• Title/Summary/Keyword: Progressive Intervention

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A Study on Strengthening Exercise for Stroke Patients through Comparison of Literature between Domestic and Foreign (국내·외 문헌적 비교를 통한 뇌졸중 환자에 대한 근력강화 운동의 고찰연구)

  • Oh, Taeyoung
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.1
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    • pp.113-124
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    • 2019
  • Purpose : The purpose of this study is to investigate the effect of strengthening program for improving the muscle strength and body function in rehabilitation of patients with stroke Methods : We found the 15 precedent studies at online portal site of "Korea education and Research information service" and found 5 precedent studies at "Pubmed". We analyzed and describe the total 19 studies involving national and international research. Results : The strengthening exercise was adapted to lower extremities and trunk muscle of participants and the isokinetic (concentric and eccentric) exercise was most of exercise type and then manual isometric exercise, functional activities, progressive task oriented resistance exercise, PNF pattern exercise was following. The studies reported that the strengthening program increased target muscle strength and improved balance capacity and walking function for the participants positively. Conclusion : Conclusionally the several strengthening program can be the intervention to increase the muscle strength without increasing spasticity for patients with stroke. We think that the strengthening of lower extremities an improve balance capacity and walking ability and it can use the intervention to change the quality of life in patients with stroke. More than 3weeks strength program might be effectiveness, in case of acute patients with stroke, the improving of muscle strength is available but need to study for improving balance and walking capacity more in the future.

Alport syndrome: new advances in the last decade

  • Kim, Ji Hyun
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.31-39
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    • 2022
  • Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked AS (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female "carriers" to "patients" and "thin basement membrane nephropathy" to "ADAS." In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

Rigid Bronchoscopy for Post-tuberculosis Tracheobronchial Stenosis

  • Hojoong Kim
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.4
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    • pp.245-250
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    • 2023
  • The healing process of tracheobronchial tuberculosis (TB) results in tracheobronchial fibrosis causing airway stenosis in 11% to 42% of patients. In Korea, where pulmonary TB is still prevalent, post-TB tracheobronchial stenosis (PTTS) is one of the main causes of benign airway stenosis causing progressive dyspnea, hypoxemia, and often life-threatening respiratory insufficiency. The development of rigid bronchoscopy replaced surgical management 30 years ago, and nowadays PTTS is mainly managed by bronchoscopic intervention in Korea. Similar to pulmonary TB, tracheobronchial TB is treated with combination of anti-TB medications. The indication of rigid bronchoscopy is more than American Thoracic Society (ATS) grade 3 dyspnea in PTTS patients. First, the narrowed airway is dilated by multiple techniques including ballooning, laser resection, and bougienation under general anesthesia. Then, most of the patients need silicone stenting to maintain the patency of dilated airway; 1.5 to 2 years after indwelling, the stent could be removed, this has shown a 70% success rate. Acute complications without mortality develop in less than 10% of patients. Subgroup analysis showed successful removal of the stent was significantly associated with male sex, young age, good baseline lung function and absence of complete one lobe collapse. In conclusion, rigid bronchoscopy could be applied to PTTS patients with acceptable efficacy and tolerable safety.

Effects of Six-week Resistance Exercise using an Outdoor Knee Extension Machine on Function and Structure of the Knee Extensor Muscles (6주간 야외용 운동기구를 사용한 저항운동이 노인 여성의 무릎신전근 기능 및 구조에 미치는 영향)

