• PNF and Movement
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• v.21 no.1
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• pp.27-35
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• 2023

Purpose: Hallux valgus (HV) is one of the most common chronic foot disorders, occurring when the first toe deviates laterally toward the other toe. HV impairs muscle strength and affects gait function (postural sway and gait speed). Thus, this study aims to investigate using the FDM system the effect of wearing braces on gait while wearing a virtual reality (VR) device. Methods: This study was conducted on 28 healthy adults with HV of 15 degrees or more. To compare differences in walking, depending on whether a toe brace can be worn, the subject walked without wearing anything, walked after wearing the VR device, and walked after wearing the VR device and the toe brace, and the FDM system was used for the gait ability measurement analysis. Results: As a result of a one-way repeated analysis of variance, the walking speed-related variables (cadence, velocity, etc.) in the HV group were higher during comfortable walking. In addition, walking while wearing a VR device and walking while wearing a VR device and a toe brace demonstrated more significant values in terms of six gait parameters (double stance phase, loading response, stage, stage, stage, and stage). The maximum pressure of the forefoot was significantly reduced when walking while wearing a VR device and a toe brace compared to comfortable walking, but in all variables, there was no statistically significant difference between walking while wearing a VR device and walking while wearing a VR device and a toe brace. Conclusion: Orthosis with a VR device during gait (OVG) and gait with a VR device (GVR) affect gait in HV patients. However, there was no significant difference between GVR and OVG. Thus, it is necessary to conduct experiments on various HV angles and increase the duration of wearing the toe brace.

• Journal of the Korean Applied Science and Technology
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• v.40 no.2
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• pp.290-300
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• 2023

This study was understood the risk mechanism of falls in the elderly and reviewed previous research data to see if the principle of Pilates rehabilitation exercise could have a positive effect on balance ability and postural stabilization in the elderly, and the purpose of this study is to present literature-based data on the fall prevention effect of rehabilitation Pilates exercise. First, the rehabilitation Pilates exercise makes it available for strengthening the center of the body to stabilize the spine and pelvis and stimulates the nerve root, thereby having an effect on the balance and the joint stabilization. Second, a proprioceptive sensory impairment and a musculoskeletal degenerative disease due to aging increase the loss of balance ability and the instability in posture maintenance, thereby coming to raise the risk of a fall damage caused by the difficulty in performing motor functions and by the gait disturbance. Third, the rehabilitation Pilates exercise leads to improving the core muscle strength in older adults, resulting in being capable of expecting the betterment in the balance and the reaction time motor function. And there is a positive impact on the improvement in body imbalance and on the stability in movement involved in the fall prevention, resulting in being able to suggest the possibility of likely contributing to a reduction in a fall risk rate. In conclusion, the rehabilitation Pilates as the elderly exercise program showed effects on the improvement in the body's muscular strength, on the upgrade in a sense of balance, and on the stabilization of core. Thus, it was considered to diminish the risk factors for a fall damage caused by musculoskeletal degeneration and to be capable of preventing a serious disorder of activity due to a chronic senile disease.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.402-417
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• 2023

Objective: Liver fibrosis is a highly conserved wound-healing response and the final common pathway of chronic inflammatory injury. This study aimed to evaluate the potential anti-fibrotic effect of the combination of Rhei Radix et Rhizoma water extract (RW) and silymarin in a thioacetamide (TAA)-induced liver fibrosis model. Methods: The liver fibrosis mouse model was established through the intraperitoneal injection of TAA (1 week 100 mg/kg, 2-3 weeks 200 mg/kg, 4-8 weeks 400 mg/kg) three times per week for eight weeks. Animal experiments were conducted in five groups; Normal, Control (TAA-induced liver fibrosis mice), Sily (silymarin 50 mg/kg), RSL (RW 50 mg/kg+silymarin 50 mg/kg), and RSH (RW 100 mg/kg+silymarin 50 mg/kg). Biochemical analyses were measured in serum, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), malondialdehyde (MDA), and ammonia levels. Liver inflammatory cytokines and fibrous biomarkers were measured by Western blot analysis, and liver histopathology was evaluated through tissue staining. Results: A significant decrease in the liver function markers AST and ALT and a reduction in ammonia and total bilirubin were observed in the group treated with RSL and RSH. Measurement of reactive oxygen species and MDA revealed a significant decrease in the RSL and RSH administration group compared to the TAA induction group. The expression of extracellular matrix-related proteins, such as transforming growth factor β1, α-smooth muscle actin, and collagen type I alpha 1, was likewise significantly decreased. All drug-administered groups had increased matrix metalloproteinase-9 but a decreasing tissue inhibitor of matrix metalloproteinase-1. RSL and RSH exerted a significant upregulation of NADPH oxidase 2, p22^phox, and p47^phox, which are oxidative stress-related factors. Furthermore, pro-inflammatory proteins such as cyclooxygenase 2 and interleukin-1β were markedly suppressed through the inhibition of nuclear factor kappa B activation. Conclusions: The administration of RW and silymarin suppressed the NADPH oxidase factor protein level and showed a tendency to reduce inflammation-related enzymes. These results suggest that the combined administration of RW and silymarin improves acute liver injury induced by TAA.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.3
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• pp.47-65
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• 2023

