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Effect of rTMS on Motor Sequence Learning and Brain Activation : A Preliminary Study (반복적 경두부 자기자극이 운동학습과 뇌 운동영역 활성화에 미치는 영향 : 예비연구)

  • Park, Ji-Won;Kim, Jong-Man;Kim, Yun-Hee
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.17-27
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    • 2003
  • Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle $60^{\circ}$, FOV 220 mm, $64{\times}64$ matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

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Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study

  • Hui-hui Chai;Yu Zhao;Zeng Zeng;Rui-zhong Ye;Qiao-hong Hu;Hong-feng He;Jung Hwan Baek;Cheng-zhong Peng
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.555-565
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    • 2022
  • Objective: To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT). Materials and Methods: This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18-87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation. Results: Complete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0-24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1-3 months. Conclusion: US-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.

Analysis of the Factors influencing the performance of Cardiopulmonary Resuscitation (심폐소생술 수행에 영향을 미치는 요인 분석)

  • Choi, Keun-Myung
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.55-78
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    • 2005
  • The purpose of this study was to provide basic data for the improvement of the guidelines and training programs regarding the cardiopulmonary resuscitation performance of bystanders who can respond to the incidents in earlier times as the first responder of the cardiac arrest incident, by reviewing the performance of basic CPR and the influencing factors after providing 70 students of Department of Emergency Medical Technology with the CPR training. For the purpose of the study, the collected data were computerized and analyzed by SPSS-WIN program(ver. 10.1). The results for this study were as follows The duration of session between the groups in the BLS CPR were 3 minutes and 36 seconds, 2 minutes and 32 seconds respectively. The average compression number per minute were 24.3 times and 33,2 times respectively(p=.000), and the average compression rate per minute were 112 times and 122 times respectively(p=.000). The average ventilation number per minute were 3.54 times and 5.1 times respectively(p=.000). The errors in compression "Too shallow" were 20.73 times(34.6%) and 23,23 times(38,7%) out of 60 times in 4 cycles with the standard of 38 nun. In CPR performance results according to gender in the first episode, males showed better results in compression depth as 41.5 mm comparing to females average 38.2 mm(p=.015). When ventilation results were compared according to the use of FS, the average ventilation number per minute, total ventilation per minute and the average volume per episode were significantly higher when FS was not used(<.040), There was no significant difference in ventilation accuracy between two groups. According to the results, we need to improve and distribute portable barrier devices, and to be familiar with those devices. We need to enforce ventilations as well as to include compressions so that faster and more accurate CPR can be performed. Additionally, we need to exclude ventilation only cases, minimize the interference time of chest compression due to inaccurate ventilation, simplify or minimize the complicatedness of CPR performance and responding time related to breathing, provide first responders with various training programs such as initial assessment and ventilations only, or initial assessment and chest compression-only CPR and than provide advanced training with AHA BLS education including CPR for more than two people according to CPR skills and target characteristics.

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Problems and Solutions for the Term of Existence of the Housing Lease in the Digital age (디지털시대에 있어서 주택임대차 존속기간에 대한 문제점과 개선방안)

  • Park, Jong-Ryeol
    • Journal of the Korea Society of Computer and Information
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    • v.20 no.4
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    • pp.139-146
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    • 2015
  • The Housing Lease Protection Act was enacted from March 5, 1981 as Law No. 3379 to guarantee the stability of residential life and legal status. After then, there were many problems, but through several times revision, it had improved insufficient part. However, in order to give guarantees actually the position strengthen for homeless poor people many issues still need to be solved and it has been raised. Along the way, with the introduction of the tenant renewal claims, in February 14, 2015, the National Assembly planned to discuss current issues by operating the Special Committee for housing welfare of ordinary people in the extra session. In the current, however, the conflict of the pros and cons is shown clearly. Meanwhile, because the contract renewal claim of tenant was not guaranteed, if the minimum duration of the lease will be lapsed, contract renewal is dependent on the intention of landlord. Thus, the residential stability of homeless poor could become unstable. Therefore, in this paper, to stabilize the residential living for tenants who are in poor status, analyze our term of existence regulation and through the compared to the national legislation about the term of existence, it will try to propose the specific legislative approach to the problem.

