A 78-year-old woman presented with weakness of the extremities, dysarthria, dizziness, and sensory impairment. Magnetic resonance imaging showed acute bilateral medial medullary infarction. Contrast enhanced magnetic resonance angiography demonstrated stenosis or occlusion of both intracranial vertebral arteries. We present a rare case of bilateral medullary infarction seen on diffusion-weighted imaging.
Genetic hearing loss crosses almost all the categories of hearing loss which includes the following: conductive, sensory, and neural; syndromic and nonsyndromic; congenital, progressive, and adult onset; high-frequency, low-frequency, or mixed frequency; mild or profound; and recessive, dominant, or sex-linked. Genes play a role in almost half of all cases of hearing loss but effective treatment options are very limited. Genetic hearing loss is considered to be extremely genetically heterogeneous. The advancements in genomics have been instrumental to the identification of more than 6,000 causative variants in more than 150 genes causing hearing loss. Identification of genes for hearing impairment provides an increased insight into the normal development and function of cells in the auditory system. These defective genes will ultimately be important therapeutic targets. However, the auditory system is extremely complex which requires tremendous advances in gene therapy including gene vectors, routes of administration, and therapeutic approaches. This review summarizes and discusses recent advances in elucidating the genomics of genetic hearing loss and technologies aimed at developing a gene therapy that may become a treatment option for in the near future.
An intraneural ganglion in the peripheral nerve and the resulting ulnar neuropathy at the elbow are uncommon and may show various symptoms ranging from local pain to motor and sensory impairment. We report a case of a 76-year-old man who was diagnosed with ulnar neuropathy caused by an intraneural ganglion derived from the elbow. We also discuss the pathophysiology, treatment, prognosis, and diagnostic value of ultrasonography in neuropathy caused by a ganglion.
Given the central role of sense of control in physical and emotional well-being, the present study examined the determinants of sense of control among Korean elders. We considered sociodemographic characteristics (age, gender, marital status, education, and self-perceived economic status), health-related factors (chronic conditions, functional disability, and sensory impairment), stressful life events, and network-related resources (network of relatives, network of friends, and filial satisfaction) as potential predictors. Sense of control was measured with Pearlin and Schooler's (1978) Mastery Scale. Hierarchical regression analyses with 291 Korean elders aged 60 or older (M age = 69.9) identified lower self-perceived economic status, more chronic conditions, greater functional disability, greater vision impairment, more stressful life events, and lower filial satisfaction as significant risk factors for a diminished sense of control. Because most of the identified risks represent normative experiences during later life, the results underscored the importance of preserving or promoting sense of control for older adults. Implications of the findings and recommendations for future studies are discussed.
Journal of Korea Entertainment Industry Association
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v.13
no.3
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pp.231-248
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2019
The purpose of this study was to implement a cognitive stimulation activity program and examine its effects elderly people who is capable of daily life and community activities but suffering from per sistent cognitive decline on the elderly's cognitive function, self-efficacy, and depression. The purpose of this study was to help elderly people who is capable of daily life and community activities but suffering from persistent cognitive decline improve their ability to perform and adapt to activity-based tasks incorporating a variety of actions of different subdomains and difficulty levels, ac cording to their characteristics and cognitive levels. The aim of the program created was to systemati cally improve the subdomains of cognitive functions and eventually preventing these conditions develo ping into dementia in those affected. This study also enabled the subjects to improve their self-effica cy through newly gained positive perceptions and attitudes toward their own abilities by successfully expressing their experience or thoughts about circumstantially and relationally meaningful events and memories, and performing activities that promote sensory stimulations. The group activities conducted as part of the study helped the subjects reduce their symptoms of depression not only by expressing their thoughts and emotions, but also by encouraging empathy with, understanding of, and caring for others. Given that this study confirmed the potential of the cognitive stimulation program designed fo r it as a clinical intervention for elderly people with cognitive impairment, it is suggested as a useful preventive program for early stage dementia.
