• Title/Summary/Keyword: Paralytic patients

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Immediate Effects of Load Stimulation on Static Balance and Muscle Activities in Chronic Stroke Patients (부하자극이 만성뇌졸중 환자의 정적 균형, 근육 활성도에 미치는 효과)

  • Lee, Seung-Won;Shin, Won-Seob;In, Tae-Sung;Lee, Sun-Hyun;Lee, Hae-Hyun;Lee, Kyoung-Jin;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.21 no.1
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    • pp.19-25
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    • 2009
  • Purpose: We investigated the changes that effects of load stimulation (LS) on static balance and muscle activities in normal healthy elders and chronic stroke patients. Methods: Subjects were instructed twenty normal healthy elders (8 men and 12 women) and ten chronic stroke patients (4 men and 6 women). They were tested while standing on a force platform under two conditions; LS, no LS were applied in random order. Prior to testing, adhesive surface EMG electrodes were fastened to the skin overlying the right (non-paralytic side in stroke patient) bellies of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles. They were assessed on postural sway and %MVC (Maximum voluntary contraction) of TA and LG. Results: Participants showed that the application of LS brought about a decrease in postural sway as expressed by average sway path and velocity. %MVC of TA and LG were increased. The application of LS to normal and stroke patients decreases postural sway during quite stance. Conclusion: These findings the application of LS to normal and stroke patients improves static balance.

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Comparison of gastric and other bowel perforations in preterm infants: a review of 20 years' experience in a single institution

  • Lee, Do Kyung;Shim, So Yeon;Cho, Su Jin;Park, Eun Ae;Lee, Sun Wha
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.288-293
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    • 2015
  • Purpose: In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. Methods: The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectively reviewed. Results: Twenty-one preterm infants underwent exploratory laparotomy to investigate the cause of the pneumoperitoneum. The sample consisted of five patients (23.8%) with gastric perforation and 16 patients (76.2%) with intestinal perforation. No statistical differences were found in the birth history and other perinatal factors between the two groups. Underlying necrotizing enterocolitis, bilious vomiting, and paralytic ileus preceding the perforation were statistically more common in the intestinal perforation group. All preterm infants with gastric perforation survived to discharge; however, six preterm infants with intestinal perforation expired during treatment in the NICU. In the gastric perforation group, sudden pneumoperitoneum was the most common finding, and the mean age at diagnosis was $4.4{\pm}1.7days$ of life. The location and size of the perforations varied, and simple closure or partial gastrectomy was performed. Conclusion: Patients with gastric perforation did not have a common clinical finding preceding the perforation diagnosis. Although mortality in previous studies was high, all patients survived to discharge in the present study. When a preterm infant aged less than one week presents with sudden abdominal distension and pneumoperitoneum, gastric perforation should first be excluded. Prompt exploratory laparotomy will increase the survival rates of these infants.

A Study of Caregiver Stress as related to the Level of Self-care in Patients Who had a Cerebro Vascular Accident(CVA) (뇌졸중환자의 자가간호 수준에 따른 보호자의 스트레스)

  • 최은숙;소희영
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.602-616
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    • 1993
  • The purpose of this study was to explore the degree of stress in caregivers caring for patients who had had a cerebro vascular accident as the stress is related to the self- care ability of the patient. The subjects for the study were caregivers of 111 CVA patients, hospitalized at two University affiliated hospitals and two general hospitals in Daejon. The survey instruments used in the study were Kang’s ADL Check List and a modified form of Lee’s Stress Inventory. The survey was conducted from July 16th to August 30th, 1992. The survey results were analyzed using the Statisitical Package for Social Sciences (SPSS) and can be sumerized as follows: 1. The level of self- care for the CVA patients was : 1) complete dependence (M=34.7, 31.2%), 2) complete independence (M=14.8. 13.3%), 3) in-complete independence ( M=17.5, 15.8% ), 4) in-complete dependence (M=14.8, 13.3%) and 5) dependence and independence (M=14.1, 12.7%). The items for which there was a high level of self-care were 1) drinking (M=3.640), 2) returning (M=2.351) and 3) eating (M=2.351) : and the items for which there was a low level of self -care were : 1) ascending and descending stairs (M=2.351), 2) dressing and undressing trousers (M=2.514) and 3) dressing and undressing jacket (M :2.532). 2. There was a statistically difference between the paralytic status and the level of self- care accord-ing to their demographic characteristics ( F=24. 7056, p(.001). 3. There was no significant difference in the degree of caregiver stress according to patient's demo-graphic characteristics. 4. There was a statistically significant difference in the degree of caregiver stress according to the following demographic characteristics : age (F=7.4189, p(.001), education level (F=5.8336, P(.01), family structure (t=2.10, p(.05) and their relationship with the patient (F=6.5099, P〈.01). 5. There was no significant difference in the degree of caregiver stress according to the level of patient self - care.

