Videofluoroscopic Swallowing Study Findings in Full-Term and Preterm Infants With Dysphagia

Kyeong Eun Uhm,Sook-Hee Yi,장현정,천희정,권정이 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.2

Objective To determine the clinical characteristics and videofluoroscopic swallowing study (VFSS) findings in infants with suspected dysphagia and compare the clinical characteristics and VFSS findings between full-term and preterm infants.Methods A total of 107 infants (67 full-term and 40 preterm) with suspected dysphagia who were referred for VFSS at a tertiary university hospital were enrolled in this retrospective study. Clinical characteristics and VFSS findings were reviewed by a physiatrist and an experienced speech-language pathologist. The association between the reasons of referral for VFSS and VFSS findings were analyzed.Results Mean gestational age was 35.1±5.3 weeks, and mean birth weight was 2,381±1,026 g. The most common reason for VFSS referral was ‘poor sucking’ in full-term infants and ‘desaturation’ in preterm infants. The most common associated medical condition was ‘congenital heart disease’ in full-term infants and ‘bronchopulmonary dysplasia’ in preterm infants. Aspiration was observed in 42 infants (39.3%) and coughing was the only clinical predictor of aspiration in VFSS. However, 34 of 42 infants (81.0%) who showed aspiration exhibited silent aspiration during VFSS. There were no significant differences in the VFSS findings between the full-term and preterm infants except for ‘decreased sustained sucking.’Conclusion There are some differences in the clinical manifestations and VFSS findings between full-term and preterm infants with suspected dysphagia. The present findings provide a better understanding of these differences and can help clarify the different pathophysiologic mechanisms of dysphagia in infants.

Applicability of the 48/6 Model of Care as a Health Screening Tool, and Its Association with Mobility in Community-Dwelling Older Adults

Kyeong Eun Uhm,Mooyeon Oh-Park,Yoon-Sook Kim,박재민,Jae-Kyung Choi,문연실,Seol-Heui Han,황정해,Kunsei Lee,Jongmin Lee 대한의학회 2020 Journal of Korean medical science Vol.35 No.7

Background: The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults. Methods: This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA. Results: A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = −10.567, P < 0.001), dysphagia (β = −9.610, P = 0.021), and pain (β = −7.369, P = 0.004) were significantly associated with life-space mobility after controlling for age. Conclusion: The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.

Effects of Combined Treatment with Thermotherapy and Electrical Stimulation on Musculoskeletal Pain Disorders: A Systematic Review

Kyeong Eun Uhm,Bo Mi Kwon,Min Woo Woo,Hyo Eun Kwon,Jongmin Lee 대한임상통증학회 2022 Clinical Pain Vol.21 No.2

Objective: This review aimed to investigate the effects of combined treatment with thermotherapy and electrical stimulation simultaneously in musculoskeletal pain disorders. Method: A systematic review was performed using electronic databases including PubMed and Embase. Following search terms were used: (simultaneous OR synchronous OR combined) AND (thermotherapy OR “thermal therapy” OR heat OR “hot pack” OR ultrasound OR microwave OR shortwave OR cold OR cryotherapy) AND (“electrical stimulation” OR electrotherapy OR TENS OR “interferential current”). Studies on the simultaneous application of thermotherapy and electrical stimulation, comparing with single physical modalities or massage were included. Results: After title and abstract exclusion, four articles were selected, according to the eligibility criteria. Combined treatment did not reveal a differential effect on pain reduction when compared to a single physical modality. However, combined treatment showed superior effects on functional aspects such as range of motion (ROM) and timed up-and-go score. Conclusion: This review suggests that combined treatment with thermotherapy and electrical stimulation simultaneously seems to have a superior effect on ROM, balance, and gait ability, but not pain reduction, in musculoskeletal pain disorders. However, the number of included studies in this review was small and study designs were heterogeneous. Therefore, further research is needed to confirm these findings.

증례 : 순환기 ; 심장 외 인공도관 폰탄 순환을 가진 환자의 인공 심박동기 삽입 증례

전경현 ( Kyeong Hyeon Chun ),엄재선 ( Jae Sun Uhm ),이상은 ( Sang Eun Lee ),서지원 ( Jiwon Seo ),양필성 ( Pil Sung Yang ),최정호 ( Jung Ho Choi ),김남균 ( Nam Kyun Kim ) 대한내과학회 2015 대한내과학회지 Vol.88 No.3

심장 외 인공도관 폰탄 술식을 시행한 선천성 심장병 환자에서 도관 천자를 통하여 정맥을 통한 인공 심박동기 삽입을 한 증례는 아직 보고된 바가 없다. 결론적으로 본 증례와 같이 심장 외 인공도관 폰탄 수술을 시행 받은 환자에서도 안전하고 효과적으로 정맥을 통해 인공 심박동기를 삽입하는 것이 가능하리라 생각된다. As the survival rate of patients with complex congenital heart disease has improved and the number of adult patients with congenital heart disease has risen, arrhythmias and heart failure have become important issues in these patients. Cardiac implantable electronic devices, including pacemakers, are also on the rise. Transvenous implantation or epicardial pacemaker implantation is challenging in patients with complex congenital heart disease. Here we report a case in which a dual-chamber pacing, dual-chamber sensing, dual response and rate-adaptive (DDDR) pacemaker was implanted transvenously into a patient with congenital heart disease. A 34-year-old male with extracardiac conduit Fontan circulation complained of dizziness; an electrocardiogram revealed junctional bradycardia. We performed transvenous implantation of a DDDR pacemaker via trans-conduit puncture. In conclusion, transvenous implantation of a pacemaker is feasible in patients with extracardiac conduit Fontan circulation. (Korean J Med 2015;88:299-302)

