• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.60-68
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• 2021

Objective : Until recently, the transfemoral approach (TFA) was used as the primary method of arterial approach in acute ischemic stroke (AIS). However, TFA resulted in longer reperfusion times and worse outcomes in the mechanical thrombectomy (MT) of patients with complex aortic arches and significant carotid tortuosity. We found that the transradial approach (TRA) is a more favorable alternative approach for MT in such cases. Methods : We performed a retrospective review of our institutional database to identify 202 patients who underwent MT for AIS between February 2015 and December 2019. Patient characteristics, cause of TFA failure, procedure time, intra-procedural complications, and outcomes were recorded. Results : Eleven (5.4%) of 202 patients, who underwent MT for AIS, crossed over to TRA for recanalization, and eight (72%) of 11 achieved successful recanalization (≥modified Treatment in Cerebral Infarction 2b). The mean age (mean±standard deviation [median]) was 82.3±6.6 (76) years, and five of the 11 patients were male. The last seen normal to puncture time was 467.9±264.72 (264) minutes; baseline National Institutes of Health Stroke Scale score was 28.9±14.5 (16). Six (55%) of the 11 patients had right vertebrobasilar occlusions, and the remaining five (45%) had anterior circulation occlusive disease. The time from groin puncture to final recanalization time (overall procedural time) was 78.0±20.1 (62) minutes. The mean crossover time from TFA to TRA was 45.2±10.5 (41) minutes. The mean time from radial puncture to final recanalization was 33.8±10.5 (28) minutes. Distal thrombus migration events in previously unaffected territories occurred in 3/8 patients (37%). At 90 days, three patients (28%) had a favorable clinical outcome. Conclusion : Although rare, failure of TFA has been known to occur during MT for AIS. Our results demonstrate that TRA may be an alternative option for AIS intervention for select patients with subsequent timely revascularization. However, the incidence of distal thrombus migration was high, and the first puncture to reperfusion time was prolonged because of the time taken for the crossover to TRA after failure of TFA. This study provides some evidence that the TRA may be a viable alternative option to the TFA for MT of AIS.

• 한국콘텐츠학회논문지
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• 제21권8호
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• pp.608-618
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• 2021

본 연구는 간호대학생을 대상으로 개발된 프로그램 학습성과 간접측정도구의 활용을 위해 타당도와 신뢰도를 검증한 연구이다. 대상자는 국내 5개 간호학과의 재학생 396명이었으며, 자료수집은 2019년 11월 22일부터 12월 10일까지 이루어졌다. 자료분석은 IBM Statistics SPSS 21.0과 AMOS 21.0 프로그램을 이용하여 문항분석, 탐색적 및 확인적 요인분석을 실시하였다. 문항분석 결과 79개 문항이 모두 요인분석 대상으로 선정되었다. 탐색적 요인 분석결과 다른 요인과 함께 부하하는 5개의 문항이 삭제되었고 최종 요인부하량의 범위는 .37부터 .86이었으며, 12개 요인에 대한 총 분산은 71.71%로 나타났다. 확인적 요인분석결과 삭제된 문항은 없었으며, 최종 척도는 74개 항목으로 구성되었다. 척도의 평균 점수는 3.78점, Cronbach' α는 .98이었다. 본 연구를 통해 간호교육 프로그램 학습성과 간접측정도구의 타당도와 신뢰성이 검증되었으므로 간호대학생을 위해 보다 표준화된 측정도구로 사용될 수 있을 것이다.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.101-105
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• 2022

Background: Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods: This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results: Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p<0.05) but were not significantly different between the two groups (p>0.05). No post-surgical complication was found in either group. Conclusions: There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.

• 대한한의학회지
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• 제42권4호
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• pp.40-60
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• 2021

Objectives: This study aimed to evaluate the impact of a training course on pharmacovigilance for future doctors of Korean medicine (DKM). Methods: In 2020, a pharmacovigilance training course was conducted for 57 senior students of a Korean medicine (KM) college, and its impact to the students were assessed in terms of the knowledge, attitudes, and perceptions of these students at three-time points: pre-training, post-training, and 4-6 months after the end of the training. Results: A total of 38 students completed the survey. The average score from the knowledge test increased significantly after training compared to prior to the training (5.47±2.140, 6.61±1.001, respectively, p<0.001) and was maintained until the final survey (6.61±1.220). The rate of correct answers to most of the knowledge test questions increased after the training but decreased in the final survey. In terms of attitudes, self-confidence in causality assessment (2.63±1.025, 4.58±0.826, p<0.001) and spontaneous reporting (2.08±1.050, 4.74±0.446, p<0.001) significantly increased after the training and then slightly decreased (3.92±1.171, 4.40±0.755). The perception level was high prior to the training, and this pattern was maintained throughout the study period. Students responded that pharmacovigilance education was necessary for DKM after training, and for the undergraduates of KM colleges. Conclusions: This study shows that this pharmacovigilance training course is effective for students majoring in KM but that retraining is required at least 6 months after the initial training. Further follow-up studies are needed to ensure that students actively participate in spontaneous reporting after graduation, and continuous education should be provided to graduates.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.175-181
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• 2023

Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

• Journal of Audiology & Otology
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• 제23권1호
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• pp.39-48
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• 2019

