Changes in Spatiotemporal Parameters and Lower Limb Coordination During Prosthetic Gait Training in Unilateral Transfemoral Amputees

Yunhee Chang,Chang-Yong Ko,Bo Ra Jeong,Jung Sun Kang,Hyuk-Jae Choi,Gyoosuk Kim,Hyunjun Shin,Sehoon Park 한국정밀공학회 2022 International Journal of Precision Engineering and Vol.23 No.3

When applying prosthetic gait training to patients with lower limb amputation, monitoring the gait change process is crucial for establishing and modifying rehabilitation training plans. In addition, since human gait involves complex movement of several joints, it is necessary to analyze the organic movement of adjacent joints rather than a single joint in the lower extremities for understanding the process of gait change. Therefore, this study aimed to analyze changes in spatiotemporal parameters and lower limb coordination during prosthetic gait training in unilateral transfemoral amputees (TFAs). This retrospective case–control study included 10 unilateral TFAs and 10 healthy individuals as controls. TFAs received prosthetic gait training for 12 weeks and gait changes were analyzed every 2 weeks using a 3D motion analysis system. The measured variables were spatiotemporal parameters and the continuous relative phase between hip and knee joints. The highest improvement in walking speed was seen at week 4 of training, and the continuous relative phase was most symmetric at week 8. The lower limb coordination pattern was more in-phase in the TFAs than in the controls, and the coordination variability was also lower for the TFAs than for the controls. In addition, the rate of change in lower limb coordination of TFAs was lower than that of spatiotemporal parameters and was significantly different from that of the controls even after training. Considering that the decrease in lower limb coordination is related to gait efficiency, balance, and risk of fall, there is a need to develop therapeutic strategies that can further improve the coordination of TFAs.

사람 HPRT 유전자 발현벡터 제조와 생쥐 Sp2/0 myeloma 세포주에서의 발현

고창보,김용만,김영진,백상기 충남대학교 기초과학연구소 1997 忠南科學硏究誌 Vol.24 No.1

To construct expression vector for the human HPRT gene, pRSVneo plasmid conferring resistance to neomycin-kanamycin(Tn5) antibiotics and pHPT 31 containing human HPRT cDNA were used to subclone human HPRT cDNA. For construction of recombinant pRSVneo carrying human HPRT, pRSVneo-HPRT, the human HPRT cDNA fragment from pHPT31 plasmid was inserted into polyadenylation site (BamHI site) behind the neo gene fragment of pRSVneo plasmid. For the other expression vector, pRSV-HPRT, the neo gene and small portion of the untranslated 5′franking region were removed from the pRSVneo-HPRT. The HPRT gene of the two vectors were constructed in right orientation. Each recombinant vector was introduced into cultured HPRT-deficient mouse cell line, Sp2/0 by calcium mediated DNA transfection and the transfected cells were selected under HAT selection condition. The HPRT activity of the lysates from the selected cell was higher than that of the lysates from spleen cells of mouse. The HPRT activity of pRSVneo-HPRT vector was higher than that of pRSV-HPRT one. To find out whether the HPRT activity of the transfected cells selected under HAT medium was expressed by transfected vectors or by spontaneous mutations, it was cultured to reselect in G418 medium. It showed that the nature of the HPRT activity was resulted from the transfected vectors.

