• Title/Summary/Keyword: Early rehabilitation

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QLF Concept and Clinical Implementation (QLF의 원리와 임상적 활용)

  • Kim, Baek-Il
    • The Journal of the Korean dental association
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    • v.49 no.8
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    • pp.443-450
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    • 2011
  • The leading paradigm of dentistry had been focused on the rehabilitation treatment that identifies active caries, manages them surgically, and restores their original functions. However, changes in the external environment including the current disease prevalence require dentistry to have a paradigm shift. The new paradigm suggests the detection of caries in their earlier stages over the visual diagnosis of cavities, and the reversal of the incipient caries by non-surgical approach. For this to be achieved, a high-technology detection device recognizing changes in the earlier stages which can not he visually observed is needed. Development of early caries detection device has recently become a major issue in preventive dentistry on account of this need, and QLF(Quantitified Light induced Fluorescence) conspicuously stands out among the newly released devices. In this study, the fundamental concept of QLF(Quantitified Light induced Fluorescence) and the possible clinical applications of the earlier intraoral camera model as well as the recently designed digital camera model will be discussed.

Treatment of Acute Achilles Tendon Rupture (급성 아킬레스건 파열의 치료)

  • Lee, Tae Hoon;Kim, Hak Jun;Jeon, Young Sik
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.77-80
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    • 2015
  • Acute Achilles tendon rupture is a frequent injury during sports and recreational activities. Treatments for Achilles tendon rupture have been controversial in recent decades. Traditionally the surgical treatment had benefit over nonsurgical treatment in terms of low rerupture rate and early functional restoration. Recently, nonsurgical treatment was found to show no statistically significant inferiority in re-rupture rate, functional outcome, and calf strength. Whereas, surgical treatment had some complications including adhesion, nerve injury, and infection. Nonsurgical treatment has been increasing due to functional rehabilitation with early weight bearing and restricted early motion. It focuses more attention on the course of caring for patients with deep discussion. There are open repair and minimally invasive repair in terms of surgical treatment. There are various techniques for minimally invasive repair of Achilles tendon, which has some advantages over the open repair. However, the optimal technique for minimally invasive repair has not been established. The number of suture strands is important regardless of suture technique.

Recent update of autism spectrum disorders

  • Kim, Sung Koo
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.8-14
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    • 2015
  • In patients with a language developmental delay, it is necessary to make a differential diagnosis for autism spectrum disorders (ASDs), specific language impairment, and mental retardation. It is important that pediatricians recognize the signs and symptoms of ASDs, as many patients with language developmental delays are ultimately diagnosed with ASDs. Pediatricians play an important role in the early recognition of ASDs, because they are usually the first point of contact for children with ASDs. A revision of the diagnostic criteria of ASDs was proposed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that was released in May 2013. The autism spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth edition of the DSM. The new diagnostic criteria encompasses previous elements from the diagnosis of autistic disorder, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified. An additional change to the DSM includes synthesizing the section on social and communication deficits into one domain. In ASD patients, the appropriate behavioral therapies and rehabilitation treatments significantly affect the prognosis. Therefore, this makes early diagnosis and treatment very important. In conclusion, pediatricians need to be able to recognize the signs and symptoms of ASDs and be attentive to them in order to make an early diagnosis and provide treatment.

Early Complications after Repair of Massive Rotator Cuff Tear (광범위 회전근개 파열의 수술적 치료 후 발생한 단기 합병증)

  • Seo, Joong-Bae;Bahng, Seung-Chul
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.27-33
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    • 2006
  • Purpose: To investigate early complications after repair of massive rotator cuff tears and to find out factors that compromise the results. Materials and Methods: Fourteen patients who had two or more cuff tendons involved were included. All patients were operated by open acromioplasty and rotator cuff repair. At 3 months after operation, we investigated whether there were any early complications or not. We used ASES scoring system for preoperative and follow up evaluation. In addition, various preoperative factors, such as duration of symptom, degree of tendon retraction, degree of fatty degeneration, and acromio-humeral distance, were compared between the complicated patients and non-complicated patients. Results: At 3 months after operation, the ASES score and pain were improved in any degree in all patients. But 5 patients complained persisting pain, and three of them showed major complications such as re-rupture of rotator cuff or deltoid rupture. But no preoperative factors in complicated patients were significantly different from those in non-complicated patients. Conclusion: None of the preoperative factors were related to the complications. There was a tendency of overestimation of fatty degeneration in MRI. Some factors in surgical technique and rehabilitation were highly suspected to be related to the complications.

