• Korean Circulation Journal
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• v.53 no.6
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• pp.406-417
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• 2023

Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO₂] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO₂ was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

• Korean Circulation Journal
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• v.53 no.8
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• pp.499-518
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• 2023

Cardiovascular diseases (CVDs), including coronary artery disease, stroke, heart failure, and hypertension, are the global leading causes of death, accounting for more than 30% of deaths worldwide. Although the risk factors of CVDs have been well understood and various treatment and preventive measures have been established, the mortality rate and the financial burden of CVDs are expected to grow exponentially over time due to the changes in lifestyles and increasing life expectancies of the present generation. Recent advancements in metagenomics and metabolomics analysis have identified gut microbiome and its associated metabolites as potential risk factors for CVDs, suggesting the possibility of developing more effective novel therapeutic strategies against CVD. In addition, increasing evidence has demonstrated the alterations in the ratio of Firmicutes to Bacteroidetes and the imbalance of microbial-dependent metabolites, including short-chain fatty acids and trimethylamine N-oxide, play a crucial role in the pathogenesis of CVD. However, the exact mechanism of action remains undefined to this day. In this review, we focus on the compositional changes in the gut microbiome and its related metabolites in various CVDs. Moreover, the potential treatment and preventive strategies targeting the gut microbiome and its metabolites are discussed.

• Korean Circulation Journal
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• v.52 no.10
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• pp.755-767
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• 2022

Background and Objectives: Cryoballoon catheter ablation for the treatment of patients with symptomatic atrial fibrillation (AF) has been adopted globally, but there are limited multicenter reports of 12-month outcomes in the Korean patient population. This analysis evaluated the clinical performance and safety of cryoballoon ablation (CBA) according to standard-of-care practices in Korea. Methods: This evaluation of Korean patients with AF was conducted within the larger Cryo Global Registry, which is a prospective, multicenter, post-market registry. Freedom from a ≥30-second recurrence of atrial arrhythmias (after a 90-day blanking period until 12 months) and procedural safety were examined in subjects treated with CBA at 3 Korean centers. Results: Overall, 299 patients with AF (60±11 years old, 24.7% female, 50.5% paroxysmal AF) underwent CBA using the Arctic Front Advance cryoballoon. Of those, 298 were followed-up for at least 12 months. Mean procedure-, left atrial dwell- and fluoroscopy time was 76±21 minutes, 56±23 minutes, and 27±23 minutes, respectively. Freedom from AF recurrence at 12 months was 83.9% (95% confidence interval [CI], 76.9-88.9%) in the paroxysmal and 61.6% (95% CI, 53.1-69.0%) in the persistent AF cohort. Rhythm monitoring was performed on average 4.7±1.4 times during the follow-up period. Serious device- or procedure-related adverse events occurred in 2 patients (0.7%). The 12-month Kaplan-Meier estimate of freedom from repeat ablation and cardiovascular-related hospitalization was 93.8% (95% CI, 90.4-96.1%) and 89.7% (95% CI, 85.6-92.7%), respectively. Conclusions: CBA is an efficient, effective, and safe procedure for the treatment of AF patients when used according to real-world practices in Korea.

• Physical Therapy Korea
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• v.31 no.2
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• pp.174-181
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• 2024

Background: Effective management of clinical assessment tools is critical in stroke and brain injury rehabilitation research. Managing rehabilitation outcome measures (ROMs) scores and training therapists in multicenter randomized clinical trials (RCTs) is challenging. Objects: The aim of this study was to develop a web-based platform, the Korean Rehabilitation Outcome Measurement (KoROM), to address these limitations and improve both therapist training and patient involvement in the rehabilitation process. Methods: The development of the KoROM spanned from June 2021 to July 2022, and included literature and web-based searches to identify relevant ROMs and design a user-friendly platform. Feedback from six physical therapy and informatics experts during pilot testing refined the platform. Results: Several clinical assessment tools categorized under the International Classification of Functioning, Disability, and Health (ICF) model are categorized in the KoROM. The therapist version includes patient management, assessment tool information, and data downloads, while the patient version provides a simplified interface for viewing scores and printing summaries. The master version provides full access to user information and clinical assessment scores. Therapists enter clinical assessment scores into the KoROM and learn ROMs through instructional videos and self-checklists as part of the therapist standardization process. Conclusion: The KoROM is a specialized online platform that improves the management of ROMs, facilitates therapist education, and promotes patient involvement in the rehabilitation process. The KoROM can be used not only in multi-site RCTs, but also in community rehabilitation exercise centers.