한국형 인공심장 내의 혈류에 대한 수치해석적 연구

심은보,박명수,여종영,고형종,박찬영,민병구 제주대학교 인공심장이식연구소 2001 인공심장 연구 Vol.2 No.1

한국형 인공심장 내의 혈액 유동을 유한요소 코드인 ADINA를 사용하여 수치적으로 조사하였다. 그 동안 많은 실험을 통해서 밝혀진 중요한 문제점들 중의 하나는 바로 혈전 생성이다. 이것은 혈액 주머니내의 작용하는 과도한 높은 전단응력 또는 정체 영역과 밀접한 관련이 있다. 한국형 인공심장 내의 혈류는 액추에이터와 혈액주머니, 그리고 혈액의 상호작용에 의하여 정의될 수 있다. 여기에서 혈액은 비압축성, 뉴우턴 유체로 가정하였으며, 혈액주머니는 등방성 선형 고체재질로 가정하였다. 2차원 모델은 액추에이터와 혈액 주머니 사이의 접측 문제 및 고체-유체 상호작용 문제를 전부 고려하였다. 3차원 모델에서는 액추에이터에 의한 변형을 접촉문제를 혈액주머니 외부에 작용하는 압력조건으로 단순화하였다. 2차원 모델 계산결과에 의하면, 입구 및 출구 부근, 그리고 모서리 부근에서 전단응력의 세기가 매우 크다는 것을 발견할 수 있었다. 또한 위쪽 돌출부에서 속도가 매우 느려지는 정체 영역이 형성되었으며, 이는 실험에서 관찰된 혈전 생성영역과 거의 일치한다. 3차원 계산의 경우에도 역시 입구와 출구 부분에서 재순환 영역이 발견되었으며, 수축시에는 입구의 아래쪽에서, 이완시에는 출구의 아래쪽에서 정체영역이 생성됨을 알 수 있었다. One of the crucial problems which make the artificial heart operate improperly is the thrombus formation. Many experimental results show the thrombus formation is strongly retated with a high shear stress and the stagnation in the blood flow. Therefore study on the blood flow in artificial hearts is very important in a practical point of view. This thesis deals with the two- and three-dimensional unsteady blood flows in the Korean total artificial hearts(KTAH). It is numerically investigated by using the commercial finite element code ADINA. The flow in the sac of artificial heart results from the mutual interaction of the acuator, sac, and blood. Blood is assumed as an incompressible viscous Newtonian fluid, while the sac is considered to be elastic and isotropic solid material. The contact problem between the actuator and sac is included in the two-dimensional modelling. Because of the tremendously calculation time, the action of the actuator is replaced by the imposition of the time-varying pressure on the outer surface of the sac. Numerical results show a high shear stress distribution near the inlet and outlet corners of the sac. From two-dimensional calculation flow stagnation is seen to be found in the upper convex part of the sac. By comparing the numerical results with the experimental ones we can conclude the thrombus is generated in regions where blood flow stagnates or is very slow.

