To clarify the safety of both total and near-total thyroidectomy, and to guide a selectionof an adequate type of surgical treatment of thyroid diseases, 192 consecutive total or near-total thyroidectomy cases were reviewed. They were divided into two groups: ont, the total thyroidectomy group(Group T,N=111) and the other, the near-total thyroidectomy group (Group NT, N=81). In both groups, complication rates, associations of complication rates with extents of surgery and stage of lesion were observed. Complication rate was significantly higher in Group T (53.6% vs 12.3%, p<0.05). But the rate of permanent complications such as permanent hypoparathyroidism and recurrent laryngeal nerve injury was remarkably low(4.5% in Group T, 6.0% in Group NT) and shows no significant difference in both groups. There was no permanent complication in cases where any type of neck dissection had not been performed regardless of the type thyroidectomy. But among whom underwent central compartmental neck dissection(CCND) and functional neck dissection(FND), 4(4.4%) and 4(6.4%) cases showed permanent complications. There was no statistical significance in differences between Group I and NT. In cases who underwent concomittant classical radical neck dissection(RND), 3(25.5%) showed permament complications. In this subgroups, complications were significantly higher in Group T(p<0.005). Complications were also directly related to the stage of the lesion. Only one patient showed permanent complication in 74 intracapsular lesions but 9 permanent complications were observed in 118 advanced lesions. We could clarify both total and near-total thyroidectomy were safe operations and the complications were related to accompanying neck dissections and the disease status rather than total or near-total thyroidectomy itself. Thus, we think that for the cases where higher complication rates are expected, such as locally advanced thryoid cancers or the cases which required wider neck dissection, the near-total thyroidectomy would be a preferrable method.
Proceedings of the Korean Society for Language and Information Conference
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2001.06a
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pp.237-257
/
2001
This paper investigates the idiosyncratic understanding of universal quantifiers such as every, each or all by young children at the ages of 4 to 7, and argues that the phenomenon is explicable in terms of the maturation of both the cognitive system and the linguistic system. Evidence for this dual explanation comes from the fact that the visual input, a picture, plays a key role in determining the children’s conceptual representation, suggesting the need for the central integration of visual and linguistic elements; and from the fact that a quantifier in the linguistic input has an intrinsic property, i.e. a <+focus> feature. I have tried to explain the nature of the cognitive factors in terms of the function of the central system, suggesting a modified form of Smith & Tsimpli’s (1995) version of Fodor’s (1983) modularity hypothesis. Conceptual representations of two kinds are in competition with each other and they are integrated into a neutral LOT (Language of Thought) representation at some point . In the process of this integration, the representations from the visual input predominate over those from the auditory input, though the quantize. (treated as new information provided by the latter) is salient in the final representations. When visual conceptual representations predominate over purely linguistic ones, quantifier spreading errors occur. By contrast, when the relevant grammatical knowledge has developed sufficiently to counteract the conceptual representations, this peculiar behaviour by children should disappear. It is argued that children have to learn two kinds of grammatical fact with regard to universal quantification: (i) they have to learn the status of the quantifier as a functional head of DP so that it has to be positioned inside DP; and (ii) they have to learn the Left-Branch Condition which specifies that movement of an element in the left-branch position is possible only by pied-piping the entire phrase.
As a measure of the combined effect of fracture geometry, the fabric tensor parameters could quantify the status of the connected fluid flow paths in discrete fracture network (DFN). The correlation analysis between fabric tensor parameters and hydraulic properties of the 2-D DFN was performed in this study. It is found that there exists a strong nonlinear relationship between the directional conductivity and the fabric tensor component estimated in the direction normal to the direction of hydraulic conductivity. The circular radial plots without significant variation of the first invariant ($F_0$) of fabric tensor for different sized 2-D DFN block are a necessary condition for treating representative element volume (REV) of a fractured rock mass. The relative error (ER) between the numerically calculated directional hydraulic conductivity and the theoretical directional hydraulic conductivity decreases with the increase in $F_0$. A strong functional relation seems to exist between the $F_0$ and the average block hydraulic conductivity.
