• Journal of Chest Surgery
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• v.31 no.12
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• pp.1172-1182
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• 1998

Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.

• The Monthly Diabetes
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• s.166
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• pp.64-67
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• 2003

인슐린 치료를 필요로 하는 당뇨병 환자에서는 당뇨병성 합병증의 발생을 예방하거나 합병증이 진행된 경우에는 기존의 고식적인 치료로 만족할 만한 효과를 거두기가 어려워 이상적인 치료 방법에 대한 기대가 높은 상태이다. 특히 췌도이식 대상자는 급증하고 있으나 공급 가능한 췌장은 한정되어 있어 이식에 필요한 췌도는 절대적인 부족 상태로 오직 일부 제 1형 당뇨병 환자에서만 제한적으로 췌도이식이 적용 가능하다. 따라서 충분한 췌도 이식원을 확보할 수 있는 췌도 이식원의 개발은 췌도이식의 가장 큰 목표라 할 수 있다. 본 난에서는 당뇨병 치료에서 시험관내 및 생체실험에서 줄기세포의 현황과 줄기세포를 이용하여 당뇨병을 극복하고자 하는 연구의 성과와 이에 따른 새로운 치료법에 대한 최근 내용을 고찰해 보고자 한다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.1-7
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• 2008

일반적으로 진행된 골관절염 등 골연골 병변에 대해서는 골연골을 치유시키는 술식에서부터 인공 관절 치환술까지 치료방법이 다양하게 보고되고 있다. 특히 견관절 인공 관절 치환술을 비롯한 여러 수술 방법에 대한 적응증 및 금기증을 잘 숙지하고, 각각의 고유 질병에 따른 병리 소견과 견관절의 정상적 해부학 및 생역학을 이해하며, 적절한 기구 선택과 정확한 술기로 수술을 시행할 때 제한된 치료 목표이지만 보다 긍정적인 치료 결과를 예측할 수 있다.

• Therapeutic Science for Rehabilitation
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• v.6 no.2
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• pp.59-70
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• 2017

Objective: It is important to assess the participation and understand the characteristics of participation for setting goal of the child's treatment and strengthening participation. In this study, we verified the validity of the LIFE-H 1.0, so that domestic occupational therapists can systematically evaluate children's participation. Methods: This study was conducted for about 2 months from February to April 2016 in 47 children with disabilities and non-disabled children. We divided the children into two groups aged 0-4 years and 5-13 years old and conducted a self-report questionnaire to parents. The collected data were verified by SPSS(Statistical Package for Social Science) statistical analysis program. Results: There was no difference between the two groups in general characteristics. In comparison of two groups, a significant difference(p<.05) was found in the LIFE-H 1.0 total performance and satisfaction score and the high discriminant validity was verified. Conclusion: The ultimate goal of occupational therapy is to increase participation. Therefore, the occupational therapist must be able to assess the level of participation and than set the goal of intervention. This study confirms the high level of validity and expects that Korean version of LIFE-H 1.0 will be widely used in clinical field and research.

• Journal of Korean Classical Literature and Education
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• no.37
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• pp.151-184
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• 2018

The purpose of therapeutic approach of humanities, including literary therapy, is ultimately encourage the growth and the development of human being rather than the development of therapeutic techniques for eradicating symptoms. This paper is noteworthy as to the fundamental work for using folktales at therapy sessions. It may be argued that therapy is the process of searching clients' own development history and accepting current challenges in relation to overall context of their own lives and this may lead to the growth clients. In this regard, this paper attempts to set up the selection criteria for folktales to be effectively applied in therapy sessions. The author of the paper argued in her previous paper that folktales may be effective in terms of self-understanding of clients. Folktales can assist clients regarding the objectification of their issues by projecting and exposing their problems. Therefore, this paper argues the method for selecting proper folktales to stimulate of clients" developmental challenges and ultimately to expose them. The first groundwork for this is understand contents of folktale as to general problems of life and view it as the development of one's entire life. The challenge of client is personal and unique but at the same time it is problems of general development process. The author examines the need for developmental approach of literary therapy and attempts to compose a classification framework for understanding folktales as to developmental process. This may use at literary therapy sessions to select proper folktales based on clients' complaining issues and their developmental age. The criteria also can be used as the basis of clients" reaction on folk-tales.

