• Title/Summary/Keyword: Chronic Patients

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Development of Grocery Shopping Skills Enhancement Program for Chronic Schizophrenia Using Delphi Study (만성조현병 환자를 위한 식료품 쇼핑 기술 강화 프로그램 기초연구: 델파이기법)

  • Kim, Yong-Sub;Lee, Seong-A
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.17-30
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    • 2020
  • Objective : The purpose of this study is to provide basic data for the development of a instrumental activities of daily living training program called grocery shopping for schizophrenic patients in Delphi. Methods : The final program items and contents were completed through the first and third delphi surveys from August 2018 to March 2019. The expert composition selected 26 occupational therapists related to mental health. Three surveys were conducted and 23 experts participated in the Delphi survey. The second questionnaire, which was created from an open questionnaire, was designed to indicate the degree of importance using the Likert 5-point scale. As a result of the response of the 3rd questionnaire, the level of expert consensus was reconfirmed by analyzing average, standard deviation, and content validity ratio (CVR). Results : Three rounds of Delphi research reveal four categories of questions: grocery shopping views, product purchase strategies, necessary functions, and expert knowledge and experience on how to make purchase decisions. 24 items were selected. Through the 2nd and 3rd Delphi surveys, 4 items that did not meet the criteria of goodness of fit of each item or duplicated the contents were deleted and finally 20 items were extracted. Conclusion : Experts' agreement on grocery shopping technology was drawn from an occupational therapy perspective so that patients with schizophrenia living in the community could recover and participate as a member of society.

Disease Characteristics and Behavior Pattern of Treatment for Patient with Fibromyalgia (섬유조직염 환자의 질병 특성과 치료행태)

  • Han, Sang-Sook;Kang, Hyun-Sook
    • Journal of muscle and joint health
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    • v.6 no.1
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    • pp.22-36
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    • 1999
  • The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

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Enterotoxigenic Bacteroides fragilis-Associated Diseases and Detection (Enterotoxigenic Bacteroides fragilis에 의한 질환과 검출)

  • Gwon, Sun-Yeong;Jang, In-Ho;Rhee, Ki-Jong
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.161-167
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    • 2015
  • These commensal intestinal bacteria can enhance the immune system and aid in nutrient absorption but can also act as opportunistic pathogens. Among these intestinal bacteria, the anaerobic Bacteroides fragilis are divided into enterotoxigenic B. fragilis (ETBF) which secrete the B. fragilis toxin (BFT) and non-enterotoxigenic B. fragilis (NTBF) which do not secrete BFT. ETBF can cause diarrhea and colitis in both humans and livestock but can also be found in asymptomatic individuals. ETBF is predominantly found in patients with inflammatory diarrheal diseases and traveller's diarrhea. Several clinical studies have also reported an increased prevalence of ETBF in human patients with inflammatory bowel disease (IBD), colitis and colorectal cancer. In small animal models (C57BL/6 wild-type mice, germ-free mice, multiple intestinal neoplasia (Min) mice, rabbits and Mongolian gerbils), ETBF have been found to initiate and/or aggravate IBD, colitis and colorectal cancer. BFT induces E-cadherin cleavage in intestinal epithelial cells resulting in loss of epithelial cell integrity. Subsequent activation of the ${\beta}$-catenin pathway leads to increased cellular proliferation. In addition, ETBF causes acute and chronic colitis in wild-type mice as well as enhances tumorigenesis in Min mice via activation of the Stat3/Th17 pathway. Currently, ETBF can be detected using a BFT toxin bioassay and by PCR. Advances in molecular biological techniques such as real-time PCR have allowed both researchers as well as clinicians to rapidly detect ETBF in clinical samples. The emergence of more sensitive techniques will likely advance molecular insight into the role of ETBF in colitis and cancer.

