• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.10-17
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• 2014

Background: The aim of this study was to assess the clinical outcomes after treatment of proximal humeral fractures with locking plates, and to determine which factors influence the clinical and radiological outcomes. Methods: Fifty six patients who were treated with locking plates for proximal humeral fractures and had been followed for more than 1 year were enrolled in this study. We performed functional evaluation using the Constant score and analyzed radiographic results. The following factors that may potentially influence the clinical outcomes were assessed: age, gender, type of fracture, presence of medial metaphyseal comminution, bone mineral density, anatomical reduction, restoration of medial mechanical support, and postoperative complications. Results: The mean Constant score was 70.1 points at the final follow-up. Female gender, 4-part fractures, AO type-C fractures, and fractures with medial metaphyseal comminution were associated with a poor clinical outcome. On the other hand, restoration of medial mechanical support and accurate anatomical reduction had a positive influence on clinical outcomes. Postoperative complications resulted in 3 patients (intra-articular screw perforation: 1 patient, varus deformity with screw loosening: 1 patient, nonunion: 1 patient). Conclusions: When treating proximal humeral fractures with locking plate fixation, following factors: a female gender, Neer type 4-part fracture, AO type C fracture, and medial metaphyseal comminution are important risk factors that surgeons should take into consideration. Factors that contribute to better clinical outcomes of operative treatment for humeral fractures are accurate anatomical reduction and restoration of medial mechanical support.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.95-101
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• 2010

Objective : Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes. Methods : We analyzed data obtained from 13 consecutive PSO-treated patients presenting with fixed sagittal imbalances from 1999 to 2006. A single spine surgeon performed all operations. The median follow-up period was 73 months (range 41-114 months). Events during peri operative course and complications were closely monitored and carefully reviewed. Radiographs were obtained and measurements were done before surgery, immediately after surgery, and at the most recent follow-up examinations. Clinical outcomes were assessed using the Oswestry Disability Index and subjective satisfaction evaluation. Results : Following surgery, lumbar lordosis increased from $-14.1^{\circ}{\pm}20.5^{\circ}$ to $-46.3^{\circ}{\pm}12.8^{\circ}$ (p<0.0001). and the C7 plumb line improved from $115{\pm}43\;mm$ to $32{\pm}38\;mm$ (p<0.0001). There were 16 surgery-related complications in 8 patients; 3 intraoperative, 3 perioperative, and 10 late-onset postoperative. The prevalence of proximal junctional kyphosis (PJK) was 23% (3 of 13 patients). However, clinical outcomes were not adversely affected by PJK. Intraoperative blood loss averaged 2,984 mL. The C7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusion : Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results.

• 의학교육논단
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• 제15권1호
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• pp.31-38
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• 2013

This paper focuses on the outcome-based curriculum of Inje University College of Medicine to describe our curriculum development process and results. Starting in 2006, we have revised the curriculum based on the competency-based clinical presentation curriculum. We stated clearly the learning outcomes from the social needs and educational goal of our university. We defined 8 exit outcomes and specified phase outcomes, course outcomes, lesson outcomes, and outcome objectives. By 2012, we identified 128 clinical presentations and 149 basic scientific concepts. Various evaluation and assessment methods and teaching-learning strategies were assigned to each outcome. Problem-based learning, standardized patient practice, and learning portfolios are the main strategies of our curriculum. We have performed a progress test to assess the level of achievement of students' outcomes. We have also collected feedback from students and faculty members about the curriculum, including every lesson, course, and the overall curriculum. To maintain this change of the curriculum, we reorganized the curriculum committee, educational faculty and teams, and administrative support system. To fine tune this curriculum, we have held three 3-day workshops on curriculum development and weekly meetings. We believe this is just the beginning of developing the curriculum of Inje University. Further upgrades will be necessary to continue to improve medical education.

• Journal of Korean Medical Science
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• 제33권48호
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• pp.309.1-309.13
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• 2018

Background: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. Methods: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. Results: Of 2,660 VLBWI, the mean gestational age and birth weight were $29^{1/7}{\pm}2^{6/7}$ weeks and $1,093{\pm}268g$ in 2013 and $29^{2/7}{\pm}2^{6/7}$ weeks and $1,125{\pm}261g$ in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. Conclusion: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.

• Perinatology
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• 제29권4호
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• pp.147-152
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• 2018

Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.

• Journal of Periodontal and Implant Science
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• 제44권4호
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• pp.201-206
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• 2014

Purpose: Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis. Methods: Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ${\geq}7mm$ and clinical attachment level (CAL) of sites with attachment loss ${\geq}5mm$ were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values. Results: Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases. Conclusions: These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.

