• 대한물리치료과학회지
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• 제8권1호
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• pp.859-867
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• 2001

The purpose of this single subject care study was to evaluate the effectiveness of a functional electrical stimulation(FES) treatment program designed to prevent glenohumeral pint stretching and subsequent subluxation and shoulder pain in hemiplegic patients. The subject was a 43-year-old male who had left side hemiparesis with shoulder pain and subluxation on affected side. He received conventional physical therapy and additional FES therapy where two flaccid shoulder muscles, supraspinatus and posterior deltoid. were induced to contract repetitively up to 20 minutes for 2 weeks. As a result. the patient showed improvements in hemiplegic arm function, reduction in subluxation(as indicated by Jig test) and range of motion(SLROM). But it was difficult to generalize. We concluded that the FES program was effective in reducing the severity of shoulder subluxation and pain. Further study must be evaluated its statistical significance.

• Journal of Korean Neurosurgical Society
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• 제29권9호
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• pp.1184-1187
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• 2000

Spontaneous spinal epidural hematoma is rare disease and usually presents with a progressive neurological syndrome for which surgical decompression is usually indicated. The cause of bleeding in epidural hematoma remains unknown in most of the cases. The most frequently identified risk factor is coagulopathy or treatment with anticoagulants. Recently, authors experienced a case of spontaneous spinal epidural hematoma with intraoperative profuse bleeding at the cervicothoracic location. Laboratory examination showed no evidence of coagulopathy or hepatic disease. On neurologic examination, left hemiparesis(Grade : II) and left side sensory change were noted. On MRI scan, there was a mass of high signal intensity in T2WI and isosignal intensity in T1WI compressing the cord to left side. The patients had good surgical outcome after decompressive laminectomy and hematoma removal.

• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.550-553
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• 2015

A 67-year-old male presented with left temporal hemianopsia and left hemiparesis. A contrast-enhanced magnetic resonance image revealed a $4.5{\times}3.5{\times}5.0cm$ rim-enhancing mass with central necrosis and associated edema located in the left occipital lobe. Of positron emission tomography and abdominal computed tomography, a 9-cm mass with poor enhancement was found in the right hepatic lobe. Craniotomy and right hemihepatectomy was performed. The resected specimen showed histological features and immunochemical staining consistent with a metastatic neuroendocrine tumor (NET). Four months later, the tumors recurred in the brain, liverand spinal cord. Palliative chemotherapy with etoposide and cisplatin led to complete remission of recurred lesions, but the patient died for pneumonia. This is the first case of a metastatic brain NET originating from the liver. If the metastatic NET of brain is suspicious, investigation for primary lesion should be considered including liver.

• 한국콘텐츠학회논문지
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• 제15권4호
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• pp.342-349
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• 2015

본 연구는 뇌졸중 환자를 대상으로 양손 보완운동 및 한손운동을 수행하는 동안 환측의 움직임을 측정하여, 양손 보완운동의 효과를 검증하고자 수행되었다. 대상자는 부산지역에 거주하는 뇌졸중 후 편마비 환자 중 12가지 기준을 적용하여 30명을 선정하였다. 과제 수행 동안 환측의 움직임 특성을 측정하기 위해 피트메터(Fitmeter) 가속도계를 부착하여 신호벡터크기(Signal Vector Magnitude: SVM), 최고 가속도(peak acceleration), 최고 감속도(peak deceleration)를 측정하였다. 연구 결과 양손 보완운동은 한손운동보다 수행시간이 짧았고(p<0.05), 신호벡터크기가 감소하였다(p<0.05). 따라서 뇌졸중 환자가 일상생활동작을 수행할 때 환측만 사용하는 것보다 건측을 보완적으로 사용하는 것이 운동형상학적으로 움직임 향상에 도움이 될 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.256-259
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• 2011

We report a rare case of Williams syndrome accompanying moyamoya disease in whom postoperative global cerebral infarction occurred unpredictably. Williams syndrome is an uncommon hereditary disorder associated with the connective tissue abnormalities and cardiovascular disease. To our knowledge, our case report is the second case of Williams syndrome accompanying moyamoya disease. A 9-year-old boy was presented with right hemiparesis after second operation for coarctation of aorta. He was diagnosed as having Williams syndrome at the age of 1 year. Brain MRI showed left cerebral cortical infarction, and angiography showed severe stenosis of bilateral internal carotid arteries and moyamoya vessels. To reduce the risk of furthermore cerebral infarction, we performed indirect anastomosis successfully. Postoperatively, the patient recovered well, but at postoperative third day, without any unusual predictive abnormal findings the patient's pupils were suddenly dilated. Brain CT showed the global cerebral infarction. Despite of vigorous treatment, the patient was not recovered and fell in brain death one week later. We suggest that in this kind of labile patient with Williams syndrome accompanying moyamoya disease, postoperative sedation should be done with more thorough strict patient monitoring than usual moyamoya patients. Also, we should decide the revascularization surgery more cautiously than usual moyamoya disease. The possibility of unpredictable postoperative ischemic complication should be kept in mind.

