• Title/Summary/Keyword: 치료의 지속성

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Classified Medical Information Service by Blood and Local Group (혈연, 지역별로 분류한 개인 맞춤형 의료정보 서비스)

  • Eui-Cheol Hwang;Eun Ju Lee;Ung-Mo Kim
    • Proceedings of the Korea Information Processing Society Conference
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    • 2008.11a
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    • pp.253-256
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    • 2008
  • 데이터베이스 시스템의 사용은 다양한 분야에서 필수적으로 사용되고 있다. 정보의 양이 증가함에 따라서 축적된 정보들의 연관성을 찾아내어 새로운 정보를 발굴하는 데이터 마이닝 기법이 지속적으로 연구 개발되고 있으며 데이터 마이닝 기법으로 얻게 된 새로운 정보들은 새로운 가치 창출을 위해 여러 분야에 적용되고 있다. 그 중에서도 의료 서비스 분야에서의 데이터베이스 시스템은 고령화 시대에 건강의 중요성이 강조됨에 따라 보다 적극적으로 활용되어지고 있다. 하지만 지금까지의 의료분야에서의 데이터베이스 시스템 활용은 개인의 의료정보를 데이터베이스 시스템에 저장하고 그것을 바탕으로 개인의 건강에 대한 검진이나 치료 등의 서비스를 제공하는데 국한되어왔다. 개인 맞춤 의료 서비스에도 불구하고 유전이나 지역특화적인 질병, 질환에 의한 때늦은 발견과 치료는 여전히 많은 이들을 고통 받게 하고 있다. 이에 본 논문에서는 각 의료기관에 등록된 환자의 각 질병의 발병 패턴과 치료 정보 등을 토대로 유전적요인과 환경적 특성을 고려한 집단으로 분류하고 환자가 속한 집단구성원에게 검진정보를 제공할 수 있는 의료검진정보 시스템을 제안한다.

Successful Opening of Ductus Arteriosus with Milrinone in a Newborn with Tetralogy of Fallot and Pulmonary Atresia

  • Won, Chong-Bock;Kim, Min-Young;Choi, Duk-Young;Cho, Hye-Jung;Shim, So-Yeon;Son, Dong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.365-369
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    • 2011
  • Tetralogy of Fallot (TOF) assumes its' most severe form when accompanied by pulmonary atresia (PA). Preserving the patent ductus arteriosus to maintain pulmonary blood flow is life-saving for patients with this congenital heart disease. Milrinone, a selective phosphodiesterase III inhibitor, is a potent vasodilator. Here, we report the successful use of milrinone for a newborn infant with TOF and PA for keeping the ductus arteriosus open and thereby maintaining pulmonary circulation. Milrinone is a useful drug because of its inotropic, lusitropic, and pulmonary vasodilating effects, in addition to its ability to keep the ductus arteriosus open and its relatively mild side-effects. Case series and comparative studies will be needed in the future to verify the effectiveness of this drug.

Outcomes of Treatment for Pathologic Fractures Secondary to Simple Bone Cyst (장관골 단순성 골낭종에 동반된 병적 골절의 치료결과)

  • Jeon, Si-Hyun;Song, Kwang-Soon;Kim, Chul-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.38-44
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    • 2003
  • Purpose: To suggest an appropriate treatment modality regarding analyze outcomes of treatment for pathologic fracture to simple bone cyst of the long bone. Materials and Methods: We selected 12 cases with pathologic fracture of the long bone among the 31 cases treated for simple bone cyst from December. 1993 to May. 2001. The mean age was 9 years ranged from 2 years to 19 years, male was 11 cases and female was 1 cases, and the mean follow up interval was 32.9 month ranged from 12 month to 69 month. The principle of treatment for pathologic fracture of the long bone was conservative treatment except operative treatment for fracture with displacement of the femur. After fracture was united, the residual lesion was treated by local steroid injection, cortical drilling, curettage & bone graft. But we observed without specific treatment in cases that had healing process of simple bone cyst followed by bony union. The clinical results were evaluated as exellent if simple bone cyst was completely healed, as good if that had process of healing, as poor if that was no change or more increased in size. Results: The pathologic fracture was united in all cases treated with conservative treatment in 9cases and by open reduction with internal fixation in 3 cases. After fracture was united, the 6 cases were observed without specific treatment, because they had healing process of cyst, and had outcomes as good and excellent. Conclusion: We suggest to need observation when simple bone cyst has healing process after pathologic fracture was united, otherwise secondary treatment will be needed when residual lesion is persisted.

