• Title/Summary/Keyword: 환자의 접근

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A Study on the Change of Gait Temporal Parameter and Ankle Joint Moment in Patients with Achilles Tendinitis (아킬레스 건염 환자의 보행 시 고관절, 슬관절 및 족관절 모멘트의 변화에 대한 연구)

  • Yu, Jae-Ho;Lee, Gyu-Chang;Lee, Dong-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5766-5772
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    • 2011
  • This study was to investigate the change of gait temporal parameter and ankle joint moment between patients with achilles tendinitis and healthy people. Thus, the purpose of this study is to clarify biomechanical change of gait in patients with achilles tendinitis and to find risk factor for prevention of achilles tendinitis. We recruited 20 patients with an achilles tendinitis and 20 healthy people. While subjects shuttled 5 times on 13 m distance with comfortable pace, we examined gait function marker with three-dimensional gait analysis system. All subject outstepped center of forceplate during gait and calculated ankle joint moment using software. Obtained data was analyzed using SPSS 12.0 software. In results, we confirmed that patients with achilles tendinitis showed reduction of extension moment in early initial phase and reduction of flexion moment in mid-stance on hip joint. and reduction of flexion moment in early initial phase and reduction of extension moment in late phase on knee joint. And we identified that patients with achilles tendinitis showed reduction of dorsiflexion moment in early stance phase, maximal plantarflexion moment in mid stance phase, and dorsiflexion moment in late stance phase. Thus, there are biomechanical changes on gait in patients with achilles tendinitis compared to healthy people. And, in clinical settings, they should focus on changes of gait in patients with achilles tendinitis. Further study will be undertaken for the biomechanical changes of patietns with achilles tendinitis.

Is Genotypic Resistance-guide Eradication Therapy Effective for Patients with Refractory Helicobacter pylori Infection? (불응성 Helicobacter pylori 감염 환자들에게 유전자형 내성을 기반한 제균 치료는 유용한가?)

  • Kim, Sung Eun
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.277-279
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    • 2018
  • 전 세계적으로 Helicobacter pylori의 항생제 내성률은 지속적으로 증가하고 있으며, 기존의 제균 치료에 실패한 H. pylori 감염 환자들에 대한 효과적인 구제요법(rescue therapy)의 필요성 역시 증가하고 있다. 이 연구는 두 개 기관, 공개, 평행 그룹, 무작위 배정 연구로서 불응성 H. pylori 감염 환자들의 구제요법으로 유전자형 내성을 기반한 치료(genotype resistance-guided therapy)와 경험적 치료(empirical therapy) 중 어느 것이 보다 효과적인지를 비교하고자 하였다. 2012년 10월부터 2017년 9월까지 20세 이상의 불응성 H. pylori 감염 환자들을 대상으로 하였으며, 불응성 H. pylori 감염은 과거 두 종류 이상의 H. pylori 제균 치료를 받았음에도 불구하고 H. pylori 제균에 실패한 환자들로 정의하였다. 이들에게서 한 군은 14일간의 유전자형 내성을 기반한 순차 치료(n=21 in trial 1, n=205 in trial 2)를, 다른 한 군은 환자들의 과거 제균 치료 종류를 감안한 14일간의 경험적 순차 치료(n=20 in trial 1, n=205 in trial 2)를 시행하였다. 순차 치료법은 첫 7일은 esomeprazole 40 mg과 amoxicillin 1 g을 하루 두 번 복용한 다음, 나머지 7일은 esomeprazole 40 mg과 metronidazole 500 mg, 그리고 1) levofloxacin 250 mg 또는 2) clarithromycin 500 mg 또는 3) tetracycline 500 mg을 하루 두 번 복용하는 것으로 구성하였다. 23S ribosomal RNA (rRNA)나 gyrase A에 대한 내성 관련 돌연변이 여부는 direct sequencing을 통한 중합효소연쇄반응(polymerase chain reaction, PCR) 검사를 이용하였고, 제균 성공 여부는 요소호기검사를 통해 확인하였다. 일차 결과 지표는 치료 방법에 따른 제균율로 정하였다. Trial 1에서는 tetracycline 대신 doxycycline 100 mg을 사용하였는데, 제균 성공률이 유전자형 내성을 기반한 치료군에서는 17명(81%), 경험적 치료군에서는 12명(60%)으로 나타났다(P=0.181). 하지만, 다른 순차 치료군들과 비교하였을 때, doxycycline을 포함한 순차 치료군의 제균율이 현저히 낮은 것으로 나타나서(15/26, 57.7%) doxycycline을 포함한 순차 치료법은 종결하기로 하고, trial 2부터는 doxycycline 대신 tetracycline으로 교체하여 연구를 지속하였다. Trial 2의 intention-to-treat (ITT) 분석 결과, 유전자형 내성을 기반한 치료군에서는 160/205명(78%), 경험적 치료군에서는 148/205명(72.2%)으로 두 그룹 간의 통계적인 제균율의 차이는 보여주지 못하였다(P=0.170). 부작용 및 환자 순응도에서도 양 군 간의 의미 있는 차이는 없었다. 따라서, 두 종류 이상 H. pylori 제균 치료에 실패한 환자들이라고 할지라도 기존의 제균 치료력을 바탕으로 적절한 경험적 치료를 시행하는 것은 유전자형 내성을 기반한 치료 정도의 효과는 있으며 접근성, 비용, 환자들의 선호도 등의 여러 가지 부가적인 사항들을 고려할 때, 제균 치료력을 고려한 경험적 치료는 간단한 수준의 유전자형 내성을 기반한 치료의 대안으로 받아들여질 수 있을 것으로 제안하였다.

Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor (족관절 내과 절골술 및 대형신연기를 이용한 제3형 거골 경부 골절의 치료 결과)

  • Park, Sung Hae;Lee, Jun Young;Lee, Jung Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.45-51
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    • 2019
  • Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.

Integrated Medicine Therapy for an End-stage Lung Cancer Patient with Brain Metastasis (양한방 협진을 통한 뇌전이 동반 말기 폐암환자 치험 1례)

  • Park, Seung-Chan;Kim, Do-Hyung;Han, Chang-Woo;Park, Seong-Ha;Lee, In;Choi, Jun-Yong
    • Journal of Korean Traditional Oncology
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    • v.16 no.2
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    • pp.43-51
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    • 2011
  • Objectives : This study reports one case of a patient diagnosed with non-small cell lung cancer with brain metastasis. Methods : A 79 year-old male patient diagnosed with non-small cell lung cancer with brain metastasis was treated chemotherapy for 3 months and quitted it due to poor general condition. He transferred to Korean medicine hospital and was treated herbal medicine(Saengmaek-san plus Baekhapgogeum-tang gagam), acupuncture, moxibustion, interferential current therapy. To evaluate the patient, we measured of Visual Analogue Scale (VAS), Functional Assessment of Cancer Therapy-Lung (FACT-L), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). Results : Patient's outcomes were improved during the 1st week regarding VAS (41${\rightarrow}$25), FACT-L (81.2${\rightarrow}$90), FACIT-fatigue (25${\rightarrow}$10). However, dyspnea and cough were was aggravated in the 2nd week. Conclusions : Treatment with Korean medicine therapy may have substantial benefit for patients with end-stage lung cancer. But, Integrated medicine therapy is necessary for proper management of end-stage cancer patients.

Oral rehabilitation of a patient with severely worn dentition using monolithic zirconia (단일구조 지르코니아 보철물을 이용한 심한 마모 환자의 전악 수복 증례)

  • Park, Jun-Seo;Ryu, Jae-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.273-279
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    • 2016
  • Severe tooth wear may lead to pathological changes of pulp, imbalance in occlusion as well as functional and esthetic problems. In this case, 34-year-old male came to the hospital because of generally worn dentition due to attrition and erosion. After evaluation, a full mouth restoration with elevation of the vertical dimension of occlusion was planned. After occlusion was stabilized by an occlusal stabilization appliance, centric relation position was recorded and subsequent provisional restorations were fabricated. After evaluation, a CAD-CAM (computer aided design-computer aided manufacturing) prosthetic restoration was carried out using monolithic zirconia. After 12 months of follow up observation, the patient was satisfied with function and esthetic appearance.

Use of artificial palate for improving facial support in the fabrication of a maxillary obturator: A case report (상악골 부분 절제술 시행한 환자에서 Artificial Palate로 안모지지를 재현한 폐색장치를 이용한 수복 증례)

  • Yoon, Hee-Kyoung;Hwang, Hee-Seong;Kim, Chul-Hoon;Kim, Jung-Han;Kim, Bok-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.319-324
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    • 2017
  • Patients with maxillectomy defects predisposed to not only difficulty in deglutition, mastication, speech but also psychological depression from impaired facial esthetics that affect life quality. Obturator prostheses play a important role in restoring the lost form, function and the quality of life for patients with maxillectomy defects. This clinical report presents the simplified approach to predict the degree of adequate facial support by Artificial palate which reflected from a maxillary interim obturator during the stabilization period after maxillectomy.

