• The Journal of Korean Physical Therapy
• /
• v.32 no.6
• /
• pp.359-364
• /
• 2020

Purpose: This study was undertaken to compare the efficacy of instrument assisted soft tissue mobilization (IASTM) and a neural dynamic technique (NDYT). As an intervention to treat spastic lower limb muscle tone, stiffness, and static balance in stroke patients. Methods: Totally, 26 participants were assigned randomly to two groups: the IASTM (n=13) and NDYT (n=13) groups. Both groups were subjected to their respective technique for 15 minutes, 5 times a week, for 6 weeks. Muscle tone, stiffness, and static balance were evaluated before and after training, to compare both group changes. Results: IASTM group showed significant decrease in the gastrocnemius medial region and semitendinosus muscle tone and stiffness (p<0.05) compare to NDYT group; however, no significant different was observed in static balance between groups (p>0.05). Conclusion: The results suggest that IASTM is an effective method for decreasing the muscle tone and stiffness in acute stroke patients.

• Archives of Plastic Surgery
• /
• v.42 no.4
• /
• pp.461-468
• /
• 2015

Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.

• The Journal of Korean Society for Radiation Therapy
• /
• v.8 no.1
• /
• pp.55-61
• /
• 1996

A radiation beam incident on irregular or sloping surface produces an inhomogeneity of absorbed dose. The use of a tissue compensator can partially correct this dose inhomogeneity. The tissue compensator should be made based on experimentally measured thickness ratio. The thickness ratio depends on beam energy, distance from the tissue compensator to the surface of patient, field size, treatment depth, tissue deficit and other factors. In this study, the thickness ratio was measured for various field size of $5cm{\times}5cm,\;10cm{\times}10cm,\;15cm{\times}15cm,\;20cm{\times}20cm$ for 4MV X-ray beams. The distance to the compensator from the X-ray target was fixed, 49cm, and measurement depth was 3, 5, 7, 9 cm. For each measurement depth, the tissue deficit was changed from 0 to(measurement depth-1)cm by 1cm increment. As a result, thickness ratio was decreased according to field size and tissue deficit was increased. Use of a representative thickness ratio for tissue compensator, there was $10\%$ difference of absorbed dose but use of a experimentally measured thickness ratio for tissue compensator, there was $2\%$ difference of absorbed dose. Therefore, it can be concluded that the tissue compensator made by experimentally measured thickness ratio can produce good distribution with acceptable inhomogeneity and such tissue compensator can be effectively applied to clinical radiotherapy.

• Archives of Craniofacial Surgery
• /
• v.13 no.2
• /
• pp.85-94
• /
• 2012

The world's first face transplantation was performed in France, in 2005. Since then, 21 cases of face transplantation have been performed. Face transplantation is one of the most prominent part of composite tissue allotransplantation (CTA) along with hand transplantation. Since these fields are not deal with life-saving organs, there are many arguments about immunosuppression therapy. Recent paradigm of face transplantation shows that surgical ranges are expanded from partial face transplantation to full face transplantation. Most immunosuppression protocols are triple therapy, which consists of tacrolimus (FK-506), mycophenolate mofetil and prednisolone. Anatomical researches, immunosuppression, and immunotolerance take great parts in the researches of CTA. The medical fields directly related to face transplantation are microsurgery, immunology, and transplantation. Nowadays, each field is performed widely. Therefore people, even medical teams think face transplantation could be easily realized, sooner or later. But there are lots of things that should be prepared for not only practice and immunosuppression therapy but also for the cooperation with relevant fields. That's the reason why only 21 cases of face transplantation have been done, while more than 70 cases of hand transplantation have been done in the past years. Especially in Korea, brain death patients are not enough even for organ transplantation and furthermore there are some troubles in taking part in the society of transplantation. Face transplantation has lots of problems concerning variable medical fields, administration, society, ethics, and laws. Therefore, for the realization of face transplantation in Korea, not only medical skills but also political powers are needed.