건강보험에서 5인 미만 사업장의 직장보험 편입 효과 평가와 정책 방향

송명섭,김창보,고수경,임정수,박지연 한국사회보장학회 2002 사회보장연구 Vol.18 No.2

본 논문은 건강보험공단이 2001년 「월 이후 추진하고 있는 5인 미만 사려장의 직장보험 편입을 평가하고 향후 정책방향을 제시하는데 목적을 두고 있다. 5인 미만 사업장의 직장보험 편입은 보험 가입자의 보험료 부과의 형평성을 제고하고, 영세사업장 노동자들의 보험료 부담을 경감시키며 건강보험재정 안정 효과를 위한 것이다. 2001년 7월 이후 12월 31일까지 직장보험으로 신규편입한 대상자는 모두 약 64만명이었으나 편입이전지역보험 대상자는 약 53만명, 직장보험 대상자는 약 10만명이었다. 또한 동일 기간동안 직장보험으로 편입된 사업장은 모두 88,751개였다. 편입 전후 개인별 보험료 수준 변화를 살펴보면 보험료 부과대상 중 77.6%는 본인이 부담해야 할 보험료가 감소하였다. 대신 사업주의 보험료 부담은 상대적으로 늘어났다. 한편 2001년 7월 이후 12월까지 직장보험 편입으로 건강보험의 재정은 약 19,530백만원의 재정절감효과가 있었다. 직장보험은 7,331백만원의 보험료 수입 증가가 발생하였으며, 지역보험은 12,199백만원의 재정절감 효과가 있었다. 향후 5인 미만 사업장의 직장보험 편입이 원만히 추진되기 위해서는 피부양자 인정기준의 개선과 영세사업장 사업주의 보험료 부담을 경감시켜주기 위한 방안을 강구해야 하며, 사회적으로는 비정규직 노동자에 대한 사회보장 적용 확대를 위한 노력이 동시에 추구되어야 할 것이다. This study was conducted for the purpose of evaluating coverage of small companies with less than 5 persons by Corporate Insurance since July 2001 and of suggesting policy implication. This coverage expansion by Corporate Insurance was intended for improving equity level of contribution imposition, alleviating financial burden of employees and achieving financial stability of health insurance. While, from July 2001 to December, the number of newly covered beneficiaries was about 642 thousand persons, the number of Regional beneficiaries before the new coverage expansion by Corporate Insurance was 533 thousand persons. And the number of Corporate Insurance beneficiaries before the coverage expansion was 101 thousand persons. For the same period, the number of companies by the new coverage expansion of Corporate Insurance was 88,751. Before and after the expansion, taking into account changes of individual contribution levels, payment share levels of contribution were reduced to the 77.6% of the beneficiaries newly covered by Corporate Insurance. Instead, payment share level of contribution of employers was increased more than before. And 19,530 million won was increased in National Health Insurance Expenditure. 7,331million won was increased in Corporate Insurance revenue. Expenditure reduction effect of 12,199 million won was able to be obtained in Regional Insurance. In order to implement successfully the coverage expansion by Corporate Insurance in times ahead, employers' contribution share should be reduced, when considering low profitability levels of small companies.

N Use Efficiency and Nitrate Leaching by Fertilization Level and Film Mulching in Sesame Cultivated Upland

Dong-Wook Lee,Ki-Do Park,Chang-Young Park,Il-Soo Son,Ui-Gum Kang,Jee-Yeon Ko,Kang-Bo Shim,Young-Son Cho,Sung-Tae Park 韓國作物學會 2007 Korean journal of crop science Vol.52 No.3

This study was conducted to evaluate the effect of slow release fertilizers (SRF), crotonylidene diurea (CDU) and latex coated urea (LCU), on nitrogen (N) use efficiency (NUE) and nitrate-N leaching in a silty clay loam soil under polyethylene film mulching (PFM) for sesame cultivation. In PFM plot, concentrations of NO3-N and NH4-N in SRF applied soils were less than that in the urea plot during the whole growing period. However, NO3-N and NH4-N in all the non-mulched plots (NM) were not significantly different. Urea-N in soil treated with SRF was higher than urea plot until 50 days after application and was comparable in all the treatments after 50 days. NO3-N concentrations in leached solution in 21 days after urea fertilization in PFM and NM were 26 mg L-1 and 83 mg L-1 , respectively. However, NO3-N in leached solution at applied CDU and LCU was less than that of urea similar to nitrate concentration in soil. NO3-N in leached solution in applied CDU and LCU in 44 days after application was about 25% lower than that urea plot and PFM, while the NO3-N concentration of CDU and LCU treatment in NM did not changed. Application of SRF increased the yield of sesame and N recovery compared to urea and there was a little difference between SRF and N levels. In conclusion, application of 80% N level with SRF increased N recovery and reduced nitrate leaching without reduction of yields compared with urea application.