A Study on Countermeasures of Convergence for Big Data and Security Threats to Attack DRDoS in U-Healthcare Device (U-Healthcare 기기에서 DRDoS공격 보안위협과 Big Data를 융합한 대응방안 연구)

  • Hur, Yun-A;Lee, Keun-Ho
    • Journal of the Korea Convergence Society
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    • v.6 no.4
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    • pp.243-248
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    • 2015
  • U-Healthcare is a convergence service with medical care and IT which enables to examine, manage and maintain the patient's health any time and any place. For communication conducted in U-Healthcare service, the transmission methods are used that patient's medical checkup analysis results or emergency data are transmitted to hospital server using wireless communication method. At this moment when the attacker who executes the malicious access makes DRDoS(Distributed Reflection DoS) attack to U-Healthcare devices or BS(Base Station), various damages occur that contextual information of urgent patients are not transmitted to hospital server. In order to deal with this problem, this study suggests DRDoS attack scenario and countermeasures against DRDoS and converges with Big Data which could process large amount of packets. When the attacker attacks U-Healthcare devices or BS(Base Station), DB is interconnected and the attack is prevented if it is coincident. This study analyzes the attack method that could occur in U-Healthcare devices or BS which are remote medical service and suggests countermeasures against the security threat using Big Data.

m-Health System for Processing of Clinical Biosignals based Android Platform (안드로이드 플랫폼 기반의 임상 바이오신호 처리를 위한 모바일 헬스 시스템)

  • Seo, Jung-Hee;Park, Hung-Bog
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.7
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    • pp.97-106
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    • 2012
  • Management of biosignal data in mobile devices causes many problems in real-time transmission of large volume of multimedia data or storage devices. Therefore, this research paper intends to suggest an m-Health system, a clinical data processing system using mobile in order to provide quick medical service. This system deployed health system on IP network, compounded outputs from many bio sensing in remote sites and performed integrated data processing electronically on various bio sensors. The m-health system measures and monitors various biosignals and sends them to data servers of remote hospitals. It is an Android-based mobile application which patients and their family and medical staff can use anywhere anytime. Medical staff access patient data from hospital data servers and provide feedback on medical diagnosis and prescription to patients or users. Video stream for patient monitoring uses a scalable transcoding technique to decides data size appropriate for network traffic and sends video stream, remarkably reducing loads of mobile systems and networks.

Design and Implementation of Integrated IEEE802.15.4 Wireless Mobile Care Application (집적형 IEEE 802.15.4 무선 모바일케어 응용시스템의 설계 및 적용)

  • Yau, Chiew-Lian;Chung, Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2007.10a
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    • pp.482-485
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    • 2007
  • Recent generation of wireless computing has focus on the integrating of exisitng technologies to enhance the mobile capabilities and developing a new approaches to meet the needs of the growing pool of applications. This paper describes an integrated IEEE802.15.4 wireless CDMA based healthcare system that interacts and received the data wirelessly from wireless medical devices of patient and forward to medical center by using the cellular network. Mobile application had been developed not only as the middle ware to handle the receive and transmit of medical data between wireless sensor network and cellular network but also provides the interface for monitoring and analyzing the health condition of patients continuously at cellular phone regardless of its physical location. This system thus enables the remote healthcare monitoring and supports medical data seamlessly roams between IEEE802.15.4 wireless network and CDMA network beyond and outside the hospital environment.

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Orthodontic Traction of Multiple Impacted upper Anterior Teeth: Case Report (상악 전치의 매복을 동반한 환자의 치험례)

  • Tark, Myung-Hyun;Cho, Jin-Woo;Chang, Na-Young;Cho, Jin-Hyoung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.407-421
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    • 2012
  • Orthodontic problems of the oral maxillofacial area could be classified into skeletal and dental problems. Dental problems might cause various occlusal disharmony and among them congenital missing or eruption failure might cause not only functional problems but also esthetic problems. Additional psychological problems are also one of the reasons for patients seeking treatment. In cases showing eruption failure of many teeth in the maxilla, not only occlusal and esthetic problems but also difficulty in alveolar bone maintainment could occur. Therefore, successive approach is necessary when multiple teeth show eruption problems. In this case, a patient with eruption problems of #13, 12, 11, 23, 43 was successfully treated by surgical exposure and successive orthodontic extrusion resulting perfect occlusion. By additional periodontal treatment, gingival recession that occurred along with teeth eruption was solved. The impacted right mandibular canine was erupted successfully only by natural arch expansion and leeway space without any special surgical treatment.