• Title/Summary/Keyword: Patient with disabilities

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A Case Report on Improvement Mental Health of the Disabled by Acupuncture and Moxibustion (침구치료로 개선된 장애인의 정신건강 증례보고)

  • Koh, Won Joon;Park, Sang Kyun
    • Korean Journal of Acupuncture
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    • v.39 no.1
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    • pp.16-21
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    • 2022
  • The purpose of this study is to report the case mental health of people with disabilities has improved through visit treatment at public health centers. From October 26, 2021 to January 04, 2022, 6 visits were conducted and Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory (BDI), Korean version of Center for Epidemiological Studies-Depression Scale (K-CES-D), Visual Analog Scale (VAS), Euro Qol-Visual Analogue Scale (EQ-VAS), Modified Barthel Index (MBI) were used to check changes. After Korean Medicine treatments such as acupuncture, electroacupuncture, electromoxibustion, PHQ-9 decreased from 18 to 8, BDI decreased from 22 to 15, K-CES-D decreased from 42 to 21. And VAS decreased from 85 to 50, EQ-VAS increased from 30 to 50. But There was no change in the MBI. Confirmation of improvement in mental health-related indicators of disabled patients through Korean Medicine treatments.

ORTHODONTIC TREATMENT FOR PATIENTS WITH CEREBRAL PALSY AND AUTISM: CASE REPORT (뇌병변 장애 환자와 자폐성 장애 환자의 교정치료: 증례 보고)

  • Moon, So yeon;Lee, Dae woo;Kim, Jae gon;Yang, Yeon mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.84-88
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    • 2019
  • Malocclusion occurs more frequently in Special Health Care Needed (SHCN) patients than those in general. As caregiver's needs for orthodontic treatment tend to increase, the dentist should know how to decide the extent of treatment. This case report is about orthodontic treatment for two SHCN patients; one patient with cerebral palsy, and another patient with autism. A 10-year-old patient with cerebral palsy showed protrusion and rotation of maxillary anterior teeth. To resolve his chief complaints and make better oral hygiene, he underwent orthodontic treatment using micro tube appliances for 6 months. Another 11-year-old patient with autism had anterior crossbite and showed space deficiency of #13 and chronic gingivitis because of poor oral hygiene. She underwent orthodontic treatment with maxillary skeletal expander, facemask and AP expansion appliance. After 18 months we found positive overjet and ended the treatment. When giving SHCNs orthodontic treatment, the extent of treatment can be chosen according to the patient's cooperative ability and the traits of disabilities. Before initiating orthodontic treatment, the caregivers should be aware of their limitations of the treatment. Since oral hygiene is crucial factor in every dental treatment, education of oral hygiene process for the caregivers and SHCN patient must be done before the orthodontic treatment.

INTRAVENOUS SEDATION OF CEREBRAL PALSY PATIENT FOR DENTAL IMPLANT CT TAKING -A CASE REPORT (정신지체가 동반된 뇌성마비 환자의 임플란트 치료를 위한 CT 촬영 시 진정법 시행 -증례보고-)

  • Seo, Kwang-Suk;Lee, Ju-Hwan;Shin, Teo-Jeon;Yi, Young-Eun;Kim, Hyun-Jeong;Yum, Kwang-Won;Kim, Myung-Jin
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.1
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    • pp.21-25
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    • 2008
  • A 33-years-old female pateint with cerebral palsy showing spastic quardriplegia and severe mental retardation was scheduled for dental implant restorations. Before implant surgery we had to take implant CT. But, because of her involuntary motion and communication difficulty, sedation was needed in order to take CT. After 8 hour NPO, propofol infusion sedation with TCI (target controlled infusion) system was administered. The propofol blood concentration of the patient was maintained 2-3 ${\mu}$/ml to keep deep sedation to prevent uncontolled movement. During sedation, we monitored ECG, pulse oximetry, blood pressure, capnometry for patient safety. Oxygen was administered via nasal prong for preventing hypoxemia and to keep airway during sedation some bands were applied to lift mandible. Total duration was 20 minutes for taking CT, and she was discharged from hospital after 30 minute rest without complication.

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A Correlation between the Visual Perception Ability and Activities of Daily Living for Children with Spastic Diplegia (경직형 양하지 뇌성마비아동의 시지각 능력과 일상생활동작과의 관련성 연구)

  • Yu, Byong-Kyu;Jung, Kum-Hee
    • The Journal of Korean Academy of Sensory Integration
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    • v.4 no.1
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    • pp.47-55
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    • 2006
  • Objective : The purpose of this study was to evaluate the correlation between visual perception ability and activities of daily living(ADL) in the children with spastic diplegia who were treated at developmental disabilities children salutary institute. Method : The subject were consisted of 8 children with spastic diplegia(mean age, 10). The visual perception ability was measured by the Developmental Test of Visual Perception(DTVP) and by the Functional Independence Measure for Children(WeeFIM) to evaluate activities of daily living. Collected data analysis were completed by using correlation analysis. Results : Visual perception ability of children with spastic diplegia is the highest in Position in Space(PS) score, and is the lowest in Visual-Motor coordination(VM) score. Average visual perception performance of children with spastic diplegia is the highest in SR(Spatial relationship) score, and is the lowest in VM score. In activities of daily living, eating component were significantly correlated with Visual-Motor coordination. Conclusions : Therefore, accurate evaluation of visual perception ability and visual perception training for children with spastic diplegia will be important to improve patient's activities of daily living skill.

