• Sleep Medicine and Psychophysiology
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• v.18 no.1
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• pp.40-44
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• 2011

Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.229-236
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• 2006

Purpose: This study was conducted to search for the type of technical error in DEXA(dual-energy X-ray absorptiometry) and the effect of error to measurement of BMD. Materials and Methods: The changes of BMD($g/cm^2$, T-score) by patients information(Age, Weight, Height, Manopause age) input error and Confirming ROI error were investigated. Using spine phantom, we canned 10 times by age(5, 10), weight(10, 20 kg), height(5, 10 cm), manopause age(5, 10) increase & decrease respectively. Scanning region(L-spine, femur, Forearm) of 10 patients was calculated by changing ROI respectively. Analysis of difference for mean(precision 1%) were carried out. Results: The error of patient information(Age, Weight, Height, Manopause age) was not changed differently. In confirming ROI, the BMD and T-score of L-spine involving T-12 was decreased to $0.063\;g/cm^2$, 0.3 and involving L-5 increased to $0.077\;g/cm^2$, 0.5. In narrowing 1 cm of vertical line of ROI, the BMD and T-score decreased to $0.006\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.15, each. In hip ROI, Upper and left shift(0.5 cm) of line was not influenced BMD and T-score. In 0.5 cm lower shift(lesser trochanter below), the BMD and T-score increased $0.031\;g/cm^2$, 0.3 and in 1 cm $0.094\;g/cm^2$, 0.65, each. In forearm ROI, the BMD and T-score decreased $0.042\;g/cm^2$, 0.9 involving 1 cm lower wrist. And expanding 1 cm of vertical line, the BMD and T-score decreased $0.008\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.3, each. The L-spine, hip, forearm ROI error was changed differently. Conclusion: There are so many kinds of technical error in BMD processing. Errors according to age, weight, height, manopause age did not influent to $BMD(g/cm^2)$ and T-score. There are mean differences BMD and T-score in confirming ROI. For the precision exam, in L-spine processing, L1-4 have to confirmed without shift of ROI vertical line. In hip processing, the ROI have to included greater trochanter, femur head and lesser trochanter. In forearm processing, the ROI have to included wrist, radius and ulnar.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.852-855
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• 2005

A 85-day-old infant was successfully operated on for truncus arteriosus (type I) with interrupted aortic arch (type A) using one-stage anterior approach without circulatory arrest. Aortic arch was reconstructed by direct anastomosis of ascending aorta and descending aorta with regional perfusion and continuity of right ventricle to pulmonary artery was established with $Shelhigh^{circledR}$ pulmonic conduit. The patient experienced left bronchus compression by descending aorta immediately postoperatively, which was improved with positional change and physiotherapy. The patient had reoperation due to stenosis of valved conduit at 13 months later. The patient is currently well under follow-up of 14 months from initial repair.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.295-302
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• 2013

PURPOSE: The purpose of this study was to investigate the effect of short-term lumbar stabilization exercise to patients suffering from chronic low back pain(CLBP) on the strength of their lumbar flexor and extensor and the postural balance of them and to suggest effective treatment duration for them. METHODS: Study subjects were 20 patients with CLBP who's been reported the pain for more than 12 weeks. For these subjects, muscle strength of both extensor and flexor of lumbar and the balancing ability were measured before and after the intervention. Lumbar stabilization exercise was composed of matt, ball and sling exercise. The intervention was applied for total 12 sessions for 4 weeks (3 times a week) and each session was for 40 minutes. RESULT: For muscle strength of both extensor and flexor of lumbar, there was significant differences after the application of lumbar stabilization exercise(p<.05). For balancing ability, stabilization shows significant differences in all of the positions except PC(eyes closed on pillows)(p<.05). Distribution of weight shows no significant differences but it was generally distributed within normal range after the exercise and Fall index shows significant differences between before and after the exercise(p<.05). CONCLUSION: These results could have positive effect on deciding different periods of therapeutic intervention.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.3 no.1
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• pp.71-84
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• 2005

