• Psychiatry investigation
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• 제15권12호
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• pp.1130-1134
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• 2018

Objective Trichotillomania is a relatively common illness whose neurobiology is poorly understood. One treatment for adult trichotillomania, n-acetyl cysteine (NAC), has antioxidative properties, as well as effects on central glutamatergic transmission. Preclinical models suggest that excessive oxidative stress may be involved in its pathophysiology. Methods Adults with trichotillomania provided a blood sample for analysis of compounds that may be influenced by oxidative stress [glutathione, angiotensin II, ferritin, iron, glucose, insulin and insulin growth factor 1 (IGF1), and hepcidin]. Participants were examined on symptom severity, disability, and impulsivity. The number of participants with out-of-reference range oxidative stress measures were compared against the null distribution. Correlations between oxidative stress markers and clinical measures were examined. Results Of 14 participants (mean age 31.2 years; 92.9% female), 35.7% (n=5) had total glutathione levels below the reference range (p=0.041). Other oxidative stress measures did not have significant proportions outside the reference ranges. Lower levels of glutathione correlated significantly with higher motor impulsiveness (Barratt Impulsiveness Scale sub-score) (r=0.97, p=0.001). Conclusion A third of patients with trichotillomania had low levels of glutathione, and lower levels of glutathione correlated significantly with higher motor impulsiveness. Because NAC is a precursor for cysteine, and cysteine is a rate limiting step for glutathione production, these results may shed light on the mechanisms through which NAC can have beneficial effects for impulsive symptoms. Confirmation of these results requires a suitable larger follow-up study, including an internal normative control group.

• International journal of advanced smart convergence
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• 제12권4호
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• pp.277-285
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• 2023

The purpose of this paper is to understand and express emotions and experiences from the perspective of others through empathy, which is crucial for maintaining social relationships. The smooth formation of interpersonal relationships through the physical activity of children with disabilities holds significant meaning. Children with disabilities often lack opportunities for interaction with their peers compared to typical children, and the absence of effective communication methods poses difficulties in forming relationships. Therefore, this study aimed to investigate the effects of a movement education program on enhancing empathy in children with disabilities. The program was implemented for 12 weeks from April to June 2023, involving five children with disabilities. The movement education program comprised 12 topics, encompassing physical, emotional, and cognitive domains. Empathy was measured in two areas: cognitive empathy and emotional empathy. The results indicated improvement in both cognitive and emotional empathy after the program compared to the pre-assessment. The rate of progress varied depending on the type and severity of the disability, but overall, positive changes in the development of empathy were observed. Through this research, it is hoped that movement programs can be practically utilized as a valuable resource.

• 한국치위생학회지
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• 제18권5호
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• pp.807-819
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• 2018

Objectives: The purpose of this study was to identify the factors affecting the oral health behavior of mothers in multicultural families and the oral health management of children. Methods: The subjects were 303 mothers in multicultural families having children in childhood. To verify the validity of the outcome, a factorial analysis was conducted. To examine differences in the outcome according to socio-demographic characteristics, a one-way ANOVA was used, and the hypothesis was tested through a multiple regression analysis. Results: According to the results, it was found that severity, self-efficacy, sensitivity, and multicultural disability that show attitudes had significant impact on the mother's oral health behavior. Moreover, it was found that self-efficacy, sensitivity, and the mother's oral health behavior that show attitudes had significant impact on the children's oral health management. Conclusions: Based on the results of this study, it would be necessary to increase the interest in mother-and-child oral health, developing a mother-and-child oral health education program targeted toward the oral health of the mothers and children in multicultural families. Moreover, it is essential to educate mothers in multicultural families in order to increase their sense of responsibility toward their children's oral health management, aiming to promote knowledge and to change attitudes and behavior.

• 대한정형도수물리치료학회지
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• 제19권1호
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• pp.79-83
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• 2013

Background: Spasmodic torticollis is a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. The purpose of this case is to describe the manual therapy for a patient with spasmodic torticollis. Methods: The patient was a 64 years old man with an 3 month history of left side laterocollis spasmodic torticollis. No known genetic history or trauma. Prior to intervention, his score on the Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 24, disability score was 20, pain score was 11. There is a noticeable distinction between left and right side cervical range of motion. The intervention consisted of manual therapy (MET, PNF) 3 times per week for the treatment during 4 weeks. Results: After intervention for 4weeks, his TWSTRS score and range of motion was improved quite a bit before therapeutic exercise. But symptoms are not improving sufficiently fast. Conclusions: Manual therapy is that MET and PNF is effective in improving for patient had spasmodic torticollis with laterocollis of neck.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.217-222
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• 2016

Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS$^{TM}$), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS$^{TM}$ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.

• Industrial Engineering and Management Systems
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• 제11권4호
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• pp.371-384
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• 2012

This study proposes a multi-level data analysis approach to identify both superficial and latent relationships among variables in the data set obtained from a vocational rehabilitation (VR) services program of people with significant disabilities. At the first layer, data mining and statistical predictive models are used to extract the superficial relationships between dependent and independent variables. To supplement the findings and relationships from the analysis at the first layer, association rule mining algorithms at the second layer are employed to extract additional sets of interesting associative relationships among variables. Finally, nonlinear nonparametric canonical correlation analysis (NLCCA) along with clustering algorithm is employed to identify latent nonlinear relationships. Experimental outputs validate the usefulness of the proposed approach. In particular, the identified latent relationship indicates that disability types (i.e., physical and mental) and severity (i.e., severe, most severe, not severe) have a significant impact on the levels of self-esteem and self-confidence of people with disabilities. The identified superficial and latent relationships can be used to train education program designers and policy developers to maximize the outcomes of VR training programs.

