Parkinson's disease(PD) is a progressive neurodegenerative disease that affects the functioning of the basal ganglia, a brain area that contributes to the control of movement. The disease is caused by the death of nerve cells in the brain that produce dopamine, a chemical messenger. The cells affected usually produce a neurotransmitter(a chemical that transmits nerver impulses) called dopamine, which acts with acetylcholine, another neurotransmitter, to fine-tune muscle control. In Parkinson's disease, the level of dopamine relative to acetylcholine is reduced, adversely affecting muscle control. When the supply of dopamine is depleted, the function of the basal ganglia is disrupted and its ability to control movement-deteriorates. The result is that PD patients experience moderate rigidity, difficulty in initiating movements and slowness in executing them, and a rhythmical tremor at rest. Although the cause of Parkinson's disease is not known, genetic factors may be involved. About 3 in 10 people with the disorder have an affected family member. About 1 in 100 people over the age of 60 in the US have Parkinson's disease. And Parkinson's disease is slightly more common in men. The course of the disease is variable, but drags may be the best effective in treating the symptoms and improving quality of life. But, The doctor may arrange physical therapy to help with physical mobility problems. It is important to continue to exercise and take care of your general health. Try to take a walk each day. Stretching exercises can help you maintain your strength and mobility. So, This papers will serve about the information of PD for clinical physical therapist. Finally, The aim of review is increasing approach method and technique for PD patients by the view of physical therapy.
Parkinson's disease(PD) is a progressive neurodegenerative disease that affects the functioning of the basal ganglia, a brain area that contributes to the control of movement. The disease is caused by the death of nerve cells in the brain that produce dopamine, a chemical messenger. The cells affected usually produce a neurotransmitter(a chemical that transmits nerver impulses) called dopamine, which acts with acetylcholine, another neurotransmitter, to fine-tune muscle control. In Parkinson's disease, the level of dopamine relative to acetylcholine is reduced, adversely affecting muscle control. When the supply of dopamine is depleted, the function of the basal ganglia is disrupted and its ability to control movement deteriorates. The result is that PD patients experience moderate rigidity, difficulty in initiating movements and slowness in executing them, and a rhythmical tremor at rest. Although the cause of Parkinson's disease is not known, genetic factors may be involved. About 3 in 10 people with the disorder have an affected family member. About 1 in 100 people over the age of 60 in the US have Parkinson's disease. And Parkinson's disease is slightly more common in men. The course of the disease is variable, but drugs may be the best effective in treating the symptoms and improving quality of life. But, The doctor may arrange physical therapy to help with physical mobility problems. It is important to continue to exercise and take care of your general health. Try to take a walk each day. Stretching exercises can help you maintain your strength and mobility. So, This papers will serve about the information of PD for clinical physical therapist. Finally, The aim of review is increasing approach method and technique for PD patients by the view of physical therapy.
Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.
Objectives : The purpose of this study was to examine the oral health behavior of shipbuilding company workers in some regions in a bid to provide information on the oral health plans for industrial fields. Methods : The subjects in this study were 310 workers in 10 shipbuilding companies and suppliers in Jeolla Namdo Province, on whom a self-administered survey was conducted. Results : 1. Concerning general information about the subjects who participated in the research, gender was possessed 94.8% by men and 5.2% by women. Age was the largest in 31~40 years old with 44.2%. Marital status was the largest in the married with 64.5%. It was the largest in under high school graduate with 71.9% for academic background, in 2,000,000 won~3,000,000 won with 49.0% for monthly family income, and in cooking with 33.9% for work field. 2. Research subjects' toothbrushing time was indicated to be the largest in after having breakfast. It was indicated to be twice a day with 41.3% for toothbrushing frequency. 90.3% of the respondents are not using auxiliary oral hygiene devices. 3. Recognition on periodontal health status was found larger in workers whose response was that their own periodontal health status is 'healthy' than workers who responded that their status is 'not healthy.' Workers, who don't have subjective symptom on periodontal status, were indicated to be larger. 4. Ratio of subjects with tooth scaling experience accounted for 59.7%. The ratio of tooth scaling experience was indicated to be different depending on academic background and monthly family income. Conclusions : Academic credential, monthly family income and the line of work were identified as the main factors to affect oral health care of the shipbuilding workers. Oral health education and dynamic implementation of corporate oral health promotion which are designed to meet the needs of workers are required.