This study had performed with purposes to analyze the influence of the change of vestibular sens, visual and proprioceptive sense to the postural sway, so as to supply the necessary clinical materials through developing the physical therapeutic interventions and assessment format for the diabetic neuropathy patients. The sample consisted of fifteen diabetic neuropathy patients with sensory disorder in their lower limbs and fifteen age-matched normal control group. Then the effect of the GVS and the visual cue open and closed to the postural sway were measured by CoP. The summary of the comparison results were obtained below. In the comparison of diabetes neuropathy patients group and age matched normal control group, however diabetes neuropathy patients group had a decrease in superficial tactile sense(p<.001) and nerve conduction velocity(p<.001), they were able to control the posture and walk. So it is, diabetes neuropaty patients had more disturbance compared with AMC group on at a hard surface, particularly in the visual cue open(p<.001) and visual cue closed(p<.01). Moreover, since diabetes neuropathy patients group had more differences in visual cue open and closed(p<. 01), GVS(p<.01), it meant that they're affected largely by vestibular sense, visual sense. In addition, since there're the largest change in doubled sense disturbance such as visual cue open and closed under GVS, it meant that compensation of other senses were quite important for the diabetes neuropathy patients' postural control. In the conclusion, diabetes neuropathy patients who decrease or lose the somatosensory system, sensory training of visual and vestibular system are likely to be quite essential to control the posture and balance.

• PNF and Movement
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• v.16 no.2
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• pp.161-168
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• 2018

Purpose: This study aimed to investigate the effects of postural control exercise on the delayed heart rate increase in heart transplant patients. Methods: The subject was a female heart transplant recipient who had a delayed increase in heart rate during exercise. The intensity of exercise was performed at MBorg level 4. The A-B-A' and A-B-A'-B' designs were used to identify the changes in heart rate during active-assisted exercise, lower limb postural control exercise, and upper limb postural control exercise. Experiments were performed for four weeks. The heart rates at pre- and post-exercise were compared, and the time to reach MBorg 4 was measured. Results: In the active-assisted exercise, the average heart rates at pre- and post-exercise and after 10 min of exercise were 88, 89, and 87.7 bpm, respectively. In the repetitive comparison of pre- and post-exercise in the lower limb postural control exercise, the difference in the mean heart rate was 3.5 and 3 bpm in stable support and 14 and 14.5 bpm in unstable support, respectively. In the repetitive comparison of pre- and post-exercise in the upper limb postural control exercise, the difference in the mean heart rate was 6 and 4 bpm in stable support and 4 and 4.5 bpm in unstable support. The time required to reach MBorg 4 was short when both the upper and lower postural control exercises were performed in an unstable state. Conclusion: We suggest that combining proper postural control exercise with strength exercise and aerobic exercise, among others, may be effective in rehabilitating patients in the recovery stage after a heart transplant.

• Journal of Oriental Neuropsychiatry
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• v.13 no.1
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• pp.127-132
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• 2002

This case show that emotional stress and wekness of gastrointestinal function occur a chronic hiccup and eructation(during 3 months), oriental medical therapy can cure completely this symptom. Seven emotional stress(anger, delight, sadness, thinking, worry, fear, horror) occur various pathologic changes. Hiccup is caused by CNS, psychologic, thoracic, abdominal factor etc. In oriental medicine, GI trouble regarded as a very importent factor that occur hiccup and eructation. Besides, emotional stress is a very important factor as well. This patient have an introvert personality ordinary times. One day, she had a miscarriage by hers husband's assault. After that time, she suffered from very serious GI trouble(dyspepsia, epigastric pain, anorexia). And then hiccup, eructation, weight loss(10kg/3months) is occured. This patient diagnosed only gastritis. This symptom did not stop during 3 months, regardless of western medical therapy(some western drugs medication, fluid supply etc). After oriental medical therapy(herb medicine;Yukunjatang, acupuncture;CV12, CV6, S36, CV17, H7, SP6, P6, moxibustion;VI2, CV6, S36, negative therapy;back area and traditional oriental medical psychotherapy;ventilation, support, desensitization and family interview) put in operation during 15 days, patient completely recover from hiccup, eructation and anxiety disorders.