• The Journal of the Korea Contents Association
• /
• v.15 no.8
• /
• pp.416-423
• /
• 2015

The study was conducted targeting 25 patients who underwent the respiratory gated radiation therapy in the abdominal region at Radiation Oncology of a University Hospital from December 2013 to June 2014 and types of cancer included liver(64%), CBD(8%), gastric(8%), GB(8%), pancreas(8%), SMA(4%). The means of ITV and PTV volume are 471.44 cm3 and 425.48 cm3, showing an increase in volume. Normal tissue volume was also found to have increased due to the increase of the section selected from PTV section to ITV section. Right kidney showed a significant increase in differences between increase in normal tissue volume, increase in target volume and increase in therapy irradiation area and difference between the means of dose applied to normal tissue. There was no significant difference in the mean dose applied to normal tissue according to the respiratory average. Both kidneys showed a significant difference in the difference between mean doses of target moving and normal tissue. In this study, both therapy methods through PTV section and ITV section volume setting were appropriate for protection doses of normal tissue and distributed over 95% of the prescribed dose and therefore, it is considered to be okay to be optionally used depending on the patient's therapeutic purpose. But in order to minimize the unexpected side effect, the plan of PTV section and ITV section should be established and used by evaluating normal tissue protection dose.

• The Journal of Korean Physical Therapy
• /
• v.28 no.2
• /
• pp.142-148
• /
• 2016

Purpose: The aim of this pilot study was to determine the effect of soft tissue technique (STT) in Axillary Web Syndrome (AWS) following sentinel Lymph Node Biopsy in breast cancer patients by examining the upper extremity function, range of motion, and pain. Methods: Nineteen patients with breast cancer-related AWS were evaluated. STT was performed on the symptom area for treatment of AWS symptoms. We evaluated AWS symptoms and pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, glenohumeral joint (GHJ) flexion and abduction range of motion (ROM) with or without elbow extension. Results: Visual analyses of the data suggest a modest effect of STT in improving GHJ flexion, abduction ROM with or without elbow extension, DASH for upper extremity function, and Pain. The statistically significant improvement in baseline observed for pain, DASH, and ROM data made it impossible to assess the effects of STT on those outcomes. There were no adverse events. Conclusions: STT may be an effective and safe treatment option for AWS patients recovering from breast cancer treatment; however, further research is needed.

• Physical Therapy Korea
• /
• v.5 no.2
• /
• pp.106-117
• /
• 1998

The pain is common among individuals with physical disabilities. It can interfere with therapy since patients with pain can become uncooperative and reluctant to move. This paper reviews the natural physiological mechanisms that can reduce pain perception, and considers physiological mechanisms which contribute to clinical pain by describing how the pain system changes its sensitivity depending upon the body's needs. The peripheral and central mechanisms contributing to sensitised nociceptive system are described with reference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous 'on-going'-projected and referred pain. It is suggested that in some chronic pain the nociceptive system maintains a state of sensitivity despite the absence of on-going tissue damage and under such circumstances the nociceptive system itself may have become dysfunctional. Such situations are often initiated by damage to nervous tissue which results in changes in the activity and organization of neuronal circuits within the central nervous system. The ability of the nociceptive system to operate in a suppressed state is also discussed with reference to pain modulation. The physical therapist can help facilitate the activation of these mechanisms through a combination of noninvasive modalities, functional activities, and the therapeutic use of self.

• Physical Therapy Korea
• /
• v.2 no.2
• /
• pp.73-84
• /
• 1995

Spasticity has been defined as a motor disorder characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting in hyperexcitability of the stretch reflexes as one component of the upper motor neuron syndrome. Weakness and loss of dexterity, however, are considered to be more disabling to the patient than changes in muscle tone. The discussion includes the important role that alterations in the physiology of motor units, notably changes in firing rates and muscle fiber atrophy, play in the manifestation of muscle weakness. This paper considers both the neural and mechanical components of spasticity and discusses, in terms of clinical intervention, the implications arising from recent research. Investigations suggest that the resistance to passive movement in individuals with spasticity is due not only to neural mechanisms but also to changes in mechanical properties of muscle. The emphasis is on training the individual to gain control over the muscles required for different tasks, and on preventing secondary and adaptive soft tissue changes and ineffective adaptive motor behaviours.

• Physical Therapy Korea
• /
• v.27 no.2
• /
• pp.133-139
• /
• 2020

Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before-after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects' GCMs for 10-15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle's architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.

• 대한방사선치료학회:학술대회논문집
• /
• 1998.06a
• /
• pp.20-20
• /
• 1998