• Title/Summary/Keyword: Short-term therapy

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Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study

  • Ji Eun Im;Eun Yeung Jung;Seok Soo Lee;Ho-Ki Min
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.96-102
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    • 2024
  • Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

Management issues of congenital adrenal hyperplasia during the transition from pediatric to adult care

  • Choi, Jin-Ho;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.60 no.2
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    • pp.31-37
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    • 2017
  • Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care.

The Effects of Screen Smart Devices on the Neck Flexion Angle

  • Lee, Jun Cheol;Kim, Kyung
    • Journal of International Academy of Physical Therapy Research
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    • v.7 no.2
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    • pp.1051-1055
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    • 2016
  • The purpose of this study was to investigate the effect of the screen size of smart devices on the bending angle of the cervical spine. The subjects of this study were 30 healthy adults(15 men and 15 women) who used smartphones and tablet PC(personal computer). The changes in the bending angle of the upper and lower cervical spine were measured in the subjects after they had used a smartphone and a tablet PC for 300 seconds each. To make sure that all subjects began in the same starting position, an angle-measuring instrument was used to set the angles of the ankle, knee, hip, and arm joints to 90 degree. The subjects were asked to keep the trunk straight. They were asked to hold a smartphone in their hand and to bend their neck so that they could look down at the screen. Once they began using the smartphone in this manner, they were free to change their posture. We used a paired t-test to compare the bending angle of the cervical spine on subjects who used smartphones and tablet PC in the long-term and short-term there production error of cervical and the significance level was cervical. The results showed that, when using a smartphone and a tablet PC for 300 seconds, there was no significant difference in the bending angle of the upper cervical spine(p>.05), although there was a significant difference in the bending angle of the lower cervical spine(p<.05).

The Effect of Joint Mobilization on the Expressions of Nadph-Diaphorase and Nitric Oxide Synthase in the Spinal Cord Neurons

  • Kuwaoka, Toshifumi;Jung, HanSuk;Ham, JooHyun;Choi, JinOk;Cho, HyeRin
    • Applied Microscopy
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    • v.45 no.3
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    • pp.135-143
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    • 2015
  • The aim of this study was to investigate effects on joint mobilization in neurochemical changes of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) and nitric oxide synthase (NOS) of the spinal cord neurons after right knee joint immobilization (RKJI) and in ultrastructural changes of the femoral nerves innervating the muscles acting on RKJI. A total of 15 guinea pigs were used and divided into 5 groups. Immunohistochemistry was performed to detect NADPH-d and NOS. NADPH-d and NOS were not expressed in the ventral horn of control and experimental groups, but were expressed or not in the dorsal horn according to the duration of release after RKJI and the presence or absence of joint mobilization. Ultrastructures of the femoral nerves in experimental groups had partial demyelination and condensed clumps in axon. Effects on manipulative therapy after RKJI were confirmed from expression of NADPH-d and NOS in the dorsal horn of the lumbosacral spinal cord. Manipulative therapy was more effective against a long-term immobilization than a short-term immobilization.

The Clinical Study of Three Patients Hospitalized Due To Sudden Sensorineural Hearing Loss (돌발성 난청 환자 3례에 대한 임상적 고찰)

  • Kwon, Kang;Choi, Kwan-Ho;Park, Jae-Young;Owi, Jong-Sung;Park, Hee-Soo;Park, Young-Hwan
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.156-168
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    • 2002
  • Backgrounds : sudden sensorineural hearing loss is defined as a disease that has abrupt onset of sensorineural hearing loss without definite cause. In some cases, this disease cause tinnitus, vertigo, headache addition to hearing loss. In traditional oriental medicine, sudden sensorineural hearing loss is could be diagnosed as deficiency of Yang-Gi(陽氣). Objects & Methods : This study is clinical observation about three sudden sensorineural hearing loss cases. For diagnosing in these cases, pure tone audiometry was used. For treatment, acupuncture, herbal-medicine and moxibustion therapy were used. Results & Conclusions : as follows. 1. Generally, in this disease, the shorter the whole period from the time that occurs to the time that starts to treat is, the more the results are better. The research shows that short-term case is more efficient than the other long-term two cases in the aspects of symptoms and pure tone audiometry . 2. In making a diagnosis of sudden sensorineural hearing loss and measuring the effect, subjective symptoms generally correspond to the improvement of pure tone audiometry, but not completely. Therefore, in treating patients, the doctor must consider these both aspects and keep the balance.

