• Title/Summary/Keyword: Long-term Care Hospital

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The effect of desk height on upper extremity muscles tension in spinal cord injured patients during computer work (시간차 회상 훈련을 병행한 운동프로그램이 치매노인의 일상생활동작, 우울, 인지에 미치는 영향)

  • Lee, Hosanna;Kim, Hyung Geun;Jung, Jee Woon;Kim, Sung-Shin
    • Journal of Korean Academy of Medicine & Therapy Science
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    • v.10 no.2
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    • pp.47-57
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    • 2018
  • Objective: The purpose of this study was to compare the effects of exercise program combined with spaced retrieval and exercise program to show the effects on elderly people with dementia by presenting them to clinics and welfare facilities such as long-term care facilities. Method: This study was conducted in 20 elderly patients with dementia and randomly assigned to exercise program combined with spaced retrieval and exercise program. After screening the subjects for compliance with the criteria, Before starting the experiment, activites of daily living, depression, and nitive evaluation were performed. After 8 weeks, 3 times per week, 40 minutes per intervention, and 4 and 8 weeks, respectively K-MBI, GDSSF-K and MMSE-K were used to evaluate the differences between the experimental and control groups. Results: There was no statistically significant difference in the daily activities, depression, and cognitive scores between the groups of exercise program combined with spaced retrieval and exercise program group. However, there was a significant difference between the two groups after training (p<.05). Particularly, there was statistically significant difference in post-training cognitive evaluation (MMSE-K) only in the exercise program combined with spaced retrieval group (p<.05) Conclusion: This study suggests that exercise program combined with spaced retrieval is more effective in improving cognitive ability. This suggests that the exercise program combined with spaced retrieval is more effective.

Impact of a Fall-Prevention Exercise Program on Balance, Gait, Lower Limb Strength, and Psychosocial Characteristics in Older Adults with Dementia (낙상예방 운동 프로그램이 치매 노인의 균형, 보행과 하지 근력, 심리사회적 특성에 미치는 영향)

  • Choi, Gi-young;Kim, Suhn-yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.75-89
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    • 2019
  • PURPOSE: This study measured the impact of a 12-week fall-prevention exercise program on balance, ambulatory ability, lower limb strength, and psychosocial characteristics in older adults diagnosed with dementia. METHODS: The participants comprised 31 older adults (9 men, 22 women) diagnosed with Alzheimer's or vascular dementia at a long-term care hospital located in Gunsan City. A fall-prevention exercise program was provided to the experimental group, while the control group was only provided with instruction and materials related to the fall-prevention exercise program. The participants were evaluated before the intervention, 6 weeks after the intervention, and 12 weeks after the intervention on static and dynamic balance abilities (using Timed Up and Go test: TUG, Tinetti-balance scale, one-leg standing test: OLS), gait (Tinetti-balance scale, 6-minute walk test: 6MWT), lower limb strength (sit to stand test; STS), and psychosocial characteristics (Short Form 36 Health Survey-Korean version, Korean Mini-Mental State Exam). RESULTS: An independent samples t-test and repeated measures analysis of variance were used for the statistical analysis. There were statistically significant improvements after the intervention (p<.05) in dynamic balance abilities (TUG and OLS using the left foot), gait (6MWT), and lower limb strength (STS) for the experimental group, but not for the control group. No difference was seen in psychosocial characteristics. CONCLUSION: Older adults with dementia who participated in the fall-prevention exercise program showed significant improvements in their static and dynamic balance abilities, lower limb strength, and ambulatory ability after the intervention.

Treatment of Mycobacterium avium Complex Pulmonary Disease

  • Kwon, Yong-Soo;Koh, Won-Jung;Daley, Charles L.
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.1
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    • pp.15-26
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    • 2019
  • The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

Artificial Intelligence in Gastric Cancer Imaging With Emphasis on Diagnostic Imaging and Body Morphometry

  • Kyung Won Kim;Jimi Huh ;Bushra Urooj ;Jeongjin Lee ;Jinseok Lee ;In-Seob Lee ;Hyesun Park ;Seongwon Na ;Yousun Ko
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.388-399
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    • 2023
  • Gastric cancer remains a significant global health concern, coercing the need for advancements in imaging techniques for ensuring accurate diagnosis and effective treatment planning. Artificial intelligence (AI) has emerged as a potent tool for gastric-cancer imaging, particularly for diagnostic imaging and body morphometry. This review article offers a comprehensive overview of the recent developments and applications of AI in gastric cancer imaging. We investigated the role of AI imaging in gastric cancer diagnosis and staging, showcasing its potential to enhance the accuracy and efficiency of these crucial aspects of patient management. Additionally, we explored the application of AI body morphometry specifically for assessing the clinical impact of gastrectomy. This aspect of AI utilization holds significant promise for understanding postoperative changes and optimizing patient outcomes. Furthermore, we examine the current state of AI techniques for the prognosis of patients with gastric cancer. These prognostic models leverage AI algorithms to predict long-term survival outcomes and assist clinicians in making informed treatment decisions. However, the implementation of AI techniques for gastric cancer imaging has several limitations. As AI continues to evolve, we hope to witness the translation of cutting-edge technologies into routine clinical practice, ultimately improving patient care and outcomes in the fight against gastric cancer.

