• Title/Summary/Keyword: early intervention

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A Diagnostic Algorithm after Newborn Screening for Hypermethioninemia (고메티오닌혈증의 신생아 선별 검사 후 진단 알고리즘)

  • Kim, Yoo-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.1-9
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    • 2016
  • Newborn screening (NBS) is important if early intervention is effective in a disorder and if there are sensitive and specific biochemical markers to detect disorder. Methionine is a useful marker to detect abnormal methionine-homocysteine metabolism, especially homocystinuria which needs urgent medical intervention. However, hypermethioninemia could occur in other metabolic disorder including liver disease, tyrosinemia type I, methionine adenosyltransferase (MAT) I/III deficiency, glycine N-methyltransferase (GNMT) deficiency, or adenosylhomocysteine hydrolase deficiency. However, experience with NBS for homocystinurias and methylation disorders is limited. Especially, MAT I/III deficiency which is the most common cause of persistent hypermethioninemia have two inheritance, autosomal recessive (AR) and autosomal dominant (AD), and their clinical manifestation is different between AR and AD. Here, author reviewed recent articles of guideline and proposed guideline for homocystinuria and methylation disorder.

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Risk Analysis of the Long-Term Outcomes of the Surgical Closure of Secundum Atrial Septal Defects

  • Kim, Hong Rae;Jung, Sung-Ho;Park, Jung Jun;Yun, Tae Jin;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.78-85
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    • 2017
  • Background: Closure of a secundum atrial septal defect (ASD) is possible through surgical intervention or device placement. During surgical intervention, concomitant pathologies are corrected. The present study was conducted to investigate the outcomes of surgical ASD closure, to determine the risk factors of mortality, and establish the effects of concomitant disease correction. Methods: Between October 1989 and October 2009, 693 adults underwent surgery for secundum ASD. Their mean age was $40.9{\pm}13.1years$, and 199 (28.7%) were male. Preoperatively, atrial fibrillation was noted in 39 patients (5.6%) and significant tricuspid regurgitation (TR) in 137 patients (19.8%). The mean follow-up duration was $12.4{\pm}4.7years$. Results: There was no 30-day mortality. The 1-, 5-, 10-, and 20-year survival rates were 99.4%, 96.8%, 94.5%, and 81.6%, respectively. In multivariate analysis, significant preoperative TR (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.09 to 3.16; p=0.023) and preoperative age (HR, 1.04; 95% CI, 1.01 to 1.06; p=0.001) were independent risk factors for late mortality. The TR grade significantly decreased after ASD closure with tricuspid repair. However, in patients with more than mild TR, repair was not associated with improved long-term survival (p=0.518). Conclusion: Surgical ASD closure is safe. Significant preoperative TR and age showed a strong negative correlation with survival. Our data showed that tricuspid valve repair improved the TR grade effectively. However, no effect on long-term survival was found. Therefore, early surgery before the development of significant TR mat be beneficial for improving postoperative survival.

The Effects of Sensory Integration Therapy on Social Behaviors and Feeding of Children with Intellectual Disorder (감각통합치료가 지적장애아동의 사회행동과 식사하기에 미치는 영향)

  • Kim, Keum-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.634-641
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    • 2017
  • This case study investigated the effects of sensory integration therapy on social behaviors and feeding of children with intellectual disabilities who lack sensory processing abilities. The study was conducted done from September to December, 2016, and an ABA(two sessions, nine sessions, two sessions/total 13 sessions) design was used among Single Subject Research Design. Nine sessions of sensory integration program were conducted for 50 minutes each, and Wilbarger's Protocol was employed 2-3 times per day. To understand children's basic development levels, observation evaluation of each area and social maturity scale were conducted in the early stage. To Understand the children's sensory processes ability, a Sensory Profile(SP) was developed, while the activities of daily living and task performance ability scale were evaluated using the Functional Independence Measure for children(WeeFIM) and Canadian Occupational Performance Measure(COPM), respectively. Search behavior and feeding, which are social behaviors of children, were evaluated through observation. The results showed that the sensory integration program improves social behaviors of children and enables them to eat. The children's feeding was stable from the 5th session after the intervention, and the search behaviors started to change from 3 weeks after the intervention and became stable after 7 weeks. These results indicate that the sensory integration program is effective in mediating difficulties that children with intellectual disabilities who lack sensory processing ability experience in daily living.

