It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.
The purpose of this study was to determine the effect of treadmill training on gait, balance, and trunk control in a patient with hemiparesis. A female subject who had suffered a left hemiparesis 12 months previously was selected for this study. A single subject ABA design was used. Eight data-collection sessions were conducted during each of three phases (baseline-intervention-withdrawal). During baseline and withdrawal phases, the treatment based on Bobath approach was performed for the subject, and during the intervention phase, treadmill walking training was added. Assessment tools were made using the 10 m walk test, Rivermead Visual Gait Assessment(RVGA), Berg Balance Scale(BBS), and a seated Lateral Reach Test(LRT). During the intervention phase, the time measured in 10 m walk test and the scores of RVGA and BBS were significantly improved, and the number of steps in 10 m walk test and LRT showed a small improvement. During withdrawal phase, the time measured in 10 m walk test and the scores of RVGA and BBS were shown the carry-over effect. This findings indicate that treadmill training has significant effect to gait function and balance in a patient with chronic hemiparesis.
The Journal of Korean Academy of Sensory Integration
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v.16
no.1
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pp.1-13
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2018
Objective : The purpose of this study was to investigate the effects of sensory integration intervention combined with oral activity on eating of child with sensitive oral senses. Methods : The study subject was 6 years old boy and diagnosed with developmental disorder. The experiment period was 15 sessions from April 21, 2017 to June 2, 2017. Experimental design used AB design in single-subject design, baseline (A) phase (sensory integration therapy) was 5 sessions and intervention phase (B) (sensory integration therapy combined oral activity) was 10 sessions. During the experiment, the child used the Goal Attainment Scale (GAS) to measure behavioral changes in eating. Results : The GAS score of voluntary eating of favorite foods was 0 on the baseline phase and increased to 1.9 on the intervention phase. The GAS score of voluntary eating of disliking foods was 0 on average during the baseline phase and increased to 1.7 on average during the intervention phase. Conclusion : This study suggests that sensory integration intervention combined with oral activity program may have a positive effect on eating of children with sensitive oral senses and limited food intake.
Objective : This case study examined the evaluation of occupational therapy and plan to intervention of community asperger syndrome child receiving coping model. Methods : We selected child which 7-year-old boy. Evaluation periods were 2weeks which consisted of external factors and internal factors. External factors were made up interaction of subject, environments and participation of school and community. Internal factors were made up observation and structured evaluation about development state and medical conditions. Also it included observation of appropriate mood and emotions. Results : After evaluation receiving coping model, we planed to intervention. First, subject able to use his time effectively. Second, we'll have intervention program about delayed fine motor areas. Third, we'll educate self-control skills and coping skills of subject's action which not controlled himself. Fourth, we'll find the personal and physical sources to care subject. Conclusion : Our research has planed occupational therapy intervention receiving coping model of asperger syndrome subject. Future research need to practical applications.
Journal of the Korean Society of Physical Medicine
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v.11
no.2
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pp.115-121
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2016
PURPOSE: Many studies have reported the improvement of cognition through physical activity among subject with dementia. This study aimed to whether the current studies supports that physical activity intervention is efficacious on cognitive performance in subject with dementia. METHODS: Two independent reviewers searched National assembly library, RISS, KISS (2005-2015) using the concepts of dementia, exercise, and physical activity. We included randomized controlled trials that examined the efficacy of physical activity in subject with dementia. A meta-analysis was performed to estimate the effect sizes cognition with CMA (Comprehensive Meta-Analysis, version 2.2.064) soft-ware program. Nine randomized controlled trials were included, providing data from 133 individuals and excluding those failing to criteria of this study. RESULTS: The meta-analysis showed that physical activity intervention had a rather small effect sizes of 0.36 (95% confidence interval 0.14-0.59) on cognition performance in subject with dementia. Outcome measurement were MMSE-K (Mini-mental state examination Korean version) and LOCTA (Loewenstein Occupational Therapy Cognitive Assessment). We found heterogeneous among studies and there was difference between the studies (Q = 19.63, d(f)=12, $I^2= 38.88$). CONCLUSION: The present analysis suggests that physical activity interventions have the low effect sizes on cognition performance in subject with dementia Further studies will be required to develop the various programs for improving the cognitive performance in subject with dementia.
