• Title/Summary/Keyword: 치료 선호도

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The Effect of Symmetrical and Asymmetric Bilateral Training for Chronic Stroke Patients in Upper Extremity Recovery (만성 뇌졸중 환자의 대칭적, 비대칭적 양측성 상지훈련의 상지기능회복 효과)

  • Kim, Sun Ho;Han, Dae Sung
    • Therapeutic Science for Rehabilitation
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    • v.6 no.1
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    • pp.35-43
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    • 2017
  • Objective : To identify the effect of symmetrical and asymmetric bilateral training For stroke patients in upper extremity recovery. Methods : 15 patients with stroke, randomized to an in- phase group(n =7) and anti-phase group(n =8). Each groups received symmetrical and asymmetric bilateral training, 30-min sessions per a day for 5 weeks, total 20 session.Accelerometer was used to evaluate the amount used for both groups. Y-BAT was used to evaluate performance status and satisfaction, ARAT was used to evaluate hand function. Results : the amount used of symmetrical movement training showed significant changes in affected and unaffected side. asymmetric bilateral training. there is a significant difference in affected side before and after receiving asymmetric bilateral training. Also, There was a significant difference between the groups on the affected side. Both training, there was no significant difference in performance, satisfaction, and upper limb function between group but, there was significant differences within-groups, Conclusions : Symmetric training showed higher motor performance than asymmetric training, but, To obtain a clearer difference, it would be necessary to use a neuromuscular assessment tool such as fMRI. Also, need a clearer training protocol and the need for follow-up studies on more stroke patients is suggested.

The Effects of Simultaneous Application of Peripheral Nerve Sensory Stimulation and Task-Oriented Training to Improve Upper Extremity Motor Function After Stroke: Single Blinded Randomized Controlled Trial (뇌졸중 환자의 상지기능 개선을 위한 말초감각신경자극과 과제 지향적 훈련의 동시 적용 효과: 단일 맹검 무작위대조군실험)

  • Kim, Sun-Ho;Won, Kyung-A;Jung, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.9 no.4
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    • pp.7-20
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    • 2020
  • Objective : This study aimed to investigate the effect of simultaneous application of peripheral nerve sensory stimulation and task-oriented training on the improvement of upper extremity motor function after stroke. Methods : This study included 29 patients with hemiplegia. The 14 subjects were in the peripheral nerve sensory stimulation and task-oriented training group for 4 weeks (30 min/d, 5 d/wk), while the 15 control group subjects underwent only task-oriented training for the same duration. The outcome measures were the percentage of voluntary baseline muscle contractions of the wrist and shoulder and Box and Block Test, grip and pinch strength, and Action Research Arm Test. Results : After 4 weeks, muscle activity of extensor carpi radialis, flexor carpi radialis and grip strength and Action Research Arm Test were significantly higher in the experimental group. Conclusion : Simultaneous application of the peripheral nerve sensory stimulation and task-oriented training was found to be superior to task-oriented training for improving upper extremity motor function of adults with stroke.

