• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.1-10
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• 2021

Botulinum toxin type A (BoNT-A), onabotulinumtoxinA (Botox) was approved by the United States Food and Drug Administration for temporary improvement of glabellar lines in patients 65 years and younger in 2002, and has also been used widely for aesthetic purposes such as hyperhidrosis, body shape contouring, and other noninvasive facial procedures. BoNT-A inhibits presynaptic exocytosis of acetylcholine (ACh)-containing vesicles into the neuromuscular junction at cholinergic nerve endings of the peripheral nervous system, thereby paralyzing skeletal muscles. ACh is the most broadly used neurotransmitter in the somatic nervous system, preganglionic and postganglionic fibers of parasympathetic nerves, and preganglionic fibers or postganglionic sudomotor nerves of sympathetic nerves. The scientific basis for using BoNT-A in various cosmetic procedures is that its function goes beyond the dual role of muscle paralysis and neuromodulation by inhibiting the secretion of ACh. Although the major target organs for aesthetic procedures are facial expression muscles, skeletal body muscles, salivary glands, and sweat glands, which are innervated by the somatic or autonomic nerves of the peripheral cholinergic nerve system, few studies have attempted to directly explain the anatomy of the areas targeted for injection by addressing the neural physiology and rationale for specific aesthetic applications of BoNT-A therapy. In this article, we classify the various cosmetic uses of BoNT-A according to the relevant component of the peripheral nervous system, and describe scientific theories regarding the anatomy and physiology of the cholinergic nervous system. We also review critical physiological factors and conditions influencing the efficacy of BoNT-A for the rational aesthetic use of BoNT-A. We hope that this comprehensive review helps promote management policies to support long-term, safe, successful practice. Furthermore, based on this, we look forward to developing and expanding new advanced indications for the aesthetic use of BoNT-A in the future.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.65-73
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• 2022

PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

• Archives of Craniofacial Surgery
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• v.25 no.1
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• pp.22-26
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• 2024

Background: This study analyzed the demographic characteristics of patients with facial palsy who were treated using either dynamic or static procedures. This study aimed to compare the frequency of procedure implementation and age distribution between the two groups. Methods: This study retrospectively analyzed the medical records of patients treated for facial palsy at a single institution from 2014 to 2022. Among cases included in our study, dynamic procedures involved cross-facial nerve graft and latissimus dorsi or gracilis muscle flap transfer. Static procedures included gold weight insertion, canthopexy, browlift, and thread lift/static slings. Results: Among the 31 patients included in our study, eight (25.8%) incorporated dynamic techniques, and the average age of patients was 44.75 years (range, 24-68 years) with a male to female ratio of 1:4. The remaining 23 patients (74.2%) underwent a static procedure, of which the average age was 59.17 years (range, 23-81 years) which was statistically significantly higher than the average age of 44.75 of dynamic patients (p= 0.013). Regarding the timing of treatment after diagnosis, no patient underwent dynamic procedures more than 20 years after initial diagnosis. A greater diversity in the timing of treatment was observed in the static group. All patients who underwent dynamic procedures were treated using static procedures during the study period. Conclusion: Because aesthetics-based static techniques are typically quick outpatient procedures that can be performed under local anesthesia, our study shows that these are often preferred treatments for all age groups, especially for debilitated or older patients. Further research is required to investigate the long-term functional outcomes of these surgical techniques in a wider population of patients.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.2
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• pp.228-242
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• 2000

Meridian massage is originated from oriental medical manipulation, and it has been mainly applied to as pain and paralysis. The purpose was to develop new method of nursing care for help hemiplegic patients to recover their functions of upper limbs and to reduce depressions. This study was carried out between 8, March, and 8, June, 2000 and the subjects of the study were .60 hemiplegic stroke patients who were participants at a hospitalized in K oriental medical center. The experimental group(30) and the control group(30) were assigned by means of participation order. The experimental group took meridian massage on affected upper limb for 10 minutes daily for 2 weeks. We evaluated muscle power and endurance with band from AVIVA corp.; range of motion with goniometer; shoulder pain with visual analogue scale; swelling with Jeweiers ring measurement of Dirette; depression with self-rating depression scale translated into Korean by Yang(1982). Data were analyzed by SPSS PC and the results are described below. The experimental group showed better muscle power and endurance than control group. Range of motiont of affected shoulder improved significantly in experimental group. Also, the experimental group showed less shoulder pain, hand edema, depression than control group. In this study, we observed that meridian massage is an effective nursing care in improving the function of upper limb and managing depression of stroke patients.

