Kim, A-Jung;Park, Tae-Jun;Bak, Young-Seok;Kim, Jun-Ho;Kim, Yong-Seok;Son, Yu-Mi;Lee, Kui-Ja
The Korean Journal of Emergency Medical Services
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v.25
no.2
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pp.39-53
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2021
Purpose: Emergency medical technicians (EMTs) have so far been trained as professionals under the same conditions, with no change in the 1995 Act. We aimed to find ways for them to secure expertise in accordance with social needs by strengthening the quality of the EMT education. Methods: This is a descriptive study comparing the operation status of the national emergency medical examination conducted by the Korea Health Personnel Licensing Examination Institute, and the national examinations of EMT paramedic and EMT basic. The scope of the national examinations for EMT was compared by subject and area. Results: The national written exam for EMT paramedic consists of five areas. EMT basic does not include basic medicine in three related subjects, 11 areas, and 18 detail areas. Paramedic care does not include advanced pediatric life support. In addition, nine areas and 20 detail areas are not included. Conclusion: The study suggests the need for institutional supplementation so that those who have completed EMT basic and the subjects prescribed by the ordinance of the Ministry of Health and Welfare at universities, etc., in the Higher Education Act can take the EMT paramedic national exam.
Purpose: The aim of this study was to evaluate and compare the accuracy performance of dental professionals in the classification of different types of dental implant systems (DISs) using panoramic radiographic images with and without the assistance of a deep learning (DL) algorithm. Methods: Using a self-reported questionnaire, the classification accuracy of dental professionals (including 5 board-certified periodontists, 8 periodontology residents, and 31 dentists not specialized in implantology working at 3 dental hospitals) with and without the assistance of an automated DL algorithm were determined and compared. The accuracy, sensitivity, specificity, confusion matrix, receiver operating characteristic (ROC) curves, and area under the ROC curves were calculated to evaluate the classification performance of the DL algorithm and dental professionals. Results: Using the DL algorithm led to a statistically significant improvement in the average classification accuracy of DISs (mean accuracy: 78.88%) compared to that without the assistance of the DL algorithm (mean accuracy: 63.13%, P<0.05). In particular, when assisted by the DL algorithm, board-certified periodontists (mean accuracy: 88.56%) showed higher average accuracy than did the DL algorithm, and dentists not specialized in implantology (mean accuracy: 77.83%) showed the largest improvement, reaching an average accuracy similar to that of the algorithm (mean accuracy: 80.56%). Conclusions: The automated DL algorithm classified DISs with accuracy and performance comparable to those of board-certified periodontists, and it may be useful for dental professionals for the classification of various types of DISs encountered in clinical practice.
Park, Jihyun;Lee, Jang Woo;Lee, Sang Eok;Kim, Byung Hee;Park, Dougho
Clinical Pain
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v.18
no.2
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pp.70-75
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2019
Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.
Background and Objectives: Fractional flow reserve (FFR) is an invasive standard method to identify ischemia-causing coronary artery disease (CAD). With the advancement of technology, FFR can be noninvasively computed from coronary computed tomography angiography (CCTA). Recently, a novel simpler method has been developed to calculate onsite CCTA-derived FFR (CT-FFR) with a commercially available workstation. Methods: A total of 319 CAD patients who underwent CCTA, invasive coronary angiography, and FFR measurement were included. The primary outcome was the accuracy of CT-FFR for defining myocardial ischemia evaluated with an invasive FFR as a reference. The presence of ischemia was defined as FFR ≤0.80. Anatomical obstructive stenosis was defined as diameter stenosis on CCTA ≥50%, and the diagnostic performance of CT-FFR and CCTA stenosis for ischemia was compared. Results: Among participants (mean age 64.7±9.4 years, male 77.7%), mean FFR was 0.82±0.10, and 126 (39.5%) patients had an invasive FFR value of ≤0.80. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-FFR were 80.6% (95% confidence interval [CI], 80.5-80.7%), 88.1% (95% CI, 82.4-93.7%), 75.6% (95% CI, 69.6-81.7%), 70.3% (95% CI, 63.1-77.4%), and 90.7% (95% CI, 86.2-95.2%), respectively. CT-FFR had higher diagnostic accuracy (80.6% vs. 59.1%, p<0.001) and discriminant ability (area under the curve from receiver operating characteristic curve 0.86 vs. 0.64, p<0.001), compared with anatomical obstructive stenosis on CCTA. Conclusions: This novel CT-FFR obtained from an on-site workstation demonstrated clinically acceptable diagnostic performance and provided better diagnostic accuracy and discriminant ability for identifying hemodynamically significant lesions than CCTA alone.
