• Title/Summary/Keyword: 환자 치료자세

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Guideline for Imaging Dose on Image-Guided Radiation Therapy (영상유도방사선치료에 있어 영상선량 가이드라인)

  • Cho, Byung Chul;Huh, Hyun Do;Kim, Jin Sung;Choi, Jin Ho;Kim, Seong Hoon;Cho, Kwang Hwan;Cho, Sam Ju;Min, Chul Kee;Shin, Dong Oh;Lee, Sang Hoon;Park, Dong Wook;Kim, Kum Bae;Choi, Sang Hyoun;Kim, Hye Young;Ahn, Woo-Sang;Kim, Tae Hyeong;Han, Su Cheol
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.1-24
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    • 2013
  • As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

Thoracoscopic Sympathectomy in Hyperhidrosis (비디오 흉강경을 이용한 다한증 수술의 임상적 고찰)

  • 김동원;배철영;신원선;好돼?;이신영
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1212-1216
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    • 1998
  • Background: Recently thoracoscopic surgery is widely applied in thoracic surgical field and hyperhidrosis is one of the most frequently operated diseases. Material and Method: From June 1997 to February 1998, 30 patients with hyperhidrosis underwent bilateral thoracic sympathectomy under thoracoscopy at Inje University Sanggye Paik Hospital. There were 10 males and 20 females whose mean age was 22.42±6.84 years ranging from 17 to 51. All patients underwent bilateral thoracic sympathectomy under semi-sitting position and two 5 mm sized trocars were inserted. Result: Mean operation time was 52.32±11.72 minutes and the mean elevation of palmar temperature after sympathectomy was 2.17±0.47℃. Eighteen patients(60%) complained compensatory hyperhidrosis. All patients except one were able to discharge at the operation day or postoperative one day. There were no recurrence during follow up from 2 to 8 months(mean 5.30±2.17 months). Conclusion: Thoracoscopic sympathectomy is simple and effective technique in hyperhidrosis and widely applied indication will be necessary. We conclude that further discussion should be made about the resection area and method to get maximal effect and minimal side effect.

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The Usefulness of a Wearable Smart Insole for Gait and Balance Analyses After Surgery for Adult Degenerative Scoliosis: Immediate and Delayed Effects (척추측만증 환자의 수술 효과 평가 수단으로서 웨어러블 스마트 깔창을 이용한 보행분석의 유용성)

  • Seo, Min Seok;Shin, Myung Jun;Kwon, Ae Ran;Park, Tae Sung;Nam, Kyoung Hyup
    • Journal of Convergence for Information Technology
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    • v.10 no.2
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    • pp.184-192
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    • 2020
  • This study presents a gait analysis method (including time series analysis) using a smart insole as an objective and quantitative evaluating method after lumbar scoliosis surgery. The participant is a degenerative lumbar scoliosis patient. She took 3-min-gait-test four times(before and 8, 16, and 204-days after surgery) and 6-min-gait-test once(204-days after surgery) with smart-insoles in her shoes. Each insole has 8-pressure sensors, an accelerometer, and a gyroscope. The measured values were used to compare the characteristics of gait before and after surgery. The analysis showed that all of the patient's gait parameters improved after surgery. And after 6 months, the gait was more stable. However, after long walk, the swing duration of one leg was slightly shorter than that of the other again. It was a preclinical problem that could not be found in the visual examination by the practitioner. With this analysis method we could evaluate the improvement of patient quantitatively and objectively. And we could find a preclinical problem. This analysis method will lead to the studies that define and distinguish gait patterns of certain diseases, helping to determine appropriate treatments.

Evaluation of dose delivery accuracy due to variation in pitch and roll (세기변조방사선치료에서 Pitch와 Roll 변화에 따른 선량전달 정확성 평가)

