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천장관절에 적용한 움직임을 동반한 관절가동술이 뇌졸중 환자의 보행에 미치는 효과 (The Effect of Mobilization With Movements Applied Sacro-Iliac Joint on Gait of Stroke Patient)

  • 임현철;공선웅;정연우
    • 대한정형도수물리치료학회지
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    • 제17권1호
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    • pp.45-50
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    • 2011
  • Background: To determine effects of mobilization with movements (MWM) application on stroke patient with hypomobility on sacroiliac joint. Methods: The subject was 47years old male who have left hemiplegia because of right intra-cerebral hemorrhage. The subject was have hypomobility on sacroiliac joint. MWM using during 4weeks and using Berg balance scale (BBS), Timed up and go (TUG), 10meter walking (10MW) test for evaluation. Results: The results of this study were summarized below; BBS score for evaluating balance ability was increased, and TUG time, 10MW test time was decrease. Conclusion: We consider that MWM application on stroke patient with hypomobility on sacroiliac joint is not only regain mobility on sacroiliac joint but also increase in balance ability and walking speed.

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환자 자기결정권과 충분한 정보에 근거한 치료거부(informed refusal): 판례 연구 (Patient's Right of Self-determination and Informed Refusal: Case Comments)

  • 배현아
    • 의료법학
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    • 제18권2호
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    • pp.105-138
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    • 2017
  • 이 글은 환자의 자기결정권에 관한 몇몇 대표적인 판례들을 연혁적으로 검토한 논문이다. 대법원은 과거 음주상태에서 농약을 음독하여 자살을 시도한 환자가 치료를 거부하자 치료를 포기한 의료진에게 특정 의학적 상태(응급상황)에서 의사의 생명보호의무가 환자의 자기결정권 존중보다 우선한다고 판단하여 의료과실을 인정하였다. 이후 대법원은 가족들의 요청에 의해 지속적 식물인간 상태인 환자에게 해당 환자의 의학적 상태(회복불가능한 사망의 단계 등)를 고려하고 환자의 의사를 추정하여 연명의료를 중단하게 하였다. 최근 대법원은 종교적 신념과 관련하여 수혈과 같은 필수적인 치료를 거부한 환자에 대하여 대법원은 환자의 생명 보호에 못지않게 환자의 자기결정권을 존중하여야 할 의무가 대등한 가치를 가지는 것으로 평가할 수 있는 판단 기준을 제시하였다. 인간의 존엄성에 근거한 환자의 자기결정권과 의사의 생명보호의무가 충돌하는 상황에 대하여 연혁적 판례 검토를 통해 법원의 입장이 우리 사회에서 환자의 주체적 역할과 자율성을 존중하는 방향을 반영하여 함께 변화되어 왔음을 확인할 수 있었다. 법원이 생명권이라는 최고의 가치만을 환자의 의사보다 더욱 우선하여 판단해오다가 적어도 명시적인 환자의 의사 또는 그렇지 못할 경우에 추정적 의사까지도 고려한 치료의 유보나 중단에 대하여 고려하기 시작한 것, 종교적 신념에 근거한 자기결정권의 행사로서의 수혈거부와 같은 치료거부에 대하여 충분한 정보에 근거한 치료거부의 몇 가지 적법한 요건들을 인정하기 시작했다는 것은 이후 우리나라 의료 환경에 적잖은 영향을 줄 것이고 의료현장에서 의료행위를 하는 의사들에게도 직 간접적인 지침이 될 것이다.

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제품별 직접구가 흰쥐의 소장수송능에 미치는 영향 (Effects of Different Company's Moxa Cautery on Small Intestinal Motility in Rats)

  • 유윤조
    • 동의생리병리학회지
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    • 제23권6호
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    • pp.1332-1340
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    • 2009
  • Moxa-combustion therapy makes use of heat stimulus and chemicals result form when cauterize the skin with moxa cones to medical cares. Despite an extensive evidence-base guiding the selection of stimulation parameters and attributes of subject, little methodologically research regarding the attributes of moxa cautery in need to provide effective stimulation. To determine moxibustion's effects of the three different moxa cautery made by three different company(as A, B, C), the small intestinal motility in rats were observed after moxibustion at ST36. Under anesthesia, each intensities(1, 5, 10 times), two regions(left and right at ST36) and a quantity(as number of 1, 5, 10 times at once) were applied to the groups divided with sex. In each intensities groups, the A product made increase with 5, 10 times in male and female group. The B and C product made increase with 10 times in male group and the B product made increase with 1, 5, 10 times and the C product made increase with 5 times in female group. In two regions(left and right at ST36) groups, the A and C product made increase with 1(right), 5(right) times and the B product made increase with 1(left), 10(left), 10(right) times in male group. In female group, the A product made increase with 5(left), 5(right), 10(right) times and the B product made increase with 1(left), 10(left), 10(right) times and the C product made increase with 5(left), 10(left) times. In a quantity(as number of 1, 5, 10 times at once) groups, the A and B product did not show any changes but the C product made increase with a quantity of 10 times in male group. In female group, The B product made increase with a quantity of 1 times and the C product made increase with a quantity of 5 times, but the A product did not show any changes. Three different moxa cautery made by three different company made differents result in each group divided with sex. With these results, it was suggested that we should consider the a process of manufacture and moxa cautery's quality for the adequate value of moxibustion.

