• Title/Summary/Keyword: Clinical results

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A Study on the Sensitivity of Human Rights and the Advocacy Activities of Korean Occupational Therapists (국내 작업치료사의 인권감수성이 옹호활동에 미치는 영향)

  • Kim, Ji-Man;Hong, Ki-Hoon;Lee, Chun-Yeop;Kim, Hee-Jung
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.2
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    • pp.11-24
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    • 2020
  • Objective : The Human Rights constitute one of the basic pillars of every work where persons are involved, such is the case of the occupational therapy field. Methods : In this study we investigate the human rights sensitivity and the advocacy activities of occupational therapists. The differences according to their characteristics, the relationship and the impact of the human rights sensitivity are examined and presented. Making use of online surveys 116 subjects participated in the study. Results : The measured average of human right sensitivity is 69.00 ± 17.67 point, being them distributed according to the following subcategories: to the perception of the situation corresponds 23.25±5.62 points, to the perception of the consequences 22.75±6.54 points and for the perception of the responsibility 23±6.54 points. In all the cases have been taken in account the equal rights, the right to education in disables, the right to pursue the happiness of the elderly, the right of the disables to have personal freedom, the privacy rights and the privacy rights for mental illness people. According to the working area the Human Right sensitiveness is higher in Seoul than in the Gyeongsang province meanwhile the advocacy activities is higher in Seoul and in Gyeonggi province than in Gyeongsang province. Depending of the type of service, general hospitals and rehabilitation/nursing hospitals showed higher human rights sensitivity than other service organizations According to the working field, occupational therapy group focused in elderly showed higher Human Right sensitivity than other fields. Professionals belonging groups of clinical experience from 3 to 5 years and from 6 to 10 years showed higher advocacy activities than professionals with more than 11 years of experience. A positive correlation was showed between the human rights sensitivity and the advocacy activities. For this situation, the human rights sensitiveness was divided in sub-categories in perception of the situation, perception of the consequences and perception of the responsibility. As showed by the result of multiple regression analyses the advocacy activities of human would grow up in accordance with the increase of the human rights sensitiveness of responsibility perception. Conclusion : Due to the actual lack of information, the collection and study of basic data is fundamental for the development of practical human rights educational programs and to emphasize the role of the defense of the human rights.

Pain Disability of Orofacial Pain Patients (구강안면통증 환자의 통증활동제한)

  • Choi, Se-Heon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.217-225
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    • 2009
  • As Pain is a comprehensive, biopsy chosocial phenomenon, improved understanding and successful management of pain need assessment of health-related quality of life and psychological states. The purpose of this study was to evaluate pain severity and pain-related interference to daily lives for patients with non-dental, orofacial pain(OFP) and a possible relation of OFP with psychological morbidity. Relation with such factors as gender, age, pain duration and diagnosis was also assessed. Inclusion criteria was all new patients with non-dental OFP attending the oral medicine.orofacial pain clinic of Dankook University Dental Hospital over 3 months' period, who completed the questionnaires of the Brief Pain Inventory (BPI) and Hospital Anxiety and Depression Scale (HADS). Prior to the first consultation, the patients were asked to fill out the questionnaire in the waiting room and were diagnosed through consultation and clinical examination. Total subjects were 163 with M:F ratio of 1:1.5 and mean age of 34.6${\pm}$17.7 years. Mean duration of pain was 13.3${\pm}$26.2 months and all patients were divided into; Trigeminal Neuralgia group (TN, N=8), Neuropathic Pain group (NeP, N=9), Persistent Idiopathic Facial Pain group (PIFP, N=8), and Temporomandibular Disorders group (TMD, N=138), subdivided into muscle problem (TMD-m, N=73), joint problem (TMD-j, N=24) and muscle-joint combined problem (TMD-c, N=41). OFP patients showed moderate pain severity and moderate pain-related interference. There was no gender difference in overall pain severity and interference and levels of anxiety and depression. Elderly patients aged ${\geq}$ 60 years showed higher pain severity (p<0.05). Patients with chronic pain ${\geq}$ 3 months reported more increased level of anxiety and depression than those with acute pain (p<0.05). Compared to TMD patients, patients with TN, NeP and PIFP suffered from higher level of pain and pain-related interference and reported higher level of anxiety and depression (p<0.05). Pain interference was closely correlated with their pain severity and with psychometric properties such as anxiety and depression. Pain severity was weakly correlated with levels of anxiety and depression. The results suggest a need for psychosocial assessment and support for successful management of OFP in addition to control of pain itself.