Prognosis for Blunt Abdominal Trauma Patients with Contrast Extravasation on the Abdominopelvic CT Scan (조영제 혈관 외 유출이 관찰된 복부 둔상 환자의 유출부위에 따른 예후)

  • Shin, Hyung Jin;Lee, Kang Hyun;Kwak, Young Soo;Kim, Sun Hyu;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.57-64
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    • 2009
  • Purpose: Computed tomography (CT) is an accurate test for evaluating hemodynamically stable patients with blunt abdominal trauma. Until now, there have been few studies concentrating on the diagnostic and prognostic significance of the intravenous contrast extravasation (CE) site. We investigated the site of CE on abdominopelvic CT (APCT) and its effect on treating trauma patients and predicting the clinical outcome. Methods: The 50 patients admitted to our emergency department with blunt abdominal trauma showing CE on APCT from January 2004 to September 2006 were included in this study. Patients were prospectively collected, and medical records were reviewed and analyzed. The patients'clinical and lab findings, Focused Assessment with Sonography for Trauma (FAST) findings, CT findings were analyzed. CE sites were classified as intraperitoneal, retroperitoneal, and pelvic cavity and were correlated with post-treatment complications, mortality, and morbidity. Results: Of the 50 patients (mean age : $45{\pm}18years$, 29 males, 21 females) included in our study, 33 patients died (66%). There was no correlation between CE site and ICU or total hospitalization duration (p=0.553, p=0.523). During the first 24 hours of resuscitation, the pelvic cavity group required a mean of 20 units more of packed red blood cell (pRBC) transfusion compared to other groups (p=0.003). In the intraperitoneal group, more patients received operative invasive intervention - either laparotomy or embolization (p=0.025). The intraperitoneal group had the highest mortality, with 13 deaths (11/33, 39%), and the highest early mortality rate (10/13, 76%) in the first 24 hours (p=0.001). Conclusion: Intraperitoneal CE on the CT scan in cases of blunt abdominal trauma is regarded as an indication of a need for invasive intervention (either angiography or laparotomy) and of a higher mortality rate in the first 24 hours. A pelvic cavity CE rquires more aggressive transfusion with pRBC. However, the CT findings themselves showed no significant correlation with overall mortality, morbidity, or hospitalization.

ORTHODONTIC TREATMENT OF SINGLE TOOTH SCISSORS BITE IN GROWING CHILDREN: CASE REPORTS (성장기 아동의 single tooth scissors bite의 교정 치료: 증례 보고)

  • Kim, Ji-In;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.427-434
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    • 2011
  • A scissors bite in the posterior teeth occurs when the upper teeth are positioned totally buccal to the lower teeth in centric occlusion, either unilaterally or bilaterally. This malocclusion can result from either excessive width of the maxilla or deficient width of the mandible, or sometimes combination of the both. Scissors bite, when left untreated without a proper dental intervention, interferes with the normal mandibular growth leading to a state where consequent disharmony in dental arch width evokes occlusal disturbances. Therefore, early preventive orthodontic treatment is necessary in patients with scissors bite. Scissors bite rarely involves anterior and posterior sites concuttently across the dental arch but usually affect single tooth. Even in the single tooth scissors bite cases, more likely to be met in the clinical fields, immediate dental intervention is indicated because continuous occlusal forces that exacerbate the already adverse axis of the posterior teeth. In this case study, patients with single tooth scissors bite, each 7, 14, 12, and 16 years old, were each treated with criss-cross elastic, fixed appliance, removable appliance, and miniscrews. With the proper selection of appliances appropriate to each specific cases, good treatment outcome can be achieved without resulting any side effects.

Predictors of Protective Factors for Depression in Adolescent using Decision Making Tree Analysis (의사결정나무분석을 이용한 청소년 우울의 보호요인 예측모형)

  • Kim, Bo-Young
    • The Journal of the Korea Contents Association
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    • v.15 no.5
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    • pp.375-385
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    • 2015
  • The study is to develop specific strategies to prevent adolescents' depression, early detection and intervention services. This study was a descriptive research study with the purpose of predictors of protective factors for depression in adolescent using decision making tree analysis. The subjects for the study were 485 student in G city. This study collected data between September 23, 2013 and September 26, 2013 and analyzed them with frequency analysis, percentage, the mean and standard deviation, ${\chi}^2$-test, t-test, and a decision-making tree by using SPSS 20.0 program. From the data analysis, the predictive model for protective factors related to depression in adolescent with 4 pathways, 12 nodes. The common predicting variables of depression in adolescent were characteristics, family cohesion, parent adolescent communication, peer communication. The specialty of training data and test data was 76.0% and 65.4%. The sensitivity of training data was 78.2% and 63.7%. As for the classification accuracy, training data and test data explained 70.1% and 69.7%. Parent adolescent communication and peer communication to decrease depression of Korean middle and high school students are necessary. This study should contribute as baseline data for intervention strategies and planning ability of depression prevention in adolescents.

Etiological Classification and Developmental Outcomes in Floppy Infants: A Single Tertiary Center Experience (늘어지는 영아 증후군의 진단적 분류와 발달 예후: 단일 3차 병원에서의 연구)

