• 기본간호학회지
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• 제7권3호
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• pp.366-378
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• 2000

Type 2 Diabetes Mellitus patients have chronic metabolic disorder and they need self care for their lifetime. But most Diabetes Mellitus patients don't know how to do a self care due to the lack of adequate support from health care professionals. It has been reported that lack of exercise therapy compliance guide is very important one. This study was conducted to develop an exercise therapy protocol applied to an efficacy expectation promoting program based on Bandura's self efficacy model for type 2 Diabetes Mellitus patients. Firstly, a conceptual framework was developed through efficacy expectation promoting Program based on Bandura's self efficacy model. In order to identify the contents of program and to design a preliminary protocol, a with the consultation experts was made. A clinical validity was tested using twenty type 2 Diabetes Mellitus patients who received follow-up care regularly through the diabetic out-patient clinic from October, 1998 to May, 2000. After this process, the final protocol was developed. The results of this study are summarized as bellows : The final exercise therapy protocol applied to an efficacy expectation promoting program for type 2 Diabetes Mellitus Patients consists of individualized exercise test and prescription, a small booklet relating personal experience with Diabetes Mellitus and a telephone coaching program for 12 weeks on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. It is concluded that the exercise therapy protocol applied to an efficacy expectation promoting program is applicable to type 2 diabetes mellitus. And this exercise therapy protocol could show a positive effect on the exercise compliance of Diabetes Mellitus patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.426-430
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• 2009

Purpose: Many patients in anti-platelet therapy have been consulted for bleeding risks before minor oral surgery. However, there has not been an established pretreatment protocol for treating these patients. The purpose of this study is to make a protocol for the preoperative management for patients in anti-platelet therapy. Patients and Methods: The existed consultation pattern of patients was examined in the Department of Oral and Maxillofacial Surgery, Yonsei Dental Hospital. Based on the observation, a protocol including classification of medical status of patients and the type of oral surgery in need was introduced. This protocol had been performed for 6 months. Result: Following this protocol, the frequency of consultation for bleeding risk was decreased. The number of minor oral surgeries with concurrent anti-platelet therapy was increased. There was no severe bleeding event observed among minor oral surgeries that were performed while maintaining anti-platelet therapy. Conclusion: This protocol can be used as a guideline for clinical practice of patients in anti-platelet therapy requiring minor oral surgery.

• 한국임상수의학회지
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• 제34권1호
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• pp.1-6
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• 2017

Heartworm disease (HWD) in dogs is a life-threatening mosquito-borne disease resulting in right-sided congestive heart failure and inflammatory pulmonary disease. Due to complications from adulticidal therapy with melarsomine, slow kill protocol either with preventive dose of ivermectin or combined with doxycycline has been proposed for an alternative adultcidal therapy in dogs with HWD. Therefore, this study evaluated the clinical outcome of adultcidal therapy in dogs with class II stage of HWD after treating either American Heartworm Society (AHS) or slow kill protocol for 10 months. Clinical outcome after therapy was evaluated by clinical, radiographic and echocardiographic examination along with hematology before (D0) and after therapy (D300). Although clinical signs associated with HWD were all resolved after therapy in both groups, the infection was not cleared out 67% of dogs treated by slow kill protocol at the end of therapy. Furthermore, pulmonary arterial flow of acceleration time to ejection time ratio (AT/ET) and the right pulmonary artery distensibility index (RPADI) have been firstly used for detecting pulmonary hypertension in this study group. The pulmonary hypertension was more common in dogs with mild clinical signs, although tricuspid and pulmonary regurgitation were not detectable in most dogs in this study. Our study findings suggested that the slow kill protocol might not be efficacious enough to clear out HWD in dogs and more attention on the presence of pulmonary hypertension might be necessary for effective management of HWD in dogs.

• The Journal of Korean Physical Therapy
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• 제17권3호
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• pp.429-440
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• 2005

The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

• 인간행동과 음악연구
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• 제10권1호
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• pp.67-83
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• 2013

음악치료에서 사정평가는 내담자의 현재 기능과 필요를 파악하기 위하여 반드시 선행되어야 하는 과정이다. 음악치료사는 사정평가의 내용을 바탕으로 치료목적 및 목표를 설정하고 이를 달성하기 위한 단계적 접근과 치료전략을 수립한다. 하지만 기존의 음악치료 사정도구는 해당 영역의 행동을 열거하고 이를 관찰하여 수치화함으로써 기능을 평가하였기 때문에, 실제 인간의 음악행동을 통한 기능의 사정이 불가능하다는 단점을 지니고 있다. 또한 음악행동을 바탕으로 하는 소수의 음악치료 사정도구에서도 음악행동을 구성하는 세부기능영역, 발달단계에 따른 근거에 따른 난이도 검증 과정을 거치지 않고 사용되어 왔다. 본 연구에서는 인지기술 사정을 위한 리듬요소군을 중심으로 한 음악 프로토콜 문항을 개발하였으며 발달학적 근거와 인지기술 수준에 따른 난이도 요소를 규명하고자 하였다. 인지발달에 따른 소리정보의 그룹핑, 구조형식의 수준, 전체-부분 관계의 명료성, 반복-변동성 수준을 고려한 리듬 연주 항목과 연주행동에 내포된 정서 행동을 분석할 수 있는 리듬 사정 프로토콜을 개발하였다. 검증과정으로는 먼저 15개의 예비 리듬문항을 난이도, 복합성, 패턴 유형을 고려하여 선정한 후 이를 일반인 61명을 대상으로 난이도 검증을 실시하여 문항별 수준과 난이도 계수를 도출하였다. 둘째, 7인의 전문가 평가팀의 검증을 통해 1차 개발된 문항들을 수정 보완하여 최종적으로 20개의 리듬프로토콜 문항을 개발하였다. 본 연구의 결과는 이후 개발될 음악치료사정평가도구의 기초 자료로 활용될 수 있다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.252-254
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• 2002

