The Transactions of the Korean Institute of Electrical Engineers D
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v.55
no.11
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pp.502-510
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2006
In this paper, we describe implementation of a computer access device for the severly motor-disability. Many people with severe motor disabilities need an augmentative communication technology. Those who are totally paralyzed, or 'locked-in' cannot use conventional augmentative technologies, all of which require some measure of muscle control. The forehead is often the last site to suffer degradation in cases of severe disability and degenerative disease. For example, In ALS(Amyotrophic Lateral Sclerosis) and MD(Muscular dystrophy) the ocular motorneurons and ocular muscles are usually spared permitting at least gross eye movements, but not precise eye pointing. We use brain and body forehead bio-potentials in a novel way to generate multiple signals for computer control inputs. A bio-amplifier within this device separates the forehead signal into three frequency channels. The lowest channel is responsive to bio-potentials resulting from an eye motion, and second channel is the band pass derived between 0.5 and 45Hz, falling within the accepted Electroencephalographic(EEG) range. A digital processing station subdivides this region into eleven components frequency bands using FFT algorithm. The third channel is defined as an Electromyographic(EMG) signal. It responds to contractions of facial muscles and is well suited to discrete on/off switch closures, keyboard commands. These signals are transmitted to a PC that analyzes in a time series and a frequency region and discriminates user's intentions. That software graphically displays user's bio-potential signals in the real time, therefore user can see their own bio-potentials and control their physiological signals little by little after some training sessions. As a result, we confirmed the performance and availability of the developed system with experimental user's bio-potentials.
Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.
Objectives: After many national physical activity guidelines have established, recent changes are deep and rapid. So the major features and implication to reverse worsening Korean physical activity indicator is desprate but related knowledge and informations are few. So review of recent features and implications of new physical activity guidelines have made. Methods: National physical activity guidelines of advanced countries were searched through snowballing methods. Major features were described according to the nation. Implication were drew through discussion for Korean realitiy. Results: New Australian physical activity and sedentary behaviour guideline explicitly included sedentary behaviour. The age in the guideline expanded to early years. Canada also presented 24-hour movement guidelines to early years. The second generation of the physical activity guidelines reflects the extensive amount of new knowledge. New aspects include discussions of additional health benefits related to brain health, additional cancer sites, and fall-related injuries; immediate and longer term benefits for how people feel, function, and sleep; further benefits among older adults and people with additional chronic conditions; risks of sedentary behavior and their relationship with physical activity; elimination of the requirement for physical activity benefits to occur in bouts of at least 10 minutes; and tested strategies that can be used to get the population more active. Conclusions: The most important message from the new guidelines is that the greatest health benefits accrue by moving from no, to even small amounts of, physical activity. Multiple studies demonstrate that the steepest reduction in disease risk occurs at the lowest levels of physical activity. People need to understand that even small amounts of physical activity are beneficial and that reductions in the risk of disease and disability occur by simply getting moving. So various evidence based proven strstegies are needed in Korea including workforce training.
Journal of The Korean Society of Integrative Medicine
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v.9
no.2
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pp.105-108
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2021
Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.
Objectives: This study aimed to analyze the correlation between oral function, oral environment, and brain cognitive function in the elderly. Methods: The subjects were 60 users of senior community center and elderly day care center. The survey was conducted from November to December 2018. Subjects were assessed by oral examination and myofunction test. Oral myofunction was measured using $IOPI^R$ and Lip de $Cum^R$. Survey data were analyzed using the statistical programs of PASW Statistics ver. 18.0. Results: Tongue muscle strength and lips muscle strength was higher in males than in females. The tongue and lip strengths were higher in the <81 years old group than the ${\geq}81$ years old group. Functional tooth analysis showed that there was a ${\geq}15$ teeth group ($40.91{\pm}7.36$) and a <15 teeth group ($32.52{\pm}7.14$). Lip muscle strength analysis showed that the ${\geq}15$ teeth group ($10.54{\pm}3.40$) was higher than the <15 teeth group ($8.20{\pm}2.41$, p<0.05). Tongue muscle strength, lumbar muscle strength, and functional tooth number were lower in the elderly subjects with mild cognitive impairment. Cognitive function was significantly correlated with functional tooth number (r=0.386, p<0.001), tongue strength (r=0.478, p<0.001), and lip strength (r=0.281, p<0.05). Tongue strength was significantly correlated with lip strength (r=0.360, p<0.001) and functional tooth number (r=0.633, p<0.001). Lip strength was significantly correlated with functional tooth number (r=0.376, p<0.001). Conclusions: These results showed that age and functional tooth number influenced oral muscle strength and that the number of functional teeth and oral muscle strength were low in the elderly with mild cognitive impairment. Oral myofunction training and oral care program are suggested to improve the quality of life of the elderly.
