• Advances in biomechanics and applications
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• v.1 no.4
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• pp.269-277
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• 2014

In skin-marker based motion analysis, knee translation measurement is highly dependent on a pre-selected reference point (functional center) on each segment determined by the location of anatomical landmarks. However, the placement of skin markers on palpable anatomical landmarks (i.e., femoral epicondyles) has limited reproducibility. Thus, it produces large variances in knee translation measurement among different subjects, as well as across studies. In order improve the repeatability of knee translation measurement, in this study an optimization method was introduced, by which the femoral functional center was numerically determined. At that point the knee anteroposterior translation during the stance phase of walking was minimized. This new method was tested on 30 healthy subjects during walking in gait lab with motion capture system. Using this new method, the impact of skin marker position (at anatomical landmarks) on the knee translation measurement has been minimized. In addition, the ranges of anteroposterior knee translations during stance phase were significantly (p<0.001) smaller than those measured by conventional method which relies on a pre-selected functional center ($11.1{\pm}3.5mm$ vs. $19.9{\pm}5.5mm$). The results of anteroposterior translation using this new method were very close to a previously reported knee translation (12.4 mm) from dual fluoroscopic imaging technique. Moreover, this new method increased the reproducibility of knee translation measurement by 50%.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.493-499
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• 2019

Thiamine (vitamin $B_1$) is a water-soluble vitamin that is not endogenously synthesized in humans. It is absorbed by the small intestine, where it is activated. Its active form acts as a coenzyme in many energy pathways. We report a rare case of thiamine deficiency in a 3.5-year old boy with short bowel syndrome secondary to extensive bowel resection due to necrotizing enterocolitis during his neonatal age. The patient was parenteral nutrition-dependent since birth and had suffered from recurrent central catheter-related bloodstream infections. He developed confusion with disorientation and unsteady gait as well as profound strabismus due to bilateral paresis of the abductor muscle. Based on these and a very low thiamine level he was diagnosed and treated for Wernicke encephalopathy due to incomplete thiamine acquisition despite adequate administration. He fully recovered after thiamine administration. After 1999 eight more cases have been reported in the PubMed mostly of iatrogenic origin.

• Korean Journal of Applied Biomechanics
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• v.27 no.1
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• pp.35-43
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• 2017

Objective: The purpose of this study was to determine how gaze angle affects muscle activity and kinematic variables during treadmill walking and to offer scientific information for effective and safe treadmill training environment. Method: Ten male subjects who have no musculoskeletal disorder were recruited. Eight pairs of surface electrodes were attached to the right side of the body to monitor the upper trapezius (UT), rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), bicep femoris (BF), tibialis anterior (TA), medialis gastrocnemius (MG), and lateral gastrocnemius (LG). Two digital camcorders were used to obtain 3-D kinematics of the lower extremity. Each subject walked on a treadmill with a TV monitor at three different heights (eye level; EL, 20% above eye level; AE, 20% below eye level; BE) at speed of 5.0 km/h. For each trial being analyzed, five critical instants and four phases were identified from the video recording. For each dependent variable, one-way ANOVA with repeated measures was used to determine whether there were significant differences among three different conditions (p<.05). When a significant difference was found, post hoc analyses were performed using the contrast procedure. Results: This study found that average and peak IEMG values for EL were generally smaller than the corresponding values for AE and BE but the differences were not statically significant. There were also no significant changes in kinematic variables among three different gaze angles. Conclusion: Based on the results of this study, gaze angle does not affect muscle activity and kinematic variables during treadmill walking. However, it is interesting to note that walking with BE may increase the muscle activity of the trapezius and the lower extremity. Moreover, it may hinder proper dorsiflexion during landing phase. Thus, it seems to reasonable to suggest that inappropriate gaze angle should be avoided in treadmill walking. It is obvious that increased walking speed may cause a significant changes in biomechanical parameters used in this study. It is recommended that future studies be conducted which are similar to the present investigation but using different walking speed.

• Journal of Digital Convergence
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• v.13 no.2
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• pp.381-391
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• 2015

The purpose of this study was to investigate the trends in research on the effects of virtual reality technology applied to rehabilitation for disabled. I have collected 60 papers published in Korea(2000-2014), and analyzed it by the P.I.C.O. method. As a result, adults and the elderly are most common subjects, and projection type has been used frequently in researches. It were included mostly balance, upper extremity function, and gait that the dependent variables represents the intervention effects. I interpreted it as the ICF factors. So, research topics were the most common mobility, in contrast to educational, vocational, recreational area as dealing with the participation area is very small. In the future, we should focused on social aspects for useful intervention in real life of people with disabilities based on virtual reality technology, and virtual reality technology should be easy to apply in terms of cost and accessibility.

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.107-120
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• 2009

Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.

• Physical Therapy Korea
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• v.20 no.4
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• pp.55-64
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• 2013