A new protocol for dosimetry in external beam radiotherapy is published by the Japan Society of Medical Physics (JSMP) in 2002. The protocol deals with proton and heavy ion beams as well as photon and electron beams, in accordance with IAEA Technical Report Series No. 398. To establish inter-institutional uniformity in proton beam dosimetry, an intercomparison program was carried out with the new protocol. The absorbed doses are measured with different cylindrical ionization chambers in a water phantom at a position of 30-mm residual range for a proton beam, that had range of 155 mm and a spread out Bragg peak (SOBP) of 60-mm width. As a result, the intercomparison showed that the use of the new protocol would improve the +/- 1.0 % (one standard deviation) and 2.7 % (maximum discrepancy) differences in absorbed doses stated by the participating institutions to +/- 0.3% and 0.9 %, respectively. The new protocol will be adopted by all of the participants.

• Childhood Kidney Diseases
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• 제5권2호
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• pp.117-124
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• 2001

목 적 : 1990년 Mendoza등이 스테로이드 저항성 신증후군에서 Mendoza protocol에 의한 장기간의 methylprednisolone pulse therapy (이하 MP 요법)가 관해를 유도하고 유지시키는 효과적인 치료방법인 것으로 보고한 이후, 스테로이드 저항성 신증후군에서 이 치료법의 효과에 관한 보고는 있어 왔지만 스테로이드 의존성 신증후군과 2차성 신증후군에서 이 치료법의 효과에 관한 보고는 아직까지 없는 실정이다. 본 연구에서는 면역억제제 또는 세포독성물질로도 스테로이드 의존성을 없애거나 재발율을 낮출 수 없었던 스테로이드 의존성 미세변화형 신증후군과 난치성 국소성 분절성 사구체 경화증 및 2차성 신증후군에서 Mendoza protocol에 따른 장기간의 MP 요법의 치료 효과를 알아보고자 하였다. 대상 및 방법 : 1997년부터 2000년사이에 세브란스병원 소아과에서 신생검에 의해 1차성 또는 2차성 신증후군을 진단받고 면역억제제 또는 세포독성 물질 치료로 스테로이드 의존성을 없애거나 재발률을 낮출 수 없었던 스테로이드 의존성 미세변화형 신증후군과 기존의 스테로이드 및 면역억제제 치료에 반응을 보이지 않았던 난치성 국소성 결절성 사구체 경화증 및 2차성 신증후군 환아 21명을 대상으로 하여 Mendoza protocol에 따라 82주 동안 MP요법을 시행하였다. 결 과 : 대상 환아를 신조직검사 소견에 따라 분류하면 1차성 신증후군이 16례($76\%$)로 이중 미세변화형 신증후군이 10례, 국소성 분절성 사구체 경화증이 6례였으며, 2차성 신증후군은 5례($24\%$)였다. 스테로이드 의존성 미세변화형 신증후군 10례 모두 ($100\%$)에서 MP요법 시작후 평균 $18{\pm}9일$ 내에 완전관해가 되었으나 전례에서 치료중 또는 치료후에 재발하였고, 연간 평균 재발횟수가 치료전에 $2.1{\pm}1.0회$, 치료중에 $1.4{\pm}0.9회$로 치료전보다 감소하였으나 통계적 의미는 없었고 치료후에는 $2.7{\pm}1.2회$로 치료전보다 증가하였다. 국소성 분절성 사구체 경화증 6례중 3례($50\%$)에서 완전관해, 1례($17\%$)에서 부분관해가 유도되었고 2례($33\%$)에서 여전히 반응하지 않았으며, 치료후 평균 $1.2{\pm}0.7$년간 추적관찰 기간 동안 관해된 4례($57\%$)중 3례($50\%$)에서 관해가 유지되었고 1례에서 재발하였다. 2차성 신증후군 5례중 4례($80\%$)에서 완전관해, 1례($20\%$)에서 부분 관해가 유도되었고 치료후 평균 $1.7{\pm}0.6$년간 추적 관찰 기간 동안 재발한 예는 없었다. MP요법의 부작용으로는 21례중 10례($48\%$)에서 methylprednisolone 정맥주사시 일시적인 고혈압이 있었다. 결 론 : Mendoza protocol에 의한 장기간의 IV-methylprednisolone pulse therapy는 난치성 국소성 분절성 사구체경화증과 2차성 신증후군의 관해유도와 관해유지에는 효과가 있는 것으로 생각되었으며 면역억제제 또는 세포독성물질로도 스테로이드 의존성을 없애거나 재발율을 낮출 수 없었던 스테로이드 의존성 미세변화형 신증후군의 치료에서는 스테로이드 의존성 혹은 재발율의 변화를 나타내지 못하였다. 따라서 장기간의 MP 요법은 스테로이드 및 면역억제제 치료에 저항성을 보이는 1차성 또는 2차성 신증후군의 치료에 시도해볼만한 치료법으로 생각된다.