The Effects of Parentification of Early Adult Non-disabled Siblings on Ambivalence over Emotional Expression and Moderating Effects of Rejection Sensitivity (성인초기 비장애형제자매의 부모화 경험이 정서표현양가성에 미치는 영향과 거부민감성의 조절효과)

  • Son, Juhee;Park, Juhee
    • Human Ecology Research
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    • v.57 no.3
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    • pp.445-457
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    • 2019
  • This study investigated the impact of parentification on ambivalence over the emotional expression of early adults who had a sibling with disabilities and examined if rejection sensitivity moderated the relationship of parentification and ambivalence over emotional expression. Participants consisted of 116 siblings in early adulthood who had a sibling with disabilities (45 male; 71 female). The data were collected from 13 centers for family disability, four community rehabilitation centers, three parent societies for people with disabilities, and three self-help groups in Seoul, Busan, and Gyeonggi province. The levels of ambivalence over emotional expression, parentification, and rejecton sensitivity were measured by the Ambivalence over Emotional Expression Questionnaire (King & Emmons, 1990), the Filial Responsibility Scale-Adult (Jurkovic, Thirkield, & Morrell, 2001), and the Rejection Sensitivity Questionnaire (Downey & Feldman, 1996), respectively. The PROCESS Macro program examined the moderating model. The Results indicated that both levels of parentification and rejection sensitivity increased the level of ambivalence over emotional expression of non-disabled siblings. In addition, rejection sensitivity moderated the effect of parentification on ambivalence over emotional expression. The influence of parentification on ambivalence over emotional expression was greater when the level of rejection sensitivity was high, compared to when it was low.

Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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Surgical versus Conservative Treatment for Lumbar Disc Herniation with Motor Weakness

  • Choi, Hong-Seok;Kwak, Kyung-Woo;Kim, Sang Woo;Ahn, Sang Ho
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.183-188
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    • 2013
  • Objective : The aim of this study is to assess outcomes during first one year for patients with severe motor weakness caused by lumbar disc herniation that underwent surgical or nonsurgical treatment. Methods : The 46 patients with motor weakness because of lumbar disc herniation who were treated at neurosurgical department and rehabilitation in our hospital from 2006 to 2010, retrospectively. Each group had 26 surgical treatments and 20 conservative treatments. We followed up 1, 3, 6 months and 12 month and monitored a Visual Analogue rating Scale (VAS) of back and leg pain, Oswestry Disability Index (ODI) and degree of motor weakness. We analyzed the differences between surgical and nonsurgical groups using Mann-Whitney U test and repeat measure ANOVA in each follow-up periods. Results : In the recovery of motor weakness, surgical treatment uncovered a rapid functional recovery in the early periods (p=0.003) and no difference between groups at the end of follow-up period was found (p>0.05). In VAS of back and leg, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). In ODI, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). Conclusion : Surgical treatment for motor weakness caused by herniated intervertebral disc resulted in a rapid recovery in the short-term period, especially 1 month. We think early and proper surgical treatment in a case of motor weakness from disc herniation could be a good way for providing a chance for rapid alleviation.

Mucopolysaccharidoses in Taiwan

  • Lin, Hsiang-Yu;Chuang, Chih-Kuang;Lin, Shuan-Pei
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.4 no.1
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    • pp.14-20
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    • 2018
  • Mucopolysaccharidoses (MPSs) are a group of rare inherited metabolic disorders caused by specific lysosomal enzyme deficiencies leading to the sequential degradation of glycosaminoglycans, causing substrate accumulation in various cells and tissues and progressive multiple organ dysfunction. The rare disease medical care team at Mackay Memorial Hospital in Taiwan has been dedicated to the study of MPSs for more than 20 years. Since 1999, more than 50 academic papers focusing on MPSs have been published in international medical journals. Topics of research include the following items regarding MPSs: incidence, natural history, clinical manifestations, gene mutation characteristics, cardiac function, bone mineral density, sleep studies, pulmonary function tests, hearing assessments, percutaneous endoscopic gastrostomy, anesthetic experience, imaging analysis, special biochemical tests, laboratory diagnostics, global expert consensus conferences, prenatal diagnosis, new drug clinical trials, newborn screening, and treatment outcomes. Of these published academic research papers, more than half were cross-domain, cross-industry, and international studies with results in cooperation with experts from European, American and other Asian countries. A cross-specialty collaboration platform was established based on high-risk population screening criteria with the acronym "BECARE" (Bone and joints, Eyes, Cardiac and central nervous system, Abdomen and appearance, Respiratory system, and Ear, nose, and throat involvement). Through this platform, orthopedic surgeons, rheumatologists, ophthalmologists, cardiologists, rehabilitation physicians, gastroenterologists, otorhinolaryngologists, and medical geneticists have been educated with regards to awareness of suspected cases of MPSs patients to allow for a further confirmative diagnosis of MPSs. Because of the progressive nature of the disease, an early diagnosis and early multidisciplinary therapeutic interventions including surgery, rehabilitation programs, symptom-based treatments, hematopoietic stem cell transplantation, and enzyme replacement therapy, are very important.