• Journal of Magnetics
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• 제19권4호
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• pp.353-356
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• 2014

The aim of the present study was to examine whether mental practice (MP) in conjunction with repetitive transcranial magnetic stimulation (rTMS) can improve the upper limb function of sub-acute stroke patients. This study was conducted with 32 subjects who were diagnosed with hemiparesis by stroke. The experimental group consisted of 16 members upon each of whom was performed MP in conjunction with rTMS, whreas the control group consisted of 16 members upon each of whom was performed MP and sham rTMS. Both groups received traditional physical therapy for 30 minutes a day, 5 days a week, for 6 weeks; additionally, they received mental practice for 15 minutes a day. The experimental group was instructed to perform rTMS, and the control group was instructed to apply sham rTMS for 15 minutes. A motor cortex excitability analysis was performed by motor evoked potentials (MEPs), and upper limb function was evaluated by Fugl-Meyer Assessment (FMA) and the Box and Block test (BBT). Results showed that the amplitude, latency, FMA, and BBT of the experimental group and the latency, FMA, and BBT of the control group were significantly improved after the experiment (p<0.05). Significant differences were found between the groups in amplitude and latency after the experiment (p<0.05). The results showed that MP in conjunction with rTMS is more effective in improving upper limb function than MP alone.

• 대한구순구개열학회지
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• 제6권1호
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• pp.35-42
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• 2003

PAP (Palatal Augmentation Prosthesis) may be given to the patients with dysphagia; especially, who cannot achieve tongue-palate contact. PAP fills hard palate area where the tongue cannot make contact and then the distance of tongue elevation is shortened. 1bat may be expected to improve swallowing and to prevent from aspiration. The purpose of this report is to show the effects of PAP in patients with dysphagia through the videofluoroscopic study. Oral-pharyngeal swallowing post PAP is analyzed in 2 cases; one is a person who had subarachnoid hemorrhage due to aneurysmal rupture, right hemiparesis, hydrocephalus and aphamia. And the other is a person who had squamous cell carcinoma on mouth floor and he had radical neck dissection and marginal mandibulectomy. In this report, the rate of aspiration, the transit time and length measurements of anatomical structure are examined in the each frame of videofluoroscopy. The results are as follows; 1) PAP decreased the aspiration in both cases. 2) In the cases of patients with PAP, the pharyngeal transit time was decreased.

• 한국전문물리치료학회지
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• 제8권4호
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• pp.91-99
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• 2001

뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonu se syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환측 상지를 사용하게 하여 기능을 반복 학습하게 함으로써 기능을 증진시키는 방법이다. 이미 여러 연구자들이 경두개 자기자극(transcranial magnetic stimulation), 움직임 관련 피질전위(movement-related cortical potential), 기능적 자기공명 영상기법(functional magnetic resonance imaging) 등을 통하여 억제-유도 치료 후 운동피질영역에서의 재조직화를 보고함으로써 기능 증진과 관련된 회복 기전을 뒷받침하고 있다. 억제-유도 치료의 영역은 확대되어 뇌졸중, 척수손상, 고관절 치환술 후로 하지에서의 기능증진을 위하여 연구가 진행되고 있으며 특히 뇌졸중 후 실어증 환자에서 새로운 방법으로 제시되고 있다. 따라서, 억제-유도 치료는 신경학적인 손상 후 움직임의 재활에 있어서 치료-유도를 통한 중추신경계의 회복에 효과적으로 작용할 수 있다.

• 재활간호학회지
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• 제4권2호
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• pp.187-197
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• 2001

The purpose of this study was to determine the effects of self-help management program which strengthens self-efficacy for post stroke elders who attend day care center in Chongju. One group pretest-posttest design was used, and the subjects were 7 post stroke elders with hemiparesis. The self-help management program consisted of 5 sessions and each session included group education on stroke, ROM exercise, recreation and self-care strategies. Those strategies for encouraging and reinforcing self-efficacy provided verbal persuasion, performance accomplishment and vicarious experience. All subjects were questioned before and after the program about ADLs, IADLs, self-efficacy, self-care behavior and depression. The analysis of data revealed that the program was effective to increase the IADLs, self-efficacy and self-care behavior. However, there was no significant difference between pre and post ADLs and depression. The results indicated that this program may be adopted to improve the physical and psychological function of post stroke elderly patients in community settings.

• 한국전문물리치료학회지
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• 제19권1호
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• pp.86-93
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• 2012

The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.