프레스다이용 코일스프링의 신뢰성평가 및 고장분석 사례 발표

  • Go, Se-Hyeon;Park, Sang-Yong;Jang, Jin-Man;Lee, Won-Sik
    • Proceedings of the Korean Reliability Society Conference
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    • 2006.05a
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    • pp.239-246
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    • 2006
  • 프레스다이용 코일스프링은 자동차 및 전자제품의 외형생산에 필요한 금형 내에 장착되는 금형용 스프링으로서 녹아웃 및 스트리퍼 등에 사용되고 있다. 프레스다이용 코일스프링이 사용 중 파손 시에는 고가인 금형의 손상 및 생산성에 영향을 미칠 수도 있기 때문에 사용 환경에서의 신뢰성확보가 요구되어지고 있다. 특히 중(重)하중 및 극중(極重)하중용 스프링은 과거 현장에서 파손사례가 자주 발생함으로 인해 외산을 선호하는 경향이 있는 형편이다. 이에 국산 스프링의 신뢰성검증 및 확보를 위해 신뢰성기반구축사업을 통해 신뢰성평가기준(RS D 0014)가 제정되었으며, 이 평가기준에 의거하여 국내 업체의 제품에 대해 신뢰성평가를 실시하였다. 프레스다이용 코일스프링의 파손원인은 주로 반복하중에 의한 피로파손과 일정한 변위의 변형으로 발생하는 코일스프링 자유높이의 축소로 크게 구분되어질 수 있다. 시험결과 주 파손양상은 피로에 의한 균열발생이었으며, 코일 끝단부와 끝단부 직하부의 코일과의 마찰에 의한 균열발생이 주원인이었다. 즉, 코일의 끝단면과 직하면 코일이 연속적으로 부딪침으로써 발생한 변형 및 마모에 의해 표면균열이 발생하고, 표면균열에서 반복적인 부하하중이 가해짐으로써 피로균열 진전을 통해 점차적으로 파손이 진행되어졌음을 알 수 있었다. 본 발표에서는 기준에 의거하여 로하중용 프레스 다이용 코일스프링을 평가한 신뢰성평가시험 결과에 대해 보고하고, 파단면 관찰과 외산제품과의 미세조직 및 조성 등의 비교분석결과 등을 기초로 파손원인을 분석한 결과에 대해 보고하고자 한다.제고할 수 있을 것으로 기대한다.X>$CdCl^+,\;CdSO_4$ 등이 형성되었다. 수은의 경우는 해수 및 증류수를 용출용매로 이용한 모든 경우에서 납, 구리, 카드뮴과는 달리 대부분 침전하였다. 더욱이 해수에 존재하는 고농도 염소($Cl^-$)와의 수착으로 인해 finite solid인 calomel($Hg_2Cl_2$)이 형성되어 대부분 침전(SI=0)되기 때문에 납, 구리, 카드뮴 보다 더 낮은 환경이동성을 갖을 것으로 사료된다. 상기 실험결과 용출용매로 증류수와 해수를 이용했을 때, 제강 슬래그에서 용출되는 납, 구리, 카드뮴, 수은의 용출 경향의 차이를 확인할 수 있었고 이에 따라서, 납, 구리, 카드뮴의 용출 유해성은 낮기 때문에 해양구조물로의 제강슬래그 유효이용은 적합할 것으로 판단되었다.im80%$로 계산되었다. 열형광선량계로 측정된 방사선량은 각각 1.8, 1.2, 0.8, 1.2, 0.8 (70 cm 거리) cGy로 측정되었으며, 환자의 복부 표면에서의 서베이메터를 이용한 측정량은 10.9 mR/h였다. 차폐구조물의 사용 시 전체 치료 동안에 태아선량은 약 1 cGy 정도로 평가되었다. 결론 : AAPM Report No.50의 자료에 따르면, 임산부의 방사선 치료 시 태아의 방사선 피폭선량은 5 cGy 이하일 경우에 방사선 피폭에 따른 태아의 위험이 거의 없는 것으로 제시되고 있다. 본원에서 차폐 구조물을 설치하였을 경우에 측정된 태아선량은 약 1 cGy로 측정되었고, 고안된 차폐구조물