The purpose of this study is to improve the classification system of sub-divided land cover map among the land cover maps provided by the Ministry of Environment. To accomplish the purpose, first, the overseas country land cover map classification items were examined in priority. Second, the area ratio of each item established by applying the previous sub-divided classification system was analyzed. Third, the survey on the improvement of classification system targeting the users (experts and general public) who actually used the sub-divided land cover map was carried out. Fourth, a new classification system which improved the previous system by reclassifying 41 classification items into 33 items was finally established. Fifth, the established land cover classification items were applied on study area, and the land cover classification result according to the improvement method was compared with the previous classification system. Ilsan area in Goyang city where there are diverse geographic features with various land surface characteristics such as the urbanization area and agricultural land were distributed evenly were selected as the study area. The basic images used in this study were 0.25 m aerial ortho-photographs captured by the National Geographic Information Institute (NGII), and digital topographic map, detailed stock map plan, land registration map and administrative area map were used as the relevant reference data. As a result of applying the improved classification system into the study area, the area of culture-sports, leisure facilities was $1.84km^2$ which was approximately more than twice larger in comparison to the previous classification system. Other areas such as transportation and communication system and educational administration facilities were not classified. The result of this study has meaningful significance that it reflects the efficiency for the establishment and renewal of sub-divided land cover map in the future and actual users' needs.
The purpose of this study was to evaluate the effects of metatarsal pad (MP) compared with barefoot and MP with using different insoles on gait. 15 healthy females who had no history of injury in the lower extremity with an average age of 22.7 year(SD=1.35), height of 160 cm(SD=3.4), weight of 48.8 kg(SD=5.52) and average foot size of 232.5 mm(SD=6.8) participated in this study as the subjects. The subjects walked on a treadmill under four different experimental conditions: 1) walking with barefoot, 2) walking wearing MP 3) walking wearing a soft insole with MP(SIMP), 4) walking wearing a rigid insole with MP(HIMP). During walking, foot pressure data such as force, contacting area, peak pressure, and mean pressure was collected using Pedar-X System(Novel Gmbh, Germany) and EMG activity of lower limb muscles such as tibialis anterior(TA), lateral gastrocnemius(LG), rectus femoris(RF), and musculus biceps femoris(MBF) was gathered using Delsys EMG Work System(Delsys, USA). Collected data was then analyzed using paired t-test in order to investigate the effects of each of experimental conditions. As a result of the analysis, when MP and HIMP were equipped, overall contacting area was increased while the force, peak pressure and the mean pressure were decreased. Especially, when the SIMP was equipped, every data were significantly decreased. In case of EMG, wearing MP, SIMP and HIMP made three muscles(TA, LG, RF)'s activity decrease. A result of the analysis will be able to apply for manufacturing functional shoes, diabetes shoes, senior shoes and lower extremity orthosis. Significance of the study due to a metatarsal pad and the insole is to analyze the changes in muscle strength.
Purpose: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer. Materials and Methods: We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy. Results: There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%). Conclusion: The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.
In the late 1980s, 5 new towns such as Bundang, Ilsan, Pyeongchon, Sanborn, Jungdong were constructed to solve housing problems and to disperse functions concentrated within Seoul. As the city got matured, it began to appear the initial signs of urban problems such as aging of high rise-density apartment sites, traffic congestion, lack of parking spaces and aging of infrastructure. Therefore, in order to cope with urban problems, it is very important to apprehend the process of urban growth, its change and the feature of physical/human elements. So, the purpose of this thesis is to analyze the changes in housing and population characteristics for past 20 years by use of Census data from 1995 to 2010. First, the new town's goal of population and housing plan at the time of construction was analyzed how it was achieved, and it is close to the performance of the goal. And the trend of changes in the population and household characteristics was analyzed by every five year's data. As the result of analysis, it shows socio-demographic changes such as aged and elderly population growth, rapid increase in one generation's household and single person household, highly educated city, monthly rent household's increase and charter household's reduction. Results of this analysis can be utilized to aforethought management of new towns. But it is required more sustained and systematic urban monitoring and data analysis because the one-off analysis of the city's characteristics alone is difficult enough to grasp them.
Purpose: This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Materials and Methods: Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using 3D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. Results: The mean of the average point-to-point distances on condylar surface was $0.11{\pm}0.03mm$. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. Conclusion: This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.
The Journal of Sustainable Design and Educational Environment Research
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v.16
no.2
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pp.34-43
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2017
The purpose of this study is to provide a basis for determining when a school established long term school plans accepted by analyzing the trend of increase or decrease elementary school students 30 years to target of following nine cities, 552 elementary schools in Korea - 4 metropolitan cities(Ilsan, Bundang, Jungdong, Pyungchon, Sanbon, Dongtan and Kwangkyo), 4 central regional cities (Chunan, Asan, Seosan and Nonsan), 3 south-eastern regional cities(Pohang, Woolsan, Jinju, Changwon and Kyungsan) and 4south-western regional cities(Kwangju, Jeonju, Suncheon and Kunsan) for this purpose. Results of this study are as follows: First, the most common type was type 5, accounting for 56.8% (658) of the total, followed by type 11 (12.8%), type 13 (7.9%), type 15 (5.6%). Of the total 15 types, type 1, type 3, type 7 and type 14 accounted for less than 1% of the total. Second, the results of the Conflict Model I and Conflict Model II showed that Type1 and Type7 were not needed to be adopted.
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