• Title/Summary/Keyword: Lower-limb

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Effects of aqueous extract from Taxillus chinensis on monosodium iodoacetate-induced osteoarthritis in rats (Monosodium iodoacetate로 유도된 골관절염 동물모델에서 상기생 물추출물의 효과)

  • Kim, Joong Sun;Lee, A Yeong;Moon, Byeong Cheol;Kim, Hyo Seon;Kim, Wook Jin;Kim, Chul;Choi, Goya;Kim, Seung-Hyung;Chun, Jin Mi
    • The Korea Journal of Herbology
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    • v.33 no.5
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    • pp.81-88
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    • 2018
  • Objectives : The aim of this study was to investigate the protective effects of an aqueous extract from Taxillus chinensis (DC.) Danser (TCE) in Monosodium iodoacetate (MIA)-induced osteoarthritis (OA) rat model. Methods : Sprague Dawley male rats were divided into the following four groups (n=6 per group): Normal (saline control), MIA (MIA-induced OA with vehicle), TCE (MIA-induced with TCE treatment), and IM (MIA-induced with indomethacin treatment). Rats in which OA was induced by MIA were treated with TCE (200 mg/kg) or indomethacin (1 mg/kg) for 4 weeks. Weight-bearing on the hind legs and body weights were measured weekly. At the end of the experiment (3 weeks after MIA injection), serum aspartate aminotransferase and alanine aminotransferase levels were measured to assess the liver toxicity induced by TCE. Its effects on serum inflammatory cytokine levels and tissue histopathology were also evaluated. Results : TCE restored the hind limb weight-bearing distribution. Serum levels of Interleukin 6 (IL-6), Tumor necrosis factor alpha (TNF-${\alpha}$) and Leukotriene B4 (LTB4) were significantly higher in the MIA group than in the Normal group, but serum IL-6 levels were significantly lower in the TCE group. In the TCE group, the synovial membrane was protected in hematoxylin and eosin and Safranin-O staining, respectively. Conclusions : TCE recovered the hind paw weight bearing distribution, inhibited the production of inflammatory cytokine, and protected synovial tissue and cartilage in the OA rat model. Therefore, TCE appears to be an effective therapeutic agent for treating OA and OA-related symptoms.

A Case Report on a Patient with Amyotrophic Lateral Sclerosis Treated with Korean Medicine (한방 치료로 호전된 근위축성측색경화증에 대한 증례 1례 : 증례보고)

  • Heo, Gi-yoon;Kang, Hee-kyung;Kim, Min-hwa;Nam, Irang;Kim, Mariah;Kim, So-yeon;Park, So-jung;Yun, Young-ju;Lee, In;Choi, Jun-yong;Han, Chang-woo;Hong, Jin-woo;Kwon, Jung-nam
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.891-900
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    • 2022
  • Purpose: The purpose of this paper is to report the improvement of a patient with amyotrophic lateral sclerosis after long-term combined Korean medical treatment. Methods: A patient diagnosed with amyotrophic lateral sclerosis was treated with herbal medicine, acupuncture, pharmacopuncture, moxibustion, and rehabilitation for four separate hospital stays. To evaluate their respiratory discomfort and limb weakness, we used Manual Muscle Testing, the Pulmonary Function Test, and the Korean Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised. Results: The weakness of the muscles of the lower extremities and respiratory function was improved. Conclusion: We consider that combined Korean medicine treatments might be an effective treatment for muscle weakness and respiratory discomfort of amyotrophic lateral sclerosis. To verify the effectiveness of these treatments, further research is required.

Korean Medicine for Gait Disturbance Accompanying Lower Limb Rigidity Caused by Bleeding of Spinal Cavernous Hemangioma: A Case Report (척추 해면상 혈관종 출혈로 인해 발생한 하지 강직감을 동반한 보행 장애에 대한 한의학 치료의 효과: 증례보고)

  • Hyunjin Choi;Seung Ho Yu;Sangjoon An;Seyun Kim;Woochul Shin;Jae-Heung Cho;Won-Seok Chung;Mi-Yeon Song;Hyungsuk Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.243-249
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    • 2023
  • This case study showed improvement both in pain and gait disturbance caused by SCH. KM can be a positive treatment for reducing pain or improving gait disturbance caused by SCH, and it can be considered a treatment option for SCH. Future studies with a larger number of cases and longer period of follow-up in SCH with gait disturbance and rigidity are needed.