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A Case Series Report on 11 Patients of Primary Palmar/Plantar Hyperhidrosis in Children and Adolescents Treated with Hospitalization Program of a Hyperhidrosis Clinic (다한증 입원 프로그램을 통해 치료한 소아 및 청소년 수족다한증 11례에 대한 증례보고)

  • Kim, Kwan-Il;Lee, Hee-Beom;Choi, Kyu-Hee;Jung, Sung-Ki;Jung, Hee-Jae
    • The Journal of Internal Korean Medicine
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    • v.33 no.3
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    • pp.327-337
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    • 2012
  • Objectives : The purpose of this study was to report the clinical effect of short- term admission program on primary palmar/plantar hyperhidrosis in children and adolescents. Methods : Between January 2011 and January 2012, a total of 11 patients with clinical diagnosis of primary palmar/plantar hyperhidrosis were treated with hospitalization which consisted of iontophoresis, electro-acupuncture, herbal medicine, topical therapy and physical therapy. The effects were evaluated as quality of life with dermatology life quality index (DLQI), severity of discomfort using visual analogue scale (VAS), and the patients' subjective satisfaction. We analyzed the patients' improvement before and after admission treatment, as well as six month later. Results : After treatment, the 11 patients' quality of life and severity of discomfort improved significantly. They also were satisfied with oriental treatments for hyper hidrosis. Six months later, 6 of 11 patients had visited the hyperhidrosis clinic. Their symptoms had improved and remained stable. Conclusions : The short-term admission program is effective on primary palmar/plantar hyperhidrosis. Further studies with a larger number of cases will be needed in the future.

Changes of body composition in obese women with short-term low calory diets (비만 여성을 대상으로 한 단기간의 저열량 식사요법에서 체구성 성분의 변화)

  • Lee, Hong-Gi;Lee, Yeong-Geon;Lee, Bok-Gi;Lee, Gyu-Rae;Kim, Gyeong-Gon;Gang, Hui-Cheol;Yun, Bang-Bu
    • Journal of Korea Association of Health Promotion
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    • v.3 no.1
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    • pp.24-34
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    • 2005
  • Background: A reasonable weight reduction is to reduce fat-body mass while preserving free-fat mass. Recently, many people in Korea have been trying reckless diet therapy for weight reduction by low calory and protein diets, which gave rise to many side effects consequently. For reasonable weight reduction, this study was undertaken to investigate the influential diet factors that change body composition during short-term low calory diet. Methods: 26 healthy obese women aged 23-27 years whose BMI was greater than 24volunteered for the 6 week diet therapy from January to April in 2003. All subjects were instructed to eat approximately 1200kca1/day and write dietary diary. In the beginning of the study, the 3rd week and the 6th week, subjects' body weight and fat body weight were measured by BlA. In the 6th week, the analysis of dietary diary was conducted. Results : There was significant positive correlation between protein intake per ideal bodyweight in the first 3 weeks and free fat mass increase in the later 3 weeks (P<0.05). At the same time, fat intake in the first 3 weeks had positive correlation with free fat mass in the second 3 weeks, too(P<0.05). But, we could not find any significant values that had effect on free fat mass increase in multiple regression analysis. Conclusion: The protein intake in the first 3 weeks helps preserve fat free mass in the later 3 weeks, and has positive effects.

