• Journal of radiological science and technology
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• v.27 no.4
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• pp.11-16
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• 2004

Classification of esophageal motility disorders not yet finalized and is still ongoing as the new disorders are reported, and the existing classification is changed or removed. In terms of radiology, the primary peristalsis does not exist, and the lower end of the esophagus show the smooth, tapered, beak-like appearance. The esophageal motility disorder, which mostly occurs in the smooth muscle area, show the symptoms of reduction or loss (hypomotility) or abnormal increase (hypermotility) of peristalsis of the esophagus. It is important to understand the anatomy and physiology of the esophagus for the appropriate radiological method and diagnosis. Furthermore, the symptom of the patient and the manometry finding must be closely referred for the radiological diagnosis. The lower esophageal sphincter can be normally functioning and open completely as the food moves lower. Sperandio M et al. argues that the name diffuse esophageal spasm must be changed to distal esophageal spasm (DES) as most of the spasm occurs in the distal esophagus, composed of the smooth muscle. According to Ott et al., usefulness of barium method for diagnosing the esophageal motility disorder is Achalasia 95%, DES 71% and NEMD 46%, with the overall sensitivity of 56%. However, excluding the nutcracker esophagus or nonspecific disorder which cannot be diagnosed with the radiological methods, the sensitivity increases to 89%. Using videofluoroscopy and 5 time swallows, the average sensitivity was over 90%. In conclusion, the barium method is a simple primary testing method for esophageal motility test. Using not only the image but also the videofluoroscopy with good knowledge of the anatomy and physiology, it is believed that the method will yield the accurate diagnosis.

• The Journal of Korean Physical Therapy
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• v.13 no.2
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• pp.359-371
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• 2001

The purpose of this study is to find out the effectiveness of the therapeutic sports massage(TSM) applied to the patients with delayed onset muscle soreness(DOMS) by measuring, assessing and analyzing the changes in intensity and unpleasantness of muscle pains before and after TSM. In the therapeutic sports massage program, such methods as effleurage, petrissage and deep transverse friction were selected as traditional massage treatments frequently used for muscles with pain and spasm. Effleurage and petrissage were applied for 20 minutes in total before and after deep transverse friction treatment. After TSM, the McGill pain questionnaire word list(MPQWL), verbal rating scale(VRS), visual analogue scale(VAS) were used to measure the degree of the pain on the patients. The major findings from this study are as follows; 1. The surveyed patients range from 15 to 63 in age, with highest numbers of 18(37.50%) registered in the twenties and next ones of 14(29.17%) in the thirties. Divided by sex, 27 are men and 21 are women totalling 48 with average age of 25.7. 2. There was significant decrease in the numerical values of VAS & VRS and MPQWL immediately after TSM(p<.05). There was also significant decrease in the numerical values of MPQWL, VRS and VAS after the 2nd, 3rd, 4th, 5th TSM(p<.05). 3. There was significant decrease in the intensity and unpleasantness of pains after TSM(p<.05). 4. From the analysis into chronological changes in the intensity and unpleasantness of pains before and after TSM with ANOVA, it became evident that the longer the period of treatment was, the higher the pains decreases drastically, while significant difference was shown in the intensity and unpleasantness of pains(p<.05). Summed up, it can be generally concluded that TSM is an effective treatment to rid the patients with DOMS of pains safely and promptly.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1704-1708
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• 2008

Many studies have emphasized the importance of resistive exercise to maintain a healthy human body, particular in prevention of weakening of physical strength. Recently, some studies advocated that an application of vibration as a supplementary means in a regular training was effective in encouraging physical strength. Aim of the current study was, therefore, to identify if an application of vibration in a resistive exercise was effective in encouraging physical strength as that in a regular training. A 3-dimensional virtual lower extremity model for a healthy male and virtual leg-press model were generated and synchronized. Dynamic leg-press exercises on a slide machine with/without extra load and on a footboard with vibration as well as on a slide machine with extra load were analyzed. The results of the current indicated that the application of the vibration on the dynamic leg-press exercise might be not greatly effective in encouraging physical strength, compared with the dynamic leg press exercise with extra load. It was, however, thought that the application of the vibration might be helpful to elderly individuals because the reduced maximum muscle strength appeared by the effect of the vibration may avoid a muscular spasm, which can be driven from a high muscle strength sometimes produced during the leg-press exercise with extra load.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.340-349
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• 2007

