Biomedical subjects

Deog Young Kim

Publications and source records attributed to Deog Young Kim.

7 recordsLinked to original sources

PubMed2006

Botulinum toxin type A for poststroke cricopharyngeal muscle dysfunction.

OBJECTIVE: To evaluate the therapeutic effectiveness of botulinum toxin type A (BTX-A) in poststroke patients with cricopharyngeal muscle dysfunction. DESIGN: Before-after trial. SETTING: University hospital. PARTICIPANTS: Eight poststroke patients. INTERVENTION: BTX-A injection into the cricopharyngeal muscle under endoscope guidance for poststroke cricopharyngeal muscle dysfunction. MAIN OUTCOME MEASURES: Clinical symptom score, disability rating scale for swallowing impairment, videofluoroscopic swallowing study, and upper esophageal sphincter (UES) manometry. RESULTS: Clinical symptom score, disability rating scale for swallowing impairment, residue in piriform sinus, and UES pressure were all significantly improved at 2 weeks after BTX-A injection compared with evaluations before injection (P<.05). The effects on the clinical symptom score and disability rating scale for swallowing impairment continued to be significantly improved to 12 weeks after injection (P<.05). However, the residue in piriform sinus and the UES pressure at 12 weeks postinjection were reduced compared with before-injection evaluations; these results were not significant. The pharyngeal transit time was not changed after injection. There were no side effects observed in the patients studied. CONCLUSIONS: The results of the present study suggest that BTX-A injection may be an effective and safe treatment in patients with poststroke cricopharyngeal muscle dysfunction.

Aged↗

PubMed2005

Biomechanical assessment with electromyography of post-stroke ankle plantar flexor spasticity.

Spasticity has been defined as a motor disorder characterized by a velocity-dependent increase in tonic stretch reflex (muscle tone). Muscle tone consists of mechanical-elastic characteristics, reflex muscle contraction and other elements. The aims of this study were to determine whether to assess spasticity quantitatively, and to characterize biomechanical and electromyographic spasticity assessment parameters. These assessment parameters were described by investigating the correlation between clinical measures and the response to passive sinusoidal movement with consecutive velocity increments. Twenty post-stroke hemiplegic patients and twenty normal healthy volunteers were included in the study. Five consecutive sinusoidal passive movements of the ankle were performed at specific velocities (60, 120, 180, and 240 degrees/ sec). We recorded the peak torque, work, and threshold angle using a computerized isokinetic dynamometer, and simultaneously measured the rectified integrated electromyographic activity. We compared these parameters both between groups and between different velocities. The peak torque, threshold angle, work, and rectified integrated electromyographic activity were significantly higher in the post-stroke spastic group at all angular velocities than in the normal control group. The threshold angle and integrated electromyographic activity increased significantly and linearly as angular velocity increased, but the peak torque and work were not increased in the post-stroke spastic group. Peak torque, work, and threshold angle were significantly correlated to the Modified Ashworth scale, but the integrated electromyographic activity was not. The biomechanical and electromyographic approach may be useful to quantitatively assess spasticity. However, it may also be very important to consider the different characteristics of each biomechanical parameter.

Adult↗

PubMed2005

Neurologic recovery according to early magnetic resonance imaging findings in traumatic cervical spinal cord injuries.

The aim of this study was to determine the usefulness of early magnetic resonance imaging findings in predicting neurologic recovery at or below the injured level in traumatic cervical spinal cord injuries. Thirty patients with traumatic cervical spinal cord injuries were included. All of the patients received a magnetic resonance imaging and a neurologic examination in the emergency room, within 7 days of injury and at 6 months following the injury. To quantify neurologic recovery below the injured level, we modified clinical scales, particularly the motor ratio and the sensory ratio. We used the neurologic level to quantify recovery around the injured level. We assessed neurologic recovery according to MRI patterns and lesion extents. The pure hemorrhagic MRI pattern was not observed. In edematous and mixed types, the improvement of neurologic levels was not significantly different. The motor ratio and sensory ratio improved significantly more in edematous type patients than in mixed type patients. Based on MRI lesion extent, the improvement of neurologic levels was not significantly different, and motor ratio and sensory ratio improved significantly more in those with one or two segments involved than in those with more than two segments involved. In conclusion, early MRI pattern and lesion extent after traumatic cervical spinal cord injury may provide important information to help predict neurologic recovery, especially below the injured level.

