• Title/Summary/Keyword: course outcome

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The Effect of Sensory Integrative Intervention Focused on Proprioceptive-Vestibular Stimuli on Adaptive Response of Children With Sensory Defensiveness: Case Study (고유-전정감각 중심의 감각통합 중재가 감각방어 아동의 적응반응에 미치는 효과: 사례보고)

  • Park, Ji-Hoon;Kim, In-Sun
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.2
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    • pp.29-39
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    • 2011
  • Objective : The purpose of this study is to verify the effect of sensory integrative intervention focused on proprioceptive-vestibular stimuli on adaptive response of children with sensory defensiveness. Methods : Subject of this study was a 6 years and 5 month old boy. The subject underwent a sensory integration (SI) treatment which was part of the SI treatment course administered by the Korean Sensory Integration Society, in 2011. The treatment goal and treatment plan had established based on the evaluation results. Treatment was done with 4 sessions and the adaptive responses of the subject were measured as outcome of the SI treatment. Results : During the SI treatment, the subject could participate in activities involving tactile stimulation without over-arousal. He also showed improved social interaction skills and his play was qualitatively extended. Conclusion : According to the results of this study, it was verified that sensory integrative intervention focused on proprioceptive-vestibular stimuli has positive effective on adaptive response for children with sensory defensiveness. For the future study, it is suggested to use standardized assessments in evaluation and provide information in changes of daily occupation as outcome data.

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The outcome of short-term low-dose aspirin treatment in Kawasaki disease based on inflammatory markers

  • Yoo, Jae Won;Kim, Ji Mok;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.60 no.1
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    • pp.24-29
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    • 2017
  • Purpose: Previously, Kawasaki disease (KD) treatment with low-dose aspirin was administered for 6-8 weeks after the acute phase. However, inflammatory marker levels normalize before 6-8 weeks. In this study, we aimed to investigate the clinical outcome of short-term low-dose aspirin treatment based on inflammatory and thrombotic marker levels. Methods: We performed a retrospective review of the medical records of patients with KD who were hospitalized at Chungnam National University Hospital between September 2012 and May 2014. When fever subsided, low-dose aspirin treatment was started. Inflammatory (white blood cell count, erythrocyte sedimentation rate, and C-reactive protein) and thrombotic markers (D-dimer) were monitored at follow-ups conducted in 1- to 2-week intervals. The low-dose aspirin administration was terminated when both markers were normalized and no cardiovascular complications were observed. Results: Eighty-four patients with KD (complete KD, n=49; incomplete KD, n=35) were enrolled. The inflammatory and thrombotic marker levels were normalized within 3-4 weeks on average. At the beginning the low-dose aspirin treatment, 9 patients had coronary artery lesions but 75 did not. When the low-dose aspirin administration was terminated at the time the inflammatory marker levels were normalized, no new CALs developed during the follow-up at 6-8 weeks. Conclusion: Most of the inflammatory marker levels were normalized within 3-4 weeks after the acute phase of KD. New cardiovascular complications did not develop during the course of the short-term aspirin treatment based on the inflammatory marker levels, clinical findings, and echocardiography.

Decompressive Hemicraniectomy and Duroplasty in Toddlers and Preschool Children with Refractory Intracranial Hypertension after Unilateral Hemispheric Stroke

  • Lee, Sang-Kook;Kim, Sang-Dae;Kim, Se-Hoon;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.86-90
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    • 2012
  • Objective : Life-threatening hemispheric stroke is associated with a high mortality and morbidity. Decompressive hemicraniectomy has been regarded as an effective treatment option for refractory intracranial hypertension. Here, we reported the clinical course of 5 children with decompressive craniectomy and duroplasty after non-traumatic refractory intracranial hypertension. Methods : Four toddlers and one preschool-girl were included in this study; there were 3 boys and 2 girls with a mean age of 34.6 months (range 17-80). Decompressive craniectomy including duroplasty was performed in cases of dilatation of pupil size after intensified standard medical therapy had proven insufficient. All children had a Pediatric Glasgow Coma Scale score <8 at pre-operation state. The mean time-point of craniectomy after stroke attack was 12 hours (range 4-19). Results : During the long-term follow-up period (mean 47.6 months), no children died. One year later, when we checked their Glasgow Outcome Scale scores, only one toddler received a score of 4 (moderate disability). But the others had good recoveries although they had minor physical or mental deficits. According to the Pediatric Cerebral Performance Category Scale, 4 children received a score of 2 (mild disability). Conclusion : Despite our small cases, we suggest that decompressive hemicraniectomy and duroplasty is an acceptable and life-saving treatment for refractory intracranial hypertension after unilateral hemispheric stroke in toddlers and preschool children.

