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Systematic Review of Occupational Therapy Programs for Upper Extremity Functions in Subacute Stroke Patients (아급성기 뇌졸중 환자의 팔 기능을 위한 작업치료프로그램에 대한 체계적 고찰)

  • Yo-Soon Bang;Eun-Sol Ju
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.105-114
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    • 2023
  • Purpose : This study systematically reviewed occupational therapy programs for upper extremity functions in subacute patients implemented over the last decade at home and abroad to utilize the findings as the basis for intervention protocols. Methods : This study was conducted with domestic and foreign randomized controlled experimental studies published from January 2013 to May 2023. Acute or subacute, CVA or stroke, upper extremity function, and program or therapy were used as search keywords in the search databases Scopus, PubMed, Riss, and DBpia. A total of 3,723 documents were retrieved, and 1,007 duplicate papers were excluded. In addition, 2,640 papers that did not meet the inclusion and exclusion criteria were excluded by the researcher examining the titles and abstracts. Thereafter, the full texts were checked. Consequently, 67 documents were excluded, and nine documents were finally used for analysis. Results : Due to the evaluation of the quality of the documents of nine studies, five items were rated "low," and two items were rated "unclear" in many studies. Males predominated the genders, and infarction predominated the types. The average age was over 50 but under 60 years, and the number of days after onset was predominantly fewer than one month. Occupational therapy programs were classified into mental programs, mirror therapy, music programs, and virtual reality programs, and virtual reality programs were frequently used. The intervention periods were predominantly 15-30 sessions for less than 30 minutes, and the Fugl-Meyer assessment-upper extremity was predominantly applied as an evaluation tool. Conclusion : This study is significant because it attempted to present the direction of intervention protocols for upper extremity functions in subacute stroke patients in clinical settings. Studies should be conducted with an expanded scope for a literature review.

Limitations of the Linear Solvation Energy Relationships in Reversed Phase Liquid Chromatography

  • Cheong, Won-Jo;Choi, Jang-Duck
    • Bulletin of the Korean Chemical Society
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    • v.15 no.10
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    • pp.868-873
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    • 1994
  • We have re-examined the linear solvation energy relationships in reversed phase liquid chromatography by considering various solutes including quite a number of compounds of strong hydrogen bond capability. We observed that solutes of strong hydrogen bond ability should be excluded in order to obtain resonable correlations between In k' and solute polarity parameters and that inclusion of one or two such solutes causes severe distortions of correlation results. This anomaly may be due to existence of residual silanol groups in the stationary phase, that is, their specific interactions with solutes.

A Clinical Study on the Modified RUCAM Application to Liver Injury Induced by Herbal Medicine (한약인성 간손상의 원인산정법으로 도입된 진단 척도(Modified RUCAM scale)에 대한 임상적 고찰)

  • Cheon, Jin-Hong;Min, Sang-Yeon;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.22 no.3
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    • pp.83-94
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    • 2008
  • Objectives : The purpose of this study is to confirm severe problem caused by using a modified RUCAM scale than that officially recognized to diagnose liver injury induced by herbal medicine. Materials and Methods : Cases with liver injury induced by herbal medicine received to a related institute from January 2004 to December 2007 were collected and evaluated by the original scale and modified scale. Results : 1. Based on this study, we couldn't clinicaly confirm that the case was not excluded by the relieved first item basis of modified RUCAM scale which has to be excluded by the first item basis of orginal RUCAM scale. 2. By modified 6th item, one score was added to the total score. 3. By adding 8th item, it gaind one point to the whole the total score. Conclusions : In this study, we can clinically confirm that the modified RUCAM application to case with liver injury induced by herbal medicine is a severe problem.

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The influence of Advanced Adult Periodontitis on the pulp (진행성 치주염이 지수 조직에 미치는 영향)

  • Lee, Kang-Woon;Lee, Chel-Woo;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.29 no.1
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    • pp.95-102
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    • 1999
  • The purpose of this study was to observe histopathologically the influence of advanced periodontitis on pulp tissue, and to conclude the correlation between the results with clinical manifestations. The samples were teeth with over 7mm pocket depth and over 50% radiographic bone loss. These were diagnosed to have very poor prognosis and thus planned to be extracted. Those with any of following conditions were excluded from the samples, loss of vitality, periapical pathology, restoration or prosthesis, dental caries, and attrition or abrasion. It was because these conditions could affect pulp without any correlation with periodontal disease. For the experiment, 17 teeth from 11 patients were selected. Average age of patient was 47. Each tooth was examined for following categoris; pocket depth, gingival recession, electric pulp test, mobility, percussion test, sensitivity test. The extracted teeth were fixed buffered neutral formalin solution. It was decalcified using 4% nitric acid. Sliced histological samples observed using light microscope, for pulp status, and severeity of inflammation. 4 samples were excluded due to histologic sample discrepency. Thus 13 samples were subject to observation. 4 showed normal conditions. Focal reversable pulpitis was shown in 5 samples. Chronic pulpitis was observed 1 sample. Pulpal abscess was observed in 3 samples.