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.711-725
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• 2000

The purpose of this study was to determine the effects of knee flexor isokinetic training on the mean peak torque of knee muscles and hamstrings-to-quadriceps ratio(H/Q ratio) in hemiplegia able to walk independently for more than 10 meters, to analyze the effect of torque increasing on functional aspects; fatigability and ambulation times, also. Forty-one adult subjects with hemiplegia secondary to a stroke partipated in this study. All participants were in/out patients at the College of Medicine, Pocheon CHA University, Pundang CHA General Hospital. The patients were allocated to two groups: one group exclusively for isokinetic maximal voluntary knee flexor training at $150^{\circ}$/sec(n=20) and the other exclusively for isokinetic maximal voluntary knee flexor training from $30^{\circ}$/sec to $150^{\circ}$/sec (n=21) gradually. The allocation was performed according to patient age, sex, affected side to minimize imbalance between the two training groups. Training was carried out from February 14th, 2000 to April 15th, 2000. Analysis of the data was done by means of t-test, x2-test, paired t-test, ANOVA, and multiple regression analysis. The results of this study were as follows: 1. There were no significant differences between the two groups in mean peak torque of knee muscles and relative decreases in knee extensor mean peak torque with increased knee flexor velocities before training (P<.05). 2.There was no significant differences between the two groups in the H/Q ratio, and no relative increases with increased knee flexor velocities before training. 3. there were significant changes in mean peak torque in group A after training(P<.05), but no significant differences as the velocity increased 4.there were significant changes in mean peak torque in group B after training(P<.05), but no significant differences as the velocity increased 5.there were no significant differences between the two groups, and no significant differences in mean peak torque increase rate between the groups with increased knee flexor velocities after training 6.H/Q ratio increased with increased knee flexor velocities between the two groups, but not statistically And there was no significant differences between the groups with increased knee flexor velocities 7.After training, Ambulation time and its decreasing rate decreased significantly in group B (P<.05) 8Before and after training, there was no significant differences between the groups in the fatiguability 9. In the multiple regression analysis, mean peak torque increase rate of the knee extensor and flexor were higher in group B than A(P<.05), and significantly higher with increased knee flexor velocities (P<.05) Also, training method influenced on Ambulation times decreases significantly(P<.05). Results indicated that knee flexor isokinetic training was effective to knee extensor and flexor mean peak torque increase in the hemiplegia able to walk independently for more than 10 meters. Therefore, we were able to conclude that gradual training from low to high velocity was more effective in the increase of mean peak torque of knee joint and decrease of Ambulation times than training only at high velocity.

• Korean Journal of Microbiology
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• v.50 no.3
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• pp.223-226
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• 2014

In the fermented soybean product known as "chungkookjang", diverse bioactive compounds are produced when the soybean proteins are degraded during fermentation. Vascular endothelial cells (EC) are crucial in vein function and the formation of new vessels. A treatment to stimulate formation of new blood vessels is needed in cerebrovascular diseases that lead to ischaemic stroke and heart attack, as well as for diabetic ulcers. VEGF (Vascular Endothelial Growth Factor) simulates EC formation. The effect of Chungkookjang ethanol extract (CEE) on the proliferation of EC was studied. CEE (100, $1000{\mu}g/ml$) and boiled CEE were as effective as VEGF (10 ng/ml) for the proliferation of human umbilical vascular endothelial cells (HUVEC). The effect of CEE on the migration of HUVEC was investigated using sprout analysis. CEE ($100{\mu}g/ml$) was as effective as VEGF (10 ng/ml) for the migration of HUVEC. Isolation of specific peptides influencing the growth and migration of EC is needed.