A Qualitative Study on the Learning Outcome of PBL Instruction (PBL 수업적용에 따른 학습 성과에 관한 질적 연구)

  • Kim, Kyung-Hwa
    • The Journal of the Korea Contents Association
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    • v.17 no.12
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    • pp.191-201
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    • 2017
  • The purpose of this study was to examine the learning outcome of problem-based learning as an efficient teaching method to improve the competencies of great talents for future society. A general education course of a university that was one of teaching profession courses titled "prevention of school violence and countermeasures" was provided in the form of PBL, and data were gathered, which were reflective journals, evaluation sheet and observational journals. As a result, PBL produced learning effects such as understanding and applying learning contents, fostering cooperativeness, problem-solving skills and a sense of responsibility, extended thinking and good understanding of PBL. Also, that provided a great opportunity for the students to build up their character by learning caring and by improving cooperativeness, a sense of responsibility and communicative competency, which preservice teachers should have. The findings of the study suggest that the expansion of PBL is necessary to bolster problem- solving skills, self-directed learning, cooperativeness and creativity that are competencies required in the era of the Fourth Industrial Revolution.

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

  • Yu, Qi;Lin, Kun;Liu, Yunhui;Li, Xinxing
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.248-260
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    • 2020
  • Objective : To investigate the efficiency of diffusion tensor imaging (DTI) fiber-tracking based neuronavigation and assess its usefulness in the preoperative surgical planning, prognostic prediction, intraoperative course and outcome improvement. Methods : Seventeen patients with cerebral masses adjacent to corticospinal tract (CST) were given standard magnetic resonance imaging and DTI examination. By incorporation of DTI data, the relation between tumor and adjacent white matter tracts was reconstructed and assessed in the neuronavigation system. Distance from tumor border to CST was measured. Results : The sub-portion of CST in closest proximity to tumor was found displaced in all patients. The chief disruptive changes were classified as follows : complete interruption, partial interruption, or simple displacement. Partial interruption was evident in seven patients (41.2%) whose lesions were close to cortex. In the other 10 patients (58.8%), delineated CSTs were intact but distorted. No complete CST interruption was identified. Overall, the mean distance from resection border to CST was 6.12 mm (range, 0-21), as opposed to 8.18 mm (range, 2-21) with simple displacement and 2.33 mm (range, 0-5) with partial interruption. The clinical outcomes were analyzed in groups stratified by intervening distances (close, <5 mm; moderated, 5-10 mm; far, >10 mm). For the primary brain tumor patients, the proportion of completely resected tumors increased progressively from close to far grouping (42.9%, 50%, and 100%, respectively). Five patients out of seven (71.4%) experienced new neurologic deficits postoperatively in the close group. At meantime, motor deterioration was found in six cases in the close group. All patients in the far and moderate groups received excellent (modified Rankin Scale [mRS] score, 0-1) or good (mRS score, 2-3) rankings, but only 57.1% of patients in the close group earned good outcome scores. Conclusion : DTI fiber tracking based neuronavigation has merit in assessing the relation between lesions and adjacent white matter tracts, allowing prediction of patient outcomes based on lesion-CST distance. It has also proven beneficial in formulating surgical strategies.

