• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.109-128
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• 2021

Objective : The purpose of this study was to develop a Korean version of the Activities of Daily Living (ADL)-focused Occupation-Based Neurobehavioral Evaluation (A-ONE) through cross-cultural adaptation and examine its validity and reliability. Methods : This study translated the A-ONE into Korean and performed cross-cultural adaptation for the Korean population. After the development of the Korean version of the A-ONE, cross-cultural and concurrent validities were analyzed. Internal consistency, test-retest reliability, and inter-rater reliability were also evaluated. Results : We adapted three items to the Korean culture. The Korean version of the A-ONE showed high cross-cultural validity with a content validity index (I-CVI) >0.9. It correlated with the Functional Independence Measure (FIM) (r=0.52-0.77, p<0.001), except for communication. Cronbach's α was 0.58-0.93 for the functional independence scale (FI) and 0.42-0.93 for the neurobehavioral specific impairment subscale (NBSIS). Intraclass correlation coefficients (ICCs) indicated high test-retest and inter-rater reliability for FI (ICC=0.79-1.00 and 0.75-1.00, respectively) and NBSIS (ICC=0.74-1.00 and 0.72-1.00, respectively). Conclusion : The Korean version of the A-ONE is well adapted to the Korean culture and has good validity and reliability. It is recommended to evaluate ADL performance skills and neurobehavioral impairments simultaneously in Korea.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.130-137
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• 2010

Objectives: So far it has been reported that acupuncture increases cerebral blood supply and stimulates the functional activity of brain nerve cells. Previous studies have demonstrated that frequently used electro-acupuncture (EA) therapies for stroke increased regional cerebral blood flow (rCBF) in normal volunteers. Though ST 36-ST 41 EA is another prevailing therapy for stroke, there had been no report about its effect on rCBF. This study was to evaluate the effect of ST 36-ST 41 EA on rCBF in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc$-ECD brain SPECT scans were performed on 10 normal volunteers (5 males, 5 female, mean age $23.6{\pm}0.5$ years). On the other study day, 7 days after the resting examination, 15 minutesEA were applied at ST 36 and ST 41 on the right side of the subjects. Immediately after ST36-ST41 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by SPM with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: EA applied at the right ST36-ST41 significantly increased rCBF in the right inferior parietal lobule (Brodmann area [BA] 40), right retrosubicular area (BA 48), left inferior parietal lobule (BA 40), left middle temporal gyrus (BA 21), left fusiform gyrus (BA 37), left inferior parietal lobule (BA 39), left inferior temporal gyrus (BA 20), and left somatosensory association cortex (BA 7). However, right ST36-ST41 EA significantly decreased rCBF in the right parahippocampal gyrus (BA 35), right cerebellum, left frontopolar area (BA 10), left orbitofrontal area (BA 11), left dorsolateral prefrontal cortex (BA 9), and left dorsal anterior cingulate cortex (BA 32). Conclusions: These results demonstrate that rightST36-ST41 EA increased rCBF prominently in both inferior parietal lobule (BA 40) and right retrosubicular area (BA 48), which suggest that there be correlation between specific EA and corresponding rCBF.

• Journal of Biomedical Engineering Research
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• v.33 no.1
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• pp.39-46
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• 2012

Electrical impedance tomography(EIT) can produce functional images with conductivity distributions associated with physiological events such as cardiac and respiratory cycles. EIT has been proposed as a clinical imaging tool for the detection of stroke and breast cancer, pulmonary function monitoring, cardiac imaging and other clinical applications. However EIT still suffers from technical challenges such as the electrode interface, hardware limitations, lack of animal or human trials, and interpretation of conductivity variations in reconstructed images. We improved the KHU Mark2 EIT system by introducing an EIT electrode interface consisting of nano-web fabric electrodes and by adding a synchronized biosignal measurement system for gated conductivity imaging. ECG and respiration signals are collected to analyze the relationship between the changes in conductivity images and cardiac activity or respiration. The biosignal measurement system provides a trigger to the EIT system to commence imaging and the EIT system produces an output trigger. This EIT acquisition time trigger signal will also allow us to operate the EIT system synchronously with other clinical devices. This type of biosignal gated conductivity imaging enables capture of fast cardiac events and may also improve images and the signal-to-noise ratio (SNR) by using signal averaging methods at the same point in cardiac or respiration cycles. As an example we monitored the beat by beat cardiac-related change of conductivity in the EIT images obtained at a common state over multiple respiration cycles. We showed that the gated conductivity imaging method reveals cardiac perfusion changes in the heart region of the EIT images on a canine animal model. These changes appear to have the expected timing relationship to the ECG and ventilator settings that were used to control respiration. As EIT is radiation free and displays high timing resolution its ability to reveal perfusion changes may be of use in intensive care units for continuous monitoring of cardiopulmonary function.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.734-740
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• 2003

