• Title/Summary/Keyword: Therapeutic technique

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Effectiveness of Transcranial Direct Current Stimulation(tDCS) on Upper Extremity Function in Stroke Patients : A Systematic Review and Meta-Analysis (뇌졸중 환자의 상지기능에 대한 경두개 직류자극술 효과 : 체계적 고찰 및 메타분석)

  • Won, Kyung-A;Yang, Min Ah;Park, Hae Yean;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.7-23
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    • 2020
  • Objective : The purpose of this article was to analyze the effects of tDCS on the recovery of upper limb function in stroke patients. Methods : We searched for papers published in journals between 2009 to 2018, using NDSL and RISS. A total 14 experimental research papers were selected for analysis. The quality of the 14 articles was evaluated using the PEDro scale and 12 articles were analyzed through the Comprehensive Meta Analysis 3.0 program. Results : All of the 14 articles that were systematically reviewed in this study were published in foreign journals. The effect sizes for upper extremity(U/Ex) strength and U/Ex motion were 0.19(small size effect) and 0.49(medium size effect) respectively. Furthermore, the effect sizes of anode mode and cathode mode were 0.71(large size effect) and 0.41(medium size effect), respectively. The effect size of U/Ex motion and the anode mode were statistically significant(p<0.05). Conclusion : We identified that tDCS can be a useful rehabilitation technique for stroke patients with limited upper body function. These findings are expected to help with suggestions for basic data on new rehabilitation techniques for stroke patients and the planning of effective interventions.

A Case Study on the Clinical Application of Lee Silverman Voice Treatment-BIG (LSVT-BIG) Program for Occupational Performance and Motor Functions of Stroke Patients (뇌졸중 환자의 작업수행과 운동기능을 위한 Lee Silverman Voice Treatment-BIG(LSVT-BIG) 프로그램의 임상적용에 대한 사례연구)

  • Jeong, Sun-A;Hong, Deok-Gi
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.63-75
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    • 2020
  • Objective : The purpose of this study was to examine the changes in work performance and motor function of stroke patients in the Lee Silverman Voice Treatment-BIG (LSVT-BIG) program and to confirm its clinical applicability. Methods : Two stroke patients underwent the LSVT-BIG program for a total of 16 sessions (60 minutes per session and, four days a week for four weeks). To assess any changes between before and after the intervention, the Canadian Occupational Performance Measurement (COPM), Berg Balance Scale (BBS), Timed Up and Go (TUG), Functional Reaching Test (FRT), Manual Function Test (MFT) were used. Differences in scores between before and after the intervention were analyzed. Results : The performance and satisfaction of occupational performance increased after the intervention in both subjects. The performance time of the TUG decreased to 0.91, 8.42 seconds for each subject, increasing the walking speed. In FRT distance change, the subject increased in both the affected side and unaffected side. The BBS score increased by 3 points in one subject and by 6 points in the other, indicating improved balance. In addition, in the MFT score, subject A showed an improvement of 1 point on the unaffected side, and subject B showed an improvement of 1 point on the unaffected side and 3 points on the affected side. Conclusion : We confirmed the applicability of the LSVT-BIG program as a new intervention technique for stroke patients. Future, complementary research on the effects of the LSVT-BIG program on stroke patients will be needed.

Use of a Postoperative Hepatic Arterial Embolization in Patients with Postoperative Bleeding due to Severe Hepatic Injuries (외상성 대량 간 손상 환자에서 수술 후 간 동맥 색전술의 유용성)

  • Cha, Soo Hyun;Jung, Yong Sik;Won, Jae Hwan;Kim, Wook Whan;Wang, Hee Jung;Kim, Myung Wook;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.59-66
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    • 2006
  • Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was $2.36{\pm}1.75$, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.