The purposes of this study were; 1) to gather data relevant to demographic features. major main management practices, and the level of impairment of the activities of daily living (ADL) of patients with back pain, 2) to test the sensitivity of the Korean Pain Rating Scale and the Graphic Rating Scales, and 3) to identify indirect indicators of back pain by analysing pain related-behaviors. The level of pain was measured by Korean Pain Rating Scale(KPRS) and Graphic Rating Scales(GRS) developed by the reserchers. The GRS consists of two dimensions; the pain intensity (sensory) and unpleasantness (affective) measures. Of the 1,650 diagnosed back pain patients, from January 4 through June 30, 1987 by visiting outpatients' clinics of orthopedic and neurosurgical departments at 11 university hospitals in different districts of Korea, 330 men and women patients were self-selected by responding to the mailed questionnaires. The results were summarised as follows: Male exceeded female patients in number and onset of back pain were more prevalent in the age groups of 20s and the 30s. The average duration of suffering from the pain were 11 months, sixty three (19.1%) of the subjects retired from their jobs, one third(36.7%) have teen hospitalized for the treatment of back pain. In two thirds(64.8%) of the cases pain was characterized as lower back pain. The average sleep hour was 6.8 hours per 24 hours and the average rest hour during the day was 3.3 hours. The mean percentage of pain measured by GRS was higher than that of KPRS. The level of sensory intensity as well as the affective level of pain measured by KPRS and GRS were not highly correlated (sensory intensity r=0.4986, affective r=0.5029) which indicated low discriminative power. On the other hand, intercorrelation between sensory and affective dimension measured by KPRS and GRS showed moderate interrelation(r=0.7247; r=0.7899). One-third(32.5%) of the subjects complied with the hospital prescribed treatment while the other one-third(31.5%) depended on self-remedy and traditional practices, and the last one-third did not imply any pain management practices. The following 6 pain-related behaviors such as length of hospitalization, rest hour during day hours, varieties of pain management practice implied, number of pain sites, need for ADL and discomfort accompanied by ADL revealed to be important indicators of back pain. An investigation of sociodemographic features of patients with back pain in a larger context, i.e. with bigger number of respondents is recommended. Tests for construct validity of KPRS, i.e. factor analysis is further recommended.
Purpose: The purpose of this study was to identify differences in health status and the utilization of long-term care service between urban and rural aged residents in Korea. Methods: Through convenience sampling, 1,405 elders (829 from urban areas and 576 from rural areas) were selected during March 1 to May 31 in 2004. All the subjects agreed to participate and filled out the survey questionnaire after signing the consent form. The instruments utilized in this study were the impairment of physio-sensory function, ADL IADL, cognitive function, and psycho-social function scale. This instrument was developed by modifying the scab developed by Gurland & Wilder (1984). Data was analyzed using the SPSS Win program. Results: There were significant differences in economic status, duration of living and type of medical insurance between rural and urban elderly(p<.05). Physio-sensory functions (t=4.53. p<.001), ADL (t=3.61. p<.001), IADL (t=2.45, p=.014), cognitive functions (t=-2.63. p=.024) and psycho-social functions (t=3.69. p<.001) were significantly different between the two groups. The utilization of long-term care facility in the urban elderly was significantly higher than that in the rural elderly ($x^2=10.14$, p<.001). Conclusion: Considering these findings. the need for long-term care should be assessed by residence characteristics. Because of different utilization of long term care facility according to the elderly's needs, long-term care services should be considered the residence characteristics.
Journal of the Korean Society of Physical Medicine
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v.15
no.2
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pp.129-136
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2020
PURPOSE: This study aimed to determine the most effective feedback condition for static balance in elderly subjects. METHODS: Thirty-eight elderly subjects (12 men and 26 women with a mean age of 77.21 years) participated in this study. They each completed a questionnaire on their general characteristics, excluding personal identification codes. The static balance ability of the participants was evaluated using a Wii Balance Board and the Balancia program (version 2.0). The following three feedback conditions were considered: condition 1 (tactile feedback), condition 2 (visual feedback), and condition 3 (no feedback). One-way repeated-measures analysis of variance was used for the comparisons according to sway length and sway velocity. The statistical significance level was set to α = .05 for all variables. RESULTS: Significant differences in the sway length and sway velocity were observed between the three conditions (p < .05). Significant differences in the sway length were noted in the order of conditions 1, 2, and 3 (p < .05), and significant differences in the sway velocity in the order of conditions 3, 2, and 1 (p < .05). CONCLUSION: Significant differences in static balance ability were observed between the three conditions. In this study, tactile feedback was found to be the most effective feedback for balance training. Owing to aging and impairment of the senses, such as that observed in the tactile receptors, visual receptors, and proprioceptors, it is recommended that elderly subjects participate in balance training.
