• Title/Summary/Keyword: early intervention

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Medicinal Leech Therapy for Salvage of the Failing Flap (피판 부전증의 구제를 위한 약용거머리 치료법)

  • Baek Chung-Hwan;Shin Juno;Park Joo-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.20-25
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    • 2000
  • The medicinal leech, Hirudo medicinalis, has been used for salvage of the venous-congested flap following reconstructive surgery, with increasing frequency during the last two decades. Medicinal leech therapy is a safe, efficacious, economical, and well-tolerated intervention. The flap salvage with leeching occurs in approximately 70% of cases, and leeches need to be used as early as possible. At the time of the bite, evacuation of blood and injection of the leech saliva products, including anticoagulants and inhibitors of platelet aggregation, maintain capillary circulation of the flap, and then venous capillary return is established across the wound by angiogenesis. One of the salivary products, hirudin, represents the first parenteral anticoagulant introduced since the discovery of heparin. We analyzed two cases in which flap salvage with leeching was attempted, and reviewed medicinal leech therapy on the basis of our experiences and literature review. This has not been documented in the head and neck surgery literature in our country.

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Transition of Symptoms and Quality of Life in Cancer Patients on Chemotherapy (항암화학요법 시행 초기 암환자의 증상 및 삶의 질 변화 양상)

  • Kim, Min-Young
    • Journal of Korean Academy of Nursing
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    • v.39 no.3
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    • pp.433-445
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    • 2009
  • Purpose: The purpose of this study was to assess changes in pain, fatigue, anorexia, anxiety and quality of life(QOL) in patients with cancer who were on chemotherapy. Methods: Symptoms and QOL were examined both before chemotherapy and after 2 cycles of chemotherapy. The participants were 76 cancer patients receiving chemotherapy in one of 7 hospitals. Results: The patients experienced a mean of 2.22-2.23 symptoms out of 4 symptoms. Patients who were female, or suffered from breast or colorectal cancer experienced more symptoms. Fatigue at present, and most severe fatigue and anorexia in the previous 3 weeks increased significantly. Anxiety and QOL decreased significantly after 2 cycles of chemotherapy. Number of symptoms, anorexia at present, most severe anorexia in past 3 weeks, and anxiety had negative correlations. QOL before chemotherapy showed a positive correlation with QOL after 2 cycles of chemotherapy. In a regression analysis, anxiety, QOL at baseline, income, and the most severe pain in the past 3 weeks were significant predictors of QOL. Conclusion: Physical and psychological factors were significant predictors of both QOL and each subscale, and these factors correlated with each other. These results demonstrate the needs for early assessment and intervention from the start of chemotherapy to decrease symptoms and improve QOL.

Comparing Effects of Academic Achievement on Academic Self-Concept in Adolescent Siblings: The Mediating Role of Differential Maternal Treatment (형제와 비교한 아동의 학업성취가 자신의 학업적 자아개념에 미치는 영향: 어머니의 차별적 양육행동의 매개적 역할)

  • We, Hyun-Ah;Park, Seong-Yeon
    • Journal of the Korean Home Economics Association
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    • v.49 no.1
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    • pp.17-25
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    • 2011
  • This study examined the impact of academic achievement and maternal differential treatment on academic self-concept among adolescent siblings. The sample consisted of 438 students attending middle schools in Seoul (M = 15.2 yrs.), who had a sibling. Data were analyzed using Structural Equation Modeling. Academic achievement compared with a sibling and maternal differential treatment had direct effects on academic self-concept, indicating that children with higher academic achievement scores than their sibling and with perceived maternal differential treatment reported a significantly higher academic self-concept. Also, the relationship between academic achievement as compared with a sibling and academic self-concept was mediated by maternal differential treatment. These findings could be used in educational settings as a basis for improving the academic self-concept of early adolescents.

Progressive Dynamic Equinovarus Deformity in Hereditary Spastic Paraplegia - A Case Report- (유전성 연축성 양하지 마비 환자에서의 족부 진행성 동적 첨내반족 -1예 보고-)

  • Bae, Su-Young;Seo, In-Seock
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.111-113
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    • 2004
  • In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

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Development of Curriculum in the Field of Industrial Physical Therapy (산업물리치료 교과 과정 개발 연구)

  • Kim, Hyun-Joo;Kang, Jeom-Deok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.96-101
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    • 2007
  • There are increasing needs for welfare in industrial environments in modern society. Industrial health is one of the most important components of industrial welfare, and it includes maintenance and improvement of physical, mental, and social health of the workers, elimination of factors threatening workers, prevention and early intervention of industrial diseases. In this regards the importance of industrial physical therapy is increasingly recognized and the need of physical therapy in industrial field is increasing. The authors surveyed and analyzed the curricula of the departments of physical therapy to promote development of curriculum or program for educating specialized industrial physical therapists. There are 40 institutes opening the department of physical therapy, 4-year courses in 17 and 3-year courses in 23. Only 2 institutes have subjects that are directly related to industrial health. This means that specific educational program for specialized industrial physicaltherapists is not established yet though there are many needs for industrial health and physical therapy in industrial fields. But many topics or knowledge of industrial health or physical therapy are scattered in several subjects. So we suggest the needs of systematic reorganization of specific curriculum that including ergonomics and prevention and treatment of industrial diseases for education of specialized industrial physical therapist.