• The Journal of Korean Physical Therapy
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• v.10 no.2
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• pp.13-32
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• 1998

A questionaire was conducted to obtain ran satisfactions in information of the 325 disabled persons among the total 9,314 handicapped people in Taejon area, and was surveyed during the period of June 1 to August 31, 1997. The results are as follows: 1. Among the studied disabled persons, $54.5\%$ of male, and $45.5\%$ of female. 2. Before disabled in occupation, $32.0\%$ of out of work group were high, $6.5\%$ of farm, student group were low. Before disabled in occupation by gender, male group is $29.9\%$ of out of work group were high, $0.6\%$ of housework group were low. female group is$34.5\%$ of out of work group were high, $4.7\%$ of student group were low(P<0.001). 3. After disabled in occupation, $75.1\%$ of out of work group wert high, $10.8\%$ of in working group were low. After disabled in occupation by gender, male group is $87.6\%$ of out of work group were high, $1.7\%$ of housework group were low. female group is $60.1\%$ of out of work group were hgh, $10.8\%$ of in working group were low(P<0.001). 4. Medical security status, $64.9\%$ of medical aid group wore high, $35.1\%$ of medical insurance group were low. Medical security status by gender, male group is $71.2\%$ of medical aid group were high, $28.8\%$ of medical insurance group were Iew. female group is $57.4\%$ of medical aid group wan high, $42.6\%$ of medical insurance were low(P<0.01). 5. Disabled record status, $68.6\%$ of record group were high, $31.4\%$ of non group were low. Disabled record status by gender, male group is $78.5\%$ of record group were high, $21.5\%$ of non record group were low. female group is $56.6\%$ of record group were high, $43.4%$ of non record group were low(P<0.001). 6. Disabled duration status, $42.2\%$ of loss than 9 year group were high, $10.2\%\;of\;20-29,\;30-39$ year group were low. Disabled duration status by gender,'male group is $44.6\%$ of less than 9 year group were high, $6.2\%$ of 20-29 year group wert low. female group is $39.2\%$ of less than 9 year were high, $39.2\%$ of 30-39 year group were low (P<0.05). 7. Cause of disabled status, $26.5\%$ of other group, $23.7\%$ of congenital group were high. $9.2\%$ of unknown group, $6.8\%$ of industry accident, $2.5\%$ of drug poisoning group were low. Cause of disabled status by gender, male group is $27.7\%$ of other group, $23.7\%$ of congenital group were high, $2.3\%$ drug poisoning group were low. female group is $25.0\%$ of other group, $20.9\%$ of congenital group were high, $2.5\%$ of drug poisoning group were low (P<0.001). 8. Disabled type status, $19.4\%$ of double disabled group were high, $2.2\%$ of muscle paralysis group were low. Disabled type status by gender, male group is $22.0\%$ of double disabled group were high, $2.3\%$ of muscle paralysis group were low. female group is $23.3\%$ of rheumatism group were high, $0.7\%$ of amputation group were low(P<0.001). 9. Smoking status, $73.2\%$ of non smoking group were high, $26.8\%$ of smoking group were low. Smoking status by gender, male group is $59.9\%$ of double non smoking group were high, $40.1\%$ of Smoking group were low, female group is $89.2\%$ of non smoking group were high, $10.8\%$ of smoking group were low(P<0.001). 10. Drinking status, $80.0\%$ of non drinking group were high, $20.0\%$ of drinking group were low. Drinking status by gender, male group is $72.3\%$ of non drinking group were high, $27.7\%$ of drinking group were low. female group is $89.2\%$ of non drinking group were high, $10.8\%$ of drinking group were low(P<0.001). 11. Stress level status, $52.9\%$ of high stress group were high, $1.8\%$ of very severe stress group were low. Stress level status by gender, male group is $50.8\%$ of high stress group were high, $2.3\%$ of very severe stress group were low. female group is $55.4\%$of high stress group were high, $1.4\%$ of very severe stress group were low. 12. Heed status, $28.0\%$ of economic support were high, $4.6\%$ of speech therapy, brace group were low. Need status by Sender, male group is $2i2\%$ of economic support group were high, $4.5\%$ of bracegroup were low. female group is$27.7\%$ of economic support group were high, $3.4\%$ of speech therapy group were low. 13. Care satisfaction comparision, 3.09, 0.55 point of IBR, 4.01, 0.45 point of CHR(P<0.001). 14. The variables which had positive correlation with IBR were gender(r=0.1406, P<0.01), age(r=0.1872, p<0.001), economic level(r=0.1246, P<0.05), disabled record(r=0.1137, P<0.05), education level(r=-0.1122. p<0.05). 15. The variables which had positive : correlation with CBR were gender(r=0.1613, P<0.01), age(r=0.2255, P<0.001). list of family(r=0.12i3, P<0.01), disabled record(r=0.1273, P<0.05). education level(r=-0.1294, P<0.01).