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The Effect of Cognitive Orientation to Daily Occupational Performance(CO-OP) on Upper Extremity Function and Occupational Performance in patients with Subacute Stroke (인지기반 작업수행 중재가 아급성기 뇌졸중 환자의 팔 기능 및 작업수행에 미치는 영향)

  • Sung-Jun, Moon;Hwan, Kim
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.4
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    • pp.123-132
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    • 2022
  • PURPOSE: The purpose of this study was to investigate the effects of cognitive orientation to daily occupational performance (CO-OP) interventions on the upper extremity function and occupational performance in subacute stroke patients. METHODS: A total of 30 eligible stroke patients were randomly distributed into the CO-OP experimental group (n = 15) and the traditional occupational therapy (OT) control group (n = 15). The CO-OP approach was applied for twelve 60-minute sessions. The Jebson Taylor Hand Function Test (JTHFT), the Korean version of the Modified Barthel Index (K-MBI), and the Performance Quality Rating Scale (PQRS) were used for outcome evaluations. RESULTS: There was a statistically significant difference in the paralytic upper extremity function before and after treatment (p < .01) between the group treated with the CO-OP approach and the group treated with traditional OT. The occupational performance of the CO-OP approach group showed a significant improvement (p < .01), and this group also showed a statistically significant improvement in quality of performance compared to the traditional OT group (p < .01). CONCLUSION: The CO-OP approach may be useful in clinical practice as a therapeutic intervention for improving the functional recovery and performance of subacute stroke patients. Future research should be carried out to investigate the persistence of this effect involving more participants and follow-up studies should also be undertaken.

Prevalence and Treatment Pattern of Korean Patients with Facial Palsy (안면신경마비 환자의 최근 5년간 연도별 진료경향 분석)

  • Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.137-146
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    • 2010
  • Objectives : While there are many studies about treatments of facial palsy, no study has been performed on general population of Korea, especially concerning about comparison between western medicine and oriental medicine. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with facial palsy through the computerized database of Health Insurance Review and Assessment Service(HIRAS). Methods : According to the HIRAS database over 5 years' period from 2004 to 2008, the medical records of patients with facial palsy as a main diagnosis were extracted. Inclusion criteria of facial palsy are Bell's palsy(G510), Geniculate ganglionitis(G511), Melkersson's syndrome(G512), Other disorders of facial nerve(G518), Disorder of facial nerve, unspecified(G519) in western medicine. And Paralytic face(G016), Deviated eye and mouth(J01), The other facial palsy(J013) were included in oriental medicine. We compared the claim number of western medical care with that of oriental medicine treatment by year and month. Results : The total claim number of facial palsy was increasing on both western medicine and oriental medicine from 2004 to 2008. In western medicine, the claim number of Bell's palsy(G510) is the most. In oriental medicine the inpatients claim number of Deviated eye and mouth(J01) is the most, while outpatients claim number of the other facial palsy(J013) is the most. Conclusions : Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment, which can be more reliable data to expect medical demand for facial palsy in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.

