• Title/Summary/Keyword: Evidence-Based Treatment

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Effects of Family-Centered Intervention for Children with Autism Spectrum Disorder in South Korea: A Systematic Review - Focusing on Parent Education and Parent Coaching - (국내 자폐스펙트럼장애 아동에 대한 가족 중심 중재 효과: 체계적 고찰 - 부모 교육 및 부모 코칭 중심으로 - )

  • Choi, Yoon-Mi;Yoo, Eun-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.3
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    • pp.65-78
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    • 2023
  • Objective : In this study, we aimed to investigate the effectiveness of family-centered intervention conducted with caregivers of children with autism spectrum disorder (ASD) in South Korea through a systematic literature review. Methods : Previous studies published from 2011 to 2021 were searched through RISS, KISS, and DBpia. The search terms applied included "autism spectrum" OR "general developmental disorder" OR "high-functioning autism" OR "Asperger's" AND "parent education" OR "family-centered intervention" OR "parent coaching" OR "parent training" OR "family participation." A total of 11 experimental studies were chosen based on the selection criteria. Results : According to the findings on the general characteristics of the study participants, intervention strategies, and effects of the intervention, it was observed that the majority of children with ASD who participated in the study were preschool-aged, and the majority of participating caregivers were mothers. The effects of family-centered interventions were evident in both children and parents. In children, the most significant effects were observed in interaction and communication skills. In parents, a reduction in parenting stress and an improvement in parenting efficacy were observed. The intervention strategies employed in the study varied, with sensory integration intervention, responsive communication, and interaction-centered intervention being the most commonly used, followed by developmental-centered intervention, positive behavior support (PBS), and parent-mediated intervention based on pivotal response treatment (PRT). Conclusion : The results of this study are significant in that they confirm that family-centered intervention is effective not only in improving the functioning of children with autism spectrum disorder, but also in reducing parenting stress and enhancing parenting efficacy, and provide evidence for clinical use.

Effects of Some Environmental Factors on Japanese Yew (Taxus cuspidata Sieb. et Zucc.) (몇 발근환경인자(發根環境因子)가 주목삽수(揷穗) 발근(發根)에 미치는 효과(効果))

  • Kim, Chang Ho;Nam, Jung Chil
    • Journal of Korean Society of Forest Science
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    • v.70 no.1
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    • pp.1-6
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    • 1985
  • The purpose of this experiment lies in finding the most appropriate cutting condition of Taxus cuspidata Sieb. et Zucc. which has been considered valuable tree species in gardening. Statistical analysis was focused on the comparison of the average ratios of rooting between greenhouses and fields, based on the observation rooted autogenis. To conduct this survey, hardwood cutting of Taxus cuspidata Sieb. et Zucc. were performed at both places of experiment above on April 20, 1982 with rooting results calculated on October 31, 1982. After formation of cuttings, it was soaked in IBA 200 ppm for 12 hours and than put in a bed. A summary of the result is presented as follows; 1) Cutting at the greenhouse showed higher average rate of rooting than at fields. Same tendency was found regardless of the differences in treatment. 2) It was clear that IBA-treatment contributed remarkably to causing higher average rooting rate. As an evidence, when twenty centimeter cuttings were inserted sandy media, IBA-treated area resulted in eighty six percent of average rooting rate, as compared with only twenty three percent in nontreatment case. In case of field cutting, IBA-treatment brought about fifty three percent of rooting in comparison with eleven percent nontreatment. 3) When sandy soil, loam and brown soil were separately used as cutting media, the highest rooting rate was found in case of sandy soil, without any difference between the two experimental places above. 4) As a result of the analysis to seek the impact of the length of cuttings on rooting, the range of length form fifteen to twenty centimeter was apparently most appropriate. It was also found that the rate of rooting declined beyond twenty five centimeter. 5) Two kinds of rooting pattern were observed. One was the case that callus cell lump was created on the lower cut side of cuttings. Importantly, root radical were formed inside the lump to influence the germination of root system. The other relates to the case that adventitious root which look like lateral roots appeared at the stem region. In abstract, first, sandy soil was effectively recommended in case of hardwood cutting in April. Second, the most appropriate length of cuttings ranged between fifteen and twenty centimeters. Third, high density IBA treatment was clearly effective. Forth, for proper environmental management, both pre-disinfection of sail by sterilizer and maintenance of high relative humidity were essentially required.

