• Physical Therapy Rehabilitation Science
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• 제10권1호
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• pp.32-39
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• 2021

Objective: The weakness of muscle strength due to stroke affects the posture control and gait in the patients with stroke. Stroke This study examined the effects of the stair climbing training with functional electrical stimulation on muscle strength, dynamic balance, and gait in individuals with chronic stroke. Design: Randomized controlled trial. Methods: Total forty-eight patients were randomly assigned to the 3 groups. Participants randomly divided to stair climbing training with functional electrical stimulation group (SCT+FES group, n=16), stair climbing training group (SCT group, n=16) and control group (n=16). Subjects in the SCT+FES group and SCT group performed stair walking training with and without functional electrical stimulation for 30 minutes, 3 sessions per week for 4 weeks and all subjects received conventional physical therapy for 30 minutes with 5 sessions per week for 4 weeks. Outcome measurements were assessed using the sit-to stand Test for strength, timed up and go test and modified-timed up and go test for dynamic balance, and 10m walk test and GaitRite system for gait. Results: In the SCT+FES group, subjects have been shown the significant increase in lower extremity strength (p<0.05), significantly improve in dynamic balance (p<0.05), and significantly improve in their temporal gait parameter (p<0.05). The SCT+FES group was significantly better than other groups in all parameters (p<0.05). Conclusions: This result suggested that the SCT+FES may be effective strategy to improve muscle strength, dynamic balance, and gait for individuals with chronic stroke.

• Clinics in Shoulder and Elbow
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• 제25권1호
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• pp.73-89
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• 2022

Background: To evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases. Methods: The PubMed, Medline, and Central databases and trial registries were searched from their inception to October 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL). Results: A total of 17 randomized controlled trials of PRP versus control were analyzed. From 8-12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01-14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provided better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6-7 months. Conclusions: PRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.

• Journal of Preventive Medicine and Public Health
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• 제26권1호
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• pp.1-19
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• 1993

1989년 10월부터 실시되고 있는 약국의료보험과 의약분업제도에 관한 태도를 조사하기 위하여 대구시내 개원의사 및 재국약사를 계통적 표본추출법(systematic sampling)에 의한 표본을 선정하여 우편설문지법으로 1992년 4월 20일부터 5월 20일까지 조사하여 회신된 개원의사 184명, 개국약사 157명의 설문지를 분석한 결과를 요약하면 다음과 같다. 현재 시행중인 약국의료보험의 성과에 대해 개원의사는 71.2%가 '실패적'이라고 한 반면 개원약사는 13.4%가 '실패적'이라고 하였다. 개원의사의 50%는 약국의료보험을 폐지하고 의약분업을 도입해야 한다고 한 반면, 개국약사는 66.9%가 의약분업제도와는 관계없이 약국의료보험자체만으로도 성공적인 제도라고 하였다. 개국약사의 약국 1일 평균조제건수는 32.2회였으며, 약국의료보험 이용횟수는 6.2회로 조제건수의 20%에 불과했고, 의사처방전을 지참한 약국의료보험이용횟수는 조제건수의 0.7%였다. 그리고 개원의사의 원외처방전 발행경험자는 58.7%였다. 의약분업제도의 실시에 대해 개원의사는 59.2%가 찬성하였으며 27.7%가 반대하였으나 재국약사는 38.0%가 찬성, 45.5%가 반대 하였다. 그리고 약사가 의사보다 의약분업의 내용을 더 많이 안다고 하였다. 의약분업제도 실시의 찬성자중 찬성이유로 개원의사는 '의약품의 남오용 방지' (54.1%)를 많이 지적한 반면 개국약사는 '의사와 약사의 전문직능 발휘'(62.0%)를 많이 제기하였다. 그리고 분업찬성자에서 개원의사는 52.3%가 '완전강제분업'을 원한 반면, 개국약사는 81.7%가 '부분분업'을 원하였다. 의약분업제도 실시시에 처방전의 발행 방법에 대해서는 개원의사와 개국약사 모두 '일반명' 처방을 44.0%, 89.8%로 가장 많이 원하였고 개원의사에서는 '상품명' 처방도 35.3%나 차지하였다. 의약분업제도의 실시가 이루어지지 않은 이유에 대해 개원의사 및 개국약사 모두 '의사 약사단체 상호간의 업권문제'를 가장 많이 지적했으며 '국민들의 인식 및 관심 부족' '정부의 의지력 결여' 순으로 일치된 결과로 나타났다. 의약분업실시를 위한 선결조건으로는 '의료시설과 약국의 도시 농촌간의 균등분포'를 가장 많이 지적하였으며 의사는 '약사들의 수용태세 확립', 약사는 '의사의 수용태세 확립'을 그 다음으로 지적해 서로 상반된 결과가 나타났다. 이상의 결과를 종합해 보면 첫째, 조사대상 개원의사들은 현행 약국의료보험제도에 대해 부정적 견해를 보인 반면 개국약사들은 긍정적 견해를 보였으나 약국의료보험이용은 극히 저조하고 의사의 처방전 발행도 저조한 실정이다. 이에 약국의료보험제도에서 의약분업제도로의 제도적 전환이 고려되어야 할 것으로 생각된다. 둘째, 의사와 약사의 의약분업에 대한 의견이 상이한 점으로 미루어 유추할 수 있지만 의약분업제도 실시의 장애요인으로 의 약사단체 상호간의 업권문제와 의약사간의 갈등이 지적되는 바, 이들 모두를 만족 할 대안을 선택하는 것이 쉬운일 아닐 것이므로 국민의 건강보호차원에서 정부의 중립적 의지가 있어야 할 것으로 생각된다.

