Earticle

예이츠의 시에서 죽음은 지속적으로 등장하는 주제이지만 죽음에 대한 시인의 태도는 정의하기 쉽지 않다. 예이츠가 시에서 죽음을 대하고 형상화하는 방식 은 하나의 것으로 귀결되지 않고 오히려 상반되는 모습을 보인다. 그는 죽음을 무시하 면서 덤덤하고 무미건조하게 서술하는가하면 상상력을 필요로 하는 수많은 상징과 이 미지들을 동원해 죽음을 거대한 존재로 만든다. 죽음 (“Death”)에서 예이츠는 전반적 으로 죽음을 어떻게 생각하는지를 드러낸다. 죽음의 장면은 죽음에 대한 꿈 (“A Dream of Death”)에서 무미건조하게 묘사되는데, 그는 감정적으로나 현실적으로 익숙 지 않은 모습을 보인다. 자아와 영혼의 대화 (“A Dialogue of Self and Soul”)에서 예이츠는 삶과 죽음을 이분법적으로 분리하면서 죽음으로부터 벗어나기 위해 상상력 을 동원한다. 마지막으로 시인은 출렁이는 마음 (“Vacillation”)에서 양극단 사이에서 방황하며 죽음과 관련된 것들을 상상력으로써 무수히 불러낸다.

Death in Yeats’s poetry is a continually represented theme but it is not easy to define his attitude to it. The way he deals with and represents death does not converge but seems contradictory: he occasionally disregards death and describes it in an apparently indifferent manner while at other times he makes death a huge existence by using a number of symbols and images that require imagination. In “Death,” Yeats reveals his overall thought about death. In “A Dream of Death,” a death scene described without feeling seems unfamiliar to him both emotionally and in reality. In “A Dialogue of Self and Soul,” Yeats takes an opposite attitude to death, separating life from death in a dichotomous way, thinking and trying to get out of it with imagination. Finally, in “Vacillation” the poet wanders between extremities and numerously calls out death-related things in imagination.

Objective To evaluate and compare the organization of descending motor pathways to upper extremity muscles among healthy children. Method The healthy children were 16 males and 7 females aged 1-19 years (average, 9 years), and eight healthy adults were enrolled as the control group. Transcranial magnetic stimulation was applied to bilateral motor cortices, and motor evoked potentials (MEPs) were recorded using surface electrodes from the first dorsal interossei (FDI), the biceps brachii (BIC), and the deltoid (DEL) muscles. The onset latency, central motor conduction time (CMCT), and amplitude were obtained during a relaxed state. Results MEPs of FDI were obtained from subjects aged 13 months. Th e frequency of obtaining MEPs in proximal and distal muscles increased with age, although there was a less frequent incidence of obtaining MEPs in the proximal BIC and DEL muscles compared with those in the distal FDI muscle. MEP amplitudes increased with age, whereas latencies were relatively constant. CMCTs showed a similar pattern of maturation, and adult values were obtained by 13-years-of-age. Conclusion These results suggest that the proximal and distal muscles of the upper extremities show different maturation and organization patterns.

Anterior spinal artery syndrome refers to the paralysis of the bilateral upper extremities, bladder dysfunction and the sensory deficit of pain and temperature below the level of injury. A 64 year-old female got a cardiac arrest event after stent insertion into the coronary artery. After CPR, she underwent the motor deficit (Z-T) of the bilateral upper extremities without any sensory deficit; proprioception, vibration and pain. The brain MRI showed no abnormality, but high signal intensity was detected in C3-C7 level by T2 sagittal plane and at the anterior horn area of gray matter by axial view of spine MRI. The ventilator has been applied after CPR. By the fluoroscopy, the movement of the diaphragm was decreased, and the nerve conduction study of both phrenic nerves showed no responses.