Background and Objectives: The influence of visual stimulus on the auditory component in the perception of auditory-visual (AV) consonant-vowel syllables has been demonstrated in different languages. Inherent properties of unimodal stimuli are known to modulate AV integration. The present study investigated how the amount of McGurk effect (an outcome of AV integration) varies across three different consonant combinations in Kannada language. The importance of unimodal syllable identification on the amount of McGurk effect was also seen. Subjects and Methods: Twenty-eight individuals performed an AV identification task with ba/ga, pa/ka and ma/ṇa consonant combinations in AV congruent, AV incongruent (McGurk combination), audio alone and visual alone condition. Cluster analysis was performed using the identification scores for the incongruent stimuli, to classify the individuals into two groups; one with high and the other with low McGurk scores. The differences in the audio alone and visual alone scores between these groups were compared. Results: The results showed significantly higher McGurk scores for ma/ṇa compared to ba/ga and pa/ka combinations in both high and low McGurk score groups. No significant difference was noted between ba/ga and pa/ka combinations in either group. Identification of /ṇa/ presented in the visual alone condition correlated negatively with the higher McGurk scores. Conclusions: The results suggest that the final percept following the AV integration is not exclusively explained by the unimodal identification of the syllables. But there are other factors which may also contribute to making inferences about the final percept.

• 대한청각학회지
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• 제23권1호
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• pp.39-48
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• 2019

Background and Objectives: The influence of visual stimulus on the auditory component in the perception of auditory-visual (AV) consonant-vowel syllables has been demonstrated in different languages. Inherent properties of unimodal stimuli are known to modulate AV integration. The present study investigated how the amount of McGurk effect (an outcome of AV integration) varies across three different consonant combinations in Kannada language. The importance of unimodal syllable identification on the amount of McGurk effect was also seen. Subjects and Methods: Twenty-eight individuals performed an AV identification task with ba/ga, pa/ka and ma/ṇa consonant combinations in AV congruent, AV incongruent (McGurk combination), audio alone and visual alone condition. Cluster analysis was performed using the identification scores for the incongruent stimuli, to classify the individuals into two groups; one with high and the other with low McGurk scores. The differences in the audio alone and visual alone scores between these groups were compared. Results: The results showed significantly higher McGurk scores for ma/ṇa compared to ba/ga and pa/ka combinations in both high and low McGurk score groups. No significant difference was noted between ba/ga and pa/ka combinations in either group. Identification of /ṇa/ presented in the visual alone condition correlated negatively with the higher McGurk scores. Conclusions: The results suggest that the final percept following the AV integration is not exclusively explained by the unimodal identification of the syllables. But there are other factors which may also contribute to making inferences about the final percept.

• Hip & pelvis
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• 제35권1호
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• pp.32-39
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• 2023

Purpose: A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the "gold standard" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur. The aim of this study is to evaluate functional results and infection control in two-stage treatment of total hip arthroplasty (THA) PJI with and without a spacer. Materials and Methods: A retrospective review of 64 consecutive patients was conducted: 34 underwent two-stage revision using a cement spacer (group A), 30 underwent two-stage revision without a spacer (group B). At the final follow-up, functional evaluation of patients with a THA in site, without PJI recurrence, was performed using the Harris hip score (HHS). Measurement of limb-length and off-set discrepancies was performed using anteroposterior pelvic X-rays. Results: Most patients in group B were older with more comorbidities preoperatively. Thirty-three patients (97.1%) in group A underwent THA reimplantation versus 22 patients (73.3%) in group B (P<0.001). No significant differences in limb-length and off-set were observed. The results of functional evaluation performed during the final follow-up (mean, 41 months) showed better function in patients in group A (mean HHS, 76.3 vs. 55.9; P<0.001). Conclusion: The use of antibiotic-loaded cement spacer seems superior in terms of functional outcomes and reimplantation rate. Resection arthroplasty might be reserved as a first-stage procedure in patients who are unfit, who might benefit from a definitive procedure.

• Safety and Health at Work
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• 제14권4호
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• pp.358-367
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• 2023

Background: This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace. Methods: This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS₂₂ and AMOS₂₀ software. Results: The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items-58-item final version of the scale-six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively. Conclusion: This study confirmed that the psychometric features of the 58-item final version of PAWPQSCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

• Hip & pelvis
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• 제36권2호
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• pp.120-128
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• 2024

Purpose: The purpose of this study was to compare the clinical and radiographic outcomes with use of short-curved stems versus standard-length single wedged stems over a minimum follow-up period of five years. Materials and Methods: A retrospective study of primary total hip arthroplasties performed using the Fitmore^® stem (127 hips, 122 patients) and the M/L taper^® stem (195 hips, 187 patients) between October 2012 and June 2014 was conducted. The clinical and radiographic outcomes were obtained for evaluation over a minimum follow-up period of five years. Results: In both the Fitmore^® and M/L taper^® groups, the mean Harris hip score improved from 52.4 and 48.9 preoperatively to 93.3 and 94.5 at the final follow-up, respectively (P=0.980). The mean Western Ontario and McMaster Universities Osteoarthritis Index scores also improved from 73.3 and 76.8 preoperatively to 22.9 and 25.6 at the final follow-up, respectively (P=0.465). Fifteen hips (Fitmore^®: 14 hips; M/L taper^®: one hip, P<0.001) developed intraoperative cracks and were treated simultaneously with cerclage wiring. Radiography showed a radiolucent line in 24 hips in the Fitmore^® group and 12 hips in the M/L taper^® group (P=0.125). Cortical hypertrophy was detected in 29 hips (Fitmore^® group: 28 hips; M/L taper^® group: one hip, P<0.001). Conclusion: Similarly favorable clinical and radiographic outcomes were achieved with use of both short-curved stems and standard-length single wedged stems. However, higher cortical hypertrophy and a higher rate of femoral crack were observed with use of Fitmore^® stems.