• The Journal of Korean society of community based occupational therapy
• /
• v.9 no.2
• /
• pp.33-42
• /
• 2019

Objective : The aim of this study was to evaluate the current knowledge regarding constraint-induced movement therapy (CIMT) and its application in clinical practice by physiatrists and therapists in pediatric rehabilitation area in Korea. Methods : Online survey via E-mails was sent to a total of 510 members (204 physiatrists and 306 therapists) of the Korean Society of Pediatric Rehabilitation and Developmental Medicine (KSPRDM). Results : The response rate was 35.1% (179 of 510). A total of 179 questionnaires was completed by 39 physiatrists, 89 physiotherapists, 48 occupational therapists, and 3 speech therapists. 45.8% of responders had worked over 6 years in the pediatric rehabilitation setting and a total of 58.1% (n=104) of the sample had used CIMT. The main limitations of clinically applying CIMT included limited staff and inappropriate clinical setting (35.1%, n=61), lack of understanding (19.5%, n=34), and developmental issues of function on the unaffected side (13.8%, n=24). The cooperation of patients (77.6%, n=76), cognitive/behavioral factors (42.9%, n=42), and cooperation of caregivers (25.5%, n=25) were the 3 major concerns that could be limitations with CIMT. Conclusions : Although considerable evidence supports the use of CIMT, many of physiatrist and therapists do not apply this method in practice. The improvement of limitations is necessary for wide use of CIMT in clinical practice in Korea.

• Journal of Preventive Medicine and Public Health
• /
• v.22 no.1 s.25
• /
• pp.125-135
• /
• 1989

This paper was carried out to study on correlation between mentally retardation and lead and zinc. The subjects were 297 mentally retarded children: 132 of Bomyung special school and Sunmyung, which were located in Taegu city of Korea. The former had their parents but the latter had not. The control group 63 children were randomly seleted from the Dong-in primary school near to Medical School of Kyungpook National University. Atomic absorption spectrophotometer, model IL-551 connected with CTF atomizer(IL. 655) was used for the analysis of lead and zinc. The mean value of lead in hair of mentally retarded children was $14.97{\pm}3.71ppm$ which is significantly higher than that of control group, $11.36{\pm}2.83ppm$. But the content of zinc was not significant in both groups. In the lead there was no significant correlation to age but significant negative correlation to IQ. Zinc showed significant correlation to age but not to IQ. Among the handicapped children, no signigicant correlation between orphan group and non orphan group. Handicaps of mentally-retarded children were speech impairment, emotional disturbance, double and triple handicaps, sensory impairment and abnormal dietary patterns. There were significantly higher contents of lead compared with normal group, except the latter two groups. The disease conditions of mentally retarded children were mongolism, autism, cerebral palsy, epilepsy and microcephaly. In comparing with mongolism, significant difference were existent only on the cerebral palsy and group of unknown etiology. We attempted to divide their past history into external etiology and internal etiology, but could not find significant difference. In view of the whole results, the relationship between mentally-retarded children and lead was presumed to be the early time exposure rather than long interval exposure during growth and the contact opportunity was considered important subject in maternal and child health care.

• The Journal of Korean Academy of Sensory Integration
• /
• v.15 no.2
• /
• pp.46-65
• /
• 2017

Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg's Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.

• Journal of Preventive Medicine and Public Health
• /
• v.22 no.3 s.27
• /
• pp.368-379
• /
• 1989

The relationship between mercury level of hair and mental retardation was investigated. The 297 subjects with mental retardation were drawn from two schools providing special educational services, one, consisted of children living in an orphan home, another, children with parents. The 117 centre] subjects were drawn from whom had got average or above average academic achivement in a regular elementary school. Hair sample were taken from the nape of the neck and the mercury analysis was carried out on an atomic absorption spectrophotometer(IL 551). There was no relationship between mercury contents and age, and there was a statistically significant difference in mercury contents between male and female in the mentally retarded children living with parents. Children in the retarded group had significantly higher mercury contents compared with control group except the female group with parents. Also, the mercury levels in the retarded group living in an orphan home were significantly higher than that of the retarded group with parents. The concomitant diseases were Down's syndrome, epilepsy, cerebral palsy and autism. There were statistically significant differences in hair mercury levels in the cases of accompanying Down's syndrome and cerebral palsy in male and Down's syndrome and autism in female compared with the control group of the same sex. The most accompanying handicap was speech disturbance(40.7%) and the others were crippled, emotional disturbance etc. The percentages of double handicap were 66.7% among 6 persons exceeding 6ppm of their hair mercury contents. 10.4% among $3{\sim}6$ ppm and 15.7% among the group of 3ppm or less. The findings of this study suggest that the more opportunities of exposure to mercury in mentally retarded children may have occurred, so it can not be excluded the possibility of mercury as a contributing factor to mental retardation. Therefore, the causal relationship between mercury levels and mental retardation should be established through the examinations about their living environments, dietary pattern, eating habit etc.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.2
• /
• pp.99-103
• /
• 2017

