• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.21-28
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• 2011

Purpose: The aim of this study was to investigate correlations between the Functional Movement Screen (FMS), pain, and performance ability in professional fencing players. Methods: Fifty-six athletes participated in this study. The pain group included those who had a score on a pain-related Visual Analogue Scale (VAS) of ${\geq}$20 and an Oswestry Disability Index (ODI) score ${\geq}$10). In the non-pain group, these scores were: VAS(<20), ODI(<10). The VAS and ODI were used to measure pain throughout the study. Performance ability included motor function of the lower extremities (as assessed by a Modified Functional Index Questionnaire, MFIQ), dynamic balance (Balance system, BS and Posture med, PM), flexor and extensor muscle strength of the lumbar region was recorded as maximal isometric strength. Results: Among athletes who had pain, 5 of 15(33.33%) showed impaired functional movement. Conversely, only 2 of 41(4.88%) of those who had no pain showed such impairment (FMS ${\leq}$14score). The athletes who had pain and who had an FMS score above 14 (10/56; 17.86%) showed a significantly higher score for extensor muscle strength of the lumbar compared with those with pain and an FMS score below 14 (5/56; 8.93%) were significant correlations between the FMS and pain (r=-0.40 to -0.42, p<0.01), the MFIQ (r=-0.33, p<0.05), dynamic balance (r=-0.27 to -0.40, p<0.05-0.01), muscle strength of the lumbar (r=0.27 to 0.29, p<0.05). Stepwise multiple regression analysis showed that the dynamic balance score (${\beta}{\beta}$=-0.41) had slightly more power in predicting FMS score than pain, motor function of lower extremity, or muscle strength. Conclusion: The FMS was significantly associated with values of pain, motor function of the lower extremities, dynamic balance, and muscle strength of the lumbar. However the FMS appears to lack relevance and reasonable evidence to suggest that it is an acceptable measurement tool for functional movement analysis.

• Therapeutic Science for Rehabilitation
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• v.8 no.4
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• pp.65-76
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• 2019

Objective : This study aimed to verify the validity and reliability of the Upper Extremity Performance Test for the Elderly (TEMPA) by modifying its items to exhibit cultural differences. Methods : This study included 171 healthy adults and older adults and 41 individuals with impaired upper extremity function. Content validity, discriminant validity, test-retest reliability, and inter-rater reliability were analyzed. Results : The following items, exhibiting cultural differences, were modified: "open a lock and take the top off a pillbox" and "write and affix a postage stamp." The discriminant validity results indicated that participants with normal upper extremity function performed better than those with impaired in the upper extremity function (p<.001). The test-retest reliability of the execution speed (intraclass correlation coefficient; ICC) was .71-.94, functional rating (kappa) was 1.0, and task analysis (ICC) was 1.0. The inter-rater reliability of the speed of execution was 1.0, functional rating was .79-1.0, and task analysis was .94-1.0. Conclusion : TEMPA has moderate to high level of reliability and is an assessment tool that can clearly distinguish individuals with upper extremity impairment from those without impairment.

• 재활복지
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• v.22 no.1
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• pp.141-156
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• 2018

The purpose of this study was to examine changes in the swallowing function with chronic stroke patient. Ten chronic stroke patients with dysphagia followed up for 3 months. Eight normal age match subjects were also participated. A total of 18 participated in this study and they were classified into two groups (stroke patient group and normal control group). Participants underwent videofluoroscopic swallowing examination. The swallowing function was evaluated over time. Oral transit duration, pharyngeal transit duration, laryngeal response duration, Modified Barium Swallowing Impairment Profile ($MBSImP^{TM(c)}$), and Functional Oral Intake Scale (FOIS) were applied. Chronic stroke patient group were showed significantly longer oral transit duration, pharyngeal transit duration and laryngeal response duration than normal control group at baseline. After 3 months in stroke patient group, the mean oral components score of MBSImP (1~5) significantly decreased and the mean score on FOIS increased compared to baseline. In conclusion, oral swallowing function and oral intake function improved by the 3 month evaluation. These results describe changes in swallowing function with chronic stroke patients over time and provide basic informations to understand dysphagia.

• IMMUNE NETWORK
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• v.14 no.4
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• pp.207-218
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• 2014

Chronic virus infection leads to the functional impairment of dendritic cells (DCs) as well as T cells, limiting the clinical usefulness of DC-based therapeutic vaccine against chronic virus infection. Meanwhile, B cells have been known to maintain the ability to differentiate plasma cells producing antibodies even during chronic virus infection. Previously, ${\alpha}$-galactosylceramide (${\alpha}GC$) and cognate peptide-loaded B cells were comparable to DCs in priming peptide-specific $CD8^+$ T cells as antigen presenting cells (APCs). Here, we investigated whether B cells activated by ${\alpha}GC$ can improve virus-specific T cell immune responses instead of DCs during chronic virus infection. We found that comparable to B cells isolated from naïve mice, chronic B cells isolated from chronically infected mice with lymphocytic choriomeningitis virus (LCMV) clone 13 (CL13) after ${\alpha}GC$-loading could activate CD1d-restricted invariant natural killer T (iNKT) cells to produce effector cytokines and upregulate co-stimulatory molecules in both naïve and chronically infected mice. Similar to naïve B cells, chronic B cells efficiently primed LCMV glycoprotein (GP) 33-41-specific P14 $CD8^+$ T cells in vivo, thereby allowing the proliferation of functional $CD8^+$ T cells. Importantly, when ${\alpha}GC$ and cognate epitope-loaded chronic B cells were transferred into chronically infected mice, the mice showed a significant increase in the population of epitope-specific $CD8^+$ T cells and the accelerated control of viremia. Therefore, our studies demonstrate that reciprocal activation between ${\alpha}GC$-loaded chronic B cells and iNKT cells can strengthen virus-specific T cell immune responses, providing an effective regimen of autologous B cell-based therapeutic vaccine to treat chronic virus infection.

