대퇴절단자와 정상인 걸음걸이의 운동학적 요인과 발목관절 강성 비교

이재훈 ( Jae Hoon Yi ),이정호 ( Jung Ho Lee ),하종규 ( Chong Ku Hah ) 한국운동역학회 2013 한국운동역학회지 Vol.23 No.1

두 집단간 운동학적 변인의 차이는 좌측스윙시간을 제외하고 모두 유의한 차이를 보였다. 그리고 좌측스윙시간이 통계적으로 유의하게 나타나지 않은 것은 절단자의 경우 보행 시 의지측의 단지지 시간을 줄이기 때문이다. 이는 절단자의 경우 보행 시 의지측과 건측간의 차이가 있다고 보고한 선행연구결과와 유사한 것으로서(Meikle, Boulias, Pauley & Devlin, 2003), 절단자 그룹이 일반인에 비하여 상대적으로 보행속도가 느리지만 보행 시의 안정성 증가를 위하여 안정성이 부족한 의지측의 단지지 시간을 의식적으로 감소시키기 위한 행동에서 비롯된 것으로 판단된다. 일반인의 속도는 절단자보다 크고, 이중지지기시간과 우측스윙시간이 작게 나왔다. 일반적으로 비정상인과 비교하여 일반인의 속도가 크게 나타나므로 이러한 변이계수는 긍정적인 의미로써 큰 평균속도의 변동성이 큼을 나타내어 일반인의 활발한 움직임이 이루어지고 있다고 판단된다. 그리고 일반인은 생체조직(신경, 근육, 골격, 건 등)을 환경, 과제와 내력을 고려하여 신체를 상변화 시킴으로서 자유로운 제어가 이루어 질 수 있는 가능성을 시사한다. 그러나 절단자의 활보장은 일반인보다 작고, 활보폭, 활보장시간과 좌측스윙시간은 크게 나타났다. 비정상인과 비교하여 일반인이 보행형태는 활보장은 크고, 활보폭, 활보 장시간 및 스윙시간이 작게 나타나는 것이 일반적이다(Nashner, 1980; Pedotti, 1997). 일견 생각하면 변이계수가 크므로 활동성이 좋다고 오해할 수 있으나 일반인의 정상걸음걸이를 고려하면 이러한 변인의 큰 변이계수는 부정적인 변이계수라고 할 수 있다. 변이계수의 대소를 일률적으로 모든 경우에 동일하게 적용해서는 안된다. 그러므로 이러한 부정적 변이계수는 기계적 장치로 되어있는 의지의 제어가 건측의 분절과 달리 제어가 잘 이루어지지 않고 있으며 의지개선 및 피팅의 필요성을 시사한다. 1st 로커에서 절단자의 발목관절강성이 일반인보다 크게 나타나 변형에 대한 저항도가 크게 나타났으며 개선을 위하여 모멘트와 각 변위 변화량을 다소 크게 하면서 기울기를 감소시켜야 한다. 그리고 2nd 로커에서 발목관절강성은 거의 동일한 변형 저항도를 보였으며, 부호 차이는 각변위 변화량의 차이로 인한 것이다. 개선을 위하여 절단자의 모멘트 변화량을 약간 작게하는 것이 바람직하다고 생각된다. 그러나 3rd 로커에서는 일반인의 변형 저항도가 절단자 보다 매우 크게 나타나 절단자는 모멘트와 각 변위 변화량을 모두 크게 증가 시키면서 기울기를 크게 하여야한다. 이 국면에서는 변형 저항도가 크게 되는 것이 정상 보행임에도 불구하고 절단자는 변형 저항도가 작게 나타나 제어를 원활히 하지 못하는 것으로 생각된다. 그러므로 개선을 위하여 각 로커 구간별 발목에 작용하는 합성력, 모멘트 팔과 각변위를 조절할 수 있는 기계적인 방법을 모색하여야 한다. 특히 발목관절강성과 활보장시간, 좌측스윙시간과 우측 스윙시간의 상관이 유의하므로 발목관절강성을 활보장 시간과 스윙시간(절단자 >일반인)을 줄일 수 있는 발목관절의 구조적인 개선과 피팅 기술을 향상시켜야 할 것이다. The purpose of this study was to compare kinematic variables and stiffnesses of ankle joints between normal person and transfemoral amputee gait in order to develop or fit prosthetic leg. Twenty subjects (ten normal persons and ten transfemoral amputees) participated in this experiment, and walked three trials at a self-selected pace. The gait motions were captured with Vicon system and variables were calculated with Visual-3D. The velocity, stride length, stride width, cycle time, double limb support time and right swing time of gaits were statistically significant. Because coefficients of variability of normal persons on velocity, double limb support time and swing time were greater than transfemoral amputees, normal persons controlled these gait variables effectively. The stiffnesses of ankle joints were not statistically significant, but patterns of stiffnesses of ankle joints during three rockers were absolutely different. The negative correlations between stiffnesses of ankle joints and cycle time and swing time were presented. These differences suggest that developing and fitting prosthetic leg were demanded. Further studies should develop fitting program and simulator of prosthetic leg.