Registering different kinds of clinical images widely used in diagnostic and surgery planning. However, cause of tumor growth or effected by gravity, human tissue has plenty of non-rigid deformation with clinically. Non-rigid registration allows the mapping of straight lines to curves. Therefore, such local deformation makes registration more complicated. In this work, we mainly introduce intra-subject, inter-modality registration. This paper mainly studies the nonlinear registration method of 2D medical image registration. The general medical image registration algorithm requires manual intervention, and cost long registration time. In our work to reduce the registration time in rough registration step, the barycenter and the direction of main axis of the image is calculated, which reduces the calculation amount compared with the method of using mutual information.
Park, Hyun-Ju;Lee, Eon-Ju;Na, Gyu-Min;Kang, Tae-Woo
PNF and Movement
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v.17
no.3
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pp.339-351
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2019
Purpose: This study identified the effects of dual-task gait training on balance, gait function, and activity of daily living in patients with Parkinson's disease. Methods: This study used a single-subject design. Two patients with Parkinson's disease participated in this study. Dual-task gait training was performed 1 hour per day 8 times during intervention phase. The subjects were measured 8 times in the baseline phase, 8 times in the intervention phase, and 8 times in the follow-up phase. The outcome measurements included a timed up and go test (TUG), a Berg balance scale (BBS), a 10 meter walk test (10MWT), a 6 minute walk test (6MWT), a dynamic gait index (DGI) and a Korean modified Barthel index (K-MBI). Results: When compared to the average of the baseline process, the data collected during the intervention period showed that the TUG and 10MWT results improved and the tendency line was above the baseline. In addition, BBS, 6MWT, DGI, and K-MBI values for both patients increased remarkably after the training. Conclusion: The results of this study revealed that dual-task gait training may be helpful to improve balance, walking function, and activity of daily living for patients with Parkinson's disease. Further studies need to confirm our findings.
Objectives: The purpose of this scoping review is to suggest future treatment and research directions for adult ADHD by examining domestic trends in Korean research on adults with ADHD tendencies. Methods: The present review used Arksey and O'Malley's scoping review methodology. Eight domestic databases were used, and a search was conducted in July 2023 while targeting domestic papers that had been published within the last 20 years. Subject keywords included 'College student', 'Soldier', and 'Adult', and the subject-related terms that were searched for included 'ADHD'. Results: From 502 initially collected articles, 78 were ultimately selected for analysis in this work. Domestic research related to adult ADHD has been steadily conducted since 2000, and most such research has been done in psychology. Regarding the research participants, those in their 20s were the most common age group, and college students accounted for more than half of participants. In terms of study design, survey studies were the most common, while there was a lack of studies on intervention. The subject most closely dealt with in ADHD studies was interpersonal relationships, followed by depression and addiction. The main intervention used in this study was cognitive behavioral therapy, however it was limited in number. Conclusions: More multifaceted studies on adult ADHD need to be conducted using various research methodologies, and there is also a need for more studies using interventions. It is also important for such research to be expanded to broader geographic areas, ages, and occupations.
Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.
The Journal of Korean Academy of Sensory Integration
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v.15
no.1
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pp.21-32
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2017
Objective : The purpose of this study is to explore the effectiveness of a perceptual motor program in promoting visual motor and motor control outcomes in a child with Attention-Deficit/Hyperactivity Disorder (ADHD) who is enrolled in an elementary school. Methods : The subject is 8-year-old boy who was diagnosed with ADHD but did not receive medication. Research design is a single-subject A-B-A(follow-up). Baseline and follow-up phase were 3 sessions and intervention phase were 8 sessions. After performing 40 minutes of free play on the baseline A and follow-up A, we used the copying subtest of the Korean Development Test of Visual Perception 2 (K-DTVP-2) for evaluating visual motor integration skill and the rope jumping subtest for motor skill. After providing the perceptual motor activity in intervention phase B, copying and ropejumping were performed. Results : The standard scores of the Copying for measuring visual motor integration skill were poor at an average of 4.7 points at baseline phase A, but maintained an average of 9.6 points at intervention phase B and an below average of 7.7 points at the follow-up phase A. In the Rope jumping for the motor skill, it was increased by 4.3 times in the baseline phase A and 5.9 times in the intervention phase B, but slightly decreased by 5 times in the follow-up phase A. Conclusion : This study suggests that perceptual motor program has a positive effect on visual motor and motor function of ADHD children.
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