비디오 투시 연하 검사에 근거한 Gugging Swallowing Screen의 타당도 평가

송원우,김은주,김한나,이숙희,박정준,최경인,류병주 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.6

Objective: To evaluate the clinical validity of gugging swallowing screen (GUSS) scale in comparison with the findings of videofluoroscopic swallowing study (VFSS) for subacute and chronic stroke patients, though GUSS was developed in order to screen dysphagia in acute stroke patients. Method: The subjects of this study were thirty-five patients who had stroke for more than 3 months and were showing the symptom of dysphagia. GUSS, VFSS and clinical examination were performed respectively by three different physiatrists. These tests were performed at intervals of 24 hours or less. The result of GUSS was compared with videofluoroscopic dysphagia scale (VDS) based on VFSS, Clinical dysphagia scale (CDS), and ASHA scale based on clinical patterns. Results: The result of GUSS was in a significant correlation with VDS, CDS, and ASHA scale (p<0.01). GUSS predicted aspiration very efficiently (area under the curve=0.928; 95% CI, 0.833 to 1.022). The cutoff value of 12 point showed sensitivity of 89.5%, specificity of 87.5%, and negative predictability of 87.5%. Conclusion: The GUSS is considered as an effective and convenient screening tool to evaluate stroke patients with dysphagia irrespective of stroke stages. Objective: To evaluate the clinical validity of gugging swallowing screen (GUSS) scale in comparison with the findings of videofluoroscopic swallowing study (VFSS) for subacute and chronic stroke patients, though GUSS was developed in order to screen dysphagia in acute stroke patients. Method: The subjects of this study were thirty-five patients who had stroke for more than 3 months and were showing the symptom of dysphagia. GUSS, VFSS and clinical examination were performed respectively by three different physiatrists. These tests were performed at intervals of 24 hours or less. The result of GUSS was compared with videofluoroscopic dysphagia scale (VDS) based on VFSS, Clinical dysphagia scale (CDS), and ASHA scale based on clinical patterns. Results: The result of GUSS was in a significant correlation with VDS, CDS, and ASHA scale (p<0.01). GUSS predicted aspiration very efficiently (area under the curve=0.928; 95% CI, 0.833 to 1.022). The cutoff value of 12 point showed sensitivity of 89.5%, specificity of 87.5%, and negative predictability of 87.5%. Conclusion: The GUSS is considered as an effective and convenient screening tool to evaluate stroke patients with dysphagia irrespective of stroke stages.

Development of Conductive Flexible Patch with Self-attachability and Superhydrophobicity

W. Song(송원우),S. Park(박성진),J. Kim(김재일),J. Kim(김진서),D. K. Kang(강동관),S. Kim(김소미),H. E. Jeong(정훈의) Korean Society for Precision Engineering 2023 한국정밀공학회 학술발표대회 논문집 Vol.2023 No.11

Skin-attatchable, self-healable, soft hydrogels with high-sensitivity for wearable electronics

W. Song(송원우),G. Choi(최건준),S. Kim(김소미),J. Kim(김재일),H. E. Jeong(정훈의) 한국생산제조학회 2023 한국생산제조시스템학회 학술발표대회 논문집 Vol.2023 No.12

뇌손상 환자의 야간뇨에 대한 경구 데스모프레신의 효과 및 안전성

최수원,송원우,김완호,김은주,김종훈,양호철,김한나 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.3

