대한대장항문학회

To eliminate the inconvenient shortcomings of our formerly designed system for the<br>biofeedback treatment, the development of second stage software was indispensable. Purpose<br>: The aims of current study were to supplement the prototype software, and to improve the<br>application software for the database management system. Moreover, we assessed the<br>practical value and outcome of biofeedback therapy for the patients with functional evacu<br>ation disorders by using the upgraded system. Methods : A new system was worked out a<br>design to be composed of Windows based GUI (graphical user interface), DB (database)<br>management software, and networking system. Main software performs a signal processing<br>and a protocol making mode to train pelvic sphincter. DB program administers patient profiles<br>and the recorded signal data. Networking system was designed to execute RS-232C serial<br>communication of signal data with use of fast ethernet LAN networking. To affirm the<br>reproducibility of signal display for the clinical practice, system was applied to 5 healthy<br>volunteers. To evaluate the practical appraisal, system was applied to 27 patients with<br>functional evacuation disorders who were undertaken anorectal physiologic tests. Patient<br>groups were categorized as nonrelaxing puborectalis group (group I, n=17), incontinence<br>group (group II, n=10). Overall patients were underwent a mean 3.7 (range, 2∼10) sessions of<br>biofeedback treatment, and the outcome was analysed in the period of 5.8 (range, 3∼12)<br>months follow-up. Results : Signal data not having drift or noise were adequately processed<br>and displayed in a real time. Specifically, data upload with use of multi-processing overay<br>display function was appropriately embodied. Overall data and profiles of patients groups<br>were safely saved, sorted, and reproduced by using the upgrading database management<br>software. Regarding to the therapeutic outcomes, 63 percent of 27 overall patients (12 of 17<br>patients in group I, 5 of 10 patients in group II) were improved. The subjective symptoms of<br>2 patients in group I were recurred in a period of 3 months follow- up. Conclusions :<br>Hardware and software functions of upgraded system were applicable to the Windows<br>environment of personal computer. A developed system with second stage software made it<br>possible to perform biofeedback treatment. Specifically, current results could be useful for the<br>improvement of the motivation and patient's willingness in the self-learning process of<br>biofeedback treatment.<br>