• Title/Summary/Keyword: Muscular Dysfunction

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A Biomechanical Modeling of Human Pharyngeal Muscular Dysfunction by Using FEM(Finite Element Method) (유한요소법을 이용한 인두의 기능이상에 대한 생체역학적 모델)

  • Kim Sung Jae;Bae Ha Suk;Choi Byeong Cheol;Kim Sung Min
    • Journal of Biomedical Engineering Research
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    • v.24 no.6 s.81
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    • pp.515-522
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    • 2003
  • Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement! into the esophagus and functioning as airway passages. In this study, structural changes of pharyngeal dysfunction are analyzed by biomechanical model using CT and FEM(finite clement method). Loading condition was assumed that equal pressure was loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model. the pharyngeal dysfunctions was classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke. we assumed that a change of material property is caused by muscular tissue stiffness. A deformation of cross sectional area of the pharynx is analyzed increasing the stiffness $25\%,\;50\%,\;75\%$ in each case on the basis of stress-strain relationship. Based on three-dimensional reconstruction of pharyngeal structure using limited factor - techniques and the optimization procedure by means of inverse dynamic approach. the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

Scapulothoracic Arthrodesis for Refractory Shoulder Dysfunction: A Retrospective Study of Indications and Functional Outcome

  • Chung, Soo-Tai;Warner, Jon J.P.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.208-208
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    • 2009
  • Eleven shoulders (9 patients) with refractory scapulothoracic dysfunction were treated with scapulothoracic arthrodesis between 2000 and 2006. Refractory shoulder dysfunction included facioscapulohumeral muscular dystrophy in five shoulders (3 patients), refractory scapular winging with long thoracic nerve palsy in one shoulder, scapular winging caused by serratus anterior palsy with trapezius dysfunction in one shoulder, post-surgical thoracic outlet syndrome due to medial clavicle resection in two shoulders, refractory scapular winging with spinal accessory nerve injury in one shoulder, and chronic trapezius rupture caused by cervical spine surgery in one shoulder. The mean active flexion was improved from 82 degrees preoperatively to 112 degrees postoperatively. The mean Constant score was improved from 27.2 points to 68.0 points. Two shoulders (1 patient) that had facioscapulohumeral muscular dystrophy had broken wires due to nonunion, and one patient had a reactive pulmonary effusion. In ten of the eleven shoulders, the patients were satisfied with their results. The scapulothoracic arthrodesis can cause significant pain relief and functional improvement in refractory scapulothoracic and/or shoulder dysfunction. By selecting patients that present with appropriate indications, and using experienced surgical technique through complete preoperative evaluation, we can diminish the complication rate and make good clinical outcomes.

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Effects of the Nuegra from Male Silkworm Extract on Enhancement of the Masculine Function and Activation of Overall Physical Function

  • Kim, D. C.;Kim, Y. W.;Park, M. S.;J. K. Suh;Lee, D. S.;Lee, S. H.;B. H. Chun;Y. K. Jun
    • International Journal of Industrial Entomology and Biomaterials
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    • v.5 no.1
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    • pp.109-122
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    • 2002
  • The purpose of this investigation is to evaluate the effects of the Nuegra on enhancement of the masculine and physical activities in general through measuring changes of the testosterone, FSH and subjective symptoms like fatigue, insomnia, urinary stream, muscular weakness, libido and erectile dysfunction. Total 168 male subjects were enrolled from 12 urology, internal medicine clinics and general practitioner, During the 6-week investigational period, 2 capsules of Nuegra were given to the subjects right after meal for 4 weeks, and 1 capsule of Nuegra was added each time in subjects with no or minimal effect. Testoster-one and FSH levels were measured at first visit and last visit, for evaluating masculine activities. To avoid bias and standardize the test results, only one clinic was assigned as a central lab, and all blood samples were transferred. General information and subjective symptoms were evaluated at first visit and at 2 weeks interval, week 2, 4 and 6 using VAS (Visual Analogue Scale). The mean age of the subjects were 51.8${\pm}$8.2 years old (range: 36.1-82.1). Based on the subjects who were tested on testosterone and FSH levels at day l and week 6, the means were 4.4${\pm}$1.4 nmol/L (range: 2.6-7.7), 8.6${\pm}$9.6 mIU/mL (range: 0.3-40.4), respectively at day 1. At week 6, the results were 4.9 ${\pm}$1.6 (2.6-8.9 range), 9.4${\pm}$13.1 (1.0-53.9 range), respectively. Marginally significant difference between pre-dose and post-dose was present. Statistically significant differences were revealed in general assessment for subjective symptoms, fatigue, insomnia, erectile dysfunction, etc. In fatigue, response rates were 39.6, 65.4 and 76.4% at week 2, 4 and 6, respectively (P < 0.0001). Response vates for erectile dysfunction were 13.4, 41.2 and 72.7% at week 2, 4, and 6 (P < 0.0001), respectively, Response rates for libido were 13.6, 51.6 and 73.5% at week 2, 4, and 6 (P < 0.0001), respectively. For urinary stream response rates were 26.9, 44.7 and 66.8% at week 2, 4, and 6 (P < 0.0001), respectively. VAS for muscular weakness did not show significant results that response rates were 40, 60 and 80% at week 2, 4, and 6 from 8.2 (P = 0.24), respectively. Response rates for insomnia were 50, 60, 100% at week 2, 4, and 6 (P < 0.0001), respectively. The results shows that Nuegra tends to enhance masculine activities including libido, erectile dysfunction and urinary stream and also effective for improving general conditions especially insomnia, muscular weakness and fatigue. In conclusion, this investigation has demonstrated that Nuegra does not only have tendency to increase masculine activities through increased secretion of the testosterone and FSH but also improve general conditions such as erectile dysfunction, libido, fatigue and muscular power.

