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Correlations of Abnormal Involuntary Movements with Blood Glucose, Lipid Levels in Chronic Schizophrenics (만성정신분열병 환자들에서 비정상적 불수의 운동과 혈당, 지질과의 상관관계)

  • Kim, Hyeong-Seob;Kim, Eung-Jo;Lee, Joo-Ho;Ji, Seong-Hak
    • Korean Journal of Biological Psychiatry
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    • v.11 no.2
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    • pp.117-126
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    • 2004
  • Objects:It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. Methods:Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance- related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. Results:There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. Conclusion:In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of $HbA_1C$, waist, and weight are recommended for schizophrenics.

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Effects of Neurofeedback Training and Computer-Assisted Cognitive Rehabilitation on Cognition and Upper Extremity Function in PostStroke. (신경되먹임 뇌파 훈련과 컴퓨터보조 인지 재활훈련이 뇌졸중 환자의 인지와 상지기능에 미치는 영향)

  • Jung, Min-Woo;Shim, Sun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.1 no.1
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    • pp.57-70
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    • 2012
  • Objective : This study was to evaluate the effects of a Neurofeedback(NFB) and Computer Assisted Cognitive Rehabilitation(CACR) training to improve on cognition and affected arm function in stroke subjects. Methods : Participants were randomly allocated to three groups: NFB(n=14), CACR(n=14) and control(n=16). All groups received occupational therapy and physical therapy for 5 session 30 minutes per week during 6 weeks. Also NFB and CACR group practiced additional NeuroComp training and RehaCom training for 30 sessions 30 minutes during 6 weeks. Results were evaluated by cognition, affected arm function. Results : There were significantly increased by CACR training that outcomes of MMSE-K(p<.05). And there weren't significantly difference by NFB and CACR training that outcomes of the affected arm function. And a difference between three groups wasn't found. Conclusion : The NFB and CACR training improves cognitive function. These results suggest that NFB and CACR training is feasible and suitable for individuals with stroke.

Usability Evaluation of Lateral Sliding Table in CT Examination (CT 검사에서 Lateral Sliding Table의 유용성 평가)

  • Choi, Jeong Hun;Kong, Chang gi;Song, Jong Nam;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.677-684
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    • 2020
  • Miscentering in the left and right X axis direction during CT examination affects dose and quality. When the CT Gantry Isocenter and the center of the examination objective are matched using the Lateral Sliding Table, the image quality is improved and the exposure dose is reduced. CTDI Head Phantom (Kimda, Korea) and dosimeter (Ray Safe, Sweden) were used to measure dose comparison CTDI (mGy) due to center deviation, and Water Phantom (HITACHI, Japan) was used to measure noise to see the difference in uniformity due to center deviation. Measurements of doses for dose comparison CTDI (mGy) with a deviation showed that doses were consistently reduced and exact dose was not projected until they were moved to 80 mm by 20 mm from the Isocenter. SD values were measured to see the difference in uniformity due to center deviation and the noise continued to increase until it was moved by 20 mm to 80 mm. The range of collimation has increased by the extent of deviating from the center and the range of exposure has increased. Using the Lateral Sliding Table, you can easily adjust the Isocenter, increase the quality of the image by adjusting the Isocenter in areaa such as the cardiac examination of the location away from the Isocenter, Extreme bone and Shoulder, and greatly reduce the collimation to the Isocenter, so it can be used to reduce unnecessary exposure dose.

Thoracoscopic Thoracic Sympathectomy for Reflex Sympathetic Dystrophy -One Case Report - (반사성 교감신경 위축증의 흉강경하 흉추교감신경절제술 - 치험 1례 -)

  • Kim, Tae-Sik;Kim, Kwang-Taik;Kim, Hyoung-Mook;Kim, Hak-Jei;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.208-211
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    • 1998
  • Reflex sympathetic dystrophy is an important clinical entity that is characterized by excessive or prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function, and trophic changes. This syndrome is among the most frequently encountered problems in clinical medicine, and proper diagnosis and therapy are critical. Accidental or surgical trauma or one of a variety of disease states may become a precipitating factor. Proper recognition and treatment result in rapid elimination of symptoms and complete recovery. A 56-years old male accidented total amputation of the proxomal part of the left index finger in May, 1996. Emergently, complete replantation procedure was successfully performed in the department of reconstructive surgery, medical center, Korea University. Afterward, he began to suffer from uncontrolled, prolonged pain in left index finger, proximally spreading pain to the left upper extremity and limited joint movement of the left shoulder. Although many treatments were used for this syndrom, not all of them were effective. Furthermore, the treatments which proved effective had detrimental side effects. However, thoracoscopic left thoracic sympathectomy was performed in our department. This therapy successfully relieved the pain and improved shoulder joint movement.