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국가에너지원으로서 가스산업의 위치 및 향후전망

  • 김호경
    • THE INDUSTRY AND TECHNOLOGY OF GAS
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    • v.2 no.1
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    • pp.6-21
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    • 1998
  • 에너지는 인류문명발달의 원동력이며 현대 산업사회에서는 모든 산업활동과 국민경제에 필수적인 요소이므로 세계 거의 모든 나라들은 에너지의 안정확보를 국가정책의 제 1로 삼고 있다. 세계적으로 볼 때 시대의 변천에 따라 에너지의 주역도 바뀌어 산업혁명 후 제2차 세계 대전까지는 석탄이 주역이었고, 2차대전 후 1970년대 석유위기 전까지는 석유가 단연 주역이었다가 석유위기 후 1980년대는 천연가스와 원자력이 상당부문 석유를 대체하고 있으며, 21세기에는 가스이용기술의 개발에 따라 편리성과 경제성에서 가스의 우월성으로 타에너지를 대체하고, 특히 지구온난화방지 노력과 관련하여 전세계적인 $CO_2$ 감축 목표에 따라 청정연료로서 타에너지 보다 사용이 크게 늘어 2010년까지는 1995년의 $50\%$가 증가하여 21세기 연료의 주역이 될 것으로 전망된다. 우리나라는 에너지의 $98\%$를 외국에서 도입하는 상황에서 석유의존도가 $60\%$를 넘고 있으며, 원자력발전소의 확장에 어려움이 많고 세계기후변화협약을 비준한 국가로서 지구온난화방지를 위한 의무를 지게 될 것이므로, 에너지 공급원의 다원화를 통한 안정확보와 청정에너지 이용의 확대 및 에너지 산업에 대한 규제완화 등으로 경제성에 입각한 시장경쟁에서 가스는 우위를 확보함으로써 1차 에너지중 가스의 비중이 매우 높아질 것으로 전망되고있다. 따라서 가스산업은 우리나라 에너지산업중 가장 크게 발전하고 또 다른 에너지가 여러면에서 제약을 받게 될 때 이러한 제약을 극복하는 대체에너지로서 역할이 크게 전망되며, 특히 발전, 열병합, 냉방, 자동차 연료부문에서의 사용이 크게 늘어날 것으로 예상되어 이러한 가스이용의 확대에 대비하여 가스자원의 개발, 국내 공급설비의 확충, 연구개발등에 대한 투자와 규제완화에 의한 시장경쟁에 대한 대비가 필요하다.계산모델 및 원자력병원에서 보유하고 있는 방사선 치료계획장치인 CAP-PLAN의 선량계산모델의 계산 결과와 비교하여, 흡수선량은 ${\pm}10\%$ 이내에서 거리로는 0.4mm 이내에서 대부분 일치하였다. 최대 오차는 각각 $11.3\%$ 및 0.8mm로 나타났다. 이상의 결과들로부터 새로 개발한 금으로 된 기구와 Ir-192 seed를 이용한 근접 방사선 치료법으로 안구의 악성종양에 대한 치료를 보다 효과적으로 시행할 수 있을 것으로 기대된다. 구성원을 간소 목적을 위하여 사용할 수 있어야 하겠다 마지막으로 이들 내의 위험 집단을 우선적으로 파악. 접근하여야 할 것이다. 위험 집단으로는 경제적 문제로 적절한 의료 이용을 할 수 없는 저소득층, 문화적으로 열등한 위치에 있는 여성층과 초기 이민 적응에 가장 문제를 일으킬 소지가 있는 노년층을 들 수 있겠다. 이 연구는 몇 가지 제한점을 가진다. 첫째. 연구 대상자 선정이 어려워서 자원자를 대상으로 연구가 행해졌다. 둘째. 적은 수의 연구 대상자를 대상으로 연구가 행해졌다. 셋째. 연구기간이 짧았던 까닭에 좀더 상세한 사례 연구가 이루어질 수 없었다 좀 더 신뢰할 수 있는 표본 추출 방법을 통하여 선정된, 많은 연구 대상자를 가지고, 심도 있는 연구가 추후 반복적으로 이루어져야 할 것이다.더욱 더 발전을 거듭하고 있으며, 외식은 여행과 여가 활동의 필수적인 요소로써 그 역할을 일조하고 있다. 이와 같은 여가시간의 증가는 독신자들에게는 좀더 많은 여유시간을 가족을 이루고 있는 가족구성원들에게는 가족과의 유대를 강화하는 휴식과 오락의 소비 트렌드를 창출시켰다. 이와 더불어 외식은 식사를 해결하기 위한 단순한 수단에서 벗어나 동기와 동반자에 따라 달라지는 행동 패턴을 나타내고 있으며, 연령과 목적에 따라 세분화되는 분명한 선호도를 나타낸다. 지난 10여 년간 외국으로부터 수입된 다양한

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YM155 Induces Apoptosis through Downregulation of Anti-apoptotic Proteins in Head and Neck AMC-HN4 Cells (YM155 처리에 의한 두경부 암 AMC-HN4 세포 세포자멸사 유도 효과)