클럽별 골프 스윙 시 지면 반력 변화에 관한 연구 (A Study of Ground Reaction Forces During Professional Golfer's Swing with Different Golf Clubs)

  • 허유진;문건필;임정
    • 한국운동역학회지
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    • 제15권2호
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    • pp.103-111
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    • 2005
  • The purpose of this study was to analysis golf swing in accordance with each club using ground reaction force data. The subject of this study was current professional golf players in Korea. Golf clubs used for this study were driver, iron4, iron7, and pitching. The ground reaction force for left and right foot was collected by one Kistler and one Bertec force platforms. Also collected visual data by NC high speed camera to check the phase which was composed of address, top of backswing, impact and finish. Sampling rate was 600Hz both ground reaction forces data and visual data. The conclusion are as follows. 1. An aspect of change for ground reaction force was that the weight between the left foot and right foot were contrary to each other in general as the phase. 2. Without regard to the type of golf club, the ratio of necessary ground reaction forces for each phase in accordance with address, top of backswing, impact, and finish was comparatively identical. 3. According to the type of golf club, the tendency of Fy was not varied. In terms of Driver, at the moment of impact, the weight of foot-both right and left-was moved to the movement direction of golf because of the rotation force from swing.

Evaluation of Neuronal Dysfunction in Schizophrenia before and after Neuroleptic Treatment by ??H MRS

  • C, Bo-Young;Paik, In-Ho;Lee, Chang-Uk;Lee, Hyoung-Koo;Suh, Tae-Suk
    • 한국자기공명학회논문지
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    • 제5권1호
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    • pp.56-65
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    • 2001
  • Localized in vivo proton magnetic resonance spectroscopy (MRS) was performed to evaluate metabolic alterations in the right and left frontal lobe before and after neuroleptic treatment of schizophrenic patients (n=24) and a group of healthy normal subjects (n=20). Proton metabolic ratios obtained from the 8㎤ yokels in the right and left frontal lobe were compared with the clinical assessment of PANSS for each subject. There was no significant difference in the metabolic ratios between the right and the left frontal lobes in either the schizophrenic group or the control group, indicating no laterality. Compared with those of the normal control group, NAA/Cr and (GABA+Glu)/Cr ratios of the schizophrenic patients showed significantly lower (p=0.023) and higher (p=0.005) value, respectively. The (GABA+Glu)/Cr ratio of the schizophrenic patients was generally decreased after neuroleptic treatment, while the NAA/Cr ratio was not changed. Significant correlation between the (GABA+Glu)/Cr ratio and the clinical symptom scores assessed by PANSS was established. The present study supports the “hypofrontality” hypothesis of schizophrenia on the basis of the altered metabolic ratios before and after neuroleptic treatment.

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하지의 동역학 모델 (A Dynamic Model of the Human Lower Extremity)

  • 최기영;손권;정민근
    • 대한인간공학회:학술대회논문집
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    • 대한인간공학회 1993년도 춘계학술대회논문집
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    • pp.1-9
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    • 1993
  • A human gait study is required for the biomechanical design of running shoes. A tow-dimensional dynamic model was developed in order to analyze lower extremity kinematics and loadings at the right ankle, knee, and hip joints. The dynamic model consists of three segments, the upper leg, the lower leg, and the foot. Each segment was assumed to be a rigid body with one or two frictionless hinge joints. The lower extremity motion was assumed to be planar in the sagittal plane. A young male subject was involved in the gait test and his anthropometric data were measured for the calculation of segement mass and moment of inertia. The experimental data were obtained from three trials of walking at 1.2m/s. The foot-floor reaction data were measured from a Kistler force plate. The kinematic data were acquired using a three-dimensional motion measurement system (Expert Vision) with six markers, five of which were placed on the right lower extremity segments and the rest one was attached to the force plate. Based on the model and experimental data for the stance phase of the right foot, the calculated vertical forces reached up to 492, 540, and 561 N at the hip, knee, ankle joints, respectively. The flexion-extension moments reached up to 155, 119, and 33 Nm in magnitude at the corresponding joints.

