• Journal of Yeungnam Medical Science
• /
• 제35권1호
• /
• pp.109-113
• /
• 2018

A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

• 대한통합의학회지
• /
• 제9권2호
• /
• pp.63-73
• /
• 2021

Purpose : Selective functional movement assessment(SFMA) is a movement-based assessment tool designed for clinicians to diagnose and treat pain and functional physical problems. This concept is used for assistance in occupations related to movement, including clinical medical personnel, such as physical therapists, physical education instructors, and athlete coaches. Although this concept is widely used by clinicians, research and scientific proofs are relatively insufficient. This study aimed to review the literature on the understanding, reliability and effectiveness of SFMA, and to consider its role in the future of rehabilitation. Methods : In this review, a total of nine articles were selected according to the eligibility criteria of three major thesis topics. The main topics covered in the literature are reliability and effectiveness of clinical use of SFMA. To gather research articles, we searched official term 'Selective Functional Movement Assessment'. Among the searched 60 studies, nine were mentioned in this study that contained overlapping information and matched our desired topic. We reviewed four reliability analyses, four case reports, and one experimental study. Results : Reliability has an intermediate degree between high raters and within raters. The validity of the SFMA system is influenced by a combination of experience and logic; hence, further improvement is needed. Therefore, if the intervention was effective based on the diagnosis result, then biomechanical evidence is necessary to further support the claim. Conclusion : In future research, to use SFMA as a diagnostic tool with high accuracy, it is necessary to improve the reliability of the main problem through breakout, support for guidelines and validity and efficiency.

• 척추신경추나의학회지
• /
• 제14권1호
• /
• pp.49-59
• /
• 2019

본 증례에서는 넘어진 후 상완골 골절 진단 하에 수술하였으나 뒤늦게 원위 요척관절 탈구로 진단되어 1차 수술 후 정복 소실되어 Sauve-Kapandji 수술받은 환자를 대상으로 한방재활치료를 약 3주간 시행하였다. 관절가동추나, 침 치료, 한약물 치료 등 한방재활치료 결과 우측 팔꿈치, 손목, 손가락 관절 가동범위, 수술부위 통증, 근력, 상지 기능 등에서 의미 있는 호전을 보였다. 본 연구는 단일 증례 보고라는 한계가 있으나, 한방재활치료가 수술 후 환자의 전반적인 경과에 효과적으로 작용하였기에 보고하는 바이다.

• Journal of Preventive Medicine and Public Health
• /
• 제52권4호
• /
• pp.250-257
• /
• 2019

Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제45권4호
• /
• pp.207-214
• /
• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• 디지털융복합연구
• /
• 제17권1호
• /
• pp.365-373
• /
• 2019

본 연구는 성별에 따른 독거노인 삶의 질의 영향요인을 파악하고자 시행되었다. 2013-2015년 국민건강영양조사대상자 22,948명 중 독거노인 959명 대상으로 하였다. IBM SPSS 23.0프로그램을 이용하여 복합표본을 형성한 후 복합표본 통계로 자료를 분석하였다. 두 그룹 간 나이, 교육수준, 칼로리 섭취, 관절염유무, 무릎통증, 허리통증, 알코올섭취 빈도와 양, 흡연유무, 주관적 건강과 삶의 질에서 유의한 차이가 나타났다. 남성 독거노인 삶의 질의 유의한 영향요인은 경제상태, 관절염유무, 활동제한, 주관적 건강이었고 이들의 설명력은 50.5%이었다(p<.001). 여성 독거노인 삶의 질의 유의한 영향요인은 허리통증, 주관적 건강, 자살생각이었고 이들의 설명력은 41.4%이었다(p<.001). 그러므로 독거노인의 삶의 질을 향상시키기 위해서는 성별에 따른 적절한 중재를 제공할 필요가 있다.