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A Study on Clinical Features and Pharmacologic Treatment Outcomes of Patients with Trigeminal Neuralgia (삼차신경통의 임상 소견과 약물 치료에 관한 연구)

  • Ko, Yu-Jeong;Kim, Kyun-Yo;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.207-216
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    • 2009
  • Trigeminal neuralgia is defined "a sudden, usually unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve". The initial treatment of choice for trigeminal neuralgia is medical therapy. In patients with medically intractable pain or intolerable medication side effects, invasive therapeutic approaches are often necessary. Based on the amount of evidence and estimated efficacy, carbamazepine is the drug of choice in the management of trigeminal neuralgia. In case of insufficient or no response to carbamazepine, second-line drugs can be added. In this study, the author tried to review and analyzed the cases of 90 patients whom had visited for treatment of trigeminal neuralgia at the Department of Oral Medicine, Kyungpook National University Hospital from 2003 to 2008. The results were as follows: 1. Trigeminal neuralgia was significantly more common with advancing age, and nearly twice as common in women than men (ratio of 2.1:1) 2. The maxillary branch of the trigeminal nerve involved most often (51.1%), and the right side of the face is affected more commonly than the left (ratio of 2.9:1). 3. 85(94.4%) patients had experiences visiting medical or dental specialties before being referred to the Department of Oral Medicine. 4. 40(44.4%) patients with trigeminal neuralgia had systemic diseases. 5. Treatment with carbamazepine monotherapy was satisfactory initially in 69(76.7%) the patients, and the mean daily dose of carbamazepine was 402.9mg. On the other hand, 16(17.8%) patients expressed effectiveness after combination therapy of carbamazepine and other drugs. 6. Of the 69 patients who had a good initial response to carbamazepine monotherapy, 18 patients became resistant, so that combination therapy of carbamazepine and other drugs were necessary. 7. 54(60%) patients developed side effects such as dizziness, drowsiness, nausea, vomiting, blood dyscrasias, skin rash and constipation, and 11 of the patients decided to stop tmedicaion due to side effects.

Analysis of the Causes of Subfrontal Recurrence in Medulloblastoma and Its Salvage Treatment (수모세포종의 방사선치료 후 전두엽하방 재발된 환자에서 원인 분석 및 구제 치료)

  • Cho Jae Ho;Koom Woong Sub;Lee Chang Geol;Kim Kyoung Ju;Shim Su Jung;Bak Jino;Jeong Kyoungkeun;Kim Tae_Gon;Kim Dong Seok;Choi oong-Uhn;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.165-176
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    • 2004
  • Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.

Case Control Study of Recognition level for Dermatomycosis of Dermatomycosis Patient to be Treated in Ulleung Hospital of Ulleung island (울릉도의 일개 병원을 내원한 피부 진균증 환자들의 피부 진균증에 대한 인식도에 관한 사례 연구)

  • Bae, Jung-Min;Jung, Man-Jin;Ha, Dong-Yeup;Jung, Ho-Keun;Jung, Ki-Hun;Jung, Byung-Wook;Oh, Min-Koo;Bae, Sung-Han;An, Woo-Sup
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.205-211
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    • 2005
  • Objectives: In Ulleung island, many people was suffered from dermatomycosis. But many patients was not recognized to dermatomycosis due to little symptom. So, public health education was needed. We will plan education direction based on evidence. So, in one way, the recognition level was needed to determine education direction. Methods: From June to July in 2005, 45 patients was made a question. The questionnaire was composed of chief complaint, site, duration, similar disease in family, 5 questiones and so on. If patients was recognized to 1 question, 1 score was added. Remain 4 question was done in same manner. Results: The low score group were that total socre was beyond 2. And The high score group were that total score was above 3. The low score group was 24 persons, average age was 59. The high score group was 21 persons and average age was 42. Male and female ratio was 7 : 17 in low score group and 10 : 11 in high score group. Coinfection was 17 patients in low score group and 2 patients in high score group. There was only 17 patients that wete recognized that dermatomycosis and "Moozom" were same disease. And, many patients was not recognized to possibility of reinfection after treatment of dermatomycosis. Conclusions: In Ulleung island, coinfection rate was higher than other area bacause of low recognition level. And infection rate in family was higher too. So, there was essential to educate of dermatomycosis prevention. Dermatomycosis patient became older and was more female than other area, so there was need to centralize people to be needed of public health education. Finally, many statistical study for dermatomycosis should be needed for many patients and general populations in Ulleung island.