• ICROS
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• v.16 no.3
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• pp.16-20
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• 2010

손 재활 로봇 연구의 목표는 손 기능 장애를 갖는 환자들을 대상으로 치료사를 대신하여 치료는 수행하는 것이다. 일반적으로 손의 운동기능 장애는 골절, 인대 손상 또는 노화에 의한 근력 소실에 의해 발생하거나 뇌졸중이나 파킨슨병, 척수 손상 등에 의한 신경계 문제에 의해 발생할 수 있다.

• The Journal of the Korean dental association
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• v.43 no.8 s.435
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• pp.540-547
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• 2005

• Journal of Music and Human Behavior
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• v.13 no.2
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• pp.17-30
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• 2016

This study aimed to examine the current state of music therapy for adults with intellectual disabilities (ID) by conducting a survey of music therapists. Completed surveys from 32 certified music therapists were included for analysis. The questionnaire was composed of 38 items that asked about the participants' background, work environment and music therapy implementation experience (including assessment, goal establishment, intervention strategy and difficulties). The results of the study showed that music therapy for adults with ID was practiced in diverse facilities. Enhancing social interaction was the most frequently set goal by music therapists, whereas facilities mostly required the music therapy services for emotional stability. Also, instrument playing was used most among music activities, and musical structure was considered most when choosing music for therapy. Among the influential institutional factors, characteristics of the facility were considered most frequently, and the level of functioning was the most considered in terms of client-related factors. To advance the effective use of music therapy interventions with adults with ID, development of music therapy assessment tools and more active communication with facility staff were also suggested when working with this population.

• Therapeutic Science for Rehabilitation
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• v.12 no.4
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• pp.67-80
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• 2023

Objective : This study aimed to investigate the current status of physical therapy in children and adolescents. Methods : Sixty questionnaires from physical therapists treating children and adolescents with disabilities were analyzed. The questionnaire consisted of questions on physical therapy, participants, satisfaction, and the assessment of pediatric and adolescent physical therapy. Descriptive statistics and frequencies were used to investigate the current status, participants, and satisfaction. Differences between physical therapy participation difficulty, importance-ability of major aspects of pediatric and adolescent physical therapy, and therapy goal frequency were analyzed using paired T-test. Results : 11 to 15 cases (66.7%) and one-on-one treatment (95.0%) were performed independently (95.0%). The main ages of the subjects were preschool and school, the diagnoses were brain lesions and developmental delay, and treatment was conducted for up to 20 years or older. Satisfaction with pediatric and adolescent physical therapy was high (70.0%), as was the intensity of work (71.7%). Neurodevelopmental therapy, gait training, and goal-directed rehabilitation were the main treatments, and Gross Motor Function Measures of 88 and 66, respectively, were used. Respondents said that current fee system is inadequate (66.1%) and appropriate fee system is needed. Conclusion : This study extensively investigated the content of and factors related to pediatric and adolescent physical therapy. Based on the current situation, efforts to improve the expertise and continuity of pediatric and adolescent physical therapists and apply the latest treatment techniques are required.

• The Monthly Diabetes
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• s.218
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• pp.56-59
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• 2008

몇 년 전부터 '웰빙'에 대한 사회적 관심과 언론매체에서 제공되는 당뇨병에 관한 다양한 정보는 당뇨인 뿐만 아니라 일반인에게까지 당뇨병의 위험성과 혈당조절의 중요성을 깨닫게 해주었다. 그러나 수명의 증가는 당뇨병과 더불어 살아가야 할 삶의 기간을 늘렸고, 또한 앞으로 합병증과 함께 살아가야 할 시간도 더욱 늘어나게 될 것이다. 당뇨합병증은 일반적으로 혈당조절 정도와 반비례해서 발생한다. 당 조절이 잘되면 합병증이 안 오거나 늦게 생긴다. 그러나 조절이 안 되는 경우 합병증이 빨리 오고 빨리 진행한다. 그래서 최근에는 과거보다 더욱 엄격한 혈당조절 목표를 제시하고 있어, 좀 더 일찍 몇 가지 혈당강하제를 병합하는 치료(조기 병합치료)를 선택하거나 혹은 좀 더 일찍 인슐린 주사치료(조기 인슐린 치료)를 시작하고 있다. 그러나 이러한 시도들, 특히 조기 인슐린 치료는 환자들의 강력한 저항에 부딪혀 실패하곤 한다. 이러한 저항은 대부분 인슐린 치료에 대한 공포(두려움)나 오해 때문에 발생하며 혈당조절을 어렵게 만든다. 따라서 필자는 당뇨병 발생과 치료에 있어 인슐린의 역할을 설명하고, 거부감 없이 인슐린 치료를 쉽게 할 수 있는 방법을 알아보고자 한다.