A Study on the Stress of Family-Caregivers and Level of Daily Living Performance with Patients of Cerebra Vascular Accident(CVA) (뇌졸중환자의 일상생활 수행수준과 가족원의 스트레스)

  • Cho, Young-Hee
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.372-386
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    • 1999
  • The purpose of this study was to explore the degree of stress in caregivers caring for CVA patients and the level of daily living performance of CVA patients. The subjects for the study were caregivers of 112 CVA patients who enter a hospital or out-patient-department (OPD) at two Oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL check list for daily living performance of patients and Choi's 4 sore scale for stress of caregivers. The survey was conducted from July 4th to August 30th in 1999. The survey results were analyzed with the Statistical Package for Social Science(SPSS) program and can be summarized as follows: 1. The level of daily living performance for the CVA patients was: 1) complete dependence (M=14.9, 13.1%), 2) complete independence (M=23.6, 20.9%), 3) incomplete independence (M=23.9, 21.0%), 4) incomplete dependence (M=26.6, 25%), 5) dependence and independence (M=23.0, 20.0%). The items for with there was a high level daily living performance were: 1) drinking (M=3.62), 2) eating(M=3.25). 3) position returning (M=3.18) : and the items for which there was a low level of daily living performance were: 1) ascending and descending stairs (M=2.08), 2) walking (M=2.47), 3) dressing and undressing trousers (M=2.55). 2. Degree of caregiver stress was: Mean=2.39 at 40 score. The items for which was a high level caregiver stress were: 1) medical fee (M=3.25), 2) being handicapped or recurrence (M=3.02) : and the items for which there was a low level of caregiver stress were: 1) discontinuity of patient's treatment (M = 1.98). 2) change of home atmosphere caused by patient's disease (M = 1.98), 3) desire of patient's knowing about disease (M= 1.99). 3. There was statistically significant difference in the degree of caregiver stress according to the following caregiver's demographic characteristics: education level (F=3.52, P=0.03). change of caregiver (F=5.41. P=0.02). 4. There was a statistically signifiant difference in the level of daily living performance according to the CVA patients demographic characteristics: patient's paralytic status (F=4.48, P=0.01), duration of disease (t=2.76, P=0.03). 5. There was significant difference in degree of caregiver stress according to the CVA patient's demographic characteristics: CVA status (F=4.75, P=0.01). 6. There was statistically significant difference in the degree of caregiver stress according to the level of daily living performance in CVA patients(r=-0.482, P<0.00).

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Effect of Acupuncture on Postoperative Ileus after Distal Gastrectomy for Gastric Cancer

  • Jung, Se Yun;Chae, Hyun Dong;Kang, Ung Rae;Kwak, Min Ah;Kim, In Hwan
    • Journal of Gastric Cancer
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    • v.17 no.1
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    • pp.11-20
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    • 2017
  • Purpose: Acupuncture has recently been accepted as a treatment option for managing postoperative ileus (POI) and various functional gastrointestinal disorders. Therefore, we conducted a prospective randomized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery. Materials and Methods: Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were randomly assigned to acupuncture or non-acupuncture (NA) groups at 1:1 ratio. The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1. The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph. The secondary outcome measure was the surgical outcome, including the times to first flatus, first defecation, start of water intake, and start of soft diet, as well as length of hospital stay and laboratory findings. Results: The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group. A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time (P<0.0001). The acupuncture group showed relatively better surgical outcomes than those in the NA group, but the differences were not statistically significant. Conclusions: In this clinical trial, acupuncture promoted the passage of sitz markers, which may reflect the possibility of reducing POI after distal gastrectomy.

Arthroscopic Ankle Fusion Using Two Medial Cannulated Screws (2개의 내측 유관나사를 이용한 관절경하에서의 족근 관절 고정술)