The Literatual Study on the Wea symptom in the View of Western and Oriental Medicine (위증에 대한 동서의학적(東西醫學的) 고찰(考察))

  • Kim, Yong Seong;Kim, Chul Jung
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.211-243
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    • 2000
  • This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.

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Lithologic and Structural Controls and Geochemistry of Uranium Deposition in the Ogcheon Black-Slate Formation (옥천대(沃川帶) 우라늄광층(鑛層)의 구조규제(構造規制) 및 지구화학적(地球化學的) 특성연구(特性硏究))

  • Lee, Dai Sung;Yun, Suckew;Lee, Jong Hyeog;Kim, Jeong Taeg
    • Economic and Environmental Geology
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    • v.19 no.spc
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    • pp.19-41
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    • 1986
  • Structural, radioactive, petrological, petrochemical, mineralogical and stable isotopic study as well as the review of previous studies of the uranium-bearing slates in the Ogcheon sequence were carried out to examine the lithological and structural controls, and geochemical environment in the uranium deposition in the sequence. And the study was extended to the coal-bearing formation (Jangseong Series-Permian) to compare the geochemical and sedimentologic aspects of uranium chemistry between Ogcheon and Hambaegsan areas. The results obtained are as follows: 1. The uranium mineralization occurs in the carbonaceous black slates of the middle to lower Guryongsan formation and its equivalents in the Ogcheon sequence. In general, two or three uranium-bearing carbonaceous beds are found with about 1 to 1.5km stratigraphic interval and they extend from Chungju to Jinsan for 90km in distance, with intermittent igneous intrusions and structural Jisturbances. Average thickness of the beds ranges from 20 to 1,500m. 2. These carbonaceous slate beds were folded by a strong $F_1$-fold and were refolded by subsequent $F_1$-fold, nearly co-axial with the $F_1$, resulting in a repeated occurrence of similar slate. The carbonaceous beds were swelled in hing zones and were shrinked or thined out in limb by the these foldings. Minor faulting and brecciation of the carbonaceous beds were followed causing metamorphism of these beds and secondary migration and alteration of uranium minerals and their close associations. 3. Uranium-rich zones with high radioactive anomalies are found in Chungju, Deogpyong-Yongyuri, MiwonBoun, Daejeon-Geumsan areas in the range of 500~3,700 cps (corresponds to 0.017~0.087%U). These zones continue along strike of the beds for several tens to a few hundred meters but also discontinue with swelling and pinches at places that should be analogously developed toward underground in their vertical extentions. The drilling surveyings in those area, more than 120 holes, indicate that the depth-frequency to uranium rich bed ranging 40~160 meter is greater. 4. The features that higher radioactive anomalies occur particularly from the carbonaceous beds among the argillaceous lithologic units, are well demonstrated on the cross sections of the lithology and radioactive values of the major uranium deposits in the Ogcheon zone. However, one anomalous radioactive zone is found in a l:ornfels bed in Samgoe, near Daejeon city. This is interpreted as a thermal metamorphic effect by which original uranium contents in the underlying black slate were migrated into the hornfels bed. 5. Principal minerals of the uranium-bearing black slates are quartz, sericite, biotite and chlorite, and as to chemical composition of the black slates, $Al_2O_3$ contents appear to be much lower than the average values by its clarke suggesting that the Changri basin has rather proximal to its source area. 6. The uranium-bearing carbonaceous beds contain minor amounts of phosphorite minerals, pyrite, pyrrhotite and other sulfides but not contain iron oxides. Vanadium. Molybdenum, Barium, Nickel, Zirconium, Lead, Cromium and fixed Carbon, and some other heavy metals appear to be positive by correlative with uranium in their concentrations, suggesting a possibility of their genetic relationships. The estimated pH and Eh of the slate suggests an euxenic marine to organic-rich saline water environment during uranium was deposited in the middle part of Ogcheon zone. 7. The Carboniferous shale of Jangseong Series(Sadong Series) of Permian in Hambaegsan area having low radioactivity and in fluvial to beach deposits is entirely different in geochemical property and depositional environment from the middle part of Ogcheon zone, so-called "Pibanryong-Type Ogcheon Zone". 8. Synthesizing various data obtained by several aspects of research on uranium mineralization in the studied sequence, it is concluded that the processes of uranium deposition were incorporated with rich organic precipitation by which soluble uranyl ions, $U{_2}^{+{+}}$ were organochemically complexed and carried down to the pre-Ogcheon sea bottoms formed in transitional environment, from Red Sea type basin to Black Sea type basin. Decomposition of the organic matter under reducing conditions to hydrogen sulfide, which reduced the $UO{_2}^{+2}$ ions to the insoluble uranium dioxide($UO_2$), on the other side the heavy metals are precipitated as sulfides. 9. The EPMA study on the identification of uraninite and others and the genetic interpretation of uranium bearing slates by isotopic values of this work are given separately by Yun, S. in 1984.

