• Title/Summary/Keyword: Functional Impairment

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Vascular health late after Kawasaki disease: implications for accelerated atherosclerosis

  • Cheung, Yiu-Fai
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.472-478
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    • 2014
  • Kawasaki disease (KD), an acute vasculitis that primarily affects young children, is the most common acquired paediatric cardiovascular disease in developed countries. While sequelae of arterial inflammation in the acute phase of KD are well documented, its late effects on vascular health are increasingly unveiled. Late vascular dysfunction is characterized by structural alterations and functional impairment in term of arterial stiffening and endothelial dysfunction and shown to involve both coronary and systemic arteries. Further evidence suggests that continuous low grade inflammation and ongoing active remodeling of coronary arterial lesions occur late after acute illness and may play a role in structural and functional alterations of the arteries. Potential importance of genetic modulation on vascular health late after KD is implicated by associations between mannose binding lectin and inflammatory gene polymorphisms with severity of peripheral arterial stiffening and carotid intima-media thickening. The changes in cholesterol and lipoproteins levels late after KD further appear similar to those proposed to be atherogenic. While data on adverse vascular health are less controversial in patients with persistent or regressed coronary arterial aneurysms, data appear conflicting in individuals with no coronary arterial involvements or only transient coronary ectasia. Notwithstanding, concerns have been raised with regard to predisposition of KD in childhood to accelerated atherosclerosis in adulthood. Until further evidence-based data are available, however, it remains important to assess and monitor cardiovascular risk factors and to promote cardiovascular health in children with a history of KD in the long term.

Self-Care in Elders with Dementia: A Concept Analysis

  • Yeom Hye-A
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1402-1408
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    • 2004
  • Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

Dysphonia : Vocal Fold Mucosal Lesions Easily Missed in Laryngoscopy (발성장애: 후두내시경 검사에서 놓치기 쉬운 성대점막질환)

  • Kim, Han-Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.17-21
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    • 2010
  • Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,

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Rapid Functional Enhancement of Ankylosing Spondylitis with Severe Hip Joint Arthritis and Muscle Strain (고관절염과 근 긴장을 동반한 강직성 척추염의 빠른 기능 회복)

  • Hwang, Sangwon;Im, Sang Hee;Shin, Ji Cheol;Park, Jinyoung
    • Clinical Pain
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    • v.18 no.2
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    • pp.121-125
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    • 2019
  • Arthritis of hip joints deteriorates the quality of life in ankylosing spondylitis (AS) patients. Secondary to the articular inflammatory process, the shortened hip-girdle muscles contribute to the decreased joint mobility which may lead to the functional impairment. As the limitation of range of motion (ROM) usually progress slowly, clinicians regard it as a chronic condition and prescribe long-term therapy. However, by short-term intensive multimodal treatment, a 20-year-old man diagnosed as AS with severely limited hip joint ROM who relied on crutches doubled the joint angle and could walk independently only within 2 weeks. The combination included intra-articular steroid injection, electrical twitch obtaining intramuscular stimulation, extracorporeal shock wave therapy, heat, manual therapy, and stretching exercises. The management focused on the relaxation of hip-girdle muscles as well as the direct control of intra-articular inflammation. Hereby, we emphasize the effectiveness of intensive multimodal treatment in improving the function even within a short period.

Facial palsy reconstruction

  • Soo Hyun Woo;Young Chul Kim;Tae Suk Oh
    • Archives of Craniofacial Surgery
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    • v.25 no.1
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    • pp.1-10
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    • 2024
  • The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

Oral Administration of Bifidobacterium lactis Ameliorates Cognitive Deficits in Mice Intracerebroventricularly Administered Amyloid Beta via Regulation the Activation of Mitogen-activated Protein Kinases

  • Jong Kyu Choi;Oh Yun Kwon;Seung Ho Lee
    • Food Science of Animal Resources
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    • v.44 no.3
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    • pp.607-619
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    • 2024
  • Probiotics are functional microorganisms that exhibit various biological activities, such as allergic reactions, inflammation, and aging. The aim of this study is to evaluate the effects of Bifidobacterium lactis CBT BL3 (BL) on the amyloid beta (Aβ)-mediated cognitive impairments. Oral administration of live BL to intracerebroventricularly Aβ-injected mice significantly attenuated short- and long-term memory loss estimated using the Y-maze and Morris water maze tests. We found that expression of apoptosisrelated proteins such as caspase-9, caspase-3, and cleaved poly (ADP-ribose) polymerase was significantly elevated in the brain tissues of Aβ-injected mouse brains when compared to that of the control mouse group. Interestingly, these expression levels were significantly decreased in the brain tissue of mice fed BL for 6 wk. In addition, the abnormal over-phosphorylation of mitogen-activated protein kinases (MAPKs) such as ERK1/2, p38 MAPK, and JNK in the brain tissue of intracerebroventricularly Aβ-injected mice was significantly attenuated by oral administration of BL. Taken together, the results indicate that Aβ-induced cognitive impairment may be ameliorated by the oral administration of BL by controlling the activation of MAPKs/apoptosis in the brain. This study strongly suggests that BL can be developed as a functional probiotic to attenuate Aβ-mediated cognitive deficits.

