• Title/Summary/Keyword: Health impairment

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DENTAL CARIES TREATMENT FOR A PATIENT WITH ANGELMAN SYNDROME : A CASE REPORT (엔젤만 증후군(Angelman syndrome) 환자의 치아 우식 치료 : 증례 보고)

  • Sang, Eun Jung;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.80-85
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    • 2017
  • Angelman syndrome is a rare disorder caused by deletion or inactivation of genes on the maternally inherited chromosome 15. This neurodevelopmental disorder is characterized by developmental and intellectual delay, speech impairment, sleep disturbance, seizures, motor dysfunction, and frequent laughing or smiling. Orofacial characteristics include a prominent mandible, large mouth, prominent cheeks, a tendency to rest the tongue between the dental arches, excessive drooling, and excessive chewing behavior. Patients with this syndrome usually require general anesthesia even in a simple operation, because of risk of perioperative seizure during dental procedure. This is a case report about dental treatment of a 3-year-old female patient with Angelman syndrome under general anesthesia. This case suggests that the dental treatment under general anesthesia can be considered a safe component for the uncooperative, delayed developmental patients with underlying disease. Also, periodic dental exam appointment should be made to provide the patients with preventive treatments and to make them remain familiar with the dental environment.

Correlation of Cognitive Function and Fall-risk Related Behavioral Factors (노인의 인지기능과 낙상유발 행동요인과의 상관분석)

  • Ju, Yumi;Lee, Heon-Joo
    • Therapeutic Science for Rehabilitation
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    • v.7 no.2
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    • pp.41-50
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    • 2018
  • Objective: This study was conducted to investigate the correlation of cognitive function and fall-risk behavioral factors. Methods: The elderly over than 65 year-old with and without cognitive impairment were recruited in four different regional areas. Total 43 data of K-MoCA and FaB were collected. Pearson correlation of total scores of K-MoCA and FaB was analyzed using SPSS 22. Correlation between total score of K-MoCA and each item of FaB which describes the fall-risk behaviors was analyzed as well. Results: The cognitive function was statistically positive correlated with the fall-related behaviors in pearson correlation analysis (p<.01). Nine items of total 30 items of FaB was significantly correlated with total score of K-MoCA. Conclusion: Fall-risk behaviors were decreased as the cognitive level was improved. If the cognitive function was vulnerable, the insight to fall-risk behaviors deficits and various fall-related behavioral factors exits. The high fall-risk behaviors were correlated with cognitive function, so that the cognitive level should be considered in fall prevention intervention in Occupational Therapy.

A Preliminary Study on Development and Evaluation of Home Health Care Nurse Clinical Practice Program -Focused on Postoperative Orthopedic Patients- (가정간호사 임상실무 훈련프로그램 개발과 평가를 위한 사전 연구 -정형외과 수술 환자를 중심으로-)

  • 서영숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.15-32
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    • 1996
  • The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

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An Ergonomic Study on Manual Lifting Tasks in Motor Assembly Processes (자동차 조립 부서 Manual Lifting 작업에 관한 인간공학적 연구)

  • Kwon, Eun-Hye;Paik, Nam-Won
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.8 no.1
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    • pp.1-23
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    • 1998
  • Work-related Low Back Pain(LBP) is one of tile most important Issues in the field of industrial safety and health. Particularly, manual lifting is known as a major cause of work-related LBP and impairment. Total number of 163 manual lifting tasks in motor assembly processes were investigated. The 1981 and the 1994 equations developed by National Institute for Occupational Safety and Health(NIOSH) were applied to evaluate potential hazards of lifting-related LBP. Comparisons between the 19R I and 1994 NIOSH criteria were made. The relationships between the NIOSH criteria and lifting-related LBP were also analyzed. The results of this study are as follows: 1. The values of Action Limit(AL) by the NIOSH 1981 lifting equation. Recommended Weight Limit(RWL) by the 1994 equation and the weight of the load handled at each manual lifting task were shown log-normal distributions. 2. LI'(the weight of tile load/AL) and LI(the weight of the load/RWL) were calculated estimate the physical stress imposed by each individual lifting task. As a result. 76.7% of the total LI' value exceeded 1 and 12.9% exceeded 3, and 84.7% of the total LI values exceeded 1 and 20.9% exceeded 3. 3. Bus 2 Department showed the highest rate of LI'>1 and LI>1 and Bus 1 Department showed the highest rate of LI'>3 and LI>3 4. In general, the RWLs by the 1994 equation were found lower than the ALs by the 1981 equation. It is assumed to he resulted from the fact that the 1994 equation includes methods evaluating asymmetrical lifting tasks and lifts of objects with less then optimal hand-container couplings, and also covers a larger range of work durations and lifting frequencies than the 1981 equation. 5. Significant correlations were found between LI' and incidence of LBP (R=0.734, p<0.05). LI and incidence of LBP(R=0.671. p<0.10) and load-weights and incidence of LBP(R=0.797, p<0.05). 6. Control measures are required to achieve the value of LI less than 1 for some tasks having high LI values. Engineering control is highly recommended for some tasks having the value of LI above 3.