• 대한정형외과스포츠의학회지
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• 제3권1호
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• pp.81-86
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• 2004

목적: 본 연구는 40세 이후에 발생한 회전근 개 파열을 동반한 재발성 견관절 탈구 환자 중 Bankart병변을 동반한 경우, Bankart복원술이나 소절개 술식(miniopen technique)을 이용한 회전근 개 봉합술을 동시에 시행한 후 후향적 임상적 결과를 분석하고자 하였다. 대상 및 방법: 본 정형외과학 교실에서 1991년 5월부터 2002년 1월까지 내원하여 수술 받은 40세 이상의 회전근 개 파열을 동반한 재발성 견관절 탈구 환자 25례의 환자 중 최종 추시가 가능하였던 22례를 대상으로 하였으며, 평균 연령은 52(범위, 41$\~$67)세, 추시기간은 평균 50.5(범위, 10$\~$47)개월이었다. 결과: 전체 환자 22례 중 Bankart병변을 동반한 환자 8례들의 최종 추시 결과 견관절 운동 범위는 전방거상은 평균 122$^{\circ}$에서 154$^{\circ}$, 외전은 평균 115$^{\circ}$ 에서 161$^{\circ}$ 로 향상되어 술전에 비해 견관절 기능이 유의하게 향상되었다. University of Pennsylvania patient self-assessment 의 동통지수는 술전 11.0에서 술후 5.5로 호전되었다. 환자가 호소하는 동통의 정도는 VAS 평가상 술전 평균 5.4에서 술후 평균 2.5로, UCLA 평가지수는 술전 20.2에서 술후 29.6로, Constant 평가지수는 술전 48.6에서 술후 69.0으로 유의하게 향상되었다. UCLA 평가지수상 전체 환자 22례 중 Bankart병변을 동반한 8례 환자들의 최종 추시 결과 우수 2명, 양호 4명 , 보통 2명이었으며, Bankart병변을 동반하지 않은 14례의 환자군의 최종 추시 시 우수 2명 , 양호 6명, 보통 5명, 불량 1명으로 양 그룹간의 통계적 의미는 없었다. 결론: 40세 이상에서의 견관절 탈구는 재발성은 적고, 회전근 개와 액와신경 손상, 상완골 대결절의 골절을 동반하는 경우가 많다고 알려져 있지만, 회전근 개 파멸과 함께 전방관절낭와순 복합체의 손상이 동반된 경우엔 재발성 불안정성이 증가하여 소절개 술식을 이용한 회전근 개 봉합술과 함께 Bankart봉합술과 같은 전방 구조물 대한 복원을 시행하는 것을 권장한다.