The Combined Effect of Adriamycin and Irradiation on the Small Intestinal Villi of Mice (방사선 조사와 Adriamycin 병용 투여가 마우스 소장에 미치는 영향에 관한 연구)

  • Hong, Seong-Eon;Ahn, Chi-Yul
    • Radiation Oncology Journal
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    • v.4 no.1
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    • pp.1-13
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    • 1986
  • In order to clarify the effect of radiation on the mouse jejunal crypt cells by combined administration of administration and radiation and also to evaluate the enhancing effect of adriamycin, the authors performed this study by delivering single irradiation of 1,000 to 1,600 rad to the whole abdomen of mice by cobalt-60 teletherapy unit. In combination with adriyamycin treatment groups, the drug was administered as single dose of 10 mg/kg either 2 hours before or 4 hours after graded single dose,900 to 1,400 rad, of irradiation. The authors studied the quantitative changes of intestinal crypt cells by microcolony survival assay technique and the morphological changes of small intestinal villi by scanning electron microscope in mice following to combined therapy with adriamycin and irradiation, The average number of jejunal crypts per circumference was $130{\pm}16$ in control group. The mean lethal dose(Do) of each irradiation alone and combined therapy groups 2 hours before and 4 hours after irradiation, were 160, 170, and 170 rad in cell survival curves, respectively. The dose effect factor(DEF) of adriamycin in each groups of pre-irradiation and post-irradiation were 1.19 and 1.26, respectively. The conical shaped villi were noted on 1,200 rad in irradiation alone group and 1,000 rad in combined groups. For the proper clinical application we must be careful of the radiation injury to small bowel when the anticancer chemotherapy and radiation therapy to the abdomen and pelvic area are used as combined therapeutic modality.

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Videothoracoscopic Surgery for Secondary Spontaneous Pneumothorax (비디오 흉강경을 이용한 이차성 자연기흉의 치료)

  • 양현웅;정해동;최종범;최순호
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.692-696
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    • 1998
  • For the management of a secondary spontaneous pneumothorax, videothoracoscopic surgery may offer the potential therapeutic benefits of a minimally invasive approach. We report on a series of 36 patients(33 men and 3 women) with a mean age of 56.3 years(range, 31 to 80 years) who underwent thoracoscopic surgical procedures for the treatment of secondary spontaneous pneumothorax. Twenty-one patients had emphysema and 20 patients had old pulmonary tuberculosis. Nineteen patients presented a persistent severe air leak more than 3 days preoperatively and 15 patients had more than one recurrence. Bullectomy or exclusion of the lesion was performed in 33 patients. Mechanical pleurodesis was performed in the entire patients, talc was sprayed in 22 and vibramycin in 14. Mild pleural adhesion at the upper lobe was shown in 10 patients and severe pleural adhesion in 7 patients. One patient with persistent air leak died of persistent air leak and respiratory failure. The mean postoperative stay was 7.0 days(range, 2 to 17 days). At a mean follow-up of 15.8 months (range, 5 to 45 months), no pneumothorax had recurred. In comparison with the result of the treatment for 112 patients with primary spontaneous pneumothorax, the operating time was not significantly longer and there were no more primary treatment failures, but the duration of postoperative chest drainage and hospital stay was longer. Videothoracoscopic surgery has proved to be an effective treatment for secondary spontaneous pneumothorax in elderly patients who represent high-risk candidates for thoracotomy.

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Characterization of Porcine Tissue Perforation Using High-Power Near-Infrared Laser at 808-nm Wavelength (808 nm 파장의 고출력 근적외선 레이저 조사 시 돼지 조직의 천공 특성 연구)

  • Kim, Seongjun;Cho, Jiyong;Choi, Jaesoon;Lee, Don Haeng;Kim, Jung Kyung
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.9
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    • pp.807-814
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    • 2013
  • A fundamental study on laser-tissue interaction was conducted with the aim of developing a therapeutic medical device that can remove lesions on the intestinal wall by irradiating a high-power 808-nm infrared laser light incorporated in an endoscopic system. The perforation depth was linearly increased in the range of 1~4 mm in proportional to laser output (3~12 W) and irradiation time (5~20 s). We demonstrated that the perforation depth during laser irradiation was varied according to the tissue property of each extracted porcine organ. The measurement of the temperature distribution suggests that the energy is localized in the irradiation spot and transferred to deep tissue, which protects the surrounding tissue from thermal injury. These results can be used to set the driving parameters for a laser incision technique as an alternative to conventional surgical interventions.