Clinical presentation of supplementary motor area (SMA) syndrome includes complete akinesia of the contralateral side of the body and mutism, with secondary recovery of neurologic deficit. Multi-joint coordination is frequently impaired following the development of a brain lesion and is generally restricted by abnormal patterns of muscle activation within the hemiparetic limb, clinically termed muscle synergies. However, no work to date has confirmed this observation with the aid of objective methods, such as gait analysis, and the development of reflex pattern has not been suggested as a possible cause. We describe two unusual cases of flexor synergy after tumor resection of SMA lesions.

Objective To determine overall handgrip strength (HGS), we assessed the short-term change of HGS after trigger point injection (TPI) in women with muscular pain in the upper extremities by comparison with established pain scales.Methods The study enrolled 50 female patients (FMS with MPS group: 29 patients with combined fibromyalgia [FMS] and myofascial pain syndrome [MPS]; MPS group: 21 patients with MPS) who presented with muscular pain in the upper extremities at Konyang University Hospital. In addition, a total of 9 healthy women (control group) were prospectively enrolled in the study. We surveyed the three groups using the following established pain scales: the Fibromyalgia Impact Questionnaire (FIQ), the 36-Item Short Form Health Survey (SF-36), and the Short Form McGill Pain Questionnaire (MPQ). HGS was measured in both hands of study participants using a handgrip dynamometer. We performed TPI (0.5% lidocaine, total 10 mL, injected at the pain site of upper extremities). After 20 minutes, we remeasured the patient’s HGS and MPQ score.Results ANOVA analysis was conducted among groups. Based on Tukey multiple comparison test, the majority of FIQ and SF-36 subscales, total FIQ and SF-36 scores, MPQ and HGS were significantly different between FMS with MPS and the other groups. There was no statistically significant difference between MPS and control groups. Higher HGS was positively associated with enhanced physical function, negatively associated with total FIQ and MPQ scores, and positively associated with the total SF-36 score calculated using Spearman correlation. Post-TPI MPQ decreased and HGS increased. In patient groups, a negative correlation was found between MPQ and HGS. Conclusion The HGS test might potentially be a complementary tool in assessing the short-term treatment effects of women with muscular pain in the upper extremities.

본 연구의 목적은 건강한 대학생을 대상으로 백팩 착용 유무 및 형태에 따른 몸통·하지 근 활성도 변인들의 차이점을 규명하는데 그 목적을 두고 있다. 26명의 건강한 성인이 연구에 참여하였다. 백팩의 무게 10%로 부하된 상태 에서, 백팩을 착용하지 않은 상태, 일반적인 백팩을 착용한 상태, 모멘트 팔을 감소시키도록 고안된 백팩을 착용한 상태 에서 몸통과 하지의 근활성도를 측정하였다. 배빗근육, 넙다리네갈래근, 앞정강근, 장딴지근의 근 활성도 분석을 위해 무선근전도 시스템을 사용하였다. 모멘트 팔을 감소시키도록 고안된 백팩을 착용한 상태에서 배빗근육, 넙다리네갈래 근 그리고 장딴지근의 보행 구간에서 RVC에 변화가 통계학적으로 유의한 차이를 보였다. 그러므로, 백팩을 주로 사용 하는 성인들에게 가방끈 조절을 적용하는 방법은 몸통과 다리근육의 활성에 긍정적인 측면을 제공한다는 것을 나타내 며, 추후 가방의 디자인과 착용방법에 대한 지속적인 가방융합개발이 필요할 것이다.

This study aims to compare muscle activities of trunk and lower extremities according to wearing/not-wearing and forms of backpack. Twenti-six healthy adults were participated in the study. In the backpack with 10% body weight, trunk and lower extremities were measured during carrying the no backpack state(NBs), general backpack state(GBs), a decrease moment arm backpack state(DMBs). The muscle activity in a fore muscles(Obilique, Quadriceps, Tibialis anterior, Gastrocnemius) were analyzed with using wireless electromyogram measuring system. DMBs showed significant improvemet in obilique, quadriceps and gastrocnemius muscle RVC

