경추 보조기가 연하 과정에 미치는 영향

한나미,김동건,김현동,안현미,이남주 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.6

Objective: To investigate the effect of cervical orthosis upon swallowing and the differences of bracing effect between normal people and spinal cord injured patients. Method: 12 normal adults and 32 cervical cord injured patients who were wearing one of the three common cervical orthoses (soft neck collar, Philadelphia brace, and Minerva brace) were recruited. Swallowing function was evaluated by videofluoroscopic swallowing study (VFSS) without cervical bracing for the baseline data and with cervical bracing to compare with baseline data. The parameters observed were oropharyngeal diameter, initiation point of swallowing, hyoid bone movement, laryngeal penetration, aspiration,and residual volume after swallowing. Results: Cervical orthoses decreased oropharyngeal diameter, reduced hyoid bone movement, increased residual volume, and changed initiation point of swallowing. Minerva brace revealed to give more influence than other braces. Normal adult group and patient group showed no difference in cervical bracing effect. Conclusion: Attention should be paid to swallowing function when cervical bracing is needed because cervical bracing itself can increase the risk of aspiration.

3차원 뉴튼(3D-NEWTON)을 이용한 척추 주위근 기능 평가의 유용성

한나미,김현동,황지선,배중혁,Han, Nami,Kim, Hyun Dong,Hwang, Ji Sun,Bae, Jung-Hyuk 대한물리치료학회 2013 대한물리치료학회지 Vol.25 No.1

Purpose: This study evaluated the validity of measuring paravertebral muscle function with 3D-NEWTON (Hanmed, Korea) by assessing the correlation between Biodex (Biodex, USA) and surface electromyography (EMG). Methods: Nineteen healthy adults participated. The function of their paravertebral muscle was measured in three ways. Maximum endurance time was measured in seconds when 3D-NEWTON was inclined forward for assessing extensor function, and inclined backward for assessing flexor function. Using surface EMG, maximum muscle activity was obtained from the eractor spinae and rectus abdominis during the 3D-NEWTON measurement. Maximum muscle activity was the mean activity from 10 seconds when the root mean squared firing data was highest. Through Biodex the peak torques of the extensor and flexor were measured during isometric exercises. The Spearman correlation coefficiencts from 3D-NEWTON, surface EMG, and Biodex were calculated. Results: The data from surface EMG and Biodex were statistically correlated when measured for flexor function, but less so for extensor function. In the case of 3D-NEWTON, the correlation coefficient with Biodex was 0.50 (p=0.05), while the coefficient with surface EMG was 0.53 (p=0.02) when measured for extensor function. Similarly, the correlation coefficienct with Biodex was 0.60 (p=0.01), while the surface EMG was 0.51 (p=0.03) for flexor function. Conclusion: 3D-NEWTON was a useful method for measuring paravertebral muscle function and can give helpful information for treating people with diseases associated with the lumbar spine.

Proteomic Changes in Rat Gastrocnemius Muscle After Botulinum Toxin A Injection

한나미,김현동,엄미자,Jun Myeong You,한진,김형규,강미선 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.2

Objective To observe the changes in protein expression induced by botulinum toxin A (BoNT-A) injection and to characterize the molecular and cellular action of mechanisms of BoNT-A injection on skeletal muscles using proteomic elements as biomarkers.Methods BoNT-A was injected into left gastrocnemius muscles of 12 Sprague-Dawley rats (2 months of age) at a dosage of 5 units/kg body weight. For the controls same volume of normal saline was injected to right gastrocnemius muscle of each rat. Muscle samples were obtained at 4 time points (3 rats per time point): 3, 7, 14, and 56 day post-injection. To reveal the alterations in muscle protein, we performed 2-dimensional electrophoresis (2DE) and compared Botox group and normal saline group at each time point. Altered protein spots in 2DE were identified using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometer (MALDI-TOF MS) proteomics analysis.Results Compared with normal saline group, 46 protein spots showed changed protein expression. Twelve protein spots demonstrated increased volume and 34 protein spots demonstrated decreased volume. Among spots of decreased volume, 17 spots showed statistically significant differences. Thirty-eight identified proteins were associated with alterations in energy metabolism, muscle contractile function, transcription, translation, cell proliferation, and cellular stress response.Conclusion BoNT-A gives influences on muscle contractile function and energy metabolism directly or indirectly besides neurotoxic effects. Proteomic expression provides better understanding about the effect of BoNT-A on skeletal muscle.