Effects of Ramulus Uncariae Cum Uncis' Herbal Acupuncture on Transient Forebrain Ischemic Injury in Rats (흰쥐의 일과성 전뇌 허혈 손상에 대한 조구등 약침의 효과)

  • 고정수;김재효;최동옥;김경식;손인철
    • The Journal of Korean Medicine
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    • v.24 no.2
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    • pp.66-80
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    • 2003
  • Objectives : Recently, herbal acupuncture has been developed in the Korea since the earlier 1960' applied to various diseases including the cerebrovascular accident. The main characteristics of herbal acupuncture are a combination the merit of acupuncture and herbal medicine. It was not well known the therapeutic effect and the mechanism of herbal acupuncture on transient forebrain ischemic injury, although it has been used frequently in clinics. Ramulus Uncariae Cum Uncis (釣鉤藤) has been claimed to possess sedative, anti-spasmodic actions, and treat childhood epilepsy in oriental medical preparation. Also, it has been stated that Ramulus Uncariae Cum Uncis was antioxidatvie effect and neuroprotection against glutamateinduced neuronal death. Methods : In this study, effects of Ramulus Uncariae Cum Uncis' herbal acupuncture on the $GV_{20}{\;}or{\;}LR_3$, named Baek-hue or Tae-chung, on neuroprotection after the transient forebrain ischemia were investigated in Sprague-Dawely rats. Expressions of cFos, FosB and BDNF protein in the hippocampus and cortex were observed at 2 hrs and 48 hrs after transient forebrain ischemia by immunohistochemistry and ELISA technique. Results : Expression of cFos protein was increased slightly in the hippocampus and cortex at 2 hrs after transient forebrain ischemia, but FosB protein was increased highly comparing to cFos protein. However, pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ significantly increased expression of cFos protein and significantly decreased expression of FosB protein compared to control group, respectively. These features were observed in the motor cortex and retrosplenial granular cortex as well as the hippocampus. Especially, cFos expression was more increased at the herbal acupuncture on $GV_{20}{\;}than{\;}LR_3$, but FosB expression was more decreased in $LR_3$ group than $GV_{20}$ group. Also, pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ significantly increased the expression of BDNF protein in the hippocampus ($254.88{\pm}12{\;}pg/ml{\;}in{\;}GV_{20}$ group, $245.93{\pm}44.4{\;}pg/ml{\;}in{\;}LR_3$ group) and the cortex ($85.81{\pm}3.45{\;}pg/ml{\;}in{\;}GV_{20}$ group, $111.51{\pm}15.79{\;}pg/ml{\;}in{\;}LR_3$, group) compared to the hippocampus ($134.07{\pm}2.96{\;}pg/ml$) and the cortex ($61.16{\pm}4.11{\;}pg/ml$) in control group at 48 hrs after transient forebrain ischemia. Conclusion : These results suggest that pretreatment with Ramulus Uncariae Cum Uncis' herbal acupuncture on $GV_{20}{\;}or{\;}LR_3$ has neuroprotective effect on transient forebrain ischemia and the herbal acupunture on $GV_{20}{\;}or{\;}LR_3$ may be related to antioxidative effect and calcium channel block of Ramulus Uncariae Cum Uncis. Also, it could be mentioned there is specificity of acupoints treating ischemic injury through the difference between the herbal acupuncture of $GV_{20}{\;}and{\;}LR_3$.