Objective: To assess the effect of oral desmopressin administration for nocturia and sleeping in brain injured patients and to confirm its safety.Method: 20 brain injured patients waking up more than twice a night for urination during sleeping have been subjected to take 0.1 mg of desmopressin at 9 p.m. everyday for 30 days. To analyze the effect of the drug before and after its administration, the frequency of patient's awakening for urination, duration of time to first urination after sleeping, total urination volume during sleeping and Pittsburgh sleep quality index (PSQI) were evaluated. All newly found symptoms one month after taking the medication were recorded to confirm the safety of the drug. Results: After taking the medication, the mean urination frequency of 20 patients was reduced from 2.4 to 1.4, the mean duration of time to the first urination after sleeping was increased from 3.4 hours to 4.9 hours (p<0.01). The mean PSQI score of 20 patients was decreased from 9.7 to 4.8 (p<0.01). 2 patients had side effects (hyponatremia, headache).Conclusion: The oral administration of desmopressin was relatively safe and effective on brain injured patients with nocturia. Objective: To assess the effect of oral desmopressin administration for nocturia and sleeping in brain injured patients and to confirm its safety.Method: 20 brain injured patients waking up more than twice a night for urination during sleeping have been subjected to take 0.1 mg of desmopressin at 9 p.m. everyday for 30 days. To analyze the effect of the drug before and after its administration, the frequency of patient's awakening for urination, duration of time to first urination after sleeping, total urination volume during sleeping and Pittsburgh sleep quality index (PSQI) were evaluated. All newly found symptoms one month after taking the medication were recorded to confirm the safety of the drug. Results: After taking the medication, the mean urination frequency of 20 patients was reduced from 2.4 to 1.4, the mean duration of time to the first urination after sleeping was increased from 3.4 hours to 4.9 hours (p<0.01). The mean PSQI score of 20 patients was decreased from 9.7 to 4.8 (p<0.01). 2 patients had side effects (hyponatremia, headache).Conclusion: The oral administration of desmopressin was relatively safe and effective on brain injured patients with nocturia.

척수손상 환자에서 혈청 Cystatin C를 이용한 신기능 평가

신지철,박창일,송원우,김은주,김상현,이진우 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.4

Objective: To evaluate the renal function by investigating the relationship among serum cystatin C, serum creatinine, creatinine clearance and the average of bilateral ERPF (effective renal plasma flow) ratio of the MAG3 renal scan for the spinal cord injured patients. Method: Seventy-one spinal cord injured patients who admitted to our department were evaluated from January 2004 to October 2004. Blood samples and 24-hour urine of all the subjects were collected for measuring serum cystatin C, serum creatinine and creatinine clearance. MAG3 renal scan was done for 47 subjects. Regression analysis and Pearson's correlation methods were utilized for statistical analysis.Results: There was significant correlation between 1/cystatin C and creatinine clearance (p<0.001) and the correlation coefficient between 1/cystatin C vs. creatinine clearance (R= 0.552) was bigger than that between 1/creatinine and creatinine clearance (R=0.329). The reciprocal of cystatin C was positively correlated with the average of bilateral ERPF ratio of MAG3 renal scan (p=0.01), while there was no significant correlation between 1/creatinine and the average of bilateral ERPF ratio. Conclusion: Measurement of serum cystatin C is a useful and convenient method for the evaluation of renal function in spinal cord injured patients.

뇌졸중 환자의 보호자들에게 핸즈온 훈련(Hands-on Training)이 미치는 영향

김은주,김완호,송원우,이고은,정재훈,김경은,김한나 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.3

