• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.26-35
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• 2024

Objective: The aim of this study is to explore how using inspiratory training affects the respiratory function and balance of stroke patients. We also plan to compare the results with a control group that does not receive the intervention. Design: A Randomized Controlled Trial Methods: In this study, 27 chronic stroke patients were randomly assigned to either a control group (n=14) or an experimental group (n=13). Both groups underwent six weeks of common interventions involving standard physiotherapy and treadmill training. Additionally, the experimental group received inspiratory training. Respiratory function and balance were evaluated using Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Maximal Inspiratory Pressure (MIP), Maximal Expiratory Pressure (MEP), Peak Expiratory Flow (PEF), Five times Sit-to-Stand (FTSTS), Seated Center of Pressure (S-COP), and Timed Up and Go (TUG) tests. Results: Respiratory function and balance were compared within each group before and after intervention. The experimental group, which received inspiratory training, showed significant improvements in FVC (0.26±0.18), FEV1 (0.35±0.32), MIP (11.54±12.39), PEF (1.12±1.52), and TUG (-3.39±2.45) compared to pre-intervention values (p<0.05). When comparing changes between groups post-intervention, the experimental group demonstrated significant increases in FVC, FEV1, MIP, PEF, and TUG compared to the control group (p<0.05). However, there were no significant differences in MEP, FTSTS, and S-COP. Conclusions: The results of this study indicate a positive effect of inspiratory training on chronic stroke patients. These findings suggest that with further research involving a larger sample size and enhanced intervention methods, inspiratory training could be employed positively in the rehabilitation of stroke patients.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.13.1-13.12
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• 2023

Background: Indoor air pollution can cause and exacerbate asthma. We report a previously undescribed case of occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range and highlight the potential risk of developing occupational asthma in this environment. Case presentation: A 31-year-old man presented with dyspnea, cough, and sputum and was diagnosed with asthma complicated by pneumonia. Objective evidence of asthma was obtained by performing a methacholine bronchial provocation test. It was suspected that the patient had occupational asthma, which began one month after changing jobs to work within the indoor air gun shooting range. The highest peak expiratory flow (PEF) diurnal variability on working days was 15%, but the highest variation was 24%, with 4 days out of 4 weeks having a variation of over 20% related to workplace exposure. Conversely, the diurnal variability on the rest days was 7%, and no day showed a variation exceeding 20%. The difference in the average PEF between working and rest days was 52 L/min. PEF deterioration during working days and improvement on rest days were noted. Conclusions: The results obtained from the in-depth analysis of the PEF were adequate to diagnose the patient with occupational asthma. Exposure to indoor air pollution and lead and the patient's atopy and allergic rhinitis may have contributed to the development of occupational asthma.

• Korean Journal of Radiology
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• v.2 no.2
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• pp.75-79
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• 2001

Objective: To evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane. Materials and Methods: Using a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice. Results: Gross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing. Conclusion: When the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.

• Journal of Korean Medicine Rehabilitation
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• v.34 no.3
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• pp.65-74
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• 2024

Objectives This study aims to establish a protocol for a systematic review to evaluate the effectiveness and safety of manual therapy (MT) for obstructive sleep apnea (OSA). Methods We will conduct a search for relevant randomized controlled trials using seven databases, including MEDLINE/PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The study includes patients with OSA treated with MT. Comparators include all other treatments excluding MT. The primary outcome is the apnea-hypopnea index; secondary outcomes include mean peripheral oxygen saturation, snoring index, quality of sleep, quality of life, peak nasal inspiratory flow, and adverse events. Results Two independent researchers will select studies based on inclusion criteria and extract necessary data. Risk of bias (RoB) will be assessed using the Cochrane RoB 2.0 tool. Meta-analysis will be conducted if there are two or more studies with the same outcome measure; otherwise, a qualitative analysis will be performed. Subgroup analysis will be conducted based on the type of MT, and evidence certainty will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Conclusions This study will evaluate the effect of MT on OSA. By systematically reviewing various MTs, it aims to refine application methods in clinical practice and provide a foundation for future research.