Trends in Domestic and International Clinical Research of Craniosacral Therapy: Scoping Review (두개천골요법의 국내외 임상 연구 동향: 스코핑 리뷰)

  • Kwak, Min-Jae;Han, Yun-Hee;Geum, Ji-Hye;Park, Shin-Hyeok;Woo, Hyeon-Jun;Ha, Won-Bae;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.13-27
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    • 2022
  • Objectives This study investigated the trends in domestic and international clinical research in craniosacral therapy, classified as a type of Chuna manual therapy, and suggested further directions in Korean medicine. Methods This scoping review was performed using the Arksey and O'Malley methodological framework and preferred reporting items as per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. Eight electronic databases (PubMed, EMBASE, Cochrane Library, Koreanstudies Information Service System [KISS], KMBASE, Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], ScienceON) were searched to identify articles with the search terms "craniosacral therapy" and "cranial osteopathy" until December 2021. Results Forty-five studies were eligible as per our inclusion criteria. Most research studies (n=44) were conducted in the field of medicine and pharmacy, especially in rehabilitation medicine (n=16). As a result of the study design, randomized controlled trials (n=20) were the most common, and chronic pain (n=9) was the most frequently targeted disease, followed by headache (n=7). Thirty-two studies suggested interventions and 20 studies used Upledger's 10-step protocol. The average duration of craniosacral therapy was 41 min per session, administered 1.4 times per week. Outcome measurements were analyzed and categorized with the examination procedure for the patient. Conclusions This is the first scoping review of craniosacral therapy in Korea, and we believe that our findings could support its utility as Chuna. In the future, more studies should be conducted to establish the evidence of clinical efficacy of craniosacral therapy and develop standard techniques in Korean medicine.

A Systematic Review of Group Programs for Community-dwelling Elderly (지역사회 거주 노인 대상의 그룹 프로그램에 대한 체계적 고찰)

  • Jeong, Eun-Hwa;Ju, Yumi
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.23-36
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    • 2021
  • Objective : The purpose of this study was to analyze group programs for the elderly living in communities and to provide basic data for applying effective occupational therapy programs for the elderly in the community. Methods : From January 2009 to December 2019, articles on group programs for the elderly in the community were searched for in the NDSL, DBPia, Riss, and PubMed databases. Based on the inclusion and exclusion criteria, a total 16 out of the 147 identified studies were selected and analyzed. This review analyzed the characteristics of the participants, contents of the group program, session and duration of the intervention, outcome measures, and effect of the group program. Results : Single group pre-post test studies with evidence level III were most common (8, 50.0%), and five (31.3%) of the studies were conducted on the community-dwelling elderly. Across all the 16 studies, there were 10 types of group programs, and the most frequently used was an exercise group program (25.0%). According to the analysis of the group program period, sessions and time, the intervention period was most commonly 12 weeks (37.5%), with 8 sessions or 12 sessions (25.0%). The intervention time in the group program was most commonly 60 minutes (43.8%). Conclusion : This study can be used as a basis for the development of effective group programs for the elderly and patients with dementia in community-based long-term care services.

Single Case Study: The Positive Impact of the Intensive Sensory Integration Intervention for the Sensory Defensiveness (감각통합기능장애에 대한 집중치료프로그램의 효과 : 사례보고)

  • Park, Ji-Hun;Noh, Jong-Su;Lee, Hyang-Sook;Cha, Jung-Jin
    • The Journal of Korean Academy of Sensory Integration
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    • v.7 no.2
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    • pp.63-76
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    • 2009
  • Objective : The purpose of this study was to identify effects of intensive sensory integration (SI) treatment and home-program for a child who has a sensory integration disorder. This study also examined whether the positive effect is long-lasting by a follow-up test. Method : A boy with sensory integration dysfunction underwent an intensive SI treatment for 2 weeks. The intervention was consisted of 9 sessions and duration of the each session was 40 minutes. Sensory diet and Wilbarger protocol was provided as home program. The child's sensory function was evaluated before and after the SI intervention. Five month later, re-evaluation was executed for follow-up purpose. Results : In the evaluation after the Si intervention, the child's sensory defensiveness was decreased. Praxis, visual perception, sensory regulation dysfunction (sleep function), affective stabilization and performance of activities of daily living are also improved. In the re-evaluation after the 5 month later, the self-regulation ability, especially sleep function, has been maintained and the visual perception was developing continually. However, the child showed some affective regulation such as bothering his mother and losing his temper. Conclusions : The intensive SI intervention showed positive effects in terms of SI function improvement and the effect lasted long without any additional therapeutic intervention.