• Asian-Australasian Journal of Animal Sciences
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• 제20권2호
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• pp.295-306
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• 2007

The growth and health of the fetus and neonate are directly influenced by the nutritional and physiological status of sows. Sows are often under catabolic conditions due to restrict feeding program during pregnancy and low voluntary feed intake during lactation. The current restrict feeding program, which aims at controlling energy intake during gestation, results in an inadequate supply of dietary protein for fetal and mammary gland growth. Low voluntary feed intake during lactation also causes massive maternal tissue mobilization. Provision of amino acids and fatty acids with specific functions may enhance the performance of pregnant and lactating sows by modulating key metabolic pathways. These nutrients include arginine, branched-chain amino acids, glutamine, tryptophan, proline, conjugated linoleic acids, docosahexaenoic acid, and eicosapentaenoic acid, which can enhance conception rates, embryogenesis, blood flow, antioxidant activity, appetite, translation initiation for protein synthesis, immune cell proliferation, and intestinal development. The outcome is to improve sow reproductive performance as well as fetal and neonatal growth and health. Dietary supplementation with functional amino acids and fatty acids holds great promise in optimizing nutrition, health, and production performance of sows and piglets. (Supported by funds from Texas Tech, USDA, NLRI-RDA-Korea, and China NSF).

• Archives of Plastic Surgery
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• 제34권5호
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• pp.656-658
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• 2007

Purpose: Prader-Willi Syndrome(PWS) is a congenital chromosomal disorder characterized by compulsive and early development of obesity. Obesity is identified as the main cause of morbidity in PWS individuals. Also, body change for rapid weight gain, such as gynecomastia, can cause considerable functional and psychological trauma, We corrected successfully gynecomastia in PWS patient, so we reported our experience of surgical method and literature reviews. Methods: A 16-year-old male patient presented with gynecomastia. He was diagnosed as with PWS at pediatric department. We performed reduction mammaplasty using inferior pedicle and Wise pattern. Excision amount was 1350g in right breast and 1415g in left breast. Also, we managed upper and lateral fullness of breast with liposuction. Results: There were no specific complications, such as hematoma, infection, nipple-areola complex necrosis, and so on. Also, aesthetic and functional outcome was acceptable Conclusion: We experienced successful correction of gynecomastia in PWS patient, and found advantages of conventional reduction mammaplasty using inferior pedicle and Wise pattern at this specific situation.

• 대한치과보철학회지
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• 제53권1호
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• pp.81-85
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• 2015

본 증례의 환자는 상악 전치부 보철물의 파절 및 기존에 사용하던 하악 의치의 불편감 때문에 임플란트를 이용한 고정성 보철을 원한다는 주소로 내원하였다. 상악동 거상술, 하악지 골이식과 함께 상악에 5개, 하악에 6개의 임플란트를 식립하였다. 전치부와 양쪽 구치부의 세 부분으로 나누어 임플란트 지지형 고정성 보철물을 장착하였다. 이상과 같은 과정을 통해 적절한 심미적, 기능적 결과를 얻었기에 이를 보고하고자 한다.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.189-194
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• 2017

Background: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. Methods: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. Results: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). Conclusions: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.172-177
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• 2000

Background and Objectives : Until now, various attempts have been made fir reinnervating paralyzed vocal cord. Nevertheless, the most cases did not produce satisfactory outcome due to occurrence of synkinesis of larynx secondary to misdirected axonal regeneration. Accordingly, the purpose of this investigation is to learn the effect of chronic electrical stimulation on regeneration of the recurrent laryngeal nerve. Material and Methods : Using 20 healthy male Sprague-Dawley rats(250-300g) with normal vocal functions, transections were made on their left recurrent laryngeal nerves and then primary anastomosis were performed under the operating microscope and they were divided into an experimental group and a control group each having 10 rats. After the procedure, for the experimental group, chronic electrical stimulation was carried out until vocal cord movement was functionally recovered. for the control group, only chronic electrical stimulation was not given. Result : In experimental group, the number of functionally recovered rats was two and in control group, that of functionally recovered rate was same. The reorganization of posterior cricoarytenoid muscle motoneuron in nucleus ambiguus appeared in the case of directed reinnervation of recurrent laryngeal nerve. Conclusion : The chronic electrical stimulation does not a direct beneficial effect on the early functional recovery in rats with injured recurrent laryngeal nerve.

• 대한간호학회지
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• 제34권8호
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• pp.1402-1408
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• 2004

Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.