• Journal of Biomedical Engineering Research
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• v.20 no.2
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• pp.183-190
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• 1999

The purpose of this study was to develop a portable and convenient closed-loop contrel type electrical stimulator for patients with foot drop. This system restores walking movement as well as prevents from atrophy or necrosis of lower limb muscles and increases blood circulation in hemiplegic patients caused by traffic accident, industrial disaster or stoke. This system detects the changes of the ankle joint angle during walking, and then controls the stimulus intensity automatically to maintain the programmed level of the ankle joint angle. Also, this automatic system controls the stimulus intensity which is affected by increased electrode impedance resulting from long time use. The system detects the joint angle by an optical sensor and includes modified PID control which adjusts the stimulus intensity if the joint angle deviates from the preset value. Stimulus parameters are 30~80 volt, 40 Hz, and 0.2 ms. The system was applied to five hemiplegic patients for 42 days. Duration of stimulation was 15 min/day for the first week and then the duration was gradually increased to 30, 60, 90 and 120 min/day. The muscle force was increased up to 29.7%, muscle fatigue was decreased compared with the level before stimulation and the pattern of locomotion was improved. These results suggest that the electrical stimulator with closed-loop control type is more convenient and effective in restoration of locomotion of patients with foot drop than open-loop system.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.48-83
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• 1996

Our conclusions for function evaluation tools of Stroke patients are as follows. 1. Evaluating tools of Activities of Daily Living, Katz Index, Barthel Index, Modified Barthel Index have high validity and reliability because of ease of measuring, high accuracy, consistency, sensitivity and sufficient stastistics, but they mainly measure motor function except sense, mentation, language, and social conception. Therefore cerebrovascular disease and brain injury in trauma patients with lacked acknowledgement and sensation, we are not able to apply these tools. 2. PULSES Profile is a useful scale for measuring the patient's over-all status, upper and lower limb functions, sensory components, excretary functions, and intellectual and emotional adaptabilities. It is recognized as a good, useful tool to evaluate patient's whole function. 3. Motor Assessment Scale was designed to measure the progress of stroke patients. The scale was supplemented with upper arm function items. We believe that the Motor Assessment Scale could be a useful evaluation tool with inter-rater reliability ,test-retest reliability. 4. The existing evaluation tools, Katz Index, Barthel Index, Modified Barthel Index, PULSES Profile, Motor Assessment Scale, mainly measured the rehabilitational motor function of sequela of cerebrovascular patients. On the other hand CNS & INH stroke scale can measure cerebrovascular disease patient's neurologic deficits and over-all stautus, which are recognition ability, speech status, motor function, sensory function, activities of daily living. Those scales have been recognized as useful tools to measure function of cerebrovascular disease patients and have increased in use. 5. Every function evaluation tool was recognized to have some validity and inter-rater, test-retest reliability in items of each evaluation tool and total scores of each evaluation tools, but it is thought that none of these scales have been fully validated and proved reliable. Therefore afterward, the development of a highly reliable rating system may best be accomplished by a careful comparison of several tools, using the same patients and the same observers in order to choose the most reliable items from each. 6. Ideal evaluation tools must have the following conditions; (1) It should show the objective functional statues at the same time. (2) It should be repeated consecutively to know changed function status. (3) It should be easy to observe the treatment program. (4) It should have the same result with another rater to help rater exchange information with treatment team members. (5) It should be practical and simple. (6) The patient should not suffer from the observer.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.169-180
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• 2010

Objectives: This study was carried out to investigate the relationship of leg length analysis and X-ray finding according to positions and valuation bases on diagnosis of pelvic malpositions. Methods: Twenty-two people who get $33.09{\pm}10.73$ as average were evaluated by leg length analysis and X-ray findings. After measuring innominate measurement(IM), femur head line. distance between S2 and posterior superior iliac spine(PSIS). ilium shadow measurement(ISM), major axis of obturator foramen(MaF), minor axis of obturator foramen(MiF) and distance between off centering measurement and symphysis pubis, those were analyzed. Results: 1. In assessment of posterior rotation malposition ilium(PI), it was showed the best coincidence between leg length analysis and X-ray analyzed by 1M in supine position(11 cases, 50.5%). 2. In assessment of inflare, coincidence index between leg length analysis and X-ray were not good($4.00{\pm}3.03$ cases, $18.15{\pm}13.82%$). And leg length analysis were not sensitive. 3. On the whole, coincidence index between leg length analysis and X-ray were not good(best: 1 case, 45.5%; worst: 11 cases, 50.0%). Conclusions: Results form this investigation showed the relationship of leg length analysis and X-ray according 10 positions and valuation bases on diagnosis of pelvic malpositions. This results are expected to contribute to establish method of assessment in diagnosis of pelvic malpositions.

