• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.355-365
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• 2019

Objectives: In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly. Methods: The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification. Results: A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91). Conclusions: We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.365-370
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• 2019

The syndrome of the trephined is a neurologic phenomenon that manifests as sudden decline in cognition, behavior, and sensorimotor function due to loss of intracranial domain. This scenario typically occurs in the setting of large craniectomy defects, resulting from trauma, infection, and/or oncologic extirpation. Cranioplasty has been shown to reverse these symptoms by normalizing cerebral hemodynamics and metabolism. However, successful reconstruction may be difficult in patients with complex and/or hostile calvarial defects. We present the case of a 48-year-old male with a large cranial bone defect, who failed autologous cranioplasty secondary to infection, and developed rapid neurologic deterioration leading to a near-vegetative state. Following debridement and antibiotic therapy, delayed cranioplasty was accomplished using a polyetheretherketone (PEEK) implant with free chimeric latissimus dorsi/serratus anterior myocutaneous flap transfer for vascularized resurfacing. Significant improvements in cognition and motor skill were noted in the early postoperative period. At 6-month follow-up, the patient had regained the ability to speak, ambulate and self-feed-correlating with evidence of cerebral/ventricular re-expansion on computed tomography. Based on our findings, we advocate delayed alloplastic implantation with total vascularized soft tissue coverage as a viable alternative for reconstructing extensive, hostile calvarial defects in patients with the syndrome of the trephined.

• 디지털융복합연구
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• 제17권1호
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• pp.423-432
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• 2019

본 연구의 목적은 요추 척추관협착증 환자에게 쿠션 인솔을 착용하게 하여서 요추의 유연성과 운동능력에 미치는 영향에 대하여 연구하는 것이다. 요추 척추관협착증이 있는 26명의 환자를 실험군 13명과 대조군 13명으로 무작위로 배치하였다. 참가자들은 6 주간 하루 2 시간 동안 쿠션인솔을 착용하게 하였다. 실험군은 8mm, 대조군은 4mm 쿠션인솔을 맹검법으로 착용하도록 하였다. 실험군의 굴곡능력 검사에서 $3.38{\pm}3.12$의 유의미한 증가(p<0.05)를 보였으나 다른 검사에서는 통계적으로 유의미하지 않았다(p>0.05). 결론적으로 쿠션인솔은 요추 척추관협착증 치료를 위한 중재의 방법으로 적합하지 않았다. 차후에 인솔의 높이나 재질을 다르게 하여 더 연구할 필요성이 있다.

• 대한금속재료학회지
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• 제46권10호
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• pp.672-682
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• 2008

The resistance spot welding of TRIP590 steels was investigated to enhance understanding of weld fracture during tensile-shear strength (TSS) test. The main failure modes for spot welds of TRIP590 steels were nugget pullout and interfacial fracture. The peak load to cause a weld interfacial failure was found to be related to fracture toughness of the weld and the weld diameter. Although interfacial fracture occurred in the samples, the load carrying capacity of the weld was high and not significantly affected by the fracture mode. Substantial part of the weld exhibits the characteristic dimple (or elongated dimple) fractures on interfacial fractured surface, in spite of the high hardness values associated with the martensite microstructures. The high load-bearing ability of the weld is directly associated with the area of ductile fracture occurred in weld. Therefore, the judgment of the quality of resistance spot welds in TRIP590 steels, the load carrying capacity of the weld should be considered as an important factor than fracture mode.

• 대한물리의학회지
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• 제17권4호
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• pp.45-52
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• 2022

PURPOSE: This study examined the center of pressure (COP) and ground reaction force (GRF) characteristics during each task-oriented sit-to-stand in stroke patients. METHODS: Twenty stroke subjects were included in this study. The task consisted of sit-to-stand (SS), sit-to-stand for reaching (SR), and sit-to-stand for walking (SW). The response time, COP, and GRF were measured during each task. The COP and GRF data were obtained using a two-force plate. The force plates were placed on a chair (below the buttock) and floor (below the feet). RESULTS: Significant differences were observed between SS (1.48 ± .48 s) and SR (2.09 ± 0.82 s) and between SS and SW (2.27 ± .72 s) in the preparatory phase time during each sit-to-stand exercise (p = .002) and showed significant differences between SS (13.90 ± 6.44 cm) and SW (34.62 ± 39.38 cm) and between SR (16.14 ± 8.04 cm) and SW in the mediolateral COP range during each sit-to-stand exercise (p = .013). CONCLUSION: These findings suggest that more complex task-oriented sit-to-stand exercise requires a high-level motor programming process than a simple sit-to-stand task. Therefore, a variety of tasks-oriented sit-to-stand exercises will be useful training to achieve better ADL ability for stroke patients.