Purpose: The purpose of this study was to measure (the degree of) injury risk perception in preschool children. Methods: The data were collected from child day care centers and kindergartens located in Seoul, and Gyeonggi and Kwangwon Province. A questionnaire consisted of 28 pictures was administered to 186 preschool children. Results: The mean score for the injury risk perception was 21.83 (${\pm}3.89$), and 77.98 converted into a 100-point scale. According to sub-categories, 'burn prevention' ($.96{\pm}.13$) was the highest, 'interpersonal safety' ($.44{\pm}.31$) was the lowest. There were significant differences in injury risk perception according to gender (t=-2.358, $p$=.019), age (t=-2.101, p=.037), experience of safety education (t=-3.719, $p$ <.001), area of residence (t=-3.445, $p$=.001), injury experience (t=3.212, $p$=.002), and mother's occupation (t=-4.858, $p$ <.001). The highest item in the percentage of correct answer item was 'making jump on the desk', the lowest item in the percentage of correct answer item was 'not wearing safety equipment when rollerblading'. Conclusion: Based on this study, studies should be continued to standardize the instrument. In addition, it is recommended that an injury prevention education program should be developed based on the results of this study to stimulate demand and interest.
Purpose: The standard treatment of esophageal cancer is the Ivor-Lewis operation, which consists of an abdominal phase involving gastric tube formation, and a chest phase involving esophagectomy and anastomosis. We aimed to report our experience of performing thoracic esophagectomy with the laparoscopic gastric pull up (LGPU) technique and its surgical outcomes. Methods: Clinicopathologic data and short-term surgical outcomes of 14 patients who underwent LGPU for thoracic esophageal cancer from August 2008 to May 2016 were retrospectively reviewed. Results: Mean age of the patients was 62.3 years and mean body mass index was $21.7kg/m^2$. Eleven patients had medical comorbidities. Patients' mean American Society of Anesthesiologists score was 2. Mean operation time was 428.5 minutes, with the mean abdominal operation time being 138.9 minutes. There was no open conversion case. Three patients had pneumonia, three patients had surgical site infection, and one patient had subcutaneous emphysema within 30 days after surgery. One patient had minor anastomosis site leakage. There was one 30-day mortality case. One patient with postoperative aspiration pneumonia developed acute respiratory distress disease, and died due to sepsis. Mean postoperative intensive care unit stay was 3.5 days, and mean postoperative hospital stay was 20.6 days. Nasogastric tubes were removed on average at 3.4 days, and mean oral intake time was 3.4 days. Conclusion: If the gastrointestinal surgeon has extensive experience in laparoscopic procedures, LGPU will be a safe and feasible technique for thoracic esophagectomy in patients with intrathoracic esophageal cancer.
The advanced knowledge is increasing day by day due to the progress of medicine and tectonics, the increase of nursing research nowadays. In parallel with these, nursing profession has a need of the nursing care with improvement of new Knowledge, tectonics and nursing procedure through the insertive education. Therefore, this study was attempted to investigate that to grasp learning need of nurses about inservice educational play a pivotal role in the progress of inservice education. This study was made from 242 clinical nurse at 4 hospitals in Seoul and through question- are consisting of 1) ideological part 2) basic sciences 3) nursing part 4) administrative part 5) the others from 10 July '75 to 7 Oct. '75. The data were treated by percentage, Licker method, arid chi- square examination. Significant difference p is 0.05. The results of this studies are as follows : A. learning needs of nurses 1) Generally the learning needs of nurses is very high. 2) Of the learning need of inservice education for nurses, the highest learning need is as follow (Table 2 ) 1 st : Charting 2 nd : The ability of grasping patient's needs and problems. 3 rd ; The contents and the methods of the advanced nursing skill. 4 th ; The importance of team work 5 th ; The general knowledge of the various disease 6 th : The decision of a propriety nursing diagnosis under the general condition. 7 th ; The introduction of the new nursing theory. 8 th : The Nurses role and the responsibility in emergency and disaster. 9 th : The improvement of nursing skill for the perfect interpersonal relationship. l0th ; Cultural education: B . Verification of hypothesis 1. Hypothesis I , learning needs of nurses and educational level of nurse will be correlated, is rejected (Table 3 ) 2. Hypothesis II, learning need of nurses and duties of post will be correlated, is rejected (Table 4) 3. Hypothesis III, learning need of nurse and clinical experience of nurses will be correlated, is rejected (Table 5).