  • Jeong, Chang Young;Bae, Sun Myung;Lee, Dong Hyung;Min, Soon Ki;Kang, Tae Young;Baek, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.239-245
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    • 2014
  • Purpose : The purpose of this study is to verify the accuracy of dose delivery according to the pitch and roll rotational setup error with 6D robotic couch in Intensity Modulated Radiation Therapy (IMRT) for pelvic region in patients. Materials and Methods : Trilogy(Varian, USA) and 6D robotic couch(ProturaTM 1.4, CIVCO, USA) were used to measure and analyze the rotational setup error of 14 patients (157 setup cases) for pelvic region. The total 157 Images(CBCT 78, Radiography 79) were used to calculate the mean value and the incidence of pitch and roll rotational setup error with Microsoft Office Excel 2007. The measured data (3 mm, 3%) at the reference angle ($0^{\circ}$) without couch rotation of pitch and roll direction was compared to the others at different pitch and roll angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$, $2.5^{\circ}$) to verify the accuracy of dose delivery by using 2D array ionization chamber (I'mRT Matrixx, IBA Dosimetry, Germany) and MultiCube Phantom(IBA Dosimetry, Germany). Result from the data, gamma index was evaluated. Results : The mean values of pitch and roll rotational setup error were $0.9^{\circ}{\pm}0.7$, $0.5^{\circ}{\pm}0.6$. The maximum values of them were $2.8^{\circ}$, $2.0^{\circ}$. All of the minimum values were zero. The mean values of gamma pass rate at four different pitch angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$, $2.5^{\circ}$) were 97.75%, 96.65%, 94.38% and 90.91%. The mean values of gamma pass rate at four different roll angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$, $2.5^{\circ}$) were 93.68%, 93.05%, 87.77% and 84.96%. when the same angles ($1^{\circ}$, $1.5^{\circ}$, $2^{\circ}$) of pitch and roll were applied simultaneously, The mean values of each angle were 94.90%, 92.37% and 87.88%, respectively. Conclusion : As a result of this study, it was able to recognize that the accuracy of dose delivered is lowered gradually as pitch and roll increases. In order to increase the accuracy of delivered dose, therefore, it is recommended to perform IGRT or correct patient's position in the pitch and roll direction, to improve the quality of treatment.

Effect of Computerized Feedback Postural Training on Balance and Muscle Activity in Stroke Patients (컴퓨터화된 자세조절훈련이 뇌졸중 환자의 균형 및 근활성도에 미치는 영향)

  • Yang, Dae-Jung;Park, Seung-Kyu;Kang, Jun-Il;Lee, Jun-Hee;Uhm, Yo-Han
    • The Journal of Korean Physical Therapy
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    • v.24 no.5
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    • pp.348-354
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    • 2012
  • Purpose: This study examined the effects of computerized feedback postural training on the balance and electromyography activity of subjects with stroke. Methods: A total of 30 chronic stroke patients were enrolled in this study. Subjects were divided into an experimental group (n=15) and a control group (n=15). Computerized feedback postural training was used in the experimental group. Both groups received intervention for six weeks, 5 times per 30 minutes period. Data analysis was performed using analysis of covariance for determination of statistical significance. Results: Significant difference in static and dynamic balance was observed in the experimental group, compared with the control group (p=0.05), and a significant difference in muscle activity was observed in the gastrocnemius muscle, quadriceps muscle, and elector spinae muscle. However, the hamstring muscle showed no significant difference. Conclusion: Computerized feedback postural training is more effective in improving the ability of balance and muscle activity than neurological physical therapy.

The immediate effect standing balance and dynamic activity on barefoot, wearing SPAFO and wearing HPAFO in hemiplegic patients (편마비환자에게 플라스틱 단하지 보조기착용 전${\cdot}$후 선자세 균형과 동적 움직임에 미치는 효과)

  • Lim Ho-Yong;Park Seung-kyu
    • The Journal of Korean Physical Therapy
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    • v.17 no.1
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    • pp.96-107
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    • 2005
  • Objective: The purpose of this study were to investigate the standing balance, dynamic activity in hemiplegic patients according to the types of ankle-foot orthosis(AFO) and to determine the most effective type of AFO for gait training. Method: A prospective study was performed for 16 patients with hemiplegia who was able to walk independently. Static balance and dynamic activity were compared in two condition : 1) barefoot and SPAFO, 2) barefoot and HPAFO. Static balance and dynamic activity characteristics were evaluated by Active Balance while they were standing with in two condition AFO and barefoot. Results: There were significant difference in standing balance between barefoot and wearing SPAFO and HPAFO(p<0.05). There were significant difference in dynamic activity balance between barefoot and wearing SPAFO and HPAFO(p<0.05). There were significant difference in gait speed between barefoot and wearing SPAFO and HPAFO(p<0.05). Conclusion: This study showed that wearing SPAFO and HPAFO gave fair amount of improvement to balance and gait ability of hemiplegic patients.

