• 대한물리의학회지
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• 제17권4호
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• pp.93-101
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• 2022

PURPOSE: This study sought to investigate the effects of treadmill gait training combined with a thoracic mobility exercise on gait and balance in patients with stroke. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 20 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (treadmill gait training combined with a thoracic mobility exercise, n = 11) or control group (treadmill gait training without the thoracic mobility exercise, n = 9). All the participants underwent comprehensive rehabilitation therapy (5 × /week for 4 weeks). Additionally, the experimental group underwent 20 min of treadmill gait training combined with 10 min of a thoracic mobility exercise (3 × / week for 4 weeks) and the control group underwent the former but not the latter. Gait and balance were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the 10-m walking test (10 MWT), timed up-and-go (TUG) test, center of pressure (COP) velocity, and COP length in the experimental group (p < .05). This group also showed a larger decrease in the 10 MWT and COP velocity than the control group (10 MWT, -3.02 sec vs. -1.68 sec, p < .05; COP velocity, -.07 mm/sec vs. .08 mm/sec, p < .05). CONCLUSION: Treadmill gait training, combined with the thoracic mobility exercise, could be effective in improving the gait and balance of stroke patients. It could also be more effective in improving walking speed and static balance than the treadmill gait training alone.

• 생약학회지
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• 제53권4호
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• pp.213-225
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• 2022

Schisandra chinensis is widely known to regulate fatigue recovery, lowering blood pressure, and contains several bioactive compounds such as schizadran. In this study, we obtained basic data for the development of health food by measuring the schizandrin content, antioxidant activity, anti-inflammatory, antibacterial activity, and enzyme activity of the hot water extract (SCW) and 40% ethanol extract (SCE) of S. chinensis grown in Sunchang-gun, Korea. Schizandrin content was measured as 7.87 ± 0.01 mg/g for SCW and 10.38 ± 0.05 mg/g for SCE. SCE had higher DPPH and ABTS radical scavenging activity than SCW, and the total polyphenol and flavonoid contents were also higher. Both SCW and SCE (500 ㎍/mL) exhibited more than 55% protective effects against oxidative stress in HepG2 cell lines. Anti-inflammatory efficacy was assessed using RAW 264.7 and Caco-2 cells and both SCW and SCE do not have cytotoxic effects. Anti-inflammatory results showed concentration-dependent NO activity and pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) inhibition. The antibacterial activity increased with increasing dose concentrations of SCW and SCE, and the MIC was 25 mg/mL for L. monocytogenes, S. typhimurium, and 75 mg/mL for H. pylori. In addition, amylase and protease enzyme activity was observed in both SCW and SCE.

• Journal of Veterinary Science
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• 제21권1호
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• pp.2.1-2.14
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• 2020

The emergence of livestock-associated (LA)-methicillin-resistant Staphylococcus aureus (MRSA) in livestock animal has become a significant zoonotic concern. In the present study, we investigated nationwide prevalence of LA-MRSA across pork production chain including pig farms, slaughterhouses, and retail markets. A total of 40 MRSA strains were isolated during the investigation and the overall prevalence of MRSA was 3.4% (n = 37), 0.6% (n = 2), and 0.4% (n = 1) in pig farms, slaughterhouses, and retail markets, respectively. Multilocus sequence typing analyses revealed that the 2 most significant clonal lineages in pork production chain in Korea were ST398 (n = 25) and ST541 (n = 6). All of the 40 MRSA isolates were further characterized to investigate key genotypic and phenotypic correlates associated with the emergence and spread of clonal complex 398 (CC398; ST398, and ST541) LA-MRSA. Although the prevalence of swine-associated MRSA was still relatively low and mostly restricted to pig farms, multidrug-resistant CC398 LA-MRSA isolates with new spa types (t18102 and t18103) were identified as a major clonal lineage. The CC398 LA-MRSA strains tended to exhibit increased levels of multiple drug resistance (MDR) phenotype compared with non-CC398 MRSA strains. Of note, in comparison with non-CC398 MRSA isolates, CC398 LA-MRSA isolates exhibited significantly enhanced tetracycline (TET) and zinc resistance. These findings suggested that co-selection pressure associated with MDR phenotype, especially TET resistance, and zinc resistance may have played a significant role in the emergence and persistence of CC398 LA-MRSA in pig farms in Korea.

• 대한화상학회지
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• 제23권2호
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• pp.31-36
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• 2020

Purpose: Scar contracture influence the outcome of burn patients significantly. This study aims to investigate the feasibility of robot-assisted training for the lower extremity rehabilitation of burn patients. Methods: This pilot study was conducted on 7 burn patients for 8 weeks between January 2019 and November 2019. Two of 7 patients withdrew from this study because one had skin abrasion on the legs which thigh fastening devices were applied on and the other was not participate in the assessment at 4 weeks after training. Final 5 patients received gait training with SUBAR^® and numeric rating scale (NRS), 6-minutes walking test, and range of motion in flexion and extension of knee and ankle joint were evaluated before training, 4 weeks and 12 weeks after training. Results: The subjects had a mean age of 51.8±98 years, mean total burn surface area of 30.8±13.7%, mean duration from injury to 1^st assessment of 102.8±39.3 days. Anyone of 5 patients did not have musculoskeletal or cardiovascular side effects such as increased or decreased blood pressure or dizziness. The significant improvement in NRS, gait speed, and range of motion in knee extension and ankle plantarflexion after robotic training (all P<0.05). Conclusion: Robot-assisted training could be feasible for the rehabilitation of burn patients and it could improve muscle strength and range of motion in lower extremities, and gait function.

