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뇌병변이 있는 환자에서 조절된 음식 농도에 따른 연하양상
배하석,박창일,장지훈,송원우,김성민,정재훈 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.6
Objective: The response of the pharyngeal phase during swallowing is influenced by various factors including viscosity, shape, firmness, fracturability, and cohesive power. These factors affect the pharyngeal phase simultaneously, but little research has been conducted into their individual effects on the pharyngeal phase. This study investigated the relationship between controlled viscosity and pharyngeal transit time (PTT). Method: The subjects were 81 patients with naso-gastric tube due to brain dysfunction. PTT was assessed by video- esophageal fluoroscopy and the viscosity of the processed starch by Brookfield viscometer. High viscosity was defined as a controlled viscosity of 12% and 9%, medium viscosity as a controlled viscosity of 7.5%, 6%, and 4.5%, and low viscosity as a controlled viscosity of 3%, 1.5%, and 0% (liquid viscosity). Results: PTT was prolonged with increasing viscosity in the experimental group. There were no significant differences between PTT of the experimental and control groups at any viscosity. Aspiration prevalence was 1.85%, 7.82%, and 22.22% in the high, medium, and low viscosity groups, respectively, and the three prevalences showed significant differences. Conclusion: PTT showed a tendency to be prolonged with increasing food viscosity in the experimental group.
편마비 환자에서 정량적 감각기능 검사로 측정한 온도감각역치
배하석,심은결,윤태식,이정민,김성민 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.1
Objectives:Hemiplegic patients with unilateral cerebral lesions suffer from sensory deficit as well as motor deficit. But clinical assessment of thermal sensation is one of the least reliable components of neurological examination and is difficult to quantify. Methods:We measured thermal sensory thresholds of cold sense, warm sense, cold pain and hot pain in hemiplegic patients with thermal sensory analyzer(TSA). To investigate and quantify the thermal sensory deficit of hemiplegic patients, we compared the measurements with normal con-trols, between body regions, and between hemiplegic and sound side. Results:Hemiplegic patients showed impaired thermal sensory thresholds in all modalities compared to their sound side and normal controls. Conclusion:Quantitative sensory test using thermal sensory analyzer can be useful to quantify the thermal sensory deficit and follow up the progress.
배하석,김호정 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.2
Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) in patients with secondary lymphedema after breast cancer treatment.Methods In a prospective clinical trial, ESWT was performed consecutively 4 times over two weeks in 7 patients who were diagnosed with stage 3 secondary lymphedema after breast cancer treatment. Each patient was treated with four sessions of ESWT (0.056—0.068 mJ/mm2, 2,000 impulses). The parameters were the circumference of the arm, thickness of the skin and volume of the arm. We measured these parameters with baseline values before ESWT and repeated the evaluation after each ESWT treatment. Subjective data on skin thickness, edema and sensory impairment were obtained using a visual analogue scale (VAS). Results The mean volume of the affected arm after four consecutive ESWT was significantly reduced from 2,332 to 2,144 mL (p<0.05). The circumference and thickness of the skin fold of the affected arm were significantly decreased after the fourth ESWT (p<0.05). The three VAS scores were significantly improved after the fourth ESWT. Almost all patients were satisfied with this treatment and felt softer texture in their affected arm after treatment.Conclusion ESWT is an effective modality in the treatment of stage 3 lymphedema after breast cancer treatment. ESWT reduced the circumference and the thickness of arms with lymphedema and satisfied almost all patients with lymphedema. Therefore, this treatment provides clinically favorable outcome to patients with breast cancer-related lymphedema.