The Effect of Different Starting Periods of Passive Exercise on the Clinical Outcome of Arthroscopic Rotator Cuff Repair

  • Back, Young-Woong;Tae, Suk-Kee;Kim, Min-Kyu;Kwon, Oh-Jin
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.57-63
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    • 2014
  • Background: To compare the effect of different starting periods of rehabilitative exercise (early or delayed passive exercise) on the rate of retear and other clinical outcomes after the arthroscopic repair of the rotator cuff. Methods: In total, 103 patients who underwent arthroscopic repair of the rotator cuff were included in the study. Determined at 2 weeks post-operation, patients who were incapable of passive forward elevation greater than $90^{\circ}$ were allotted to the early exercise group (group I: 79 patients; 42 males, 37 females), whilst those capable were allotted to the delayed exercise group (group II: 24 patients; 14 males, 10 females). The group I started passive exercise, i.e. stretching, within 2 weeks of operation, whilst group II started within 6 weeks. The results were compared on average 15.8 months (11-49 months) post-operation using the passive range of motion, the Visual Analog Scale (VAS) pain score, and the University of California at Los Angeles (UCLA) and Constant scores. Stiffness was defined as passive forward elevation or external rotation of less than $30^{\circ}C$ compared to the contralateral side. Follow-up magnetic resonance imaging (MRI) was carried out on average 1 year post-operation and the rate of retear was compared with Sugaya's criteria. Results: There were no differences between the two groups in gender, age, smoking, presence of diabetes, arm dominance, period of tear unattended, pre-operative range of motion, shape and size of tear, degree of tendon retraction, and tendon quality. There were no significant differences in clinical outcomes. Whilst stiffness was more frequent in group II (p-value 0.03), retear was more frequent in group I (p-value 0.028) according to the MRI follow-up. Conclusions: During rehabilitation after the arthroscopic repair of the rotator cuff, the delay of passive exercise seems to decrease the rate of retear but increase the risk of stiffness.

Effects of trunk Muscles Endurance, Hip Joint Muscular Strength, and Pelvic Alignment on Mild Low Back Pain

  • Kim, Wondeuk;Seo, Miryea;Park, Dongchun;Shin, Doochul
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.156-160
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    • 2021
  • Objective: Low back pain easily becomes chronic and has a high recurrence rate. Therefore, it is most important to prevent chronicity and reduce the risk of recurrence in the early stages of back pain or at the stage with mild pain. Therefore, this study was conducted to compare hip joint muscle strength, trunk muscle endurance, and pelvic alignment between subjects with mild low back pain and subjects without back pain. Design: Crossed-sectional study Methods: The study was conducted by recruiting 30 students in their twenties who are enrolled in K University in Gyeongsangnam-do, and classifying them into 15 patients with mild back pain and 15 patients with normal. The subjects who participated in the experiment were measured for hip flexor and extensor muscle strength, trunk flexion and extension muscle endurance, and pelvic alignment. To measure hip joint muscle strength, biodex was used, and muscle endurance of the trunk was recorded at the end range of the trunk flexion and extension. And pelvic alignment was measured using Formetric 4D. Results: There were no significant differences in hip joint muscle strength, pelvic alignment, and trunk extension muscle endurance. The retention time was found to be significantly shorter in the mild low back pain group than in the normal group for trunk flexion muscle endurance. Conclusions: In the early stages of back pain or in the mild pain stage, training to increase muscle endurance of the flexor muscles may be helpful.