• Journal of Korean Neurosurgical Society
• /
• 제62권5호
• /
• pp.561-566
• /
• 2019

Objective : Functional outcomes have traditionally been evaluated and compared using subjective surveys, such as visual analog scores (VAS), the Oswestry disability index (ODI), and Short Form-36 (SF-36), to assess symptoms and quality of life. However, these surveys are limited by their subjective natures and inherent bias caused by differences in patient perceptions of symptoms. The Fitbit $Charge^{(R)}$ (Fitbit Inc., San Francisco, CA, USA) provides accurate and objective measures of physical activity. The use of this device in patients after laminectomy would provide objective physical measures that define ambulatory function, activity level, and degree of recovery. Therefore, the present study was conducted to identify relationships between the number of steps taken by patients per day and VAS pain scores, prognoses, and postoperative functional outcomes. Methods : We prospectively investigated 22 consecutive patients that underwent laminectomy for spinal stenosis or a herniated lumbar disc between June 2015 and April 2016 by the same surgeon. When patients were admitted for surgery and first visited after surgery, preoperative and postoperative functional scores were recorded using VAS scores, ODI scores, and SF-36. The VAS scores and physical activities were recorded daily from postoperative day (POD) 1 to POD 7. The relationship between daily VAS scores and daily physical activities were investigated by simple correlation analysis and the relationship between mean number of steps taken and ODI scores after surgery was subjected to simple regression analysis. In addition, Wilcoxon's signed-rank test was used to investigate the significance of pre-to-postoperative differences in VAS, ODI, and SF-36 scores. Results : Pre-to-postoperative VAS (p<0.001), ODI (p<0.001), SF-36 mental composite scores (p=0.009), and SF-36 physical composite scores (p<0.001) scores were found to be significantly different. Numbers of steps taken from POD 1 to POD 7 were negatively correlated with daily VAS scores (r=-0.981, p<0.001). In addition, the mean number of steps from POD 3 to POD 7 and the decrease in ODI conducted one month after surgery were statistically significant (p=0.029). Conclusion : Wearable devices are not only being used increasingly by consumers as lifestyle devices, but are also progressively being used in the medical area. This is the first study to demonstrate the usefulness of a wearable device for checking patient physical activity and predicting pain and prognosis after laminectomy. Based on our experience, the wearable device used to provide measures of physical activity in the present study has the potential to provide objective information on pain severity and prognosis.

• Korean Journal of Radiology
• /
• 제22권2호
• /
• pp.159-167
• /
• 2021

Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001-0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40-49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

• 한국항만경제학회지
• /
• 제32권4호
• /
• pp.73-87
• /
• 2016

본 논문에서는 동북아시아 24개 컨테이너항만들의 4년간 자료(2009년-2012년)를 이용하여 5개의 투입요소(겐트리 크레인 수, 선석 수, 총 선석길이, 터미널면적, 평균수심), 2개의 산출요소(컨테이너화물처리량, 직기항 선사수)를 이용하여 항만효율성 측정 시 AR가중치를 부여하는 방법(다중회귀분석방법과 AHP방법)을 실증적으로 검증하였다. 즉, AHP/DEA-AR분석 결과에 대해서, 다중회귀분석방법으로 AR을 결정하고 항만들의 효율성을 측정한 후에 항만들 간의 순위를 이용하여 윌콕슨부호순위검정과 Mann-Whitney 윌콕슨 순위 합 검정방법으로 그 결과를 비교분석하여 검증하였다. 실증분석의 주요한 결과는 다음과 같다. 첫째, 측정한 순위를 근거로 윌콕슨부호순위검정을 실시한 결과 P값(유의확율)이 유의수준 0.05보다 훨씬 더 크게 나타났으므로, 귀무가설 Ho는 채택하였다. 즉, AHP/DEA-AR모형에 의한 효율성 순위와 다중회귀분석에서 도출된 AR을 이용한 효율성분석에 의한 순위에는 차이가 없는 것으로 나타났다. Mann-Whitney 윌콕슨 순위 합 검정도 동일한 결과를 보였다. 둘째, 평균적으로 보았을 때, 윌콕슨 부호순위검정에서 P값(유의확율)이 평균 0.845 수준에서 양 모형의 효율성 수치에 의한 순위가 서로 일치함을 보여 주었으며, Mann-Whitney 윌콕슨 순위 합 검정의 평균유의확율은 0.963으로 더 높게 나타났다. 셋째, 전체자료를 한꺼번에 고려하여 측정한 경우에는 윌콕슨부호순위검정에서 상대적으로 유의확율이 크게 낮아(0.845->0.694)졌으며, Mann-Whitney 윌콕슨 순위 합 검정도 낮아(0.963->0.925)졌다. 본 논문의 정책적인 함의는 항만운영자들이나 항만정책의 입안가들이 항만들에 대한 효율성을 측정할 때, 본 논문에서 제시한 AR가중치를 적용한 방법을 도입하여 시행함으로써 보다 정확한 항만효율성을 측정할 수 있어야만 한다는 점이다. 또한 더욱 확장시켜서 AHP법과 다중회귀분석방법을 접목한 방법을 도입하여 측정해야만 한다는 점이다. 항만투자금액을 결정할 때, 그러한 측정결과도 참고한다면 효과적인 항만관리 및 정책이 시행될 수 있을 것으로 확신한다. 본 논문의 한계는 퍼지분석법, 비방사적 DEA분석을 도입하지 못했으며, 그리고 AHP법과 다중회귀분석방법을 혼합한 측정결과를 제시하지 못했다는 점이다. 차후연구에서 다루고자 한다.