Purpose: This study aimed to investigate the effects of Polking, a newly designed exercise for muscle strengthening, by observing the differences in muscle activation and plantar pressure between Polking and normal walking. Methods: A crossover study was conducted with 16 young adults, each performing normal walking and Polking along a 10-m path. Muscle activation by EMG of the eight upper and lower limb muscles and plantar pressure were measured before and after exercise and compared between the two walking types. Results: Except for the latissimus dorsi and tibialis anterior muscles, there was a significant increase (P < .01) in all muscles (i.e., anterior deltoid, biceps brachii, and triceps brachii for the upper extremity; gastrocnemius, vastus medialis, and adductor longus for the lower extremity). The average plantar pressure in g/cm² (P = .01) and delta CoF (P = .008) were higher during Polking than during normal walking. Conclusion: This study examined the full-body effects of Polking as a combined aerobic and anaerobic exercise and as a potential gait training method, showing notable increases in muscle activity in the upper and lower extremities.

Objective: To analyze the biomechanics of young patients with flat foot or malalignment syndrome of lower extremities and to provide some information and strategies in examining and treating them for other researchers or successive studies. Method: Between January 2004 and March 2006, 274 patients were engaged who had been diagnosed as flatfoot in 586 patients aged between 0 and 18. All patients were examined physically by one physiatrist to find other biomechanic abnormalities of lower extremities and to measure resting calcaneal stance position (RCSP) angle, bimalleolar angle (BMA). To detect the existence of scoliosis and the difference in leg length, radiographs were taken of the spine and the lower extremities. Flat foot was defined as when either of the feet had lower than ?4° degrees of RCSP angle. Results: When comparing the value of RCSP angle between right side and left side, the left side was more pronated than the right side. The value of RCSP angle increased in proportion to age but there are other factors that caused the persistence of foot pronation and ligament laxity. The value of BMA tends to increase in proportion to age. The foot was more pronated, the tibia of the same side was more rotated internally and tibia of the other side was more rotated externally. The most common combined biomechanic abnormality of lower extremities was toe-in gait. Conclusion: Because the biomechanic effect of a foot could influence the leg, pelvis of the same side and the other side lower extremity, the flat foot should be regarded as an element of malalignment syndrome, anatomical abnormality, and also functional impairment.

Objective: To investigate the state of musculoskeletal deformities in spine and lower extremities in teenagers with cerebral palsy. Method: 79 teenagers with cerebral palsy attending special schools were examined for deformities of the spine and the lower extremities with physical examinations and radiographic studies. Results: The number of cases with scoliosis was 47 (59.5%) and the mean of Cobb's angle was 21.7 degrees. There were 42 joints (26.6%) of hip subluxation and 10 joints (6.3%) of hip dislocation out of 158 hip joints. The mean of migration percentage was 53.6%. 30 participants (38.0%) had pelvic obliquity. The coxa valga appeared in 147 hip joints (93.0%), with the mean of femur neck-shaft angle was 156.0 degrees. It had a casual link with migration percentage (p＜0.001). 131 knee joints (82.9%) had the increased popliteal angle and 113 knees (71.5%) had patella alta. 72 cases (91.1%) had equinus feet, and 49 cases (62.0%) had planovalgus feet deformities on radiographic studies. As the score of Gross motor function measure (GMFM) was decreased, the migration percentage (p＜0.01), the Cobb's angle (p＜0.01), the popliteal angle increased (p＜0.001) and femur neck- shaft angle (p＜0.05). Conclusion: Teenagers with cerebral palsy are highly risk to develop musculoskeletal deformities in their spine and the lower extremities. Therefore, a close medical inspection should be paid on this group.