Clinical Significance of Bifrontotemporal Decompressive Craniectomy in the Treatment of Severe Refractory Posttraumatic Brain Swelling (중증 외상성 뇌부종 환자에서 양측 전두-측두부 감압적 개두술의 의의)

  • Shin, Hyung Shik;Kim, Jin Yong;Kim, Tae Hong;Hwang, Yong Soon;Kim, Sang Jin;Park, Sang Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1179-1183
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    • 2000
  • Objective : The treatment of malignant posttraumatic brain swelling remains a frustrating endeavor for neurosurgeon. Mortality and morbidity rates remain high depite advances in medical treatment of increased intracranial pressure. If conventional therapy fails in patients suffering from intracranial hypertension, there is only small number of second-tier option left including decompressive craniectomy. The role of decompressive craniectomy in posttraumatic brain swelling remains controversial. We assessed the efficacy and indications of decompressive craniectomy. Methods : The authors performed decompressive bifrontotemporal craniectomy in 22 patients with malignant posttraumatic brain swelling. Epidural pressure monotoring was performed in all patients. The clnical data and surgical outcomes were reviewed retrospectively. Result : The favorable outcome(GOS score 4-5) was 59%(13 of 22 patients), whereas the mortality rate was 32% (7 of 22 patients). Two patients(9%) remained in severely disabled state. Increased rate of favorable outcome was seen in the patients who had 8 or more of GCS score at admission and exhibited B wave in ICP monitoring and who showed steady state or slow deterioration in clinical course. Conclusion : If conservative therapy fails, decompressive bifrontotemporal craniectomy should be considered in the management of malignant posttraumatic brain swelling before irreversible ischemic brain damage occur.

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Adipose-Derived Stem Cells Improve Efficacy of Melanocyte Transplantation in Animal Skin

  • Lim, Won-Suk;Kim, Chang-Hyun;Kim, Ji-Young;Do, Byung-Rok;Kim, Eo Jin;Lee, Ai-Young
    • Biomolecules & Therapeutics
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    • v.22 no.4
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    • pp.328-333
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    • 2014
  • Vitiligo is a pigmentary disorder induced by a loss of melanocytes. In addition to replacement of pure melanocytes, cocultures of melanocytes with keratinocytes have been used to improve the repigmentation outcome in vitiligo treatment. We previously identified by in vitro studies, that adipose-derived stem cells (ADSCs) could be a potential substitute for keratinocytes in cocultures with melanocytes. In this study, the efficacy of pigmentation including durability of grafted melanocytes and short-term safety was examined in the nude mouse and Sprague-Dawley rat after grafting of primary cultured human melanocytes, with or without different ratios of primary cultured human ADSCs. Simultaneous grafting of melanocytes and ADSCs, which were separately cultured and mixed on grafting at the ratios of 1:1, 1:2, or 1:3, showed better efficacy than that of pure melanocytes. Grafting of melanocytes cocultured with ADSCs resulted in a similar outcome as the grafting of cell mixtures. Skin pigmentation by melanocytes : ADSCs at the ratios of 1:1 and 1:2 was better than at 1:3. No significant difference was observed between the 1-week and 2-week durations in coculturing. Time-course microscopic examination showed that the grafted melanocytes remained a little longer than 6-week post-grafting. No inflammatory cell infiltration was observed in the grafted skin and no melanocytes were detectable in other organs. Collectively, grafting of melanocytes and ADSCs was equally safe and more effective than grafting of melanocytes alone. Despite the absence of significant differences in efficacy between the group of 1:1 and that of 1:2 ratio, 1:2 ratio for 1-week coculturing may be better for clinical use from the cost-benefit viewpoint.

Automation of Fuel Filter Manufacturing Process Via IT Convergence (IT융합기반의 연료필터 제조공정 자동화)

  • Yun, Suck-Chang;Han, Woo-Hyun;Yoon, Dal-Hwan
    • Journal of IKEEE
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    • v.19 no.1
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    • pp.64-72
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    • 2015
  • In this paper, we have developed the gantry automation system via information technology (IT) to improve the productivity of fuel filter manufacturing process. The monitoring system of manufacturing process plays an important role in analyzing the defective products as well as improving the production yield rate. The experimental results of 3 months with 10000 samples validate that the error rate is decreased from 0.65 % to 0.45 %. Also, the defect of raw material is decreased via monitoring of material tools which can notify the time for replacement and accurate insertion of raw materials to the loader. The productivity is increased by reducing the process time from 94.7 sec to 78.8 sec per raw material through comparing the whole manufacturing courses : from inserting of raw material to outcome of product. The process time is decreased by 20.2 % by automation of inserting and outcome course. Moreover, safety of worker as well as reduction of transfer time are highly related with increase of productivity.