The purpose of this study was to compare the balance and gait between fallers and non-fallers in elderly. A brief questionnaire was used to obtain the fall history. Twenty-seven women subjects were evaluated in this study. Eleven subjects and a mean age of 84.5 years (SD=4.6) were designated as the faller group. Sixteen subjects and a mean age of 80.3 years (SD=5.3) were designated as the non-faller group. The fall-related factors (mental status, balance, range of motion and muscle strength of lower extremity, sensation of foot, and cadence, walking velocity, stride length) were compared between faller group and non-faller group and measured. The results showed that faller group had significantly less range of motion of the hip flexion and knee extension, and strength of the knee extensor and ankle dorsiflexor and plantar flexor than non-faller group. The scores of the Functional reach test and One leg standing were significantly less in faller group than in non-faller group. Faller group showed less walking velocity and stride length compared to non-faller group. However, there was no significant difference in cadence during comfortable waking and fast walking between two groups. There were no significant differences in pressure, position sensory between two groups. These results suggest that exercise for improving the flexibility, muscle strength of the lower extremity and balance may be useful strategies to prevent fall in elderly. Further studies are needed to identify which specific factors are related to fall in the elderly population.
Purpose: Long-term care facilities have a responsibility to provide care service that enables residents to maintain their maximal functional capacity and quality of life. Also their needs must be reflected to the service programs. In oder to provide an adequate service, we should assess the elderly's physical, psychological and social health status and the need. In addition to this, the long-term care facilities must be defined clearly by the type of services. This study would contribute to conduct appropriate services in public long-term care policy for the older population in the future. This study would provide informations of long-term care facilities' services and older persons' needs for long-term care. Method: To achieve this objectives, this paper investigates the types, service programs of long-term care institutes and job descriptions of workers. The subjects were consisted of 150 long-term care institutes. 150 institutes of long-term care facilities were drawn from all over the country by a nonrandom, convenience sampling. The data were analyzed by frequency, percentage, $x^2$-test using SPSS program. The instruments of this study were self-reported questionnaires for long-term care institutes. The data were collected from March 1, 2004 to may 31, 2004. Results: Service programs of long-term care institutes were not enough for residents' demands. The job descriptions among nurse, social worker and physical therapist were not clearly defined. The nurse's main role was medication and checking vital sign(49.7%), that of social worker's was observation and supervising (31.2%). The most significant problems were lacking of diverse service programs for residents. Conclusion: Considering these findings and conclusion, the needs of long-term care services should be provided by individual physical and psychological level. And the professional manpower for elderly should be educated in multi disciplines.
Kang Ji Yeon;Kim Soo Yeon;Lee Min Sook;Ahn Hong Seok
Korean Journal of Community Nutrition
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v.10
no.2
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pp.183-188
/
2005
The aim of this study was to assess the effect of 6-week vegetable juice supplementation (360 ml/day) on serum lipid profiles and antioxidant activity in college women. Twenty women (mean age: 21) with normal life style and dietary pattern and who are free of any specific diseases were recruited among the student in S women's university. The subjects consumed vegetable juice to take part in an uncontrolled clinical trial for a 6-week intervention period. While there was no difference in the concentration of total cholesterol and HDL-cholesterol, serum concentrations of TG and HDL/LDL ratio were significantly reduced by $22\%$ (p = 0.013) and $6\%$ (p =0.007) respectively. Significant decrease in manlondialdehyde (p = 0.000) was accompanied by an increase in the activity of serum antioxidant enzymes, such as GSHPx (p = 0.000), SOD (p=0.007). It was also found that total antioxidant status was improved by $5.4\%$ (p=0.009). Serum parameters were all changed without affecting body mass index, waist and hip circumferences, or nutrient intakes after six week of supplementation. This study demonstrated that the supplementation regular meals with vegetable juice can favorably affect serum lipid profiles and antioxidant systems, and hence could contribute to reduce the risks of chronic diseases in college women.