  • Kim, Hak-Jun;Kim, Taik-Seon;Yoon, Jeong-Ro;Kim, Kyoung-Soo;Noh, Haeng-Kee;Yoon, Kwang-Sup
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.171-175
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    • 2004
  • Purpose: We evaluated the clinical and radiological results of arthroscopic ankle fusion using 2 medial screws which had advantages of less morbidity, early weight-bearing and high union rate. Material and Methods: From April, 2002 to March, 2004, 8 patients who had ankle osteoarthritis were treated by ankle fusion using 2 medial screws under arthroscopy; five patients with post-traumatic osteoarthritis, two with post-infectious arthritis and one with paralytic foot. There were 5 male and 3 female. Average age was 67 years old ranging from 57 to 71 years. We evaluated them clinically preoperative and postoperative using AOFAS score, VAS pain scale and patient's satisfaction. In regard to radiological fusion, we checked them by simple AP, lateral and mortise view. Follow up period was average 11 months (range, $6{\sim}24$ months). Results: All ankles were successfully fused with 2 medial screws under arthroscopy. The mean time of fusion was 10.5 weeks (range, $8{\sim}14$ weeks). Patient's satisfaction checked at 6 months after operation had favorable results (excellent and good 75%). One case had pain on medial malleolar area because of screw's protrusion. Conclusion: Arthroscopic ankle fusion using 2 medial screws was good modality of ankle fusion with less morbidity and early weight-bearing in some cases of ankle arthritis.

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Early Results of the Nuss Procedure (Nuss 술식의 조기 결과)

  • 박경택;김기봉;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.472-476
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    • 2001
  • Background: Minimally invasive surgery of pectus excavatum by Dr. Nuss is a new technique that allows the repair of this deformity without any cartilage resection or sternal osteotomy We describe the early experiences with Nuss procedure. Material and Method: From December 1999 to January 2001, twenty patients with pectus excavatum underwent repair by Nuss procedure There were 14 males and 6 females whose mean age was 10.1$\pm$7.7 years, ranging from 1 to 33 years. Most patients(N=19) were below 20 years, except 33 years old female patient(N=1). Result: The severity of depression was assessed by computed topography(CT). CT index was mean 4.9$\pm$5.7(ranged from 3.3 to 8). The average operating time was 85.8$\pm$23.7 minutes. The used metal bars were ranged in length from 8 inches to 16 inches(average 11.8$\pm$14.4 inches). Early postoperative complications were pneumothorax in three patients, paralytic ileus in one, and postoperative chest pain requiring analgesics in all patients. Epidural analgesia was used in one adult patient for control of postoperative pain. In our experiences, there were no serious complications posteoperatively. Conclusion: There were good early results with the Nuss procedure that we performed for repairing of pectus excavatum. However, we believe the procedure needs to be observed for the long term results for it to be broadly accepted.

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Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009

  • Cho, Hye-Kyung;Lee, Na-Yong;Lee, Hyun-Ju;Kim, Hae-Soon;Seo, Jeong-Wan;Hong, Young-Mi;Lee, Seung-Joo;Lee, Sun-Wha;Cheon, Doo-Sung;Hong, Ji-Young;Kang, Byung-Hak;Kim, Jong-Hyun;Kim, Kyung-Hyo
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.639-643
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    • 2010
  • Purpose: Hand-foot-mouth disease (HFMD) is a common viral illness in children, which is usually mild and self-limiting. However, in recent epidemics of HFMD in Asia, enterovirus 71 (EV71) has been recognized as a causative agent with severe neurological symptoms with or without cardiopulmonary involvement. HFMD was epidemic in Korea in the spring of 2009. Severe cases with complications including death have been reported. The clinical characteristics in children with neurologic manifestations of EV71 were studied in Ewha Womans University Mokdong Hospital. Methods: Examinations for EV71 were performed from the stools, respiratory secretion or CSF of children who presented neurologic symptoms associated with HFMD by realtime PCR. Clinical and radiologic data of the patients were collected and analyzed. Results: EV71 was isolated from the stool of 16 patients but not from respiratory secretion or CSF. Among the 16 patients, meningitis (n=10) was the most common manifestation, followed by Guillain-Barre syndrome (n=3), meningoencephalitis (n=2), poliomyelitis-like paralytic disease (n=1), and myoclonus (n=1). Gene analysis showed that most of them were caused by EV71 subgenotype C4a, which was prevalent in China in 2008. Conclusion: Because EV71 causes severe complications and death in children, a surveillance system to predict upcoming outbreaks should be established and maintained and adequate public health measures are needed to control disease.