응급의학과에서의 인공호흡기 처치

이삼범,도호석,도병수,이창현,심민철,권굉보 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study Objectives : To investigate and resolve the problems related with ventilator management in ED(emergency department). At present the ventilator is essential equipment of ED on university hospital and emergency center in Korea. Design : Retrospective consecutive case series. Setting : University teaching hospital Type of participants : All patients admitted and recieved ventilator management in ED of yeungnam university hospital from Jan. 1994 to jul. 1995. Methods and interventions : Charts of all patients were reviewed to determine the frequency, the types and causes of respiratory failure, the death rate, the mean duration of admission, the complications, and CPR(cardiopulmonary resuscitation) related with ventilator management in ED. We also identified the problems related with ventilator management by ED physicians and nurses through the answers to seven questions that suggested by us about ventilator management in ED. Measurements and main result : There were 34,751 admissions through ED during the study period. Of these 160 patients managed with ventilator in ED. The frequency of ventilator management in ED is increased at 1995(0.73%) that compared with 1994(0.32%). Non-trauma(113 cases) and hypoxic respiratory failure(83 cases) patients are more common than trauma(37 cases) and ventilatory failure Total CPR rate related with ventilator management are 25.3%. The mean duration of admission are 12.56±20.28 days, and the death rates are 45.3%. The incidence of complications occurred during ventilator management in ED are 37 cases. About seven questions suggested by us to 30 ED staffs(ED physician, nurses and paramedics), most frequent answer is the difficulty of keeping ventilator in ED because other department rent ventilator from ED and lost a part of ventilator. Conclusion : As the use of ventilator in ED is increased the emergency physician should be well trained for the indications, complications, setting mode and general problems of machine occurred during ventilator management in ED patients.

대구 상인동 가스참사로 본 지역 응급의료체계에 대한 고찰

이삼범,도호석,도병수,이창현,심민철,권굉보 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Disaster may be defined as a sudden calamitous event associated with great damage or destruction. A more common definition, among emergency-preparedness planners, is a medical occurrence that overwhelms medical care systems and facilities. Most regional disaster plans are formulated to respond to disasters of moderate size. At 07:50 A.M. on 28 April 1995, gas explosion was happened at Sangin-Dong where was going to be under construction of subway in Taegu, Korea. 102 victims had died and 178 victims had moderate or minor injuries. Problems in the organization at the scene, triage, field management, transport to the hospital, and the communication contributed to the confusion in the management of victims. An analysis of this disaster allows several lessons to be learn about perimeter control, command functions, crowd control, and transportation priorities. It will benefit disaster planners in other communities.

N Use Efficiency and Nitrate Leaching by Fertilization Level and Film Mulching in Sesame Cultivated Upland

Lee, Dong-Wook,Park, Ki-Do,Park, Chang-Young,Son, Il-Soo,Kang, Ui-Gum,Ko, Jee-Yeon,Shim, Kang-Bo,Cho, Young-Son,Park, Sung-Tae The Korean Society of Crop Science 2007 Korean journal of crop science Vol.52 No.3

This study was conducted to evaluate the effect of slow release fertilizers (SRF), crotonylidene diurea (CDU) and latex coated urea (LCU), on nitrogen (N) use efficiency (NUE) and nitrate-N leaching in a silty clay loam soil under polyethylene film mulching (PFM) for sesame cultivation. In PFM plot, concentrations of $NO_3-N$ and $NH_4-N$ in SRF applied soils were less than that in the urea plot during the whole growing period. However, $NO_3-N$ and $NH_4-N$ in all the non-mulched plots (NM) were not significantly different. Urea-N in soil treated with SRF was higher than urea plot until 50 days after application and was comparable in all the treatments after 50 days. $NO_3-N$ concentrations in leached solution in 21 days after urea fertilization in PFM and NM were 26 mg $L^{-1}$ and 83 mg $L^{-1}$, respectively. However, $NO_3-N$ in leached solution at applied CDU and LCU was less than that of urea similar to nitrate concentration in soil. $NO_3-N$ in leached solution in applied CDU and LCU in 44 days after application was about 25% lower than that urea plot and PFM, while the $NO_3-N$ concentration of CDU and LCU treatment in NM did not changed. Application of SRF increased the yield of sesame and N recovery compared to urea and there was a little difference between SRF and N levels. In conclusion, application of 80% N level with SRF increased N recovery and reduced nitrate leaching without reduction of yields compared with urea application.

