근육경직의 약물치료

고은재,김대열 대한의사협회 2022 대한의사협회지 Vol.65 No.2

Background: Muscle spasticity is a neurologic disorder, which is considered one of the positive signs of upper motor neuron diseases. Spasticity is common after brain or spinal cord injury. Since spasticity results in tendon retraction, muscle weakness, pain, ankylosis, and disability in activities of daily living, treatment is warranted. Current Concepts: Spasticity is usually assessed using the Modified Ashworth Scale or Modified Tardieu Scale. It is treated with various methods, including physical therapy, occupational therapy, orthosis, medication, and surgery. Pharmacological management should be selected according to the location and severity of the symptom and includes oral medications, chemical nerve block, and intrathecal baclofen pump insertion. Oral medications include baclofen, benzodiazepine, dantrolene, and tizanidine. Chemoneurolysis of spasticity is done with botulinum toxin or a mixture of phenol and alcohol. Discussion and Conclusion: Since muscle spasticity affects motor function and activities of daily living, understanding of this symptom and choosing an optimal treatment are necessary. Pharmacologic treatments should be administered with caution especially with the side effects. Optimal treatment of spasticity will bring the best neurological outcome for the patients.

대학생의 스마트폰 중독 정도, 안구건조증, 경부 통증 및 수면의 질에 관한 연구

고은재,김나연,김도연,김은혜,김지연,박영신,심현수,윤지현,이소미,이해수,박효정 이화여자대학교간호학회 2020 이화간호학회지 Vol.- No.54

Purpose: The purpose of this study was to identify correlation among the degree of smartphone addiction, dry eye syndromes, neck pain and sleep quality. Method: A total of 172 students were recruited for the data collection. Data were analyzed using frequency, percentage, average, standard deviation, t-test, ANOVA, Scheffe test and Pearson's correlation using the SPSS program. Results: The degree of smartphone addiction, dry eye syndromes, neck pain and sleep quality showed positive correlation. As the level of smartphone addiction is higher, dry eye syndromes, neck pain and sleep quality become worsen. Conclusion: Based on the results of this study, it shows that the quality of sleep had a significant correlation with smartphone addiction. Therefore, it is necessary to consider the nursing intervention to increase the quality of sleep, neck pain and dry eye syndromes in further study.

Visual Evoked Potential in Children With Developmental Disorders: Correlation With Neurodevelopmental Outcomes

김자영,성인영,고은재,정민지 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.2

Objective To investigate the neurodevelopmental outcomes in children with developmental disorder according to visual evoked potential (VEP) results. Methods We retrospectively analyzed children who visited our Department of Pediatric Rehabilitation Medicine with a chief complaint of developmental disability from January 2001 to July 2015. Of the 549 medical records reviewed, 322 children younger than 42 months who underwent both Bayley Scales of Infant and Toddler Development second edition (BSID-II) and VEP studies were enrolled. We compared the development of 182 children with normal VEP latency and 140 children with delayed VEP latency results using the BSID-II results. The Mann-Whitney U-test was used to analyze the differences between the two groups. Results There were no significant differences in baseline characteristics between the two groups. The delayed VEP latency group showed a significant delay in BSID-II index scores and developmental quotients compared with the normal VEP latency group. In addition, a comparative analysis of developmental quotients of mental and psychomotor domains according to age (younger than 12 months, 12–23 months, and 24–42 months) revealed significantly lower values in children with delayed VEP latency compared to children with normal VEP latency, younger than 12 months and from 12 to 23 months. Conclusion Children with delayed VEP latency showed more developmental delay than children with normal VEP latency. It is suggested that VEP can be easily applied to children with suspected developmental delay when physicians have concerns about visual impairment. Furthermore, it is proposed that VEP results could provide an insight into children’s development and serve as early indicators for consultation with an ophthalmologist for the existing problem.

COVID-19 폐렴 후 폐 이식을 받은 근감소증 환자에서의 호흡재활: 증례보고 및 12개월 추적 관찰

신희태,김원,고은재 대한노인재활의학회 2023 Geriatric rehabilitation Vol.13 No.1

Sarcopenia is common in lung transplant patients and COVID-19 infection could significantly affect the degree of sarcopenia. In these patients, rehabilitation is important not only for reversal of muscle mass loss, but also for respiratory function. We report of case of 63-year old patient who received lung transplantation due to COVID-19 acute respiratory distress syndrome (ARDS). She was admitted to the intensive care unit (ICU) due to severe COVID-19 pneumonia and met the ICU-acquired weakness (ICU-AW) diagnostic criteria. She underwent pre-habilitation in the intensive care unit before lung transplantation. After surgery, pulmonary rehabilitation was performed with transfer, gait training and resistance exercise. Muscle mass, muscle strength, physical performance, and respiratory function were observed to gradually improve for 1 year after the surgery. However, even after 1 year, the patient is still included in the diagnostic criteria for sarcopenia and complains of functional limitations

Comparison of Videofluoroscopic Swallowing Study and Radionuclide Salivagram for Aspiration Pneumonia in Children With Swallowing Difficulty

