Background: The PyeongChang 2018 Winter Paralympic Games (WPG) being one of the most successful Paralympic Games (PG) in modern athletic world history, hosted the largest number of elite athletes representing 49 National Paralympic Committees (NPCs). Objects: The present investigation highlighted the demographic and clinical characteristics of injured athletes and non-athletes and the physiotherapy services provided during the PyeongChang 2018 WPG. Methods: Prospective descriptive epidemiology study, in which the study group comprised of 201 participants (51 athletes and 150 non-athletes) who were admitted to and utilized the polyclinic physiotherapy service of 2018 PyeongChang WPG in Physiotherapy Department of Paralympic Village from March 1, 2018 to March 20, 2018. Results: Qualitative frequency analysis of injury type demonstrated highest number of chronic injuries (51%, n = 100) in athletes and non-athletes. Anatomical injury site analysis revealed that the spine and shoulder areas were affected with equal frequency for athletes (54.9%, n = 14), whereas for non-athletes, the frequencies of spine and shoulder area injuries were 36.7% (n = 55) and 26% (n = 39), respectively. The Pyeongchang WPG showed a high rate of athletes visiting the physiotherapy service during the pre-competition period (33.3%, n = 50), which may have led to smaller incidence rate of traumatic injury. The physiotherapy treatment service analysis demonstrated that manual therapy (35.4%, n = 230) was most commonly utilized, followed by transcutaneous electrical nerve stimulation/interference current therapy (TENS/ICT), therapeutic massage and therapeutic exercise. Conclusion: We established the importance of prophylactic and preventive physiotherapy services to reduce the risk of sports injuries during WPG.

Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson’s correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson’s correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

Background: The oxygen uptake efficiency slope (OUES) is the most important index for accurately measuring cardiopulmonary function in patients with acute ischemic heart disease. However, the relationship between the OUES variables and important cardiopulmonary function parameters remain unelucidated for patients with acute ischemic heart disease, which accounts for the largest proportion of heart disease. Objects: The present cross sectional clinical study aimed to determine the multiple relationships among the cardiopulmonary function variables mentioned above in adults with acute ischemic heart disease. Methods: A convenience sample of 110 adult inpatients with ischemic heart disease (age: 57.4 ± 11.3 y; 95 males, 15 females) was enrolled at the hospital cardiac rehabilitation center. The correlation between the important cardiopulmonary function indicators including peak oxygen uptake (VO2 peak), minute ventilation (VE)/carbon dioxide production (VCO2) slope, heart rate recovery (HRR), and ejection fraction (EF) and OUES was confirmed. Results: This study showed that OUES was highly correlated with VO2 peak, VE/VCO2 slope, and HRR parameters. Conclusion: The OUES can be used as an accurate indicator for cardiopulmonary function. There are other factors that influence aerobic capacity besides EF, so there is no correlation with EF. Effective cardiopulmonary rehabilitation programs can be designed based on OUES during submaximal exercise in patients with acute ischemic heart disease.

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson’s correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856–0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.

This study was carried out to investigate the management characteristics and growth performance of L. edodes from the cooling stage to incubation. Bags of different heights and weights are available for bagging. When the medium size of 17x13 cm was used and the size of the inoculation hole was changed from 1/3 to 2/3, the browning period was shortened to 30 days. Mycelial growth was evaluated according to the cooling temperature after sterilization. It was observed to be the highest at 122 mm/15 days at 10 °C and 114 mm/15 days and 117 mm/15 days at 15 °C and 20 °C, respectively. The contamination rate of the sawdust media before inoculation was measured as 0, 4.5x10, 1.3x102, 4.0x103 cfu at 5 °C, 10 °C, 15 °C, and 24 °C respectively. The average of 1.6x108 colony forming units (cfu) of microorganisms was observed in the sawdust that had been piled for six months outdoors. In summer, the sawdust has to be used immediately after mixing. The sterilized medium had an average of 4x103 cfu of microorganisms at 24 °C and 1.3×102 cfu at 15 °C. After 15 days of inoculation in vitro, the growth conditions of the sawdust was the best at 132 mm, followed by grain and liquid. When inoculated with liquid spawn, the moisture content of the substrate should be adjusted between 50% and 55% in advance.

Biological efficiency (BE), the ratio of fresh mushrooms harvested per dry substrate weight, expressed as the percentage of Lentinula edodes, also known as shiitake, was determined using the ‘Sanjo 701’ strain stored in the Department of Mushroom at the Korea National College of Agriculture and Fisheries. The mycelia were grown in glass columns with varying levels of moisture content and varying mixing periods of 0.5, 1, 2, and 3 hours. The substrate was sterilized using a steam pressure autoclave sterilizer at normal and high pressure to avoid contamination. The results showed that mycelial growth (126 mm/15 days) was optimized at 55% moisture content. The best mycelial growth of 117 mm/15 days was obtained with 2 hours of mixing time. Normal pressure sterilization yielded better results with mycelial growth of 96 mm/15 days at 100°C compared to 88 mm /15 days with sterilization at 121°C. Mycelial density was higher, i.e. 3(+++), with normal pressure sterilization compared to 2(++) with high pressure sterilization. Furthermore, sawdust mixed with 5% woodchips increased the substrate porosity and yielded higher mycelial growth. Thus, we demonstrated that the optimum harvest or potential increased yield of shiitake can be obtained by modulating moisture content, mixing time, and substrate porosity.