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On the penecontemporaneous deformation structures of the Sinri area at the mid western boundary of the Jinan Basin (진안분지 서변 중앙부 신리지역의 준퇴적동시성 변형구조)

  • Lee Young-Up
    • The Korean Journal of Petroleum Geology
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    • v.6 no.1_2 s.7
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    • pp.8-19
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    • 1998
  • In the Sinri area located at the mid western boundary of the Jinan basin, the Manduksan Formation which mainly consists of coarse sandstone narrowly intercalated with shale and the alternation of sand and shale and the Dalgil Formation mainly of shale are distributed. It consists of four lithofacies, such as coarse sandstone, interbedded sandstone/shale, shale and volcanic rock lithofacies. All sediments are interpreted to be deposited by turbidity currents and free fallouts in a lacustrine basin. In these rocks many penecontemporaneous defomation structures are observed such as fold and thrust fault at large scale, and swelling, boudin structure, flame structure, load structure, ptygmatic fold and convolute bedding at small scale. All these structures are developed between upper and lower undisturbed sedimentary strata. Two large folds are similar folds, but lower one gradually developed into concentric shape. The swelling structures by convergence of the sediments are observed in the hinge area and the boudin structures are developed in the limb. The thrust faults including minor folds and sandstone lobes show duplex structure with asymmetric and kink fold on and below in front of the detached sandstone layer. Development of the swellings, boudins and lobes indicates the flexbility of the sediments during deformational episodes. The folds and thrust faults rarely contain fractures relative their scales and lithologies. This feature also indicates the retrievability of sediments during deformation. At the flanks of the thrust faults the normal faults are formed contemporaneously. The deformation structures at small scale such as flame structures, load structures, ptygmatic folds and convolute beddings are syndepositional and penecontemporaneous, which show the effects of tectonic movements. All these deformed sedimentary structures of the Sinri area suggest the continuing tectonic movements during and/or after deposition.

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Effects of Different Types of Dietary Fat on Muscle Atrophy According to Muscle Fiber Types and PPAR${\delta}$ Expression in Hindlimb-Immobilized Rats (지방의 종류가 다른 식이의 섭취가 하지고정 흰 쥐의 근 섬유별 근 위축과 PPAR${\delta}$ 활성에 미치는 영향)