This study aimed to explore the life experiences of middle-aged and older women with disabilities using the photovoice method. Six middle-aged and older women with physical disabilities or brain lesions selected four themes through group discussion and shared their experiences using photos they took that reflect the four themes: my worsening health and the way I manage my health (identifying red flags for ill health, trying to coping with poor health), my leisure life (my limited leisure activities, enjoying my own leisure time), my social participation (participating in social activities that give me pleasure, participating in social activities to help make a better society), and my later life (worryingabout financial hardships and being alone in my later life, hoping for happiness in my later life). Study findings indicate the value of services and policies for middle-aged and older women with disabilities that provide guidance for health management and psychological counseling, extend opportunities for leisure and community participation, and provide skill training and educational programs for promoting financial and emotional independence in later life.
Karaoz, Erdal;Tepekoy, Filiz;Yilmaz, Irem;Subasi, Cansu;Kabatas, Serdar
Journal of Korean Neurosurgical Society
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v.62
no.2
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pp.153-165
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2019
Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma and accompanied by elevated levels of inflammation indicators. Stem cell-based therapy is promising some valuable strategies for its functional recovery. Nestin-positive progenitor and/or stem cells (SC) isolated from pancreatic islets (PI) show mesenchymal stem cell (MSC) characteristics. For this reason, we aimed to analyze the effects of rat pancreatic islet derived stem cell (rPI-SC) delivery on functional recovery, as well as the levels of inflammation factors following SCI. Methods : rPI-SCs were isolated, cultured and their MSC characteristics were determined through flow cytometry and immunofluorescence analysis. The experimental rat population was divided into three groups : 1) laminectomy & trauma, 2) laminectomy & trauma & phosphate-buffered saline (PBS), and 3) laminectomy+trauma+SCs. Green fluorescent protein (GFP) labelled rPI-SCs were transplanted into the injured rat spinal cord. Their motilities were evaluated with Basso, Beattie and Bresnahan (BBB) Score. After 4-weeks, spinal cord sections were analyzed for GFP labeled SCs and stained for vimentin, $S100{\beta}$, brain derived neurotrophic factor (BDNF), 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase), vascular endothelial growth factor (VEGF) and proinflammatory (interleukin [IL]-6, transforming growth factor $[TGF]-{\beta}$, macrophage inflammatory protein [MIP]-2, myeloperoxidase [MPO]) and anti-inflammatory (IL-1 receptor antagonis) factors. Results : rPI-SCs were revealed to display MSC characteristics and express neural and glial cell markers including BDNF, glial fibrillary acidic protein (GFAP), fibronectin, microtubule associated protein-2a,b (MAP2a,b), ${\beta}3$-tubulin and nestin as well as anti-inflammatory prostaglandin E2 receptor, EP3. The BBB scores showed significant motor recovery in group 3. GFP-labelled cells were localized on the injury site. In addition, decreased proinflammatory factor levels and increased intensity of anti-inflammatory factors were determined. Conclusion : Transplantation of PI-SCs might be an effective strategy to improve functional recovery following spinal cord trauma.
We develop a complete system that includes data collection, signal processing, and real-time interaction for effective neurofeedback training. Our system supports a sophisticated technique to find threshold values which are quite important for effective neurofeedback system. A therapist specifies a target success rate of positive feedback, allowable error and time. The system computes a current success rate and compare it with the target one. If the difference between two rates exceeds the allowable error for allowable time, we find an optimum threshold value to obtain the target success rate by using numerical optimization technique. We conduct several experiments by varying input parameters: target success rate, allowable error and time, and demonstrate the effectiveness of our technique by showing the desired target success rate is stably obtained and systematically controlled by input parameters.
Spiking neural network is a neural network that applies the working principle of real brain neurons. Due to the biological mechanism of neurons, it consumes less power for training and reasoning than conventional neural networks. Recently, as deep learning models become huge and operating costs increase exponentially, the spiking neural network is attracting attention as a third-generation neural network that connects convolution neural networks and recurrent neural networks, and related research is being actively conducted. However, in order to apply the spiking neural network model to the industry, a lot of research still needs to be done, and the problem of model retraining to apply a new model must also be solved. In this paper, we propose a method to minimize the cost of model retraining by extracting the weights of the existing trained deep learning model and converting them into the weights of the spiking neural network model. In addition, it was found that weight conversion worked correctly by comparing the results of inference using the converted weights with the results of the existing model.
Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.
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