경수 손상 환자의 삼킴 양상

한상형 ( Sang Hyoung Han ),서정환 ( Jeong Hwan Seo ),고명환 ( Myoung Hwan Ko ),박성희 ( Sung Hee Park ),송경진 ( Kyung Jin Song ) 전북대학교 의과학연구소 2008 全北醫大論文集 Vol.32 No.1

Objective: To evaluate the characteristics of dysphagia by using the videofluoroscopic swallowing study (VFSS) and the clinical dysphagia scale in patients with cervical spinal cord injury. Method: Twelve patients with cervical spinal cord injury and six normal adults were included in this study. Physical examination and clinical dysphagia scale were checked before VFSS. The parameters observed were penetration, aspiration, oral transit time (OTT), pharyngeal transit time (PTT), and pharyngeal delay time (PDT) during VFSS. Results: Five (41.7%) cervical spinal cord injury patients showed penetration or aspiration in VFSS. The duration of each phases in swallowing (OTT, PTT, PDT) was longer in cervical spinal cord injury patients than normal adults in VFSS (p<0.05). The score of clinical dysphagia scale was higher in patients with cervical spinal cord injury than normal adults. Tracheostomy and mechanical ventilation history seemed to be the predictor of dysphagia in cervical spinal cord injury patients. Conclusion: Swallowing abnormalities were very frequent (41.7%) in cervical spinal cord injury patients. We suggest that the risk of dysphagia should be evaluated for all of the cervical spinal cord injury patients to increase the quality of life via VFSS and clinical dysphagia scale.

다중 파워 모듈 열 관리를 위한 제트 충돌 기반 양면 냉각 시스템 설계

한상형(Sanghyung Han),김승우(Seungwoo Kim),맹수현(Su Hyeon Maeng),남영석(Youngsuk Nam) 대한기계학회 2024 대한기계학회 춘추학술대회 Vol.2024 No.4

뇌졸중에서 새로운 이동형 측정 시스템을 이용한 경직의 신장반사 역치

서정환,한상형,김거식,송철규,고명환,박성희 대한근전도전기진단의학회 2009 대한근전도 전기진단의학회지 Vol.11 No.2

Objective: To introduce a new hand-driven portable system for measuring the spasticity and to test the availability of the new portable system for measuring the spasticity. Method: Spasticity was evaluated in 15 patients with stroke using a new portable system and the Modified Ashworth scale (MAS). The device was designed in order to measure the joint angle, angular velocity, electromyographic signals, and torque. Each sets of 10 passive elbow joint movements were completed using a new portable system at 60, 90, 120, 150, and 180 degrees per second (deg/s) while surface electromyographic data were collected from the biceps, and triceps. Velocity-dependent dynamic stretch reflex thresholds (DSRTs) were recorded. These values were used to compute tonic stretch reflex threshold (TSRT). The correlations between TSRT and the MAS were investigated. Results: MAS grade was distributed from 1 to 2 grade (1: 40.0%, 1+: 33.3%, 2: 26.7%). TSRT, r2 values ranged from 116.6 to 134.6 and 0.45 to 0.88, respectively. The correlation between MAS grade and TSRT was strong correlation (rho=-0.708, p=0.003). Conclusion: We showed that the new portable system is clinically more useful instrument, which can produce reliable objective data and were more convenient on spasticity measurement. The new measuring system is a portable hand-driven spasticity-measurement system, which encompass various scopes of spasticity-related human signals such as electrophysiologic, kinematic, and biomechanical data. We suggest that this new system can diagnose the spasticity of the muscles, objectively.

이상운동형 뇌성마비 환자에서의 수근관 증후군 2예 −증례 보고−

박성희,한상형,고명환,서정환,손수연 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.4

Carpal tunnel syndrome (CTS) is the most frequent entrapment mono-neuropathy, a pressure-induced neuropathy of the median nerve at the wrist. Two patients with dyskinetic cerebral palsy presented tingling sense of bilateral hands and marked flattening of both thenar eminences. In two patients, the involuntary dystonic muscle contractions kept the wrist position in hyperextension or more frequently, in hyperflexion with ulnar deviation and finger in flexion strongly. We performed careful history taking and physical examination, and then diagnosed bilateral carpal tunnel syndrome in two patients through medical workup including electromyography and ultrasonography. In this report, we present these cases and discuss their physiopathology. (J Korean Acad Rehab Med 2010; 34: 475-479)

