• Title/Summary/Keyword: The congenital disabilities

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Factors Affecting the Cost of Rehabilitation Services for People with Congenital Disabilities (선천성 장애인의 재활서비스 비용에 영향을 미치는 요인)

  • Lee, Hyun-Joo
    • Journal of Industrial Convergence
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    • v.20 no.10
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    • pp.197-207
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    • 2022
  • The purpose of this study is to identify factors that affect the cost of rehabilitation services for people with congenital disabilities. The subjects of this study were 712 persons who had a disability from prenatal life from data of the 2020 National Survey of the Disabled Persons. 19-40 years, middle-class economic status, monthly family income level, use of vouchers, satisfaction with service institutions, autistic disability types significantly contributed to the cost of rehabilitation services. Among them use of vouchers had the greatest influence on the cost of rehabilitation services. Therefore, in order to reduce the cost of rehabilitation services for people with the congenital disabilities, it is suggested to improve the target of the voucher program and to establish a rehabilitation service support system for the entire life span.

General Anesthesia for Dental Treatment in the Congenital Hypothyroidism and Psuedohypoparathyroidism (선천성 갑상선기능저하증과 가성부갑상선기능저하증을 동반한 환자의 전신마취 하 치과치료)

  • Seo, Kwang-Suk;Shin, Teo-Jeon;Kim, Hyun-Jeong;Chang, Juhea
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.139-143
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    • 2013
  • The patient who has congenital hypothyroidism and pseudohypoparathyroidism could have mental retardation even though adequate hormone treatment and cannot endure conventional dental treatment. In this case, general anesthesia is selected to administer effective dental treatment. But, there could be symptoms such as anemia, neuropathy, associated pituitary or adrenal hypofunction, cardiac failure even in euthyroid state. And, bradycardia, mental dullness, hypothermia, slow reflexes can appear in case of inadequate thyroid hormone replacement. Especially, macroglosssia, slow drug metabolism, exaggerated responses to anesthetic agents and decreased ventilatory responses could be problem during general anesthesia. The presentation of hypoparathyroidism also varies depending on the chronicity of the result of hypocalcemia. Muscle spasms/tetany, paresthesias, and seizures may occur in an acute onset. Chronic hypocalcaemia causes fatigue, muscle cramps, lethargy, personality changes, and cerebration defects.

Prospects for the Development of Rehabilitation Medical Robots (재활의료로봇의 발전 전망)

  • Moon, Jeong Eun;Cho, Yong Jin
    • Journal of Digital Convergence
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    • v.19 no.6
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    • pp.393-398
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    • 2021
  • As society becomes more complex and advanced, the risk of accidents is inevitably increased, and this is an opportunity to increase the occurrence of not only congenital disabilities but also acquired disabilities. In this situation, the use of rehabilitation robots, a complex of advanced technologies, is expected to increase steadily in the future. So the authors would take a look the technological trends and future development prospects of domestic and foreign rehabilitation robots. Until now, disability assistive robot technology has been mainly developed in the field of supporting disability with walking disabilities or work limitations rather than cognitive disabilities. However, another issue of population aging is that cognitive impairment has the potential to increase, so development of a disability assistance robot that secures user safety must be actively promoted. It is thought that empirical results should be derived and converged

DECREASE OF OXYGEN SATURATION DURING DENTAL TREATMENT UNDER GENERAL ANESTHESIA OF DOWN SYNDROME PATIENT WITH CONGENITAL HEART DISEASE -A CASE REPORT- (선천성 심장질환을 가진 다운증후군환자에서 치과치료를 위한 전신마취 시 산소포화도 하강 -증례보고-)

  • Seo, Kwang-Suk;Chang, Ju-Hea;Shin, Teo-Jeon;Kim, Hyun-Jeong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.1
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    • pp.18-22
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    • 2009
  • A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.

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Incidence of congenital hypothyroidism by gestational age: a retrospective observational study

  • Ha Young Jo;Eun Hye Yang;Young Mi Kim;Soo-Han Choi;Kyung Hee Park;Hye Won Yoo;Su Jeong Park;Min Jung Kwak
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.30-36
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    • 2023
  • Background: Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns. Methods: We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks. Results: Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32-37, 28-31, and <28 weeks were 2.568 (95% confidence interval [CI], 1.141-5.778), 5.917 (95% CI, 2.264-15.464), and 7.441 (95% CI, 2.617-21.159) times higher, respectively, than those delivered at term. The ORs of CH in infants weighing 1,500-2,499 g, 1,000-1,499 g, and <1,000 g were 4.664 (95% CI, 1.928-11.279), 11.076 (95% CI, 4.089-29.999), and 12.544 (95% CI, 4.350-36.176) times greater, respectively, than those in infants weighing ≥2,500 g. The OR of CH was 6.795 (95% CI, 3.553-13.692) times greater in SGA than in non-SGA infants. Conclusion: The CH incidence in South Korea has increased significantly compared with that in the past. Gestational age, birth weight, and SGA were significantly associated with CH incidence.