The primary responsibility for the oral hygiene of the disabled is usually the parents. Dental care of the disabled is early detection and recovery of lesions and continuous management. For this to be successful it is necessary to use diagnostic tool that can detect the early stages of dental caries which is difficult to detect with the naked eye. It is also important to educate and motivate the caregivers on oral hygiene management. Quantitative Light-induced Fluorescence-Digital (Billuminator, Inspektor Researh Systems BV, Amsterdam, The Netherlands), which provides overall caries inspection and visual information, can be useful for caregiver education. A 3-year-old girl who was hospitalized with Pallister-Killian syndrome, Hypothyroidism visited our clinic with chief complaint of rugged upper incisors. This girl had multiple dental caries and oral hygiene was very poor. Periodic QLF-D images were taken to provide caregiver education and oral hygiene management was improved. A 13-year-old girl with cerebral palsy visited our clinic for regular check up. Using QLF-D, we explained to the parents that there is a need for treatment of dental caries, and education of oral hygiene management was conducted. Improvement of oral hygiene in the disabled can be achieved through caregiver education. QLF-D is a diagnostic device that can detects early caries by irradiating light in the visible ray area to the teeth. It can also detects microleakage of restoration, plaque and calculus without disclosing agent. Clinicians can use the QLF-D to perform a general oral examination for the disabled. Also, QLF-D can be used to store visual information and educate caregivers. The accumulation of information using QLF-D makes it possible to provide feedback on oral care of parents, which is more advantageous for caregivers education.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.1
• /
• pp.45-50
• /
• 2012

The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.

• Journal of the Korea Computer Graphics Society
• /
• v.20 no.1
• /
• pp.1-11
• /
• 2014

Patients with cerebral palsy or arthritis have deformities in lower limb which cause unstable gait or posture and pains. Surgeons perform a deformity correction osteotomy with surgical plan. But sometimes they find the unexpected angular or rotational deformation after surgery. The problems are that there is no method to predict the result of a surgical plan and also there are so many factors to must consider in surgical planning step such as clinical measurements, rotation angle, wedge angle, morphology of lower limb, etc. This paper presents new methods for planning the deformity correction osteotomy efficiently. There are two approaches based on the 3D mesh model and the accurate assessment of the patient's lower limb. One is the manual pre-simulation of surgery using forward kinematics. And the other is the automatic surgical planning using inverse kinematics and nonlinear optimization. Using these methods, we can predict and verify the results of various surgical treatments and also we can find a more effective surgical plan easily compared to conventional methods.

• Clinical and Experimental Pediatrics
• /
• v.53 no.6
• /
• pp.694-700
• /
• 2010

Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

• Journal of Korean Academy of Nursing
• /
• v.4 no.1
• /
• pp.64-80
• /
• 1974

The social understanding of the rehabilitation and welfare work for the handicapped children is nearly devoid in Korea. Especially the medical rehabilitation or nursing for them is left ign. ored as well as the literature preferential to this study is wanted. For the purpose of conducting the study of this thesis Sam Yook Children's Rehabilitation Center, Inc. and Crippled Children's Center, Yonsei University Medical center sampled out; covering three months from Aug. 1 to Oct. 30, 1973, the problems of children's rehabilitation, the characteristics of the children, the medical rehabilitation, nursing, education, and vocational rehabilitation were interviewed and widely grasped. This thesis aimed at developing the rehabilitation, the professional nursing and especially aimed at contributing to the improvement of welfare for the handicapped by analysing, observing the result of this study. The result is as follows: 1. Sam Yook Children's Rehabilitation Center, Inc. has, since its establishment, contributed to the advancement of the crippled children and its purpose consists in implementing services, medical rehabilitation, nursing, education and vocational training. Crippled Children's Center, Yonsei University Medical Center is, being based on Christianity, aiming at the medical treatment and education for the crippled children. 2. All of the children admitted in the children's rehabilitation centers are the crippled children. The ratio of boys io girls is three to two. Boys are more than girls. Orphan formed 55.2 per sent of them. About 60 per cent of them is receiving medical attention free of charge. But there is no orphan in Crippled Children's Center, Yonsei University Medical Center. 3. 15.7 per cent of them have received the previous medical attention before their admitting in the centers; in Sam Yook Children's Rehabilitation Center 8.6 percent, Crippled Children's Center, Yonsei University Medical Center 50 percent; there is remarkable difference between the two. 4. On the standpoint of period of being in the centers, the children who have been over three years in Sam Yook Children's Rehabilitation Center formed 48.7 per cent; in Crippled Children's Center, Yonsei University Medical Center 2.6 percent; there is also considerable difference between the two; they couldn't discharge from the centers owing to the economic conditions and being orphan. 5. Among the diagnosis of the crippled children, poliomyelitis formed highest 51.7 percent of them ; cerebral palsy formed 30 percent secondly in order. Environmental factors (67.8 percent formed about three times of congenital factors (23.7 percent). 6. The children who are capable of doing independently activity of daily living formed 87.9 percent; 73.2 percent can walk about 300 m by wearing brace and so on. The ratio of wearing brace or leg prosthesis formed 47.4 per cent: crutch 44.3 per cent. The medical rehabilitation service and education for the crippled, are comparatively well carried out. But it is desired to improve and cultivate the vocational training, vocational guidance and special nursing to the insufficiency of their implementation. In the tendency that the rehabilitation and welfare for the handicapped are today emphasized, International Handicapped Rehabilitation Association, declaring that 1970s are the decade of rehabilitation, urged to improve positively the policy of rehabilitation and welfare for the handicapped. But here in korea the handicapped, being the object of social prejudice, ignorance, disdain lives in obscurity. Therefore the government or the community should draw up countermeasure on social under-standing, financial support, and rehabilitation services for the handicapped as well as should endeavor to make them participate in social activities as the productive total- person though they are physically imperfect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.4
• /
• pp.303-308
• /
• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.