Dysfunction of Pelvic Floor and Therapeutic Exercise (골반저 기능부전과 치료적 운동)

  • Kwon, Hei-Jeoung;Hwang, Seong-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.5 no.1
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    • pp.17-26
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    • 1999
  • The pelvic floor is a muscular structure, pierced by urologic, genital, and distal intestinal tract. Also pelvic floor is not a frozen but a functional unit. The pelvic floor dysfunction has 1) laxity of soft tissue and muscle 2)rupture of pelvic floor, 3)increased the tension. The purpose of this study is to give information about the pelvic floor dysfunction and pelvic exercise. This investigate the pelvic floor structure and function, pelvic floor dysfunction, pelvic floor exercise, and recent research trends. The pelvic floor exercise is one of important exercise in physical therapy, this exercise program will be improved patients with pelvic floor dysfunction.

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Movement Dysfunction in Spastic Hemiparesis: A Problem of Spasticity or Muscular Weakness? (강직성 편마비 환자에서의 운동장애는 강직 때문인가? 근육약화 때문인가?)

  • Kim, Jong-Man;Ahn, Duck-Hyun
    • Physical Therapy Korea
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    • v.9 no.3
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    • pp.125-135
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    • 2002
  • In most of the medical literature that discusses the common problem of movement in patients with cerebral lesions. This critical problem is ascribed to a mechanism involving uninhibited neural activity. The goals of neurological physical therapy are focus on reduce of muscle hypertonicity, facilitates muscle activities, and improve of performance in living environment. A variety of studies suggest that spasticity is a distinct problem and separate from the muscle weakness. It has become increasingly recognized that the major functional deficits following brain damage are largely due to negative features such as muscle weakness and loss of performance rather than spasticity. Adequate recruitment of prime mover, not release was able to carry out the movement tasks well. The strengthening exercise of spastic limbs on changes in muscle properties and performance skill, the repeated motor practice has been identified as crucial for motor recovery. This article support the concept that strengthening is an appropriate intervention to improve the quality of physical function in patients with central nervous system lesions. Further studies and therapeutic approaches should be efforts at improving motor neuron recruitment in agonist rather than reducing activity in antagonists while retraining muscle strengthening.

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Rebound excitability mediates motor abnormalities in Parkinson's disease

  • Kim, Jeongjin;Kim, Daesoo
    • BMB Reports
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    • v.51 no.1
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    • pp.3-4
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    • 2018
  • Parkinson's disease (PD) is a debilitating disorder resulting from loss of dopamine neurons. In dopamine deficient state, the basal ganglia increases inhibitory synaptic outputs to the thalamus. This increased inhibition by the basal ganglia output is known to reduce firing rate of thalamic neurons that relay motor signals to the motor cortex. This 'rate model' suggests that the reduced excitability of thalamic neurons is the key for inducing motor abnormalities in PD patients. We reveal that in response to inhibition, thalamic neurons generate rebound firing at the end of inhibition. This rebound firing increases motor cortical activity and induces muscular responses that triggers Parkinsonian motor dysfunction. Genetic and optogenetic intervention of the rebound firing prevent motor dysfunction in a mouse model of PD. Our results suggest that inhibitory synaptic mechanism mediates motor dysfunction by generating rebound excitability in the thalamocortical pathway.