Free flap transplantation with microvascular anastomosis has been successfully performed by development of surgical technique, materials and postoperative monitoring equipments of flap. But success rate of microvascular anastomosis is influenced by various factors, and failure rate is about 5-10%. The most influential factor for success rate is surgical technique and other factors that influence failure of microvascular anastomosis are ischemic time of free flap, thrombus formation of anastomosis region and vascular spasm. In this study, vascular patency and thrombus formation in experimental micro-venous anastomosis, and endothelial repair were observed with histologic analysis, scanning electron microscopy, transmission electron microscopic examination. The results were obtained as follows: 1. In vascular patency test in 30 minute and 7 days after micro-venous anastomosis with heparin irrigation, all of 12 anastomosis site were good vascular patency. 2. In thrombus formation in 2 weeks group(Experimental I), 2 site of 6 cases were observed thrombus, and in 4 weeks group(Experimental II), 1 site of 6 cases were observed thrombus. 3. In histologic examination, normal vein(Control Group) showed continued internal elastic lamina, well formed thick smooth muscle layer and connective tissue. The group of 2 weeks after microvenous anastomosis(Experimental I) showd locally recovered internal lamina, discontinued internal lamina, disorganized smooth muscle cells and granulation tissue around suture silk. In the group of 4 weeks after micro-venous anastomosis(Experimental II), anastomosis site showed almostly continued internal lamina, disorganized smooth muscle cells and cicartrized tissue around suture silk. 4. In scanning electron microscope examination in 2 weeks(Experimental I) after micro-venous anastomosis, mesh fibrin formation showed near to endothelial cells, and in 4 weeks after micro-venous anastomosis(EXperimental II), numerous blood cells and fibrin mesh formation was seen associated with irregular endothelial cell arrangement. 5. In transmission electron microscope examination in 2 weeks after micro-venous anastomosis(Experimental I), irregular arrangement of smooth muscle cells was seen adjacent to collagenized tissue around suture silk. In 4 weeks after micro-venous anastomosis(Experimental II), denuded venous wall composed of relatively well arranged smooth muscle cells was covered by endothelial cells, but fibroblast cells and foreign body giant cells near to suture silk was remained. From the results obtained in this study, results of good vascular patiency and anti-thrombotic effect of heparin were obtained as a local irrigation solution, and repair of venous endothelial cell was observed in 2 weeks after micro-venous anastomosis.

• Journal of Acupuncture Research
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• v.19 no.3
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• pp.230-239
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• 2002

Kyphotic cervical curvature, straghtening is commonly caused by trauma, muscle spasm without trauma and wrong posture, etc. Objective : This study is performed to evaluate the clinical effect of neck pain associated with Kyphotic cervical curvatre on cervical x-ray lateral view. Methods : One of the many causes, We examined the patients with neck pain & upper back pain who visited to Department of Acupuncture & Moxibustion, Gumi Oriental Hospital of Kyung-San University from 16th June 1999 to 22th June 2000. Pre and post treatment, We evaluated the cervical angle, Jochumsen's method, VAS(visual analogue scale) and effective score of treatment. Results & Conclusion : 1. Kyphotic cervical curvature is mainly caused by wrong posture during long term, sudden trauma, etc. therfore, postcervical muscles and tendon are injuryed by strong stress. So, muscle imbalance and pain is occured. 2. On these cases, The improvement index for pre/post treatment showed 28/42, 10/15, 9/30, 28/42 degree in cervical angle. Jochumsen's method showed -1/+2, -9/-3, -5/-2, -1/+2mm. Afer treatment VAS is 2, 1, 1, 1 and effective score of treatment is above good. The results suggest that treatments of Oriental Medicine(Acupuncture & Moxibustion, Chu-Na, Cupping and Physical therapy) are effective methods for neck pain with kyphotic cervical curvature on cervical x-ray lateral view.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.97-100
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• 2000

