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Comparison of Dysphagia Rehabilitation Therapy with Natural Recovery on Swallowing Ability among Acute Stroke Patients (연하재활치료의 효과와 자연회복과의 비교연구 - 급성기 뇌졸중 환자를 중심으로 -)

  • Heo, S.Y.;Kim, K.K.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.8 no.2
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    • pp.109-118
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    • 2014
  • The purpose of this study was to compare the effectiveness of rehabilitation therapy with natural recovery in patients who had dysphagia due to stroke. Swallowing functions were examined on a total of 98 patients with stroke-caused dysphagia based on a videofluoroscopic swallowing study (VFSS) for 8 weeks. The each group was evaluated with DOSS, DSS and FOSS to assess swallowing ability in the first week and re-evaluated in the $8^{th}$ week during the session for investigating the recovery status. The author compared the above initial data and follow-up data using a Mann-Whitney U test, Kruskal-Wallis test and Wilcoxon's Signed Rank test, ANCOVA to confirm statistically controlling for the effects of other continuous variables, performed by IBM SPSS Statistics 20.0 for windows. There was statistically significant recovery in the experimental group except measure of DOSS (p>0.05). In the control group, it showed improvement in all the scales(p<0.05). After terminating each session, the comparison of the two group of patients showed statistical significant differences in DSS and FOSS(p<0.05). These results suggest that possibility of natural neurologic recovery has positive effects on early stage of dysphagia caused by stroke.

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Dedicatory Inscriptions on the Amitabha Buddha and Maitreya Bodhisattva Sculptures of Gamsansa Temple (감산사(甘山寺) 아미타불상(阿彌陁佛像)과 미륵보살상(彌勒菩薩像) 조상기(造像記)의 연구)

  • Nam, Dongsin
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.98
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    • pp.22-53
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    • 2020
  • This paper analyzes the contents, characteristics, and historical significance of the dedicatory inscriptions (josanggi) on the Amitabha Buddha and the Maitreya Bodhisattva statues of Gamsansa Temple, two masterpieces of Buddhist sculpture from the Unified Silla period. In the first section, I summarize research results from the past century (divided into four periods), before presenting a new perspective and methodology that questions the pre-existing notion that the Maitreya Bodhisattva has a higher rank than the Amitabha Buddha. In the second section, through my own analysis of the dedicatory inscriptions, arrangement, and overall appearance of the two images, I assert that the Amitabha Buddha sculpture actually held a higher rank and greater significance than the Maitreya Bodhisattva sculpture. In the third section, for the first time, I provide a new interpretation of two previously undeciphered characters from the inscriptions. In addition, by comparing the sentence structures from the respective inscriptions and revising the current understanding of the author (chanja) and calligrapher (seoja), I elucidate the possible meaning of some ambiguous phrases. Finally, in the fourth section, I reexamine the content of both inscriptions, differentiating between the parts relating to the patron (josangju), the dedication (josang), and the prayers of the patrons or donors (balwon). In particular, I argue that the phrase "for my deceased parents" is not merely a general axiom, but a specific reference. To summarize, the dedicatory inscriptions can be interpreted as follows: when Kim Jiseong's parents died, they were cremated and he scattered most of their remains by the East Sea. But years later, he regretted having no physical memorial of them to which to pay his respects. Thus, in his later years, he donated his estate on Gamsan as alms and led the construction of Gamsansa Temple. He then commissioned the production of the two stone sculptures of Amitabha Buddha and Maitreya Bodhisattva for the temple, asking that they be sculpted realistically to reflect the actual appearance of his parents. Finally, he enshrined the remains of his parents in the sculptures through the hole in the back of the head (jeonghyeol). The Maitreya Bodhisattva is a standing image with a nirmanakaya, or "transformation Buddha," on the crown. As various art historians have pointed out, this iconography is virtually unprecedented among Maitreya images in East Asian Buddhist sculpture, leading some to speculate that the standing image is actually the Avalokitesvara. However, anyone who reads the dedicatory inscription can have no doubt that this image is in fact the Maitreya. To ensure that the sculpture properly embodied his mother (who wished to be reborn in Tushita Heaven with Maitreya Bodhisattva), Kim Jiseong combined the iconography of the Maitreya and Avalokitesvara (the reincarnation of compassion). Hence, Kim Jiseong's deep love for his mother motivated him to modify the conventional iconography of the Maitreya and Avalokitesvara. A similar sentiment can be found in the sculpture of Amitabha Buddha. To this day, any visitor to the temple who first looks at the sculptures from the front before reading the text on the back will be deeply touched by the filial love of Kim Jiseong, who truly cherished the memory of his parents.

Usefulness of the Chin Press Maneuver in Assessing the Severity of Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증후군의 진단에 있어 턱 압박술의 유용성)

  • Kim, Moo-Jin
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.22-29
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.

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