• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.169-174
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• 2017

Purpose: The purpose of this study was to resolve, in an efficient manner, the mechanoreceptor problems of the part far from the paretic upper extremity in stroke patients, as well as to provide clinical basic data of an intervention program for efficient neurodynamic in stroke patients, by developing a rhythmic neurodynamic exercise program and verifying functional changes depending on the increase in the upper extremity nerve conduction velocity. Methods: Samples were extracted from 18 patients with hemiplegia, caused by stroke, and were randomly assigned to either the experimental group I for the general upper extremity neurodynamic (n=9) and the experimental group II for rhythmic upper extremity neurodynamic (n=9). An intervention program was applied ten times per set (three sets one time) and four times a week for two weeks (once a day). As a pre-test, changes in the upper extremity nerve conduction velocity and functions were assessed, and two weeks later, a post-test was conducted to re-measure them in the same manner. Results: The wrist and palm sections of the radial nerve and the wrist and elbow sections of the median nerve, as well as the wrist, lower elbow, upper elbow, and axilla sections of the ulnar nerve had significant differences with respect to the upper extremity nerve conduction velocity between the two groups (p<0.05)(p<0.01), and significant differences were also found in the upper extremity functions (p<0.05). Conclusion: Rhythmic neurodynamic accelerated the nerve conduction velocity more in broader neural sections than the general neurodynamic. In conclusion, rhythmic neurodynamic was proven to be effective for improving the functions of upper extremity.

• Physical Therapy Korea
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• v.27 no.2
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• pp.126-132
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• 2020

Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, as does the effect of augmented somatosensory feedback on muscle co-contraction. Objects: We compared postural sway and ankle muscle co-contraction without feedback (control) and with either of two forms of somatosensory feedback (AFOs and vibration). Methods: We recruited 15 healthy subjects and tested them under three feedback conditions (control, AFOs, vibration) with two sensory conditions (eyes open, or eyes closed and the head tilted back), in random order. Postural sway was measured using a force platform; the mean sway area of the 95% confidence ellipse (AREA) and the mean velocity of the center-of-pressure displacement (VEL) were assessed. Co-contraction of the tibialis anterior and gastrocnemius muscles was measured using electromyography and converted into a co-contraction index (CI). Results: We found significant main effects of the three feedback states on postural sway (AREA, VEL) and the CI. The two sensory conditions exerted significant main effects on postural sway (AREA and VEL). AFOs reduced postural sway to a level significantly lower than that of the control (p = 0.014, p < 0.001) or that afforded by vibration (p = 0.024, p < 0.001). In terms of CI amelioration, the AFOs condition was significantly better than the control (p = 0.004). Vibration did not significantly improve either postural sway or the CI compared to the control condition. There was no significant interaction effect between the three feedback conditions and the two sensory conditions. Conclusion: Lower-extremity devices such as AFOs enhance somatosensory perception, improving postural control and decreasing the CI during static standing.

• International Journal of Vascular Biomedical Engineering
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• v.3 no.2
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• pp.1-9
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• 2005

Flow-induced dilation of blood vessel is the result of a series of bioreaction in vascular endothelial cells(VEC). Shear stress change by blood flow in human artery or vein is sensed by the mechanoreceptor and responsible for such a chain reaction. The inositol(1,4,5)-triphophate($IP_3$) is produced in the first stage to elevate permeability of the intercellular membrane to calcium ions by which the cytosolic calcium concentration is consequently increased. This intracellular calcium transient triggers synthesis of EDRF and prostacyclin. The mathematical model of this VEC calcium dynamics is reproduced from the literature. We then use the Computational Fluid Dynamics(CFD) technique to investigate the blood stream dictating the VEC calcium dynamics. The pulsatile blood flow in a stenosed blood vessel is considered here as a part of study on thrombogenesis. We calculate the pulsating shear stress (thus its temporal change) distributed over the stenosed artery that is implemented to the VEC calcium dynamics model. It has been found that the pulsatile shear stress induces larger intracellular $Ca^{2+}$ transient plus much higher amount of EDRF and prostacyclin release in comparison with the steady shear stress case. It is concluded that pulsatility of the physiological shear stress is important to keep the vasodilation function in the stenosed part of the blood vessel.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.233-236
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• 2006

