• 제목/요약/키워드: Follow-up Management

검색결과 1,705건 처리시간 0.033초

Experience with Conventional Radiofrequency Thermorhizotomy in Patients with Failed Medical Management for Trigeminal Neuralgia

  • Singh, Sarita;Verma, Reetu;Kumar, Manoj;Rastogi, Virendra;Bogra, Jaishree
    • The Korean Journal of Pain
    • /
    • 제27권3호
    • /
    • pp.260-265
    • /
    • 2014
  • Background: To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. Methods: Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. Results: Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. Conclusions: CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.

ISO 인증 중소기업의 사후관리에 관한 실증적 연구 (An Empirical Study on the ISO 9000 Follow-up Management Practices of Korean Small Enterprises)

  • 이재관
    • 품질경영학회지
    • /
    • 제32권4호
    • /
    • pp.78-91
    • /
    • 2004
  • The ISO 9000 Follow-up Management Practices (FMP) as an integrated area including training, QM systems, management commitment, customer focus, communication and related issues are examined. A sample of 191 small and medium-sized firms data from mail survey is analyzed by the SPSSWIN. A model of FMP including three factors (Systems, Training, and Customer Focus) is introduced. In this paper, a focus is laid on the comparison between ISO 9000:1994 vs. ISO 9000:2000 or 05 9000 certificates and between groups classified by the time length after certification, and on regression relationships between FMP level and business performance. The result shows that the difference of FMP level is significant between two versions and between groups. Quality level and system satisfaction are influenced significantly by the three factors.

Outcomes of Non-Operative Management for Pseudarthrosis after Pedicle Subtraction Osteotomies at Minimum 5 Years Follow-Up

  • Kim, Yong-Chan;Kim, Ki-Tack;Kim, Cheung-Kue;Hwang, Il-Yeong;Jin, Woo-Young;Lenke, Lawrence G.;Cha, Jae-Ryong
    • Journal of Korean Neurosurgical Society
    • /
    • 제62권5호
    • /
    • pp.567-576
    • /
    • 2019
  • Objective : Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection. Methods : Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5-10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed. Results : Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05). Conclusion : Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.

지속 가능한 마을만들기를 위한 추진체계 개선방안 - 김해시를 중심으로 - (Improvement Plan for Promotion System of Sustainable Rural Community Building)

  • 최영완;엄민호;김영주
    • 농촌계획
    • /
    • 제28권4호
    • /
    • pp.55-67
    • /
    • 2022
  • In this study, the village development promotion system was reorganized for Gimhae-si, and improvement plans and post-operation management plans were prepared through expert surveys. Through the Village Development Project, the landscape and environment of the village were improved, and the village and residents were positively changed. The Village Development Project laid the foundation for regional revitalization, giving the next generation hope for the sustainable development of the village. While maintaining the framework of the existing Rural Development Projects guidelines through case analysis of other regions, we operate educational programs for each stage by reflecting regional characteristics, and utilize and communicate with intermediate support organizations, systematically operate, and actively intervene by Eup·Myeon administration. In addition, as a follow-up management program, various follow-up management programs were being operated, such as support for capacity building such as consulting, as well as facility maintenance and support for village managers. As a result of the expert survey to review the adequacy of the improvement plan, the improvement plan derived from the overall average of 4.28 points and the standard deviation of 0 to 0.94 points for the process is judged to be appropriate. In particular, the item of 'self-reliance stage follow-up management' was very important as all experts responded with 5 points. By establishing the village development performance goals, we tried to check whether the qualitative/quantitative goals were achieved by year, and to secure quantified status data in response to changes such as resetting performance goals or adding new performance indicators. In this study, in order to improve the capacity to achieve regional development in response to the rural agreement, we prepared our own sustainable village development promotion system, governance establishment, and follow-up management plan. In addition, it is expected to be used as a reference material for the selection of new districts and the follow-up management of completed districts by establishing the village development goals.

Cost-Effectiveness of Intensive Vs. Standard Follow-Up Models for Patients with Breast Cancer in Shiraz, Iran

  • Hatam, Nahid;Ahmadloo, Niloofar;Vazirzadeh, Mina;Jafari, Abdossaleh;Askarian, Mehrdad
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권12호
    • /
    • pp.5309-5314
    • /
    • 2016
  • Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.

Partially Parametric Estimation of Lifetime Distribution from a Record of Failures and Follow-Ups

  • Yoon, Byoung Chang
    • 품질경영학회지
    • /
    • 제22권4호
    • /
    • pp.59-78
    • /
    • 1994
  • In some observational studies, we have often random censoring model. However, the data available may be partially observable censored data consisting of the observed failure times and only those nonfailure times which are subject to follow up. In this paper, we present an extension of the problem of partially parametric estimation of the survival function to such partially observable censored data. The proposed estimator treats the observed failure times nonparametrically and uses a parametric model only for those nonfailure times which are subject to follow-up. We discuss the motivation and construction of the proposed estimator and investigate the limiting properties of the proposed estimator such as asymptotic normality. Also, when the assumed parametric model is exponential, the asymptotic variance of the estimator is obtained. Furthermore, an example is given to compare the proposed estimator with the modified Kaplan Meier(MKM) estimator. From the results, it is shown that the relative efficiency of the proposed estimator is higher than that of the MKM estimator in the follow-up study with increasing time.