• 한국의료질향상학회지
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• 제19권1호
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• pp.44-52
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• 2013

Objectives: Several studies on hospital malnutrition have reported that malnutrition among patients is highly prevalent and that more than 40% of hospitalized patients have nutritional risk factors. The purpose of this study was to assess the implementation of physicians' prescribed nutrition therapy before and after a protocol on nutrition therapy for malnourished inpatients was instituted. Methods: Data regarding the rates of physician implementation of nutritional therapy and the duration of therapy were collected and analyzed using SPSS version 20. Results: The percentages of physicians who prescribed nutrition therapy before and after the protocol was initiated were 47.5% and 74.6%, respectively, which statistically significant with 95% confidence. The rates of therapy lasting less than 24 hours before and after the protocol was in place were 100% and 86.4%, respectively, which was not statistically significant. This result suggests that the improvement activity was not effective. Conclusion : The percentage of physicians who prescribed nutritional therapy based on improved nutritional program was significantly increased. Nutrition therapy for malnourished inpatients can be advanced through this new model.

• 대한통합의학회지
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• 제11권2호
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• pp.141-147
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• 2023

Purpose : This study aimed to find out the effect of aerobic exercise using Bruce protocol on heart rate, oxygen saturation, and blood pressure after recovery from COVID-19 infection. Methods : In this study, 34 students from D University located in J city were targeted, COVID-19 infected group (17 people) and non-COVID-19 non-infected group (17 people). The Bruce protocol using a treadmill was applied to the aerobic exercise of this study. The Bruce protocol has in the first stage of METs 4 (slope 10 %, speed 2.7 km/h). The second stage was METs 5 (slope 12 %, speed 4 km/h), and the third stage was METs 6 (slope 14 %, speed 5.4 km/h). All measurements were measured 3 times and the average value was used. Results : As a result of this study, as a result of comparing heart rate changes according to aerobic exercise using the Bruce protocol. EG group and the CG group increased significantly according to the progressive exercise load (METs 4~5), and in the third stage of the Bruce protocol between groups, The EG group showed a significantly lower heart rate. As a result of comparing changes in oxygen saturation and blood pressure, there was no significant difference between the EG and C groups according to the gradual exercise load. Conclusion : In conclusion, there was no difference between normal and pressure when MET of moderate intensity exercise (4 to 6) was applied to the effect on heart rate, oxygen saturation, and blood pressure in healthy adults who were fully recovered from COVID-19. Secondary side effects may occur when high intensity exercise with a MET of 6 or higher, so it is strongly recommended that hospitals or specialized institutions measure exercise and physical ability according to individual exercise intensity.

• 동의생리병리학회지
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• 제27권4호
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• pp.350-361
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• 2013

aksun(藥饍), or 'Traditional oriental medicine nutrition therapy', is expected to be an effective nutritional intervention for the patients suffering from chronic diseases. However, there are no systemized protocol that utilize Yaksun as an effective nutrition therapy for Asian patients even though they are accustomed to traditional oriental diet. We investigated the possibility of using Yaksun for developing an effective Medical Nutrition Therapy for Asian patients and proposed factors that have to be considered. Articles published between 1995-2012 about MNT (Medical Nutrition Therapy) and Yaksun were reviewed. Male and female patients of two Korean Medicine Hospitals (n=93) and one Korean Medicine Clinic (n=20) answered a questionnaire asking about their thoughts on the effectiveness of nutritional intervention for their disease management and about their expectations toward Medical Nutrition Therapy on Korean Medicine. 92.9% of the patients have perceived that nutritional intervention is important in disease management. 79.6% of the patients have positively responded that they are willing to use the Medical Nutrition Therapy on Korean Medicine as a clinical nutrition therapy if developed. Female patients, aged in their forties and fifties, educated equivalent to high school graduates and more, and who visited Korean medicine clinic were most interested in the Medical Nutritional Therapy on Korean Medicine. The factors considered in developing the protocol are 1. effectiveness 2. safety 3. expense, in order of importance. Nutritional intervention protocol using Yacksun is necessary for the patients. Medical Nutrition Therapy on Korean Medicine is in need of development. Accumulated case-control studies, cost effectiveness studies, and studies about programming and systemizing the protocol are needed.