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홍보영,조이찬,김준성,임성훈,배정민 대한의학회 2017 Journal of Korean medical science Vol.32 No.5
The study was designed to identify factors influencing the short term effect of intensive therapy on gross motor function in children with cerebral palsy or developmental delay. Retrospectively, total Gross Motor Function Measure-88 (GMFM-88) scores measured during the first and last weeks of intensive therapy were analyzed (n = 103). Good and poor responder groups were defined as those in the top and bottom 25% in terms of score difference, respectively. The GMFM-88 score increased to 4.67 ± 3.93 after 8 weeks of intensive therapy (P < 0.001). Gross Motor Function Classification System (GMFCS) level (I–II vs. IV–V; odds ratio [OR] = 7.763, 95% confidence interval [CI] = 2.177–27.682, P = 0.002) was a significant factor in a good response to therapy. Age (≥ 36 months; OR = 2.737, 95% CI = 1.003–7.471, P = 0.049) and GMFCS level (I–II vs. IV–V; OR = 0.189, 95% CI = 0.057–0.630, P = 0.007; and III vs. IV–V; OR = 0.095, 95% CI = 0.011–0.785, P = 0.029) were significantly associated with a poor response. GMFCS level is the most important prognostic factor for the effect of intensive therapy on gross motor function. In addition, age ≥ 36 months, is associated with a poor outcome.
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Spontaneous Bilateral Femoral Neuropathy: A Case Report
윤수인,조이찬,홍보영,김준성,신보경,임성훈 대한근전도전기진단의학회 2021 대한근전도 전기진단의학회지 Vol.23 No.1
Spontaneous femoral neuropathy rarely occurs in young, healthy men. Herein, we present the first reported case of bilateral spontaneous femoral neuropathy. A 25-year-old man was admitted to the neuropsychiatric inpatient clinic with drug intoxication and showed bilateral knee extensor weakness. He had taken medication for several years for depression. He took an overdose of medication due to severe stress at the army recruit training center for beginning military service. He had slept for over 24 hours. After waking up, bilateral lower extremity weakness had developed. Magnetic resonance imaging showed a small hematoma between the left psoas and quadratus lumborum muscles, and signal intensity changes in the left femoral nerve-innervated muscles. An electrodiagnostic study demonstrated bilateral femoral neuropathy with axonal injury. Two months later, his weakness had partially recovered, and a follow-up examination revealed partial electrodiagnostic recovery. At a long-term third follow-up visit, both symptoms and electrodiagnostic findings had improved.
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김준성,조이찬,백준현,임성훈,홍보영 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.1
Persistent enterocutaneous fistula after the removal of a gastrostomy tube is an unusual complication of per-cutaneous endoscopic gastrostomy (PEG). The following case report describes an 81-year-old man diagnosed with stroke and dysphagia in May 2008. The patient had been using a PEG since 2008, and PEG site infection occurred in June 2013. The PEG tube was removed and a new PEG tube was inserted. Thereafter, formation of gastrocutaneous fistula around the previous infected PEG site was observed. The fistula was refractory to medical management, accompanied by long duration of fasting and peripheral alimentation. Therefore, gastrojejunostomy tube insertion via the previously inserted PEG tube was performed, under fluoroscopic guidance; this mode of management was successful. For patients who have a gastrocutaneous fistula, gastrojejunostomy tube insertion via the pre-existing PEG tube is a safe and effective alternative management for enteral feeding.
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전소연,조이찬,임성훈,홍보영,인연권,김준성 대한근전도전기진단의학회 2017 대한근전도 전기진단의학회지 Vol.19 No.1
Spinal arteriovenous fistula is the most common vascular malformation of the spinal cord and causes progressive impairment like paraplegia or tetraplegia. Diagnosis of the disease is often challenging because its heterogeneous presentation mimics those of other neurological disorders, such as lumbosacral radiculopathy or peripheral polyneuropathy. Here we report a case of thoracic myelopathy resulting from spinal arteriovenous fistula in a patient treated with chemotherapy. In our clinic, he was diagnosed with spinal arteriovenous fistulas through magnetic resonance imaging and spinal angiography. Electromyography was used to evaluate the clinical features of the patient. Subsequently, he underwent surgery and was transferred to our outpatient department to continue rehabilitation therapy. Eventually, the motor power grade in his lower extremities improved from poor to fair and he was able to walk independently with a wheel walker.
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