Chronic Lymphocytic Leukemia and Prognostic Factors

  • Mozaheb, Zahra;NazarAbadi, Mohamad Hasan Hasanzadeh;Aghaee, Monavar Afzal
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3009-3013
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    • 2012
  • Background: The clinical course of individual chronic lymphocytic leukemia (CLL) is highly variable and clinical staging systems do not help us to predict if and at what rate there will be disease progression in an individual patient diagnosed with early stage disease. Recently, several important observations related to other prognostic factors including lymphocyte doubling time (LDT), ${\beta}_2$-microglobulin (${\beta}_2$-MG), and percent of smudge cell in peripheral blood smears, cytogenetic and molecular analysis have been made. The aim of this study was to evaluate a range of prognostic factors in our CLL patients. Design and methods: Seventy patients with CLL were enrolled. Prognostic factors of disease including Binet staging, LDT, ${\beta}_2$-MG, ESR, LDH, percent of smudge cell in peripheral blood smear, absolute lymphocyte count, and conventional cytogenetic (CC) analysis were evaluated at diagnosis, and the patients were followed up to determine their outcome. We compared factors with each other and with Binet staging and prognosis. Results: Enrolled patients aged 37-85 years at diagnosis or during follow up. There was no relationship between serum LDH level (P=0.3), ESR (P=0.11), percent of smudge cells in peripheral blood smear (P=0.94), and absolute lymphocyte count (P=0.18) with the stage of disease and prognosis, but the ${\beta}_2$ macroglobulin level (p<0.0001), LDT (p<0.001) had direct and significant relation with staging and outcome. In 19% of patients cytogenetic alteration were seen. Conclusion: The detection of cytogenetic alteration only using the CC method is not sufficient and we need to use FISH, but because FISH study is an expensive method not available in all areas, instead we believe that ${\beta}_2$ MG can be applied in its place as a good prognostic factor for CLL at diagnosis and during follow up. We suggest to add it to Binet staging for prognostic subgrouping of CLL.

Outcome after Simultaneous Resection of Gastric Primary Tumour and Synchronous Liver Metastases: Survival Analysis of a Single-center Experience in China

  • Liu, Qian;Bi, Jian-Jun;Tian, Yan-Tao;Feng, Qiang;Zheng, Zhao-Xu;Wang, Zheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1665-1669
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    • 2015
  • Background: The optimal surgical strategy for the treatment of synchronous resectable gastric cancer liver metastases remains controversial. The aims of this study were to analyze the outcome and overall survival of patients presenting with gastric cancer and liver metastases treated by simultaneous resection. Materials and Methods: Between January 1990 and June 2009, 35 patients diagnosed with synchronous hepatic metastases from gastric carcinoma received simultaneous resection of both primary gastric cancer and synchronous hepatic metastases. The clinicopathologic features and the surgical results of the 35 patients were retrospectively analyzed. Results: The 5-year overall survival rate after surgery was 14.3%. Five patients survived for more than 5 years after surgery. No mortality has occurred within 30 days after resection, although two patients (5.7%) developed complications during the peri-operative course. Univariate analysis revealed that patients with the presence of lymphovascular invasion of the primary tumor, bilateral liver metastasis and multiple liver metastases suffered poor survival. Lymphovascular invasion by the primary lesion and multiple liver metastases were significant prognostic factors that influenced survival in the multivariate analysis (p=0.02, p=0.001, respectively). Conclusions: The presence of lymphovascular invasion of the primary tumor and multiple liver metastases are significant prognostic determinants of survival. Gastric cancer patients without lymphovascular invasion and with a solitary synchronous liver metastasis may be good candidates for hepatic resection. Simultaneous resection of both primary gastric cancer and synchronous hepatic metastases may effectively prolong survival in strictly selected patients.