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Measurement of Total Plasma Homocysteine in Patients with Chronic Renal Failure Using HPLC/FLD (만성신부전증환자에서 HPLC/FLD를 이용한 혈장 Homocysteine의 측정)

  • Kyung-Ok Lee;Bo-Kyung Kang;Hyung-Jin Roh;Kwang-Suk Ryoo;Jeong-Yeon Yoo;Man-Jeong Paik;Kang-Hyeob Lee
    • Biomedical Science Letters
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    • v.3 no.1
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    • pp.29-35
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    • 1997
  • Cardiovascular disease has been the leading cause of death among patients with chronic renal failure. Many reports have been described that homocysteine is one of the independent risk factor to the occulsive vascular disease. In this study, HPLC/FLD (high performance liquid chromatography-fluorescence detector) technique was used to measure homocysteine level in patients with chronic renal failure and normal control group. The detection limit and recovery of total plasma homocysteine using HPLC/FLD were 98.6$\pm$5.8% and 0.2 nmol/ml, respectively. The linearity of this method was established in concentration range of 2~50 nmol/ml (correlation coefficient=0.9997). The concentrations of total plasma homocysteine were 6.81$\pm$1.54 nmol/ml and 27.28$\pm$14.94 nmol/ml in normal control (n=20) and patient group (n=90), respectively (p<0.05). In this study, the HPLC/FLD method showed high sensitivity and reproducibility for a routine clinical laboratory testing. Moreover determination of homocysteine level in plasma might be useful for a biochemical marker for predicting the cardiovascular diseases and for monitoring of therapeutic effect of lowering homocysteine in patients with chronic renal failure.

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Simple Methods for Production of Chimeric Mouse by Coculture with TT2 Embryonic Stem Cells (TT2 Embryonic Stem Cell 을 이용한 Chimeric Mouse 생산에 있어서 간단한 공배양방법)

  • Cho, Y.Y.;Moon, S.J.;Kang, M.J.
    • Korean Journal of Animal Reproduction
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    • v.24 no.4
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    • pp.451-455
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    • 2000
  • Gene targeting are very useful tools for the research on the gene function in vivo, mass production of foreign materials and biomedical approach of therapeutic process. But this process is very complicated and necessary highly skilled technique, because it is very different from ES cell origin, genetic background of embryo, and experimental conditions. We investigated the productivity ability of chimeric mouse after aggregation with TT2 ES cells. Increse of ES cell density caused gradual decrease in embryo development in vitro and in th $\varepsilon$ production of chimeric mice in vivo. One million ES cell density for the aggregation was very efficient to produce high percentage chimeric mice in their coat color. These results suggested that appropriate cell density plays a key role in the development and production of chimeric mice by a 8-cell aggregation method.

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Photon Energy Dependence of the Sensitivity of LiF TLDs Loaded with Thin Material (얇은 박막을 얹은 TLD 반응감도의 광자 에너지에 대한 의존성)

  • Min Byongim J;Kim Sookil;Loh John J.K;Cho Young Kap
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.256-260
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    • 1999
  • Purpose : An investigation has been carried out on the factors which affect the response reading of thermoluminescent dosimeters (TLD-100) loaded with thin material in high energy Photon. The aim of the study was to assess the energy response of TLD-100 to the therapeutic ranges of photon beam. Materials and Methods : In this technique, TLD-100 (abbreviated as TLD) chips and three different thin material (Tin, Gold, and Tissue equivalent plastic plate) which mounted on the TLD chip were used in the clinical photon beam. The thickness of each metal plates was 0.1 mm and TE plastic plate was 1 mm thick. These compared with the photon energy dependence of the sensitivities of TLD (normal chip), TLD loaded with Tin or Gold plate, for the photon energy range 6 MV to 15 MV, which was of interest in radiotherapy. Results : The enhancement of surface dose in the TLD with metal plate was clearly detected. The TLD chips with a Gold plate was found to larger response by a factor of 1.83 in 10 MV photon beam with respect to normal chip. The sensitivity of TLD loaded with Tin was less than that for normal TLD and TLD loaded with Gold. The relative sensitivity of TLD loaded with metal has little energy dependence. Conclusion : The good stability and linearity with respect to monitor units of TLD loaded with metal were demonstrated by relative measurements in high energy Photon ($6\~15$ MV) beams. The TLD laminated with metals embedded system in solid water phantom is a suitable detector for relative dose measurements in a small beam size and surface dose.

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