  • Choi, Dong-Sung;Kim, Jin-Sun;Kim, Dong-Il;Jeon, Justin-Y.;Won, Young-Shin;Lee, Hae-Dong
    • Korean Journal of Applied Biomechanics
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    • v.22 no.2
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    • pp.201-208
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    • 2012
  • The purpose of this study was to investigate the effect of leg extension exercises performed on outdoor resistance exercise machines on knee extension muscle strength and quadriceps muscle group cross sectional area (CSA) in elderly women. Two groups were recruited for this study, including an exercise group (EG: n=13, $71.38{\pm}2.79$ yrs) and a control group (CG: n=5, $73.4{\pm}5.94$), In all subjects, maximum isometric and isokinetic muscle strength of knee flexion and extension were measured using an isokinetic dynamometer (Cybex(R) Humac Norm Testing & Rehabilitation System, USA). Quadriceps muscle group CSA were measured using MRI (Philps, Intera 1.5 T, NE Netherlands). The results of this study showed that post-intervention isometric knee extension peak torque value were higher than pre-intervention measures in the EG. However, the EG did not show improvement in quadriceps muscle group CSA, Also, no differences in the shift of optimal knee joint angle were observed between pre and post-intervention exercise. Outdoor leg extension exercise showed small increases in muscle strength in comparison to other resistance training exercises. The results of this study suggest that because outdoor leg extension exercise machines lack a progressive loading mechanism, significant increases in muscle strength may not be obtained.

The latest development in Dementia (치매에 관한 최근의 연구 동향)

  • Na, Chang-Su;Kim, Jeong-Sang;Chae, U-Seok;Park, Seok-Cheon
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.291-300
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    • 1998
  • Dementia is the neurodegenerative process that affects cognition, behavior and function and one of the most prominent diseases of dementia is Alzheimer's disease(AD). AD is a dementing illness characterized clinically by the progressive and irreversible deafferentation of the limbic system, association neocortex and basal forebrain. A number of conditions are known to be predisposing risk factors for AD. In several of these, initiation of glial-mediated inflammatory pathways as a mechanism of AD is getting a lot of attention. On the other hand, a biochemical marker for monitoring the onset and progression of the disease would be a valuable tool for disease management. Also such a marker might be used as an end point in clinical intervention protocols. This biochemical marker will have the potential for identifying subjects afflicted with the disease and possibly for monitoring the onset and longitudinal progression of the disease. Here we have reviewed the latest papers of different approaches to AD. Of course, there is a section of PET which is very useful clinically nowadays.

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Multiple Tuberculoma Involving the Brain and Spinal Cord in a Patient with Miliary Pulmonary Tuberculosis

  • Park, Hyun-Seok;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.36-39
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    • 2008
  • Although tuberculosis of the central nervous system is well known, the incidence of intramedullary tuberculomas is low and a combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of disseminated tuberculoma involving brain and spine with miliary pulmonary tuberculosis in a 66-year-old woman initially presenting with fever, general weakness, back pain and motor weakness of both lower extremities. Despite medical therapy, she developed progressive motor weakness of both lower extremities with muscle strength 1/5 in both lower extremities. Urgent surgical intervention was followed and her muscle power and motor functions were improved gradually. The anti-tuberculous drugs were continued and the follow-up magnetic resonance imaging (MRI) of brain and spine showed that the lesions had become smaller or disappeared.

Necrotizing fasciitis of the masticator space with osteomyelitis of the mandible in an edentulous patient

  • Shin, Jongweon;Park, Song I;Cho, Jin Tae;Jung, Sung-No;Byeon, Junhee;Seo, Bommie Florence
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.270-273
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    • 2019
  • Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the subcutaneous tissue and fascia, caused by bacterial infection. Usually presenting in the extremities, trunk, or perineum, it is uncommon in the craniofacial or cervical area. Cervicofacial NF is a potentially fatal infection, which should be managed with early detection and intervention. Most cases have a primary odontogenic source of infection, especially when the masticator space is involved. We report a case of masticator space NF that developed without odontogenic origin in a 78-year old female who was treated with prompt surgical drainage and intravenous antibiotics.