Thoracic outlet syndrome (TOS) is a combination of signs and symptoms caused by the compression of the vital neurovascular structure at the thoracic outlet region. It may stem from a number of abnormalities, including degenerative or bony disorders, trauma to cervical spine, fibromuscular bands, vascular abnormalities and spasm of the anterior scalene muscle. CPT (current perception threshold) is defined as the minimum amount of current applied transcutaneously that an individual consciously perceives. It enables quantification of the hyperesthesia that precedes progressive nerve impairment, as well as hypoesthetic conditions. We experienced a case of thoracic outlet syndrome caused by fibrosis of anterior scalene muscle. The patient was a 30 years old woman with a 3 years history of numbness on the ulnar side, progressive weakness and coldness of both hand, tiredness in the left arm, nocturnal pain in the left forearm, and pain in the left elbow, shoulder and neck. Conservative treatment, stellate ganglion block, cervical epidural block, anterior scalene block and previous operation, including both carpal tunnel release, provided no remarkable relief to the patient. A left scalenectomy and first rib resection were performed by transaxillary approach and left cervical root neurolysis was done. After surgery, we measured CPT using neurometer and found conditions worsening in the opposite arm. We performed the same procedure on right side, and followed by CPT measurement. This case suggests that CPT is a useful measurement of recovery and progression of TOS.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.325-331
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• 2013

Botulinum neurotoxin(BoNT) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Recently, the therapeutic use of BoNT have expanded to include a wide range of medical and dental conditions. Botulinum neurotoxin type A(BoNT/A) is used off-label in the orofacial region to treat primary and secondary masticatory and facial muscle spasm, severe bruxism, facial tics, orofacial dyskinesias, dystonias, and hypertrophy of the masticatory muscles. Local hematoma, infection, and persistent pain in the injection site are the site-of-injection side effects. Medication-related side effects are adjacent muscle weakness, slurred speech, an alteration in the character of the saliva, and severe headaches. In most cases, these complications are not persistent and bothersome. We reported a case report of a patient who had transient anterior open bite after BoNT/A injection on masseter muscles to treat the refractory myofascial pain.

• Archives of Reconstructive Microsurgery
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• v.17 no.2
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• pp.94-100
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• 2008

In the past decade, there has been increasing breast reconstructions after mastectomy, and the abdomen has been the gold standard for donor site. TRAM (transverse rectus abdominis myocutaneous), MSTRAM (muscle sparing transverse rectus abdominis myocutaneous), DIEP (deep inferior epigastric artery perforator), SIEA (superficial inferior epigastric artery) flap has been widely used nowadays. Among them, DIEP free flap spares the whole rectus abdominis muscle and anterior rectus sheath resulting in decreased donor site morbidity. Between March of 2006 and February of 2008, six patients had undergone immediate breast reconstructions using DIEP free flap. The mean age of patients was 48.5 years. All patients had unilateral breast reconstructions. We dissected two perforators which were included in the unilateral pedicle. Thoracodorsal artery and its venae comitantes were chosen as recipient vessels. For venous anastomosis, we used the GEM Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Inc., Birmingham, Ala.) in four cases. All flaps were survived completely except one who showed fatty abdomen in old age. She showed repetitive vascular spasm intraoperatively. None of the patients had abdominal hernia, bulge or weakness. We believe that DIEP free flap provides a reliable method for autologous breast reconstruction if the patients are selected appropriately and performed by a skillful surgeon.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.59-64
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• 2017

Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.23-37
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• 2004

Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.