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높은 굽이 균형 수행과 근활성도에 미치는 영향 (The Effects of Shoes Heel Height on EMG and Balance Performance)

  • 김주경;김민정;이성란;오태영
    • 대한물리치료과학회지
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    • 제19권1호
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    • pp.55-62
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    • 2012
  • Objectives : The purpose of this study was to determine the effects of high heeled shoes on the static & dynamic balance performance and electromyography(EMG) of back and lower extremity muscles. Materials & Methods : Sixteen women participated in this study. Subjects were composed two groups with LL shoes group and higher heel shoes group. We carried out Romberg's test and muscle activity of left and right Paraspinalis, Quadriceps femoris, Tibialis anterior, Gastrocnemius muscles by EMG in order to determine static balance performance according heel height. Using by Biorescue(Incenierie company), we trained subject to transfer of COG each direction(Anterior, posterior, Right, Left), we carried out this test for distance, surface, distance/surface in order to determine dynamic balance performance according heel height. The data were analyzed by independent t-test between lower and high heel height using SPSS(ver. 17.0)/PC program. Results : There was significant difference of distance(p<.05) of weight perturbation between lower and high group in dynamic balance performance and EMG value of left Gastrocnemius(p<.05), both Tibialis anterior(p<.05) muscle in static balance performance. Conclusions : Height of heel has effect on dynamic balance performance in distance of the Anterior, posterior direction. EMG of Gastrocnemius and Tibialis anterior muscles were affected by Romberg's test.

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Postero-Anterior Cephalometry를 이용한 안모의 비대칭에 관한 연구 (A RADIOGRAPHIC STUDY ON CRANIOFACIAL ASYMMETRY BY POSTERO-ANTERIOR CEPHALOMETRY)

  • 고재경;김재덕
    • 치과방사선
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    • 제17권1호
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    • pp.249-258
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    • 1987
  • The purpose of this article was to determine the amount of cranio-facial asymmetry in normal subject before the analysis of the cranio-facial asymmetry as the result of internal derangement in T.M.J. dysfunction. The author has conducted analysis using Cephalometric P-A reviews of 54 males and 51 females. Following the Grayson's method of measurement, the standard value of cranio-facial asymmetry in normal subject was obtained. The following results were obtained: 1. Compared with right and left width, asymmetry could be identified in normal subject, although the degree of the difference appears to be small. 2. In male, asymmetric value of contact point of the upper central incisors is 0.76±0.84㎜ that of the lower central incisors is 0.86±0.86㎜, and that of center of genial tubercle is 0.87±1.06㎜. In female, asymmetric value of contact point of the upper central incisors is 1.03±1.29㎜, that of lower incisors is 1.11 ±1.18㎜, and that of center of genial tubercle is 1.45±2.15㎜. 3. Cranio-facial saymmetry in female is somewhat greater than that of male.

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노인 낙상 후 충격량 측정 및 기립여부 판단 시스템 구현 (Development of fall Detection System by Estimating the Amount of Impact and the Status of Torso Posture of the Elderly)

  • 김충현;이영재;이필재;이정환
    • 전기학회논문지
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    • 제60권6호
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    • pp.1204-1208
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    • 2011
  • In this study, we proposed the system that calculates the algorithm with an accelerometer signal and detects the fall shock and it's direction. In order to gather the activity patterns of fall status and attach on the subject's body without consciousness, the device needs to be small. With this aim, it is attached on the right side of subject's waist. With roll and pitch angle which represent the activity of upper body, the fall situation is determined and classified into the posture pattern. The impact is calculated by the vector magnitude of accelerometer signal. And in the case of the elderly keep the same posture after fall, it can distinguish the situation whether they can stand by themselves or not. Our experimental results showed that 95% successful detection rate of fall activity with 10 subjects. For further improvement of our system, it is necessary to include tasks-oriented classifying algorithm to diverse fall conditions.

시각작업의 배경 조건과 8개 Meridian을 고려한 시각영역의 생성 (Generation of Visual Field Considering 8 Meridians and Background Conditions of Visual Tasks)

  • 기도형;김형수;정의승;강동석
    • 대한산업공학회지
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    • 제23권3호
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    • pp.533-544
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    • 1997
  • Among numerous factors that have an effect on visual field, the effects of background condition on the size of the visual field were investigated to obtain more practical visual field that can be readily applicable to industrial settings. A visual experiment was conducted, in which the subject was instructed to search a target with distinct orientations. Size contrast, meridian, nontarget density, and subject's gender showed a significant effect on the size of the visual field at $\alpha=0.01$. The size of the visual field was linearly proportional to size contrast, and inversely proportional to density. Female's visual fields were found to be significantly larger than male subjects', The size of the visual field on horizontal axis was larger than that on vertical axis, and the size of the head & eye field on right meridian was also larger than that on left meridian. The shape was found to be horizontally oriented oval and statistically asymmetric with respect to horizontal and vertical axes. The regression equations to predict the visual fields on the given background condition were suggested. The visual fields suggested in this study would be valuable to the design of visual displays and the panel layout of various displays and controls.

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