• Physical Therapy Korea
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• v.25 no.3
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• pp.19-26
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• 2018

Background: Genu varum is also known as bow leg. It is a deformity wherein there is lateral bowing of the legs at the knee. it does give rise to pain, and persistent bowing can often give rise to discomfort in knees, hips and ankles. Objects: This study investigated the effect of narrow squats on the knee joint during a gait and distance between the knees of person with genu varum. Methods: This study analyzed 23 patient with genu varum that grade III, 12 narrow squat group and 11 genenal squat group in motion analysis laboratory. The subjects of experiment took gait before and after intervention, the range of joint motion, moment of knee joint adduction, power, distance of the knees were measured. And in order to make an analysis between groups, an paiered t-test and independent t-test was carried out. For statistical significance testing, it was decided that significance level ${\alpha}$ be .05. Results: It was shown that the group of narrow squat exercise significantly decreased in distance of knees (p<.05),In moment of adduction of knee joint, it was shown to significantly decrease in two groups (p<.05), was significantly decreased in adduction, abduction, and rotation (p<.05). In relation of peak-knee adduction moment and valgus angle, there was significant decrease in narrow squat group (p<.05). Conclusion: When the above result of study were examined, a narrow squat exercise given to the genu varum patients significantly decreased the distance between the knees, range of knee adduction and abduction, knee adduction moment, knee power. And stability gains through the decrease of excursion of knee medial part be effective for the correction of genu varum deformation.

• Journal of Korean Medicine for Obesity Research
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• v.5 no.1
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• pp.1-8
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• 2005

Objectives: Although electro-acupuncture is being utilized to reduce weight in Korea, its usefulness in obesity management has not been fully evaluated yet. The objective of this study is to evaluate the effect of Electro-acupuncture on thigh circumference. Methods: 12 healthy volunteers participated in this study. We measured the circumference of both thighs, and treated the thicker one with transcutaneous electro-acupuncture at 8 acupoints, 10 times in total. The electrical parameters were : 1st step frequency set was at 15Hz and the treatment proceeded for 50 minutes, 2nd step at 50Hz for 10 minutes and at 3rd step the acupunctures were removed and electrodes were attached on the lower limb at 166Hz for 15 minutes. In order to evaluate the effect of the treatment, total body weight, percentage of body fat and thigh circumference were measured 4 times. Before the treatment, after 5th and 10th treatment and 1 month after completion of the whole treating procedure. Statistical significance(P<0.05) was determined using the Wilcoxon signed rank test. We did not control diet, exercise and lifestyle of the volunteers. Results: No significant change was shown in body weight after 10 times of treatment. Yet the thigh circumference of effect group significantly decreased after 5th treatment and 10th treatment. The circumference of control group that was not treated by electro-acupuncture significantly decreased too. At first, difference between the two thighs in circumference was obvious, but no difference was left after 10 times of treatments on the thicker thigh. Percentage of body fat was significantly decreased. 1 month after having completed the treatment, there was no significant difference of body weight, thigh circumferences and percentage of body fat. Conclusion: These results suggest that electro-acupuncture effectively regulates regional fat, body fat percentage and body shape.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.69-74
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• 2009