Objective: To assess the impact of active training (“hands- on training”) caregivers on their attitudes for handling the patients and to examine the effectiveness of hands-on training in improving psychosocial outcomes for stroke patients and their caregivers. Method: The subjects were 59 stroke patients and their family caregivers. They were randomly divided into two groups: a control group and a training group. The training group received active hands-on training about personal care with handling techniques. We collected the data through interviewing the patients and their caregivers on admission and at discharge. The stroke patients and caregivers were evaluated with the functional status, caregiver appraisal scale, psychological state, quality of life. Results: Caregivers in the training group experienced a significant reduction in caregiving burden and anxiety (p<0.05). There were no differences in depression or physical health between the two groups, although caregivers in the intervention group were found to have significantly better mental health. Patients in the caregiver training group also experienced less anxiety and better mental health (p<0.05), and had a modest benefit in functional status (independence in activities of daily living) (p<0.05). Conclusion: A hands-on training for caregivers of post- stroke inpatients resulted in reducing burden of care and anxiety while improving psychosocial outcomes for caregivers, proving that the hands-on training might be helpful in caregivers of stroke inpatients. (J Korean Acad Rehab Med 2010; 34: 270-277) Objective: To assess the impact of active training (“hands- on training”) caregivers on their attitudes for handling the patients and to examine the effectiveness of hands-on training in improving psychosocial outcomes for stroke patients and their caregivers. Method: The subjects were 59 stroke patients and their family caregivers. They were randomly divided into two groups: a control group and a training group. The training group received active hands-on training about personal care with handling techniques. We collected the data through interviewing the patients and their caregivers on admission and at discharge. The stroke patients and caregivers were evaluated with the functional status, caregiver appraisal scale, psychological state, quality of life. Results: Caregivers in the training group experienced a significant reduction in caregiving burden and anxiety (p<0.05). There were no differences in depression or physical health between the two groups, although caregivers in the intervention group were found to have significantly better mental health. Patients in the caregiver training group also experienced less anxiety and better mental health (p<0.05), and had a modest benefit in functional status (independence in activities of daily living) (p<0.05). Conclusion: A hands-on training for caregivers of post- stroke inpatients resulted in reducing burden of care and anxiety while improving psychosocial outcomes for caregivers, proving that the hands-on training might be helpful in caregivers of stroke inpatients. (J Korean Acad Rehab Med 2010; 34: 270-277)

뇌졸중 환자의 예비심박수를 이용한 유산소 운동의 강도 선택

김은주,김완호,송원우,양호철,김종훈,이숙희,이용석,김홍채 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.3

Objective: To determine the intensity of aerobic exercise in stroke patients using heart rate reserve (HRR) by comparing maximal oxygen consumption (VO2max) and VO2 at % HRR in maximal exercise test of treadmill, arm ergometer and bicycle ergometer. Method: Twenty nine stroke patients who could walk independently were included. Maximal exercise test using treadmill, arm ergometer and bicycle ergometer was performed. Heart rate, rating of perceived exertion, minute ventilation, oxygen consumption and respiratory exchange ratio were measured through respiratory gas analysis. When the standard criteria for maximal oxygen consumption (VO2max) was achieved, each test was terminated. We compared the measured VO2max with the VO2 at % heart rate reserve (HRR) and figured out the statistically significant % HRR point. Results: Twenty-four (82.7%), twenty-four (82.7%) and twenty-five (86.2%) patients completed maximal exercise test using treadmill, arm ergometer and bicycle ergometer. Most patients who completed maximal exercise test satisfied the VO2max criteria with VO2 plateau at the end of the exercise test (41.3∼48.2%) or RER>1.0 (79.3∼82.7%) or peak HR>age-predicted maximal heart rate (APMHR)-10 or peak HR>70% {208−(0.7×age)} when they took β- blockers (6.8∼13.7%). The differences between measured VO2max and VO2 above 60% HRR at treadmill test, 65% HRR at arm ergometer test, 65% HRR at bicycle ergometer test were not statistically significant (p>0.05). Conclusion: Exercise above 60% HRR at treadmill test, 65% HRR at arm and bicycle ergometer test can be useful as aerobic exercise intensity in stroke patients. Objective: To determine the intensity of aerobic exercise in stroke patients using heart rate reserve (HRR) by comparing maximal oxygen consumption (VO2max) and VO2 at % HRR in maximal exercise test of treadmill, arm ergometer and bicycle ergometer. Method: Twenty nine stroke patients who could walk independently were included. Maximal exercise test using treadmill, arm ergometer and bicycle ergometer was performed. Heart rate, rating of perceived exertion, minute ventilation, oxygen consumption and respiratory exchange ratio were measured through respiratory gas analysis. When the standard criteria for maximal oxygen consumption (VO2max) was achieved, each test was terminated. We compared the measured VO2max with the VO2 at % heart rate reserve (HRR) and figured out the statistically significant % HRR point. Results: Twenty-four (82.7%), twenty-four (82.7%) and twenty-five (86.2%) patients completed maximal exercise test using treadmill, arm ergometer and bicycle ergometer. Most patients who completed maximal exercise test satisfied the VO2max criteria with VO2 plateau at the end of the exercise test (41.3∼48.2%) or RER>1.0 (79.3∼82.7%) or peak HR>age-predicted maximal heart rate (APMHR)-10 or peak HR>70% {208−(0.7×age)} when they took β- blockers (6.8∼13.7%). The differences between measured VO2max and VO2 above 60% HRR at treadmill test, 65% HRR at arm ergometer test, 65% HRR at bicycle ergometer test were not statistically significant (p>0.05). Conclusion: Exercise above 60% HRR at treadmill test, 65% HRR at arm and bicycle ergometer test can be useful as aerobic exercise intensity in stroke patients.