• 대한한의학회지
• /
• 제34권1호
• /
• pp.80-88
• /
• 2013

Objectives: The purpose of this study was to examine the effect of Temporomandibular joint Balance Appliance for Golf (TBA-G) of Functional Cerebrospinal Therapy (FCST) on golf driver head speed and back muscle power. Methods: Twenty-one participants that had a golf career of 4 years or more were involved. We measured golf drive head speed and back muscular strength before and after applying TBA-G in the mouth. A paired t test or Wilcoxon singed rank test was performed to identify the difference of effect between before and after applying TBA-G, using IBM SPSS 19.0. We considered difference significant at P<0.05. Results: Driver head speed increased significantly by 2 mph (1.99%) after applying TBA-G [from $100.52{\pm}9.82$ mph ($mean{\pm}SD$) to $102.52{\pm}10.43$ mph, P<0.001]. Back muscular strength also increased by 7.28 kg (5.60%) [from $129.90{\pm}28.31$ kg to $137.18{\pm}28.81$ kg, P<0.001]. In stratification analysis, a more significant increase was found in the drive head speed and back muscular strength of groups of males with weight more than 69kg, with height more than 175cm, and with golf experience more than 7 years, compared to those of other groups. Conclusions: The results suggest that TBA-G could improve golf drive head speed and back muscular strength.

• 한국의료질향상학회지
• /
• 제7권1호
• /
• pp.60-70
• /
• 2000

Background : The aim of this study was to examine the effectiveness of the critical pathway to diabetic patients who were admitted in the hospital. Methods : For establishment of critical pathway for diabetic patients, we organized the multidisciplinary care team. During 5 months, 31 diabetic inpatients were applied the critical pathway and the results were compared with 11 diabetic inpatients who were treated with conventional way. We assessed the patients satisfaction, knowledge on the disease, compliance of medical regimen, length of stay(LOS) and hospital cost. We used the computer program SAS for statistical analysis. Data were summarized with mean, and analyzed using t-test repeated measures ANOVA and Wilcoxon rank sum test. Results : Length of stay(LOS) was remarkably shortened in critical pathway group compared with the conventional treatment group($7.6{\pm}1.23$ vs $12.0{\pm}4.73$, p<0.000). Although LOS was significantly shortened in critical pathway group, patients satisfaction was much higher than conventional treatment group. There were no significant difference of knowledge on the disease, compliance of medical regimen and blood glucose level between two groups at discharge. Hospital cost of each patients also significantly decreased in critical pathway group(890,000 won vs 1,280,000 won, p<0.05). Conclusion : These results showed that establishment of critical pathway for diabetic inpatients with team approach is the one of the way to improve the quality of diabetic patients management and to enhance the efficiency of hospital management.

• 한국자동차공학회논문집
• /
• 제21권4호
• /
• pp.62-69
• /
• 2013

Visual demands associated with in-vehicle display usage and text messaging distract a driver's visual attention from the roadway. To minimize eyes-off-the-road demands, voice interaction systems are widely introduced. Under cognitively distracted condition, however, awareness of the operating environment will be degraded although the driver remains oriented to the roadway. It is also know that the risk of inattentive driving varies with age, thus systematic analysis of driving risks is required for the older drivers. This paper aims to understand the age-related driving performance degradation and visual attention changes under auditory cognitive demand which consists of three graded levels of cognitive complexity. In this study, two groups, aged 25-35 and 60-69, engaged in a delayed auditory recall task, so called N-back task, while driving a simulated highway. Comparisons of younger and older drivers' driving performance including mean speed, speed variability and standard deviation of lane position, and gaze dispersion changes, which consist of x-axis and y-axis of visual attention, were conducted. As a result, it was observed that gaze dispersion decreased with each level of demand, demonstrating that these indices can correctly rank order cognitive workload. Moreover, gaze dispersion change patterns were quite consistent in younger and older age groups. Effects were also observed on driving performance measures, but they were subtle, nonlinear, and did not effectively differentiate the levels of cognitive workload.

• Archives of Plastic Surgery
• /
• 제35권3호
• /
• pp.303-308
• /
• 2008

Purpose: The purpose of this study is to develop three-dimensional computerized anthropometry(3DCA) and to compare its reliability and accuracy 3DCA with manual anthropometry(MA) for measurement of lips and nasal deformities in unilateral cleft lips and palate(UCLP) patients. Methods: Samples were consisted of six UCLP patients whose facial plaster models were available immediately before and 3 months after the cleft lip surgery. MA of the facial plaster models was carried out using an electronic caliper. In 3DCA, three-dimensional auto-measuring program was used to digitize landmarks and to measure three-dimensional virtual facial models (3DVFM), which was generated with a laser scanner and 3D virtual modeling program. Intraclass correlation coefficients(ICC) were calculated to evaluate reliability and reproducibility of the variables in both methods, and Wilcoxon's signed rank test was done to investigate the difference in values of the same variables of facial models of each patient between two methods. Results: All ICC values were higher than 0.8, so both methods could be considered reliable. Although most variables showed statistical differences between two methods(p<0.05), differences between mean values were very small and could be considered not significant in clinical situation. Conclusion: In clinical situation, 3DCA can be an objective, reliable and accurate tool for evaluation of lips and nasal deformities in the cleft patients.

