• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.85-123
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• 2004

Back ground : Subcutaneous fat area is the main factor involved in replacement disease and arteriosclerosis. Simple weight control is the appropriate medical treatment. It's understood that weight reduction does not only reduce the fat concentrations in blood but also reduces blood pressure, improves glucose levels in diabetes patients and reduces incidents of heart disease. there are several methods for reducing fat in the abdominal region but their effectiveness is not folly understood. one method is electrical stimulation of the problem areas. Method : From May 1st 2002 to October 31st. The 15 subjects who received medical examination were aged between 25 and 53 and were of mixed gender. The subjects were divided into two groups one to received functional electrical stimulation and the other a control group. Using Broca's criterion for judging fat grades. I analysed the differences between the two groups before and after the treatment. Subjects received functional electrical stimulation on the abdominal muscle intensity 50Hz. They received this treatment 4 days a week for 40 minutes a day. In the case of aerobic exercise, at the Treadmill, we used it with the intensity of $75\%$ maximum heart rate (220-age). Result 1)After functional electrical stimulation in the case of male subjects, the weight was reduced 1.93kg, obesity $2.60\%$, fat mass 2.73kg, Percent body fat $4.40\%$, waist circumference 6.53cm, circumference of hips 5.53cm. On the other side, the quality of muscle was increased at the rate of 1.03kg, but it's not attentional level. The subcutaneous fat area was reduced by $26.63cm^2$, the visceral fat area was reduced by $43.00cm^2$, In the female subjects, we can see the reduction of fat grade by $26.63cm^2$, the quantity of body fat by 1.5kg, percent body fat by $1.77\%$, circumference of waist by 4.02cm, circumference of hips by 3.67cm, weight by 1.40kg but was increased 0.72kg at the quantity of muscles. We can see the reduction also in the subcutaneous fat area $24.03cm^2$, the visceral fat area by $25.36cm^2$. 2)After aerobic exercise, on the male subjects, we can see reduction of weight by 3.36kg, obesity by $4.00\%$, fat mass by 2.83kg and we can see increase at the soft lean mass by 2.96kg, but we can see reduction, the percent body fat by $3.03\%$, fat distribution by $0.023\%$, circumference of waist by 3.10cm, circumference of hips by 2.23cm. The female subjects show a reduction in the weight by 2.48kg, percent body fat by $2.20\%$, show an increase in the soft lean mass by 1.54kg. We can see a reduction in the quantity of fat mass by 2.32kg, the percent body fat by $2.80\%$, the circumference of waist by 2.16cm, the circumference of hips by 2.68cm, the fat distribution by $0.016\%$, the subcutaneous fat area by $15.25cm^2$ the visceral fat area by $11.52cm^2$. After aerobic exercise, we can't see the attentional change at the total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. 3)After the application of functional electrical stimulation and aerobic exercise, in result of measurement on the body ingredient, we could see the weight reduction and increase the quantity of muscle with the male group who exercised aerobic. We can see the attentional rate on the electrical stimulation about abdominal fat rate, circumference of waist, circumference of hips. The other hand, I couldn't see the attentional differences between the two groups in the rate of fatness and quantity of body fat and the rate of body fat. There isn't any attentional difference in the area of fat under skin, on the contrary, There is attentional difference in the fat in the internal organs area at the electrical stimulation site. We can't see the attentional change of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol between electrical stimulation and aerobic exercise. 4)After execution of functional electrical stimulation and aerobic exercise, in result of measurement on change of body ingredient among female objects, We could see weight reduction, increase at muscle quantity in the aerobic exercise group. We could see the attentional differences in the rate of fatness, the rate of abdominal region, the circumference which received electrical stimulation. But, we couldn't see the attentional differences between two groups in the quantity of body fatness, the circumference of hips. The subcutaneous fat area doesn't show the attentional differences. On the Contrary, we could see lots of differences in the visceral fat area of the electrical stimulation group. Conclusion The results show that functional electrical stimulation and aerobic exercise have insignificant differences when if comes to total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. Though there is affirmative change in body ingredient after both electrical stimulation and aerobic exercise. Functional electrical stimulation is more effective on the subcutaneous fat area and in changing visceral fat area. There fore. It is concluded that the physical therapy is more effective in the treatment of abdominal fatness.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.56-78
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• 1998

Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.379-388
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• 1994

Background : In sleep apnea syndrome, arterial oxygen saturation($SaO_2$) decreases at a variable rate and to a variable degree for a given apneic period from patient to patient, and various kinds of cardiac arrythmia are known to occur. Factors supposed to affect arterial oxygen desaturation during apnea are duration of apnea, lung voulume at which apnea occurs, and oxygen consumption rate of the subject. The lung serves as preferential oxygen source during apnea, and there have been many reports related with the influence of lung volume on $SaO_2$ during apnea, but there are few, if any, studies about the influence of oxygen consumption rate of an individual on $SaO_2$ during breath holding or about the profile of arterial oxygen resaturation after breathing resumed. Methods : To investigate the changes of $SaO_2$ and heart rate(HR) during breath holding(BH) and rebreathing(RB) and to evaluate the physiologic factors responsible for the changes, lung volume measurements, and arterial blood gas analyses were performed in 17 healthy subjects. Nasal airflow by thermistor, $SaO_2$ by pulse oxymeter and ECG tracing were recorded on Polygraph(TA 4000, Gould, U.S.A.) during voluntary BH & RB at total lung capacity(TLC), at functional residual capacity(FRC) and at residual volume(RV), respectively, for the study subjects. Each subject's basal metabolic rate(BMR) was assumed on Harris-Benedict equation. Results: The time needed for $SaO_2$ to drop 2% from the basal level during breath holding(T2%) were $70.1{\pm}14.2$ sec(mean${\pm}$standard deviation) at TLC, $44.0{\pm}11.6$ sec at FRC, and $33.2{\pm}11.1$ sec at RV(TLC vs. FRC, p<0.05; FRC vs. RV, p<0.05). On rebreathing after $SaO_2$ decreased 2%, further decrement in $SaO_2$ was observed and it was significantly greater at RV($4.3{\pm}2.1%$) than at TLC($1.4{\pm}1.0%$)(p<0.05) or at FRC($1.9{\pm}1.4%$)(p<0.05). The time required for $SaO_2$ to return to the basal level after RB(Tr) at TLC was not significantly different from those at FRC or at RV. T2% had no significant correlation either with lung volumes or with BMR respectively. On the other hand, T2% had significant correlation with TLC/BMR(r=0.693, p<0.01) and FRC/BMR (r=0.615, p<0.025) but not with RV/BMR(r=0.227, p>0.05). The differences between maximal and minimal HR(${\Delta}HR$) during the BH-RB manuever were $27.5{\pm}9.2/min$ at TLC, $26.4{\pm}14.0/min$ at RV, and $19.1{\pm}6.0/min$ at FRC which was significantly smaller than those at TLC(p<0.05) or at RV(p<0.05). The mean difference of 5 p-p intervals before and after RB were $0.8{\pm}0.10$ sec and $0.72{\pm}0.09$ sec at TLC(p<0.001), $0.82{\pm}0.11$ sec and $0.73{\pm}0.09$ sec at FRC(p<0.025), and $0.77{\pm}0.09$ sec and $0.72{\pm}0.09$ sec at RV(p<0.05). Conclusion Healthy subjects showed arterial desaturation of various rates and extent during breath holding at different lung volumes. When breath held at lung volume greater than FRC, the rate of arterial desaturation significantly correlated with lung volume/basal metabolic rate, but when breath held at RV, the rate of arterial desaturation did not correlate linearly with RV/BMR. Sinus arrythmias occurred during breath holding and rebreathing manuever irrespective of the size of the lung volume at which breath holding started, and the amount of change was smallest when breath held at FRC and the change in vagal tone induced by alteration in respiratory movement might be the major responsible factor for the sinus arrythmia.