Usefulness of Ultrasound Examination in Evaluation of Breast Cancer-Related Lymphedema

한나미,Yoon-jung Cho,Ji-sun Hwang,Hyun-dong Kim,Geun-yeol Cho 대한재활의학회 2011 Annals of Rehabilitation Medicine Vol.35 No.1

Objective To evaluate the usefulness of ultrasound examination as an adjunctive measurement tool in breast cancer- related lymphedema. Method Twenty healthy volunteers and 20 women who had been treated for unilateral breast cancer and had subsequently developed lymphedema were recruited. Examiners measured the volume of both arm with volumeter and the circumference of both forearm and upper arm with tape measure. Then the thickness of the skin and subcutis on the ventral aspect of forearm and upper arm were measured by ultrasonography. These results were compared with each other. Results The ICCs for interrater reliability of ultrasound examination was high (mostly>0.98). The volume of the swollen arm (2,308 ml) was larger than contralateral arm (1,873 ml). The circumference of swollen forearm (24.50 cm) and upper arm (30.81 cm) were larger than contralateral forearm (21.54 cm) and upper arm (27.60 cm). In the swollen side, average thickness of the forearm skin, forearm subcutis, upper arm skin and upper arm subcutis were 0.23 mm, 1.03 mm, 0.19 mm and 0.95 mm respectively. In the contralateral side, average thickness of the forearm skin, forearm subcutis, upper arm skin and upper arm subcutis were 0.12 mm, 0.69 mm, 0.13 mm, 0.73 mm respectively. The degree of increase in mid-forearm skin thickness were correlated with the degree of swelling calculated with volumeter (r=0.651, p=0.002). Conclusion Ultrasonography is able to give valuable information on the extent of edema and fibrosis of skin and subcutis. It will be a useful tool to follow the results of lymphedema treatment and its progression over time. Objective To evaluate the usefulness of ultrasound examination as an adjunctive measurement tool in breast cancer- related lymphedema. Method Twenty healthy volunteers and 20 women who had been treated for unilateral breast cancer and had subsequently developed lymphedema were recruited. Examiners measured the volume of both arm with volumeter and the circumference of both forearm and upper arm with tape measure. Then the thickness of the skin and subcutis on the ventral aspect of forearm and upper arm were measured by ultrasonography. These results were compared with each other. Results The ICCs for interrater reliability of ultrasound examination was high (mostly>0.98). The volume of the swollen arm (2,308 ml) was larger than contralateral arm (1,873 ml). The circumference of swollen forearm (24.50 cm) and upper arm (30.81 cm) were larger than contralateral forearm (21.54 cm) and upper arm (27.60 cm). In the swollen side, average thickness of the forearm skin, forearm subcutis, upper arm skin and upper arm subcutis were 0.23 mm, 1.03 mm, 0.19 mm and 0.95 mm respectively. In the contralateral side, average thickness of the forearm skin, forearm subcutis, upper arm skin and upper arm subcutis were 0.12 mm, 0.69 mm, 0.13 mm, 0.73 mm respectively. The degree of increase in mid-forearm skin thickness were correlated with the degree of swelling calculated with volumeter (r=0.651, p=0.002). Conclusion Ultrasonography is able to give valuable information on the extent of edema and fibrosis of skin and subcutis. It will be a useful tool to follow the results of lymphedema treatment and its progression over time.

부산경남에 거주하는 정상인에서 신장과 사지 길이의 관계

한나미,김현동,정규영,박상옥 대한재활의학회 2004 Annals of Rehabilitation Medicine Vol.28 No.5

Objective: To identify the relation between height and limb length using anthropometric data in healthy people. Method: One hundred and fifty healthy subjects between the age of 7 months and 67 years were subdivided into five groups: group I (age under 5), group II (5~10), group III (11~20), group IV (21~60), and group V (61 or more). Each group included 15 males and 15 females. Upper arm was measured between acromion and olecranon, and forearm was measured between olecranon and thumb tip. Thigh was measured between ASIS and medial plateau of tibia, and lower leg was measured between medial plateau of tibia and the floor vertically. Results: Ratios of upper arm to height were 0.18±0.01 in group I, 0.19±0.02 in group II, 0.19±0.01 in group III, 0.19±0.01 in group IV, and 0.18±0.01 in group V. Ratios of forearm to height were 0.23±0.03, 0.23±0.03, 0.23±0.02, 0.22±0.01, and 0.22±0.01, respectively. Ratios of thigh to height were 0.27±0.03, 0.29±0.02, 0.31±0.02, 0.31±0.01, and 0.31±0.01 in each age group. Ratios of lower leg to height were 0.22±0.02, 0.25±0.02, 0.25±0.01, 0.26±0.01, and 0.25±0.01, respectively. Conclusion: Ratio of each body segment to height was useful in producing prosthesis for the people lost their both upper or lower extremities calculating the ultimate length of extremities through it.