An Analysis of 94 Percutaneous Renal Biopsies (경피적 신생검 94례에 대한 분석)

  • Kang, Ho-Jung;Lim, Sang-Woo;Do, Joo-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.84-95
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    • 1995
  • A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2. The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%), mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), TypeI membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

  • Song, Jason Jungsik;Song, Yeong Wook;Bae, Sang Cheol;Cha, Hoon-Suk;Choe, Jung-Yoon;Choi, Sung Jae;Kim, Hyun Ah;Kim, Jinseok;Kim, Sung-Soo;Lee, Choong-Ki;Lee, Jisoo;Lee, Sang-Heon;Lee, Shin-Seok;Lee, Soo-Kon;Lee, Sung Won;Park, Sung-Hwan;Park, Won;Shim, Seung Cheol;Suh, Chang-Hee;Yoo, Bin;Yoo, Dae-Hyun;Yoo, Wan-Hee
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.346.1-346.11
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    • 2018
  • Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

Long-term Outcomes of Conjunctivo-limbal Autograft Alone and Additional Widening of Limbal Incision in Recurrent Pterygia (군날개 재발에 있어서 자가윤부결막이식술 단독 및 추가 윤부절개술의 장기 결과)

  • Chung, In Kwon;Kim, Jin Hyoung;Lee, Jong Hyun;Lee, Do Hyung
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1114-1121
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    • 2018
  • Purpose: We report the clinical outcomes of patients undergoing additional widening of the limbal incision to prevent disease recurrence after conjunctivo-limbal autograft combined with pterygial excision. Methods: We retrospectively compared 95 eyes with primary and 12 eyes with recurrent pterygia randomized to treatment via two surgical methods: conjunctivo-limbal autograft alone and combined with widening of the limbal incision to allow for pterygial removal. We widened the limbal incisions by 1 mm on both the superior and inferior limbal margins and removed the pterygia. The outcomes were compared between 39 eyes undergoing conjunctivo-limbal autograft alone and 68 eyes undergoing conjunctivo-limbal autograft with widening of the limbal incision. Results: The mean overall postoperative follow-up period was $29.6{\pm}10.5months$ and conjunctivo-limbal autograft alone group was $27.4{\pm}11.5months$, combined with widening of the limbal incision group was $30.7{\pm}9.7months$. Six pterygia (15.4%; four primary and two recurrent) developed in those undergoing conjunctivo-limbal autograft alone and two (2.9%; one primary and one recurrent) in those undergoing additional widening of the limbal incision; the recurrence rate differed significantly between the two groups (p < 0.05). In the group treated with conjunctivo-limbal autograft alone, the mean time to development of a new primary pterygium was $6.3{\pm}3.4months$ and that to development of a recurrent pterygium $4.3{\pm}2.5months$; the respective values for the group undergoing additional widening of the limbal incision were $12.1{\pm}2.6$ and $8.4{\pm}4.6months$; the recurrence rates differed significantly (p < 0.05). Conclusions: Conjunctivo-limbal autograft with additional widening of the limbal incision used to treat both new primary and recurrent pterygia was more effective in terms of reducing pterygial recurrence than conjunctivo-limbal aAutograft alone.

Clinical Effects of an Improved Pump Reaction Rate and Automatic Occlusion Sensing System in Phacoemulsification (수정체유화장치의 초음파 출력속도 및 자동막힘감지 기능 향상의 술 후 임상결과 비교)

  • Kim, You Na;Lee, Jin Ah;Kim, Jae Yong;Kim, Myoung Joon;Tchah, Hung Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1017-1023
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    • 2018
  • Purpose: A recently introduced phacoemulsification system, the WhiteStar $Signature^{(R)}$ PRO, has demonstrated improved nucleus followability and cutting efficiency via an improved pump regulator with a higher reaction response and an automatic occlusion sensing system. In this study, we compared various phacoemulsification parameters between the new system and an older version of the device. Methods: A total of 80 eyes of 68 patients with cataracts who had undergone phacoemulsification by a single surgeon were included in this study. Forty eyes of patients underwent phacoemulsification using the older $Signature^{(R)}$ system (WhiteStar); these patients were classified as the control group. Another 40 eyes of patients underwent phacoemulsification with the newer enhanced system, the WhiteStar $Signature^{(R)}$ PRO; these patients were assigned to the experimental group. During the operation, operative parameters, including the effective phaco time (parameter of effective phaco time with a specific coefficient for the transversal movement expressed in seconds, EFX), ultrasound time (seconds [s]), effective phacoemulsification time (EPT, s), average phacoemulsification power (AVG, %), and balanced salt solution usage, were measured to determine the performance enhancement offered by the updated system. Central corneal thickness was measured before and after surgery to compare corneal edema. The relationships between the two groups were analyzed using an independent t-test. Results: The Signature $PRO^{(R)}$ system showed a lower EFX (p < 0.001), a shorter EPT (p < 0.001), and a smaller AVG (p < 0.001). Postoperative corneal thickness did not differ significantly between the two groups. Conclusions: Comparing the efficacy of the improved reaction speed of the device and automatic occlusion sensing system in performing phacoemulsification, the updated Signature $PRO^{(R)}$ system demonstrated superior followability and cutting efficiency regardless of nuclear cataract hardness.