Adult↗

PubMed2004

A virtual reality assessment and training system for unilateral neglect.

Patients with unilateral neglect have problems reporting, responding, or orienting to novel or meaningful stimuli that is presented to the side opposite to that of a brain lesion. This creates a serous problem in regards to daily living activities. However, the established methods for assessing and training of unilateral neglect patients have several deficits. Recently, virtual reality (VR) technologies have been used as an assessment and treatment tool for rehabilitation. Hence, this study designed a VR system to assess and train unilateral neglect patients. In addition, the suitability and feasibility of our VR system for unilateral neglect patients was verified.

Activities of Daily Living↗

PubMed2003

The characteristics of sit-to-stand transfer in young children with spastic cerebral palsy based on kinematic and kinetic data.

The aim of this study is to investigate the kinetic and kinematic characteristics of sit-to-stand transfer in children with spastic cerebral palsy (CP) in comparison with normal children. Fifteen spastic diplegic children, 12 spastic hemiplegic children and 21 normally developed children participated in this study. The sit-to-stand task was evaluated using a Motion analyzer (Vicon 370 MA with six infrared cameras). The consistent pattern of sit-to-stand transfer and six transitional points were identified in normal children. The motion analysis of sit-to-stand in children with CP showed slowness in the task, increased anterior pelvic tilting, and hip flexion during the task. An early abrupt knee extension was noted in diplegic children, as compared with normal controls. Decreased maximal knee extensor moment and decreased extensor power generation of the hip and knee joints were the major kinetic characteristics of the involved limbs of both diplegic and hemiplegic CP.

Ankle Joint↗

PubMed2003

A virtual reality system for the assessment and rehabilitation of the activities of daily living.

Successful rehabilitation with respect to the activities of daily living (ADL) requires accurate and effective assessment and training. A number of studies have emphasized the requirement for rehabilitation methods that are both relevant to the patient's real world environment, and that can also be transferred to other daily living tasks. Virtual reality (VR) has many advantages over other ADL rehabilitation techniques, and offers the potential to develop a human performance testing and training environment. Therefore, in this study, the virtual supermarket was developed and the possibility of using a VR system to assess and train cognitive ability in ADL investigated. This study demonstrates that VR technology offers great promise in the field of ADL training.

Activities of Daily Living↗

PubMed2002

The effect of spasticity on cortical somatosensory-evoked potentials: changes of cortical somatosensory-evoked potentials after botulinum toxin type A injection.

OBJECTIVE: To evaluate the changes in cortical somatosensory-evoked potentials (SEPs) after botulinum toxin type A injection to determine what effect spasticity has on cortical SEPs. DESIGN: Intervention study and before-after trial. SETTING: University-affiliated hospital in Korea. PARTICIPANTS: Twelve children with spastic hemiplegic cerebral palsy (CP), 7 children with spastic diplegic CP, and 8 patients with traumatic brain injury. INTERVENTION: All participants had botulinum toxin type A injected into the muscles of the spastic limb. MAIN OUTCOME MEASURES: SEPs were recorded before and 7 days after the botulinum toxin type A injection. Spasticity of the affected spastic limb was also measured. The short latency and amplitude of waves in SEPs were measured. The SEP results were divided into 3 groups: flat (no evoked potential), abnormal (evoked but delayed in latency), and normal (clear waveform with normal latency). RESULTS: The normal response of cortical SEP increased after injection. The SEPs exhibited more frequent improvement in the limbs, with greater improvement of spasticity in grade (>1.0 grade) and in patients of younger age (<3y) after injection (P<.05). CONCLUSION: The observed improvement of cortical SEPs with associated reduction of spasticity that occurred after the botulinum toxin type A injection indicates that spasticity itself can be considered a factor affecting cortical SEPs.

Adolescent↗