• The Journal of Korean society of community based occupational therapy
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• v.1 no.2
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• pp.31-43
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• 2011

Objective : The purpose of this case study was to proposed a introduction and result of the disabled with stroke in community using services of Community-Based Rehabilitation. Methods : The subject was a 63-years old female patient with stroke who first visit to Public health center in July. She was evaluated on activity daily living action level by using the Modified Barthel Index(MBI) and depression level by using Beck Depression Inventory(BDI). The intervention that was suggested by WHO were Community-Based Rehabilitation(CBR) and general occupational therapy. We were applied from April, 27th 2011, to November 30th, 2011 by occupational therapist. Results : The patient's total MBI score increased from 35 to 55, it means that activity daily living performance capacity was improved. And BDI score decreased from 26 to 14, it means that depressed symptoms were in great decline. She could stand until 5-10 minutes at first, but later stand over 30minutes now. It means her muscle strength and endurance level was increased. The patient's mood condition also was stabilized and then she often showed her smiling face during the therapy. And her protector feels the client's change too. Conclusion : We could know that function level and quality of life of the patient with stroke who return to the community was improved through service of community-based rehabilitation.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.89-93
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• 2017

Background. Ever since the first report of deltopectoral flap in pharyngo-esophageal reconstruction in 1965, various methods of flap reconstruction have been introduced, allowing surgical eradication of tumors that were once thought to be inoperable. Despite these advancement, many literatures emphasize distant metastasis and second primary malignancies as the most important factors that contribute to the low 5-year survival rate of the patients. Specific consensus about defining second primary cancer is still debatable, due to small number of reports regarding second primary tumors arising in flaps used for reconstruction of defects in the head and neck region. Case. We report a case of a 72-year-old male patient who, under the diagnosis of hypopharyngeal cancer, underwent total laryngectomy with partial pharyngectomy, extended right radical neck dissection with extended left lateral neck dissection, right hemithyroidectomy and radial forearm free flap reconstruction on June 16, 2003. After 37 cycles of radiation therapy, the patient exhibited no sign of recurrence. The patient revisited our department on June 14, 2016 with chief complaint of dysphagia that started two months before the visit. Radiologic studies and histology revealed squamous cell carcinoma in neopharynx, one that had been reconstructed with forearm free flap. Conclusion. Until now, only a handful of reports regarding patients with second primary cancer in reconstructed flaps have been described. Despite its rarity, diagnostic criteria for second primary cancer should always kept in consideration for patients with recurred tumor.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.515-522
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• 2020

Objectives: This study aimed to describe whether Saenggangunbi-tang supports clinical management of a patient with decompensated liver cirrhosis without unfavorable side effects. Methods: A 78-year-old woman diagnosed with unspecified liver cirrhosis in 2014, who had undergone abdominal paracentesis twice until 2014 and variceal ligation twice until 2017, took Saenggangunbi-tang from July 25, 2019 to March 23, 2020. We observed clinical changes, such as fatigue, leg edema, and gingival bleeding, as well as laboratory findings. Results: After taking Saenggangunbi-tang for about eight months, the patient's symptoms and serum levels of liver enzymes were improved in comparison to her symptoms and serum levels at the first visit. Moreover, there was no occurrence of any complications, such as ascites and gastroesophageal variceal bleeding by portal hypertension. Conclusions: This study suggests that Saenggangunbi-tang might be effective in the treatment of decompensated liver cirrhosis.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.13 no.2
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• pp.98-103
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• 2013