본 연구는 족욕요법이 수술실 간호사의 하지부종, 스트레스, 피로에 미치는 효과를 규명하기 위함이다. 방법: 본 연구는 무작위배정 대조군 전후 시차설계이다. 자료수집은 2013년 8월에서 10월까지이며 대상자는 울산광역시 대학교병원의 수술실 간호사 50명을 대상자로 하였다. 실험군 25명, 대조군 25명. 실험군은 40℃ 물의 온도로 족욕기를 사용하여 20분 동안 발이 복사뼈 위까지 잠길 정도로 실행하였다. 족욕요법 횟수는 1회/일, 4일/주, 3주간 총 12회 실시하였다. 결과: 족욕요법 실험처치 후 종아리 하지부종, 신체적 스트레스, 피로가 유의한 감소를 보였다. 결론: 본 연구는 족욕요법이 수술실 간호사의 하지부종, 스트레스, 피로를 감소시키는 결과를 보였다. 따라서 족욕요법은 수술실 간호사의 하지부종, 스트레스, 피로를 감소를 시키는 편안하고 경제적인 중재방법이다.

nurses’ lower extremities edema, stress, and fatigue. Methods: This study used a randomized control group non-synchronized design. The data were collected from August to October 2013, and a total of 50 OR nurses in an university hospital in U Metropolitan City participated in the study: 25 nurses for the experimental group and 25 for the control group. The experimental group received foot bath in which feet were soaked in 40C° water and immersed up to ankle line for 20 minutes per a day for 12 times. Results: There were significant decrease in the calf edema, physical stress, and fatigue between pre and post foot bath therapy. Conclusion: The findings of this study show that foot bath had the effect in decreasing lower extremities edema, stress, and fatigue among OR nurses. Foot bath therapy, therefore, is suggested as a comfort and easy-to-use method in clinical setting to reduce OR nurses’ lower extremities edema, stress, and fatigue.

Purpose: The purpose of this study was to examine the effects of early passive range of motion (ROM) exercise on ROM of lower extremities and foot edema in hemiplegic patients after stroke. Methods: The data were collected between August 2009 and April 2010 from 11 patients in the experimental group and 13 in the control group. The passive ROM exercise was performed twice a day for 2 weeks. Results: In the experimental group, ROM of lower extremities (flexion of hip, flexion of knee and ankle) increased significantly compared to that of the control group. There was no significant difference in foot edema between the two groups. Conclusion: The results indicated that the early passive ROM exercise can improve the ROM of lower extremities, but not the foot edema in patients after stroke.

Objective: To investigate the mean values and correlations between the rotational profiles of bilateral lower extremities in Korean elderly men. Method: 100 lower extremities were examined for the rotational profiles of bilateral lower extremities with radiographic examination.Results: The mean values of femoral anteversion, axial rotation of the knee joint, proximal and distal tibial torsion, bimalleolar axis (BMA), and Q angle were 8.72°, 0.19°, 34.53°, 26.25°, 20.97°, 5.65°. In Korean elderly men, the result of tibial torsion and Q angle was smaller than the results of other studies, and the bilateral differences were detected in the measured profiles of lower extremities, except axial rotation of the knee joint. However, all profiles represented a positive correlation between right and left lower extremities. The correlation between proximal tibial torsion and BMA had a positive correlation, But the femoral anteversion and tibial torsion had no correlations among the profiles in Korean elderly men. Conclusion: We suspected that Korean elderly healthy men have reduced tibial torsion and more genu varus alignment, and the rotational profiles of lower extremities showed side to side difference, but there were symmetrical tendency. It will be helpful in assessing the evaluation, treating, researching of the musculoskeletal problem in Korean elderly people.

Purpose: The purpose of this study was to identify the effect of Meridian pressure on the functions of upper extremities and discomfort of ADLs of hemiplegic patients. Methods: The research design was a nonequivalent control group, non-synchronized design. Subjects were 35 hemiplegic patients who were hospitalized at L Oriental Medical Hospital; 18 for the experimental group and 17 for the control group. The experimental group was given meridian pressure for 10 minutes daily for 2 weeks. The data were analyzed by SPSS 12.0 program. The 2-test and t-test were used for the two groups' homogeneity, and t-test was used for the hypothesis test. Results: Manual muscle test, ROMs of wrist extension, elbow flexion, and shoulder extension of the experimental group increased compared to the control group. Shoulder pain and index finger circumference of the experimental group decreased compared to the control group. The experimental group showed to have less discomfort of ADLs than the control group. Conclusion: The study results verified that meridian pressure is effective for improving the functions of hemiplegic patients’ upper extremities as well as reducing discomfort of ADLs.