Most of clinical morbidity in cardiology are associated with abnormalities of the left ventricle. Several methods have been developed to measure the left ventricular function, including cardiac catheterization with cineangiography, echocardiography, and systolic time interval. But these methods have many limitations. ECG gated cardiac blood pool scan provides a safe, noninvasive, repeatable method for determining the left ventricular function. Utilizing the cardiac blood pool scan, we measured the left ventricular function in 165 cardiac patients, and in 26 normal subject. 1. Left ventricular ejection fractions were measured by cardiac blood pool scan, and compared in 20 patients with that measured by x-ray cineangiography. Correlation coefficient was 0.885. 2. Ejection fractions were classified by funtional class made in New York Heart Association. Ejection fractions well represented the functional status. 3. Ejection fractions decreased in cardiomyopathy ($20.1{\pm}4.8%$) and ischemic heart disease ($34.4{\pm}16.7%$). Impaired ejection fractions in myocardial infarction were associated with the extent of infarction. 4. Regional left ventricular wall motion was evaluated from the end-diastolic and end-systolic images. In cardiomyopathy diffuse hypokinesia was noted and in myocardial infarction akinesia was noted on the infarcted areas.
Purpose: Aspiration pneumonia (AP) is the major complication of dysphagia in patients with acute stroke. Nursing management for dysphagia influences on patients' health outcomes. The purpose of this study was to develop and evaluate the effects of Dysphagia Nursing Protocol (DNP) for patients with acute stroke. We aimed to examine the incidence of AP and the dependency rate at the discharge. Methods: We used a non-equivalent control group posttest only design in this study. DNP was developed with content validity index > 0.75 in all items. This protocol was composed of the evaluation, education, complication prevention, and checking phases. After training the staff nurses, we applied DNP protocol to the experimental group. The control group was enrolled from June to August 2013 (n=80), and the experimental group was June to August 2014 (n=64). Results: The incidence of AP was 16.3% in control group while 4.7% in experimental group (p=.028), and the Odds Ratio (OR) was 0.26 (p=.045). The dependency ratio was 66.3% in control group while 43.8% in experimental group (p=.011), and the OR was 0.33 (p=.011). Conclusion: DNP was beneficial for the reducing the risk of AP and the improved the functional status.
Purpose: The purpose of this study was to investigate caregiver burden and health related quality of life (HRQoL) among male spouses who cared for partners with a stroke. Methods: The subjects were spouses of 121 female patients who visited the neurology outpatients department in one tertiary hospital located in Seoul between February and April in 2011. Results: The mean age of the male caregivers was $71.25{\pm}5.51$ years. The mean score of caregiver's burden was moderate ($63.28{\pm}9.85$). The average reported caregiving time was $58.48{\pm}5.51$ min/day with the male spouses spending more time in house-working than with caregiving activities. The reported depression and care giving time, plus the cognitive status and functional dependencies of the spouse were significantly related to male caregiver's burden. The mean scores of 'physical health' and 'mental health' for quality of life for the male caregivers was moderate (47.49 and 47.33 respectively). Overall, caregiver's burden has a negative effect on the HRQoL of male spouses. Conclusion: Caregiver's burden and HRQoL are important problems which are in need of nurses' attention. It is suggested that intervention programs for male spouses be developed with a focus on emotional and social support as well as education about the caregiving role.
Background: Gestational trophoblastic neoplasia (GTN) is a malignant disease which occurs in women of reproductive age. Treatment of GTN has an excellent outcome and further pregnancies can be expected. However, data concerning quality of life in these cancer survivor patients are limited. This study aimed to assess quality of life in women who were diagnosed with GTN and remission after treatment, and to determine factors that may affect quality of life status. Materials and Methods: This cross sectional study was conducted from July 2013 to May 2014 in the Gestational Trophoblastic Disease Clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Patients who were diagnosed GTN and complete remission were recruited. Data collection was accomplished by interview with two sets of questionnaires, one general covering demographic data and the other focusing on quality of life, the fourth version of Functional Assessment of Cancer Therapy (FACT-G). Descriptive statistics were used to determine general data and quality of life scores. Students t-test and one way ANOVA were used to compare between categorical and continuous data. Results: Forty four patients were enrolled in this study. The overall mean quality of life score (FACT-G) was 98.2. The overall FACT-G score was not significantly correlated with age, education level, stage of disease, treatment modalities, and time interval from remission to enrollment. However, patients who needed further fertility showed significant lower FACT-G scores in the emotional well-being domain (p=0.02). Conclusions: Overall quality of life scores in post-treatment gestational trophoblastic neoplasia patients are in the mild impairment range. Patients who desire fertility suffer lower quality of life in the emotional well-being domain.
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