The evolution of electrocardiographic changes in patients with Duchenne muscular dystrophies

  • Yoo, Woo Hyun;Cho, Min-Jung;Chun, Peter;Kim, Kwang Hun;Lee, Je Sang;Shin, Yong Beom
    • Clinical and Experimental Pediatrics
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    • v.60 no.6
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    • pp.196-201
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    • 2017
  • Purpose: Myocardial dysfunction and dysrhythmias are inevitable consequences of Duchenne muscular dystrophy. We aimed to evaluate specific trends of electrocardiographic changes that reflect the progress of cardiomyopathy in patients with Duchenne muscular dystrophy. Methods: Fifty electrocardiograms (ECGs) of 30 patients (ages 1 to 27 years) who had not been prescribed medications for heart failure treatment at the time of examination were retrospectively analyzed and compared with 116 ECGs of age-matched healthy 116 controls. Heart rate, leads with fragmented QRS (fQRS), corrected QT, Tpeak-to-Tend, and Tpeak-to-Tend/QT were analyzed. Results: The patients with Duchenne muscular dystrophy failed to show a normal age-related decline in heart rate but showed an increasing trend in the prevalence of fQRS, corrected QT, corrected Tpeakto-Tend, and Tpeak-to-Tend/QT over time. In the ${\leq}10-year-old$ patient group, a significant difference was found only in the prevalence of fQRS between the patients and the controls. The prevalence of fQRS, heart rate, Tpeak-to-Tend/QT, and corrected Tpeak-to-Tend demonstrated significant differences between the patients and the controls in the middle age group (11 to 15 years old). All the indexes were statistically significantly different in the ${\geq}16-year-old$ patient group. Conclusion: The prevalence of lead with fQRS representing regional wall motion abnormalities was higher in the young patients than in the young healthy controls, and this might be one of the first signs of myocardial change in the patients. Markers of depolarization and repolarization abnormalities were gradually prominent in the patients aged >10 years. Further studies are needed to confirm these findings.

Abnormality on Liver Function Test

  • Kang, Ki-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.225-232
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    • 2013
  • Children with abnormal liver function can often be seen in outpatient clinics or inpatients wards. Most of them have respiratory disease, or gastroenteritis by virus infection, accompanying fever. Occasionally, hepatitis by the viruses causing systemic infection may occur, and screening tests are required. In patients with jaundice, the tests for differential diagnosis and appropriate treatment are important. In the case of a child with hepatitis B virus infection vertically from a hepatitis B surface antigen positive mother, the importance of the recognition of immune clearance can't be overstressed, for the decision of time to begin treatment. Early diagnosis changes the fate of a child with Wilson disease. So, screening test for the disease should not be omitted. Non-alcoholic fatty liver disease, which is mainly discovered in obese children, is a new strong candidate triggering abnormal liver function. Muscular dystrophy is a representative disease mimicking liver dysfunction. Although muscular dystrophy is a progressive disorder, and early diagnosis can't change the fate of patients, it will be better to avoid parent's blame for delayed diagnosis.

The Review of Functional Electrical Stimulation (기능적 전기자극에 대한 고찰)

  • Park, Kyu-Hyun;Kim, Sun-Kyoo;Chung, Hyun-Ae;Park, Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.13 no.2
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    • pp.399-405
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    • 2001
  • Attainment of the goals of functional electrical stimulation(FES) applications such as strengthening of muscle, increasing muscular endurance, improvement in joint range of motion or the reduction of spasticity does not insure that patients will be able to produce voluntary muscle contraction sufficient to maintain posture or produce purposeful movements. In many patients who have sustained CNS damage, the control exerted by higher nervous system center over muscle contraction may impaired. In Searched patients, a variety of advanced therapeutic exercise techniques have been employed traditionally to facilitate the return of controlled functional muscular activity or maintain postural alignment until recovery from dysfunction occurs Among the most common clinical applications of FES for functional muscle contraction is as a substitute for static or dynamic orthotic devices

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Literature Review on the Association Between a Cervical Dysfunction and the Change of Neuromuscular Control Activity (경추부 장애와 신경근 조절 활동 변화와의 관련성에 대한 고찰)

  • Kim, Suhn-Yeop;Lee, Hae-Jung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.1
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    • pp.57-67
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    • 2006
  • Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

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