Objectives We evaluated the wound healing effects of Dangguijakyak-san (DJ) using C57BL/6 mice that were generated open wound. Methods The study was conducted with seven C57BL/6 mice assigned to each group, divided into the normal group, control group, vitamin E group, DJ low-dose group, DJ high-dose group. We measured total polyphenol, flavonoid contents, the size of the wound, liver function, pro-inflammatory cytokine activity in serum, inflammation-related proteins, adhesion molecules and chemokine proteins, collagen-related proteins in skin tissue and histopathological changes by H&E and Masson's staining. Results DJ treatment significantly reduced the area of the wound compared to the control group. Also, inflammatory cytokines were reduced and the expression of anti-inflammatory-related factors (interleukin-4 [IL-4] and IL-10) was significantly increased in the DJ treatment group. We identified that DJ treatment inhibits both pathways of inflammation, the mitogen-activated protein kinases and nuclear factor-κB pathway. Moreover, the protein expressions of Sirt1 (sirtuin 1), MCP-1 (monocyte chemoattractant protein 1), ICAM-1 (intercellular adhesion molecule 1), and VCAM-1 (vascular cell adhesion molecule 1) were decreased by DJ administration. Also, the expression of α-smooth muscle actin and collagen type I alpha 1, collagen-related proteins, that help skin recovery was significantly increased in the DJ treatment group. Histopathologically, a relatively thin epithelial layer could be observed in the DJ administration group, as well as an increase in fibroblasts and collagen fibers. Conclusions These data suggest that DJ treatment is effective in wound healing, suppressing inflammatory proteins, increasing skin repair factors and improving histopathological changes caused by wounds.

• 한국노년학
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• v.30 no.4
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• pp.1107-1116
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• 2010

The elderly people with advancing years have many problems such as the decline of the proprioceptive, visual & vestibular function and muscle weakness. Furthermore the decrease of the reflex which influences the balance ability in sudden change of the movement could cause the falls. The difficulty of the balance caused by the fear releated to the fall aggravates the Falls Efficacy and causes a lot of the disability of the independent activities of daily living. The purpose of this study was the effect of a Virtual Reality Program on Static Balance control and Fall efficacy of Elderly people. 14 elderly people(subjects) who were ≥65years of age partiripated in this study and they were divided into VR(Virtual Reality) group(n=7) and Control group (n=7). VR group took the general physical therapy & IREX and only the general physical therapy was carried out in the control group. VR group of intervention was carried out for 30min. total 8times. They were evaluated by BIO-Rescue, Fall Efficacy Scale before and after treatment. The Static Balance control and Fall efficacy were assessed by Bio-Rescue & Falls Efficacy Scale. The analysis of the resulf was assessed by Wilcoxon signed test & Mann-Whitney U test. The result showed that the static balance of VR group with the open eyes was improved in a static balance test and range of the movement was increased in limited of stability. And Falls Efficacy was also efficacious. IREX was effective to static balance control and Falls Efficacy of the elderly When we think about these effects, various treatments and objective assessments using VR program will be needed for the elderly

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.81-94
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• 2024

PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.646-650
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• 2003

Many surgical techniques for ischemic mitral regurgitation (IMR) have been used with their excellent results and advantages. Here, we report our simple posterior annuloplasty techniques using vascular graft strip with their early results. Material and Method: Twenty two patients (13 male) underwent the operations for IMR (excluding the papillary muscle rupture) from December 2001 to January 2003. Preoperative risk factors were low ejection fraction (<35％, n=9), hypertension (n=13), diabetes (n=9), and renal failure (Cr>2.5, n=4). The wide dissection beneath the both vena cavae and interatrial groove after bicaval cannulation enabled the easy exposure of mitral valve even in the small left atrium. After eight or nine interrupted sutures in posterior annulus for anchoring the 6 mm width vascular graft strip, symmetric (n=8) or asymmetric (n=14) annuloplasty were done. Combined surgeries were CABG (n=21), Dor procedures (n=3), tricuspid valve annuloplasty (n=1), Maze operation (n=1), and aorto-right subclavian artery bypass (n=1). Result: Except for one surgical mortality, all the patients were doing well and the mean grade of regurgitation was decreased from 2.95 to 0.88, however the ejection fraction had not changed significantly just before discharge. Post-operative valve function evaluated before discharge revealed no residual regurgitation in 8 (including 1 patient with mild stenosis due to over reduction), minimal in 11, mild in 2, and mild to moderate regurgitation in 1. One patient who had ischemic cardiomyopathy and renal failure died of the arrhythmia during the hemodialysis. Conclusion: These observations suggest that the annuloplasty with vascular graft strip could be a safe and cost effective techniques for ischemic mitral regurgitation. However, the long term evaluation for the mitral valve function should be defined for the final conclusion.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.92-98
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• 2007

