• Title/Summary/Keyword: The Disabled

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DENTAL TREATMENT OF A PEDIATRIC PATIENT WITH HOMOZYGOUS PROTEIN C DEFICIENCY: A CASE REPORT (동형접합성 단백 C 결핍 환아의 치과적 치험례)

  • Yoon, Mi;Kim, Seung-Oh;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.207-212
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    • 2010
  • Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.

The Experiences of Sexually Abused Women with Intellectual Disability in the Ecosystems Perspective: Focused on Disabled Women Living in Residential Care Facilities (생태체계 관점에서 본 성폭력 피해 지적장애여성의 성폭력 이후의 경험에 대한 연구: 시설거주 장애인을 중심으로)

  • Kim, Ji-Hye;Kim, HeeJoo
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.382-395
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    • 2017
  • This study attempted to examine how sexually abused women with intellectual disability living in residential care facilities interact with their environment, such as personal life, family and communities, and to identify contextual characteristics and needs of these women. Qualitative case study method was adopted, and data was collected through individual and intake interviews, participant observation and a survey with 11 participants residing in a residential care facility for sexually abused women with intellectual disability. The results showed that participants struggled with stresses and emotional instability affected by traumatic experiences of sexual abuse. Family was a system that sexual abused took place, while the systems of residential facilities protected them from potential dangers and violence. Work and school systems also provided them opportunities of learning and having dreams in the future. However, the community system which participants would live after discharging from the facility, had risk factors vulnerable to sexual violence against participants. In conclusion, this study suggested diverse services and programs, such as professional psychotherapy programs, integrated support programs for victim and their families and provision of professional care facilities.

The guideline and outcome about powered wheelchair use for children with disabilities (장애아동을 대상으로 한 전동휠체어 적용 지침 및 성과)

  • Kim, Mijung;Kim, Seoeun;Ma, Hyunjeong
    • Therapeutic Science for Rehabilitation
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    • v.4 no.2
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    • pp.17-32
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    • 2015
  • Purose : This study was to find the factors of guideline and expressing outcome about powered wheelchair use for children with disabilities. Method : The chosen studies were 38 published in Korea or abroad from 2000 to 2014, and the key research is 2 review articles among them. And 19 studies were used by first search and 2 review articles to find outcome factors and categorize followed ICF terminology. Moreover, 2 studies were analysed to find the guidelines about powered wheelchair use for children with disabilities. Result : All reviewed researches were published abroad. These suggested that powered wheelchair use for children with disabilities didn't affect delayed development but many advantages. And they recommended checking information about the guideline, child, parents and environmental support befor applying the powered wheelchair to children with disabilities. Also, they usually used participation level to express outcome about powered mobility use. Conclusion : The power wheelchair was useful means of mobility for children who were delayed movement, and it was important strategy to apply the powered wheelchair early for promote children's development and participation normally. Finally, professionals needed to intervene contextual approaches concerning children's families and environment, also institutional and social effort.

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.

Empirical Study on Cooperative Ship Operation and A Free Contract on the Towage Market (항만예선업시장의 공동배선제와 자유계약제에 대한 실증적 분석)

  • Kim, Kwang-Hee
    • Journal of Korea Port Economic Association
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    • v.25 no.3
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    • pp.67-92
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    • 2009
  • A tugboat (tug) is a boat that maneuvers vessels by pushing or towing them. Tugs move vessels that should not move themselves alone, such as ships in a crowded harbor or a narrow canal, or those that cannot move themselves, such as barges, disabled ships, or oil platforms. Tugboats are powerful for their size and strongly built, some are ocean-going. Historically tugboats were the first seagoing vessels to receive steam propulsion, freedom from the restraint of the wind, and capability of going in any direction. As such, they were employed in harbors to assist ships in docking and departure. Towage is in essence a service by one vessel to another vessel for a fixed remuneration. The most common reason for requiring this service is the lack of its own motive power. Conventionally, towage is defined as "the employment of one vessel to expedite the voyage of another, when nothing more is required than the accelerating of her progress". Apart from accelerating vessels, acquiring towage service is a common practice for towing barges, platform of drilling oil, floating ship yards, etc.

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Effect of Sensory Integration Group Therapy on Sensory Processing, Peer Interaction and Task Performance of Children With Intellectual Disabilities (그룹감각통합치료가 지적장애아동의 감각처리와 또래상호작용, 과제수행에 미치는 영향)

  • Choi, Ji-Hyon;Kim, Hee;Lee, Jae-Shin;Yoo, Doo-Han
    • Korean Journal of Occupational Therapy
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    • v.26 no.4
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    • pp.111-125
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    • 2018
  • Objective : This study was designed to determine the effects of sensory integration group therapy with regard to the sensory processing, peer interactions, and task performance, and whether they continue. Methods : Twelve children aged 7 to 13 years enrolled in this study for 60 minutes per session, three times a week for 8 weeks. Sensory integration group therapy consisted of a total of 24 activities that included sensory processing, play skills, and interaction with peers. Short Sensory Profile was used to select subjects. In order to measure the outcome, we used the Short Sensory Profile, Penn Interactive Peer Play Scale and Canadian Occupational Performance Measure at pre, post, and follow-up evaluations. The results were analyzed by means of repeated measures analysis, and the pre-test, post-test, and follow-up tests were compared using the Wilcoxon matched-pair signed rank test. Results : After sensory integration group therapy, sensory processing, peer interaction, and task performance significantly improved(p<.05). In addition, we confirmed that the effects of treatment were maintained in the 4 weeks follow-up test. Conclusion : Sensory integration group therapy is an effective way of mediating effects not only by improving sensory processing skills, but also by providing imitation and training in groups for children in need of peer interaction and linking them to daily life.

