• Osteoporosis and Sarcopenia
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• v.3 no.3
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• pp.117-122
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• 2017

Sarcopenia is the degenerative loss of muscle mass and function with aging. Recently sarcopenia was recognized as a clinical disease by the International Classification of Disease, 10th revision, Clinical Modification. An imbalance between protein synthesis and degradation causes a gradual loss of muscle mass, resulting in a decline of muscle function as a progress of sarcopenia. Many mechanisms involved in the onset of sarcopenia include age-related factors as well as activity-, disease-, and nutrition-related factors. The stage of sarcopenia reflecting the severity of conditions assists clinical management of sarcopenia. It is important that systemic descriptions of the disease conditions include age, sex, and other environmental risk factors as well as levels of physical function. To develop a new therapeutic intervention needed is the detailed understanding of molecular and cellular mechanisms by which apoptosis, autophagy, atrophy, and hypertrophy occur in the muscle stem cells, myotubes, and/or neuromuscular junction. The new strategy to managing sarcopenia will be signal-modulating small molecules, natural compounds, repurposing of old drugs, and muscle-specific microRNAs.

• Journal of Acupuncture Research
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• v.29 no.5
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• pp.139-149
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• 2012

Objectives : The aim of this study was to investigate clinical features of the patients admitted to the department of acupuncture and moxibustion in an oriental medicine hospital in order to provide clinical preliminary data for advancement of acupuncture and moxibustion Methods : Total 526 patients were admitted to the department of Acupuncture and Moxibustion in Dunsan Oriental Hospital of Daejeon University from September 1st, 2011 to August 31st, 2012. Of these patients 11 were discharged on the day that they were admitted and the remaining 526 patients who were hospitalized for over 2 days were investigated this study. We analyzed inpatients by discharge progress notes and medical records, using PASW statistics 18.0 for statistical analysis. Results : 1. There were 361 females(62.9%) and 213 males(37.1%). The age distribution was skewed to 40s and 50s and the average age of the patients was 42.91 years. 2. The prevalence of the diseases groups was in the order of musculoskeletal disease, neuromuscular disease, neuro-psychological disease, and EENT disease. The musculoskeletal disease and neuromuscular disease together made up 92% of all diseases. 3. The prevalence of individual diagnosis was in the order of Bell's palsy, cervical sprain, lumbar sprain, herniated lumbar disc, herniated cervical disc, and lumbar spinal stenosis. 4. There were 261 patients with single diagnosis and 193 with two and 120 with three or more diagnoses. The days of hospitalization significantly increased with the number of diseases the patients were diagnosed with. Conclusions : With high concentration of patients seen in certain disease groups, continuous efforts needed to expand the usage of acupuncture and moxibustion treatments to other disease groups and to explore and develop other diverse treatment methods for better outcome of the disease treated.

• PNF and Movement
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• v.9 no.3
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• pp.31-39
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• 2011

Purpose : The purpose of this study was to evaluate the criterion-related validity of the Berg balance test between fallers and non-fallers in individuals with Parkinson's disease. Methods : Thirty-one patients were recruited for this study. Their initial diagnosis had been made on average $30.1{\pm}10.1$ years earlier. Score of Berg balance test showed significant correlations with indicators of motor functioning and daily living capacity. Berg balance test score was inversely associated with the unified Parkinson's disease rating scale-motor score, and Schwab and England activities of daily living rating scale. Results : In all 3 correlations, lower scores on the Berg balance test correlated with higher unified Parkinson's disease rating scale-motor scores. Results support the criterion-related validity of the Berg balance test. Conclusion : Our research results agree with other published research in suggesting that the Berg balance test may be used as a screening tool and ongoing assessment tool for patients with Parkinson's disease.

• The Korean Journal of Physiology and Pharmacology
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• v.3 no.1
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• pp.101-117
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• 1999

Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease of unknown etiology in which the upper and lower motor neurons are progressively destroyed. Recent evidences support the role of autoimmune mechanisms in the pathogenesis of ALS. This study investigated the effects of sera from ALS patients on neuromuscular transmission in phrenic nerve-hemidiaphragm preparations and on calcium currents of single isolated dorsal root ganglion (DRG) cells in mice. Mice were injected with either control sera from healthy adults or ALS sera from 18 patients with ALS of sporadic form, for three days. Miniature end plate potential (MEPP) and nerve-evoked end plate potential (EPP) were measured using intracellular recording technique and the quantal content was determined. Single isolated DRG cells were voltage-clamped with the whole-cell configuration and membrane currents were recorded. Sera from 14 of 18 ALS patients caused a significant increase in MEPP frequency in normal Ringer's solution $(4.62{\pm}0.14\;Hz)$ compared with the control $(2.18{\pm}0.15\;Hz).$ In a high $Mg^{2+}/low\;Ca^{2+}$ solution, sera from 13 of 18 ALS patients caused a significant increase in MEPP frequency, from $2.18{\pm}0.31$ Hz to $6.09{\pm}0.38$ Hz. Sera from 11 of 18 patients produced a significant increase of nerve-evoked EPP amplitude, from $0.92{\pm}0.05$ mV to $1.30{\pm}0.04$ mV, while the other seven ALS sera did not alter EPP amplitude. In the ALS group, EPP quantal content was also elevated by the sera of 14 patients (from $1.49{\pm}0.07$ to $2.35{\pm}0.07).$ MEPP frequency and amplitude in wobbler mouse were $4.03{\pm}0.53$ Hz and $1.37{\pm}0.18$ mV, respectively, which were significantly higher than those of wobbler controls (wobblers without the symptoms of wobbler). Sera from ALS patients significantly reduced HVA calcium currents of DRG cells to 42.7% at -10 mV. Furthermore, the inactivation curve shifted to more negative potentials with its half-inactivation potential changed by 6.98 mV. There were, however, significant changes neither in the reversal potential of $I_{Ca}$ nor in the I-V curve. From these results it was concluded that: 1) The serum factors of sporadic ALS patients increase neuromuscular transmission and can alter motor nerve terminal presynaptic function. This suggests that ALS serum factors may play an important role in the early stage of ALS, and 2) Calcium currents in DRG cells were reduced and rapidly inactivated by ALS sera, suggesting that in these cells, ALS serum factors may exert interaction with the calcium channel.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.5 no.1
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• pp.59-71
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• 2007

The purpose of this study was to study for the change of neural adaptation by muscle contraction force when neuromuscular electrical stimulation(NMES) was applied. Sixteen subjects(8 male, 8 female) without neuromuscular disease volunteered to participate in the study. All subjects were divided into two subgroups: control(no electrical stimulation) group, NMES(50% maximal voluntary isometric contraction) group. NMES training program was performed in the calf muscle over three times a week for 12 weeks. Before and after experiment MVIC of ankle plantar flexor was measured by use of dynamometer. H-reflex and V-wave in tibial nerve were measured. The following results were obtained; MVIC and V/Mmax ratio were significantly increased in the electrical stimulation groups. However, H/Mmax ratio was not changed. It was closely relationship between MVIC and V/Mmax ratio. In this study, the effect of neural adaptation of central neural adaptation was found in this study. Accordingly, NMES means not only a change of muscle fiber and skeletal muscle volume but also a effect of neural adaptation of central neural drive. Also, it was found that there was closely relationship between MVIC and neural adaptation of central neural drive by NMES.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.130-134
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• 2018

A 36-year-old male patient developed diffuse low back pain. His past medical history was unremarkable and had no family history of neuromuscular disease. He had no bladder and bowel problems. Creatine kinase was 172 U/L (normal < 170). Other fluid and blood chemistry tests were normal. Manual muscle test grades of extremities and sensory examination were normal. Muscle stretch reflexes were normal. Fasciculations and myotonia were not detected. Straight leg raising test was negative. There was no spinal root compression, spinal stenosis, or signal intensity change of spinal cord on magnetic resonance imaging (MRI). Fatty change and atrophy of the cervical, thoracic and lumbar paraspinal muscles were noted on MRI. Nerve conduction studies were normal. Electromyography showed 1+ positive sharp waves in the lumbar paraspinal muscles. Electromyography of upper and lower extremity muscles revealed no abnormal spontaneous activity. We report a rare case of severe paraspinal muscle atrophy with fatty degeneration in a Young Adult.

• Korean Journal of Adult Nursing
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• v.28 no.5
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• pp.595-606
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• 2016

Purpose: This study aimed to investigate the influencing factors on self care, respiratory difficulty, sleep impediment, anxiety and depression among patients with neuromuscular disease who are dependent on Home Mechanical Ventilator (HMV). Methods: 157 patients were recruited through hospital based home nursing care departments and HMV rental centers. Data were collected by questionnaires. The analytic methods were n(%)/$M{\pm}SD$, $x^2$/t-test or ANOVA and multiple linear regression. Results: Patients with Amyotrophic lateral sclerosis were more likely to utilize HMV, had shorter periods of morbidity and the most extended daily use of HMV. As for medical equipment, they had ambu-bag (87.2%) and oxygenator (15.4%). Reports of respiratory difficulty and sleep impediment were low. There were no significant difference. In contrast, reported anxiety and depression were high and showed significant difference between non invasive HMV and invasive HMV. Anxiety contributes to respiratory difficulty (t=3.62, p=.002), sleep impediment (t=2.06, p=.042), and depression (t=7.24, p<.001). However, home nursing care exerts a positive influence in reducing anxiety (t=-2.73, p=.008). Conclusion: Anxiety contributes to respiratory difficulty, sleep impediment, and depression. However, those who use home nursing care reported less anxiety. Home nursing care positively impacts patients dependent on HMV as a practical service and available resource.