Soft tissue sarcomas of popliteal fossa are rare, accounting for less than 5% of all soft tissue sarcomas of the extremities. In an extracompartmental space such as the popliteal, cubital fossa and inguinal space, where major vessels and nerves traverse, performing resections with wide margin is difficult and sometimes marginal margin is inevitable for limb salvage. For popliteal tumor resection, posterior approach would be a classic method. For tumors with small size and not adherent to surrounding structures, tumor is easily resected by this approach and dissection of nerve sheath or adventitia of vessel. On the contrary, tumors of large size and infiltrating the posterior structure of knee joint may show difficulty in en-bloc resection itself. These cases were candidates for amputation. Furthermore, tumors involving both popliteal fossa and anterior compartment usually had no choice but to have an amputation to prevent local recurrence. We regarded soft tissue sarcoma showing this kind of presentation as bone tumor having extraosseous mass. We performed wide en-bloc resection of proximal tibia and fibula along with sarcoma involving both compartment on liposarcoma of 47-year old man.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.52-59
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• 2007

Purpose: The venous flap is used as an alternative method to the standard free flap for the management of small and thin soft tissue defects. Especially, the venous flap has advantages of being thin, easy harvest and various donor sites, as well as it having lower morbidity. Yet their clinical applications have been limited by their unstable postoperative course and also by their complications such as partial necrosis. The aim of this study is to extend the clinical indications of venous flaps with using various methods. Methods: From May 2005 to March 2006, total of 19 patients(21 cases) underwent various venous flaps for soft tissue defects as a result of trauma(15 cases), facial skin cancer(3 cases), chronic ulcer(1 case) and surgical wound for congenital anomaly(2 cases). The arterialized venous free flap were applied in 18 cases, the pure venous free flap was applied in 1 case and the pure venous pedicled flap were applied in 2 cases. Among them, two flow-through arterialized venous free flaps were applied that used the great saphenous vein to reconstructed major arteries as well as the injured skin and soft tissues in the arm. All the flap were harvested from the volar wrist(11 cases), dorsum of foot(5 cases), thenar(2 cases), and medial thigh(3 cases). Results: The sizes of the flap ranged from $0.75cm^2$ to $264cm^2$(mean size: $40.06cm^2$). The follow-up period ranged from two to twelve months. In the majority of cases, we obtained satisfying results, which was the excellent reconstruction of skin and soft tissue defects and especially in the case of limb salvage, replantation and cancer reconstruction. However, there were 5 cases of partial necrosis and 2 cases of complete failure. The donor sites were closed primarily in 7 cases and wound closure with skin graft were in 14 cases. Conclusion: We conclude that the venous flap will not only be useful for reconstruction of small defect in the hand and foot, but also be useful for various other clinical indications.

• Molecules and Cells
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• v.40 no.2
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• pp.133-142
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• 2017

Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.

• Vascular Specialist International
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• v.34 no.4
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• pp.94-102
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• 2018

Purpose: Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods: This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was $24.2{\pm}2.3$ months. Results: Overall, 149 patients (mean age: $68.6{\pm}8.3$ years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion: PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.45-51
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• 2019

Objective: The purpose of this study was to investigate the muscle activity ratio of the lower limb according to changes in straight leg raise (SLR) test angles on hamstring muscle shortening during squat exercises. Design: Randomized controlled trial. Methods: The subjects were 14 healthy adults who were informed of and agreed to the method and purpose of the study. The participants were classified into SLR groups according to two angles (over $80^{\circ}$ or under $80^{\circ}$) assessed using the SLR tests. After training and practicing the wall squat posture to be applied to the experiment, electromyography (EMG) was used to measure changes in muscle activity during the performance of a wall squat. After stretching, a sequence of pre-stretch tests were performed again, and the active and passive SLR tests were also reconducted; thereafter, a wall squat was performed again by attaching EMG electrodes. The EMG results before and after stretching were compared. Results: The muscle activity of the vastus lateralis oblique muscle increased in both groups. The muscle activity of the vastus medialis oblique muscle decreased in over both group. Rectus femorus activity increased in the under 80-degree groups but decreased in the over 80-degree group. The muscle activity of the biceps femoris muscle decreased after stretching in the over 80-degree group and increased in the under 80-degree group, and the semitendinosus muscle activity after stretching was decreased. The quadriceps-to-hamstring muscle (Q:H) ratio before and after stretching between groups showed that the hamstring muscle ratio decreased after stretching in both groups. Conclusions: The results of this study showed that the Q:H ratio before and after stretching between groups was not significantly different.