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Vslue of Squamous Cell Carcinoma Associated Antigen fTA-41 in Patients Iurith Invasive Carcinoma of the Uterine Cervix (침윤성 자궁경부암 환자에서 SCC Antigen (TA-4) 측정의 유용성)

  • Cho Moon-June;Kim Jae-Sung;Park Seoung-Ho;Nam Sang-Lyun
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.397-401
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    • 1993
  • We investigated the usefulness of tumor-associated antigen (TA-4) by a radioimmunoasay method in estimating the extent of disease and tracking the clinical course of disease in 58 patients with cervical cancer. According to our results and those of other authors, the normal range of serum TA-4 was arbitrarily taken to be less than 2 ng/ml. The proportion of the pretreatment positive serum TA-4 level of 48 squamous cell carcinoma patients was $60\%.$ And $40\%$ in 5 adenocarcinoma patients. Advanced disease group showed higher incidence of positive serum TA-4 level; $40\%,\;72\%,\;63\%,\;and\;100\%$ in stage I to IV, respectively. And the absolute values of TA-4 were higher in advanced disease. In patients treated with radiation, elevated serum TA-4 level usually declined after 3000 cGy and further dropped to normal range in $44\%$ after 5000 cGy. The positive rate in primary cervical cancer was $59\%,$ (32/54) and $100\%$ (4/4) in recurrent conical cancer. And 15 patients with recurrent or persistent disease during follow-up revealed $80\%$ positive serum TA-4 level. In conclusion, it would be suggested that serial serum TA-4 measurements may be helpful in tracking the clinical course during and after treatment.

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Improvement of Attention Span and Impulsivity of Children with Attention Deficit Hyperactivity Disorder through Structured Violin Learning (주의력결핍과잉행동장애 아동의 집중력 향상과 충동성 조절을 위한 바이올린 교습 중심의 음악치료 사례 연구)

  • Kang, Hyun Jung
    • Journal of Music and Human Behavior
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    • v.3 no.2
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    • pp.1-14
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    • 2006
  • The purpose of this study is to examine the effect of violin learning as to enhance the attention span and impulsiveness of children with Attention Deficit Hyperactivity Disorder(ADHD). Three children with ADHD, grade 2, 3, 4 were selected to participate in the research. A total of 15 session were given during 8 week time span, including a final performance session. For measurement, Korean-Child Behavior Checklist(K-CBCL), Home Situation Questionnaire-Revised (HSQ-R), Conners Teacher Rating Scale-Revised (CTRS-R) were administered before and after the implementation. Other behavioral checklist were used to record inappropriate or interruptive behaviors. The results showed that violin learning has increased attention span and reduced impulsive behaviors of all three children with ADHD. Along with these changes, the identified inappropriate behaviors reduced as sessions progressed. Also the changes observed within the music environment were generalized to non-music environment, such as family and school. These results also indicate that violin can be a therapeutic medium used in music therapy setting to bring positive changes for children with ADHD problems.

A Study of Effectiveness of Outpatient Treatment Orders and Compliance with Outpatient Treatment (외래치료 명령제의 실효성과 외래 치료 순응도에 관한 연구)

  • Jang, Seung-Ho;Park, In-Hwan;Lee, Sang-Yeol;Roh, Suhee;Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.46-55
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    • 2017
  • Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

A study on the therapeutic effects of Topiramate according to the types of migraine (편두통의 형태에 따른 Topiramate의 치료효과 - 무 전조 편두통, 전조 편두통, 그리고 개연적 편두통에 대한 topiramate의 치료 효과 및 치료이후의 임상경과 -)

  • Lee, Jun-Hwa;Cho, Kyung-Lae
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.554-559
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    • 2010
  • Purpose : The purpose of this study was to evaluate whether the therapeutic effects of topiramate differ according to the types of migraine. Methods : We recruited 38 children and adolescents with migraine who had been treated with topiramate. The effect of topiramate was evaluated on the basis of the change in the frequency of migraine attacks after treatment. Results : Among patients having migraine with aura, 85.7% showed complete recovery, 1 (7.1%) showed partial recovery, and 1 did not show any recovery. Among patients having migraine without aura, 47.1% showed complete recovery, 29.4 % showed partial recovery, and 23.5% showed no recovery. Among patients suspected with migraine, 1 (20%) showed complete recovery, 1 (20%) showed partial recovery, and 3 (60%) showed no recovery. Conclusion : Our results indicated that topiramate exhibited excellent therapeutic effects for migraine accompanied with aura, and it was effective in migraine without aura. However, the effect of topiramate in patients suspected with migraine was uncertain.

Treatment of Shepherd's Crook Deformity with Huckstep's nail in Fibrous Dysplasia - A Case Report - (섬유성 골이형성증에서 Huckstep 정을 이용한 Shepherd's Crook 변형의 치료 - 증례 보고 -)

  • Whang, Kuhn-Sung;Kim, Tae-Seung;Kim, Byoung-Hoon;Lee, Jong-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.27-31
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    • 2002
  • Clinical symptoms of fibrous dysplasia in proximal femur include pain, limping, and leglength discrepancy. Occasionally varus deformity, which may range from mild coxa vara to a marked shepherd's crook deformity was developed. Surgical intervention generally is considered advisable in the presence of persistent pain unresponsive to conservative treatment or significant or progressive deformity. Depending on the lesion size, lesion site, and deformity, several treatment methods have been used. This is a report on one case of bilateral shepherd's crook deformity in fibrous dysplasia, which was treated with corrective osteotomy by Huckstep nail.