  • Lee, Ho-Uk;Park, Mi-Na;Lee, Yeon-Sook
    • Journal of Nutrition and Health
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    • v.44 no.5
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    • pp.355-365
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    • 2011
  • This study investigated how dietary fat affects muscle atrophy and lipid metabolism in various muscles during hindlimb immobilization in rats. Twenty-four male Sprague?Dawley rats had their left hindlimb immobilized and were divided into four groups by dietary fat content and composition. The contralateral hindlimb (control) was compared with the immobilized limb in all dietary groups. Rats (n = 6/group) were fed a 4% corn oil diet (CO), 2.6% corn oil + 1.4% fish oil diet (FO), 30% corn oil diet (HCO), or a 30% beef tallow diet (HBT)after their hind limbs were immobilized for 10 days. Data were collected for the gastrocnemius, plantaris and soleus muscles. Muscle atrophy was induced significantly after 10 days of hindlimb immobilization, resulting in significantly decreased muscle mass and total muscle protein content. The protein levels of peroxisome proliferator activated receptor ${\delta}$ (PPAR${\delta}$) in the plantaris, gastrocnemius, and soleus increased following hindlimb immobilization irrespective of dietary fat intake. Interestingly, the PPAR${\delta}$ mRNA level in the plantaris decreased significantly in all groups and that in the FO group was lower than that in the other groups. The soleus PPAR${\delta}$ mRNA level decreased significantly following hindlimb immobilization in the FO group only. Muscle carnitine palmitoyl transferase 1 (mCPT1) mRNA level was not affected by hindlimb immobilization. However, the mCPT1 mRNA level in the FO group was significantly lower in the plantaris but higher in the soleus than that in the other groups. The pyruvate dehydrogenase kinase 4 (PDK4) mRNA level in the plantaris decreased significantly, whereas that in the soleus increased significantly following hindlimb immobilization. The plantaris, but not soleus, PDK4 mRNA level was significantly higher in the FO group than that in the CO group. The increased PPAR${\delta}$ protein level following hindlimb immobilization may have suppressed triglyceride accumulation in muscles and different types of dietary fat may have differentially affected muscle atrophy according to muscle type. Our results suggest that ${\omega}$-3 polyunsaturated fatty acids may suppress muscle atrophy and lipid accumulation by positively affecting the expression level and activity of PPAR${\delta}$ and PPAR${\delta}$-related enzymes, which are supposed to play an important role in muscle lipid metabolism.

Voluntary Motor Control Change after Gait Training in Patients with Spinal Cord Injury (척수신경손상 환자의 보행훈련 전.후의 능동적 근육제어의 변화)

  • 임현균;이동철;이영신;셔우드아더
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.133-140
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    • 2003
  • In this study, muscle activity was measured using surface EMG (sEMG) during a voluntary maneuver (ankle dorsiflexion) in the supine position was compared pre and post gait training. Nine patients with incomplete spinal cord injury participated in a supported treadmill ambulation training (STAT), twenty minutes a day, five days a week for three months. Two tests, a gait speed test and a voluntary maneuver test, were made the same day, or at least the same week, pre and post gait training. Ten healthy subjects' data recorded using the same voluntary maneuvers were used for the reference. sEMG measured from ten lower limb muscles was used to observe the two features of amplitude and motor control distribution pattern, named response vector. The result showed that the average gait speed of patients increased significantly (p〈0.1) from 0.47$\pm$0.35 m/s to 0.68$\pm$0.52 m/s. In sEMG analysis, six out of nine patients showed a tendency to increase the right tibialis anterior activity during right ankle dorsiflexion from 109.7$\pm$148.5 $mutextrm{V}$ to 145.9$\pm$180.7 $mutextrm{V}$ but it was not significant (p〈0.055). In addition, only two patients showed increase of correlation coefficient and total muscle activity in the left fide during left dorsiflexion. Patients' muscle activity changes after gait training varied individually and generally depended on their muscle control abilities of the pre-STAT status. Response vector being introduced for quantitative analysis showed good Possibility to anticipate. evaluate, and/or guide patients with SCI, before and after gait training.

An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly (노인의 근력강화운동이 일상생활기능 및 삶의 질에 미치는 효과)

  • Kim, Hee-Ja;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.6 no.1
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    • pp.55-73
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    • 1995
  • An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

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THE CURRENT STATUS OF BIOMEDICAL ENGINEERING IN THE USA

  • Webster, John G.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.27-47
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    • 1992
  • Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

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