Journal of The Korean Society of Integrative Medicine
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v.8
no.1
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pp.87-99
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2020
Purpose : This study aims to investigate the effect of somatosensory stimulation on the upper limb sensory and function and self-esteem of stroke patients. Methods : This study period was march 4 to april 4 (5 weeks). The subject were 20 stroke patients with somatosensory impairment in B hospital, seongnam, gyeonggi province. They were devided into two group-experimental and control-with 10 members each. The members of the experimental group underwent somatosensory stimulation, whereas the members of the control group underwent an occupation-based intervention for 5 weeks. Thirty-minute therapy was provided 3 times per week for 5 weeks. Before and after the intervention, both groups were evaluated via light touch, static two-point discrimination, stereognosis, Fugl-Meyer assessment (FMA), and self-esteem scale Results : In this study, light touch was not significant in both groups. Static two-point discrimination was significant among the experimental group member's index fingers. Among the control group members, it was significant in the ring finger. The comparison between the two groups was significant in the index finger. The stereognosis results were significant in the experimental group but not in the control group. The comparison between the groups after the intervention was not significant. FMA was significant in the shoulder/ elbow/ forearm (SEF), hand and coordination among the experimental group. Among the control group, it was significant in the SEF and hand. The comparison between the groups was significant in the SEF, hand and coordination. The self-esteem scale results were significant among both groups, and the comparison between the group's score was likewise significant. Conclusion : In conclusion, somatosensory stimulation therapy increases the static two-point discrimination, stereognosis, upper extremity function, and self-esteem of patients with stroke. Therefore, while somatosensory stimulation therapy is not the best therapy, it is one of the best occupational therapies for stroke patients.
Ha, Han-Soo;Park, Yeong-Cheol;Kim, Hae-Kyoo;Baik, Seong-Wan;Chung, Kyoo-Sub
The Korean Journal of Pain
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v.7
no.2
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pp.188-192
/
1994
Recently, epidural morphine has been administrated to decrease patients' systemic stress responses such as: suffers, endocrine responses and impairment of pulmonary function, etc. Epidural morphine provided excellent analgesic effect, but incomplete sensory blockade as compared to epidural local anesthetics, which has sympathetic blockade effect and tachyphylaxis. Therefore, the authors surmised that low dose bupivacaine on low dose epidural morphine improved postoperative pain with greater sensory analgesia than epidural morphine alone. The effect of low dose bupivacaine on epidural morphine analgesia for postoperative pain was evaluated in seventy patients. They were physical status I-III by ASA classification. Patients were randomly divided into 2 groups and they were administrated morphine 2.5 mg only (group I), morphine 2.5 mg plus 0.125% bupivacaine (group II) through epidural catheter 1 hour before the end of the operation. During postoperative second days, their analgesic effects were evaluated by visual analogue scale (0-10). Side effects were also evaluated. The results were as follows, 1) On the day of the operation, VAS score showed significant differences between two groups (morphine group $3.20{\pm}0.16$, morphine plus bupivacaine group $2.77{\pm}0.08$; p < 0.05). 2) On the postoperative and second day, there were no statistical differences between the groups according to VAS score. 3) The incidence of pruritus, nausea, and vomiting were no differences in both groups. 4) None of the patients showed objective sedation or a low respiratory rate (< 10 bpm). We concluded that epidural administration of low dose bupivacaine on the epidural morphine analgesia was an effective method to decrease postoperative pain with little change in frequencies of side effects compared to epidural morphine alone.
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