• Physical Therapy Rehabilitation Science
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• v.13 no.2
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• pp.179-186
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• 2024

Objective: This study aims to assess the reliability and validity of the new hand-held spirometer as a potential substitute for traditional pulmonary function testing (PFT) devices. Design: Cross-sectional study. Methods: In this study, thirty healthy adults underwent spirometry using both the new hand-held spirometer and the MIR spirometer, which is a standard PFT device. Parameters including peak expiratory flow (PEF), forced expiratory volume in one second (FEV₁), and forced vital capacity (FVC) were measured and analyzed for validity and reliability. Inter-rater reliability and validity were evaluated through 95% limits of agreement (LOA) and intraclass correlation coefficients (ICC). Statistical analyses, including the Bland-Altman plots and the ICC, were utilized to assess agreement between the two devices. Results: The new hand-held spirometer exhibited a good agreement with intra-class coefficient (ICC [2,1]) ranging 0.762 to 0.956 and 95% LOA of -1.94 to 1.80 when compared with MIR. The test-retest reliability of the hand-held spirometer analyzed using - ICC [2,1] demonstrated a good level of consistency (ICC [2,1] =0.849-0.934). Conclusions: In conclusion, the study aimed to assess the potential of the new hand-held spirometer as a viable alternative to traditional PFT devices, with a specific focus on its reliability and validity in spirometric measurements. The new hand-held spirometer exhibited good test-retest reliability across all measured variables, suggesting its potential as a valid and reliable tool for simultaneous PFT measurements.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.529-538
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• 2002

Background : Many clinicians are reluctant to prescribe systemic corticosteroids to manage an asthmatic attack because of many complications such as osteoporosis, cushing's syndrome, diabetes, hypertension and bleeding tendency. The use of nebulized budesonide may be of value in some infants, old men, and in particular adult asthmatic patients who complain of severe dyspnea. A clinical validation and steroid-sparing effect of nebulized budesonide in asthmatic adults and COPD were evaluated, and the short-term effects of budesonide use on the HPA axis were assessed. Materials and Methods : Study A was prospectively done with 41 patients diagnosed with pure asthma and 30 patients diagnosed with COPD (including asthmatic component) in Soonchunhyang Hospital, Chunan from June. 2000 to Sep. 2001. They were treated with nebulized budesonide including systemic steroids (Group 1), a budesonide tubuhaler including a systemic steroid (Group 2), or only the systemic steroid(Group 3). The peak flow rate, arterial blood gas in room air, pulmonary function test, symptom scoring, steroid amount and hospital stay were analyzed. Study B was conducted with 19 patients to evaluate the short-term effects on the HPA axis of treatment with nebulized budesonide 1mg twice daily and a budesonide turbuhaler 5 puffs twice daily. The adrenal function was assessed prior to budesonide inhalation and after 7 days of budesonide inhalation. Results : In the pure asthmatic patients, the mean value of the symptoms (dyspnea, wheezing, cough, night asthma) or the arterial BGAs, total amounts of steroid or hospital stay and the difference in the results of the pulmonary function tests or peak expiratory flow rate were similar in the three groups. In COPD with an asthmatic component, there were no significant differences among the three groups. Although nebulized budesonide suppressed HPA function,(p=0.006) the HPA responses from the nebulized budesonide and turbuhaler budesonide were similar (p=0.288) Conclusion : This result suggests that systemic steroid should only be made available for acute asthmatic patients irrespective of the inhaled budesonides. Nebulized budesonide at the therapeutic dose has similar effects on the HPA axis compared to that of turbuhaler budesonide.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.468-475
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• 2005

Transmyocardial revascularization (TMR) in end stage ischemic heart disease results in variable clinical responses. We investigated the acute effect of early reperfusion and the angiogenesis after formation of the transmyocardial channel in a transplanted rat heart model with acute myocardial infarction. Material and Method: In the 30 transplanted hearts we induced acute myocardial infarction by ligating the proximal left coronary artery and inserted a porous 22G intravenous cannula into the left ventricle. After ten minutes of reperfusion, we removed the cannula. At every stage, we recorded the heart rate, QRS size, and left coronary arterial blood flow using the electrocardiogram and Doppler. One week later the rats were sacrificed and evaluated for the patency of intramyocardial channels and the angiogenesis. Result: The heart rates after ligation and after cannula insertion were $239.1\pm61.7,\;235.8\pm58.0bpm$ respectively, and they were statistically significantly slower than that of before ligation, $277.6\pm40.3bpm\;(p=0.017,\;p=0.007\;respectively)$. QRS sizes before ligation, after ligation, and after cannula insertion were $3.6\pm3.3mm,\;2.8\pm3.3 mm,\;and\;2.4\pm2.2mm,$respectively, and there was no significant difference in the three groups. Doppler findings after ligation showed that average peak and mean values of coronary perfusion were significantly decreased from $2.11\pm0.17kHz,\;1.25\pm0.22kHz\;to\;0.83\pm0.15kHz,\;0.38\pm0.11kHz$(p<0.05 respectively). After insertion of the porous cannula, the average peak and mean values of coronary perfusion were $0.61\pm0.05kHz\;and\;0.33\pm0.05 kHz$ respectively, but there was no statistically significant change compared to values after ligation. In all cases except one, pathologic findings showed no patent channels in the acute stage, however, one case showed the angiogenesis. Conclusion: We confirmed that TMR in a rat heart transplant model did not show blood flow through the channel in the acute stage. However, reperfusion effect in some cases had a potential for angiogenesis.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.570-578
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• 2003

