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안형선,이정원,최은희 한국인지운동치료협회 2010 한국신경인지재활치료학회지 Vol.2 No.-
Objective: This case study aimed to investigate the effects of cognitive therapeutic exercise(CTE) on recovery of lingual function as tongue of strength, form discrimination, controlled mobility, sensory etc. in poststroke. Methods: Subject was a 55 year-old male with right hemiplegia and poor lingual function due to cerebral infarction of the left Basal ganglia and temporal lobe. This study was single subject experimental design for five weeks. The CTE program were consisted of tongue midline orientation, form discrimination, and controlled mobility for recovery of lingual function. Measurement of the lingual function were before, during and after CTE program. Data analysis were used to Wilcoxon matched-pairs signed-ranks test and univariate ANOVA. Results: Subject was significantly to increased tongue strength(p<.05), controlled mobility(p≤.001), form discrimination ability(p≤.001), and to decreased tongue deviation from midline(p≤.01). Also, he was ignificantly to improved swallowing function(p<.01). Conclusion : The findings indicate that lingual function enables poststroke patients to increase tongue of strength, mobility, midline orientation, form discrimination ability with associated swallowing. 목적: 인간이 음식을 먹을 때 혀의 기능은 매우 중요하다. 본 연구는 삼킴관련 장애를 가지고 있는 편마비 환자를 대상으로 적용한 인지운동치료가 혀 기능회복에 미치는 효과를 알아보았다. 방법: 연구대상자는 55세의 남자로 왼바닥핵 및 관자엽 경색으로 오른편마비가 되었으며, 혀의 공간인지능력의 저하,혀의 정중선 변화,혀의 운동성, 근력저하로 인하여 음식물을 씹고 삼키는 것에 어려움을 갖고 있다. 환자의 혀 기능 회복을 위하여 인지운동치료를 적용하기 전,치료 중,치료 후에 혀의 공간인지 능력,정중선,운동성,근력 등을 평가하였다. 결과: 혀의 도형인지능력이 치료 전에는 3점에서 치료 후에는 10점으로 향상되었다(≤.001). 혀의 정중선이 치료전에는 마비측으로 30° 편위되었고, 치료 후에는 5° 편위되어 83.4%의 개선을 보였다(p≤.01). 혀의 운동성은 치료 전에는 1분에 6회 직사각형을 입안에서 굴렸고,치료 후에는17회로 증가되어 250%의 향상을 보였다(p≤.001). 혀의 근력은 평균 .44㎏ 증가하였다(p<.05). 또한 삼킴기능이 향상되었다(p≤.01).결론: 인지운동치료가 편마비환자의 삼킴관련 혀근력,운동성,정중선,도형구별 능력에 효과가 있었다.
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연하장애환자에서 구강훈련이 구강기의 기능 향상에 미치는 효과
안형선,정원미,안시내 한국인지운동치료협회 2013 한국신경인지재활치료학회지 Vol.5 No.-
Objective: This case study aimed to investigate the effects of cognitive therapeutic exercise (CTE) on oral sensory, motor function and quality of life in poststroke. Methods: Subject was a 67 year-old male with quadriplegia, poor oral motor function and sensory impairment due to both cerebellum infarction, cerebral infarction of the left Basal ganglia and right thalamus. This study was CTE programs were applied in single subject for 8weeks. To compare swallowing function before and after the each MASA, GUSS used. also, the change of Quality of life were measured with a SWAL-QOL. Data analysis were used to Wilcoxon matched-pairs signed-ranks test and univariate ANOVA. Results: Subject was significantly to MASS score(p<.05), GUSS score(p<.05). Also, he was signifi-cantly to SWAL-QOL(P<.05). Conclusion: The findings indicate the that the cte therapy are beneficial in improving the swallowing function of stroke patients. (J Korean Society of Neurocognitive Rehabilitation 2013;5:55-65) 목적: 본 연구는 삼킴관련 장애를 가지고 있는 편마비 환자를 대상으로 적용한 인지운동치료가 구강 감각과 운동기능 그리고 삶의 질에 미치는 효과를 알아보았다. 방법: 연구대상자는 67세 남자로 양쪽 소뇌 경색과 왼바닥 핵 및 시상의 경색으로 사지마비가 되었으며 저하된 구강운동 기능과 감각의 손상을 갖고 있다. 이 연구에서 한 대상에게 인지운동 프로그램을 8주간 적용 하였다. 삼킴 기능의 전후 비교를 MASA, GUSS를 사용하였고 삶의 질의 변화를 SWAL-QOL로 측정하였다. 결과: MASA 점수는 치료 전의 항목들의 총점은 108점 이었으며 치료 후의 총점은 160점으로 향상 되었다(p<.05). GUSS 점수는 치료 전의 항목들의 총점은 1점 이었으며 치료 후의 총점은 4점으로 향상 되었다(p<.05). 또한 삶의 질을 측정하는 SWAL-QOL 점수는 치료 전의 항목들의 총점은 82점 이었으며 치료 후의 총점은 114점으로 향상 되었다 (p<.05). 결론? 인지운동치료가 삼킴 장애를 가진 뇌졸중 환자에게 유익한 효과를 보였고 특히 구강준비단계와 구강단계에 효과를 보였다.