  • Chang, Ho Joon;Kwon, Taeg Kyu;Kim, Dong Eun
    • Journal of Life Science
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    • v.29 no.3
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    • pp.318-324
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    • 2019
  • Squamous cell carcinoma is the primary tumor type in head and neck cancers, the fifth most common malignant neoplasm world-wide. Survivin, a member of the inhibitor of apoptosis family, is highly expressed in head and neck carcinoma patients and correlated with more aggressive forms. In this study, we investigated whether YM155, a specific survivin inhibitor, could induce apoptosis in head and neck AMC-HN4 cells. YM155 was found to markedly induce apoptosis and cleavage of PARP, a marker of apoptosis. Furthermore, YM155 promoted apoptosis in other cancer cells, such as glioma (U251MG) and renal carcinoma (Caki) cells. In contrast, YM155 had no effect on apoptosis in normal mesangial cells. YM155 significantly induced caspase activation, and pan caspase inhibitor z-VAD-fmk markedly blocked apoptosis, PARP cleavage, and caspase-3 cleavage. Therefore, YM155 was seen to instigate caspase-dependent apoptosis in head and neck AMC-HN4 cells, inducing downregulation of survivin as well as other apoptotic proteins such as c-FLIP and Mcl-1. In addition, the induction of apoptosis and PARP cleavage by YM155 treatment was effectively inhibited in survivin-, c-FLIP- and Mcl-1-over-expressing head and neck AMC-HN4 cells. In conclusion, YM155 is a potent candidate for inducing cell death in head and neck AMC-HN4 cells.

Risk Factors in Stability after Immobilization of the Distal Radius in Unstable Fractures in Children (소아 요골 원위부 불안정 골절의 캐스트 후 안정성에 영향을 미치는 요소)

  • Shin, Yong-Woon;Sohn, Jong Min;Park, Sang-Yoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.215-223
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    • 2021
  • Purpose: Distal radius fractures in youth are treated conservatively in most cases, but there are some cases of redisplacement in the follow-up period after cast immobilization, even after complete reduction. This study examined the risk factors of redisplacement in reduced unstable distal radius fractures. Materials and Methods: From February 2011 to June 2018, 44 unstable distal radius fractures were managed with a closed reduction and cast immobilization. The patients were aged between 6 and 14 years. The cases of redisplacement were analyzed with the fracture characteristics (fracture obliquity, fracture level ratio, ulnar fracture combined), cast qualities (gap index, cast index, 3 point index, and radius-2nd metacarpal angle) and host factors (age, sex). Results: The mean angulation in the union was 9.2° (0°-32.8°). In the categorical grouping 29 cases were within 10° angulation, and 15 cases were more than 10°. No significant differences in the factors of the cast indices or host factors were noted. The meaningful factor was the fracture level calculated by the relative width of the fracture site divided by the sum of width of diaphysis and epiphysis (p=0.001) and combined ulnar fracture (p=0.019). Conclusion: Unstable distal radius fractures should be treated with more stubborn guidelines lest the fracture loses its anatomical alignment. In particular, in patients with less remodeling power, operative treatment would secure a better result if the fracture occurs in a more proximal location.

The Normative Study of the Montreal Cognitive Assessment-Korea (MoCA-K) as Instrument for Screening of Mild Cognitive Impairment (MCI) (경도인지장애 선별검사로서 Montreal Cognitive Assessment-Korea (MoCA-K)의 규준 연구)

