• Clinical and Experimental Pediatrics
• /
• v.64 no.7
• /
• pp.313-321
• /
• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• Journal of Sensor Science and Technology
• /
• v.28 no.5
• /
• pp.299-304
• /
• 2019

Recently, the development of rehabilitation medical technology has resulted in an increased interest in speech therapy equipment. In particular, research on articulation therapy for communication disorders is being actively conducted. Existing methods for the diagnosis and treatment of speech disorders have many limitations, such as traditional tactile perception tests and methods based on empirical judgment of speech therapists. Moreover, the position and tension of the tongue are key factors of speech disorders with regards to articulation. This is a very important factor in the distinction of Korean characters such as lax, fortis, and aspirated consonants. In this study, we proposed a Korean electropalatography (EPG) system to easily measure and monitor the position and tension of the tongue in articulation treatment and diagnosis. In the proposed EPG system, a sensor was fabricated using an AgCl electrode and biocompatible silicon. Furthermore, the measured signal was analyzed by implementing the bio-signal processing module and monitoring program. In particular, the bio-signal was measured by inserting it into the palatal from an experimental control group. As a result, it was confirmed that it could be applied to clinical treatment in speech therapy.

• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.1
• /
• pp.173-181
• /
• 2021

Purpose : The purpose of this study is to compare muscle activity after applying two muscle energy techniques (MET) to subjects with forward head posture to see if the post isometric relaxation (PIR) technique is more effective than the reciprocal inhibition (RI) technique. Methods : The muscle activity was measured using EMG after applying the PIR and RI techniques to 30 adults at K College. Subjects were selected for forward head posture whose ear center was 2.5 ㎝ front of the center of the shoulder. EMG equipment was used to measure muscle activity, and the measurement sites were measured in cervical flexor and extensor muscles. The experiment period was performed once a week for a total of two weeks, and after the pre-measurement was performed for 5 minutes PIR and RI exercise. In the PIR technique, the head is tilted back in a sitting position, and the experimenter applies resistance with the same force for 7~10 seconds and repeats 3-5 times after rest. In the RI technique, in a sitting position, the subject gives the force to bend the head forward, and the experimenter applies resistance with the same force for 7 to 10 seconds, and repeats 3 to 5 times after rest. Results : The result is same as the following. In the comparison of muscle activity, there was a significant decrease in both PIR and RI at 1 and 2 weeks. And there was a greater decrease in muscle activity in PIR. There was no difference in the comparison of decrease in muscle activity at 1 week and 2 week. Conclusion : Both PRI and RI can be said to be effective in improving the function of the forward head posture in the neck muscles. Therefore, the selection of the two techniques in clinical practice should be appropriately performed under the judgment of experts according to the patient's situation.

• The Journal of Internal Korean Medicine
• /
• v.42 no.6
• /
• pp.1303-1318
• /
• 2021

Objectives: The aim of this study was to examine the debate on the use of medical devices between Western Medicine and Korean Medicine, as this is one of the greatest conflicts in Korea's medical profession. Judicial precedents and interpretations of authority serve as regulations because medical affairs law states that Korean Medicine practices are ambiguous. Method: We conducted a search in the Korean RISS, OASIS, and DBPIA databases using several keywords associated with medical devices, Korean Medicine, and Korean Medicine Doctors. The search period was until November 5 2021. The retrieved papers were classified according to the selection and exclusion criteria by checking the title, abstract, and text. For precedents, searches were done regarding comprehensive legal information, etc., and in the case of non-disclosure precedents, we requested access to the precedents by web-court requests. Results: A total of 80 documents were found as a result of the search, and 13 publications were included in the study. The selected publications were classified and analyzed by this research team into Korean medicine, Western medicine, and legal or state agency research. In the existing literature and judgments, the arguments that played a major role changed depending on the time the judgment was made. "Social conventions", "curriculum", "academic principles", and "health and hygiene dangers" were the key arguments. Conclusions: Further studies will be needed that can comprehensively arrange the existing literature and clinical results, and continuous study will be needed to verify that the use of medical devices by Korean medicine doctors is helpful for prognosis and accurate treatment of their patients.

• Archives of Plastic Surgery
• /
• v.49 no.4
• /
• pp.488-493
• /
• 2022

Background Currently, the BREAST-Q can effectively measure patient's satisfaction on the quality of life from the patient's perspective in relation to different type of breast reconstruction. However, evaluation of patient satisfaction and cosmetic outcomes in breast reconstruction may have potential to led bias. Methods To maximize the benefits of using BREAST-Q to evaluate clinical outcome, we performed comparative study focused on the correlation between postoperative BREAST-Q and cosmetic outcomes assessed by medical professionals. For the current analysis, we used three postoperative BREAST-Q scales (satisfaction with breast, psychosocial well-being, and sexual well-being). The Ten-Point Scale by Visser et al was applied to provide reproducible grading of the postoperative cosmetic outcomes of the breast. The system includes six subscales that measured overall aesthetic outcome, volume, shape, symmetry, scarring, and nipple-areolar complex. The photographic assessments were made by five medical professionals who were shown photographs on a computer screen in a random order. Obtained data were stored in Excel and evaluated by Spearman's correlations using SPSS Statistics. Results We enrolled 92 women in this study, 10 did not respond to all scales of postoperative BREAST-Q, the remaining 82 women had undergone breast reconstruction. The correlation between BREAST-Q score and aesthetic score measured by Ten-Point Scale for the three BREAST-Q scales all show positive values in Spearman's correlation coefficient. Conclusion A significant correlation without any bias observed was found between the patient's satisfaction measured by BREAST-Q after breast reconstruction and the medical expert's aesthetic evaluation.