• 한국전문물리치료학회지
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• 제29권4호
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• pp.269-273
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is used for muscle strengthening. While voluntary muscle contraction follows Henneman et al.'s size principle, the NMES-induced muscle training disrespects the neurophysiology, which may lead to unwanted changes (i.e., declined balance ability). Objects: We examined how the balance was affected by abdominal muscle training with the NMES. Methods: Fifteen young adults (10 males and 5 females) aged between 21 and 30 received abdominal muscle strengthening with NMES for 23 minutes. Before and after the training, participants' balance was measured through one leg standing on a force plate with eyes open or closed. Outcome variables included mean distance (MDIST), root mean square distance (RDIST), total excursion (TOTEX), mean velocity (MVELO), and 95% confidence circle area (AREA) of center of pressure data. Two-way repeated measures analysis of variance was used to test if these outcome variables were associated with time (pre and post) and vision. Results: All outcome variables were not associated with time (p > 0.05). However, all outcome variables were associated with vision (p = 0.0001), and MVELO and TOTEX were 52.4% (45.5 mm/s versus 95.6 mm/s) and 52.4% (364.1 mm versus 764.5 mm) smaller, respectively, in eyes open than eyes closed (F = 55.8, p = 0.0005; F = 55.8, p = 0.0005). Furthermore, there was no interaction between time and vision (F = 0.024, p = 0.877). Conclusion: Despite the different neurophysiology of muscle contraction, abdominal muscle strengthening with NMES did not affect balance.

• 한국산업융합학회 논문집
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• 제25권4_2호
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• pp.637-644
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• 2022

In this study, the flow characteristics according to the shape of the vortex nozzle was studied by numerical analysis and the amount of microbubble generation was measured experimentally. The shape of the vortex nozzle is cylindrical, diffuser, and conical type. The axial fluid velocity in the induced tube gradually increased from the inlet to the outlet. In particular, the fluid velocity in the nozzle part increased rapidly. The velocity distribution of the fluid at the inlet of the induced tube showed that the flow rotates counterclockwise in the outer region and the inner center of the induced tube. At the outlet of the induced tube, the cylindrical and conical type showed rotational flow, and the diffuser type showed irregular turbulent flow. The dimensionless pressure ratio 𝜂 of the inner region of the induced tube was lower than that of the outer region. Also, 𝜂 near the outlet of the induced tube in cylindrical and conical type showed a similar tendency to the inlet area. At the outer region of inlet of induced tube, intense vorticity was observed on the wall and in lower region. At the inner region of inlet of induced tube, intense vorticity was observed on the inner wall of the induced tube and in the central region of the inlet of the induced tube. At the outlet of induced tube, in the case of the cylindrical and conical type, intense vorticity was observed near the inner wall, the diffuser type showed irregular strong vorticity inside the tube. The total number of bubbles measured was the most in the cylindrical type, and the microbubbles less than 50mm occurred the most in the conical type.

• Clinical and Experimental Pediatrics
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• 제65권3호
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• pp.142-149
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• 2022

Background: Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. Purpose: This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. Methods: We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. Results: A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. Conclusion: The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.187-193
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.7-17
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• 2023

Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

• 국제학술발표논문집
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• The 2th International Conference on Construction Engineering and Project Management
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• pp.642-652
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• 2007

Many contracting firms and project managers in the construction industry have started to utilize multi objective optimization methods to handle multiple conflicting goals for completing the project within the stipulated time and budget with required quality and safety. These optimization methods have increased the pressure on decision makers to search for an optimal resources utilization plan that optimizes simultaneously the total project cost, completion time, and crashing cost by considering indirect cost, contractual penalty cost etc., practically charging them in terms of direct cost of the project which is fuzzy in nature. This paper presents a multiple fuzzy goal programming model (MFGP) that supports decision makers in performing the challenging task. The model incorporates the fuzziness which stems from the imprecise aspiration levels attained by the decision maker to these objectives that are quantified through fuzzy linear membership function. The membership values of these objectives are then maximized which forms the fuzzy decision. The problem is solved using LINGO 8 optimization solver and the best compromise solution is identified. Comparison between solutions of MFGP, fuzzy multi objective linear programming (FMOLP) and multiple goal programming (MGP) are also presented. Additionally, an interactive decision making process is developed to enable the decision maker to interact with the system in modifying the fuzzy data and model parameters until a satisfactory solution is obtained. A case study is considered to demonstrate the feasibility of the proposed model for optimization of project network parameters in the construction industry.