• Journal of Chest Surgery
• /
• 제24권2호
• /
• pp.212-216
• /
• 1991

A surgical correction was successfully performed in a adult female who had pulmonary atresia with almost non-confluent pulmonary artery, PDA and ventricular septal defect. Initially as a first stage of corrective surgery isolation of patent ductus arteriosus, ligation of aortopulmonary collaterals and identification of the pathologic anatomy of left pulmonary artery through left posterolateral approach were performed. At the second stage, a week after the initial operation, total correction was done making both pulmonary arteries confluent with albumin coated woven-dacron graft, external valved conduit and closure of large VSD of subarterial and perimembranous type. The PDA was ligated with previously encircled heavy stitch soon after partial bypass was started. Although massive bleeding from anastomotic site of dilated left pulmonary artery to the graft occurred preoperatively, postoperative functional improvement was excellent in terms of disappearance of cyanosis and normal exercise tolerance.

• 대한정형도수물리치료학회지
• /
• 제23권1호
• /
• pp.15-22
• /
• 2017

Background: The purpose of this study was to investigate into the effect of soft tissue mobilization using prop on the pain, grip strength and functional activity in patients with lateral epicondylitis. Methods: Fifteen patients with lateral epicondylitis were recruited. Before treatment, they were evaluated using visual analogue scale (VAS), grip strength, test, patient-rated tennis elbow evaluation (PRTEE), proprioception, and were reevaluated after six weeks of treatment. Results: As a result of comparing all participants before and after the experiment, the grip strength increased significantly (p<.05). And the VAS, PRTEE, and proprioception decreased significantly (p<.05). Conclusion: According to the results above, soft tissue mobilization using prop can help improve pain, grip strength, PRTEE and proprioception. Also, soft tissue mobilization using Blackroll's Twister technique was able to select interventions depending on the patient's condition and the desired goal.

• 한국전문물리치료학회지
• /
• 제25권3호
• /
• pp.19-26
• /
• 2018

Background: Genu varum is also known as bow leg. It is a deformity wherein there is lateral bowing of the legs at the knee. it does give rise to pain, and persistent bowing can often give rise to discomfort in knees, hips and ankles. Objects: This study investigated the effect of narrow squats on the knee joint during a gait and distance between the knees of person with genu varum. Methods: This study analyzed 23 patient with genu varum that grade III, 12 narrow squat group and 11 genenal squat group in motion analysis laboratory. The subjects of experiment took gait before and after intervention, the range of joint motion, moment of knee joint adduction, power, distance of the knees were measured. And in order to make an analysis between groups, an paiered t-test and independent t-test was carried out. For statistical significance testing, it was decided that significance level ${\alpha}$ be .05. Results: It was shown that the group of narrow squat exercise significantly decreased in distance of knees (p<.05),In moment of adduction of knee joint, it was shown to significantly decrease in two groups (p<.05), was significantly decreased in adduction, abduction, and rotation (p<.05). In relation of peak-knee adduction moment and valgus angle, there was significant decrease in narrow squat group (p<.05). Conclusion: When the above result of study were examined, a narrow squat exercise given to the genu varum patients significantly decreased the distance between the knees, range of knee adduction and abduction, knee adduction moment, knee power. And stability gains through the decrease of excursion of knee medial part be effective for the correction of genu varum deformation.

• 대한정형도수물리치료학회지
• /
• 제30권1호
• /
• pp.85-93
• /
• 2024

Background: This study examined the Immediate effects of IASTM using microcurrent and the flossing band on the lower extremity fascia thickness in subjects with Intrinsic patellofemoral pain syndrome. Methods: Sixty-six subjects with patellofemoral pain syndrome were randomized into three groups (22 each in the microcurrent IASTM (instrument assisted soft-tissue mobilization) group, and flossing band group, and combined microcurrent IASTM and flossing band group) to evaluate the immediate effects of the lower extremity fascia thickness before and after intervention. The thickness of the lower extremity fascia was measured using an ultrasound machine. Using SPSS Window. 22.0, a Shapiro Wilk was conducted to test the normality of all variables; within-group comparisons were made with a paired-samples t-test, and between-group interventions were subjected to a one-way analysis of variance. Results: Changes in the thickness of the fascia in the thigh area were observed before and after intervention in all three groups. There was a significant decrease, and in the combined group, there was a significant decrease in fascia thickness compared to when the IASTM group and the flossing band group were applied separately (p<.05). Conclusion: Through this study, the effect on fascia thickness was confirmed when IASTM and flossing band intervention were combined, and it is believed that it can be used as basic clinical data for patients with knee-thigh pain syndrome.

