• Title/Summary/Keyword: 치료효율

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A Survey of Physical Therapy Clinical Progress Note in Korea (한국 물리치료사의 임상기록에 대한 조사연구)

  • Kim, Seung-Joon
    • The Journal of Korean Physical Therapy
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    • v.17 no.4
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    • pp.485-492
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    • 2005
  • 환자에 대한 기록은 일정한 형식을 가지고 환자 내원 초기부터 환자 및 의료진의 요구와 관리목적에 부합한 효과적인 평가, 치료계획, 치료적 중재를 수립할 수 있게 만드는 필수적인 일련의 상호관련학적 의사소통 도구임과 동시에 치료사가 환자관리에 포함된 사고 과정을 분석하는 데 도움을 주며 문제해결에 대한 사고를 체계화하는데 있어 중요한 역할을 한다. 본 연구의 목적은 물리치료사의 일반적 특성과 임상기록의 실태, 임상기록의 중요성을 인식하고 임상활동의 문제점을 개선하며 기록의 체계화를 이루어 임상기록의 활성화와 나아가 물리치료의 질적 향상과 물리치료 서비스에 대한 효율성을 높이는데 있다. 이 연구는 전국 의료기관이나 보건관련기관에서 근무하는 물리치료사를 선정하였다. 2005년 7월1일부터 8월30일 사이에 구조화된 설문지 320매를 직접 전달해 치료사가 작성한 설문지 314매를 직접 수거하였다. 분석 방법으로는 백분율과 빈도, Kuskal-Wallis Test. Pearson Chi-Square, Mann-Whitney U로 검정하였다. 잘못 표기한 응답자 1명을 제외한 응답자 총 313명 중 남자 142명 (45.2%), 여자 171명 (54.5%) 이었으며, 25세 이상 29세 이하 연령층이 119명 (37.9%)으로 가장 많이 분포하였다. 근무처에 따른 근무 개월, 일일 평균 환자수는 통계학적 검정으로 유의한 차이가 있는 것으로 나타났다(p<.05). 근무처에 따른 임상기록 작성에서도 통계학적 검정이 유의하였다(p<.05) 임상기록 작성이 효율적인 치료. 치료사 만족도에도 통계학적으로 유의한 결과가 나타났다(p<.05).

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Biologic rationale of cancer treatment with hyperthermia (고온온열치료장치를 사용한 종양치료의 생물학적 원리)

  • 김명세
    • Proceedings of the Korea Electromagnetic Engineering Society Conference
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    • 1999.07a
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    • pp.47-55
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    • 1999
  • 고온온열치료는 radiofrequency, ultrasound , microwave, 원적외선 등을 이용하여 신체의 부분 혹은 전신을 4$0^{\circ}C$ 이상으로 가열하여 암을 치료하는 방법이다. 우리나라에 도 입된 15기의 기계중 현재까지 사용되고 있는 것은 대부분이 radiofrequency를 사용하는 기 계이며 현재 고신의대, 동아의대, 부산메리놀병원, 여의도 성모병원, 영남의대, 전주예수병원 등에서 환자치료에 사용하고 있다. 고온 온열치료제(hyperthermia)는 직접 암세포를 죽이는 작용, 방사선치료나 항암제치료와 병행하여 그 효과를 증강시키는 작용으로 크게 나눌수 있 다. 직접 암세포를 죽이기 위하여는 43$^{\circ}C$이상의 고온을 사용하여야 하나 인체에서는 42.5$^{\circ}C$ 이상으로 가온하기가 쉽지않아 4$0^{\circ}C$~42$^{\circ}C$ 정도의 온도에서 방사선 치료나 항암제 치료효과 를 증진시키는 작용을 임상에서 주로 사용하고 있다. 특히 방사선 치료와 병합 사용시 그 효과가 뛰어나 간암, 난소암, 대장 직장암, 식도암, 위암, 자궁암, 전립선안, 췌장암, 폐암등, 거의 모든 암에서 부작용을 증가시키지 않으면서 그 효율을 1.1-6.14배나 증가시킨다고 보 고되고 있어 지난 10여 년간 제자리걸음을 하고 있는 암의 치료에 희망을 주고 있다. 방사 선 치료와 병합시 효과를 증대시키는 기전은 1)세포의 핵 합성기 (S-phase)는 방사선 치료 에는 매우 저항력이 강하여 잘 죽지 않으나 고온온열치료에는 예민함으로 암세포는 정상조 직에 비해 산소가 부족하여 염기성대사(anaerobic metabolism)를 많이 함으로 그 부산물인 유산 (lactic acid)이 많이 생성됨으로 정상조직보다 pH가 낮아 암 조직이 정상조직에 비해 고온온열치료에 더 잘 듣는 원인이 된다. 3) 영양이 부족한 상태의 세포는 고온온열치료에 훨씬 예민하다. 4) 암조직은 혈관상태가 정상조직에 비해 좋지 않음으로 정상조직보다 쉽게 가온이 되며, 일단 가온된 온도는 잘 식지 않음으로 정상조직에 비해 훨씬 효율적이다. 5)고 온온열치료는 4$0^{\circ}C$~43.5 $^{\circ}C$정도에서만 이 작용이 일어남으로 정상인체에서 43$^{\circ}C$이상의 가온 은 쉽지 않음으로 이 효과는 암조직에서 주고 일어나게 된다. 6)고온온열치료는 방사선치료 후에 생기는 손상의 재생을 억제함으로 방사선의 치료효과를 높인다. 7)38.5$^{\circ}C$~41.5$^{\circ}C$의 낮 은 온도에서도 암조직의 산소 상태를 호전시켜 방사선 치료효과를 증대시키는 역할을 한다.