Efficacy and Tolerability of Moclobemide Compared with Amitriptyline in Dysthymic Disorder (기분부전장애에서 Moclobemide와 Amitriptyline의 치료 효과와 내약성 비교 연구)

  • Lee, Min Soo;Nam, Jong Won;Ryu, Seung Ho;Cha, Ji Hyun;Kim, Yong Ku
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.96-101
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    • 1999
  • Background : Since dysthymia begins in late childhood or adolescence and has a chronic course, long-term pharmacotherapy may be required. New generation antidepressant, moclobemide, with more acceptable side effect profiles, is effective in the treatment of dysthymia. The main objective of this study was to determine whether they exhibit comparable efficacy and tolerability in dysthymia to amitriptyline. Method and Materials : The efficacy and tolerability of the moclobemide and amitriptyline, were compared in a eight-week single-centre double-blind study in patients(n=37) with dysthymia using he HAMD-17, the Clinical Global Impression Scale(CGI), the Montgomery-Asberg Depression Rating Scale (MADRS), Efficacy Index-Therapeutic Index(EITE), 4-point Index Side Effect Scale(4-PISES), and Efficacy Index- Side Effect Scale(EISE). Results : A total of 37 patients entered the study, 19 were randomly assigned to the moclobemide group and 18 to be amitriptyline group. Demo-graphic and illness characteristics were similar in both groups. There were no significant difference between two groups at the total 17-HDRS score, the HAMD-17% improvement, the total MADRS score, CGI response, and the EITE. In the comparison of EISE between two groups, the scores of the moclobemide group were relatively lower than the amitriptylinen group in full treatment. And the differences were significant(moclobemide group $1.39{\pm}0.61$ ; amitriptyline group $2.00{\pm}0.85$, p<.001). At the 4-PISE, There was no serious or treatment threatening side effects. And there was no specific difference in side effects between two groups. The moclobemide group reported higher EIR scores than the amitriptyline group at every follow up day, but the differences were not significant. And, there was no significant differences in the scores of five HRQOL subcategories which is compared between two groups at every follow up days. Conclusions : In terms of 17-HDRS and MADRS, moclobemide and amitriptyline are equally effective at least in allevating dysthymic symptoms. But moclobemide tended to be less troubling and better tolerated than amitriptyline. Therefore, moclobemide treatment can be used as a safe, and higher satisfactory treatment strategy for the dysthymia.

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Effect of Yinjinchunggan-tang based Herb Formulae Containing Wasong and Eosungcho on Fibrogenesis (인진청간탕 및 와송 어성초 가미방의 간섬유화억제에 미치는 효과)

  • Moon, Young-Hoon;Woo, Hong-Jung
    • The Journal of Internal Korean Medicine
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    • v.32 no.2
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    • pp.153-169
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    • 2011
  • Objectives : This study was performed to investigate the anti-fibrogenic effect and the effect on cell growth and apoptosis in YJCGT, YJCGT YSO and YJCGT YSCO on thioacetamide-induced rat liver tissue and the immortalized human hepatic cell line LX2. Materials and Methods : LX2 cells were treated with various concentrations (0, 50, 150, 300 ug/ml) of YJCGT, Y+YSO, and Y+YSCO extract for 24, 48 and 72 hours. After the treatment, cell viability was measured by using MTT assay. Caspase inhibitor assay, and cell viability were determined by a colorimetric assay with PMS/MTS solution. Rat liver fibrosis was induced by intraperitoneal thioacetamide injection 150 mg/kg 3 times a week for 5 weeks. After the treatment, body weight, liver & spleen weights, liver function test, the complete blood cell count and the change of portal pressure were studied. After YJCGT, Y+YSO, and Y+YSCO treatment, percentages of collagen in thioacetamide-induced rat liver tissue were measured. Results : The viability of the LX2 cell decreased in a dose- and time-dependent manner. Exposure of LX2 cells to YJCGT, YJCGT+YSO and YJCGT+YSCO induced caspase-3 activation, but co-treatment of YJCGT, YJCGT+YSO and YJCGT+YSCO with the pan-caspase inhibitor Z-VAD-FMK, and the caspase-3 inhibitor Z-DEVE-FMK, blocked apoptosis. There was no difference in rat body weight between the thioacetamide only group and the YJCGT, YJCGT+YSO and YJCGT+YSCO groups. In the YJCGT, YJCGT YSO and YJCGT YSCO groups, the serum level of GPT significantly went down compared with the thioacetamide only group. In the YJCGT, Y+YSO, Y+YSCO groups, white blood cell elevated by thioacetamide injection decreased but RBC, Hgb, and Hct increased. In the Y+YSO group, the portal pressure elevated by thioacetamide injection significantly decreased. In the histological finding, thioacetamide injections caused severe fibrosis, but YJCGT, Y+YSO, and Y+YSCO treatment significantly reduced the amounts of hepatic collagens. Conclusions : YJCGT, Y+YSO, and Y+YSCO inhibit the growth of LX2 cells by inducing apoptosis through caspase activity. YJCGT, Y+YSO, and Y+YSCO have beneficial effects on the treatment of cirrhotic patients as well as patients with chronic hepatitis.