Objective: To evaluate quantitative changes in arterial blood flow in the legs and systemic changes in blood flow after hot pack therapy on a leg. Method: It was conducted on 60 legs of 30 adults without the symptom of peripheral vascular disease. The blood flow of both popliteal arteries were recorded before and after hot pack therapy on a leg. Also, the blood pressure and pulse rate were recorded every two minutes using a pulsimeter. T-test was done to examine differences between blood flow of the popliteal artery on both legs before and after hot pack therapy. Paired t-test was used to examine differences in each leg before and after hot pack therapy and systemic effect after hot pack therapy. Results: After hot pack therapy, there were statistically meaningful changes in all the variables except the popliteal arterial diameter in a leg with hot pack therapy, whereas there were no significantly meaningful changes in a leg without therapy. Pulse rate was changed significantly, but blood pressures were not. Conclusion: There were an increase in regional arterial blood velocity and blood flow, skin temperature, and a reduction in peripheral resistance in a leg with hot pack therapy, but no meaningful changes without thrapy. There is no evidence of reflex vasodilatation. There is no meaningful changes in blood pressure, but an increase in pulse rate.

The mobility provided by a car can obviously give much greater independence and opportunities for work and social activities to people with physical handicaps, even though they may still find it difficult to drive an ordinary production car. But, in our country, the driver's license test is to the disadvantage for driving of the handicapped people who can drive a car with suitable modifications. The authors examined the relationship between the motor ability test of driver's license test for the handicapped people and actual car-driving abilities in three handicapped people who have driven suitably modified cars for several years. All three subjects failed in steering wheel operation of motor ability test and one subject failed in parking brake operation. These results showed that the motor ability test of driver's license test for the handicapped people was inappropriate and had to be changed.

본 연구는 장시간 서서 업무를 수행하는 간호사를 대상으로 테이핑요법이 하지불편감 및 피로에 미치는 효과를 파악하여 간호사의 건강 문제 중 하지 순환시스템 문제를 예방하기 위한 건강교육 프로그램 개발에 근거자료로 제시하고자 하였다. 연구방법은 정형외과 병동에서 5일 연속 낮번 근무를 하는 여자 간호사를 대상으로 테이핑요법 을 적용한 비동등성 대조군 전후 설계를 이용한 유사 실험연구이다. 자료수집은 2020년 11월 2일부터 12월 18일 까지였으며, B광역시에 소재한 2개의 정형외과 전문병원에서 실험군 30명, 대조군 30명, 총 60명을 모집하였다. 자료는 SPSS WIN 22.0 프로그램을 활용하여 카이제곱 검정, t-test와 paired t-test로 분석하였다. 연구결과 실험군은 대조군보다 하지불편감(t=-1.27, p=<.001)과 피로 점수(t=-0.60, p=<.001)가 낮았으며, 통계적으로 유의 하게 효과가 있는 것으로 확인되어 테이핑요법이 매우 효과적인 간호중재임이 증명되었다.

This study is presented as evidence for developing a health education program to prevent lower extermity circulatory system problems among nurses’s health problem by identifying the effects of taping therapy on lower extermites discomfort and fatigue for nurses who stand for long periods of time. The study method is a similar experimental study using a nonequivalent control group pretest-posttest design in which taping therapy was applied to female nurses who work day shifts for 5 consecutive days in an orthopedic surgery ward. Data collection was from November 2 to December 18, 2020, and a total of 60 nurses, 30 in the experimental group and 30 in the control group, were recruited from two orthopedic surgery hospitals located in B city. The data were analyzed by chi-square test, t-test and paired t-test using the SPSS WIN 22.0 program. As a result of the study, the experimental group had lower extermities discomfort(t=-1.27, p=<.001) and fatigue score(t=-0.60, p=<.001) than the control group, and it was confirmed that there was a statistically significant effect. It has been proven that taping therapy is a very effective nursing intervention.