  • Park, Jung Min;Choi, Young Ha;Lee, Ha Neul;Chung, Hee Jung
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.189-196
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    • 2018
  • Purpose: Floppy infants or congenital hypotonia indicates decreased muscle tone in infants secondary to abnormalities of the central or the peripheral nervous system, or both. Previous literature classified its causes as those attributable to a central vs. peripheral origin; however, recent studies have introduced a newer classification describing a combined origin. We invenstigated floppy infants by applying the new etiological classification and reviewed the most common etiologies based on the age of presentation. We additionally reviewed the clinical characteristics, diagnoses, and the developmental outcomes in these infants. Methods: We retrospectively reviewed the electronic medical charts and recruited 116 infants diagnosed with floppy infant syndrome between January 2005 and December 2016 at Severance Children's Hospital. Among these infants, 66 with a confirmed diagnosis were reviewed for the etiological classification. Information regarding developmental outcomes was obtained via phone interviews with the infants' families. Results: Based on the new etiological classification, among 69 infants with a confirmed diagnosis, in 40 (34.5%) this syndrome was of central origin, in 19 (16.4%) of peripheral origin, and in 10 (8.6%) of combined origin. Prader-Willi syndrome, myotonic dystrophy, and spinal muscular atrophy were the most common disorders observed and combined hypotonia showed the poorest developmental outcome. Conclusion: The study states the importance of proper evaluation of etiological diagnosis and optimal intervention for developmental prognosis. The introduction of a new etiological group of combined hypotonia especially emphasizes regular monitoring and timely rehabilitative intervention in patients for the better quality of life in them as well as their caregivers.

Thematic Trends in the Research on Green Urbanism (그린 어바니즘의 국제 동향과 주요 화제)

  • Jeong, Sang-kyu;Jeon, Sook-ja;Ban, Yong-un;Park, Joon-young
    • Land and Housing Review
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    • v.12 no.2
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    • pp.61-78
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    • 2021
  • This study aims to understand the thematic trends globally developed in the 'Green Urbanism' related research. Research methodology is based on systemic review of international literature published for the past 20 years period between 2000 and 2020. The specific methods applied include not only literature search by citation, co-authorship, and co-occurrence but social network analysis in order to find correlations among the publication. The correlations are visualized and analysed using VOSviewer and Ucinet software. The analysis indicates that total of 51 studies were carried out by 89 authors from 54 institutions across 21 countries during the period. The majority of the research was done by a country-specific study and only a few research were collaborative studies with other countries. The most common theme that occurred in the early years was 'sustainability and the theme evolved toward specific ones such as 'built environment', 'infrastructure', and 'health'. Having considered that climate change has become a global challenge, green urbanism is expected to be a future direction to pursue environmentally sustainable urban spaces. This study also implies that governance, policy support, and intervention are crucial factors in developing sustainable urban spaces.

Affecting Variables on Subjective Memory Impairment in the Elderly with Benign Prostatic Hyperplasia (전립선비대증 노인의 주관적 기억장애 영향요인)

  • Kim, Jee-won;Choi, Soon-Ock
    • 한국노년학
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    • v.38 no.4
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    • pp.853-869
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    • 2018
  • This study aimed to investigate variables affecting subjective memory impairment in the elderly with benign prostatic hyperplasia. We used 179 survey data collected from the urology department of two metropolitan general hospitals. The subjects were patients with benign prostatic hyperplasia. T-test, one-way analysis of variance, and $Scheff{\acute{e}}^{\prime}s$ test were performed to identify differences among variables. Pearson's correlation-coefficient and stepwise multiple regression were used to identify variables that affect subjective memory impairment. This study revealed that lower urinary tract symptom and activities of daily living were statistically significant variables, with an explanatory power of 30.0%. The lower urinary tract symptom was due to the benign prostatic hyperplasia increasing the risk of subjective memory impairment. Treatment of the lower urinary tract symptom was delayed because as the elderly got older, they increasingly recognized benign prostatic hyperplasia as a reasonable symptom. Timely intervention and early screening are necessary to prevent lower urinary tract symptom. Finally, programs to reduce the incidence of lower urinary tract symptom and educate nurses to assess, evaluate, perform intervention for subjective memory impairment should be developed.

Effects of Occupation based Reminiscence Therapy on Early Dementia Patients' Cognitive function, Depression and quality of life (작업 중심 회상치료가 경도 치매 노인 환자의 인지기능과 우울, 삶의 질에 미치는 영향)

  • Park, Ju-Hyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.758-764
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    • 2018
  • This study was performed to investigate the effects of Occupation based Reminiscence therapy on cognitive function, depression, and quality of life in elderly patients with mild dementia. Thirty-one elderly patients with mild dementia underwent Occupation based Reminiscence therapy for 40 minutes per session, once weekly, for 8 weeks. Montreal Cognitive Assessment Korean Version (MoCA-K), Short Form of Geriatric Depression Scale-Korean Version (SGDS-K), and Geriatric Quality of Life-Dementia (GQOL-D) were used to measure cognitive function, depression level, and quality of life, respectively. Mean MoCA-K score increased from $14.62{\pm}5.07$ before intervention to $16.88{\pm}4.55$ after intervention; mean SGDS-K score decreased from $7.28{\pm}4.28$ to $6.10{\pm}4.09$, and mean GQOL-D score increased from $26.05{\pm}5.45$ to $28.55{\pm}5.74$. Furthermore, these positive changes were all statistically significant. Based on the results of this study, it was concluded Occupation based Reminiscence therapy may positively affect cognitive function, depression, and quality of life in elderly patients with mild dementia.