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The U. S. Antitrust Law on the Exclusion of Medical Staff Privilege and its Implication (참여의 특권 배제에 관한 미국 독점금지법 법리와 그 시사점)

  • Jeong, Jae-Hun
    • The Korean Society of Law and Medicine
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    • v.12 no.2
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    • pp.295-316
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    • 2011
  • If the medical staff privileges, which mean the eligibility to practice at open hospitals, are excluded in the United States, antitrust claims based on the violation of the Sherman Act have been raised a lot. The proliferation of these lawsuits in the United States, which are characterized as antitrust lawsuits, can be understandable situation. The reason is because doctors who don't belong to specific hospitals are seriously damaged, if the medical staff privileges are excluded and doctors cannot use facilities of open hospitals. In order to decide to allow the privileges of certain doctors, hospitals have to rely on peer review to maintain high quality of medical services, and it is not easy to find alternative of peer review in the professional areas like healthcare. However, there are possibilities that members of the peer review can abuse power to unfairly exclude privileges of potential competitors. In this sense, it is asserted in the U.S. antitrust lawsuits that the restraint of medical staff privilege can be the illegal restraint of trade in violation of section 1 of Sherman Act and can be monopolization or an attempt to monopoly by hospitals in violation of section 2 of Sherman Act. As Korea adopted open hospital system quite recently, there is still no case related with the exclusion of medical staff privileges. However, medical staff privilege system of Korea is not different from that of the United States in principle. Thus, the U.S. jurisprudence on the exclusion of medical staff privileges can be referred in the interpretation of "practice that interferes with or restricts the activities or contents of the business" based on Article 19.1.9 of Monopoly Regulation and Fair Trade Law of Korea.

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A Retrospective Analysis of Liver Function Test in Patients Taking Heshouwu (하수오를 복용한 환자의 간기능 검사에 대한 후향적 조사)

  • Han, Chang-Woo
    • The Journal of Internal Korean Medicine
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    • v.31 no.1
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    • pp.113-117
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    • 2010
  • Objectives : in recent years, there have been some case reports about liver injuries suspected to be caused by Heshouwu, the root of Polygonum multiflorum. So, I investigated liver function tests of patients who had taken Heshouwu, to know whether Heshouwu was hepatotoxic. Methods : I surveyed whether Heshouwu caused liver injury in patients, who had been admitted and taken Heshouwu at Dongguk University International Hospital, from May 2005 to July 2008. I looked over all the liver function tests of those patients, done during medication and 30 days after. Results : Among 1,449 inpatients, there were 124 patients who had taken Heshouwu. Among those 124 patients, 14 cases whose liver function tests were abnormal before medication were excluded. 69 cases who did not take liver function test 30 days after were also excluded. As a result, 41 patients were enrolled, and their mean dosage was 14.04(8-24) g/day, and the mean medication period was 13.8 (1-89) days. During and after medication, there were no abnormal liver function test results at all, in the enrolled cases. Conclusions : Roughly speaking, according to the above results, it seems that taking Heshouwu for about two weeks as per the commonly taken dosage did not cause hepatotoxicity, though we needs more laboratory and clinical research to reach a more definitive conclusion.

The Growth of the Korean Welfare State and its implications for redistribution: Who has been excluded? (한국 복지국가 성장의 재분배적 함의: 누가 복지국가로부터 소외됐는가?)

  • Nahm, Jaewook
    • 한국사회정책
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    • v.25 no.4
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    • pp.3-38
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    • 2018
  • This study aims to analyse the redistributive impact of the welfare state growth in Korea after 2000s and establish whether there are people excluded from the benefits of the growth. The growth of the Korean welfare state has been achieved by universalizing welfare benefits under the social insurance-centered institutions which are the legacies of the productivist/developmental welfare regime. When it comes to redistribution impacts, the welfare state growth improved inequality among old age populations to a certain degree due to the introduction of the Basic Pension. On the other hand, welfare benefits for the working poor population has hardly been improved in spite of the growing welfare state. It can be said, therefore, that low-income working-age populations have been excluded from the growth of Korean welfare state. These groups are mostly in middle-old age, unemployed or precariously employed and half of them were female householders. The exclusion of these groups from the Korean welfare state shows that the growth of the Korean welfare state was unbalanced. To include the excluded into the Korean welfare state, it is necessary to increase non-insurance social provisions, extend the range of application of the social insurances, integrate income protection, employment service, and vocational training for the working poor, and combine universal and targeted welfare benefits.

Development of Critical Paths for Appendectomy (표준 진료 지침서(Critical Paths) 개발에 관한 연구 - 충수절제술(Appendectomy) 환자용 -)

  • Kim, Yong-Soon;Park, Jee-Won;Park, Yon-Ok;Cho, Eun-Sook;Kim, Myung-Wook
    • Quality Improvement in Health Care
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    • v.2 no.2
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    • pp.32-45
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    • 1996
  • Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

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Postpneumonectomy Esophagopleural Fistula: Muscle Flap Transposition for Closure (우측폐 전절제술후 발생한 식도늑막루의 수술 치험 : 1례 보고)

  • 이형교
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1275-1279
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    • 1990
  • Esophagopleural fistula is a rare complication that should be suspected in all patients with recurrent empyema following pneumonectomy and in whom a bronchopleural fistula can be excluded. In late postpneumonectomy esophagopleural fistula, diagnosis is difficult due to its rarity and no specific symptom and sign, but we have experienced a man who had suffered dysphagia and odynophagia. In surgical treatment of late postpneumonectomy esophageal fistula, closure of empyema space is of prime importance. We have adopted a type of latissimus dorsi muscle and serratus anterior muscle flap transposition We present here this technique and result obtained in patient with late postpneumonectomy esophagopleural fistula.

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On the Management of Nutrition for High Altitude Training (고지(高地) 훈련시(訓練時) 영양관리(營養管理)에 관(關)하여)

  • Sung, N.E.;Lee, C.H.
    • Journal of Nutrition and Health
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    • v.1 no.1
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    • pp.27-31
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    • 1968
  • The author investigated the effects of dietary composition upon the work efficiency of Splague Dowley rat at high altitude, and obtained the following results: 1. At high altitude a carbohydrate-rich diets worked more favorably upon work efficiency of the animal then a protein and or fat-rich diets did. 2. It may be recommended that fibrous components be excluded from the diets. 3. Ingestion of large amounts of sugars prior to the onset of work load is highly recommended.

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