Increasing interest in the use of arterial conduits is based on the better patency of left internal thoracic artery (LITA) than that of saphenous vein (SV) graft and radial artery (RA) is emerging as one of them. We compared the early result of coronary artery bypass grafting (CABG) using UTA and RA (RA group) with CABG using UTA and SV only (SV group). Material and Method: We compared the early operative results of 45 cases in RA group with 45 cases in SV group selected from 165 cases who had CABG between January 2000 and December 2002. The two groups had similar profiles of age, sex, NYHA functional class, left ventricular ejection fraction and coronary angiographic anatomy. We analysed each group on the preoperative risk factors and operative results. Result: There were no statically signigicant difference between groups in operative mortality and each morbidities (stroke, IABP insertion, perioperative MI), respectively. However, the overall incidence of mortality and morbidities was lower in RA group compared to SV group (p < 0.05). RA group (2.93$\pm$0.62 days) had shorter duration of ICU stay than SV group (3.55$\pm$0.95 days) (p<0.001). The patency on postoperative coronary angiography at 7∼14 days after operation in RA group patients were 100% of LITA and RA and 94.9% of SV. Conclusion: We had better early operative results in RA group compared with SV group.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1996.04a
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• pp.19-29
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• 1996

The neurological manifestations of AIDS include dementia, encountered even in the absence of opportunistic superinfection or malignancy. The AIDS Dementia Complex appears to be associated with several neuropathological abnormalities, including astrogliosis and neuronal injury or loss. How can HIV-1 result in neuronal damage if neurons themselves are only rarely, if ever, infected by the vitus\ulcorner In vitro experiments from several different laboratiories have lent support to the existence of HIV- and immune-related toxins. In one recently defined pathway to neuronal injury, HIV-infected macrophages/microglia as well as macrophages activated by HIV-1 envelope protein gp120 appear to secrete excitants/neurotoxins. These substances may include arachidonic acid, platelet-activating factor, free radicals (NO - and O$_2$), glutamate, quinolinate, cysteine, cytokines (TNF-${\alpha}$, IL1-B, IL-6), and as yet unidentified factors emanating from stimulated macrophages and possibly reactive astrocytes. A final common pathway for newonal suscepubility appears to be operative, similar to that observed in stroke, trauma, epilepsy, and several neurodegenerative diseases, including Huntington's disease, Parkinson's disease, and amyotrophic lateral sclerosis. This mechanism involves excessive activation of N-methyl-D-aspartate (NMDA) receptor-operated channels, with resultant excessive influx of Ca$\^$2+/ leading to neuronal damage, and thus offers hope for future pharmacological intervention. This chapter reviews two clinically-tolerated NMDA antagonists, memantine and nitroglycerin; (ⅰ) Memantine is an open-channel blocker of the NMDA-associated ion channel and a close congener of the anti-viral and anti-parkinsonian drug amantadine. Memantine blocks the effects of escalating levels of excitotoxins to a greater degree than lower (piysiological) levels of these excitatory amino acids, thus sparing to some extent normal neuronal function. (ⅱ) Niuoglycerin acts at a redox modulatory site of the NMDA receptor/complex to downregulate its activity. The neuroprotective action of nitroglycerin at this site is mediated by n chemical species related to nitric oxide, but in a higher oxidation state, resulting in transfer of an NO group to a critical cysteine on the NMDA receptor. Because of the clinical safety of these drugs, they have the potential for trials in humans. As the structural basis for redox modulation is further elucidated, it may become possible to design even better redox reactive reagents of chinical value. To this end, redox modulatory sites of NMDA receptors have begun to be characterized at a molecular level using site-directed mutagenesis of recombinant subunits (NMDAR1, NMDAR2A-D). Two types of redox modulation can be distinguished. The first type gives rise to a persistent change in the functional activity of the receptor, and we have identified two cysteine residues on the NMDARI subunit (#744 and #798) that are responsible for this action. A second site, presumably also a cysteine(s) because <1 mM N-ethylmaleimide can block its effect in native neurons, underlies the other, more transient redox action. It appears to be at this, as yet unidentified, site on the NMDA receptor that the NO group acts, at least in recombinant receptors.