• 신경치료
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• 제22권3호
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• pp.43-48
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• 2018

Purpose The purpose of this study is to identify the prevalence, risk factors, characteristics, and interventions of hip joint problems in children with cerebral palsy, and to be able to serve as leverage for early detection, prevention, and function recovery. Method The electronic journal site was searched by the search terms "cerebral palsy", "hip joint", "hip joint dislocation", we analyzed and descript the cited articles from domestic and foreign papers in Pubmed 9, Science Direct 7, and K RISS analysis and analysis. Results Children with cerebral palsy showed the different prevalence according to their disability type, severity, and functional level, and we knew that abnormal neuromuscular control, stiffness, and biomechanical changes could be risk factors. Migration Index, Acetabolum Index, Neck shaft angle using by radiography and passive ROM test, special tests were available for the diagnosis and evaluation of the hip joint. Combination of physical therapy and orthopedic surgery was very important intervention, and complementary alternative therapy, orthosis, and postural assistant are effective. Conclusion We suggested that early detection and prevention is the most important periodic examination and that a multidisciplinary approach is a major factor in intervention.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권5호
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• pp.413-429
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• 2021

Background: Migraine headaches are the second leading cause of disability worldwide and are responsible for significant morbidity, reduction in the quality of life, and loss of productivity on a global scale. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of ketamine on migraines and other primary headache disorders compared to placebo and other active interventions, such as midazolam, metoclopramide/diphenhydramine, and prochlorperazine/diphenhydramine. Methods: An electronic search of databases published up to February 2021, including Medline via PubMed, EMBASE, Web of Science, and Cochrane Library, a hand search of the bibliographies of the included studies, as well as literature and systematic reviews found through the search was conducted to identify randomized controlled trials (RCTs) investigating ketamine in the treatment of migraine/headache disorders compared to the placebo. The authors assessed the risk of bias according to the Cochrane Handbook guidelines. Results: The initial search strategy yielded 398 unduplicated references, which were independently assessed by three review authors. After evaluation, this number was reduced to five RCTs (two unclear risk of bias and three high risk of bias). The total number of patients in all the studies was 193. Due to the high risk of bias, small sample size, heterogeneity of the outcomes reported, and heterogeneity of the comparison groups, the quality of the evidence was very low. One RCT reported that intranasal ketamine was superior to intranasal midazolam in improving the aura attack severity, but not duration, while another reported that intranasal ketamine was not superior to metoclopramide and diphenhydramine in reducing the headache severity. In one trial, subcutaneous ketamine was superior to saline in migraine severity reduction; however, intravenous (I.V.) ketamine was inferior to I.V. prochlorperazine and diphenhydramine in another study. Conclusion: Further double-blind controlled studies are needed to assess the efficacy of ketamine in treating acute and chronic refractory migraines and other primary headaches using intranasal and subcutaneous routes. These studies should include a long-term follow-up and different ketamine dosages in diagnosed patients following international standards for diagnosing headache/migraine.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.37-43
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• 2009

Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.

• 한국응용과학기술학회지
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• 제35권2호
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• pp.433-444
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• 2018

본 연구는 국민건강보험공단의 장애와 건강통계 자료를 분석하여 장애인 건강검진 수검률을 살펴보고 건강검진에 따른 문제점과 향후 개선방안을 제시하고 건강검진 문진조사 결과를 바탕으로 장애인의 건강관리 형태 등을 소고하고자 한다. 연구대상은 장애인복지법 제2조에 따른 신체적, 정신적 장애로 오랫동안 일상생활이나 사회생활에서 제약을 받고, 2015. 12. 31. 기준 등록한 장애인2,479,080명 중 건강검진과 건강형태 조사에 참여한 장애인으로 한정하여 정책적 의견을 제시하였다. 결론으로 장애인 건강검진은 첫째, 장애인에 적합한 건강검진 서비스를 준비하기 위해서는 장애인 당사자들의 의견이 필요할 것이다. 둘째, 장애유형 및 중증도별 건강검진 항목 개발이 필요할 것으로 생각된다. 셋째, 장애인건강검진 의료장비 및 편의시설에 대하여 고민해 보아야 할 것이다. 넷째, 서비스 제공자에 대한 인력 확보와 교육이 필요할 것으로 생각된다. 다섯째, 장애인의 이동권을 확보할 수 있도록 하여야 할 것이다. 장애인의 건강형태는 첫째, 장애인 건강증진을 위한 각 영역별 전문가 협의체를 구성하여야 할 것이다. 둘째 장애인 건강증진 프로그램과 이를 운영하는 시설 현황분석이 필요할 것으로 생각된다. 셋째, 장애인건강권 및 의료접근성 보장에 관한 법률에 나와 있는 중앙장애인 보건의료센터에서 장애유형 및 중증도별 표준화된 건강증진 프로그램 개발이 필요할 것으로 생각된다. 지금까지 장애인 건강검진과 건강형태에 대한 내용을 살펴보고 이에 따른 정책적 의견을 제시하였다. 따라서 향후 연구로 본 연구에서 제시하고 있는 과제를 바탕으로 세부적인 연구들이 추진되길 바라며 장애인의 건강과 관련된 프로그램의 인과관계가 지속적으로 밝혀져야 할 것이다.