Oral Manifestation of Unknown Hematopoietic Malignancy

  • Hyun Jun, Oh;Buyanbileg, Sodnom-Ish;Mi Young, Eo;Ju Young, Lee;Kyung-Hoe, Huh;Soung Min, Kim
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.162-165
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    • 2022
  • Burkitt lymphoma is a highly aggressive type of hematopoietic malignancy that is comparatively common in children and young people. It is important that Burkitt lymphoma be diagnosed as early as possible for prompt intervention due to its rapidly progressive, high-grade malignant nature. Dentists, especially maxillofacial surgeons, can play a life-saving role in patients with such unknown malignancy as the first clinical or radiological manifestation might occur in the oral region.

Clinical Experience of Pyoderma Gangrenosum with Extensive Soft Tissue Necrosis (광범위 연조직 괴사를 동반한 괴저농피증의 치험례)

  • Lim, Sung Yoon;Park, Dong Ha;Pae, Nam Suk;Park, Myong Chul
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.615-618
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    • 2008
  • Purpose: Pyoderma gangrenosum is a rare cutaneous ulcerative disease. First described in 1930, the condition is characterized by progressive ulceration with deeply undermined purple-red edge. The lower extremities are most commonly affected but other parts of the skin and mucous membranes may also be involved. Although medical treatments with topical wound therapy are commonly used, surgical intervention is still controversial. In this paper, we report an atypical case of pyoderma gangrenosum which was characterized by extensive soft tissue breakdown. Methods: A 27-year-old male patient was referred to our institution with a $7{\times}8cm$ sized deeply undermined ulceration with pus-like discharge and fever. Incision and drainage was performed at another clinic 3 days prior to admission to our institution. After a thorough physical examination and the MRI review, a diagnosis of necrotizing faciitis was made. Accordingly, fasciotomy and debridement was performed. However, the wound enlarged progressively and the patient remained highly febrile for 9 days after the treatment. Septic screening did not reveal any occult infection. After a secondary review of the case, the initial diagnosis of necrotizing fasciitis was rejected and changed to pyoderma gangrenosum. With the use of dexamethasone intravenously, the wound improved dramatically and the fever was eliminated. Steroid mediation was tapered with duration of 1 month. The wound was stabilized and subsequently covered with split-thickness skin graft. Results: Split-thickness skin grafting with 1 : 1.5 mesh was successfully taken. Conclusion: Initial clinical features of pyoderma gangrenosum are very similar to that of necrotizing fasciitis. High fever and progressive ulceration with severe pain could invite earlier surgical approach. The advancing wound margins (the well defined violaceous, undermined border and necrotic ulcer base) and lack of isolation of pathogenic organism was used to make the correct diagnosis of pyoderma gangrenosum. We achieved a good result with proper medication and split-thickness skin graft.

A Clinical Study of Treatment with Scalp Acupuncture for Learning Disorders (학습장애 아동의 두침 병행 치료 효과에 대한 임상적 연구)

  • Lee, Yu-Jin;Yoo, Song-Wun;Lee, Su-Bin;Ko, In-Sung;Park, Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.2
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    • pp.145-154
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    • 2013
  • Objectives : The purpose of this study is to examine the effects of treatment with scalp acupunctures for children with learning disorders. Methods : For this study, we evaluated Korea standard progressive matrices test (K-SPM) on 24 children with learning disorders who visited Korean medical center neuropsychiatry outpatient clinic from July 2012 to January 2013. Scalp acupuncture, cognitive enhancement therapy and speech-language therapy were applied. All children were treated 2 times a week for 4 months and we compared K-SPM test scores before treatment and 30 times after the treatment. Results : 1) After the treatment, K-SPM test scores have increased significantly (p<0.05) and the number of children in grade 5 (<5%) have decreased from 14 to 6. 2) Comparing K-SPM test scores between two groups: one with medical history and the other without medical history, the scores in both groups have increased significantly (p<0.05). 3) We also divided the children into two groups according to age: under the age of 13 and over the age of 13, and compared K-SPM test scores. Although the scores in both groups have increased respectively, it is the scores of the former group (under the age of 13) that have increased significantly (p<0.05). Conclusions : The treatments with scalp acupunctures were shown to be an effective intervention when improving K-SPM test scores of children with learning disorders.