, oxygen saturation level was observed at 99% level through all steps in both jaw groups, and there was no statistical significance between the maxilla and the mandible groups(p>0.05). The purpose of this study was to evaluate the effect of routine dental treatment on the pulse rate and oxygen saturation level in nonmedicated pediatric patients during routine restorative procedures in the maxilla and mandible.

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Therapeutic Use of Music for Stuttering Children (말더듬 아동을 위한 음악치료적 접근)

  • Cho, Jung Min
    • Journal of Music and Human Behavior
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    • v.4 no.1
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    • pp.21-30
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    • 2007
  • Unlike other common forms of speech disorder, such as phonological disorder or dysphonia, stuttering has not been studied within the context of music therapy. Most cases of stuttering display no difficulty in singing, and fluency within the musical structure does not translate to fluency in speech. Hence, musical approach has been generally considered to be ineffective to the treatment of stuttering. However, the fundamentals of music therapy assume its extensive application in treating variety of speech disorders, including the case of stuttering. Presented in this paper are the case studies designed to validate the efficacy of music therapy as a remedy for stuttering. This study enrolled 6 children with stuttering and conducted 20 individual sessions over a period of 10 weeks. The sessions focused on the Melodic Intonation Therapy, Reinforcement of speech rhythm, song writing and singing. Musical elements were structured to enhance the verbal expression and rhythmic senses, as well as to facilitate the initiation of verbal communication. The result is as follows. First, it was noticed that the disfluency had been decreased in before and after of the music therapy in every child although the result was somewhat different depending the child. The overall result of the investigation shows the significant difference statistically. And categorically speaking, the significant difference was checked in the frequency of the stuttering. In the steps of the session, the increase and decrease was happened repeatedly, and then after it was decreased little by little. Secondly, the Communication Attitude was decreased in before and after of the music therapy, and also there was significant difference statistically. although the avoidance behavior was decreased in before and after of the music therapy, the increase and the decrease was repeated irregularly in the steps of session. All the results described above shows that music therapy gives positive effect to decrease in disfluency of stuttering child and also to develop the Communication Attitude. And new possibility and effectiveness can be proposed in the musical approach to the stuttering.

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What is the Optimal Treatment for Kienböck's Disease? (Kienböck 질환의 적정 치료는 무엇인가?)

  • Park, Min Jong;Chae, Sang Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.461-471
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    • 2021
  • Kienböck's disease is known as avascular necrosis of the lunar bone, but its natural course or optimal treatment in various stages has not been identified clearly. The textbook divides the progression of the disease and suggests treatment methods according to the stages, but it is unclear if conforming to the principle without sufficient verification is the correct treatment method. While diagnosing and treating many Kienböck's diseases, the author has had many questions regarding the treatment choices described in the textbook and tried to establish an optimal treatment based on data evidence and experience. This review presents the most appropriate and reasonable treatment method while questioning whether the previous knowledge is based on an accurate basis.

첨단과학기술현장-유전자치료의 오늘과 내일

  • Hyeon, Won-Bok
    • The Science & Technology
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    • v.31 no.2 s.345
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    • pp.67-71
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    • 1998
  • 1990년 9월 프렌치 엔더슨(현 남가주대학 유전자치료센터 소장)과 2명의 동료들이 미 연방정부의 승인을 받고 처음으로 유전자를 이용하여 중증 종합면역결핍증(SCID)을 앓고 있던 아샨티 데실비양을 치료한 이래 유전자치료에 대한 관심은 전세계적으로 번져 나가 현재 2천5백명 이상의 환자들이 이런 요법의 임상실험을 받고 있다. 우리나라에서도 1995년 서울대병원을 시작으로 1996년에는 중앙대병원과 삼성서울병원에서 말기 암환자를 대상으로 유전자치료 임상시험을 하고 있다. 그런데 열성적인 일부 연구자들과 업계대표들 그리고 매체들의 유전자치료의 '장미빛 미래'를 지나치게 강조한 나머지 일반인에게 유전자치료가 이미 광범위한 응용단계로 들어갈 정도로 발전한 것 같은 인상을 주고 있다. 그러나 전세계를 통틀어 유전자치료를 받거나 받고 있는 환자중에서 결정적으로 완쾌된 환자는 아직도 거의 없다는 것이 오늘의 현실이다. 유전자치료의 현황과 그 앞날을 알아본다.

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