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Evaluation of Physical Growth and Developmental Status of Infants and Children of Married Immigrant Women in Rural Areas (일 농촌지역 여성결혼이주자 자녀의 신체성장과 발달 평가)

  • Kim, Tae-Im;Kim, Mi-Jong;Kwon, Yun-Jung;Jun, Man-Kil
    • Child Health Nursing Research
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    • v.16 no.2
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    • pp.164-174
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    • 2010
  • Purpose: The purpose of this study was to evaluate the physical growth and developmental status of infants and children of married immigrant women. Methods: The participants were 92 infants and children aged from birth to 6 yr whose mothers were married immigrant women living in one rural area. Physical growth and developmental status were evaluated by using anthropometric assessment, and Korean Denver II developmental screening test. Results: Of the participants, 10.8% were below the 3rd percentile for weight, 13.0% for length, 5.4% for head circumference, and from 69.6% to 79.3% were distributed below the 50th percentile on growth charts. Further, 18.5% were classified as having questionable development. Factors related to low physical growth in infants and children were mother's weight and mother's level in Korean language classes. Conclusion: The physical growth and developmental status of children is vulnerable and serious. The study results suggest a need for regular growth and developmental evaluations. Political support is important for these mothers. In addition, there also is a need to develop early intervention strategies to promote growth and development of the infants and children of these married immigrant women.

Clinical Analysis of Esophageal Carcinoma (식도암의 임상적 고찰)

  • 임종수
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.122-127
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    • 1990
  • The management of esophageal carcinoma continues to be a difficult problem with most surgically treated patients under-going extensive operative procedures for palliation only. Although recent advances in preoperative and postoperative care have decreased the operative mortality rate, survival has not changed significantly. Twenty five patients with esophageal carcinoma who were treated with operative intervention at the Department of Thoracic and Cardiovascular Surgery in Kyung Hee University Hospital between January, 1980 and December, 1987 had been evaluated clinical manifestation and operative results. The stamm typed feeding gastrostomy and Celestin tube insertion were performed for the cases of nonresectable esophageal cancer. Also 14 cases with esophagogastrostomy and are case with esophagocologastrostomy were performed for the resectable cases. Two deaths with resectable cases occurred within 30days of operation, a hospital death rate of 8 per cent. There were significant differences in the survival rate between T.N.M. staging I, II, and III, IV group after the resection of the esophageal cancer. The former group revealed higher one year survival rate than the later group. [p< 0.05]. In conclusion, the clinical manifestations and operative results were similar to the western ones and the postoperative survival rate was very poor. So, the earlier the operation of the esophageal cancer was done, the better result will be achieved. To defect the early esophageal cancer; routine esophagoscopy should be recommended.

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The Paternal Attachment to Neonate in One Hospital (일 병원 신생아 아버지의 부성애착)

  • Oh, Jin-A;Oh, Young-A;Nam, Young-Hui
    • Korean Parent-Child Health Journal
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    • v.8 no.2
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    • pp.137-146
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    • 2005
  • This study was conducted to find out the paternal attachment to neonate, and to identify factors affecting paternal attachment. The purpose was to make the base data for nursing intervention to improve paternal attachment. The subjects of this study were 93 fathers whose partners have delivered normal neonate in 1 hospital in Busan. Data were collected from Sep. 1th to Oct. 31th 2005 by a self-report questionnaire. The instrument for this study was based on 7 kinds of characteristics of paternal attachment by Greenberg & Morris(1974), and modified by researchers. The statistical methods for data analysis were percentage, mean, standard deviation, t-test, ANOVA with SPSS program Ver 10. The conclusions are as follows. Fathers had the high degree of paternal attachment to neonate. But, there were not significant correlations between paternal attachment and the father's demographic characteristics, pregnancy plan, delivery pattern, delivery order, sex of neonate and past experience. Also there were not significant correlations between paternal attachment and early visual contact frequency of father-neonate. Further research about factors affecting paternal attachment to neonate and high risk neonate as well as low birth weight neonate is required.

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Fatal Case of Cerebral Aspergillosis : A Case Report and Literature Review

  • Lee, Jae-Chang;Lim, Dong-Jun;Ha, Sung-Kon;Kim, Sang-Dae;Kim, Se-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.420-422
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    • 2012
  • Cerebral aspergillosis is rare and usually misdiagnosed because its presentation is similar to that of a tumor. The correct diagnosis is usually made intra-operatively. Cerebral abscess with fungal infection is extremely rare and few cases have been reported, but it carries a poor prognosis. A 73 year-old man presented with decreased visual acuity and paresis of the right cranial nerve III. Magnetic resonance imaging (MRI) revealed a mass in the right cavernous sinus, extened to the anterior crainial fossa and the superior orbital fissure. During surgery, a well encapsulated pus pocket was found, and histopathological examination of the mass resulted in the diagnosis of aspergillosis. Despite appropriate anti-fungal treatment, the patient eventually died from fatal cerebral ischemic change and severe brain swelling. The correct diagnosis of cerebral aspergillosis can only be achieved by histopathological examination because clinical and radiological findings including MRI are not specific. Surgical intervention and antifungal therapy should be considered the optimal treatment. Early diagnosis and aggressive antifungal treatment provide good results.

Recent Advances in Diagnosis and Treatment of Alzheimer's Disease (알츠하이머병의 최신지견)

  • Lee, Jung Jae;Lee, Seok Bum
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.