• Physical Therapy Rehabilitation Science
• /
• 제8권1호
• /
• pp.8-14
• /
• 2019

Objective: Degenerative knee arthritis is the most common disease that occurs in older people. Constriction-induced movement therapy (CIMT) has been reported to be as an effective treatment for the impairments, such as asymmetric weight-bearing and reduced balance that occurs after receiving a total knee replacement (TKR). Game-based rehabilitation training for persons with TKR is interesting and provides a variety of feedback. Design: Randomized controlled trial. Methods: Thirty-six subjects with TKR were randomly assigned to either the CIMT game training (n=12), general game training (n=12), or the control (n=12) group. Each group underwent twelve sessions (30 min/d, 3 d/wk for 4 weeks). In the CIMT game training group, the application of CIMT adjusted the weight of the pressure delivered from the two boards used in Wii games. In the general game training group, the game was played without adjusting the weight of pressure. The game training used the Wii Fit's Ski Slalom application. Subjects were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities-specific Balance Confidence (ABC) Scale. Results: All three groups showed significant improvements in pain, stiffness and physical function, total WOMAC scores, and ABC scores after the intervention (p<0.05). Significant differences were observed in physical function, total WOMAC scores, and ABC scores of the CIMT game training group compared with the other groups (p<0.05). Conclusions: The CIMT game training and general game training exhibited improvements on stiffness, but the CIMT game training exhibited a larger effect on lower extremity function and balance confidence levels.

• 융합정보논문지
• /
• 제9권5호
• /
• pp.147-157
• /
• 2019

본 연구에서는 상담심리전공 대학생들의 관계 외상 경험에 초점을 맞추어 이들이 겪은 외상의 의미를 파악하고, 이를 통한 상담자로서의 성장 과정을 살펴보았다. 이를 위해 본 연구자는 외상의 경험과 외상 후 성장에 관한 설문을 실시하고 최종 6명의 학생을 대상으로 면대면 면담을 하였고, 수집된 자료를 질적 사례 연구의 방법에 따라 분석하였다. 그 결과 외상 및 이후의 성장 경험은 38개의 의미단위, 15개의 하위범주, 5개의 범주로 범주화 되었고, 그 내용으로는 '고통의 시간들', '복잡한 감정을 홀로 감당하는 삶', '이해받고 이해하는 경험', '변화를 향한 시도와 새로운 의미', '상담자로서의 성장에 대한 걱정과 기대'이다. 본 연구의 결과는 외상을 경험한 상담심리 전공 학생들의 개입 방안에 필요한 기초적인 정보와 교육 자료를 제공하였다는데 의의가 있다.

• 대한정형도수물리치료학회지
• /
• 제27권2호
• /
• pp.17-25
• /
• 2021

Background: The purpose of this study is to investigate basic data about the effects of muscle energy technique on the shoulder complex range of motion and posture alignment in the round shoulder posture. Methods: The subjects included 15 women that gave consent to participate in the study voluntarily. They performed the muscle energy technique for 30 minutes twice. The round shoulder posture was measured with a straight edge ruler. The shoulder complex range of motion was measured with the apley scratch test. The forward head posture was measured with ImageJ. The pectoralis minor muscle length was measured with a tape measure. Results: There were statistically significant differences in the round shoulder posture both right and left (p<.05). The experiment group showed statistically significant differences in the pectoralis minor muscle length (p<.05). There were significant differences in the shoulder complex range of motion including flexion, left lateral flexion, right lateral flexion, left side bending, and right side bending (p<.05), but no significant differences were found in extension (p>.05). The forward head posture showed significant differences in CVA changes (p<.05) and no significant differences in CRA changes (p>.05). Conclusion: These findings demonstrate that the muscle energy technique relaxed muscles around the shoulders and increased the shoulder complex range of motion. The technique is also expected to prevent pain in the neck and shoulders and lower injury risk. In conclusion, the muscle energy technique can be applied as an effective intervention for round shoulder posture.

• 대한정형도수물리치료학회지
• /
• 제27권2호
• /
• pp.69-76
• /
• 2021

Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.