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.313-318
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• 1986

Primary aldosteronism is a disease that the stimulus for the excessive aldosterone production resides within the adrenal gland. It was first described by conn in 1955. And many cases were reported by physicians at present in the world. But it is relatively rare in Korea, probably due to lack of attension and medical facilities. Only about 13 cases have been reported at present. The clinical, biochemical features in 1 case of primary aldosteranism caused by adrenal hyperplasia that was diagnosed at Yeungnam University Hospital was observed and the following result were obtained. 1. Clinical feature: The present case was 27-year-old woman who was admitted due to general weakness and easy fatigability. The above mensioned chief complaints occurred 8 months prior to admission when she delivered of second baby by cesarian section. Symptoms such as above chief complaints, intermittent muscle paralysis and cramping were noticed. Trousseau's sign was also present. The average blood pressure ranged from 170/90 to 200/120. 2. Biochemical abnormalities: Severe hypokalemia lower than 2.5 mEq/L was presented and 24 hours urine potassium showed markedly increased urinary loss.(228 mEq/day). Plasma renin activity was decreased under normal range with furosemide administration.(Basal renin; 0.01ng/ml/hr, stimulated renin 0.12ng/ml/hr). Saline suppression test revealed markedly elevated levels of aldosterone higher than normal range. (Basal aldosterone; 320.68pg/ml stimulated aldosterone; 451.86pg/ml). And posture test showed decreased plasma renin activity and increased plasma aldosterone level. - PRA(ng/ml/hr)=Bsal: 0.05(0.15~2.33), Stimulated: 0.22(1.31~3.95) - Aldosterone(pg/ml)=Bsal: 242.77(10~160), Stimulated: 432.09(40~310) 3. Adrenal CT scan revealed no abnormal findings. 4. Treatment and course: Spironolactone was given at OPD with regular follow-up. Her blood pressure ranged from 150/90 to 160/100 and symptoms were improved. The effect of treatment was satisfactory and further follow up would be performed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.2
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• pp.113-117
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• 2005