• BMB Reports
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• 제55권10호
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• pp.512-517
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• 2022

Traumatic brain injury (TBI) is brain damage which is caused by the impact of external mechanical forces. TBI can lead to the temporary or permanent impairment of physical and cognitive abilities, resulting in abnormal behavior. We recently observed that a single session of early exercise in animals with TBI improved their behavioral performance in the absence of other cognitive abnormalities. In the present study, we investigated the therapeutic effects of continuous exercise during the early stages of TBI in rats. We found that continuous low-intensity exercise in early-stage improves the locomotion recovery in the TBI of animal models; however, it does not significantly enhance short-term memory capabilities. Moreover, continuous early exercise not only reduces the protein expression of cerebral damage-related markers, such as Glial Fibrillary Acid Protein (GFAP), Neuron-Specific Enolase (NSE), S100β, Protein Gene Products 9.5 (PGP9.5), and Heat Shock Protein 70 (HSP70), but it also decreases the expression of apoptosis-related protein BAX and cleaved caspase 3. Furthermore, exercise training in animals with TBI decreases the microglia activation and the expression of inflammatory cytokines in the serum, such as CCL20, IL-13, IL-1α, and IL-1β. These findings thus demonstrate that early exercise therapy for TBI may be an effective strategy in improving physiological function, and that serum protein levels are useful biomarkers for the predicition of the effectiveness of early exercise therapy.

• International Journal of Computer Science & Network Security
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• 제22권11호
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• pp.157-162
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• 2022

Cerebral palsy is one of the most serious forms of disorders of the psychophysical development of children, which manifests itself in disturbances of motor functions, which are often combined with speech disorders, other complications of the formation of higher mental functions, and often with a decrease in intelligence. The article will discuss the speech disorder in children with cerebral palsy. Emphasis is placed on some important aspects, which should bear in mind, investigating the problem of specifics of speech development of children with cerebral palsy. In particular at the heart of speech disorders in the cerebral palsy is not only damage to certain structures of the brain, but also the later formation or underdevelopment of those parts of the cerebral cortex, which are of major importance in linguistic and mental activity. This is an ontogenetically young region of the cerebral cortex, which is most rapidly developing after birth (premotor, frontal, temmono-temporal). It is important to take into account, that children with cerebral palsy have disturbances of phonemic perception. Often, children do not distinguish between hearing sounds, cannot repeat component rows, allocate sounds in words. At dysarthria, there are violations of pronunciation of vowel and consonant sounds, tempo of speech, modulation of voice, breathing, phonation, as well as asynchronous breathing, alignment and articulation. As a result, we identified the main features and specifics of the speech development of children with cerebral palsy and described the conditions necessary for the full development of language. Language disturbances in children's cerebral palsy depend on the localization and severity of brain damage. Great importance in the mechanism of speech disorders has a pathology that limits the ability of movement and knowledge of the world.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.324-331
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• 2023

Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.

• 대한중풍순환신경학회지
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• 제8권1호
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• pp.48-57
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• 2007

Stroke is a disease which results in impairment of body functions and affects everyday life. The ability of cerebral neurons to become reorganized and restore function after damage is called plasticity. Motor impairment typically appears contralateral to the affected cerebral hemisphere in patients with cerebral lesions. The authors report a case of a patient with hemiplegia ipsilateral to affected cerebral hemisphere, along with its conjectured mechanism.

• 대한토목학회논문집
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• 제29권1D호
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• pp.111-120
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• 2009

최근 우리나라에서는 도시공간구조를 자동차 중심형 에너지 다소비형에서 대중교통과 보행을 우선하는 형태로 재편하여 대중교통이용자의 편의를 도모하는 동시에 에너지소비를 줄이려는 노력이 확대되고 있다. 우리나라의 도시는 미국과 유럽의 도시들에 비해 상대적으로 고밀로 개발되어 있고 대중교통서비스도 상대적으로 양호하여 대중교통중심형 도시구조로의 발전 잠재력은 매우 높다고 할 수 있다. 그러나 현재 우리나라의 도시들은 선진국의 주요도시들에 비해 대중교통수송분담률이 낮고 도시환경의 질도 상대적으로 낮다. 본 연구의 목적은 우리나라 도시들이 대중교통중심형 도시로 탈바꿈하기 위하여 풀어 나가야 할 도시구조상의 문제가 무엇인지 분석하는데 있다. 이를 위해 본 연구에서는 수도권 내에 위치한 대중교통결절점을 중심으로 실태를 조사하여 토지이용밀도, 토지이용복합성, 보행편의성, 대중교통연계 측면에서의 문제점을 분석하였다. 또한 분석 결과를 토대로 우리나라 도시들이 대중교통중심형 도시공간구조로 전환되기 위한 도시계획 측면의 개선방향을 제시하고자 한다.