• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.2
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• pp.100-103
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• 2009

Dental treatment of mentally challenged patients under general anesthesia is a series of challenging procedures not only for dental operators but also for dental anesthesiologists. Patients presenting with uncooperative behavior often resist the perioperative management for adesthestic administration. This case report suggests oral premedication as a conjuctive method for anestheitic induction. A 26-year-old male dental patient with autism was referred to dental treatment under general anesthesia. The patient refused to enter dental clinic office and was not able to receive preoperative assessment. In the day of operation, 15 mg of midazolam was given to the patient for oral premedication prior to anesthetic induction. Ater 20 minutes, the patient presented with drowziness and was transferred to the office. Anesthestic staff were able to achieve appropriate intravenous access and mask inhalation. The patient recieved 8 hrs long dental treatment and recovered in a noncomplicated way. Oral midazolam is commonly used to reduce anxiety for combative and irritated pateints. In this case, oral midazolam sedation was used as a preanesthetic management of a highly uncoopearive patient.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.35-41
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• 2010

Objectives: In Korea, the top 10% of Medical Aid recipients represent nearly 60% of total payment, with the costs for those disabled for over 365 days representing approximately 30% of total payment. The purpose of this study was to compare Medical Aid use of the disabled with non-disabled recipients, and to identify contributing factors to the total payment in the top 2% of recipients identified as Medical Aid overusers. Methods: Subjects (n=2,211) selected were ${\geq}18$-years-of-age and received >1000 days of co-payment-free type I Medical Aid. Case managers (n=200) conducted interviews in December 2006, and collected data from Health Insurance Review & Assessment Service. Amounts over the 9 months from January September 2006 were analyzed descriptively and using Chi-square, ANCOVA, and robust multiple linear regression. Results: Disabled individuals (mean age 61.3 years) composed 36.6% of subjects; 44.8% of the disabled were male. On a monthly basis per capita, the disabled group averaged 10.5 outpatient days, total payment of 523,000 Korean Won(￦), inpatient payment of ￦359,000, and outpatient payment of ￦183,000. All values exceeded the monthly average for non-disabled individuals. Contributing factors were identified as male gender (￦82,000), elementary school or lower educational level (￦64,000), residence in a small city (￦82,000), lack of family support (￦61,000), kidney disability (￦673,000), intellectual disability (￦151,000), and multiple disabilities (￦119,000). Conclusions: The identification of contributing factors to Medical Aid use by those defined as disabled supports the adoption of comprehensive alternative policies such as strengthening of education and consultation services, provision of alternative facilities, and promotion of self-care.

• Journal of Acupuncture Research
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• v.28 no.1
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• pp.117-124
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• 2011

Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.351-357
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• 2014

Purpose: The purpose of this study was to investigate level of functioning in patients with stroke using Modified Bathel Index (MBI), World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and ICF core-set for stroke. Methods: Sixty-four patients with stroke were recruited for this study from nine medical institutes. The ICF core-set for stroke, WHODAS 2.0, and MBI were used to collect subjects' functional levels. ICF core-set was employed here as a standard frame to observe multi-dimension of functioning, that is physiological bodily function, activity and participation (AP) in daily life, and current environmental factors (EF) in patients with stroke. WHODAS 2.0 and MBI were also used in order to have a specific functioning level for subjects. The linkage of each item in WHODAS 2.0 and MBI into the ICF core-set for stroke was examined. Pearson correlation coefficient was used for analysis of their relationships. Results: Functioning level of participants showed moderate resulting from MBI and WHODAS 2.0 ($73.48{\pm}22.27$ and $35.55{\pm}12.53$, respectively). Strong relationship was observed between ICF core-set and WHODAS 2.0, and with MBI. Each item of disability scales was obtained its linkage into ICF in the domain of AP. However, lack of correlation between MBI and ICF in the domain of EF was found due to absence of related factors. Conclusion: MBI was found to be linked mainly into ICF in the domain of AP and to have limited linkage into EF. Therefore, it should be suggested that the ICF concept frame should be used as a multi-dimensional approach to patients with stroke.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.90-95
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• 2009

Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

• Journal of Korean Academy of Nursing
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• v.6 no.1
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• pp.23-28
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• 1976

This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.