Changes in cognitive function and functional disability in older adults - Comparison of groups converted and not converted to dementia among cognitively normal older adults - (노년기 인지기능과 일상생활기능장애 변화에 대한 연구 - 치매발생집단과 정상유지집단 간 차이 -)

  • Lee, Hyun Joo
    • Korean Journal of Social Welfare Studies
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    • v.44 no.2
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    • pp.327-358
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    • 2013
  • This study aimed to analyze the trajectories of cognitive function and functional disability, and to identify the impacts of socio-demographic factors on the two variables. Based on the assumption that there are differences according to the progress of cognitive impairment, it focused on examining the differences in trajectories of cognitive function and functional disability between two groups: dementia conversion group and dementia non-conversion group among cognitively normal older adults. This study was conducted based on the data from a 3-wave panel study of a sample of 966 Yeoncheon elderly cohort aged 65 and over between 1997 and 2003. Latent growth curve model and multi-group structural equation modeling were used to examine the hypothesis. Results revealed that dementia conversion group exhibited faster rate of cognitive decline as well as lower initial cognitive level. Difference between two groups was not significant in the initial level of functional disability, yet dementia conversion group showed greater degree of deterioration in the functional disability over time than dementia non-conversion group did. In terms of the influence of socio-demographic factors on cognitive function and functional disability, the cognitive decline was more drastic in the female group, whereas functional decline was more apparent for the male group. The level of education in early life had a strong impact on the cognitive function in later life. Based on these findings, practical implication for high risk groups in cognitive function and functional disability were discussed.

THE CORRECTION OF SECONDARY CLEFT LIP NASAL DEFORMITY;A CASE REPORT (이차성 구순열 비변형의 교정술;증례보고)

  • Kim, Young-Kyun;Yeo, Hwan-Ho;Byun, Ung-Rae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.2
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    • pp.153-158
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    • 1995
  • A wide variety of deformities can occur following repair of the cleft lip. Especially, cleft lip nasal deformities offer the severe psychologic, esthetic, and functional impairment. We must restore the deformities of alar cartilge, nasal tip, septum, columella, or pyriform aperture. The authors reconstructed the cleft lip nasal deformities using with the alar cartilage rearrangement, postauricular cartilage graft, and/or columellar lengthening. The 3 case reports are presented.

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Korean Agrammatic Production : Testing The Tree-Pruning Hypothesis

  • Kim SuJung;Halliwell John F.
    • Proceedings of the Acoustical Society of Korea Conference
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    • autumn
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    • pp.337-340
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    • 1999
  • The most salient and discussed features of speech production in agrammatic aphasia are the omission and substitution of grammatical morphemes. Cross-linguistic studies have shown that the pattern of omission/substitution is not random but occurs in a systematic and highly constrained way. Although these descriptions are important, they do not explain why all grammatical morphemes are not equally impaired. Friedmann and Grodzinsky (1997) proposed the Tree-Pruning Hypothesis (TPH) to account for these patterns of sparing and loss. The TPH claims that in an agrammatic representation, an impaired functional node is underspecified, thus allowing inappropriate affixation to occur. Additionally, whenever a node is impaired, all nodes above it will also be impaired. Using four types of narratives collected from two Korean agrammatic patients, We test the claim that the impairment in agrammatism is based on such hierarchical representation. It was found that these patients consistently produced appropriate grammatical morphemes that are higher in a syntactic tree than the impaired morphemes. The finding that an intact node exists higher than an impaired node refutes the TPH.

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Loss of Integrity: Impairment of the Blood-brain Barrier in Heavy Metal-associated Ischemic Stroke

  • Kim, Jeong-Hyeon;Byun, Hyeong-Min;Chung, Eui-Cheol;Chung, Han-Young;Bae, Ok-Nam
    • Toxicological Research
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    • v.29 no.3
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    • pp.157-164
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    • 2013
  • Although stroke is one of the leading causes of death and disability worldwide, preventive or therapeutic options are still limited. Therefore, a better understanding of the pathophysiological characteristics of this life-threatening disease is urgently needed. The incidence and prevalence of ischemic stroke are increased by exposure to certain types of xenobiotics, including heavy metals, suggesting the possible toxicological contribution of these compounds to the onset or aggravation of stroke. Among the potential targets, we have focused on alterations to cerebral endothelial cells (CECs), which play important roles in maintaining the functional integrity of brain tissue.