Patient Satisfaction with Mobile Health (mHealth) Application for Exercise Intervention in Breast Cancer Survivors

Lee, Hannah,Uhm, Kyeong Eun,Cheong, In Yae,Yoo, Ji Sung,Chung, Seung Hyun,Park, Yong Hyun,Lee, Ji Youl,Hwang, Ji Hye Springer-Verlag 2018 Journal of Medical Systems Vol.42 No.12

Postoperative Lumbar Plexopathy Secondary to Retroperitoneal Liposarcoma: A Case Report

Kim Kyungmin,Uhm Kyeong Eun 대한근전도전기진단의학회 2022 대한근전도 전기진단의학회지 Vol.24 No.3

Liposarcoma is a rare malignancy that usually originates in the extremities or the retroperitoneum. The lumbar plexus, a complex neural network formed by divisions of the first four lumbar roots, penetrates the psoas muscle before it exits the pelvis. Owing to their anatomical proximity, neoplasms in the vicinity of the psoas muscle may involve the lumbar plexus. We report a case of postoperative lumbar plexopathy involving the posterior divisions of the lumbar plexus, following the resection of a recurrent retroperitoneal liposarcoma located in the dorsal aspect of the psoas muscle. A 50-year-old man visited a rehabilitation clinic for an evaluation of proximal weakness of the unilateral lower extremity after resection of a recurrent liposarcoma of the left psoas muscle. Physical examination showed weakness of left hip flexion and knee extension accompanied by sensory loss in the left anteromedial thigh and the medial lower leg. An electrophysiological study revealed left lumbar plexopathy with selective involvement of the posterior divisions of the lumbar plexus. The patient could walk independently without a walking aid on level surfaces while he underwent exercise therapy. A comprehensive evaluation, including a physical examination, the use of imaging modalities such as computed tomography for anatomical characterization, and electrophysiological studies, is important for accurate diagnosis.

Suggested Assessments for Sarcopenia in Patients With Stroke Who Can Walk Independently

Ho Joong Jung,Yong Min Lee,Minsun Kim,Kyeong Eun Uhm,Jongmin Lee 대한재활의학회 2020 Annals of Rehabilitation Medicine Vol.44 No.1

Objective To investigate variables for assessment of stroke-related sarcopenia that are alternative options to the current assessment for sarcopenia, which focuses on age-related sarcopenia and also has limitations in addressing sarcopenia due to weakness resulting from stroke. Methods Forty patients (17 men, 23 women; mean age, 66.9±15.4 years) with first-ever stroke who can walk independently were included. Muscle mass was determined by measuring ultrasonographic muscle thickness of vastus intermedius, rectus femoris, tibialis anterior, medial gastrocnemius, and biceps brachii muscles in addition to using the skeletal muscle index (SMI) with bioelectrical impedance analysis. Muscle strength was assessed with the Medical Research Council (MRC) sum score as well as handgrip (HG) strength. Physical performance was measured by the Berg Balance Scale (BBS) along with 4-meter gait speed (4MGS). Correlations between each assessment in the three categories were analyzed and adjusted by stroke severity, comorbidity, and nutritional status. Results For muscle mass, SMI showed the highest correlation with the tibialis anterior muscle (r=0.783, p<0.001) among the other muscles. Regarding muscle strength, the MRC sum score correlated with the HG (r=0.660, p<0.001). For physical performance, the BBS correlated with the 4MGS (r=0.834, p<0.001). The same result was obtained after adjusting for factors of stroke severity, comorbidity, and nutritional status. Conclusion These results suggest that ultrasonographic muscle thickness of the tibialis anterior, the MRC sum score, and BBS might be alternatives to SMI, HG, and usual gait speed for sarcopenia in stroke patients.

Feasibility of Left Atrial Appendage Occlusion for Left Atrial Appendage Thrombus in Patients With Persistent Atrial Fibrillation

Lee, Oh-Hyun,Kim, Jung-Sun,Pak, Hui-Nam,Hong, Geu-Ru,Shim, Chi Young,Uhm, Jae-Sun,Cho, In-Jeong,Joung, Boyoung,Yu, Cheol-Woong,Lee, Hyun-Jong,Kang, Woong-Chol,Shin, Eun-Seok,Choi, Rak-kyeong,Lim, Do-S Elsevier 2018 The American Journal of Cardiology Vol.121 No.12

<P>This study sought to investigate the safety of percutaneous left atrial appendage (LAA) occlusion for stroke prevention in patients with nonvalvular atrial fibrillation who have LAA thrombus. From October 2010 to October 2016, LAA occlusions were performed in facilities within a Korean multicenter registry in patients without (n = 132) or with (n = 10) LAA thrombus (detected during preprocedural assessments). The incidences of periprocedural complications, including stroke, pericardial tamponade, major bleeding, and device embolization, were assessed and compared between the groups. The incidence of periprocedural complications was not significantly different between patients with and without LAA thrombus (0% vs 5% [6 of 132]; p = 0.49). During the mean 23.2 ± 17.5-month follow-up duration, 7 major adverse cardiac events occurred (1 cardiovascular death, 6 ischemic strokes), but overall event rates were not significantly different between the groups (14% vs 9%; p = 0.47). In conclusion, percutaneous LAA occlusion in nonvalvular atrial fibrillation patients with LAA thrombus may be a safe and feasible alternative to anticoagulation in select patients at a high risk of bleeding or contraindication to anticoagulation, or in whom anticoagulation failed to prevent stroke.</P>