뇌졸중 환자에서 경두개 직류전류 자극에 의한 손 기능 호전

고명환,박성희,서정환,한상형 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.3

Objective: To investigate therapeutic effects of anodal direct current (DC) polarization on the primary motor cortex in subacute and chronic stroke patients by measuring changes of hand function and corticospinal excitability before and after stimulation. Method: Fourteen subacute and chronic stroke patients were included in this study. This study was designed as a sham-controlled, double-blind, and crossover experiment. The anode was positioned on the primary motor cortex of the affected hemisphere. The primary motor cortex was identified using transcranial magnetic stimulation (TMS), the motor evoked potentials (MEPs) were recorded by surface electrodes placed over the contralateral first dorsal interosseous muscle. DC was delivered for 20 minute at 2 mA with 25 cm2 saline-soaked sponge electrodes. Before and after DC polarization, we checked the box and block test, nine hole peg test, grip power, lateral prehension power, MEPs amplitude, and MEPs latency. Results: The box and block test, grip power, lateral prehension power, and MEPs amplitude increased after anodal DC to primary motor cortex (p<0.05). Positive correlation showed between improvement of box and block test and change of MEPs amplitude (r=0.808, p=0.001). Conclusion: Increased hand functions and the corticospinal tract excitability were obtained by 2 mA, 20 minute anodal DC polarization. Anodal DC polarization to primary motor cortex may play a potential role for facilitating the corticospinal tract thereby enhancing hand motor recovery in stroke patients. Objective: To investigate therapeutic effects of anodal direct current (DC) polarization on the primary motor cortex in subacute and chronic stroke patients by measuring changes of hand function and corticospinal excitability before and after stimulation. Method: Fourteen subacute and chronic stroke patients were included in this study. This study was designed as a sham-controlled, double-blind, and crossover experiment. The anode was positioned on the primary motor cortex of the affected hemisphere. The primary motor cortex was identified using transcranial magnetic stimulation (TMS), the motor evoked potentials (MEPs) were recorded by surface electrodes placed over the contralateral first dorsal interosseous muscle. DC was delivered for 20 minute at 2 mA with 25 cm2 saline-soaked sponge electrodes. Before and after DC polarization, we checked the box and block test, nine hole peg test, grip power, lateral prehension power, MEPs amplitude, and MEPs latency. Results: The box and block test, grip power, lateral prehension power, and MEPs amplitude increased after anodal DC to primary motor cortex (p<0.05). Positive correlation showed between improvement of box and block test and change of MEPs amplitude (r=0.808, p=0.001). Conclusion: Increased hand functions and the corticospinal tract excitability were obtained by 2 mA, 20 minute anodal DC polarization. Anodal DC polarization to primary motor cortex may play a potential role for facilitating the corticospinal tract thereby enhancing hand motor recovery in stroke patients.

중추신경계 손상에 의한 경직의 이동형 측정 시스템

송철규(Chul-Gyu Song),서정환(Jeong-Hwan Seo),한상형(Sang-Hyung Han),김거식(Keo-Sik Kim),안양수(Yang-Su An) 대한전기학회 2009 전기학회논문지 Vol.58 No.6

Spasticity is a velocity-dependent stretch reflex disorder of the body motor system developing after the injury of the central nervous system, in which certain muscles are continuously contracted involuntarily. Conventional methods such as the modified Ashworth scale, Spasm frequency scale, pendulum test and isokinetic dynamometer had some disadvantages: limitation in discriminating the increase of resistance, immovable and expensive device, not enough study parameters. Therefore, it is necessary to introduce clinically more useful instrument, which can produce objective data and are more convenient on spasticity measurement. Spasticity measuring methods were reviewed and a new measuring instrument was designed and introduced. The new measuring system is a portable spasticity-measurement system, which encompass various scopes of spasticity-related human signals such as electrophysiologic, kinematic and biomechanical data. Our device was designed in order to measure the joint angle, angular velocity, electromyographic signals and force. We suggest that this new system can diagnose the spasticity of the muscles, objectively.