• The Journal of the Korea Contents Association
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• v.11 no.3
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• pp.281-292
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• 2011

In this study, for examining an effect of lower limbs' muscle activity on balance capability when applying sprinter pattern among the PNF, the experiment was conducted as followed. Under the object of 24 people diagnosed by hemiplegia, they were divided into control group and experimental group and the experiment was conducted on the experimental group, three times per a week for six weeks. Experimental group received Sprinter pattern of combined PNF upper extremity and lower extremity pattern. For the lower limbs' muscle activity, effective values of Vastus medialis laterails, medial lateral hamstrings, lateral gastrocnemius' action potential were analyzed. The balance ability tests was conducted with FICSIT-4, FSST and MTD-Balance system. For the significance test of control group and experimental group for measuring time by exercise application method, two-way repeated measure ANOVA was conducted and for the significance test among the groups by each measuring time, independent t-test was conducted. Also, for examining the correlation among the measuring item, pearson correlation was used for the analysis. As the result, the application of sprinter pattern increased muscle activity of lower limbs in paretic side and improve static and dynamic balance ability effectively. Therefore, it will be necessary to develop new intervention by combining active application of the therapeutic intervention program for lower limbs' effective muscle mobilizing in paretic side with various exercising patterns.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.220-227
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• 2019

Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.

• The Journal of Korean Medicine
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• v.44 no.3
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• pp.150-162
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• 2023

Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. The main pathological finding is endolymphatic hydrops, but the etiology of disease and effective treatment methods are still disputed. Recently, Cervical spine disorders(CSD) and Temporomandibular disorders(TMD) have been attracting attention as one of the causes of Meniere's disease. A 65-year-old female Meniere patient with musculoskeletal problems in the cervical and mandible area was treated by Korean medical therapies including pharmacoacupuncture treatment. After 5 weeks of treatment, there was no meaningful change in hearing level evaluated with pure tone audiometry, but the subjective symptoms of Meniere improved significantly. Numerical rating scale (NRS) decreased from 10 to 0 for hearing loss, 10 to 3 for tinnitus and 8 to 3 for ear fullness. Also NRS of cervicalgia was reduced from 5 to 0 after treatment. The result suggests that the Korean medical therapy including pharmacoapuncture targeting CSD and TMD could be safe and effective method for patients with Meniere's disease.

• The Journal of Internal Korean Medicine
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• v.45 no.4
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• pp.726-743
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• 2024

Objectives: This study was conducted to evaluate the effectiveness of the combination therapy of Saengmaek-san decoction and Western medicine on heart failure. Methods: A search was conducted on June 22, 2024 using keywords such as "heart failure", "saengmaeksan", and "shengmaisan". A meta-analysis was conducted according to the outcome measurements such as the total effective rate (TER), serum B-type natriuretic peptide (BNP), echocardiography results (left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), stroke volume (SV)), and six-minute walk test (6MWT). Data analysis was performed using the RevMan 5.4.1 software, and Cochrane's risk of bias (ROB) was used to assess the quality of the papers. Results: A total of eight randomized control trials were selected. The treatment group combining Saengmaek-san and Western medicine showed significant improvement effects in terms of TER, BNP, LVEF, LVESD, LVEDD, SV, and 6MWT compared to the control group using Western medicine alone [TER] RR=1.23, 95% CI: 1.13-1.34, p<0.00001; [BNP] MD=-206.14, 95% CI : -257.49--154.79, p<0.00001; [LVEF] MD=6.40, 95% CI : 5.54-7.27, p<0.00001; [LVEDD] MD=-6.55, 95% CI : -7.24--5.85, p<0.00001; [LVESD] MD=-3.07, 95% CI: -3.92--2.22, p<0.00001; [SV] MD=7.12, 95% CI : 5.73-8.50, p<0.00001; [6MWT] MD=43.69, 95% CI : 31.55-55.84, p<0.00001. Conclusion: This study suggests that the combination therapy of Saengmaek-san decoction and Western medicine is effective in treating heart failure. However, these findings should be interpreted cautiously due to the unknown or high risk of bias in the included trials.