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안형선(Hyung Sun An),이정원(Jeong Weon Lee),최은희(Eun Hee Choi) 한국인지운동치료협회 2010 한국신경인지재활치료학회지 Vol.2 No.1
Objective : This case study aimed to investigate the effects of cognitive therapeutic exercise(CTE) on recovery of lingual function as tongue of strength, form discrimination, controlled mobility, sensory etc. in poststroke. Methods : Subject was a 55 year-old male with right hemiplegia and poor lingual function due to cerebral infarction of the left Basal ganglia and temporal lobe. This study was single subject experimental design for five weeks. The CTE program were consisted of tongue midline orientation, form discrimination, and controlled mobility for recovery of lingual function. Measurement of the lingual function were before, during and after CTE program. Data analysis were used to Wilcoxon matched-pairs signed-ranks test and univariate ANOVA. Results : Subject was significantly to increased tongue strength(p<.05), controlled mobility(p≦.001), form discrimination ability(p≦.001), and to decreased tongue deviation from midline(p≦.01). Also, he was significantly to improved swallowing function(p<.01). Conclusion : The findings indicate that lingual function enables poststroke patients to increase tongue of strength, mobility, midline orientation, form discrimination ability with associated swallowing.
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Cable Plate를 이용한 대퇴골 인공 삽입물 주위 골절의 치료
안형선 ( Hyung Sun Ahn ),이기원 ( Ki Won Lee ),김정환 ( Chung Hwan Kim ),이재헌 ( Jae Hun Lee ),전주식 ( Ju Sik Jeon ) 대한골절학회 2006 대한골절학회지 Vol.19 No.1
목적: 인공 고관절 치환술 후 발생한 대퇴골 삽입물 주위 골절에서 Cable plate를 이용한 치료 결과를 분석하고자 한다. 대상 및 방법: 2002년 11월부터 2004년 5월까지 인공 고관절 치환술 후 발생한 대퇴골 삽입물 주위 골절 환자 10예를 대상으로 평균 1년 8개월간 추 시하였다. 골절의 형태는 Vancouver 분류기준에 따라, B1형이 7예, B3형이 1예, C형이 2예였다. 결과 판정은 평균 골유합 기간, 합병증, Harris 고관절 점수를 통해 시행하였다. 결과: B1형 골절 환자의 평균 골유합 시기는 4.8개월, B3형 골절과 C형 골절의 평균 골유합 기간은 각각 6개월과 8개월이었으며, 합병증으로 2예에서 재골절, 1예에서 불유합이 발생하였다. 평균 Harris 고관절 점수는 B1형 골절에서 골절 전 93.2점에서 수술 후 91.5점, B3형 골절은 각각 90점과 85점, C형 골절에서는 92.3점과 72.5점이었다. 결론: Cable plate를 이용한 대퇴골 인공 삽입물 주위 골절의 치료는 많은 장점을 가지나, 골막 혈행의 차단, 재골절 및 금속 부전증의 위험이 있어 골절의 형태와 환자의 상태에 따라 신중한 선택이 필요할 것으로 사료된다. Purpose: To evaluate the results of Cable plate fixation for the treatment of periprosthetic femoral fracture after hip arthroplasty. Materials and Methods: We reviewed 10 cases of periprosthetic femoral fractures after hip arthroplasty between Nov. 2002 and May 2004. The mean follow up periods were 20 months. The fractures were classified according to Vancouver classification. Seven cases of type B1, one case of type B3 and two cases of type C were treated with open reduction and internal fixation with Cable plate. Evaluation of results was based on mean union time, postoperative complications and Harris hip score. Results: The mean time for bony union was 4.8 months in type B1, 6 months in type B3 and 8 months in type C fracture. As for complications, there were refracture, metal breakage and nonunion. The postoperative mean Harris hip score was 91.5 points for type B1, 85 points for type B3 and 72.5 points for type C fracure. Conclusion: Cable plate can be useful for treatment of periprosthetic femoral fractures after hip arthroplasty, but the selection of treatment methods should be cautiously made according to the type of fracture and status of patients.
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화농성 관절염에 있어서 활액내 포도당 농도의 임상적 의의
안형선,이춘성 울산대학교 의과대학 1994 울산의대학술지 Vol.3 No.2
Despite potent antimicrobial agents, septic arthritis continues to be one of the most damaging and prevalent forms of arthritis, resulting in serious sequelae. Synovial fluid analysis has been widely recommended as an important diagnostic tool for the diagnosis of the septic arthritis. But, there has been a debate about the clinical relevance of synovial fluid leukocyte count and glucose concentration in the diagnosis of septic arthritis. So, this study was performed to assess the clinical significances of synovial fluid analysis, especially glucose concentration of joint fluid in septic arthritis. From August 1989 to March 1994, the data of the synovial fluid analyses were reviewed in fifty cases who were initially suspected of septic arthritis. We classified them into two groups, one with twenty culture-positive cases and the other with thirty culture-negative cases on synovial fluid bacterial culture. The results were as follows. 1. In culture-positive group, blood and synovial fluid leukocyte counts were not significantly increased, but the proportion of synovial fluid polymorphonuclear leukocytes was significantly increased(90% in average) as compared with culture-negative group. 2. The difference between serum and synovial fluid glucose concentrations showed a statistically significant increase in culture-positive group(54mg/dl in average of 15 cases) in contrast to culture-negative group(25mg/dl in average of 22 cases). 3. The ratio of synovial fluid glucose to that of the serum was significantly decreased in culture-positive group(44% in average of 15 cases) in contrast to culture-negative group (81% in average of 22 cases).