Background and Objective : Vocal fold augmentation by injectable material under direct visual control is an easy and simple operation. However, when autologous fat or bovine collagen is used, the resoiption creates a problem. And autologous fascia is debating about absorption now days. We previously reported on the one year results of injected autologous auricular cartilage for volumetric augmentation in paralyzed canine vocal cord. This study evaluates the long-term histomorphologic results of injected autologous auricular cartilage for the augmentation of the paralyzed canine vocal fold at two year. Material and Methods . A prospective trial of autologous cartilage augmentation of vocal cord in animal model. Three dogs were operated upon. A piece of auricular cartilage was harvested from the ear and minced into tiny chips with a scalpel. Fat was harvested from inguinal area and minced with a scalpel. The minced cartilage and fat-paste (0.2ml) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle using direct laryngoscopy. Three animals were sacrificed at 2 years. Each subject underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior vocal fold were made. Results There was no significant complication perioperatively and during follow-up. The injected cartilage which appeared to have lost viability existed in the vocalis muscles until 24 months. Fibrotic change was exhibited in the surrounding injected cartilage. Conclusion : The autologous auricular cartilage graft is well tolerated and may be very effective material for volumetric augmentation on paralyzed vocal cord.

• Journal of fish pathology
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• v.22 no.1
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• pp.67-73
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• 2009

It was examined whether the common belief that "cultured puffer fishes do not contain tetrodotoxin (TTX)", the major lethal substance that accidently causes death in consumers of those fishes, is true in river puffer fish Takifugu obscurus. In mouse bioassay, lethal levels of toxins were detected in the ranks: gonad>liver>intestine>muscle>skin in wild puffer fish. In contrast, no mortality occurred in the mouse bioassay on cultured fish. However, there were sleepiness, sluggish behavior, and hind limb paralysis with the tissue extracts of cultured fish suggesting the presence of TTX or other similarly acting toxins. An attempt to confirm the presence of TTX in cultured fish with high performance liquid chromatography (HPLC) was not very successful. The results suggest possible existence of TTX toxins or similarly acting toxins.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.90-95
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• 2014

Background and Objectives : Arytenoid adduction procedure is one of the main surgical options addressed for the correction of glottal incompetence in patients with unilateral vocal cord paralysis. Traditionally, a midline approach is used for identifying and suturing around the muscular process, which often needs over-traction of the thyroid cartilage and results in patient's discomfort as well as surgeon's distress. The authors investigated the advantage of a modified procedure, lateral approach, in which the arytenoid cartilage is exposed through the space between strap muscles and sternocleidomastoid muscle. Materials and Methods : Retrospective chart review was performed for 66 patients who received arytenoid adduction surgery at Samsung Medical Center, between the year 1997 and 2014. Operation time, types of anesthesia, voice outcomes and complications were compared between the midline (n=22) and the lateral (n=44) approach group. Results : Operation time was shorter in the lateral approach group ($125{\pm}24min$) than in the midline group ($144{\pm}24min$). Arytenoid adduction was proceeded under local anesthesia in 66% (n=29/44) and 14% (n=3/22) of patients with lateral and midline approach group, respectively. Voice outcomes and complication rates were comparable between the two groups. Injection laryngoplasty in conjunction with arytenoid adduction resulted in more favorable voice outcomes. Conclusion : A lateral approach for the arytenoid adduction procedure showed comparable voice outcomes and similar complication rates with those of a midline approach. However, lateral approach provided less discomfort to the patients and less distress to a surgeon, and therefore, shorter operation time was needed and local anesthesia could be more frequently applied for this modified procedure.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.479-487
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• 2004

Biopotential signals have been used as command in systems using electrical stimulation of motor nerves to restore movement after an injury to the central nervous system (CNS). In order to use the voluntary EMG (electromyography) among the biopotentials as a control signal for the electrical stimulation of the same muscle for CNS injury patients, it is necessary to remove M-wave of having high magnitude from raw data. We designed an optimal filter for removing the M-wave and preserving the voluntary EMG and showed that the optimal filter is eigen filter. We also proved that the previous method using the prediction error filter(PEF) is a suboptimal filtering in the sense of preserving the voluntary EMG. On basis of the data obtained from a model for M-wave and voluntary EMG and from actual CNS injury patients, with false-positive rate analysis, the proposed adaptive filter showed a very promising performance in comparison with previous method.