  • PDF

하천 내 친수지구의 사후관리 의사결정 절차 방법 연구 (Study of Decision Making Procedures for Follow-up Management of Water-friendly Riverfront)

  • 이승연;이상은;김나희;이승오
    • 한국방재안전학회논문집
    • /
    • 제14권4호
    • /
    • pp.81-91
    • /
    • 2021
  • 본 연구는 국가하천 내 친수지구를 대상으로 친수지구의 용도가 저하되었을 때 사후관리를 수행하기 위한 합리적인 의사결정 절차를 제안하였다. 의사결정 절차는 2가지로 대상지 선택과 사후관리 전략 및 대안 선별이 이에 해당한다. 선행연구로 도출된 친수지구의 이용등급을 고려하여 이용도가 낮은 IV등급과 매우 낮은 V등급을 후보지로 선정하였고 경제성평가를 통해 경제적 효용이 미흡한 경우 사후관리가 필요한 후보지라 판단하여 협의를 통해 대상지로 선정하였다. 또한 정해진 대상지에 대해 사후관리 기본구상을 검토하고 대상지 별 친수지구 운영 필요성을 고려하여 전략에 맞는 대안을 도출할 수 있도록 하였다. 친수지구의 사후관리 의사결정 절차에 관한 선행연구는 아직 체계화되어 있지 않았으나, 현재 하천 시설의 생애주기가 만료되어가는 시점에서 이용자의 편리함과 안전성을 위해서는 체계적인 절차가 반드시 필요하므로 본 연구가 향후 행정절차에 활용될 수 있을 것으로 기대된다.

무역금융제도의 운용상 문제점과 그 개선방안에 관한 연구 (A Study on the Problems and Its Improvement Plans in Operation of Korean Trade Finance System)

  • 채진익
    • 무역학회지
    • /
    • 제44권6호
    • /
    • pp.39-54
    • /
    • 2019
  • Trade finance promotes export performance, and every small- and medium-sized export business has the right to use policy finance. The credit line is also stipulated by relevant laws and regulations. However, trade finance has repeatedly been misused, so these matters can lead to substantial financial loss and damage to the related financial institutions. The lack of expertise of K-SURE and the backwardness of banks represent even bigger problems in the follow-up management. The existing trade finance system should be improved in the following ways from the institutional and legal perspectives. Firstly, follow-up management of beneficiary companies should be reinforced and systematized through examining business tendencies, financial status, and other important factors. There is also a need for advancement of following up management. An effective and streamlined financing system must be established by abolishing the Korea Trade Insurance Corporation. This study presents improvements and their implications by looking into the main issues under the current trade finance system. This study is based on documentary research and practical cases.

Management of Precancerous Cervical Lesions in Iran: A Cost Minimizing Study

  • Nahvijou, Azin;Sari, Ali Akbari;Zendehdel, Kazem;Marnani, Ahmad Barati
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권19호
    • /
    • pp.8209-8213
    • /
    • 2014
  • Background: Cervical cancer is a common, preventable and manageable disease in women worldwide. Objectives: This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Materials and Methods: Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Results: Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174$ respectively. Conclusions: The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

데이터마이닝 기법을 활용한 맞춤형 고혈압 사후관리 모형 개발 (A Development of a Tailored Follow up Management Model Using the Data Mining Technique on Hypertension)

  • 박일수;용왕식;김유미;강성홍;한준태
    • 응용통계연구
    • /
    • 제21권4호
    • /
    • pp.639-647
    • /
    • 2008
  • 본 연구는 국민건강보험공단의 건강검진데이터, 자격 및 보험료 그리고 진료비 데이터를 활용하여 고혈압 관리를 위한 맞춤형 고혈압 사후관리모형(고혈압 진료예측모형 및 고혈압 진료순응도세분화모형)을 개발하고자 하였다. 모형 개발에는 데이터마이닝의 로지스틱 회귀모형, 의사결정나무 그리고 앙상블 모형을 활용하였다. 고혈압 진료예측모형에서는 3가지 모형 중 로지스틱 회귀모형이 가장 우수한 모형으로 채택되었으며, 고혈압 진료순응도세분화모형은 의사결정나무모형을 통해 개발되었다. 본 연구는 전국 규모의 수년간 축적된 자료를 데이터마이닝을 활용함으로써 고혈압의 진료 및 진료순응도에 이르는 고혈압 사후관리 프로세스 전반에 걸친 결과를 도출함으로써 우리나라 고혈압 사후관리체계 구축에 기여할 것으로 사료된다.