Study on Influencing Factors on Subjective Quality of Life and Family Burden of Caretaking Family Members who have a Patient with a Psychiatric Disorder - Comparison between Schizophrenia and Alcohol Dependence - (정신과 환자 주 보호자의 삶의 질과 부담 영향 요인 - 정신분열병과 알콜 의존 환자의 보호자 비교 -)

  • Ryu, Seuk-Hwan
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.56-65
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    • 2004
  • Objectives: The aim of this study was to investigate the quality of life of caretaking family members who have a patient with psychiatric disorders. The results will be served as a basic data of ameliorating the quality of life of caregivers. Methods: 78 caretaking family members who have a patient with schizophrenia and 54 caretaking family members who have a patient with alcohol dependence, a total of 132 persons completed the questionnaire, and analyzed. The Korean version of the SmithKline Beecham Quality of Life Scale and the Family Burden Scale were applied. Results: There was no statistically significant correlation between burden and sex, age, income, and duration of living with patients before onset. The male caregiver showed higher quality of life than that of female. It showed statistically significant correlation between age and factor physical well-being and factor activity. 41% of variance of quality of life of caregivers were explained by the stress response, burden, and overall merits of the field of psychiatry, and the tension had the most explanatory power. Conclusion: The chronic illness may give a burden on caregivers, and that decrease the quality of life of caregivers. The longer duration of illness of patients, the lower quality of life of caregivers on competence factor. Therefore, the authors recommend the therapeutic modality must be offered to the caregivers who may experience the stress and burden.

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Comparison of various methods of glomerular filtration rate measurements in children (소아 환아에서 다양한 사구체 여과율 측정법의 비교)

  • Lee, Na Mi;Lim, In Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.999-1004
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    • 2009
  • Purpose : Glomerular filtration rate (GFR) is a fundamental parameter in assessing renal function and predicting the progression of chronic renal disease. Because the use of serum creatinine has several disadvantages, many studies have investigated the use of cystatin C for estimating GFR. We compared creatinine clearance and GFR with formulas using serum creatinine and cystatin C. Methods : We retrospectively analyzed 211 patients with various renal diseases and classified them into two groups according to creatinine clearance (Group 1: CrCl >$90mL/min/1.73m^2$, Group 2: CrCl <$90mL/min/1.73m^2$). We measured serum creatinine, cystatin C, and creatinine clearance. We calculated GFR using the Schwartz, Counahan, Filler and Lepage, Bokencamp et al, and Grubb et al formulas. Results : GFR determined by the Schwartz formula had the highest correlation to creatinine clearance (r=0.415, P=0.00). GFR determined by various formulas using cystatin C had lower correlation to creatinine clearance (r=0.187, r=0.187, r=0.291). The Schwartz and Counahan formulas showed greater diagnostic accuracy in detecting decreased GFR than cystatin C in group 2 (areas under the curve: Schwartz, 0.596; Counahan, 0.572; Filler, 0.512; Bokencamp, 0.508; and Grubb, 0.514). Conclusion : GFR determined by the Schwartz and Counahan formulas using serum creatinine showed higher correlation coefficient than that determined by formulas using cystatin C. The formulas using cystatin C were not superior to those using serum creatinine in detecting decreased GFR. Cystatin C measurement was not satisfactory for assessing GFR in patients whose renal function was not severely decreased.