Background : Ambient particles during Asian dust events are usually sized less than $10{\mu}m$, known to be associated with the adverse effects on the general populations. But, there has been no considerable evidence linking these particles to the adverse effects on airways. The objectives of this study was to investigate the possible adverse effects of Asian dust events on respiratory function and symptoms in subjects with bronchial asthma. Patients and Methods : From march to June 2002, Asthmatic patients who were diagnosed with bronchial challenge test or bronchodilator response were enrolled. We divided them into three groups; mild, moderate, and severe, according to the severity. Subjects with other organ insufficiency such as heart, kidney, liver, and malignancy were excluded. All patients completed twice daily diaries and recorded peak flow rate, respiratory symptom, and daily activity. Daily and hourly mean pollutant levels of particulate matter < $10{\mu}m$ in diameter($PM_{10}$), nitrogen dioxide($NO_2$), sulphur dioxide($SO_2$), ozone($O_3$) and carbon monoxide(CO) were measured at the 10 different monitoring sites. Results : Dust events occured 14 times during the study period. Daily averages of 4 air pollutant were measured with an increased level of $PM_{10}$, decreased level of $NO_2$ and $SO_2$, and no change in CO during dust days compared to those during control days. An increase in $PM_{10}$ concentration was associated with an increase of subjects with PEF variability of >20% (p<0.05), night time symptom(p<0.05), and a decrease in mean PEF (p<0.05), which were calculated by the longitudinal data analysis. Otherwise, there was no association between $PM_{10}$ level and bronchodialtor inhaler, and daytime respiratory symptoms. Conclusion : This study shows evidence that ambient air pollution, especially $PM_{10}$, during Asian dust events, could be one of the many aggravating factors at least in patients with airway diseases. This data can be used as a primary source to set up a new policy on air environmental control and to evaluate the safety of air pollution index. We also expect that this research will help identify precise components of dust, which are more linked to the adverse effects.

• Sim-seong Yeon-gu
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• v.38 no.1
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• pp.1-44
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• 2023