This study was carried out to investigate the management characteristics and techniques by comparing and analyzing the process of mixing, sterilization, cooling, inoculation and incubation for bag cultivation of L. edodes. The medium was sterilized after mixing it for 30 minutes, 1 and 2 hours respectively. The general moisture content of the sawdust substrate has been adjusted to 65%, while the case of the L. edodes substrate was 55%. Only 5% of wood chips of 5-8 mm in particle size were mixed to secure the space of the sawdust particles. As a result, mycelial growth was 1.4cm faster and the density was better(+++) than control(++). Wood chips are soaked in advance for a week during winter and 4 days during summer. There is an average number of 1.6x108 (cfu) of microorganisms in the sawdust that has been piled for six months outdoor. In summer, it has to be used immediately after mixing sawdust. High-pressure sterilization should be performed to use as a mushroom spawn, and to improve physical properties, it was great to sterilize the medium at a normal-pressure. There are height and width type for bags to be consumed for bagging. When the height was reduced into 17cm and the width was increased into 13cm, the browning period was shortened by 30 days and the period of mycelial growth was shortened by 25 days. The sterilized medium had an average of 4x103(cfu) of microorganisms at 25°C and 1.3×102 (cfu) at 15°C. After 25 days from inoculation in vitro, the growth condition of sawdust was the best with 13.2 cm, followed by grain spawn and liquid respectively. When inoculated with liquid spawn, the moisture content of substrate should be adjusted to 55% to 50% in advance.

This study has been conducted on the subjects of eight undergradu˗ ate students with abdominal obesity and eight undergraduate stu˗ dents with normal weight to find out correlation between substantial fatigue and Ratings of perceived exertion through analysis of their blood components when they took exercises to strengthen their abdominal muscular power. Comparatively analyzing HDL-C, LDL-C and lactic acid before and after they took sit-up at level of RPE 19-20, no statistically significant differences in HDL, LDL, lactic acid meas˗ ures were observed between groups, but a significant difference in RPE was noted between groups(p<0.05) Our findings suggest that control group showed no significant differ˗ ence in increase of fatigue material whereas the obese group showed a lower frequency of sit-up, though both groups took the same abdominal exercise. Additionally, the lower frequency of sit-up in obese group results from relatively higher Ratings of perceived exer˗ tion rather than increase of substantial fatigue material. This study invites future research that examines the effect of a comprehensive obesity exercise program combined with dietetic

Highly homogeneous and functional stem cell-derived hepatocyte-like cells (HLCs) are considered a promising option in the treatment of liver disease and the development of effective in vitro toxicity screening tool. However, the purity of cells and expression and/or activity of drug metabolizing enzymes in stem cell-derived HLCs are usually too low to be useful for clinical or in vitro applications. Here, we describe a highly optimized differentiation protocol, which produces more than 90% albumin-positive HLCs with no purification process. In addition, we show that hepatic enzyme gene expressions and activities were significantly improved by generating three-dimensional (3D) spheroidal aggregate of HLCs. The 3D differentiation method increased expressions of nuclear receptors that regulate the proper expression of key hepatic enzymes. Furthermore, a significantly increased hepatic functions such as albumin and urea secretion were observed in 3D hepatic spheroids and HLCs in the spheroid exhibited morphological and ultrastructural features of normal hepatocytes. Importantly, we show that repeated exposures to xenobiotics facilitated the functional maturation of HLC, as confirmed by increased expression of genes for drug metabolizing enzymes and transcription factors. In conclusion, the 3D culture system with repeated exposures to xenobiotics may be a new strategy for enhancing hepatic maturation of stem cell-derived HLCs as a cell source for in vitro high-throughput hepatotoxicity models.

Hepatocyte-like cells (HLCs) derived from human pluripotent stem cells have received extensive attention in the development of drug screening and toxicity testing. However, it has been reported that stem cell-derived HLCs showed hepatic functions that were too limited to be of use in drug screening and toxicity testing, possibly due to the lack of sufficient intercellular communication under conventional two-dimensional (2D) culture conditions. Therefore, a 3D differentiation system may overcome the in vitro limitation of 2D culture to produce stem cell-derived hepatocytes with mature metabolic functions. In this study, the feasibility of using a silicone-based spherofilm, specifically designed to produce spherical cell clusters, to generate uniformly sized 3D hepatic spheroids from hESCs was investigated. Hepatic spheroids generated on the spherofilm showed more homogenous size and shape than those generated in conventional low-attachment suspension culture dishes. Results of immunohistochemical analysis showed that expression of the mature hepatic marker albumin (ALB) increased over time during the hepatic maturation process. Furthermore, the 3D culture system mimicked the in vivo 3D microenvironment. Laminin, which is an important component of hepatic ECM, was expressed in hepatic spheroids. The results of immunohistochemical analysis indicated that the 3D culture environment is capable of generating an in vivo-like microenvironment. In addition, quantitative PCR analysis showed that the mature hepatic marker ALB and cytochrome P450 (CYP) enzymes CYP3A4 and CYP3A7 were expressed at higher levels in 3D culture than in 2D culture. This indicates that the 3D culture system is suitable for hepatic maturation and that our size-controlled 3D culture conditions might accelerate hepatic function. These results suggest that 3D hepatic spheroids significantly enhance metabolic maturation of hepatocytes derived from hESCs