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De novo interstitial deletion of 15q22q23 with global developmental delay and hypotonia: the first Korean case

  • Kim, Ha-Su;Han, Jin-Yeong;Kim, Myo-Jing
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.313-316
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    • 2015
  • Interstitial deletions involving the chromosome band 15q22q24 are very rare and only nine cases have been previously reported. Here, we report on a 12-day-old patient with a de novo 15q22q23 interstitial deletion. He was born by elective cesarean section with a birth weight of 3,120 g at 41.3-week gestation. He presented with hypotonia, sensory and neural hearing loss, dysmorphism with frontal bossing, flat nasal bridge, microretrognathia with normal palate and uvula, thin upper lip in an inverted V-shape, a midline sacral dimple, severe calcanovalgus at admission, and severe global developmental delay at 18 months of age. Fluorescence in situ hybridization findings confirmed that the deleted regions contained at least 15q22. The chromosome analysis revealed a karyotype of 46,XY,del(15) (q22q23). Parental chromosome analysis was performed and results were normal. After reviewing the limited literature on interstitial 15q deletions, we believe that the presented case is the first description of mapping of an interstitial deletion involving the chromosome 15q22q23 segment in Korea. This report adds to the knowledge of the clinical phenotype associated with the 15q22q23 deletion.

Multiple implant therapy with multiple inductions of general anesthesia in non-compliant patients with schizophrenia: A case report

  • Choi, Yong-suk;Kim, Hyungseok;Rhee, Seung-Hyun;Ryoo, Seung-Hwa;Karm, Myong-Hwan;Seo, Kwang-Suk;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.239-244
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    • 2019
  • The effectiveness of dental implants in patients with disability, who are non-compliant during treatment, is controversial because of their poor oral health. Thus, oral health-care and management in such patients is concerning. Moreover, limited information is available on prognosis after implant placement. Herein, we describe a patient with schizophrenia who underwent dental implantation under multiple inductions of general anesthesia (5 times) and required conservative treatment and tooth extraction for multiple dental caries and retained roots because of inadequate oral health-care. Postoperatively, fracture of the prosthodontics and progression of dental caries were observed, and with 3 additional inductions of general anesthesia, conservative treatment, implant surgery, and prosthesis implantation were conducted. Postoperative 12-month follow-up since the last prosthesis implantation showed successful results. For patients with schizophrenia, multiple implantation can reduce horizontal bone loss and achieve aesthetic results compared to treatment with removable prosthodontics and could serve as an alternative treatment modality.

Evaluation of general anesthesia and sedation during dental treatment in patients with special needs: A retrospective study

  • Akpinar, Hatice
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.191-199
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    • 2019
  • Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

Complex open elbow fracture-dislocation with severe proximal ulna bone loss: a case report of massive osteochondral allograft surgical treatment

  • Concina, Chiara;Crucil, Marina;Theodorakis, Emmanouil;Saggin, Giorgio;Perin, Silvia;Gherlinzoni, Franco
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.183-188
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    • 2021
  • We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

Identification of Potocki-Lupski syndrome in patients with developmental delay and growth failure

  • Jun, Sujin;Lee, Yena;Oh, Arum;Kim, Gu-Hwan;Seo, Eulju;Lee, Beom Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.16 no.2
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    • pp.49-54
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    • 2019
  • Purpose: Potocki-Lupski syndrome (PTLS), is a recently identified, rare genomic disorder. The patients are affected by infantile hypotonia, poor growth and developmental delay. Facial dysmorphism may not be obvious in some patients. PTLS is associated with microduplication at chromosome 17p11.2. In the current study, three Korean patients are reported with their clinical and genetic features. Materials and Methods: The clinical findings of each patient were reviewed. Karyotyping and multiplex ligation-dependent probe amplification (MLPA) analyses were done for genetic diagnoses. Results: All the patients did not have the characteristic dysmorphic features, such as broad forehead, triangular face, asymmetric smile and palpebral fissures. On the other hand, all three patients were affected by variable degree of developmental delay, poor oral intake, failure to thrive, and language development disorders. Chromosome 17p11.2 duplication was identified by conventional karyotyping analysis only in one patient, whereas the other confirmed by MLPA analyses. Conclusion: Delayed development was mostly commonly observed in our patients without distinct dysmorphic facial features. In this respect, genomic screening in patients with developmental delay would identify more cases with PTLS to understand their long-term clinical courses with the development of adequate psychological and rehabilitation education program.

A Case Report of Problem Behavior in Adult with Severe Intellectual Disability Treated with the Korean Herbal Medicine Yokukan-san-gami (Yigan-san-jiawei) (성인 중증 지적장애에서의 문제행동에 대한 억간산가미(抑肝散加味) 치험 1례 보고)

  • Choi, Eun-ji;Suh, Hyo-weon;Chung, Sun Yong;Kim, Jong Woo
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.4
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    • pp.341-347
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    • 2017
  • This case report presents a 31-year-old male intellectual disability patient with problem behavior such as food refusal and temper tantrums. He was treated with the Korean traditional herbal medicine (Yokukan-san-gami) continuously for 56 days. The effects of the treatment were measured by the frequency of his problem behavior and the score of the Korean version of Aberrant Behavior Checklist (ABC). After treatment, his challenging behavior became reduced, and his ABC score had been decreased by 24.6%. The findings from this case suggest that the Korean traditional herbal medicine (Yokukan-san) could be effective for challenging behavior in patients with intellectual disabilities.