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The Effects of Standing Posture Improvement Exercise to the Turning Round Movement in Patients with Parkinson Disease (기립자세 증진 운동이 파킨슨병 환자의 제자리 돌기 동작에 미치는 영향)

  • Kim, Joo-Hyoun;Hwang, Byong-Yong;Yoon, Hui-Jong
    • The Journal of Korean Physical Therapy
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    • v.19 no.5
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    • pp.21-28
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    • 2007
  • Purpose: The aims of this study was to evaluate the effects of shoulder lateral rotation and trunk extension exercises on standing posture improvement exercises using turning round in the patients with Parkinson's disease. Methods: For twenty-one patients with Parkinson's disease, shoulder lateral rotation and trunk extension exercises were performed for a total of three sets, ten times a set, three days a week for twelve weeks. To measure turning round, ink foot-print method was used. The number of steps and time were measured every week for before and after study (twelve weeks). Results: The results are as follows: Changes in steps and time on each week during twelve weeks showed significant differences, compared with before test(p<0.05). Conclusion: Standing posture improvement exercises can help perform turning round in the patients with Parkinson's disease.

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Case Report of Korean Medical Treatment on Acute Peroneal Nerve Palsy Patient Caused by Prolonged Immobilization (장시간 부동 자세로 야기된 급성 비골신경 마비 환자의 한방치료 증례보고)

  • Kim, Min-Soo;Kim, Jin-Hee;Lee, Ji-Young;Yeom, Seung-Ryong;Kwon, Young-Dal
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.3
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    • pp.127-136
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    • 2015
  • Objectives This study was carried out to investigate the clinical effects of Korean medical treatment on acute peroneal nerve palsy caused by prolonged immobilization. Methods One patient with acute peroneal nerve palsy was treated with various korean medical techniques such as acupuncture, moxibustion, cupping and herbal medicine, bee-venom acupuncture for 12 weeks. Manual Muscle Test, Range of motion, Numerical Rating Scale, Ankle-hindfoot scale, Digital infrared thermographing imaging system were used to evaluate treatment effect. Results After treatment, all the scales mentioned above were improved significantly. Conclusions This result showed that Korean medical treatment is effective on acute peroneal nerve palsy caused by prolonged immoblization.

Effects of Changes in Postural Alignment on Foot Pressure and Balance of Patients with Stroke (뇌졸중 환자에서 자세정렬변화가 족저압 및 균형에 미치는 영향)

  • Yang, Dae-Jung;Park, Seung-Kyu;Kang, Jeong-Il;Park, Seong-Bin
    • The Journal of Korean Physical Therapy
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    • v.26 no.4
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    • pp.226-233
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    • 2014
  • Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.

The Effects of Symmetrical Scapular Alignment on Weight Bearing of Hemiplegic Patients During Standing Position (편마비 환자의 견갑골 대칭적 정렬상태가 선 자세에서 체중부하지지율에 미치는 영향)

  • You, Young-Youl;Ann, Chang-Sik
    • The Journal of Korean Physical Therapy
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    • v.21 no.2
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    • pp.23-29
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    • 2009
  • Purpose: This study examined the effects of the symmetrical scapular alignment on the weight bearing of hemiplegic patients in the standing position. Methods: PALM (PALpation Meter) test and Gaitview AFA-50 were used to measure the skeletal alignment of the scapula and the weight bearing loaded on the affected and unaffected sides before and after training. The data was analyzed using a paired t-test on the SPSS 12.0 program for descriptive statistics. A p value <0.05 was considered significant. Results: The mean difference in the scapular alignments on sup. & mid. & inf. area in the hemiplegic side before and after training was $0.93\pm0.50cm$ and $0.58\pm0.43cm$, respectively. There was a significant decrease after training rather than that before (p<0.05). The mean weight bearing on the foot area in the hemiplegic patients before and after training was $9.12\pm5.51N/cm^2$ and $4.36\pm4.11N/cm^2$, respectively,. There was a significant decrease after training rather than that before (p<0.05). The scapuar alignments and weight bearing data on the standing position were grouped around the average (to central point) in the distribution graph. Conclusion: These findings suggest that the symmetrical scapular alignment can serve as an effective means of improving the weight bearing ability of hemiplegic patients.

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