뇌병변이 있는 환자에서 조절된 음식 농도에 따른 연하양상

배하석,박창일,장지훈,송원우,김성민,정재훈 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.6

Objective: The response of the pharyngeal phase during swallowing is influenced by various factors including viscosity, shape, firmness, fracturability, and cohesive power. These factors affect the pharyngeal phase simultaneously, but little research has been conducted into their individual effects on the pharyngeal phase. This study investigated the relationship between controlled viscosity and pharyngeal transit time (PTT). Method: The subjects were 81 patients with naso-gastric tube due to brain dysfunction. PTT was assessed by video- esophageal fluoroscopy and the viscosity of the processed starch by Brookfield viscometer. High viscosity was defined as a controlled viscosity of 12% and 9%, medium viscosity as a controlled viscosity of 7.5%, 6%, and 4.5%, and low viscosity as a controlled viscosity of 3%, 1.5%, and 0% (liquid viscosity). Results: PTT was prolonged with increasing viscosity in the experimental group. There were no significant differences between PTT of the experimental and control groups at any viscosity. Aspiration prevalence was 1.85%, 7.82%, and 22.22% in the high, medium, and low viscosity groups, respectively, and the three prevalences showed significant differences. Conclusion: PTT showed a tendency to be prolonged with increasing food viscosity in the experimental group.

노인 뇌졸중 환자의 24시간 심박변동 분석을 이용한 자율 신경 기능 분석

김용욱(Yong-Wook Kim),박창일(Chang-Il Park),송원우(Won-Woo Song),장지훈(Ji-Hoon Jang) 대한임상노인의학회 2005 대한임상노인의학회지 Vol.6 No.2

연구배경: 뇌졸중 급성기에 자율신경 이상이 발생하는 것은 널리 알려져 있는 사실이나 노인 환자를 대상으로 한 연구는 거의 이루어지지 못한 실정이다. 본 연구를 통해 노인 뇌졸중 생존자에서 자율신경계의 변화를 알아보고자 하였다. 방법: 65세 이상의 20명의 뇌졸중 환자와 20명의 대조군을 24시간 심박변동분석을 이용하여 분석 비교하였다. 결과: 노인 뇌졸중 환자에서 심박변동 분석 결과 시간 영역 및 주파수 영역에서 변수들이 대조군에 비해 모두 유의하게 감소된 소견을 보였다. 편마비 환자를 우반구 및 좌반구로 나누어 분석하였을 때는 심박변동 분석 결과 유의한 차이가 없었다. 사지마비 대상군에서 편마비에 비해 시간 영역 및 주파수 영역의 심박변동 변수들이 감소된 소견을 보였다. 결론: 노인 뇌졸중 환자에서 자율 신경 기능이 손상되어 있는 것으로 생각한다. Background: Impaired autonomic function is common in the acute poststroke phase but little is known about autonomic function in the geriatric stroke survivor. We wanted to determine if autonomic function is impaired after stroke recovery in older patients. Methods: 24-hour heart rate variability (HRV) analysis was performed for 20 ischemic stroke patients older than 65 years old and 20 control subjects older than 65 years old. Results: Geriatric stroke patients had lower parameters of time domain and power spectrum of HRV compared with control. There was no significant difference of HRV between right and left hemiplegic subjects. Quadriplegic subjects had lower parameters of time domain and power spectrum of HRV compared with hemiplegic subjects. Conclusion: Cardiovascular autonomic function is impaired in old aged stroke survivors.