• Archives of Plastic Surgery
• /
• 제35권3호
• /
• pp.243-247
• /
• 2008

Purpose: For a proper wound care, the correct evaluation of wound is very important. Usually the evaluation of wound was subjective, and as a result, wound care was empirical. There were many attempts to objectify the wound evaluation, and one of them was measurement of the wound pH. The purpose of this study is to observe the wound pH changes during wound healing phase. Methods: From 2005 to 2007, we measured the pH values of 6 acute wounds, which were split thickness skin graft donor sites. In addition, we measured the pH values of 18 chronic wounds, which were 17 pressure sores and 1 tuberculosis ulcer. After pH meter ($SkinCheck1^{(R)}$, Hanna Instruments, Italy) was calibrated, wound pH was checked. Wound was cleansed with saline gauze and dressed with polyurethane foam dressing($Medifoam^{(R)}$, Biopol, Korea). Results: In split thickness skin graft donor sites, the pH raised(mean pH value: $7.45{\rightarrow}7.62$) when the wound was on the process of healing(*p=0.027, analysis of Wilcoxon signed-rank test). If wound became re-epithelialised, the pH value dropped to that of normal skin. However, we could not find a relation between time and the pH values in chronic wound. Conclusion: We could observe the consistent wound pH changes during wound healing phase in acute wound.

• 한국학교보건학회지
• /
• 제23권1호
• /
• pp.29-40
• /
• 2010

Purpose: The purposes of this study were: (a) to assess indoor air quality such as $PM_{10}$, $CO_2$ concentrations in child daycare centers, (b) to compare the levels with each standard, and (c) to identify teachers' awareness of indoor air quality in child care centers. Methods: Data were obtained from seventeen child daycare centers and ninety-eight teachers in a district of Seoul, from April 3 to May 12, 2009. Collected data were analyzed by SAS 8.2, and descriptive statistics, $x^2$ test, student t-test, Pearson correlation analysis, and Spearman rank correlation were used. Results: The mean of $PM_{10}$ and $CO_2$ level were $50.3{\mu}g/m^3$ and 792.1ppm. Sixteen child daycare centers (94.2%) met the guidelines of the $PM_{10}$ level, so did thirteen child daycare centers (76.5%) in the $CO_2$ level. $CO_2$ levels were significantly low in child daycare centers using air cleaners than those do not using them (t=-6.03, p<.001). Types of child daycare centers were significantly correlated to the levels of $CO_2$, which public child daycare centers were low in $CO_2$ levels than those of private child daycare centers (t=-2.54, p=.013). There was no significant correlation between teachers' awareness and management attitude of indoor air quality while teachers' awareness of indoor air quality significantly raised the frequency of carpet cleaning. Methods of cleaning routines were significantly correlated with $PM_{10}$, and $CO_2$ levels. Conclusion: The $PM_{10}$ and $CO_2$ concentrations in child daycare centers were satisfactory. Those conditions are affected by general characteristics of child daycare centers and teachers' attitude regarding management of indoor air quality.

• Journal of Chest Surgery
• /
• 제53권6호
• /
• pp.375-380
• /
• 2020

Background: Prolonged ischemic time is a risk factor for primary graft dysfunction in patients who undergo heart transplantation. We investigated the effect of a supplemental cardioplegia infusion before anastomosis in patients with long ischemic times. Methods: We identified 236 consecutive patients who underwent orthotopic heart transplantation between February 2010 and December 2014. Among them, the patients with total ischemic times of longer than 3 hours (n=59) were categorized based on whether they were administered a complementary cardioplegia solution (CPS) immediately before implantation (CPS+, n=30; CPS-, n=29). Results: The mean total ischemic times in the CPS+ and CPS- groups were 238.1±30.1 minutes and 230.1±28.2 minutes, respectively (p=0.3). The incidence of left ventricular primary graft dysfunction (CPS+, n=6 [20.0%]; CPS-, n=5 [17.2%]; p=0.79) was comparable between the groups. In the Kaplan-Meier survival analysis, no significant difference in overall survival at 5 years was observed between the CPS+ and CPS- groups (83.1%±6.9% vs. 89.7%±5.7%, respectively; log-rank p=0.7). No inter-group differences in early mortality (CPS+, n=0; CPS-, n=1 [3.4%]; p=0.98) or complications were observed. Conclusion: The additional infusion of a cardioplegia solution immediately before implantation in patients with longer ischemic times is a simple, reproducible, and safe procedure. However, we did not observe benefits of this strategy in the present study.