• The Journal of Korean Physical Therapy
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• v.13 no.2
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• pp.381-397
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• 2001

In the patients with hemiplegia caused by stroke and TBI. postural sway is increased and open displaced laterally over the non-affected leg, reflecting asymmetry in weight bearing on lower extremities during standing balance. Recovery of symmetric weight bearing and postural stability is an important aim in physical therapy. Plastic AFO has been used for hemiplegic patients in order to help their abnormal walking patterns. Past studies have mainly focused on the AFO influences on hemiplegic walking patterns without balance function approaches. The purpose of this study was to identify the immediate effects of plastic AFO and shoes on the static balance in hemiplegic patients. The scale for static balance were weight bearing on affected leg(%), sway area(mm2), sway path(mm), maximal sway velocity(mm/s), anteroposterior sway angle($^{\circ}$ ), and lateral angle($^{\circ}$ ). Seventeen hemiplegic patients participated in this study: 13 men and 4 women, with an average age of 50.18 years. Static balance was measured using BPM(balance performance monitor; dataprint software version 5.3) under four standing condition namely bare-foot standing. standing in shoes, standing with AFO, and standing in shoes with AFO. In order to assure the statistical significance of the results, an one-way ANOVA, the independent t-test. and a pearson's correlation were applied at the .05 level of significant. The results of this study were as follows: 1) There were statistically significant differences in weight bearing(%) on the static balance between affected leg and non-affected leg(p<.01). 2) There were statistically significant differences in sway reverse frequence(Hz) in standing with AFO between affected leg and non-affected leg(p<.05). 3) Sway area(mm2) on standing in shoes with AFO was lower than bare-foot standing(p<.05), Lateral sway angle($^{\circ}$ ) on standing in shoes with AFO was lower than bare-foot standing and standing in shoes(p<.05). 4) Weight bearing in affected leg was not significantly correlated with postural sway.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.291-299
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• 2012

Purpose: This study examined the improved sensory, hand function, postural balance and activities of daily living (ADL) through somatosensory stimulation, such as the facilitation of functional reaching and tactile, proprioceptive stimulus of the upper limb (UL) and hand. Methods: Seventeen stroke patients having problems with motor and somatosensory deficits were selected in Bobath Memorial Hospital adult rehabilitation center. The patients were divided into two groups; the sensorimotor deficit group (SMDG) and motor deficit group (MDG). Somatosensory stimulation on the UL, physical therapy and occupational therapy were carried out three times a week over a six week these treatments were performed in both group period. To compare each group, the following assessment tools were used: such as tactile detection thresholds (TDT), two point discrimination on the affected side (TPDas), unaffected side (TPDus) stereognosis (ST) manual function test, hand function on the affected side (HFas) and unaffected side (HFus), Postural Assessment Scale for Stroke (PASS) and Korean version Modified Barthel Index (K-MBI). Results: In the SMDG, somatosensory stimulation on the UL was statistically important for TDT, TPDas, TPDus (except for the thener), ST, hand function on HFas, on HFus, PASS length of displacement with foam (LDFSEO), and K-MBI. In the MDG, somatosensory stimulation on the UL was important for TDT, TPDas, TPDus (except index finger) length of displacement with the eyes open, LDFSEO, HFas, HFus, PASS and K-MBI. In addition, there was a significant difference in the PASS between SMDG and MDG. Conclusion: Somatosensory stimulation on the UL affects the sensory, hand function, postural control and ADLs performance.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.655-666
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• 2013

PURPOSE: The main objective of this study is observing the effects of the functional postural trunk exercise (FPTE) on deep cranio-cervical flexor (CCF) muscle endurance applied on neck pain patients suffering from the acute whiplash-association disorder (WAD). METHODS: The study was tested with 47 patients with neck pain. All patients were equally treated with the ordinary therapy, only experimental group (n=23) was treated with FPTE: assumption of an upright lumbo-pelvic and spinal postural position, adding a neck lengthening manoeuvre in addition. Patients attended physical therapy for 3 times a week, for 4 weeks. Visual analogue scale (VAS) for pain, neck disability index (NDI), range of motion (ROM), were recorded both before and after the intervention. Also muscle activity in the CCF test was employed to analyze the changes between before and after. RESULT: After 4 weeks of training intervention, a remarkable increase in muscle endurance, rotation, extension ROM (p<.05) and decrease in pain and NDI (p<.05) in both groups. Further, the differences between groups were muscle endurance (F=60.350, p<.01), pain, and the left rotation ROM (p<.05). CONCLUSION: From the results, the experimental group had significant the increase in muscle endurance, and the significant decrease in pain. Whilst further research in this category is necessary, these observations suggest that applying exercise in early diagnosis can be of help to treat the neck pain patients suffering from the WAD.