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DENTAL TREATMENT IN A PATIENT WITH ANGELMAN SYNDROME DUE TO UNIPARENTAL DISOMY (편친 이염색체성 엔젤만 증후군(Angelman syndrome) 환자의 치과치료)

  • Park, Sung-Hee;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.11-15
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    • 2016
  • Angelman syndrome is characterized by a partial deficit of paired autosomal chromosome 15, which contains a subunit of the GABA (Gamma-Amino Butyric Acid) receptor. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, and speech impairment. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking swallowing disorder, and excessive chewing behavior. A 3-year-6-month old girl with Angelman syndrome was scheduled for dental treatment. She had multiple caries, but she was poorly cooperative for treatment due to developmental delay and movement disorder, so general anesthesia was considered. The patient with Angelman syndrome was successfully treated under general anesthesia. There were no postoperative complications related to anesthesia and dental treatment. When treating children with this syndrome, the dentist needs to manage their uncooperative behavior and medical problem.

TREATMENT OF OPENBITE WITH MYOFUNCTIONAL THERAPY IN MOYAMOYA DISEASE PATIENT (근기능요법을 통한 모야모야병 환자의 개방 교합 치료)

  • Lee, Chang Keun;Lee, Dae Woo;Kim, Jae Gon;Yang, Yeon Mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.19-22
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    • 2017
  • Moyamoya disease is characterized by progressive bilateral narrowing of the internal carotid arteries(ICA) and their main branches, and formation of a fine vascular network (moyamoya vessels) at the base of brain. Mild intellectual or motor impairment, or both can be seen in moyamoya disease patient. Patients having intellectual disability usually have malocclusions associated with oral habits such as tongue thrusting, bruxism, or clenching. A patient with moyamoya disease and cerebral palsy visited Chonbuk National University hospital for dental examination. She showed mild openbite on anterior teeth, and had oral habits such as mouth breathing, tongue thrusting, and drooling. She was treated with myofunctional therapy(MFT) whose purpose was to strengthen orofacial muscles. Lip closing force and bite force were recorded to evaluate the muscle tone. Tongue crib was delivered to restrict tongue thrusting habit, since her compliance to the MFT was decreased after 6 months of treatment. With the MFT and tongue crib, the openbite was fairly improved. When myofunctional therapy has difficulty in obtaining good compliances, the treatment should not be effective enough. Although intellectually disabled patients are not compliant enough, thus a habit breaking device should be needed to treat the openbite caused by oral habits, dentist should make an effort to do MFT, since it could reduce a treatment period, and enhance the stability.

Change of Cerebral Blood Flow during Tilt Tests in Children with Vasovagal Syncope (혈관미주 신경성 실신 소아에서 기립경사 검사 동안에 뇌혈류 변화)