• The Journal of Internal Korean Medicine
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• v.35 no.1
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• pp.24-36
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• 2014

Objectives : This study was performed to evaluate the effects of moxibustion on cerebral blood flow, peripheral blood flow and blood pressure. Methods : We designed a randomized, cross-over study that included 20 healthy, male volunteers who were randomly assigned to one of two groups (the moxibustion group or the control group). The initial trial was followed by a washout period of one week before the groups were switched and the trial repeated. The cerebral blood flow and peripheral blood flow of the volunteers in both groups were measured by mean velocity (Vm), peak systolic velocity (Vs), pulsatility index (PI), perfusion units (PU) and mean blood pressure (BP) before the intervention (baseline), 30 minutes after the intervention, and again 60 minutes after the intervention. Results : 1. The Vm increased significantly in the moxibustion group. The Vs also constantly increased in moxibustion group, but there was no significant difference. 2. The PI decreased significantly in the control group at 0-30 minutes and in the moxibustion group at 30-60 minutes. 3. The PU constantly decreased in moxibustion group. In control group, the PU decreased at 30 minutes and increased slightly at 60 minutes. 4. The mean blood pressure did not show any significant difference between the two groups. Conclusions : This study shows that moxibustion at CV12 increased the cerebral blood flow. Based on this result, we can suggest that moxibustion at CV12 might be helpful in improving the functional recovery of stroke patients. However, further research needs to be conducted on a larger numbers of subjects in order to confirm these effects.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.294-300
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• 2011

This study was performed to examine the presence of dysphagia and analyze characteristics of the symptoms in cerebrovascular accident(CVA) patients without awareness of dysphagia. A questionnaire for this study was given to CVA patients who had visited P rehabilitation medical center in Busan. Eleven patients (4 males and 7 females) who answered no awareness of dysphasia were given to VFSS, functional dysphasia scale, and NCSE. Descriptive statistics and Pearson correlation analysis were performed by SPSS 12.0. All of subjects without awareness of dysphasia showed characteristics of dysphasia symptoms. Prominent dysfunctions were problems in oral phase and delay of swallowing reflex in pharyngeal phase. For the aspect of cognition, they showed lower score in construction, memory, and similarity than other NCSE items. There was highly significant correlation between orientation, judgment and delay of swallowing reflex. Verbal comprehension and residual materials in oral cavity showed closed correlation. CVA patients without awareness had dysphagia with high probability. The early evaluation of dysphagia should be performed in CVA patients in order to prevent complications due to CVA, so it is necessary to increase the effectiveness of rehabilitation therapy.

• 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.

• Science of Emotion and Sensibility
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• v.19 no.1
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• pp.31-38
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• 2016

The brain and muscles both of which are composed of top-down structure occur the connectivity with the change of Electroencephalogram(EEG) and Electromyogram(EMG). In this paper, we studied the difference of functional connectivity between brain and muscles that by applying coherence method to EEG and EMG signals when users exercised upper limb with and without the movement intention. The changes in the EEG and EMG signals were inspected using coherence method. During the upper limb exercise, the mu (8~14 Hz) and beta (15~30 Hz) rhythms of the EEG signal at the motor cortex area are activated. And then the beta and piper (30~60 Hz) rhythms of the EMG signal are activated as well. The result of coherence analysis between EEG and EMG showed the coefficient of active exercise including movement intention is significantly higher than passive exercise. The coherence relations between cognitive response and muscle movement could interpret that the connectivity between the brain and muscle appear during active exercise with movement intention. The feature of coherence between brain and muscles by the status of movement intention will be useful in designing the rehabilitation system requiring feedback depending on the users' movement intention status.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.3
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• pp.645-661
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• 2009

The water extract of Dohongsamul-Tang(DHSMT) has been traditionally used to stroke and brain injuries in Oriental Medicine. The present study was designed to investigate the effects of DHSMT on the gene expression profile of cerebral infarction by cDNA microarray in photothrombotic ischemia mouse model. Photothrombotic ischemia was induced in stereotactically held male BALB/c mice using rose bengal and cold light. MRI was performed 24 hours after inducing photothrombosis using 1.5 T MRI and 47 mm surface coil to obtain T2-weighted, and contrast-enhanced images. After MRI test, animal was sacrificed and the brain sections were stained for hematoxylin and eosin and immunohistochemistry. MRI and histological analysis revealed that lesion of thrombotic ischemia was well induced in the cortex with the evidence of biological courses of infarction. The target area of thrombotic infarction was 1 mm anterior to bregma and 3 mm lateral to midline with 2 mm in diameter, which were decreased by administration of DHSMT. To assess gene expression pattern of cerebral infarction, mRNA was isolated and reacted with microarray chip(Agilant's DNA Microarray 44K). Scatter and MA plot analysis were performed to clustering of each functional genes. M value [M=log2(R/G), A={log2(R ${\times}$ G)}/2] was between -0.5 and +0.5 with 40% difference. After pretreatment with DHSMT, the expression levels of mRNA of many genes involved in various signaling pathway such as apoptosis, cell cycle, cell proliferation, response to oxidative stress, immune response, angiogenesis, and inflammatory cytokine were markedly inhibited in photothrombotic ischemia lesion compared to the control group. These results suggest that DHSMT prevent ischemic death of brain on photothrombotic ischemia model of mice through modulation of gene expression at the transcriptional level.