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Early & Midterm Results after Redo Coronary Artery Bypass Grafting (관상동맥우회술 후 재수술의 단기 및 증기 성적)

  • 김준성;김홍관;장우익;김기봉
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.146-153
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    • 2004
  • As the experience of coronary artery bypass grafting (CABG) has been accumulated, the number of reoperation after CABG is increasing. We analyzed our clinical experience of redo-CABG. Material and Method: Fourteen patients who underwent redo-CABG between Jan. 1994 and Dec. 2002 were included in this study. The mean period from the first operation to reoperation was 66$\pm$56 (3∼157) months, and the average ages were 62.8$\pm$8.7 (51∼78) years. The survivors were followed up 39$\pm$29 (4∼101) months postoperatively. Indications of reoperation were stenosis or occlusion of previous grafts in 11 patients, progression of native coronary artery disease in one patient, and both etiologies in two patients. Result: There were two in-hospital mortalities (14.3%) resulting from low cardiac output syndrome, Postoperative morbidities were perioperative myocardiac infarction in 2 patients (14.3%), mediastinitis in one patient (7.2%), duodenal perforation in one patient, ischemic necrosis of the lower extremity in one patient, gastric perforation after mesenteric infarct in one patient, delayed brain infarct in one patient, and intraoperative splenic rupture in one patient. There was one late mortality at six months postoperatively during the follow up. There was no angina recurrence during the follow up. Conclusion: Although redo CABG demonstrated relatively high operative mortalities and morbidities, postoperative status and clinical outcome of the survivors were favorable.

Correlates of Lymphedema in Women with Breast Cancer: a Case Control Study in Shiraz, Southern Iran

  • Honarvar, Behnam;Sayar, Negin;Tahmasebi, Sedigheh;Zakeri, Zeinab;Talei, Asra;Rostami, Sara;Khademi, Sahar;Sarvestani, Amene Sabzi;Sekhavati, Eghbal
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.81-85
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    • 2016
  • Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was $52.3{\pm}11.0years$ and of the control group was $50.1{\pm}10.9years$. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was $4.4{\pm}2.5cm$ and the difference in volume displacement was $528.7{\pm}374.4milliliters$. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI :2.6-73.3), invasiveness of BC (OR =13.7, 95% CI :7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI :2.3-7.9), BMI =>25 (OR=4.2, 95% CI :2-8.7), radiotherapy (OR=3.9, 95% CI :1.8-8.2), past history of limb damage (OR=1.7, 95% CI :0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI :1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in BC patients to prevent development of BCRL and improve QOL of these patients.

Comparison of Two Different Immobilization Devices for Pelvic Region Radiotherapy in Tomotherapy

  • Kim, Dae Gun;Jung, James J;Cho, Kwang Hwan;Ryu, Mi Ryeong;Moon, Seong Kwon;Bae, Sun Hyun;Ahn, Jae Ouk;Jung, Jae Hong
    • Progress in Medical Physics
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    • v.27 no.4
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    • pp.250-257
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    • 2016
  • The purpose of this study was to compare the patient setup errors of two different immobilization devices (Feet Fix: FF and Leg Fix: LF) for pelvic region radiotherapy in Tomotherapy. Thirty six-patients previously treated with IMRT technique were selected, and divided into two groups based on applied immobilization devices (FF versus LF). We performed a retrospective clinical analysis including the mean, systematic, random variation, 3D-error, and calculated the planning target volume (PTV) margin. In addition, a rotational error (angles, $^{\circ}$) for each patient was analyzed using the automatic image registration. The 3D-errors for the FF and the LF groups were 3.70 mm and 4.26 mm, respectively; the LF group value was 15.1% higher than in the FF group. The treatment margin in the ML, SI, and AP directions were 5.23 mm (6.08 mm), 4.64 mm (6.29 mm), 5.83 mm (8.69 mm) in the FF group (and the LF group), respectively, that the FF group was lower than in the LF group. The percentage in treatment fractions for the FF group (ant the LF group) in greater than 5 mm at ML, SI, and AP direction was 1.7% (3.6%), 3.3% (10.7%), and 5.0% (16.1%), respectively. Two different immobilization devices were affected the patient setup errors due to different fixed location in low extremity. The radiotherapy for the pelvic region by Tomotherapy should be considering variation for the rotational angles including Yaw and Pitch direction that incorrect setup error during the treatment. In addition the choice of an appropriate immobilization device is important because an unalterable rotation angle affects the setup error.