Symptoms, Mental Health, and Quality of Life Among Patients After COVID-19 Infection: A Cross-sectional Study in Vietnam

  • Hai Nguyen Thanh;Duc Cap Minh;Hien Hoang Thu;Duc Nguyen Quang
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.2
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    • pp.128-137
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    • 2024
  • Objectives: This study was conducted to characterize the symptoms, mental health, quality of life (QoL), and associated factors following the coronavirus disease 2019 (COVID-19) infection. Methods: This cross-sectional study included 394 participants previously infected with COVID-19 in Ho Chi Minh City, Vietnam. Mental health was assessed using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Participants self-reported health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale. Results: Among the participants, 76.4% reported experiencing at least one symptom following COVID-19 infection. The most common symptoms were fatigue (42.1%), cognitive dysfunction (42.9%), and hair loss (27.9%). According to the DASS-21 results, the proportions of depression, anxiety, and stress were 28.7%, 26.4%, and 20.6%, respectively. The mean scores on the EQ-5D-5L and the EuroQol Visual Analog Scale were 0.94±0.11 and 84.20±13.11, respectively. Regarding QoL issues, the highest proportion of participants (32.7%) reported experiencing anxiety or depression, followed by pain or discomfort (25.4%). Multivariable logistic regression analysis revealed that factors associated with the presence of symptoms following COVID-19 infection included female (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.65 to 4.91) and having QoL issues (OR, 3.25; 95% CI, 1.71 to 6.19). Conclusions: The study investigated the prevalence rates of various symptoms following COVID-19 infection. These findings underscore the need to prioritize comprehensive care for individuals recovering from COVID-19 and to implement strategies to mitigate the long-term impact of the disease on mental health and QoL.

Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center (출생체중 500 g 미만의 태아영아 치료성적 및 치료의 실제)

  • Chang, Yun Sil;Kim, Yu Jin;Koo, Soo Hyun;Lee, Jang Hoon;Hwang, Jong Hee;Choi, Chang Won;Shim, Jae Won;Kim, Sung Shin;Ko, Sun Young;Lee, Eun Kyung;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.939-945
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    • 2005
  • Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

Kinematic Analysis in Reaching Depending on the Localized Vibration Duration in Persons With Hemiparetic Stroke (국소 진동자극이 편마비 뇌졸중 환자의 팔 뻗기 수행에 미치는 영향에 대한 운동학적 분석)

  • Yoo, Eun-Young;Park, Ji-Hyuk;Kwon, Jae-Sung;Cho, Sang-Yoon;Lee, Bo-Mi;Kim, Yeong-Jo;Kim, Jae-Nam;Kim, Sun-Ho
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.79-88
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    • 2018
  • Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.

Mid- and Long Term Outcome of Fontan Procedure: Extracardiac Conduit Fontan versus Lateral Tunnel Fontan (폰탄 술식의 중장기 성적: 심장외 도관 술식과 가측터널 술식의 비교)

  • Kwak, Jae-Gun;Kim, Dong-Jung;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.805-810
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    • 2007
  • Background: This paper reviews our experience retrospectively to examine the clinical results and effectiveness of lateral tunnel (LT) and extracardiac conduit (ECC) Fontan procedures at a single institution. Material and Method: One hundred and sixty five Fontan procedures were performed (67 LT and 98 ECC) between January 1996 and December 2006. Preoperative and postoperative hemodynamic values, arrhythmia, hospital and intensive care unit stay, chest tube drain, morbidity and mortality were reviewed. Result: The overall operative mortality in the LT and ECC groups was 4.5% (3) and 2.0% (2), respectively. There was a significant difference in the immediate postoperative transpulmonary gradient (LT $8.5{\pm}2.5$ vs ECC $6.6{\pm}2.4$, p-value<0.001) and central venous pressure (LT $18.3{\pm}3.8$ vs ECC $15.6{\pm}2.4$, p-value=0.001) between the two groups. The mean follow-up in the LT and ECC groups was $74.1{\pm}31.5$ and $38.1{\pm}29.1$ months, respectively. There was one late death. The actuarial survival at 10 years in the LT and ECC groups was 92% and 89%, respectively. In arrhythmia, the ECC patients showed a slightly low incidence but the difference was not statistically significant. Conclusion: Both the LT and ECC Fontan procedures showed comparable early and mid-term outcomes in terms of the surgical morbidity and mortality, postoperative hemodynamics, and mid-term survival. The ECC Fontan procedure reduces the risk of arrhythmia in the follow up period.

Clinical observation of meconium aspiration syndrome and effect of suctioning through endotracheal intubation on prognosis of meconium aspiration syndrome (태변 흡인 증후군의 임상적 고찰과 기관 내 삽관 후 조기 태변 흡인이 예후에 미치는 영향)

  • Yoon, Yong Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.959-964
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    • 2007
  • Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.

Endocrine dysfunction after bone marrow transplantation during childhood and adolescence (소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전)

  • Jin, Hye Young;Choi, Jin-Ho;Im, Ho-Joon;Seo, Jong-Jin;Moon, Hyung-Nam;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.420-427
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    • 2010
  • Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.