Effects of Oral Vitamins on the Elderly with Mild Cognitive Impairment (비타민 보충제 영양강화요법이 경도인지기능장애 노인에게 미치는 효과)

  • Lee, Hye-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.294-303
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    • 2017
  • As the elderly population increases, the prevalence of various geriatric chronic diseases and dementia diseases is also rapidly increasing; accordingly, dementia is becoming a major concern of our society. In this study, 48 elderly patients with mild cognitive impairment located in K district were selected from a group of experimental groups in one building and a control group in one building and evaluated for blood homocysteine levels and cognitive function changes after 4,8, and 12 weeks of taking vitamin supplements. The Chi-squared test, Fisher's Exact test, independent t-test, repeated measures ANOVA, contrast test, repeated measures ANCOVA, and Wilks' lambda test were utilized to analyze the data. The results revealed that the cognitive function of the experimental group was significantly higher than that of the control group at 12 weeks (p<0.05), and so, the experimental group higher than that of the control group (p<0.01), the effect of taking vitamins was significantly increased, indicating that homocysteine was decreased relative to the control group. Therefore, vitamin supplements may prevent decreases in cognitive functions and dementia among elderly patients with mild cognitive impairment.

Effects of Home-based Virtual Reality on Upper Extremity Motor Function for Stroke - An Experimenter Blind Case Study (가정-중심 가상현실이 만성뇌졸중환자의 팔 운동기능에 미치는 영향 - 실험자 맹검 단일실험연구)

  • Lee, Jung-Ah;Hwang, Su-Jin;Song, Chiang-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.3023-3029
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    • 2012
  • The purpose of this study was to investigate the effect of the home-based virtual reality (VR) on upper extremity motor function in hemiparetic stroke patients. Two matched subjects with left hemiplegia were volunteered to participate in this study. One subject received the home-based VR whereas the other subject recovered a modified home-based constraint-induced movement therapy (CIMT). Both interventions were given for 4 hours x 5 times a week for 4 weeks. Outcome measures included Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Wolf Motor Function Test (WMFT). The VR-trained subject showed considerable improvement in all the tested motor functions when compared with the home-based CIMT. Specifically, the FMA measure demonstrated that the VR subject showed 17% enhancement whereas the CIMT subject showed 5% increase. Similarly, Amount of Use (AOU) and Quality of Movement (QOM) of the MAL scores of the VR subject showed 40% and 20% increase whereas the CIMT subject showed 0% and 20% increase, respectively. The WMFT scores of the VR subject and CIMT subject showed 20% increase. Our home-based VR was effective in upper extremity motor recovery of chronic hemiparetic patients even when compared with the well-established CIMT approach in stroke victims.

The Efficacy of Treadmill Training with Body Weight Support on Ambulation with Stroke Patients (체중현수 트래드밀 훈련이 뇌졸중 환자의 보행에 미치는 영향)

  • Kim, Seong-Hak;Park, Rae-Joon;Park, Heung-Gi;Kim, Ho-Bong;Chae, Soo-Gyung;Kim, Chun-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.1
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    • pp.83-101
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    • 2004
  • The propose of the study was to evaluate the efficacy of the partial body weight support during treadmill training on the ambulation in elderly with chronic stroke. Fourteen hemiplegic volunteers participated and were divided into an experimental and control groups. In the experimental group, the body weight support during treadmill training was performed 3 times per week for 6 weeks. In the control group, usual treadmill training was applied. Before and after experiments, temporal-spatial gait parameters were measured. The date of 14 patients who carried out the whole experimental course were statistically analyzed. The results of the study were : 1. In the comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the gait velocity between groups, there was not, significant difference between the experimental group and the control group(p>.05). 2. In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in both groups(p<.05). In the comparison of difference of the gait cadence between groups, there was not significant difference between the experimental group and the control group(p>.05). 3. In the comparison of step length before and after experiment, the step length was significantly increased in the experimental group and the control group(p<.05). In the comparison of difference of the step length between groups, there was not significant difference between the experimental group and the control group(p>.05). 4. In the comparison of single support time asymmetry before and after experiment, the single support time asymmetry was no significant difference between groups(p>.05). In the comparison of difference of the single support time asymmetry between groups, there was not significant difference between the experimental group and the control group(p>.05). 5. In the comparison of step length asymmetry before and. after experiment, the step length asymmetry was not significant difference between the experimental group and the control group(p>.05). In the comparison of difference of the single step length asymmetry between groups, there was not significant difference between the experimental group and the control group(p>.05).

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