Morphometric Analysis of Distances between Sacral Hiatus and Conus Medullaris Using Magnetic Resonance Image in Korean Adult (자기공명영상을 이용한 한국 성인의 엉치뼈틈새와 척수원뿔 사이 거리 연구)

  • Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
    • Anatomy & Biological Anthropology
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    • v.29 no.4
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    • pp.145-154
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    • 2016
  • The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.

The Prognostic Factors Affecting the Occurrence of Subsequent Unprovoked Seizure in Patients Who Present with Febrile Seizure after 6 Years of Age (6세 이후 열경련 환자의 비열성발작으로 진행되는 위험 인자)

  • Lee, Hyeon Ju;Kim, Seung Hyo
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.215-220
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    • 2018
  • Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.

Age-Based Characteristics of West Syndrome in Patients with Mitochondrial Disease (미토콘드리아 질환에서 웨스트 증후군 환자의 경련 발생 연령에 따른 임상 양상 비교)

  • Choi, Young Ha;Baek, Min-Seong;Na, Ji-Hoon;Kang, Hoon-Chul;Lee, Joon Soo;Kim, Heung Dong;Lee, Young-Mock
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.197-204
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    • 2018
  • Purpose: West syndrome is a severe form of age-specific epilepsy that typically affects infants younger than 2 years of age with mitochondrial disease. We aimed to examine age-specific characteristics of the syndrome in these patients. Methods: We retrospectively analyzed 54 patients with West syndrome diagnosed with mitochondrial disease between March 2006 and March 2016. We compared treatment strategies and diagnostic and clinical variables between patients with early-onset (<6 months of age) and late-onset (${\geq}6$ months of age) seizures. Results: Seizure was the first symptom in 30 (90.9%) and 13 (65%) patients of the early-onset and late-onset groups, respectively (P=0.046). Delayed development was observed in 3 (9.1%) and 7 (35%) patients of the early-onset and late-onset groups, respectively (P=0.023). Lactate levels were normal in 17 patients (55%) of the early-onset group and 5 (25%) of the late-onset group (P=0.036), while initial brain magnetic resonance imaging (MRI) findings were normal in 23 (67.6%) and 8 (40%) patients of the early-onset and late-onset groups, respectively. Final MRI findings were abnormal in 32 patients (94.1%) of the early-onset group and 18 (90%) of the late-onset group (P=0.036). Although ketogenic diets reduced seizure frequency in both groups, the difference was not significant. Conclusion: There is no significant difference in epilepsy-related variables when patients are divided based on a cut-off age of 6 months. However, differences in the first symptom at onset and MRI findings were observed. Although lactate levels were not of significant diagnostic value in the early-onset group, they may be in the late-onset group.

Association of Low Serum Ionized Magnesium Level with Fever-Triggered Seizures in Epileptic Children (소아 뇌전증 환자에서 발열이 동반된 경련을 하는 것과 저 이온화 마그네슘 혈증과의 관련성)

  • Suh, Sunny;Kim, Kyungju;Byeon, Jung Hye;Eun, So-Hee;Eun, Baik-Lin;Kim, Gun-Ha
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.205-209
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    • 2018
  • Purpose: Several studies have shown that magnesium plays an important role in modulating N-methyl-D-aspartate (NMDA)-related seizures by blocking NMDA ion channel receptors. Clinicians usually measure total serum magnesium levels instead of biologically active ionized magnesium levels. We compared the serum ionized magnesium ($iMg^{2+}$) level between epileptic children with and without a history of fever-triggered seizure (FTS). Methods: All epileptic children who visited the outpatient clinic or pediatric emergency department at Korea University Guro Hospital between January 2015 and July 2017 were included. Only epileptic children aged 1-8 years who were newly diagnosed within 2 years were included. Results: There were 12 children with FTS and 16 without FTS. Median serum $iMg^{2+}$ level was 0.93 (0.85-1.14, quartile) mEq/L. Serum $iMg^{2+}$ level was significantly lower in epileptic children with FTS (0.86 mEq/L) compared to those without FTS (1.10 mEq/L) (P=0.005). No difference was noted in clinical variables between the two groups. Lower serum $iMg^{2+}$ level significantly increased the risk of having FTS in epileptic children based on multivariable logistic regression analysis (odds ratio [OR]=0.028). Conclusion: Serum $iMg^{2+}$ level was significantly lower in epileptic children with FTS than in those without FTS. Measurement of biologically active serum $iMg^{2+}$ level could be considered in epileptic children with recurrent FTS. A large-scale prospective study is warranted.