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Development of Firefighting Performance Test Drills while Wearing Personal Protective Equipment (소방방화복을 착용했을 때의 소방진압 업무 적합도 평가 프로토콜의 개발)

  • Kim, Siyeon;Lee, Joo-Young
    • Fire Science and Engineering
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    • v.30 no.1
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    • pp.138-148
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    • 2016
  • A firefighting simulation was developed in order to assess the physical work capacity of firefighters. The simulation consisted of eight common firefighting tasks, including walking with radiant heat for 3 min while wearing full personal protective equipment (PPE). Nine professional firefighters performed the test a total of three times with a 5 min rest interval between each session. The entire series of tests took approximately 30 min to complete ($381{\pm}30s$). Rectal temperatures were found to increase from $37.4{\pm}0.3^{\circ}C$ to $38.5{\pm}0.4^{\circ}C$, while heart rates were found to increase from $92{\pm}18bpm$ to $185{\pm}13bpm$ during testing. Time to completion of the test drills and non-modified physical fitness values showed a significantly negative correlation (r = -0.728, p < 0.05). Firefighters who had longer periods of firefighting service had longer duration time and also recorded higher scores using an integrated scoring system of time to completion (TTC) and physiological strain index (PhSI). The results indicated that the determination of TTC alone can be a misrepresentation of capability, as it neglects to account for accumulated heat strain. The simulated firefighting test provided a useful insight into physical fitness level, but also the comprehensive work capacity of the firefighters when assessed based on TTC and PhSI.

The Trend of Overseas Studies on the Intervention of Multisensory Environment: Systemic Review (다감각환경중재에 관한 국외 연구의 경향: 체계적 고찰)

  • Cho, Eun-Hee;Song, Hyun-Eun;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.54-64
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    • 2019
  • Objective : The purpose of this study is to study the effects of multisensory environment interventions, to provide information about clinical applications, and to aid South Korean research on the multisensory environment. Methods : PubMed, Cochrane, and Google Scholar were used to search for papers published from 2008 to 2018. The main search terms were "multisensory environment" and "snoezelen", a total of 10 foreign research articles were selected. And they were summarized according to Patient, Intervention, Comparison, Outcome (PICO). Results : Among the 10 papers, 6 included participants with dementia. The other studies examined patients with intellectual disabilities, patients with schizophrenia, and pregnant women. The study periods ranged from 3 weeks to 10 months. Most of the interventions included 2 or 3 sessions per week. The duration of each intervention session was 30 to 60 minutes. The dependent variables were psychological factors (such as anxiety and depression), social factors (such as quality of life), and cognitive and physical domains. The multisensory environment used for the interventions in the studies consisted of visual, auditory, and tactile senses, as well as additional olfactory and taste sensations, and vestibular sensations. Conclusion : In the future, the research should be applied to various target groups, especially children, who are interested in multisensory environmental intervention in South Korea.

Radiofrequency Ablation of Papillary Thyroid Microcarcinoma: A 10-Year Follow-Up Study (갑상선 미세유두암의 고주파 절제술 후 10년 경과 관찰)

  • Yoo Kyeong Seo;Seong Whi Cho;Jung Suk Sim;Go Eun Yang;Woojin Cho
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.914-922
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    • 2021
  • Purpose To investigate the efficacy and safety of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) after > 10 years of follow-up. Materials and Methods This study included five patients who underwent RFA to treat PTMCs (five lesions, mean diameter 0.5 cm, range 0.4-0.7 cm) between November 2006 and December 2009. The inclusion criteria were histopathologically confirmed PTMCs, a single PTMC lesion without extrathyroidal extension, no metastasis, and ineligibility or refusal to undergo surgery. RFA was performed by a single radiologist using a radiofrequency generator and an internally cooled electrode. We retrospectively analyzed the procedure-induced complications, serial changes in ablated tumors, recurrence, and local as well as lymph node metastasis based on data obtained from medical records and radiological images. Results The mean follow-up period was 130.6 months (range 121-159 months). Three patients underwent a single RFA session, and two patients underwent two RFA sessions. We observed no procedure-induced complications. Three tumors completely disappeared after ablation, and ablation of the other two tumors resulted in the formation of a small scar that showed long-term stability (mean duration 16.8 months, range 12-27 months). At the last follow-up, no patient showed recurrence or lymph node metastasis, and serum thyroglobulin levels were within normal limits in all patients. Conclusion RFA may be effective and safe to treat low-risk PTMC in patients who refuse or are ineligible for surgery.