• The Journal of Korean Physical Therapy
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• v.17 no.1
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• pp.43-68
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• 2005

The purpose of this study was to report the physical status of adult with cerebral palsy who live in local community areas including Seoul, Busan, Daegu in Republic of Korea at 2004. 202-individuals with cerebral palsy(140 male, 62 female; mean age 31.9 years; range 19 to 64 years) were surveyed. Measures included a 29-item self-reported health status measure focusing on musculoskeletal status and functional performances. Adult cerebral palsy required continuous management for musculoskeletal and ambulatory function through therapeutic approach. This survey is restricted to population who had cared in welfare center for cerebral palsy in local community, so it needs to investigate home-residual adults with cerebral palsy and the population in rural community. The results were as follows: 1. Participants reported that they had a limitation of a daily of life activity due to musculoskeletal pain($43\%$), there was significant differences between a limitation of a daily of life activity and the decreased ambulatory function(p<.05). 2. Thirty six point six percentile of participants had the decreased ADL function, it was significant related with the impaired body location(p<.05) 3. Thirty nine point one percentile of participants who can independently gait had the decreased ambulatory function, it was significant differences with the usage of ambulatory assistive devices(p<.05). 4. There was significant differences ambulatory function both the body region with impairment and a grade of disability(p<.05). 5. Sixteen point three percentile of participants could not ambulate any more, there was significant differences between a age and a point of time for non-ambulation(p<.05). 6. There was significant differences between ambulatory function and physical activity(p<.05).

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.221-227
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• 2012

Objective : Spinal cord hemangioblastomas are rare tumors. Despite their benign, slow-growing nature, they can cause severe neurological consequences. The purpose of this study was to evaluate variable factors, including clinical features, tumor findings, the extent of resection, and its recurrence or progression, which determine postoperative functional outcomes. Methods : This study included sixteen patients at our institute who underwent microsurgical resection for sporadic spinal intramedullary hemangioblastomas and spinal intramedullary hemangioblastomas associated with von Hippel-Lindau (VHL) disease, between June 2003 and March 2012. Results : A total of 30 operations were performed. Total resection (TR) of the tumor was achieved in 10 patients, and subtotal resection (STR) was achieved in 6. Postoperatively, the initial presenting symptoms were improved in 18.7% of the patients and were unchanged in 56.3%, but 25% were worse. Stable postoperative neurological functions were found in 83% of patients with preoperative McCormick grade I, and TR was achieved in 75% of these patients. In the STR group, poorer neurological status was observed in one patient, despite multiple operations. There were no poorer outcomes in the four cases of VHL disease. Various factors were analyzed, but only a correlation between the pre- and postoperative neurological status was verified in the TR-group patients. Conclusion : Preoperative focal neurological impairment and meticulous microsurgical manipulation may be predictors of favorable outcomes for solitary hemangioblastomas. In addition, the preservation of function is more important than the extent of resection in VHL disease.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.418-424
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• 2018

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

• BMB Reports
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• v.50 no.2
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• pp.60-70
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• 2017

Glaucoma is characterized by a slow and progressive degeneration of the optic nerve, including retinal ganglion cell (RGC) axons in the optic nerve head (ONH), leading to visual impairment. Despite its high prevalence, the biological basis of glaucoma pathogenesis still is not yet fully understood, and the factors contributing to its progression are currently not well characterized. Intraocular pressure (IOP) is the only modifiable risk factor, and reduction of IOP is the standard treatment for glaucoma. However, lowering IOP itself is not always effective for preserving visual function in patients with primary open-angle glaucoma. The second messenger cyclic adenosine 3',5'-monophosphate (cAMP) regulates numerous biological processes in the central nervous system including the retina and the optic nerve. Although recent studies revealed that cAMP generated by adenylyl cyclases (ACs) is important in regulating aqueous humor dynamics in ocular tissues, such as the ciliary body and trabecular meshwork, as well as cell death and growth in the retina and optic nerve, the functional role and significance of cAMP in glaucoma remain to be elucidated. In this review, we will discuss the functional role of cAMP in aqueous humor dynamics and IOP regulation, and review the current medications, which are related to the cAMP signaling pathway, for glaucoma treatment. Also, we will further focus on cAMP signaling in RGC growth and regeneration by soluble AC as well as ONH astrocytes by transmembrane ACs to understand its potential role in the pathogenesis of glaucoma neurodegeneration.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.165-169
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• 1993

Functional cerebral impairments have been verified objectively by brain SPECT and q-EEG (quantitative electroencephalography). Microcerebral circulatory defects without anatomical changes can-not be detected by the brain CT or MRI. Brain SPECT using $^{99m}Tc$-HMPAO (Hexamethyl propyleneamine oxime) as a key radioisotope may be accepted as the useful method for identifying functional cerebral impairments. We studied 25 patients with mild head trauma to define whether the SPECT was helpful in detecting cerebral impairment. Results were as follows: The SPECT was positive in 23 patients out of 25, q-EEG positive in 16 patients and brain CT was positive in 3 cases. SPECT and q-EEG were more sensitive than CT, SPECT would be more useful method than brain CT to investigate cerebral function after head injury.