• 기술혁신학회지
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• 제11권4호
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• pp.613-638
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• 2008

2005년 '국가연구개발사업 등의 성과평가 및 성과관리에 관한 법률'이 제정되고, 이를 수행하기 위한 '연구성과관리활용기본계획(안)'이 수립되면서 연구개발성과관리 및 활용 그리고 이에 대한 체계적인 관리가 본격화되고 있다. 본 연구는 관련 법령과'연구성과관리활용기본계획(안)'의 기본 목적에 부합하면서 성과 활용가능성이 크게 요구되고 있는 산업기술분야의 국가연구개발 성과확산을 촉진할 수 있는 추적평가관리체계 모형과 본 모형을 현행 연구기관평가체계와 양립할 수 있는 세 가지 적용방안을 제안한다. 특히, 국가 연구개발사업 및 과제의 성과에 대한 체계적이고 합리적인 추적평가를 위하여 AHP 및 DEA 등 계량적 방법론을 활용 상대 평가할 수 있는 방안을 제시한다.

• Journal of the Korean Data and Information Science Society
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• 제24권6호
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• pp.1285-1296
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• 2013

강의평가 결과에 영향을 미치는 특성변수로는 교과목 수준의 다양한 강좌특성 변수들과 수강생 수준의 다양한 인적특성 변수들이 있다. 특정 수강생은 다수의 교과목을 이수하기 때문에 다수의 교과목들은 동일한 수강생 안에 속하게 됨으로써 공유되는 특성이 있게 된다. 즉 강의평가 결과는 교과목 수준의 강좌특성 (1-수준)과 수강생 수준의 인적특성 (2-수준)에 의해 영향을 받는 다층구조 (multilevel)를 가지게 되며, 위계적 자료 특성을 가지는 복수의 분석단위의 구조가 된다. 따라서 전통적인 회귀분석에서와 같이 개별 교과목들이 독립이라는 가정을 할 수 없게 된다. 본 논문에서는 강의평가결과에 영향을 미치는 다층구조의 특성을 가진 변수들의 영향력을 보다 타당하게 분석하기 위한 방법으로 위계선형모형 (HLM; hierarchical linear model)을 이용하였다. 분석결과는 다음과 같다. 먼저 교과목 수준의 특성변수들 중에 강좌규모, 개설학년, 담당교수의 전임여부, 해당 교과목의 총 평균평점, 원어강좌 여부가 통계적으로 유의하게 강의평가 결과에 영향을 미친 것으로 나타났다. 또한 수강생 수준의 인적특성 변수들 중에는 성별, 학과계열, 대입당시 전형방법, 평균평점 등이 유의하게 강의평가 결과에 영향을 미친 것으로 나타났다.

• Pediatric Infection and Vaccine
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• 제15권1호
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• pp.20-29
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• 2008

The basis of the economic evaluation of vaccination is the balance between the use of the resources (input) and the improvements that result from the vaccination (output). Techniques used for economic evaluation of vaccination are cost analysis, cost-minimization analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. Cost analysis seeks to characterize the costs of a given vaccination program. Cost-effective analysis is to helps policy-makers decide on the best use of allocated resources, whether cost-benefit analysis is to helps policy-makers decide on the overall allocation of resources. Cost-utility analysis is a specific form of cost-effective analysis in which outcomes are reduced to a common denominator such as the quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Many economic analyses have been conducted on vaccines in the world, but there have been a little studies on economic evaluation on vaccines in Korea. This paper reviewed the methodology used to economic evaluation on vaccines and immunizations and addressed some examples of the methods.

• 한방재활의학과학회지
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• 제26권4호
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• pp.45-55
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• 2016

Objectives The aim of this review is to provide fundamental data for temporomandibular disorders diagnosis and evaluation criteria which can be used in clinical trial. Methods We investigated the clinical studies on temporomandibular disorders via PubMed. Also, we searched domestic articles through "OASIS", "NDSL", "KISS", "Korean Traditional Knowledge Portal (KTKP)". The articles we focused on were the recent decade from 2007 to 2016. A total of 139 studies were analyzed: 42 domestic articles and 97 overseas articles. This study focuses on the diagnosis and evaluation criteria on temporomandibular disorders. Results 1) In diagnosis criteria, Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used 14 times in domestic articles and 63 times in overseas articles. Clinical symptoms were used 13 times in domestic articles, 17 times in overseas articles. 2) In evaluation criteria, Visual Analog Scale (VAS) was used as a pain scale 12 times in domestic articles, 63 times in overseas articles. Pressure Pain Threshold (PPT) was used 16 times in overseas articles. Whereas, no clinical trials used PPT in domestic articles. In psychological scale, Symptom Checklist-90-Revised (SCL-90-R) was used 6 times. However, SCL-90-R was used 2 times in domestic articles. ROM(Maximum Mouth Opening (MMO), Maximum Comfortable Opening (MCO) were used 24 times in overseas. In domestic articles, MMO was counted 12 times, while MCO was counted 5 times. Conclusions This research reviewed the tendency of using diagnosis methods and evaluating outcomes of the clinical on TMD. It is expected that this investigation would develop further treatment for TMD in the Korean Medicine.