• Child Health Nursing Research
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• v.12 no.1
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• pp.44-56
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• 2006

Purpose: The purpose of this study was to investigate the health education needs of mothers who are nurturing children with disabilities. Method: A descriptive study was done and the participants were 108 mothers of children with disabilities such being mentally challenged, developmentally delayed or having a disability involving brain damage. The questionnaire was a health education need assessment with 11 categories(58 items) developed by Han et al. The data were analyzed using SPSS program. Results: The mean score for health education needs of the mothers of children with disabilities was 3.83 (SD=0.58) out of a maximum 5. The health education need for acquisition of knowledge and information had the highest score (4.40±0.54) followed by health education needs for cognitive development and learning (4.31±0.64), interpersonal relationships (4.04±0.65) and behavior and emotion (4.04±0.79). There were significant differences between the children's sex (t=2.08, p=.04), birth order (t=2.17, p=.03), grade of disability (F=3.32, p=.02) and sex education suitable to the child's in age. Conclusion: The health education needs of mothers of children who are disabled were very high and varied. Therefore, it was important to develop comprehensive education programs which include this content and provide opportunities for mothers of children with disabilities to receive this education.

• Physical Therapy Korea
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• v.16 no.2
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• pp.24-30
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• 2009

The purpose of this study was to determine the reliability and validity of the fear-avoidance beliefs questionnaire (FABQ) in assessing Korean patients with low back pain. We performed translation and cross-cultural adaptation of the questionnaire and enrolled 52 patients (18 males and 34 females) with low back pain. The subjects completed a standardized self-administered questionnaire that included the FABQ assessment along with evaluations for the visual analogue scale (VAS), Oswestry disability index (ODI), self-rating anxiety scale (SAS), and Beck depression inventory-Korean version (K-BDI). The reliability of the obtained data was determined by evaluating the internal consistency on the basis of the intraclass correlation coefficient (ICC) and the Cronbach's alpha values, while the validity of the data was examined by correlating the FABQ scores to the VAS, ODI, SAS, and K-BDI scores. The translated versions of the FABQ showed good test-retest reliability: ICC (3, 1)=.90 (FABQ for physical activity) and .97 (FABQ for work) these values were statistically significant (p<.01). The Cronbach's alpha value for FABQ was .90 (p<.01). FABQ moderately correlated with pain, disability, anxiety, and depression (p<.01). The results of this study indicate that the Korean version of the FABQ is a reliable and valid instrument for measuring fear-avoidance beliefs in Korean patients with low back pain.

• Journal of Korean Physical Therapy Science
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• v.15 no.3
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• pp.19-29
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• 2008

Background : Ankle inversion sprains are one of the most common injuries in sports and activities of daily living that mostly concern physically active individuals. In most researches, proprioceptive deficit, muscle weakness and/or absent coordination have been regarded as a contributing factors. Despite the high incidence of ankle sprain and instability, therapeutic approaches to properly manage the symptoms have rarely been investigated. This study aimed to identify the effect of proprioceptive exercise program that is easy to integrate in normal training program. Methods : Subjects were randomly allocated to control group and experimental group consisting of 11 and 10 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound and TENS. In addition, the experimental group performed 7 exercises to enhance proprioceptive function of ankle joint. The therapeutic intervention of the controland experimental groups was performed a total of 20 exercise sessions, averaging 50 hour each, 5 times per week for 4 weeks. To compare the two groups, the level of ankle disability was assessed by using the ankle injury score scale in pre- and post-treatment. Results : On assessment of post-treatment, there were statistically significant differences in the scores of all sub-items, except for ankle laxity and range of motion, and the total score of ankle injury score scale between the two groups(p<0.05). In comparison between pre- and post-treatments, the significant difference in the scores of all sub-items and total score didn't appear for the control group, while the scores of most sub-items and total score of the experimental group were shown the statistically significant difference(p<0.05). Conclusion : The findings suggest that the proprioceptive exercise program is more effective for relieving ankle disability than conservative treatment therefore, the program to improve proprioceptive function should be recommended for prevention and rehabilitation of recurrent ankle inversion injuries.