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연하장애환자에서 구강훈련이 구강기의 기능 향상에 미치는 효과
안형선(Hyung Sun An),정원미(Won Mee Jeong),안시내(Si Nae Ahn) 한국인지운동치료연구회 2013 한국신경인지재활치료학회지 Vol.5 No.1
본 연구는 삼킴관련 장애를 가지고 있는 편마비 환자를 대상으로 적용한 인지운동치료가 구강 감각과 운동기능 그리고 삶의 질에 미치는 효과를 알아보았다. 방법: 연구대상자는 67세 남자로 양쪽 소뇌 경색과 왼바닥 핵 및 시상의 경색으로 사지마비가 되었으며 저하된 구강운동 기능과 감각의 손상을 갖고 있다. 이 연구에서 한 대상에게 인지운동 프로그램을 8주간 적용 하였다. 삼킴 기능의 전후 비교를 MASA, GUSS를 사용하였고 삶의 질의 변화를 SWAL-QOL로 측정하였다. 결과: MASA 점수는 치료 전의 항목들의 총점은 108점 이었으며 치료 후의 총점은 160점으로 향상 되었다(p<.05). GUSS 점수는 치료 전의 항목들의 총점은 1점 이었으며 치료 후의 총점은 4점으로 향상 되었다(p<.05). 또한 삶의 질을 측정하는 SWAL-QOL 점수는 치료 전의 항목들의 총점은 82점 이었으며 치료 후의 총점은 114점으로 향상 되었다 (p<.05). 결론? 인지운동치료가 삼킴 장애를 가진 뇌졸중 환자에게 유익한 효과를 보였고 특히 구강준비단계와 구강단계에 효과를 보였다. This case study aimed to investigate the effects of cognitive therapeutic exercise (CTE) on oral sensory, motor function and quality of life in poststroke. Methods: Subject was a 67 year-old male with quadriplegia, poor oral motor function and sensory impairment due to both cerebellum infarction, cerebral infarction of the left Basal ganglia and right thalamus. This study was CTE programs were applied in single subject for 8weeks. To compare swallowing function before and after the each MASA, GUSS used. also, the change of Quality of life were measured with a SWAL-QOL. Data analysis were used to Wilcoxon matched-pairs signed-ranks test and univariate ANOVA. Results: Subject was significantly to MASS score(p<.05), GUSS score(p<.05). Also, he was signifi-cantly to SWAL-QOL(P<.05). Conclusion: The findings indicate the that the cte therapy are beneficial in improving the swallowing function of stroke patients. (J Korean Society of Neurocognitive Rehabilitation 2013;5:55-65)
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나화엽,김영태,안형선,김기용 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.1
Although a few reports have described the histopathologic findings of the removed disc material after lumbar discectomy, the interrelationship of the histologic, radio- logic and clinical findings is rarely recognized. We performed a retrospective histopathologic, radiographic and clinical review of the results for patients who had a discectomy for the treatment of herniated lumbar intervertebral disc to find out any prognostic factors. We analysed ninety five patients who had been treated by partial laminectomy and discectomy for intervertebral disc herniation from Jun. 1989 to Apr. 1992 at Department of Orthopedic Surgery, Asan Medical Center. The mean follow up duration was 18 months(range, 12-36 months). The results were as follows: In 69 histopathological studies, all cases included the component of annulus fibro- sus, but none of them contained the component of nucleus pulopsus alone. An avul- sion type of the herniated disc materials composed of cartilage end plate and annu- lus fibrosus was 62% (43/69) of the cases, and we could not find any statistically significant correlation between age and the incidences of avulsion type, but we could find a statistically significant correlation between types on preoperative magnetic resonance imaging and the incidences of avulsion type(p<0.05). That is to say, avul- sion type was significantly more common in non-contained type than contained type. 2.The space-occupying ratio of herniated disc mass to spinal canal averaged 34. 3%, and it was correlated with the weight of removed disc material(p<0.05), but not with the postoperative clinical results. 3.The reduction of the heights of operated disc levels at the latest follow-up radiograph in comparison with preoperative radiograph averaged 5.1%, and this post- operative disc height change did not have any statistically significant correlation with either weight of removed disc material or clinical results. 4.The weight of removed disc material averaged 1.6 grams per level, and it didn't show any statistically significant correlation with the postoperative clinical results. That is to say, the more increased weight of removed disc material didn' guarantee the better clinical results.
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