The first purpose was to identify the plantar pressure distributions (peak pressure, pressure integral time, and contact area) during level walking, and stair ascent and descent in asymptomatic flexible flatfoot (AFF). The second purpose was to investigate whether peak pressure data during level walking could be used to predict peak pressure during stair walking by identifying correlations between the peak pressures of level walking and stair walking. Twenty young adult subjects (8 males and 12 females, age $21.0{\pm}1.7$ years) with AFF were recruited. A distance greater than 10 mm in a navicular drop test was defined as flexible flatfoot. Each subject performed at least 10 steps during level walking, and stair ascent and descent. The plantar pressure distribution was measured in nine foot regions using a pressure measurement system. A two-way repeated analysis of variance was conducted to examine the differences in the three dependent variables with two within-subject factors (activity type and foot region). Linear regression analysis was conducted to predict peak pressure during stair walking using the peak pressure in the metatarsal regions during level walking. Significant interaction effects were observed between activity type and foot region for peak pressure (F=9.508, p<.001), pressure time integral (F=5.912, p=.003), and contact area (F=15.510, p<.001). The regression equations predicting peak pressure during stair walking accounted for variance in the range of 25.7% and 65.8%. The findings indicate that plantar pressures in AFF were influenced by both activity type and foot region. Furthermore the findings suggest that peak pressure data during level walking could be used to predict the peak pressure data during stair walking. These data collected for AFF can be useful for evaluating gait patterns and for predicting pressure data of flexible flatfoot subjects who have difficulty performing activities such as stair walking. Further studies should investigate plantar pressure distribution during various functional activities in symptomatic flexible flatfoot, and consider other predictors for regression analysis.

• Korean Journal of Applied Biomechanics
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• v.28 no.1
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• pp.45-54
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• 2018

Objective: The purpose of this study was to investigate the effect of foot strengthening exercise program and functional insoles on joint angle and plantar pressure in elderly women. Thirteen elderly women who were enrolled in a university senior citizens academy of a metropolitan city in 2017 were divided into two groups: exercise group with functional insole (n=7) and exercise group without functional insole (n=6). Method: Three-dimensional motion analysis and Pedar-X were performed to compute the joint angle and the foot plantar pressure, respectively. Two-way repeated measure ANOVA was conducted to compare dependent variables within and between groups. The significance level was set at ${\alpha}=.05$. Results: The range of motion (ROM) of the ankle, knee, and hip joints in the exercise group with functional insole increased significantly more than the exercise group without functional insole. In both the experimental group and the comparison group, the maximum foot plantar pressure and the mean foot plantar pressure were decreased, but the comparison group without functional insole showed more decrease. Since the experimental group demonstrated greater pressure than the comparison group in the contact area (forefoot, midfoot), it was distributed over a greater area. Conclusion: The results of this study suggest that participation in foot strengthening exercises and using a functional insole has more positive effects than foot strengthening exercises alone on the joint angle and plantar pressure in elderly women. Increased foot plantar pressure led to an increased contact area (forefoot, midfoot) for distribution of the foot plantar pressure, but the effect of reducing the maximum and average plantar pressures was incomplete. However, wearing functional insoles along with exercise, could help in improving the stability of the joints, by increasing the range of motion, and could help the elderly in movement of the muscles more effectively, leading to an improvement in gait function.

• Journal of Sasang Constitutional Medicine
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• v.33 no.3
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• pp.138-145
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• 2021

Objectives Edema occurs in various disorders, such as heart failure, nephrotic syndrome, renal failure, liver cirrhosis, and cancer. The excessive accumulation of interstitial fluid in limb tissue will often manifest with ankle and knee swelling and lowers patient's quality of life. But the conventional treatment includes restricting dietary sodium and using diuretics. The purpose of this study is about significant improvement of a patient with edema who had suffered from dependent gait accompanied by mild pain, after treatment by herbal medicine based on SCM(Sasang constitutional medicine). Methods The pattern identification of the patient was diagnosed with a superficial disease of Taeeumin. So after the admission, Gunyuljejo-tang was used, almost two times per day during 2 weeks. Also, we applied acupuncture routinely every day and western medicine as needed. We measured the circumferences of Lt. thigh and followed up the bioelectrical impedance analysis and checked the appearance of lower limb. Results and Conclusions The therapy was effective, and the circumferences, which was 59.69cm at onset time, decreased to 52.07cm almost same to the healthy side of her thigh. There was no more edematous sign on the body, either. This case showed that management of Taeeumin's healthy energy(呼散之氣, the energy of exhalation) could be effective in treating edema.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.437-448
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• 2018

Objective: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. Methods: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. Results: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. Conclusion: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.

• Toxicological Research
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• v.23 no.2
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• pp.151-158
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• 2007

tert-Butyl acetate is an organic solvent used for coatings, industrial cleaning, and surface treatment applications. This study investigated the potential adverse effects of tert-butyl acetate on pregnant dams and embryo-fetal development after maternal exposure on gestational days 6 through 19 in rats. The test chemical was administered to pregnant rats by gavage at dose levels of 0, 500, 1,000, 1,500, and 2,000 mg/kg/day. All dams were subjected to a caesarean section on day 20 of gestation and their fetuses were examined for any external, visceral, and skeletal abnormalities. At 2,000 mg/kg, treatment-related clinical signs, including piloerection, abnormal gait, decreased locomotor activity, loss of fur, reddish tear, anorexia, nasal discharge, vocalization and coma, were observed in a dose-dependent manner. All dams died between the 2nd day and 5th day of treatment due to a severe systemic toxicity. At 1,500 mg/kg, minimal maternal toxicity including an increase in the incidence of decreased locomotor activity and loss of fur, and an increase in the weights of adrenal glands and liver was observed. On the contrary, no significant adverse effect on the embryo-fetal development was detected. There were no adverse effects on either pregnant dams or embryo-fetal development at <1,000 mg/kg. These results show that a 14-day repeated oral dose of tert-butyl acetate in rats caused a minimal maternal toxicity including increases in the incidence of clinical signs and the weights of adrenal glands and liver, but no embryotoxicity and teratogenicity at 1,500 mg/kg/day. Under these experimental conditions, the no-observed-adverse-effect level (NOAEL) of tert-butyl acetate is estimated to be 1,000 mg/kg per day for dams and 1,500 mg/kg per day for embryo-fetal development.