김고은,성인영,고은재,최경효,김재승 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.1

Objective To determine whether the use of both videofluoroscopic swallowing study (VFSS) and radionuclide salivagram was beneficial for detecting aspiration-induced pneumonia in children with swallowing difficulty. Methods From 2001 to 2016, children who underwent both VFSS and salivagram consecutively for suspected aspiration or dysphagia were included in the study. Demographic data, findings of VFSS and salivagram, and medical records were reviewed. Results Aspiration pneumonia (AP) was present in 34 out of 110 children; 48 showed positive aspiration findings in VFSS and 33 showed positive aspiration findings in salivagram. Among the 62 children who were negative of aspiration in VFSS, 12 (19.4%) showed positive aspiration findings in salivagram. Four out of 12 children were diagnosed with AP. The aspiration findings in both VFSS and salivagram were significantly related to AP. However, the aspiration findings in the two tests were weakly consistent. Even if one test showed negative aspiration, it was helpful to additionally detect AP using another test, which showed positive aspiration finding. If aspiration findings were positive in only one of the two tests, the probability of AP was 38.5%, whereas if they were positive in both tests, the probability increased to 66.7%. If the aspiration findings were negative in both tests, AP did not occur with a probability of 90%. Conclusion Salivagram is a valuable tool for monitoring of aspiration in children with swallowing difficulties. It could be helpful in assessment of children at a high risk of AP, even if the VFSS showed negative aspiration findings. Thus, testing for AP using both VFSS and salivagram is desirable.

The Relationship Between Magnetic Resonance Imaging and Electrodiagnostic Studies in Patients with Ulnar Neuropathy at the Elbow

Kang Min Soo,Seo Yu Jin,고은재,Kim Dae Yul,Lee Jung Eun,이민희 대한근전도전기진단의학회 2022 대한근전도 전기진단의학회지 Vol.24 No.2

Objective: This study investigated the correlations between magnetic resonance imaging (MRI) and nerve conduction studies (NCS) in patients with ulnar neuropathy at the elbow (UNE).Methods:In total, 46 patients who underwent elbow MRI and NCS at a single center from 2014 to 2018 were included. Motor studies, including segmental and inching tests, and sensory NCS were performed. The 5-point severity score was evaluated based on the signal change and swelling in the fat-suppressed T2 weighted sequence. The findings of MRI and NCS were grouped into 3 categories. The Spearman rank test was used to evaluate correlations between the severity score on MRI and electrodiagnostic parameters.Results:The locations of the lesions on MRI and NCS were correlated in 20 of the 46 patients with UNE, while the other 20 patients had no correlations. Six patients who could not be categorized according to the location showed various findings. The severity score based on MRI showed significant negative correlations with amplitude on the segmental study (r = -0.423, p = 0.002) and the inching study (r = -0.456, p = 0.002), and with conduction velocity in the segmental study (r = -0.526, p < 0.001) and the inching study (r = -0.548, p < 0.001).Conclusion Electrodiagnostic outcomes had negative correlations with the severity score, reflecting the structural changes seen on MRI. Combining electrodiagnostic studies and MRI could make the diagnosis and localization more precise.

Infantile-Onset LMNA-Related Congenital Muscular Dystrophy Presenting as Torticollis: A Case Report

Kim Ji Ae,Ye Dong Hyun,Shin Hee Tae,Lee Seung Hak,고은재 대한근전도전기진단의학회 2023 대한근전도 전기진단의학회지 Vol.25 No.1

Lamin A (<i>LMNA</i>)-related congenital muscular dystrophy usually presents with hypotonia and severe axial muscle weakness in early infancy. We report a patient who initially presented with torticollis but was finally diagnosed with <i>LMNA</i>-related congenital muscular dystrophy. A 7-month-old infant presented to the outpatient clinic with a chief complaint of torticollis. During a thorough physical examination, axial muscle weakness and gross motor delay were noted, and she was admitted to the pediatric rehabilitation department for further evaluation. The serum creatine kinase level was elevated, and electromyography demonstrated the possibility of hereditary myopathy or a motor neuron disorder. A gene study was conducted, and it showed a c.745C>T (p.Arg249Trp) mutation in the <i>LMNA</i> gene, which is known to cause congenital muscular dystrophy in rare cases. Since there are few reports describing nerve conduction and electromyography studies in patients with <i>LMNA</i>-related congenital muscular dystrophy, this case is meaningful.

Early Neurodevelopmental Assessments of Neonates Discharged From the Neonatal Intensive Care Unit: A Physiatrist’s Perspective

Hyun Sung Eun,Kwon Jeong-Yi,Hong Bo Young,Yoon Jin A,Choi Ja Young,Hong Jiyeon,Koh Seong-Eun,고은재,Kim Seung Ki,Song Min-Keun,Yi Sook-Hee,Cho AhRa,Kwon Bum Sun 대한재활의학회 2023 Annals of Rehabilitation Medicine Vol.47 No.3

The survival rate of children admitted in the neonatal intensive care unit (NICU) after birth is on the increase; hence, proper evaluation and care of their neurodevelopment has become an important issue. Neurodevelopmental assessments of individual domains regarding motor, language, cognition, and sensory perception are crucial in planning prompt interventions for neonates requiring immediate support and rehabilitation treatment. These assessments are essential for identifying areas of weakness and designing targeted interventions to improve future functional outcomes and the quality of lives for both the infants and their families. However, initial stratification of risk to select those who are in danger of neurodevelopmental disorders is also important in terms of cost-effectiveness. Efficient and robust functional evaluations to recognize early signs of developmental disorders will help NICU graduates receive interventions and enhance functional capabilities if needed. Several age-dependent, domain-specific neurodevelopmental assessment tools are available; therefore, this review summarizes the characteristics of these tools and aims to develop multidimensional, standardized, and regular follow-up plans for NICU graduates in Korea.