• KIPS Transactions on Software and Data Engineering
• /
• v.12 no.6
• /
• pp.243-250
• /
• 2023

Chest X-ray is radiological examination for xeamining the lungs and haert, and is particularly widely used for diagnosing lung disease. Since the quality of these chest X-rays can affect the doctor's diagnosis, the process of evaluating the quality must necessarily go through. This process can involve the subjectivity of radiologists and is manual, so it takes a lot of time and csot. Therefore, in this paper, based on the chest X-ray quality assessment guidelines used in clinical settings, we propose a tool that automates the five quality assessments of artificial shadow, coverage, patient posture, inspiratory level, and permeability. The proposed tool reduces the time and cost required for quality judgment, and can be further utilized in the pre-processing process of selecting high-quality learning data for the development of a learning model for diagnosing chest lesions.

• Korean Medical Education Review
• /
• v.25 no.2
• /
• pp.159-173
• /
• 2023

The purpose of this study was to develop and validate a competency tool for new nurses and to pilot-test it with new nurses. A Delphi survey was conducted to develop a competency tool, and a self-evaluation was conducted among new nurses who pilot-tested the finally derived competencies. The Delphi survey panel consisted of 18 people, including adjunct professors at the College of Nursing, nursing managers, and nurses with master's degrees. The Delphi survey asked about the validity of the competencies constructed in two rounds. After analyzing the Delphi results with mean, standard deviation, content validity ratio, degrees of convergence, and degrees of consensus, 12 core competencies and 36 enabling competencies were finally derived. The competencies consisted of clinical judgment and management (nine items), task competence (four items), patient orientation (five items), moral value orientation (three items), cooperation (two items), supply management (two items), professional development (three items), confidence (one item), self-control (two items), flexibility (two items), influence (one item), and nurturing others (two items). The finally derived competencies were pilot-tested with 229 new nurses who had worked for 2-12 months. The self-evaluation scores of new nurses were distributed differently according to their working period. In this study, the competencies required for new nurses were identified and the corresponding enabling competencies were identified. In the future, it is expected that a competency-based education program will be prepared based on these findings, and furthermore, it will be possible to provide high-quality medical and nursing services that meet patients' needs by improving the competency of new nurses and lowering the turnover rate.

• Journal of Gastric Cancer
• /
• v.23 no.3
• /
• pp.375-387
• /
• 2023

Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions. Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.

• The Journal of the Convergence on Culture Technology
• /
• v.10 no.1
• /
• pp.171-182
• /
• 2024

The purpose of the study was to review the evidence of effects of SBAR for communication in domestic nursing students. Four databases were searched for articles publised until June 2023 that databases include RISS, KISS, DBpia & KCI. Key word used for search include 'nursing students,' 'nursing,' 'SBAR,' 'communication.' Of 57 papers searched, seventeen studies were selected for data analysis. Studies evaluated outcomes including communication clarity, communication competence, communication confidence, critical thinking ability, self-efficacy, reporting confidence, clinical judgment, and communication satisfaction that most studies reported positive effects while some figures were not statistically significant. Accordingly, we intend to analyze the characteristics and contents of communication interventions using SBAR, evaluate their effectiveness, and use them as evidence for future follow-up research on communication interventions using SBAR.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.2
• /
• pp.118-125
• /
• 2005

Purpose: The expression of apoptosis-related genes, such as survivin, bcl-2, and bax has been examined in the human osteosarcoma and then evaluated the correlation with clinical data of patients. Materials and Methods: Fifty human osteosarcoma specimens were established from incisional biopsy and examination of survivin, bcl-2, and bax by immunohistochemical study was performed. We investigated the correlation of survivin, bcl-2, bax and their two or three combined expressions with clinical data including the response of chemotherapy, local recurrence, distance metastasis, and oncologic outcome. Results: Survivin was showed in 26 cases (52%), bcl-2 in 23 cases (46%), and bax in 21 cases (42%) osteosarcoma. And coexpression of survivin and bcl-2 was showed in 19 cases (38%), survivin and bax in 13 cases (26%), bcl-2 and bax in 8 cases (16%), and all three expression was showed in 8 cases (16%). There was no correlation between their apoptosis related gene and histologic difference, the presence of local recurrence and distant metastasis. Whereas neoadjuvant chemotherapy response correlated with bcl-2 expression (P=0.04), and survivin and bcl-2 coexpression (P=0.044) with poor chemoresponse. The rate of died of disease was correlated with bcl-2 (P=0.001), survivin and bcl-2 coexpression (P=0.027) with bad outcome. Survival curves of bcl-2 (P=0.0075), survivin and bcl-2 (P=0.0012) was showed negative correlation in the Kaplan-Meier method. Conclusion: The apoptosis related gene expression was relatively high in osteosarcoma, bcl-2 expression was correlated with poor chemotherapy response and poor survival rate, but survivin was correlated with this oncologic outcome only in the bcl-2 coexpression. The examination of immunohistochemical stain of apoptosis related gene in osteosarcoma could be helpful in the judgment of osteosarcoma prognosis.