A Method of Feature Extraction on Motor Imagery EEG Using FLD and PCA Based on Sub-Band CSP (서브 밴드 CSP기반 FLD 및 PCA를 이용한 동작 상상 EEG 특징 추출 방법 연구)

  • Park, Sang-Hoon;Lee, Sang-Goog
    • Journal of KIISE
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    • v.42 no.12
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    • pp.1535-1543
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    • 2015
  • The brain-computer interface obtains a user's electroencephalogram as a replacement communication unit for the disabled such that the user is able to control machines by simply thinking instead of using hands or feet. In this paper, we propose a feature extraction method based on a non-selected filter by SBCSP to classify motor imagery EEG. First, we divide frequencies (4~40 Hz) into 4-Hz units and apply CSP to each Unit. Second, we obtain the FLD score vector by combining FLD results. Finally, the FLD score vector is projected onto the optimal plane for classification using PCA. We use BCI Competition III dataset IVa, and Extracted features are used as input for LS-SVM. The classification accuracy of the proposed method was evaluated using $10{\times}10$ fold cross-validation. For subjects 'aa', 'al', 'av', 'aw', and 'ay', results were $85.29{\pm}0.93%$, $95.43{\pm}0.57%$, $72.57{\pm}2.37%$, $91.82{\pm}1.38%$, and $93.50{\pm}0.69%$, respectively.

Dental Treatment of a Patient with Cerebral Palsy under General Anesthesia (뇌성마비 환자의 전신마취 하 치과치료)

  • Chung, Jun-Min;Seo, Kwang-Suk;Yi, Young-Eun;Han, Hee-Jung;Han, Jin-Hee;Kim, Hye-Jung;Shin, Teo-Jeon;Kim, Hyun-Jeong;Yum, Kwang-Won;Chang, Ju-He
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.1
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    • pp.22-28
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    • 2008
  • Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

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A Meta-Analysis on Improvement in Locomotor Skills of Children with Disabilities by Physical Activity Programs (신체활동 프로그램 참여가 장애아동의 이동운동능력에 미치는 효과: 메타분석)

  • Han, Byum Suk;Lee, Tae Hee;Chun, Hea Ja
    • 재활복지
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    • v.20 no.3
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    • pp.83-104
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    • 2016
  • The purpose of this study was to identify improvement in locomotor skills by physical activity programs. Method of this study indicates that the current literature (2004-2015) were reviewed and the data from 24 studies with 518 disabled children were analyzed by using CMA3 (Comprehensive Meta-Analysis ver.3) program. Analyzing the data of the primary studies included gender, age, type of disabilities, duration of the physical activity program intervention(weeks, session per week, minutes per session), run, gallop, hop, leap, horizontal jump, and slide. For sensitivity analysis, publication bias and outlier were reviewed. Results of analysis indicates that the overall effect size of improvement in locomotor skills by physical activity programs was 1.143. There were large effect size in categorical analyses. Autistic spectrum among type of disabilities was 1.697 and run among 6 of locomotor skills was 1.019. 8~10 aged was 0.920 and the intervention of 100~120minutes(1.261)per session, 3sessions(1.078) per week, 16~20(1.587)weeks was found to be more larger than the others. In conclusion, improvement in locomotor skills by program participation showed that treated group was 37% more effective than control group.

Effect of Sensory Integration Group Therapy on Fine Motor, Social Interaction and Playfulness of Preschool Children With Intellectual Disabilities (그룹감각통합치료가 학령전기 지적장애 아동의 소근육 기능, 상호작용 및 놀이에 미치는 영향)

  • Choi, Ji-Hyun;Kim, Hee
    • The Journal of Korean Academy of Sensory Integration
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    • v.16 no.1
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    • pp.25-34
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    • 2018
  • Objective : This study aims to figure out the effect that sensory integration group therapy has on the fine motor, social interaction and playfulness of preschool children with intellectual disability. Methods : Participants were four children from three to five years old who were diagnosed with intellectual disabilities and they participated in twelve sessions of sensory integration group therapy, sixty minutes per session and once a week. Sensory integration group therapy was composed of parallel and peer play-centered gross motor activities, art activities and sensory plays that were related to each theme. Erhardt Developmental Prehension Assessment (EDPA), Penn Interactive Peer Play Scale (PIPPS) and Test of Playfulness (ToP) were used to evaluate participants' fine motor, social interaction and playfulness before and after the intervention. Results of fine motor, social interaction and playfulness before and after the intervention were compared using Wilcoxon matched-pair signed rank test. Results : After sensory integration group therapy intervention, the fine motor skills of participants did not show significant increases, but social interaction and playfulness showed significant increases (p< .05). Conclusion : Although sensory integration group therapy with preschool children with intellectual disability did not show positive improvement in fine motor skills, it showed positive effect on social interaction and playfulness. Group sensory integration therapy might be an intervention approach for all children with disabilities.