A Systematic Review of Constraint Induced Movement Therapy about Upper Extremity in Stroke (뇌졸중 환자의 상지 강제유도운동치료에 관한 체계적 고찰)

  • Park, Su-Hyang;Baek, Soon-Hyung;Shin, Joong-il
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.149-161
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    • 2016
  • The purpose of this study is provided to useful data to establish the Constraint Induced Movement Therapy(CIMT) in clinical plan to more specific for stroke patients. Also It is provided way for further study about CIMT. Methods used a systematic review. Systematic review is a research method that can be presented to the scientific evidence. Data were organized by PICO(Patient, Intervention, Comparison, Outcome). Research using the database Embase and Medline, It was searched for CIMT and Stroke. We selected for a total of 42 studies that meet the purpose of the present study. We was selected for a total of 42 studies that meet the purpose of the present study. Results was that the quality of the study is a systematic review, meta-analyzes, randomized controlled. CIMT studies was based on a high quality level of 50% of the total. The difference between the study period was 42.8%, more research was conducted prior to 2010. CIMT has been used more than mCIMT by to differ 40.5%. It is effective in over 75% of study, regardless of the CIMT intervention. In conclusion, CIMT has an effect on the upper limbs of stroke patients damaged, results will be used as a useful material to develop a CIMT in the clinical treatment plan. In future studies will need to validate studies on the effectiveness of the mCIMT, It will require a review of the effectiveness of validation studies.

The Effect of Thromboprophylaxis in Lower Extremity Arthroscopic Surgery on Coagulation Test : Enoxaparin versus Rivaroxaban (하지 관절경 수술에 대하여 시행된 항응고 요법에 의한 혈액 응고 검사의 변화 : Enoxaparin versus Rivaroxaban)

  • Park, Sang Eun;Back, Young Woong;Kim, Jong Dai
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.121-127
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    • 2012
  • Purpose: To compare coagulation test results of the arthroscopic surgery patients who received thromboprophylaxis with typical two kinds of anticoagulation drugs, we performed coagulation tests before and after surgery with two groups and then compared the results. Materials and Methods: Forty-seven patients who underwent arthroscopic surgery were randomly divided into two groups to rivaroxaban and enoxaparin group, and we performed coagulation tests before and 5 days after arthroscopic surgery to two drugs groups in order to investigate about the difference in clotting capacity. Results: Preoperative coagulation tests did not differ significantly between the two groups. However, coagulation tests after 5 days of the surgery, the level of prothrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT) increased, particularly in patients with rivaroxaban compared with enoxaparin (P<0.05). Conclusion: Anticoagulation for arthroscopic surgery with a drug is effective and has safe range in terms of bleeding tendency, but in the rivaroxaban group, there was one patient who showed high bleeding tendency with abnormal range. Therefore it should be careful of using rivaroxaban for thromboprophylaxis.

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Analysis of the Sports Injury in the Taekwondo Matches (태권도 경기 중 스포츠 손상에 대한 분석)

  • Her, Jin-Gang;Kim, Kwang-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.5 no.1
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    • pp.75-80
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    • 1999
  • The Taekwondo being a martial sports, there are higher chances for the injury to occur than the non martial sports. Therefore, this study analyze the frequency, the area, the type, and the condition of the injury which are prone to occur in the Taekwondo matches; it is to help the Taekwondo players in prevention of the injury and in treatment. The subjects of this study were the 48 players (male 24, female 24) who participated in the final selection contest of the national team player on March 9 to 12, 1993. The data of the injury were obtained from the medical recoder staff and were analyzed to the frequency of the injury per match, the vulnerable area of the injury, the type of injury, and the condition of the injury with a gender difference. There were 24 matches for the male and 24 matches for the female, total 48 matches. Therefore, the total participation number of the players are the double of the match number. 1. The frequency of the injury per match was 18.3%(11/60) for male and 23.1%(12/52) for women. 2. The areas of the injury were ankle 36.4%(4), foot 18.2%(2), knee 18.2%(2), lower leg 18.2%(2), wrist 9.1%(1) in male; foot 33.4%(4), ankle 16.7%(2), knee 16.7%(2), lower back 16.7%(2), lower leg 8.3%(1), face 8.3%(1) in female. 3. The types of the injury were contusion 45.5%(5), sprain 27.3%(3), abrasion 9.1%(1), laceration 9.1%(1), tendon rupture 9.1%(1) in male; contusion 33.3%(4), sprain 33.3%(4), abrasion 16.7%(2), subcutaneous hemorrhage 8.3%(1), dislocation 8.3%(1) in female. 4. The condition of the injury were the unblocked attack 36.4%(4), attacking kick 27.3%(3), blocking a kick 18.2%(2), attacking punch 9.1%, impact with surface 9.1%(1) in male; attacking kick 33.3%(4), unblocked attack 25%(3), blocking a kick 25%(3), attacking punch 8.3%(1), impact with surface 8.3%(1) in female. This study shows that the injury from the Taekwondo matches occurred most in the lower extremity joints and the foot, and shows that the most of the injury types were contusion and sprain. Therefore, it is believed to be helpful to wear the proper fitting ankle or the knee protector and using other protective equipment to prevent the sports injury in the Taekwondo matches.

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