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Pharmacogenomics of Depressive Disorders (우울증의 약물유전체학)

  • Ham, Byung-Joo;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.226-232
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    • 2001
  • The pharmacotherapy of depression has reduced morbidity and improved outcome for many depressive patients. A wide range of classical and new antidepressants are available for their treatment. However, 30-40% of all patients do not respond sufficiently to the initial treatment and present adverse effects. Pharmacogenetics studies the genetic basis of an individual's ability to respond to pharmacotherapy. Recently, some reports on serotonin transporter gene polymorphisms and their influence on the response to antidepressive therapy provide an interesting diagnostic tool in assessing the chances of response to antidepressants. We also investigated the relationship between serotonin transprter polymorphisms(5-HTTLPR) and the long-term effect of the antidepressant treatment. 128 depressive patients were enrolled into 2nd year study. The therapeutic response of each subset was not different at 8th, 16th week, but the subset with homozygote(l/l) of long variant showed a better therapeutic response to antidepressant than the heterozygote(l/s) of long and short variant, which showed a better therapeutic response than the subset with homozygote (s/s) of short variant at 1st year and 2nd year after the antidepressant treatment. This result shows that the serotonin transporter polymorphisms may be related to the long-term effect of antidepressant treatment. The potential for pharmacogenomics, the use of genetic information to guide pharmacotherapy and improve outcome by providing individualized treatment decisions, has gained increasing attention. pharmacogenomics will contribute to individualize drug choice by using genotype to predict positive clinical outcomes, adverse reactions, and levels of drug metabolism. Personalized medicine, the use of marker-assisted diagnosis and targeted therapies derived from an individual molecular profile, will impact the antidepressant therapy and this approach will replace the traditional trial-and-error practice of medicine.

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Effects of Combined Postural Correction Exercises on Selected Muscle Activity and Stiffness in Children With Cerebral Spastic Diplegia: Case Study (융합적 자세교정치료가 뇌성경직양측마비 아동의 선택된 근육 활성도와 강직도에 미치는 영향: 사례연구)

  • Shim, Jae-Hun;Kang, Min-Soo
    • Journal of the Korea Convergence Society
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    • v.9 no.2
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    • pp.91-99
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    • 2018
  • The aim of this study was to investigate the short-term effects of combined postural correction exercises (CPCE) on muscle stiffness and muscle activity in children with cerebral spastic diplegia(CSD). The subjects were 3 children (2 male and 1 female) with CSD from 4 to 7 years old. The measurement sites were upper trapezius muscle(UT), rectus abdominis muscle(RA), and gluteus maximus muscle(Gmax), muscle stiffness and muscle activity were measured using Myoton and surface EMG, and the symmetry of both sides was also examined. As a result, children with severe compensatory action showed decreased muscle stiffness and muscle activity in UT and RA and increase in Gmax after CPCE intervention. Especially, the left and right symmetry of the muscles was decreased. In this study, despite some limitations, CPCE have shown a positive effect in posture correction of children with CSD.

Effect of Manual Therapy on a Patient With Atlantoaxial Rotatory Subluxation (환축추 회전 아탈구 환자에 대한 도수치료 효과)

  • Jeon, Jae-guk;Yang, Seong-hwa;Shin, Eui-ju
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.25 no.1
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    • pp.71-76
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    • 2019
  • Background: An 8-year-old girl had severe neck pain and stiffness after trauma. CT scan showed atlantoaxial rotatory subluxation (AARS). She had conservative treatment because she did not have neurological symptoms and spinal basilar artery dysfunction. Conservative therapy was halter traction twice for 4 weeks. However, pain and stiffness persisted. She had been recommended to have surgery from her physician, but she received manual therapy for non-surgical procedures. Methods: The joint mobilization, muscle energy technique, motor control exercise, and deep neck flexor (DNF) endurance exercise were applied as manual therapy and 10 session for 2weeks. Results: Clinical outcomes were measured at initial baseline, after 2 weeks, and after 6weeks. Active range of motion was completely restored after 6weeks and numeric pain rating scale was completely reduced after 2 weeks. The strength of neck flexor muscle recovered to normal after 2 weeks, and the DNF endurance was improved to 25 seconds after 2 weeks and to 42 seconds after 6weeks. Motor control capacity recovered to 30 ㎜Hg after 2 weeks. Conclusions: This case report describes the immediate and short-term clinical outcomes for a patient presenting with symptoms of neck pain following AARS. Clinical rationale and patient preference aided the decision to incorporate manual therapy as a treatment for this patient. Manual therapy has shown a successful recovery in AARS patients, more research is needed to validate the inference of this case report.