Objective: To report a fatal case of Multidrug-resistant Acinetobacter baumannii (MDR-AB) in a patient with interstitial lung disease (ILD) on high-dose glucocorticoids. Case Summary: A 66-year-old man with a history of coniosis was transferred to the hospital with progressive cough and sputum production. This patient has been diagnosed with pneumonia and ILD on admission, requires antimicrobial therapy and systemic immunosuppressants. He received high dose of methylprednisolone and cyclophosphamide for ILD as well as ceftriaxone and azithromycin for pneumonia. On day 7 in the intensive care units (ICUs), patient had fever and leukocytosis, thus antimicrobials were switched to piperacillin. After 13 days in the ICU, Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA) were isolated on transtracheal aspirate (TTA) and meropenem was initiated. However, it was revealed a multidrug-resistant Acinetobacter baumannii (MDR-AB) species, resistant to carbapenem. Patient was administered colistin but expired due to septic shock on day 84. Discussion: Systemic immunosuppressive therapy can result in infections that may compromise patient's survival. MDR-AB has emerged as a serious cause of nosocomial infections in immunocompromised patients. MDR-AB is resistant to most standard antimicrobials and therapeutic options are limited. Conclusion: We report our recent experience with a fatal MDR-AB pneumonia in a patient with ILD, who had to be treated with high dose glucocorticoids and immunosuppressnts.
Purpose: The vegetative state is a clinical condition with complete unawareness of self and environment, but with preservation of brain - stem functions. Vegetative patients may have nosocomial infections in their wounds, like pressure sores and infected craniums after cranioplasties. Usually flap surgery is necessary for those wounds, but decision of undergoing surgery is difficult because of various adverse conditions of vegetative patients. We share our experience of several successful flap surgeries in vegetative patients, and evaluate obstacles and requirements to get satisfactory results. Methods: From December 2005 to September 2008, a total of 4 vegetative patients underwent surgeries. In 2 patients with infected artificial craniums, scalp reconstructions with free flaps were performed. In other 2 patients with huge pressure sores with sepsis, island flap coverage of wounds was done. Retrospective study was done on hospital day, vegetative period, number of surgeries done, underlying diseases, causative bacteria, and contents of informed consent. Results: Mean hospital day was 14 months and mean vegetative period was 17.5 months. Patients underwent average of 4.5 surgeries under general anesthesia. There were several underlying diseases like hypertension, DM, CHF and chronic anemia. MRSA(Methicilin - resistant Staphylococcus Aureus) was cultured from every patient's wounds. Informed consent included a warning for high mortality and a need of attentive familial cooperation. Conclusion: There are three requirements for doing flap surgeries in vegetative patients. First, to prevent aggravation of brain damage and underlying diseases by general anesthesia, multidisciplinary team approach is needed. Second, operation should be beneficial for prolonging patient's lifespan. Third, because postoperative care is very difficult and long hospitalization is needed, detailed informed consent and highly cooperative attitude of family should be confirmed before operation.
This study was performed to investigate the dietary habit based on residence types of male college students who registered nutrition course for nonmajor. Self reports on dietary habit and one-day dietary records were obtained from 158 male college students in Chungbuk area. The distribution of residence type of male college student was as follows; self-boarding(43.0%), home(41.1%), boarding with meal(12.7%), and others(3.2%). The mean age of subjects were $22.6{\pm}2.5$, and the mean height and weight were $175.0{\pm}5.6cm\;and\;69.1{\pm}9.3kg$, respectively. The dietary habit of male college students considered to be taken more care of, showing indifference to dietary balance, irregularity of meal, and skipping breakfast. One-day dietary records by 24hr recall methods also showed less diverse food intake(mean DVS, 12.7; mean DDS, 3.92). Especially, the students with self boarding residence were more likely not to eat properly, including indifference to dietary balance, irregularity of meal, skipping breakfast, frequent dining-out, high experience of smoking and drinking, and low DVS and DDS. Also the students with self boarding residence seemed not to make a good choice for food, showing high food intake frequency score in canned food, fast food and instant ramyun, while low score in fruit and fishes. More attention should be taken for self-boarding students to recognize the problems in their own dietary behavior, and more practical suggestion to improve their dietary status would be necessary.
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