• Clinical and Experimental Pediatrics
• /
• 제53권2호
• /
• pp.248-252
• /
• 2010

관상동맥의 이상 기시는 소아에서 드문 질환이다. 이러한 이상 기시들은 대동맥과 폐동맥간과의 해부학적인 관계에 의해 3가지 형태로 분류할 수 있다. 우리 환자의 경우와 같이 기형 동맥이 대동맥과 폐동맥사이로 주행하는 경우 젊은 연령에서 급사의 위험도가 증가하기 때문에 빠른 진단과 치료가 필요하다. 관상동맥의 이상 기시를 교정하는 방법으로는 잘 알려진 re-implantation, 관상동맥 우회술과 unroofing의 세가지 방식이 있고, 아직까지 좌 관상동맥의 이상 기시의 치료에 대해서는 많은 견해들이 있으나 일단 수술적 교정이 되면 좋은 결과를 보인다. 우리는 운동 중 발생한 흉통과 실신을 주소로 내원한 12세 여아에서 심초음파와 관상동맥 전상화 단층촬영을 통하여 좌 관상동맥의 우 관상동맥동으로부터의 이상 기시를 진단받고 re-implantation, 관상동맥 우회술, 그리고 unroofig 방법을 통해 치료받은 1례를 경험하여 이를 보고하고자 한다.

• 운동영양학회지
• /
• 제16권2호
• /
• pp.65-71
• /
• 2012

Oxygen is the final acceptor of electron transport from fat and carbohydrate oxidation, which is the rate-limiting factor for cellular ATP production. Under altitude hypoxia condition, energy reliance on anaerobic glycolysis increases to compensate for the shortfall caused by reduced fatty acid oxidation [1]. Therefore, training at altitude is expected to strongly influence the human metabolic system, and has the potential to be designed as a non-pharmacological or recreational intervention regimen for correcting diabetes or related metabolic problems. However, most people cannot accommodate high altitude exposure above 4500 M due to acute mountain sickness (AMS) and insulin resistance corresponding to a increased levels of the stress hormones cortisol and catecholamine [2]. Thus, less stringent conditions were evaluated to determine whether glucose tolerance and insulin sensitivity could be improved by moderate altitude exposure (below 4000 M). In 2003, we and another group in Austria reported that short-term moderate altitude exposure plus endurance-related physical activity significantly improves glucose tolerance (not fasting glucose) in humans [3,4], which is associated with the improvement in the whole-body insulin sensitivity [5]. With daily hiking at an altitude of approximately 4000 M, glucose tolerance can still be improved but fasting glucose was slightly elevated. Individuals vary widely in their response to altitude challenge. In particular, the improvement in glucose tolerance and insulin sensitivity by prolonged altitude hiking activity is not apparent in those individuals with low baseline DHEA-S concentration [6]. In addition, hematopoietic adaptation against altitude hypoxia can also be impaired in individuals with low DHEA-S. In short-lived mammals like rodents, the DHEA-S level is barely detectable since their adrenal cortex does not appear to produce this steroid [7]. In this model, exercise training recovery under prolonged hypoxia exposure (14-15% oxygen, 8 h per day for 6 weeks) can still improve insulin sensitivity, secondary to an effective suppression of adiposity [8]. Genetically obese rats exhibit hyperinsulinemia (sign of insulin resistance) with up-regulated baseline levels of AMP-activated protein kinase and AS160 phosphorylation in skeletal muscle compared to lean rats. After prolonged hypoxia training, this abnormality can be reversed concomitant with an approximately 50% increase in GLUT4 protein expression. Additionally, prolonged moderate hypoxia training results in decreased diffusion distance of muscle fiber (reduced cross-sectional area) without affecting muscle weight. In humans, moderate hypoxia increases postprandial blood distribution towards skeletal muscle during a training recovery. This physiological response plays a role in the redistribution of fuel storage among important energy storage sites and may explain its potent effect on changing body composition. Conclusion: Prolonged moderate altitude hypoxia (rangingfrom 1700 to 2400 M), but not acute high attitude hypoxia (above 4000 M), can effectively improve insulin sensitivity and glucose tolerance for humans and antagonizes the obese phenotype in animals with a genetic defect. In humans, the magnitude of the improvementvaries widely and correlates with baseline plasma DHEA-S levels. Compared to training at sea-level, training at altitude effectively decreases fat mass in parallel with increased muscle mass. This change may be associated with increased perfusion of insulin and fuel towards skeletal muscle that favors muscle competing postprandial fuel in circulation against adipose tissues.