Current Status and the Future Prospect of Rehabilitation Nursing in Korea (한국 재활간호 현황과 전망)

  • Kang, Hyun-Sook;Suh, Yeon-Ok;Lee, Hae-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.240-247
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    • 2001
  • The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

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Difficult intubation caused by an immature upper airway in a patient with cri-du-chat syndrome: a case report

  • So, Eunsun;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.1
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    • pp.49-53
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    • 2020
  • Cri-du-chat syndrome (CdCS) is caused by the deletion of the short arm of chromosome 5. Most patients with CdCS develop intellectual disabilities. Therefore, they have poor oral hygiene and a high caries index. However, treating such patients is not an easy task, because of the difficulty in communication. General anesthesia may be a useful option in adult patients with CdCS and intellectual disability. General anesthesia should be administered very carefully, owing to the presence of comorbid diseases, which may need airway management. Infants with CdCS need general anesthesia if they have a concomitant cardiac anomaly. Intubation is reportedly difficult for such patients was, owing to the structural and functional abnormalities in the larynx and vocal cords. The purpose of this study was to report a case of difficult intubation while inducing general anesthesia in a patient with CdCS during dental treatment, due to a narrow larynx and trachea.

Identification of 1p36 deletion syndrome in patients with facial dysmorphism and developmental delay

  • Seo, Go Hun;Kim, Ja Hye;Cho, Ja Hyang;Kim, Gu-Hwan;Seo, Eul-Ju;Lee, Beom Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.59 no.1
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    • pp.16-23
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    • 2016
  • Purpose: The 1p36 deletion syndrome is a microdeletion syndrome characterized by developmental delays/intellectual disability, craniofacial dysmorphism, and other congenital anomalies. To date, many cases of this syndrome have been reported worldwide. However, cases with this syndrome have not been reported in Korean populations anywhere. This study was performed to report the clinical and molecular characteristics of five Korean patients with the 1p36 deletion syndrome. Methods: The clinical characteristics of the 5 patients were reviewed. Karyotyping and multiplex ligation-dependent probe amplification (MLPA) analyses were performed for genetic diagnoses. Results: All 5 patients had typical dysmorphic features including frontal bossing, flat right parietal bone, low-set ears, straight eyebrows, down-slanting palpebral fissure, hypotelorism, flat nasal roots, midface hypoplasia, pointed chins, small lips, and variable degrees of developmental delay. Each patient had multiple and variable anomalies such as a congenital heart defect including ventricular septal defect, atrial septal defect, and patent duct arteriosus, ventriculomegaly, cryptorchism, or hearing loss. Karyotyping revealed the 1p36 deletion in only 1 patient, although it was confirmed in all 5 patients by MLPA analyses. Conclusion: All the patients had the typical features of 1p36 deletion. These hallmarks can be used to identify other patients with this condition in their early years in order to provide more appropriate care.

DENTAL TREATMENT OF PATIENTS WITH DOWN SYNDROME UNDER GENERAL ANESTHESIA (다운증후군 환자의 전신마취 하 치과치료)

  • Lee, Sung-Ju;Yi, Young-Eun;Kim, Hye-Jung;Seo, Kwang-Suk;Kim, Hyun-Jeong;Yum, Kwang-Won;Kim, Dong-Wuk
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.2
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    • pp.75-79
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    • 2007
  • Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

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Costello syndrome: three sporadic cases (Costello 증후군 3례)

  • Kim, Ji Youn;Kim, Mi Jeong;Song, Eun Song;Cho, Young Kuk;Choi, Young Youn;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.1024-1029
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    • 2007
  • Costello syndrome (CS) is a rare multiple congenital abnormality syndrome characterized by a typical coarse face, developmental delay, psychomotor and growth retardation, neurologic abnormalities, cardiac and cutaneous anomalies, severe feeding difficulties with postnatal growth failure, and increased risk of tumors. Since Costello first described it in 1971 and again in 1977, over 100 cases have been reported worldwide. It was recently shown that CS is a congenital condition caused by heterozygous de novo missense mutations affecting the codon for glycine 12 or 13 of the HRAS gene. We experienced three unrelated cases with coarse faces, developmental delays, short statures, macrocephaly, and redundant skin with deep palmar and plantar creases, hypertrophic cardiomyopathy and atrial tachycardia, which are characteristic of CS.