  • Kwak, Ho-Soung;Kim, Sun-Ho
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.37-45
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    • 2021
  • Purpose : This study aimed to present normative data and cut-off points for older Korean adults completing the Montreal Cognitive Assessment - Korean (MoCA-K), which is used as a screening test for mild cognitive impairment in Korea. Methods : A total of 195 healthy adults ≥60 years were recruited. All participants completed the MoCA-K and the Korean - Mini-Mental State Examination (MMSE-K) to assess their cognitive function. Participants were divided into six groups based on their age: 60-64 years, 65~69 years, 70~74 years, 75~79 years, 80~84 years, and 85~89 years. Results : The results revealed that MoCA-K score decreased significantly with age (mean score ± standard deviation [SD]; 27.63±2.80 in subjects aged 60~64 years; 27.00±2.39 in subjects aged 65~69 years; 24.94±2.96 in subjects aged 70~74 years; 24.74±3.37 in subjects aged 75~79 years; 22.59±4.72 in subjects aged 80~84 years; and 18.83±5.38 in subjects aged 85~89 years; p<.001). Additionally, MoCA-K score also increased significantly with educational level (mean score±standard deviation [SD]; 19.95±4.78 in no formal education group; 24.95±2.22 in elementary school graduated group; 26.35±2.72 in middle school graduated group; 28.32±1.36 in high school graduated group; and 28.50±1.51 in more than college graduated group; p<.001). The optimal cut-off points were 24/25 for 60~69 years old group, 21/22 for 70~79 years old group, 17/18 for 80~84 years old group, and 13/14 for 85~89 years old group. The optimal cut-off points were 15/16 for individuals who were illiterate, 22/23 for individuals with 6 years of education, 22/24 for individuals with 9 years of education, and 26/27 for individuals with 12 or more years of education. Conclusions : This study presents normative data and cut-off points for the MoCA-K in older Korean adults. This data will facilitate more accurate detection and follow-up of the risk of mild cognitive impairment in this population, taking into consideration age and education. Future studies are required that should focus on the cut-off score on the level of education according to age.

A study of post-operative changes in facial height and width of mandibular prognathic patients (하악전돌증 환자의 수술후 안모길이 및 폭경의 변화에 관한 연구)

  • Kim, Eun-Joo;Moon, Cheol-Hyun
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.367-375
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    • 2000
  • If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.

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A STUDY ON THE MAXIMUM BITE FORCE AND FACIAL MORPHOLOGY ACCORDING TO CHEWING SIDE PREFERENCE (저작습관에 따른 교합력과 안면골격형태의 비교연구)

  • Jeong, Mi-Ra;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.25 no.3 s.50
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    • pp.311-321
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    • 1995
  • This study was undertaken to investigate the distribution of the chewing side preference and variations in the maximum bite force and facial morphology according to chewing side preference since unilateral chewing may cause morphologic and functional anomalies. 50 dental students who had no signs or symptoms of masticatory system and Angle's Class I relationship in posterior segments were selected, and divided into two groups, that is, 25 in bilateral chewing group(19 male and 6 female) and 25 in unilateral chewing group(10 male and 15 female). Maximum bite force was estimated ana posteroanterior cephalogram were measured ana statistically analyzed. The results were as follows : 1. Their were more students with bilateral chewing side preference($68\%$) and unilateral chewing side group consisted of right side preference($68\%$) and left side preference($32\%$). 2. There was no significant difference in the strength of max. bite force between the right and left side in bilateral chewing group. The bite force of the chewing side nab greater in the unilateral chewing group but less in the non-chewing side compared to those of bilateral chewing group with Bo significant difference. Max. bite force of chewing side was greater than that of non-chewing side in the unilateral chewing group(Female p<0.05). Max. bite force of males was about twice in that of females in both groups(p<0.05). Max. bite force of chewing side of the unilateral chewing group was similar to that of the bilateral chewing group, but that of non-chewing side was less than that of the bilateral chewing group. 3. In comparison of the facial morphology, there was no statistically significant difference in the size between the right and left side of the bilateral chewing group and between chewing and non-chewing side of the unilateral chewing group.

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A Study for the Certified Security Certification in Private Security Industry in Korea (민간경비 자격제도에 관한 연구)

  • Ahn, Hwang-Kwon
    • Korean Security Journal
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    • no.11
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    • pp.159-181
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    • 2006
  • This study is concerned on Why The Certified Security certification is needed and How to control the security quality to get better service to the clients. Theses days are required The Certified Certificate in all the industry. And in this point of view, the certified certificate is a kind of confirmation by an authority to the person who has how much special knowledge and practice in a certain field. Moreover, in the functionalism society the certified certificate system would be very positive effect to the related industry and society as official measurement by an authority. The security is freedom from fear and anxiety. Which means the security can not be operated in isolation from citizen's safe-living expectation, and which is also dealing with valuable human being's life. For getting the better purpose the security industry employees should have more organized special training and education. As my understanding the certified certificate exam system is the confirmation by an authority, the certified certificate is only neutral evidence to get the confidence and credit from the clients. In this point of view the core point is How to control The Certified Certificate by a credied authority.

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