Hexagram Bi (比 ䷇ 8) is one of the hexagrams comprised of one-unbroken line and five-broken lines. The hexagrams of one-unbroken and five-broken lines symbolize the relationship and dynamics between one yang-consciousness and the five-yin unconsciousness. The hexagram of one-unbroken line and five-broken lines has six different images depending on the position of the one unbroken line from the beginning line to the top line. In terms of psychology, this means that the position change of one yang line in relation to five yin lines may symbolize the function of consciousness which clarifies and determines the content of the psyche. In addition, the flow of psychic energy can be examined through the process of one unbroken line's movement. In other words, the psychic contents of the beginning line of hexagram Bok (復 ䷗ 24), which is the beginning of the hexagram of one-unbroken line and five-broken lines, proceed sequentially, and then arrive at the process of the last sixth, hexagram Bak (剝 ䷖ 23) through the fifth, the hexagram Bi (8). That is, it can be said that the content of the hexagram and the line determined according to the position of one unbroken line show a certain psychic flow. As a result, the first hexagram Bok (復 ䷗ 24), after recovering and starting newly, means the beginning of consciousness. After that the process of proceeding with the second, third, and fourth lines represents the flow of consciousness. And in the fifth place, the fifth line of hexagram Bi, it reaches its peak and is placed in the optimal state of consciousness because of its right and centered position at this hexagram Bi. Like nature, the psyche gradually enters the path of decline from the highest state, which leads to the last sixth, the top line of hexagram Bak. However, the top line of the hexagram Bak, where everything falls off, contains the content of starting again in its top line. It is the beginning line of hexagram Bok to inherit this. This means the circumambulation of the psyche that changes from a psychologically difficult state of depression to a stage of recovery. There is a stage that must be passed in this circulation process, and that is the hexagram Gon (坤 ䷁ 2). October(tenth month)'s hexagram Gon is placed between hexagram Bak, the ninth month of the lunar calendar, and hexagram Bok, the eleventh month of the lunar calendar. This represents that the flow of recovery must go through a maternal process of hexagram Gon. The retreat to the psychological uterus is inevitable in regenerating the psyche. This process flows from the hexagram Bak and through hexagram Gon to the hexagram Bok. At this situation the hexagram Gon acts the absolutely necessary role. In addition, the main body of the hexagrams of one-unbroken and five-broken lines, including the Bi hexagram, is also the Gon hexagram composed of six-broken lines. In other words, all six hexagrams of one-unbroken and five-broken lines have a certain relationship with the Gon hexagram, and it would be meaningful to look at the correlation between the unbroken lines of the hexagrams of one-unbroken and five-broken lines and the corresponding broken lines of the hexagram Gon. This can be said to be the dynamics of the maternal unconscious connected to the state of consciousness in six forms. Therefore, each hexagram of one-unbroken and five-broken lines symbolizes the expression of the integration the mother archetype with the consciousness. Revealing this well is the meaning of the hexagram of one-unbroken and five-broken lines. Its hexagram image consists of a combination of Gon (☷), which symbolizes the mother, and the thunder (☳) the eldest son, the water (☵) the middle son and the mountain (☶) the third son. As a result, the hexagram Bok (復 ䷗ 24), Sa (師 ䷆ 7), Gyeom (謙 ䷠ 15), Ye (豫 ䷏ 16), Bi (比 ䷇ 8) and Bak (剝 ䷖ 23) are sequentially created in the order of the unbroken line. This is symbolically the evolutionary process of consciousness. In this way, the hexagrams of one-unbroken and five-broken lines, which mean the conjunction of mother and son, represent the advancing relationship between the maternal unconscious and consciousness. In addition, the relationship with the mother according to the position of the son is related to the dynamics of mother archetype to the attitude of consciousness. The psychological meaning can be deduced from the flow of six lines of hexagrams of one-unbroken and five-broken lines. And the state in which the activation of the consciousness is at its peak is the fifth line of the hexagram Bi, and comparing it with the contents of the corresponding fifth line of hexagram Gon not only can find the state and meaning of the conjunction of consciousness and the maternal unconscious, but the entire flow can be compared to the individuation process.

• Journal of Korea Soil Environment Society
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• v.2 no.2
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• pp.81-94
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• 1997

In many solute transport studies, either flux or resident concentration has been used. Choice of the concentration mode was dependent on the monitoring device in solute displacement experiments. It has been accepted that no priority exists in the selection of concentration mode in the study of solute transport. It would be questionable, however, to accept the equivalency in the solute transport parameters between flux and resident concentrations in structured soils exhibiting preferential movement of solute. In this study, we investigate how they differ in the monitored breakthrough curves (BTCs) and transport parameters for a given boundary and flow condition by performing solute displacement experiments on a number of undisturbed soil columns. Both flux and resident concentrations have been simultaneously obtained by monitoring the effluent and resistance of the horizontally-positioned TDR probes. Two different solute transport models namely, convection-dispersion equation (CDE) and convective lognormal transfer function (CLT) models, were fitted to the observed breakthrough data in order to quantify the difference between two concentration modes. The study reveals that soil columns having relatively high flux densities exhibited great differences in the degree of peak concentration and travel time of peak between flux and resident concentrations. The peak concentration in flux mode was several times higher than that in resident one. Accordingly, the estimated parameters of flux mode differed greatly from those of resident mode and the difference was more pronounced in CDE than CLT model. Especially in CDE model, the parameters of flux mode were much higher than those of resident mode. This was mainly due to the bypassing of solute through soil macropores and failure of the equilibrium CDE model to adequate description of solute transport in studied soils. In the domain of the relationship between the ratio of hydrodynamic dispersion to molecular diffusion and the peclet number, both concentrations fall on a zone of predominant mechanical dispersion. However, it appears that more molecular diffusion contributes to the solute spreading in the matrix region than the macropore region due to the nonliearity present in the pore water velocity and dispersion coefficient relationship.