• 디지털융복합연구
• /
• 제14권5호
• /
• pp.445-457
• /
• 2016

본 연구는 골반변위에 따른 신체 불균형에 대한 톰슨터미널테크닉과 근에너지기법의 교정 효과의 비교분석을 하는 것을 주목적으로 하고 이에 가능하면 효율적인 치료의 방법을 제시하고자 하였다. 연구대상자는 톰슨실험군, 근에너지실험군 및 정상군으로 구성되었으며 각 집단별 남녀 각 5명씩 총 10명이 무작위로 배정되었으며 톰슨실험군은 카이로프랙틱의 톰슨터미널테크닉을 사용하여 교정효과와 교정 후 유지효과를 측정하였다. 톰슨터미널테크닉과 근에너지기법의 경우 43.01%p 정도의 효과 차이가 있다. 골반변위의 교정에는 톰슨터미널테크닉을 활용한 경우가 근에너지기법 및 정상군에 비해 효과가 크다 할 수 있다. 결과적으로 톰슨터미널테크닉과 근에너지기법을 신체 불균형 교정에 사용하는 것은 효과적이며 톰슨터미널테크닉만으로도 효과가 있지만 최대의 효과를 내기 위해 톰슨터미널테크닉 교정 후 근에너지기법을 적용하는 것이 바람직할 것으로 사료된다.

• Journal of Korean Neurosurgical Society
• /
• 제60권2호
• /
• pp.125-129
• /
• 2017

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

• 재활치료과학
• /
• 제13권3호
• /
• pp.85-100
• /
• 2024

목적 : 사례연구를 통해 심장이식 수술 후 연하장애가 발생한 환자의 증상을 알아보고 작업치료실에서 적용한 연하장애 재활치료의 효과에 대해 알아보고자 하였다. 연구방법 : 심장 이식 수술 후 연하장애가 발생한 환자 1명을 대상으로 비디오 투시 연하검사를 통해 기능적 연하장애 척도와 침습-흡인 척도, 삼킴 곤란 결과 및 증증도 척도를 2주 간격으로 총 3회 실시하였다. 치료 기간은 2023년 7월 19일부터 8월 21일까지 회기당 30분씩 총 8회 실시하였다. 후두 상승과 상부식도조임근의 충분한 열림 및 잔여물의 감소를 위한 교정적 치료(혀-유지 기법, 저항성 턱 당기기 운동, 멘델슨 기법, 노력 삼킴, 호흠근육 운동)와 기도보호를 위한 보상적 치료(턱 당기기 자세, 여러 번 삼키기, 음식 양과 점도 변경) 및 보호자 교육을 실시하였다. 결과 : 기능적 연하장애 척도 검사의 점수가 50점에서 30점으로 감소하였으며, 침습-흡인 척도의 단계는 5단계에서 3단계로 향상되었다. 삼킴 곤란 결과 및 중증도 척도에서는 2단계에서 4단계로 향상되었다. 결론 : 심장 이식 수술 후 연하장애를 보이는 경우 연하재활치료가 환자의 삼킴 기능 향상에 도움을 주는 것을 확인하였다. 향후 심장 이식 수술 환자의 연하장애 재활치료의 효과에 대한 보완 연구가 필요할 것이다.