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기술혁신이 디지털 헬스케어 수용성에 미치는 영향 연구: 확장된 통합기술수용모델 기반 스마트워치 혁신기술 매개효과 중심

  • Jin, Ik-Seong;Lee, So-Yeong
    • 한국벤처창업학회:학술대회논문집
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    • 2022.11a
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    • pp.95-104
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    • 2022
  • 근래 지구온난화에 따른 자연재해의 증가와 장기 코로나19의 전염으로 사회적 비대면 필요성이 증대되면서 온라인을 통한 건강관리 및 의료 진단·처방 등 디지털 헬스케어의 필요성이 증대되고 있다. 디지털 헬스케어로 기존 병원 진료의 온라인 원격 진료/처방이 지속 증가하고 있을 뿐만 아니라 관련 빅데이터를 모아 개인 건강과 질병 상태 정보를 취합하여 건강 관리 및 치료를 하는 디지털 치료제 개발이 급속 진행되고 있으며 관련 벤처 창업도 활발히 진행되고 있다. 이러한 디지털 헬스케어, 디지털 치료제 산업의 활성화는 각 개인의 신체 상태를 상시 측정하고 이 정보를 관련 시스템과 연동 할 수 있는 웨어러블 디바이스, 특히 스마트워치의 보급 증대에 힘입은 바가 크다. 본 연구에서는 스마트워치의 기술혁신이 디지털 헬스케어의 수용성에 어떻게 영향을 미치는지 확장된 통합기술수용모델을 적용하여 분석하고, 혁신 사례로 스마트워치를 활용한 디지털 수면 치료제 벤처 개발 현황을 제시하였다. 본 연구를 통해 확인한 결과는 다음과 같다. 첫째 디지털 헬스케어 스마트워치의 개인혁신성, 효용가치, 사용편의 등 ICT 변인들에 대한 기술발전의 매개 영향은 유의한 것으로 나타났다. 둘째 ICT 변인들과 기술발전 매개변수는 디지털 헬스케에 스마트워치 수용의도에 대부분 정(+)의 영향을 미치는 것으로 확인되었다. 단 기술발전은 개인혁신성에는 크게 매개하지 않는 것으로 나타났다. 이러한 혁신기술의 디지털 헬스케어 스마트워치 수용의도 영향 평가 결과는 스마트워치 각종 서비스 상품기획과 마케팅에 유효하게 참조 할 수 있을 것으로 보이며 추후 세분화 연구를 통하여 더욱 소비자 특화된 제품과 서비스를 창출하는데 기여 할 수 있을 것으로 사료 된다.

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Concurrent Chemoradiation in Patients with Cancer of the Esophagus (식도암에서의 동시화학방사선요법)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Shin Hyun Soo;Lee Chong In;Chang Woo Ick;Shim Young Hak
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.7-16
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    • 1998
  • Purpose : To evaluate survival rate and prognostic factors affecting survival of patients with esophageal cancer treated with concurrent chemoradiation. Materials and Methods : Eligibility included biopsy proven invasive carcinoma of the cervical or thoracic esophagus, confined to esophagus and mediastinum with or without regional lymph node and supraclavicular lymph node, and ECOG Performance status $H_0-H_2$. Patients received radiation therapy with 5940cGy over 7 weeks and chemotherapy, consisted of 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days, days 1 to 5 and days 29 to 33) and mitomycin C($8mg/m^2$ intravenous bolus at day 1). After concurrent chemoradiation, maintenance chemotherapy was followed with 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days at 9th, 13th, and 17th weeks) and cisplatin($80mg/m^2$ intravenous bolus at the first day of each cycle). Results : From November 1989 to November 1995, 44 patients were entered in this study. After treatment, complete response rate and partial response rate were $59\%$ and $41\%$. Overall 1, 2, and 5-year survivals were $59\%$, $38\%$, and $9.6\%$(median 17 months), Prognostic factors affecting survival were response to treatment and T-stage. Among 26 complete responders, there were 6 local recurrences, 3 distant recurrences, 1 local and distant recurrence, and 2 unknown site recurrences Acute and chronic complication rates with grade 3 or more were $20\%$ and $13.0\%$ and there was no treatment-related mortality. Conclusion : Concurrent chemoradiation, compared with historical control groups that treated with radiation alone, improved median survival and did not significantly increase treatment-related complications. Complete responders had longer survival duration than partial responders. Predominant failure pattern was local failure. So, efforts to improve local control should be proposed.

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