목적 : 지역사회에 거주하는 장기요양보험심사 등급외 판정노인의 잔존 운동기능과 수단적 일생생활동작의 수행 독립성 양상을 각각 파악하고, 잔존 운동기능과 수단적 일상생활(Instrumental Activities of Daily Living; IADLs)의 독립성 간의 관계를 분석하는 것이다. 그 결과에 기초하여 등급외 판정 노인을 위한 지역사회 건강관리 서비스의 보완 방안을 고찰하고자 한다. 연구방법 : 본 횡단분석 연구를 위해 건강보험공단에서 제공하는 2015년 노인코호트 데이터 베이스를 사 용하였다. 지역사회에 거주하며 등급외 판정을 받은 노인의 사지의 운동장애 여부, IADLs 10개 항목에 대한 의존 수행 여부, 나이, 성별, 독거여부, 건강 보험료분위, 인지기능에 관한 정보를 추출하고, SAS Enterprise 7.1을 이용하여 기술통계와 이항 로지스틱 회귀분석을 통해 자료를 분석하였다. 결과 : 결측치가 없는 3,706명의 자료를 분석에 사용하였다. 대상자의 평균연령은 81.48세(표준편차 5.27)였으며, 여성비율은 75.63% 였다. 사지별 무장애 수준은 77.8~95.7% 였고, IADLs 수행 독립성 수준은 몸단장하기(50.0%), 약 챙겨먹기(70.4%) 항목에서 응답자의 과반 이상이 독립 수행을 보고했 고, 나머지 8개 항목에서 독립성 수준은 13.5~45.7% 였다. 부위별로 차이는 있으나 나이, 성별, 독거여 부, 건강 보험료분위, 인지기능을 통제했을 때, 대상자의 사지 운동 장애는 IADLs 수행 의존과 통계적 으로 유의한 정적 상관관계가 있는 것으로 나타났다. 결론 : 대상자들의 사지 무장애 비율에 비해서 IADLs 의존 수행이 높았다. 사지의 운동장애는 IADLs 의 존 수행과 상관관계가 있음을 확인했다. 등급 외 판정 노인의 장기요양집단 진입 예방에 효과적인 프로 그램 운영을 위해 기존의 지역사회 건강관리 서비스의 활용 및 다양화가 제안된다.

Objective: The aim of this study was to investigate and examine the associations between the motor function of upper and lower extremities and independent instrumental activities of daily living (IADLs) in community-dwelling older adults who are non-beneficiaries of the long-term care insurance program. Based on the results, we suggest the way to provide the community health care services effectively for the non-beneficiaries of the long-term care insurance program. Methods: For this cross-sectional study, we used the 2015 Elderly Cohort database which was collected and administrated by National Health Insurance of South Korea. Information on the motor disability of four extremities, dependency in ten IADLs items, age, sex, living status, socioeconomic status, and cognitive function were used for analysis. Descriptive analysis and binary logistic regression analysis were conducted using SAS Enterprise 7.1. Results: Data from 3,706 older adults without missing valus were used for analysis. Mean age was 81.48 years (SD 5.27) and female was 75.63%. The rates of people without motor disability in four extremities for each were 77.8% - 95.7%. Excepting for bodycare (50.0%) and medication (70.4%) which showed relatively high rate of independence, the levels of independence in eight items were 13.5% - 45.7%. Although there were differences according to the extremities, motor disability was positively associated with dependency in IALDs when adjusting for confounders. Conclusion: Compared to the rate of extremities without motor disability, the rate of dependence in IADLs was relatively high. There were statistically significant positive associations between motor function of extremities and dependent IADLs. It is recommended that developing diverse community health care services in addition to utilizing the present health care services to prevent non-beneficiary older adults of the long-term care insurance program from entering long-term care service users group.