• The Journal of Korean Physical Therapy
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• v.30 no.4
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• pp.129-134
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• 2018

Purpose: This study aims to investigate the changes in pulmonary function, gait ability, and quality of life when NMES is applied along with CBE and to provide basic clinical data to be used in pulmonary rehabilitation guidelines for patients with COPD to treat patients with severe COPD. Methods: For this study, CBE and NMES of quadriceps femoris on both sides were applied to the experimental group (n=10), and only CBE was applied to the control group (n=10). For a pre-test, a 6-minute walk test was performed, and pulmonary function and health-related quality of life were measured. Moreover, an exercise program was applied to each group for 30 minutes per session, 5 times a week, for 6 weeks. After that, a post-test was conducted the same way as the pre-test. Results: In the within-group comparison, there were significant differences in forced expiratory volume in one second, 6-minute walk test and health-related quality of life between the experimental group and the control group (p<0.01)(p<0.05). In the between-group comparison, the experimental group showed an increase in forced expiratory volume in one second and 6-minute walk test (p<0.05) and showed a decline in health-related quality of life (p<0.05). Conclusion: The 6-weeks NMES program improved health-related quality in patients with severe COPD by increasing expiratory volume by reinforcing the function of quadriceps femoris. This finding implies that NMES could be an alternative mode for improving physical functions of patients with severe COPD, who cannot participate in a breathing exercise program or are reluctant to participate.

• Journal of Society of Preventive Korean Medicine
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• v.14 no.1
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• pp.37-48
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• 2010

Objective : The purpose of this research was to provide basic data for developing the collaborating care of Korean traditional medicine and western medicines by analyzing the perceptions of residents visiting local health centers on the collaborating care. Method : To this end, a self-administrated questionnaire was surveyed to 417 participants from March 10 to March 19, 2005. The questionnaires were regarding medical preferences, effectiveness, co-operative treatment types, and the demographic characteristics of the study population. The main statistical methods employed for analysis were frequency chi-square test analysis, using SPSS system 12.0 software for Windows. Result : First, the perceptions of collaborating care, such as preference and effectiveness, were better for residents who had experienced Korean traditional medicine(p < 0.05). Second, the most favorable collaborating care type was the neuromuscular disease and rehabilitation, and in particular, the preference of the patient who had experienced Korean traditional medicine was much higher than those who had not experienced it(p < 0.05). Third, as for recognizing the future of collaborating care, respondents insisted that collaboration care has to be conducted under evidence-based research. The reasons why collaborating care has not been active were reported as "difference in solving disease problems between oriental medicine and western medicine." The most important role of the Korean traditional medicines in the public sector was to provide specialized service for the elderly and low income households. Conclusion : Most respondents expected the positive effects of the collaborating care and wanted it to develop, particularly for neuromuscular diseases. As for the health promotion program in health centers, it was more popular than the home visiting program for the elderly and preventive rehabilitation for stroke. Now we must plan to balance between the need of the community and the medical provider on collaborating care.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.81-89
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• 2019

PURPOSE: To solve the problems of chronic obstructive pulmonary disease (COPD) patients complaining of muscle fatigue and having limited motor abilities, this study provided the clinical basic data for pulmonary rehabilitation by examining the effects of High Low-Frequency Neuromuscular Electrical Stimulation (NMES) on the respiratory muscle strength, quadriceps muscle activity, and life quality. METHODS: Samples were collected from 20 COPD patients and placed randomly in a low-frequency group (n=10) and high-frequency group (n=10). For a pretest, the respiratory muscle strength (MIP, MEP), quadriceps muscle activity (LF, VM, VL), and life quality (SGRQ) were measured. After applying NMES to each group for 30 minutes at a time, five times a week, for four weeks, a posttest was conducted in the same way as the pretest. RESULTS: Both groups showed significant differences in the respiratory muscle strength, quadriceps muscle activity, and quality of life within the groups and there were significant differences in the quadriceps muscle activity between the groups. CONCLUSION: The four-weeks NMES positively influenced the respiratory muscle strength and life quality by enhancing the function of the quadriceps and exercise tolerance. In particular, high-frequency(75 Hz) NMES was more effective than low-frequency (15 Hz) NMES. This result can be an alternative means to improve the physical functions of COPD patients clinically in the future.