Merkel cell carcinoma is rare skin malignancy originated from epidermal mechanoreceptor of neural origin. The tumor usually affects older individuals at sun exposed area such as head, neck and extremity. Subclinical involvement of regional lymph node is reported frequently at the time of initial treatment. Thus even asymptomatic patients who present with clinically localized tumor should undergo evaluation with computed tomography and lymphangiography. Positron emission tomography(PET) scans can imaging the metabolic difference of malignant tumors. Increased glucose uptake of malignant tumor cells are detected by PET scanner. PET scans can provide qualitative and quantitative informations about systemic metastasis of tumors. Although there are no data that define the efficacy of PET scans in the initial diagnostic evaluation of head and neck cancer, they could be considered. Current standards of treatment of Merkel cell carcinoma is wide surgical excision and regional lymphadenectomy if there are suspicious lymph nodes. The author reported a patient with Merkel cell carcinoma of cheek. Wide surgical excision and postoperative PET/CT was done for evaluation of regional lymph node and distant metastasis. There were two hot-uptakes in patient's neck, so they were considered as metastatic node, but finally they were proved to be tuberculosis lymphadenitis after excision.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.21-28
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• 2015

Background: The purpose is to investigate the immediate effects of kinesio taping on quadriceps induced fatigue by short-term squat. Methods: This research is cross-over designed study and conducted as a single-blind. Eleven students (Age: $18.91{\pm}0.49yrs$, height: $167.09{\pm}8.46cm$, $62.55{\pm}11.32kg$) were participated in this study. All the participants were applied short-term squat for inducing fatigue, and then intervented all three conditions (kinesio taping applied condition, placebo taping applied condition, non-taping applied condition). The interval of each intervention was at least a seven days to prevent carry-over effects. The participants were tested peak torque (isometric contracture) and active joint position sense (active JPS) pre-post intervention. A paired t-test was used to find the significance of pre-post intervention results and one-way ANOVA was used to find the significance between interventions with significant level as .05. Results: Peak torque was significantly increased on KT condition (p<.05). But there were no significant effects on active JPS. Because kinesio taping facilitates Ia afferent by tactile stimulation with stretched skin, reduced muscle power by short term squat which induce muscle fatigue was increased. But kinesio taping does not affect mechanoreceptor in muscles, induced active JPS by short-term squat had no changes.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.171-188
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• 2011

Objectives : The aim of this study is to analyze the actual investigation and classification of osteopathic manipulation by investigation of the various literature of the inside and outside of the country, and to present the application plan of osteopathy in chuna manual therapy for meridian sinew system. Methods : I referred to the domestic and foreign books about osteopathy and chiropractic. In order to investigate domestic dissertations, I searched 4 Korean medical databases and 4 Korean medical journals of osteopathy. Search terms used were osteopathy, osteopathic, fascia, proprioreceptor, mechanoreceptor, muscle spindle, golgi tendon organ, osteopathic manipulation technics. And I classified all the searched studies into principle and region and etc. In order to investigate foreign dissertations, I search 'NCBI pubmed'. Search terms used were osteopathy, osteopathic technique, osteopathic manipulative technique. Results : 1. Osteopathy do not regard the systems which compose the human body in individual territory, but regard whole. It is diagnosis, prevention and medicine which treats 2. Osteopathic manipulation techniques are classified into direct techniques, indirect techniques, and compound techniques. 3. Osteopathic manipulation techniques are classified into fascia, muscle, ligament-joint in applied region. 4. I could search clinical cases in domestic and foreign study. I found cases about myofascial release technique(MFR), postisometric relaxation(PIR), proprioceptive neuromuscular fascilitation(PNF), muscle energy technique(MET), joint mobilization in domestic studies, and strain-counterstrain technique(SCS), MET, AK in foreign studies. Conclusions : Osteopathic manipulation techniques can be used in diagnosis and treatment of meridian muscle theory, because osteopathy and the oriental medicine have many similarities in theoretical background. So osteopathic manipulation technique can be useful in oriental medicine treatment techniques.

• Sleep Medicine and Psychophysiology
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• v.6 no.1
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• pp.19-25
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• 1999

Sleep alters both breathing pattern and the ventilatory responses to external stimuli. These changes during sleep permit the development or aggravation of sleep-related hypoxemia in patients with respiratory disease and contribute to the pathogenesis of apneas in patients with the sleep apnea syndrome. Fundamental effects of sleep on the ventilatory control system are 1) removal of wakefulness input to the upper airway leading to the increase in upper airway resistance, 2) loss of wakefulness drive to the respiratory pump, 3) compromise of protective respiratory reflexes, and 4) additional sleep-induced compromise of ventilatory control initiated by reduced functional residual capacity on supine position assumed in sleep, decreased $CO_2$ production during sleep, and increased cerebral blood flow in especially rapid eye movement(REM) sleep. These effects resulted in periodic breathing during unsteady non-rapid eye movement(NREM) sleep even in normal subjects, regular but low ventilation during steady NREM sleep, and irregular breathing during REM sleep. Sleep-induced breathing instabilities are divided due primarily to transient increase in upper airway resistance and those that involve overshoots and undershoots in neural feedback mechanisms regulating the timing and/or amplitude of respiratory output. Following ventilatory overshoots, breathing stability will be maintained if excitatory short-term potentiation is the prevailing influence. On the other hand, apnea and hypopnea will occur if inhibitory mechanisms dominate following the ventilatory overshoot. These inhibitory mechanisms include 1) hypocapnia, 2) inhibitory effect from lung stretch, 3) baroreceptor stimulation, 4) upper airway mechanoreceptor reflexes, 5) central depression by hypoxia, and 6) central system inertia. While the respiratory control system functions well during wakefulness, the control of breathing is commonly disrupted during sleep. These changes in respiratory control resulting in breathing instability during sleep are related with the pathophysiologic mechanisms of obstructive and/or central apnea, and have the therapeutic implications for nocturnal hypoventilation in patients with chronic obstructive pulmonary disease or alveolar hypoventilation syndrome.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.29-35
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• 2005