뇌손상 환자에서의 보호자 우울에 대한 인지행동학적 특성의 영향

도현경,한나미,정규영,김현동,공보금,황지선,조윤정,이동석 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.1

Objective: To evaluate the relationship between depression and cognitive-behavioral characteristics of caregivers using social problem solving inventory (SPSI), social support or conflict scale (SSS or SCS) and somatic symptoms (SS). Method: Fifty five couples of brain-injured patients and caregivers participated in this study. We conducted a questionnaire survey of caregivers with Beck depression index (BDI), SPSI, SSS, SCS and SS for cognitive-behavioral characteristics. And also we studied demographic factors of patients and caregivers, clinical features of brain-injured patients, care- giving duration and time per day through interview and review of medical records. The statistical analyses were performed by independent t-test, one-way ANOVA, Pearson correlation test and linear regression analysis-stepwise method. Results: BDI of the caregivers showed a negative correlation with SPSI, SSS, patients’ MMSE and caregivers’ education level, also a positive correlation with SCS, SS and patients’ GDS (p<0.05). And married caregivers showed more depressive mood (p<0.05). Of these factors, the most influencing factors on BDI were GDS and SCS through linear regression analysis (p<0.01). Conclusion: MMSE, GDS and education level as cognitive- mental factors rather than physical and economic strain had a statistical correlation with depression of caregivers. Especially, SPSI, SSS and SCS as cognitive-behavioral characteristics should be considered on evaluation of depression of caregivers and will be helpful for successful rehabilitation for patients and caregivers. Objective: To evaluate the relationship between depression and cognitive-behavioral characteristics of caregivers using social problem solving inventory (SPSI), social support or conflict scale (SSS or SCS) and somatic symptoms (SS). Method: Fifty five couples of brain-injured patients and caregivers participated in this study. We conducted a questionnaire survey of caregivers with Beck depression index (BDI), SPSI, SSS, SCS and SS for cognitive-behavioral characteristics. And also we studied demographic factors of patients and caregivers, clinical features of brain-injured patients, care- giving duration and time per day through interview and review of medical records. The statistical analyses were performed by independent t-test, one-way ANOVA, Pearson correlation test and linear regression analysis-stepwise method. Results: BDI of the caregivers showed a negative correlation with SPSI, SSS, patients’ MMSE and caregivers’ education level, also a positive correlation with SCS, SS and patients’ GDS (p<0.05). And married caregivers showed more depressive mood (p<0.05). Of these factors, the most influencing factors on BDI were GDS and SCS through linear regression analysis (p<0.01). Conclusion: MMSE, GDS and education level as cognitive- mental factors rather than physical and economic strain had a statistical correlation with depression of caregivers. Especially, SPSI, SSS and SCS as cognitive-behavioral characteristics should be considered on evaluation of depression of caregivers and will be helpful for successful rehabilitation for patients and caregivers.

Evaluation of Ataxia in Mild Ischemic Stroke Patients Using the Scale for the Assessment and Rating of Ataxia (SARA)

최성원,한나미,정상훈,김현동,엄미자,배현우 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.3

Objective To demonstrate the utility of Scale for the Assessment and Rating of Ataxia (SARA) for evaluation of posterior circulation-related features in patients with mild stroke. Methods Forty-five subjects, diagnosed with acute infarction in the cerebellum, basis pontis, thalamus, corona radiata, posterior limb of internal capsule, and their National Institutes of Health Stroke Scale (NIHSS) scores ≤5 were enrolled. SARA scores were graded by the cut-off value of severity in dependency of activities of daily living (ADL). SARA, Berg Balance Scale (BBS), Timed Up-and-Go (TUG), and Trunk Control Test (TCT) were correlated in regression analysis with the modified Rankin Scale (mRS) at discharge. Correlation between SARA and other tools was analyzed. Patients were divided based on mRS at admission (group A, mRS 0–2; group B, mRS 3–5). Scores between the two groups were compared. Results Among the subjects, 48.9% (22/45) scored above 5.5 on SARA, and even 11.1% (5/45) scored higher than 14.25, which is the cut-off value of ‘severe dependency’ in ADL. SARA showed significant value for prediction of mRS at discharge. SARA was correlated with BBS (r=-0.946, p<0.001), TUG (r=-0.584, p<0.001), and TCT (r=-0.799, p<0.001). The SARA, BBS, TUG, and TCT scores between were lower in group B than in group A patients. SARA as well as BBS, TUG, and TCT reflect the functional severity of all patients. Conclusion SARA is a complementary tool for evaluation of the severity of ataxia in mild stroke patients with features of posterior circulation.

소형 어선 어업 어부들의 요통 증상률과 요통의 특성

김정호,김현동,한나미,이선주,추혜정,김현웅,윤창기,서춘희,김건형,이채관,손병철,김대환 대한직업환경의학회 2017 대한직업환경의학회 학술대회 논문집 Vol.2017 No.11

해녀들의 근골격계 증상과 건강관련 삶의 질

김정호,김현동,한나미,이선주,이경진,김세영,서춘희,김건형,이채관,손병철,김대환,이종태 대한직업환경의학회 2016 대한직업환경의학회 학술대회 논문집 Vol.2016 No.11

소형 어선 어업 어부들의 작업 능력과 관련 건강 요소

김정호,김현동,한나미,이선주,추혜정,김현웅,윤창기,서춘희,김건형,류지영,김대환 대한직업환경의학회 2017 대한직업환경의학회 학술대회 논문집 Vol.2017 No.11