삼출성늑막염 환자에서의 내유임파선 생검법의 진단적 의의에 대하여

진창건 ( Chang Kon Chin ),정경한 ( Kyong Han Chong ),이정호 ( Chong Ho Yi ),김승환 ( Seung Whan Kim ) 대한내과학회 1967 대한내과학회지 Vol.10 No.2

訓民正音의 易學的 硏究

李正浩 忠南大學校 1972 論文集 Vol.11 No.-

There is no need to quote Tagore in order to show the light of culture dawned early in Korea. The invention of language for th transmission of ideas was one of the earliest achievements of humanity, but the creation of writing belongs to more recent history. In Korea it dates from the Three Kingdoms period. There are legends of the Sinji's writing used in the era of Tan'gun, but that theory can be supported by no evidence; the earliest Korean writing certainly known to us is the idu of Silla. Idu, however, consisted of borrowed Chinese characters, used sometimes according to their sound and sometimes according to them meaning, so that the system of writing Korean with it was difficult and ambiguous both to reader and to judge. When Sejong, fourth king of the Ye dynasty, took account of the nation's needs and applied his skill and imagination to the creation of Hunmin-choˇngum, an alphabet of 28 letters, he not only satisfied a need that had gone untended for thousands of years, but laid foundations for the development of Korean culture. The principles on which Sejong relied most heavily in creating his new alphabet were derived from the study of the Book of Changes and the synthesized philosophy of Sung confucianism. The king's exhaustive concern for the study of the confucian classics and special interest in philosophy left a deep impression on the brilliant culture which he inspired, but above all on his achievement in inventing the alphabet. Both the forms and the meaning of the Book of Changes are shown in its letters: the forms in the shapes of the five basic elements of the initial consonants and the three elements of the vowels; and the meaning in the method of indicating the aspiration and reduplication of the sounds. the relation between labials and nasals, the relations between the various aspirates and the placing of the basic elements of the letters in the writing of the vowels. Thus the letters have an intrinsic philosophical value and, furthermore, their five and three fundamental elements are consonant and vowel with a principle of maintaing the forms of Chinese old seal script. The actual pronunciation of the sounds is indicated by relation of the speech organs to the theory of the five elements as applied to the parts of the human body; and the correspondence of the throat to heaven, the lips to earth, and the movements of speech to the variations between. The precision and accuracy with which this imaginative scheme was carried out are astonishing. The letters reflect the whole theory of yin and yang; the relations of heaven, earth and man; and the Great Extreme as the ground of the Five Elements…in fact the whole gamut of the extended theory of the Book of Changes. The present author's contention is that there can be no question that Sejong consciously used this theory in the creation of his twenty-eight letters. Next, the author deals in order with the five basic elements of the initial consonants and the three elements of the vowels, explaining their significance in terms of the philosophy of the changes, and proceeds to study plane and three-dmensional diagrams of these five forms and of the eleven vowels, so as to explain their meanings and to examine the relationships between the two groups. Finally the author goes on to demonstrate the correspondence between the parts of the Book of Changes and the arrangement of the Korean alphabet. Both show the essential harmony of the philosophical theory involved, and thus the Hunmin Choˇngum proves to be not merely a treatise on language, but also a treatise on philosophy in its own right. Just as the Book of Changes in China developed a mature philosophy from the primitive trigrams, so the Choˇngum was developed in Korea as a mature philosophy of speech and writing based on the same philosophical principles. Other aspects of the Korean alphabet, including the juxtaposition of letters, euphonic changes, and the theory of the four tones as applied to Korean are all related in the same way to the same principles. The author concludes that (1) the choˇngum was created by Sejong himself; (2) the twenty-eight letters were based on the forms of the speech organs and on the similarities to the old seal characters; (3) the choˇngum is a treatise on the philosophy of changes; (4) Sejong was a true sage, born in Korea; (5) the value of the choˇngum is enhanced by its philosophical content.