말단비대증 환자에서의 수술전 Octreotide 투여 효과

박경수,김현규,조보연,이홍규,고창순,민헌기,김성연,고경수,이석인,한대희,최길수,정희원,김현집 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.1

Seven patients with previously untreated acromegaly and invasive pituitary macroadenomas were treated with the long-acting somatostatin analog, octreotide (San- dostatin*, Sandoz) for 3~6 months, before transsphenoidal pituitary adenomectomy. Preoperatively, treatment with octreotide for 3 months reduced the pituitary tumor size by 55~60% in 2 patients, 20~39% in 3 patients and little in the remaining 2 patients. Six patients were treated for another 3 monts, but the size of the pituiary tumor showed no further remarkable changes. Mean basal serum GH concentration fell from 251.6(53.0~470.0) ng/ml to 80.1(9.5~308.0) ng/ml after 3~6months treatment with octreotide. Postopercentrationn of one patient whose pituitary tumor size decreased 65% fell into the normal range. Thus, preoperative administration of octreotide induced shrinkage of GH-producing pituitary rumors in some patients and might have favorable effects on the remission rate in the treated patients. (J Kor Endocrinol 8:35~41, 1993)

갑상선 질환에서의 혈압과 적혈구 막 Na+ Transport의 변화

이석인,이홍규,김원배,고창순,민헌기,고경수,김성연,조보연 대한내분비학회 1991 Endocrinology and metabolism Vol.6 No.1

To evaluate the effect of thyroid hormone on blood pressure and RBC membrane Na+ transport, and to delineate the relation between changes of blood pressure and RBC membrane Na+transport in patients with thyroid disease, we measured membrane Na+ transport of intact red cells in healthy subjects (n=12), in hyperthyroid patients (n=17) and in hypothyroid patients (n=16) before and after treatment. 1) Before treatment, intracellular (RBC) Na+ concentrations were higher in hyperthyroid patients (12.4 2.1 mmol/l) than those of control subjects (10.2 1.8 mmol/l), but there was no difference between hypothyroid patients and control subjects. Vmax of Na+ pump decreased in hyperthyroid patients (3.33 0.67(mmol/l. cells/hr)),and increased in hypothyroid patients (4.52 0.69) comparing with that of control subjects (3.94 0.88). Vmax of Na+-K+ cotransport and Na+ permeability increased, and Vmax of SLC decreased in hyperthyroid patients, but these parameters showed no significant changes in hypothyroid patients. 2) After 2 3 months of antithyroid medication, above changes in Na+ transport parameters tend to reverse in hyperthyroid patients (not statistically significant), but no changes of parameters were found in hypothyroid patients after 1 2 months of thyroid homone replacement. 3) Systolic hypertension ($gt;140mmHg) was observed in 35%(6 patients) of hyperthyroid patients, but there was no hypothyroid patients who had systolic or diastolic hypertension. Systolic blood pressure returned to normal range after treatment of hyperthyroidism, and both systolic and diastolic blood pressure decreased significantly after treatment of hypothyroidism. 4) There was no relation between blood pressure levels and Na+ transport parameters of red cell membrane. 5) In multiple regression analysis, BMI (Body Mass Index) was the only variable that showed significant correlation with systolic (r=0.53, p$lt;0.05) and diastolic blood pressure (r=0.58, p$lt;0.01) in hyperthyroid patients, and age of the patient was the only variable that showed significant correlation with systolic (r=0.46, p$lt;0.05) and diastolic blood pressure (r=0.46, p$lt;0.05) in hypothyroid patients. These findings suggest that thyroid homone alter the status of Na+ transport in red cell membrane that is not reversible in relatively short period (for 2 3 months). And we observed the reversible increase of systolic blood pressure in hyperthyroidism and reversible increase of systolic and diastolic blood pressure in hypothyroidism, but such changes were not attributable to the changes of Na+ transport in red cell membrane (J Kor Soc Endocrinol 6:25 37, 1991).