Purpose: MAT-I/III deficiency by MAT1A gene mutation causes isolated hypermethioninemia, which is considered to be a clinically benign disease. But in some patients, mental retardation, developmental delay, myelination disorder may be shown. This study was performed to find out the clinical manifestations and genetic characteristics of patients with isolated hypermethioninemia. Methods: Clinical, biochemical and genetic analysis were done to 10 patients with isolated hypermethioninemia who were referred to department of pediatrics, Soonchunhyang University Hospital from March 1999 to March 2012. Results: At first visit, all patients' mean plasma methionine level was 5.5 mg/dL (2.1-14.6) and there were no increase of amino acid levels including homocystine in all patients. Serum homocysteine level was evaluated in seven patients who visited after year 2003, and ranged from 4.96 to $11.15{\mu}mol/L$ (normal < $25{\mu}mol/L$). Methionine restricted diet was started to all patients. Nine patients who managed regularly showed normal development, but one patient whose initial plasma methionine level was 14.6 mg/dL showed language delay at 1 year of age and was diagnosed as mild mental retardation (IQ=66) at 6 years of age. Genetic analysis was done to eight patients, R264H mutation was identified in seven patients. Also, both R299C and R356Q mutation were identified in one patient. Conclusion: Clinical findings in patients with isolated hypermethioninemia were generally good, but one patient showed mental retardation and language difficulty. R264H mutation which usually inherits as an autosomal dominant trait was most frequently found in our patients, and R299C/R356Q mutation were also identified.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.402-408
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• 2018

Background/Aims: With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment. Methods: Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL. Results: A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue and weakness were the most frequent symptoms. Conclusions: The data shows that as many as 50% of total patients returned to work after receiving LT. Fatigue and weakness were the most common complaints of the unemployed group, and resolving the causes of these symptoms may help to increase the employment rate.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.3
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• pp.162-170
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• 2022

In the case of patients with pathological tooth wear, it is necessary to evaluate the loss of the vertical dimension. Setting the appropriate vertical dimension is important to rehabilitate the patient's stable intermaxillary relationship. A 77-year-old female patient's chief complaint was the pain of the mandibular incisors and the lack of molars. At the first visit, pathologic tooth wear of the mandibular incisors were observed. After diagnosis and evaluation, loss of vertical dimension was not observed, but insufficient intermaxillary space for prosthetic restoration was confirmed. Mandibular rehabilitation was performed with vertical dimension increase and this showed satisfactory results both functionally and aesthetically.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.207-214
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• 2021

Objectives: This study aimed to identify whether herbal medicine improves the clinical symptoms and abnormal blood tests of a patient with fatty liver accompanied by hypertriglyceridemia. Methods: A 44-year-old man with fatty liver and hypertriglyceridemia was prescribed Saenggangunbi-tang from July 20, 2020, to November 11, 2020, to reduce fatigue and to improve laboratory findings, such as liver enzymes and the lipid profile. We observed changes in symptoms, serum levels of liver enzymes, and the lipid profile during about 4-month treatment. We also recorded changes in the bioelectrical impedance analyzer findings during that time. Results: In this case study, an approximately 4-month treatment with Saenggangunbi-tang led to considerable improvement in laboratory findings and visceral fat area. In particular, the patient experienced a noticeable decrease in triglyceride levels compared with the baseline parameters of the first visit. In addition, no side effects-including weight gain and liver enzyme increases-were observed during treatment. Conclusion: This study suggests that appropriately prescribed herbal medicine is a therapeutic option to manage fatty liver combined with hypertriglyceridemia.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.1
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• pp.139-147
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• 2021

Objectives The purpose of this study is to investigate differences in brain activities when Neurodevelopmental treatment (NDT) is used alone compare to NDT is combined with intradermal acupuncture (IDA) treatment, using functional infrared spectroscopy (fNIRS) Methods Three children less than 7 year-old with cerebral palsy were participated. On their first visit, only NDT was used. After a week, they were treated with both NDT and IDA. During the treatment, fNIRS was used to measure any changes in their brain activities. Results In first patient with NDT, oxyhemoglobin level was increased during Standing exercise and Gait training compared to resting state. When the patient was treated with NDT and IDA, oxyhemoglobin level was decreased during Standing exercise and Gait training compared to resting state, and the result was significant (p<0.05). In second patient, oxyhemoglobin level was decreased in Gait training compared to resting state when NDT was used, but the level was increased when NDT and IDA were used in Gait training compared to resting state (p<0.05). In third patient, the difference in oxyhemoglobin levels between Gait training and resting state was significant (p<0.05). Conclusions Treatment involving both NDT and IDA has more potential to improve brain activities compared to that of NDT alone, and no adverse effect was reported. In order to confirm the finding, larger scale randomized controlled trials are needed.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.265-273
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• 2010

Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.