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권동락,Jung Gu Kwon,박기영 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.3
A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP)children did not change the intrinsic stiffness. Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modifi ed Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP. Additionally, we indentifi ed decreased muscle stiff ness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.
Augmentation of respiratory muscle activities in preterm infants with feeding desaturation
권동락,박기영,정지은,김우택,이은주 대한소아청소년과학회 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.3
Purpose: Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables. Methods: Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-square (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated. Results: The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants. Conclusion: This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.
권동락,Sung-uk Lee,박기영 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.4
Objective To investigate whether the cartilage regenerative effects of intra-aricular platelet-rich plasma (PRP) are different, according to the severity of osteoarthritis (OA), in a collagenase-induced knee OA rabbit model.Method New Zealand white rabbits (N=21) were randomly divided into three groups. Three different doses (0.25 mg, group 1; 0.5 mg, group 2; and 1.0 mg, group 3) of collagenase were injected twice into both knees of each group under an ultrasound guidance. The mean platelet concentration of the PRP fraction was 2,664±970×103/μl and was enriched 8.2-times, compared with the whole blood. PRP (0.3 ml) was injected into the left knee and saline (0.3 ml) into the right knee at 4 weeks, and macroscopic and histological scores of both injected knees were evaluated at 9 weeks after the first collagenase injection.Results Macroscopic and histological scores of group 3 were significantly higher than those of group 1 and 2 (p<0.05). Macroscopic and histological scores of the PRP-injected knees were significantly lower than those of the saline-injected knees, in all groups (p<0.05). Differences of gross morphologic and histologic scores between sa-line- and PRP-injected knees in group 3 were significantly higher than those in group 1 and 2 (p<0.05).Conclusion Intra-articular PRP injection influences cartilage regeneration in all severities of rabbit knee OA, and the cartilage regenerative power of PRP injection in moderate knee OA was greater than that in mild or very mild OA. A large preclinical trial is needed to establish the validity of our study.
한국인에서 정상인과 유착성 관절낭염 환자의 부리위팔 인대 두께 비교
권동락,김민영,채유진,김주섭,이태임,박준성 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.4
Objective: To evaluate the difference of coracohumeral ligament (CHL) thickness between asymptomatic shoulders and adhesive capsulitis. Method: Ultrasound examination was performed in 44 consecutive shoulders of 24 individuals (12 males and 12 females). Nine were diagnosed as adhesive capsulitis by clinical examination. We measured the maximum thickness of CHL. For CHL assessment, participants were scanned in sitting position with shoulder in maximal external rotation, elbow in 90° flexion, forearm in neutral position, and hand in fist. The transducer was positioned between coracoid process and greater tuberosity of humerus. We used t test to compare the CHL thickness between asymptomatic and adhesive capsulitis and bivariate correlation analysis to assess a correlation between age and CHL thickness. Results: There was a significant positive linear relationship between age and CHL thickness (p<0.01, γ=0.424). In female, there was a positive linear relationship between age and CHL thickness (p<0.01, γ=0.610). However, in male, there was no significant correlation (γ=0.224). The mean value of CHL thickness was 1.53 mm in 9 adhesive capsulitis and 0.92 mm in 35 asymptomatic ones. CHL thickness was significantly greater in adhesive capsulitis than in asymptomatic ones (p<0.01). Conclusion: The thickened CHL is a good suggestive diagnostic value of adhesive capsulitis. Objective: To evaluate the difference of coracohumeral ligament (CHL) thickness between asymptomatic shoulders and adhesive capsulitis. Method: Ultrasound examination was performed in 44 consecutive shoulders of 24 individuals (12 males and 12 females). Nine were diagnosed as adhesive capsulitis by clinical examination. We measured the maximum thickness of CHL. For CHL assessment, participants were scanned in sitting position with shoulder in maximal external rotation, elbow in 90° flexion, forearm in neutral position, and hand in fist. The transducer was positioned between coracoid process and greater tuberosity of humerus. We used t test to compare the CHL thickness between asymptomatic and adhesive capsulitis and bivariate correlation analysis to assess a correlation between age and CHL thickness. Results: There was a significant positive linear relationship between age and CHL thickness (p<0.01, γ=0.424). In female, there was a positive linear relationship between age and CHL thickness (p<0.01, γ=0.610). However, in male, there was no significant correlation (γ=0.224). The mean value of CHL thickness was 1.53 mm in 9 adhesive capsulitis and 0.92 mm in 35 asymptomatic ones. CHL thickness was significantly greater in adhesive capsulitis than in asymptomatic ones (p<0.01). Conclusion: The thickened CHL is a good suggestive diagnostic value of adhesive capsulitis.
권동락,박정아,이영수,곽재혁,도진국,김지언 대한수면연구학회 2019 Journal of sleep medicine Vol.16 No.1
Objectives: To investigate the therapeutic effect of cranial electrotherapy stimulation (CES) with sleep hygiene in patients with chronic insomnia. Methods: This study was designed as a prospective, doubleblinded, and randomized controlled trial. Twenty-seven patients with chronic insomnia were recruited and randomly allocated to two groups; cranial microcurrent therapy (MC) group and sham group. All patients received sleep hygiene education. Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were measured at baseline (pre-treatment), and 2 weeks and 4 weeks of treatment. Results: In MC group, the PSQI and ISI showed a tendency to decrease consistently until 4 weeks of treatment. In sham group, PSQI and ISI initially decreased during the first 2 weeks, but it increased after 2 weeks of treatment. Conclusions: This study showed that combination treatment of CES and sleep hygiene is more effective in treating chronic insomnia than sleep hygiene only as demonstrated by improvement and maintenance of sleep score for 1 month.