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Development of a cylindrical ultrasound applicator for Intracavitary Hyperthermia (강내온열 치료를 위한 원통형 초음파 치료기 개발)

  • Lee, Rena J.;Hyunsuk Suh
    • Progress in Medical Physics
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    • v.13 no.2
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    • pp.79-84
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    • 2002
  • In this study, a cylindrical ultrasound applicator is developed for the treatment of vagina and rectum in combination with high dose rate brachytherapy. A cylindrical transducer (PZT-8, 1=1.5 cm, thickness=1.5mm OD=2.5 cm) was used as an energy source for induction of hyperthermia. Three single-element applicators were constructed to examine the performance of the PZT material. Vector impedance was measured to determine driving frequency. The efficiencies of the elements were determined using a radiation force technique to evaluate the feasibility of using the applicator as a hyperthermia source. A multi-element ultrasound applicator was designed using the PZT-8 material for the treatment of vagina. Results from the vector impedance measurements showed maximum magnitude at 1.78, 1.77, and 1.77 MHz for applicator 1,2, and 3, respectively. The radiation force measurements showed that the acoustic power of 40 watts was obtained in all three elements. The average efficiencies of the elements were 61.4, 65.2, and 54.0% for element 1, 2, and 3, respectively. The designed ultrasound hyperthermia applicator could be used in combination with high dose rate brachytherapy for the treatment of vagina and rectum. The use of this applicator with intracavitary brachytherapy could offer improved tumor control by increasing radiosensitiyity of the tumor.

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Development of a Methodology for Oxygen Partial Pressure Increase : Example of Veterinary Hyperbaric Chambers (고압산소챔버 내의 산소분압 적정 증가 방안 개발 : 동물실험용 챔버 대상)

  • Wang, Soon-Joo;Kim, Eun;Kang, Pooreun
    • Proceedings of the Korean Society of Disaster Information Conference
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    • 2023.11a
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    • pp.351-352
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    • 2023
  • 동물용 고압산소치료 시 산소를 통한 가압은 이미 있는 공기를 제거하고 산소로 대치시키는데 효율성이 떨어져서 100%에 가까운 산소분압을 구현하는데 어려움이 있고, 그 방법도 표준화되지 않았다. 따라서 어떠한 방식의 산소가압이 신속하고 효율적으로 100%에 가까운 산소분압을 구현할 수 있는지에 대한 방안을 개발하고 표준화할 필요가 있다. 동물용 고압산소치료를 활용한 동물실험이나 동물의 치료 중 가압 단계에서 간헐적 환기 방법이 더 신속하게 100%에 가까운 산소 분압을 보이므로 향후 표준 지침 개발을 위한 중요한 기반 연구와 제안으로 활용 가능하다. 이는 재난 기반으로의 고압산소챔버의 활용을 위한 기초 자료가 될 것이다.

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A Study on the Efficiency of Children's Shelter in Korea using DEA Analysis Method

  • Jeong, Seong-Bae;Joo, Mi-yeon
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.6
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    • pp.207-217
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    • 2020
  • The purpose of this study is to analyze the efficiency of Korean child welfare facilities using the DEA analysis method and to present policies. The input variables for the analysis of this data were the number of employees, the number of facilities, and the number of gardens, and the output variables were the current sources. The results of the study are as follows. As a result of CCR analysis, inefficient facilities were found to be temporary protection facilities and comprehensive facilities. As a result of BCC analysis, inefficient facilities were identified as temporary protection facilities. As a result of SE analysis, inefficient facilities were found to be temporary protection facilities. The suggestion is as follows. First, adjustment of the capacity of temporary protection facilities is required. Second, it is necessary to strengthen the professionalism of workers in child welfare facilities. Third, strengthen the expertise of the child welfare facility manager.

Finite element analysis of tissue differentiation process in fractured bones applied by a composite IM-rod based on a mechano-regulation theory (메카노 규제 이론에 기초한 복합재료 IM-rod가 적용된 골절부의 세포분화과정의 유한요소해석)

  • Son, Dae-Sung;Mehboob, Hassan;Chang, Seung-Hwan
    • Composites Research
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    • v.25 no.5
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    • pp.136-140
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    • 2012
  • This paper describes the bone healing process of fractured long bones such as a tibia applied by composite IM rods using finite element analysis. To simulated tissue differentiation process mechano-regulation theory with a deviatoric strain was implemented and a user's subroutine programmed by a Python code for an iterative calculation was used. To broadly find the appropriate rod modulus for healing bone fractures, composite IM rods were analyzed considering the stacking sequence. To compare mechanical stimulation at fracture gap, two kinds of initial loading conditions were applied. As a result, it was found that the initial loading condition was the most sensitive factor for the healing performance. In case a composite IM rod made of a plain weave carbon fiber/epoxy (WSN3k) had a stacking sequence of $[{\pm}45]_{nT}$, the healing efficiency was the most effective under a initial load of 10%BW.