  • Kim, Su Jung;Yom, Hye Won;Hong, Young Mi;Yoo, Jung Hyen;Lee, Sook Hee;Kim, Chong Hee
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.983-988
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    • 2003
  • Purpose : Syncope appears to be common. However, the mechanism of syncope is not clear. Increased vagal activity and withdrawal of sympathetic stimulation cause hypotension, bradycardia and finally loss of consciousness. The purpose of this study was to evaluate changes of cerebral blood flow velocity, blood pressure, and heart rate during tilt test in children with vasovagal syncope. Methods : Sixty four children with a past history of syncope were evaluated. The stand up test was performed for 15 minutes after a rest at supine position for 10 minutes, followed by an $80^{\circ}$ tilt test lasting 45 minutes. If presyncope(lightheadedness, nausea, blurred vision, or sweating) or syncope occurred, the study was discontinued. 12-lead electrocardiography, echocardiography, and electroencephalography were performed. Transcranial Doppler study was performed at the middle cerebral artery with 2 MHz continuous Doppler probe in 10 children with positive tilt test. Systolic, diastolic, mean cerebral blood flow velocity, integral, and pulsatility index were measured with blood pressure, heart rate, and $O_2$ saturation. Results : The positive rate of tilt test was 31.3%(20/64). Systolic, diastolic, and mean cerebral blood flow velocity decreased significantly in absence of hypotension or bradycardia during presyncope. Time velocity integral of cerebral artery also decreased significantly. Conclusion : Decreased cerebral blood flow velocity can predict the presyncope manifestation. Impairment of autoregulation of cerebral blood flow might play an important role in the pathophysiology of vasovagal syncope.

Studies on the Regulation for Use, Metabolism, Intake, and Safety of Sodium Nitrite in Meat Products (육가공품에 사용되는 아질산염의 사용기준, 대사, 섭취량과 안전성에 대한 조사 연구)

  • Lee Keun-Taik;Kang Jong-Ok;Kim Cheon-Jei;Lee Mooha;Lee Sung Ki;Lee Joo-Yeon;Lee Ju-Woon;Cho Soo-Hyun;Joo Seon-Tea;Chin Koo B.;Choi Sung-Hee
    • Food Science of Animal Resources
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    • v.25 no.1
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    • pp.103-120
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    • 2005
  • During the 1970s, concern arose that cured meats contained high levels of residual nitrite and preformed nitrosamines. Therefore, the search for alternatives and alternative approaches to the use of nitrite have been still continued, however no complete alternative for nitrite has yet been identified. Recently, it was publicized in Korea that nitrite-containing meat products would be detrimental to health, about which consumers have been seriously concerned. Therefore, this study was carried out to inform the consumer of the safety status of nitrite and thereby to lead proper consumption of meat products. For assessing the safety of nitrite, data regarding the regulation for use, metabolism in human body, and dietary intake amounts of nitrite were collected and analyzed. The mean intake level of nitrite for Korean per capita was recently reported to be not more than 1% of ADI set by JECFA. On the contrary, a calculation indicated that the daily nitrite intake per capita from saliva by ingestion of vegetables in Korea would be about 300-fold higher than that from cured meats. In consideration of the low consumption amount of meat products per capita of Korean, that is, at least one fifth, compared to European and American, there is no particular reason to concern about the impairment of health by nitrite intake from meat products for Korean. However, any effort for the reduction of residual nitrite content in cured meats should be given with an idea to minimize the intake of nitrite even from the minor source.

MULTIDISCIPLINARY APPROACH OF A PATIENT WITH MENTAL RETARDATION UNDER GENERAL ANESTHESIA : A CASE REPORT (정신지체 환자의 협력 진료에 의한 전신마취 하 치과치료 증례)

  • Jang, Yoon-Hyoung;Pae, Ah-Ran;Choi, Sung-Chul;Park, Jae-Hong;Kim, Kwang-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.1
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    • pp.23-26
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    • 2009
  • Mental retardation is defined by the American Psychiatric Association as" subnormal general intellectual functioning which originates during the developmental period and is associated with impairment of either learning and social adjustment or maturation, or both." A patient with mild to moderate mental retardation can be managed adequately using restraints and medications. However, in case of severe or profound mental disability, dental treatment cannot be accomplished even with the use of behavior modification, physical restraints and sedation techniques. When treatment in the dental office has much difficulty, hospitalization for dental treatment under general anesthesia can and should be considered. This case presents the treatment of a patient with mental retardation who was referred to our department for comprehensive dental care. Dental examination revealed widespread dental caries and a severe anterior open bite with crowding problems. Under general anesthesia, generalized caries treatment was performed by our department, and the anterior dental esthetics was achieved in collaboration with the department of prosthodontic dentistry.

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DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA: CASE REPORT (모야모야병(moyamoya disease) 환자의 전신마취 하 치과치료: 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.40-44
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    • 2019
  • Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries. A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease. MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.