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Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

Comparison of healing pattern with or without bone graft after odontogenic cyst enucleation (악골에서 발생한 치성 낭종제거 후 골이식 여부에 따른 치유속도와 양상 비교)

  • Baek, Chae-Hwan;Park, Joon-Hyung;Kim, Gun-Jong;Hong, Jong-Rak;Kim, Chang-Soo;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.515-519
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    • 2010
  • Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

PERIPHERAL ODONTOMA IN A CHILD: CASE REPORT (소아에서 발생한 변연성 치아종의 증례보고)

  • Lee, Young-Ho;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.301-305
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    • 2012
  • The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.

Clinical Practice Guideline of Acute Respiratory Distress Syndrome

  • Cho, Young-Jae;Moon, Jae Young;Shin, Ein-Soon;Kim, Je Hyeong;Jung, Hoon;Park, So Young;Kim, Ho Cheol;Sim, Yun Su;Rhee, Chin Kook;Lim, Jaemin;Lee, Seok Jeong;Lee, Won-Yeon;Lee, Hyun Jeong;Kwak, Sang Hyun;Kang, Eun Kyeong;Chung, Kyung Soo;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.214-233
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    • 2016
  • There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment. We also suggest high positive end-expiratory pressure (2B), extracorporeal membrane oxygenation as a rescue therapy (2C), and neuromuscular blockage for 48 hours after starting mechanical ventilation (2B). The application of recruitment maneuver may reduce mortality (2B), however, the use of systemic steroids cannot reduce mortality (2B). In mechanically ventilated patients, we recommend light sedation (1B) and low tidal volume even without ARDS (1B) and suggest lung protective ventilation strategy during the operation to lower the incidence of lung complications including ARDS (2B). Early tracheostomy in mechanically ventilated patients can be performed only in limited patients (2A). In conclusion, of 12 recommendations, nine were in the management of ARDS, and three for mechanically ventilated patients.

Heat shock protein X purified from Mycobacterium tuberculosis enhances the efficacy of dendritic cells-based immunotherapy for the treatment of allergic asthma

  • Kim, Hye-Young;Kang, Hyun Kyu;Cho, Joon;Jung, In Duk;Yoon, Gun Young;Lee, Min-Goo;Shin, Sung Jae;Park, Won Sun;Park, Jong-Hwan;Ryu, Seung-Wook;Park, Yeong-Min;You, Ji Chang
    • BMB Reports
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    • v.48 no.3
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    • pp.178-183
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    • 2015
  • Dendritic cells play an important role in determining whether na${\ddot{i}}$ve T cells mature into either Th1 or Th2 cells. We determined whether heat-shock protein X (HspX) purified from Mycobacterium tuberculosis regulates the Th1/Th2 immune response in an ovalbumin (OVA)-induced murine model of asthma. HspX increased interferon-gamma, IL-17A, -12 and transforming growth factor (TGF)-${\beta}$ production and T-bet gene expression but reduced IL-13 production and GATA-3 gene expression. HspX also inhibited asthmatic reactions as demonstrated by an increase in the number of eosinophils in bronchoalveolar lavage fluid, inflammatory cell infiltration in lung tissues, airway luminal narrowing, and airway hyper-responsiveness. Furthermore, HspX enhanced OVA-induced decrease of regulatory T cells in the mediastinal lymph nodes. This study provides evidence that HspX plays critical roles in the amelioration of asthmatic inflammation in mice. These findings provide new insights into the immunotherapeutic role of HspX with respect to its effects on a murine model of asthma.