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.354-363
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• 2001

Background : Although lung involvement has been reported in 5 to 46% of dermatomyositis/polymyositis(DM/PM) patients, reports of the condition in Korea are rare. This study evaluated the clinical features of lung involvement in DM/PM patients. Methods : The medical records, laboratory results and radiologic findings of 79 DM/pM patients, who attended the Seoul National University Hospital (SNUH) between 1989 and 1999, were reviewed retrospectively. Results : A total 79 patients of whom 24 patients(33%) showed lung involvement, were enrolled in this study. More patients with lung involvement were female(F:M=11:1), and older compared with those without lung involvement. Patients with lung involvement presented with dyspnea(79%), coughing(67%), an elevated ESR, and CK/LD. Anti-Jo 1 antibody test was positive in 30%, which is significantly higher in patients with lung involvement. A simple chest X-ray of the patients with lung involvement exhibited reticular opacity(50%), reticulonodular opacity(30%), patchy opacity(29%), nodular opacity(13%) and linear opacity(4%). HRCT(n=24) showed ground glass opacity(75%), linear or septal thickening(50%), patchy consolidation(42%), honey-combing(33%) and nodular opacity(17%). The pulmonary function test showed a restrictive ventilatory pattern(77%) and a lower diffusing capacity(62%). The patients were followed up during a mean duration of $30{\pm}28$ months. They were treated with steroid only(50%) or a combination of steroids and cytotoxic agents(46%). Muscle symptoms were improved in 89% with treatment, but an improvement in the respiratory symptoms or in the pulmonary function test was rare. Patients with lung involvement had a higher mortality rate(21%) than those without lung involvement(10%) during the follow-up periods. Conclusion : DM/PM patients with lung involvement were mostly female, older and had a higher positive rate Anti-Jo 1 antibodies, but there was no significant difference in prognosis.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.3
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• pp.92-95
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• 2017

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by an ${\alpha}$-galactosidase A (GLA, MIM 300644) enzyme deficiency due to pathogenic variants in the ${\alpha}$-galactosidase A gene (GLA). The disease leads to accumulation of globotriaosylceramide (Gb3) and related glycophospholipids affecting nearly all major organ systems, with the primary sites damaged by Gb3 including renal glomeruli, myocardium, neurons of the dorsal ganglion and autonomic nervous system, and vascular endothelial and smooth muscle. Progressive deposition in these organ systems present with various clinical manifestations including acroparesthesia, renal failure and heart failure. Here, we report a Chinese male diagnosed with Fabry disease in his late $4^{th}$ decades showing improvement of acroparesthesia during enzyme replacement therapy (ERT). A 48-year-old Chinese man who presented with chronic recurrent severe burning pain in his fingers and toes since the age of 10, with worse involvement of the former visited to our clinic for further evaluation. His medical history included a transient ischemic attack aged 40 and diagnosed with stage 4-5 chronic kidney disease aged 47. In the family history, the patient's brother was found to be have Fabry disease 1 month before his visit. Except for his brother, all other members of the family are healthy. Based on his medical history and family history, he was strongly suspicious for Fabry disease. He was found to have a galactose-alpha-1,3-galactose level 4.96 (Reference range, 42.5-67.9) suggestive of Fabry disease. The followed sequencing of GLA coding region in our patient revealed hemizyosity for the mutation c.988C>T (Q330X) in Exon 7. Since ERT start, he showed significant improvement in his symptoms of burning sensation of fingers and toes. On the contrary, due to deteriorating kidney function even with ERT, he is considered for kidney transplantation. Despite of diagnostic delay until late 4th decades, ERT showed a potential improvement of acroparesthesia in our patient. However, late start of ERT can lead to poor outcome in multiorgan function. Therefore, early diagnosis with high index of suspicion followed by continuous ERT with regular monitoring have an impact on quality of life in Fabry disease.