• Journal of Korean Neurosurgical Society
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• v.67 no.5
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• pp.568-577
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• 2024

Objective : Post-stroke shoulder pain (PSSP) is a common complication that limits the range of motion (ROM) of the shoulder, the patient's rehabilitation and in turn, affects the patients' quality of life (QoL). Several treatment modalities such as sling, positioning, strapping, functional electrical stimulation, and nerve block have been suggested in literatures, however none of the treatments had long-term effects for PSSP. In this study, the authors evaluated clinical efficacy of pulsed radiofrequency (PRF) neuromodulation on the suprascapular nerve for PSSP, and suggested it as a potential treatment with long-term effect. Methods : This retrospective case series was conducted at a single center, a private practice institution. From 2013 to 2021, 13 patients with PSSP underwent PRF neuromodulation of the suprascapular nerve. The primary outcome measure was the Visual analog scale (VAS) score. The secondary outcome measurements included the shoulder ROM, Disability assessment scale (DAS), modified Ashworth scale, modified Rankin scale (mRS), and EuroQol-5 dimension-3L questionnaire (EQ-5D-3L) scores. These parameters were evaluated before PRF modulation, immediately after PRF modulation, and every 3 months until the final follow-up visit. Results : Six men and seven women were enrolled, and all patients were followed-up for a minimum of 12 months. The mean VAS score was 7.07 points before PRF neuromodulation and 2.38 points immediately post-procedure. Shoulder ROM for abduction and flexion, DAS for pain, mRS, and EQ-5D-3L demonstrated marked improvement. No complications were reported. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective modality in patients with PSSP, and has long-term effect of pain relief, improvement of QoL.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.37-43
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• 2006

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The purpose of this study was to determine the biophysical effects of continuous ultrasound on median local forearm temperature and motor nerve conduction velocities using frequencies of 3.0 MHz. SUBJECTS: Twelve healthy subjects (6 males, 6 females, age $22.30{\pm}2.41$ yrs, weight $61.33{\pm}10.16$ kg, height $167.58{\pm}8.04$ cm) without a history of neurological or musculoskeletal injury to their dominant arm volunteered for this study. METHODS AND MATERIALS: Each subject received a total of five treatments, one each at .0, 0.5, 1.0, 1.5, 2.0 W/$cm^2$ of 3 MHz continuous ultrasound on the anterior surface of the middle area of dominant forearm for 10 minutes. Dependent measures for forearm local temperature and median motor nerve conduction velocity (MNCV) were taken pretreatment and immediately post-treatment. One-way ANOVA were used for each dependent measure. RESULTS: The posttreatment forearm local temperature were differed significantly (p<0.001) between intensities of ultrasound. The posttreatment forearm local temperature of the ultrasound treated with 1.0 w/$cm^2$, 1.5 w/$cm^2$ and 2.0 w/$cm^2$ were significantly higher than 0.5 w/$cm^2$ and 0.0 w/$cm^2$ of ultrasound (p<0.05). The posttreatment median MNCV were differed significantly from the respective pretreatment velocities (p<0.001). The MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were significantly (p<0.05) slower than that observed pretreatment, while the three ultrasound intensities produced significantly increased posttreatment MNCV: 1.0 w/$cm^2$ and 1.5 w/$cm^2$ and 2.0 W/$cm^2$. The posttreatment MNCV at 2.0 w/$cm^2$ and 1.5 w/$cm^2$ was significantly faster than that at 0 w/$cm^2$, 0.5 w/$cm^2$ and 1.0 w/$cm^2$ (p<0.05), the MNCV at 1.0 w/$cm^2$ was significantly faster than that associated with 0 w/$cm^2$ and 0.5 w/$cm^2$ of ultrasound (p<0.05). CONCLUSIONS: The decreased median motor forearm local temperature and MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were attributed to the cooling effect by ultrasound transmission gel. Local forearm temperature and nerve conduction velocity were directly related to the intensity of ultrasound. Alterations in MNCV from ultrasound on healthy nerves appeared to be related to temperature changes induced by thermal effects of ultrasound.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.559-566
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• 2011

Purpose: The use of tissue expander/implant in breast reconstruction using tissue expander-implant is one of the most common surgical procedures. The use of AlloDerm as a sling to reestablish the lower pole of the pectoralis major muscle results a decrease in morbidity compared with more invasive procedures. However the use of AlloDerm is more expensive than other options. We decided to compare AlloDerm with Permacol, which has been safely used in human body reconstruction and is less costly than AlloDerm. Methods: After mastectomy, the inferolateral origin of the pectoralis major muscle was elevated. Either AlloDerm or Permacol was sutured to the chest wall at the level of the previously marked inframammary fold. The lower border of the pectoralis major muscle and the upper portion of the crescent-shaped piece of either AlloDerm or Permacol was sutured together using a tension free technique, and a tissue expander was subsequently inserted into the subpectoral-subAlloDerm (or Permacol) dual pocket. Results: AlloDerm was used in twenty-one patients (28 breasts) and Permacol was used in six patients (11 breasts) for tissue expander-implant breast reconstruction. During the mean follow-up period of 17 months (8~25 months). Two infections (7%) occurred in AlloDerm cases and four infections (36%) occurred in Permacol cases. Conclusion: This study is the first comparison of tissue expander/implant breast reconstruction using AlloDerm and Permacol. The use of Permacol resulted in more postoperative infection compared with the use of AlloDerm. This report is still limited with the small number of cases studied.

• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.171-180
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• 2021

The present study investigated the effects of dynamic tubing gait (DTG II) program on the balancing ability for the promotion of life care of patients with chronic stroke. In the study, 25 sessions of DTG II program (30 minutes per session, 5 sessions per week, for a total of 5 weeks) were applied to 10 patients with chronic stroke. To determine the effects of DTG II program for improving balance, surface electromyography(external oblique, erector spinae, iliopsoas, gluteus maximus), symmetry index test on three pelvic axes, and dynamic gait index test were performed before and after the intervention. The results showed statistically significant differences between preand post-intervention measurements of the gluteus maximus muscle at early and mid-stance phases(p<.05). The pelvic symmetry index differed significantly between pre- and post-intervention measurements of diagonal and rotational movement(p<.05). Comparison of dynamic gait index also showed statistically significant differences between pre- and post-intervention measurements(p<.05). Based on these findings, it was determined that the DTG II program was able to improve the balancing ability of patients with chronic stroke by activating their trunk muscles and improving the symmetry of diagonal pelvic movement and rotation. Therefore, DTG II program is recommended as an interventional method to improve life-care through improving the balancing ability of patients with chronic stroke.