Clinical Characteristics and Treatment Outcomes of Patients with Pulmonary tuberculosis at a Private General Hospital (한 민간종합병원에서 진단된 폐결핵 환자의 특성과 치료성적)

  • Koh, Won-Jung;Kwon, O Jung;Kim, Cheol Hong;Ahn, Young Mee;Lim, Seong Yong;Yun, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Jung Wook;Suh, Jin Sook
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.154-164
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    • 2003
  • Background : Until the early 1990's in Korea, treatment outcomes of patients with pulmonary tuberculosis in the private sector were reported to be inferior to those of the public health center under the National Tuberculosis Programme. The purpose of this study was to analyze the clinical characteristics and the treatment efficacy of the patients with pulmonary tuberculosis recently diagnosed at a private general hospital. Materials and Methods : The study included all pulmonary tuberculosis patients diagnosed at Samsung Medical Center and notified to the public health center from August 2000 to January 2001. Results : Of the 232 patients included in the study during a 6-month period, 188 were (81.0%) initial treatment cases and 44 (19.0%) were re-treatment cases. Eighty-three (35.8%) patients had smear-positive sputa, and 27 (11.6%) had smear-negative, culture-positive sputa. Initial sputum examinations were not performed in 47 (20.3%) patients. A six-month, short-course treatment using isoniazid, rifampin, ethambutol and pyrazinamide was prescribed for 31.4% of the patients under the initial treatment. The success rate (cured plus treatment completed) of the initial treatment for the smear-positive patients was 69.1%. Eleven (13.3%) of the 83 patients with smear-positive pulmonary tuberculosis discontinued their treatment without notice. Conclusions : To improve the treatment efficacy and decrease the default rates of the patients with pulmonary tuberculosis in the private sector, further efforts are required in line with the Korean Academy of Tuberculosis and Respiratory Disease Treatment Guidelines and in the implementation of an appropriate model of public-private mix for tuberculosis control in Korea.

A Development of Evaluation Indicators for Performance Improvement of Horticultural Therapy Garden (원예치료정원의 성능개선을 위한 평가지표 개발)

  • Ahn, Je-Jun;Park, Yool-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.4
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    • pp.113-123
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    • 2018
  • The purpose of this research is to develop evaluation indicators forperformance improvement of horticultural therapy garden. In order to achieve a therapeutic purpose, the gardening activity held by the trained horticultural therapist. Moreover, horticultural therapy is 'a medical model' for the treatment and basic premise of the research was set, as horticultural therapy garden is characterized area to support activities of patients and horticultural therapist functionally and efficiently. For this study, three times of Delphi and AHP techniques were proceeded to export panels who were recruited by purposive sampling. Through these techniques, it was possible to deduct the evaluation indicator which maximizes the performance of the horticultural therapy garden. The evaluation items were prioritized by typing and stratification of the indicator. The results and discussions were stated as followings. Firstly, a questionnaire of experts was conducted to horticultural therapists and civil servants who were in charge of horticultural therapy. As results(horticultural therapists: 87.8%, civil servants: 75.2%), It is possible to conclude that both positions have the high recognition and agreed on the necessity of horticultural therapy. Secondly, Delphi investigation was conducted three times in order to develop the evaluation indicator for performance evaluation. After Delphi analysis, total 34 of evaluation elements to improve the performance of the horticultural therapy garden by reliability and validity analysis results. Thirdly, AHP analysis of each evaluation indicator was conducted on the relative importance and weighting. Moreover, the results showed 'interaction between nature and human' as the most important element, and in order of 'plan of the program', 'social interaction', 'sustainable environmental', and 'universal design rule', respectively. On the other hand, the exports from the university and research institute evaluated the importance of 'interaction between nature and human', while horticultural therapists chose 'plan of the program' as the most important element. Fourthly, the total weight was used to develop weight applied evaluation indicator for the performance evaluation of the horticultural therapy garden. The weight applying to evaluation index is generally calculated multiply the evaluation scores and the total weight using AHP analysis. Finally, 'the evaluation indicator and evaluation score sheet for performance improvement of the horticultural therapy garden' was finally stated based on the relative order of priority between evaluation indicators and analyzing the weight. If it was deducted the improvement points for the efficiency of already established horticultural therapy garden using the 'weight applied evaluation sheet', it is possible to expand it by judging the importance with the decision of the priority because the item importance decided by experts was reflected. Moreover, in the condition of new garden establishment, it is expected to be helpful in suggesting ways for performance improvement and in setting the guidelines by understanding the major indicators of performance improvement in horticultural therapy activity.