Purpose: The anterior cruciate ligament(ACL) has a neuromuscular control function as evidenced by the presence within it of mechanoreceptor. Although these mechanoreceptors have been identified, the afferent somatosensory pathways from ACL to the cerebrum have yet to be demonstrated in their entirety. In order to trace these afferent pathway, we conducted a viral trans-synaptic tracing experiment using the neurotropic pseudorabies virus(PRV). Material and Methods: The PRV was injected into the ACL of rats and allowed to replicate and spread trans-synaptically for 6 to 7 days. The brain and spinal cord of each sacrificed rat was then removed and processed immunohistochemically to detect the presence of PRV. Results: PRV-immunoreactive neurons were found to be localized in several different regions from the spinal cord to the cerebrum. Four nuclei in the reticular formation of the brain stem demonstrated strong positive labeling: the mesencephalic reticular nucleus, magnocelluar reticular nucleus, paragigantocellular reticular nucleus, and gigantocellular reticular nucleus. Conclusions: This findings suggests that the nerve endings of the rat ACL project into the cerebrum and that the reticular formation may play an important role in the afferent pathway of those nerve endings.

• Physical Therapy Korea
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• v.3 no.2
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• pp.95-105
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• 1996

Type I, II, III are regarded as "true" joint receptors, type IV is considered a class of pain receptor. Type I, II and III mechanoreceptors, via static and dynamic input, signal joint position, intraarticular pressure changes, and the direction, amplitude, and velocity of joint movements. Type I mechanoreceptor subserve both static and dynamic physiologic functions. Type I are found primarily in the stratum fibrosum of the joint capsule and ligaments. Type I receptors have a low threshold for activation and are allow to adapt to changes altering their firing frequency. Type II receptors have a low threshold for activation. These dynamic receptors respond to joint movement. Type II receptors are thus termed rapidly adapting. Type II joint receptors are located at the junction of the synovial membrane and fibrosum of the joint capsule and intraarticular and extraarticular fat pads. Type III receptors have been found in collateral ligaments of the joints of the extremities. Morphologically similar to Golgi tendon organ. These dynamic receptors have a high threshold to stimulation and are slowly adating. Type IV receptors possess free nerve ending that have been found in joint capsule and fat pads. They are not normally active, but respond to extreme mechanical deformation of the joint as well as to direct chemical or mechanical irritation. Small amplitude oscillatory and distraction movements(joint mobilization) techniques are used to stimulate the mechanoreceptors that may inhibit the transmission of nociceptors stimuli at the spinal cord or brain stem levels.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.92-98
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• 2007

Purpose: We evaluated the clinical results of arthroscopic ACL reconstruction using quadrupled hamstring tendon with tibial remnant-preserving technique. Materials and Methods: Thirty-five cases were evaluated from Feb, 2003 to May, 2006. The average interval from injury to surgery was $2.6{\pm}1.6$ months. The cause of injury was mostly sports-related trauma. The average follow-up period was 17 months. Tibial remnant was preserved as much as possible and caution was taken not to damage the remnant during ACL reconstruction. Postoperative rehabilitation was the same as the usual rehabilitation method after ACL reconstruction, except for delaying motion for 2 weeks with an extension locking brace. Clinical evaluation was performed using ROM; Lachman test; pivot-shift test; anterior displacement measurement using KT-2000 arthrometer; Lysholm score and proprioception measured by single limb standing test. Results: There was no limitation of knee motion without contracture. The Lachman test and pivot-shift test were both negative. The side-to-side difference of anterior displacement measured using KT-2000 arthrometer was improved from 6.7 mm to 2.2 mm. The average Lysholm score improved from 81 to 96. The single limb standing test for proprioceptive evaluation showed no significant difference from a normal leg. Conclusion: ACL reconstruction with tibial remnant-preserving technique can preserve mechanoreceptors with prorioception and expect good functional recovery.