• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.445-455
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• 2005

Purpose: We developed an animal SPECT system using clinical Philips ARGUS scintillation camera and pinhole collimator with specially manufactured small apertures. In this study, we evaluated the physical characteristics of this system and biological feasibility for animal experiments. Materials and Methods: Rotating station for small animals using a step motor and operating software were developed. Pinhole inserts with small apertures (diameter of 0.5, 1.0, and 2.0 mm) were manufactured and physical parameters including planar spatial resolution and sensitivity and reconstructed resolution were measured for some apertures. In order to measure the size of the usable field of view according to the distance from the focal point, manufactured multiple line sources separated with the same distance were scanned and numbers of lines within the field of view were counted. Using a Tc-99m line source with 0.5 mm diameter and 12 mm length placed in the exact center of field of view, planar spatial resolution according to the distance was measured. Calibration factor to obtain FWHM values in 'mm' unit was calculated from the planar image of two separated line sources. Te-99m point source with i mm diameter was used for the measurement of system sensitivity. In addition, SPECT data of micro phantom with cold and hot line inserts and rat brain after intravenous injection of [I-123]FP-CIT were acquired and reconstructed using filtered back protection reconstruction algorithm for pinhole collimator. Results: Size of usable field of view was proportional to the distance from the focal point and their relationship could be fitted into a linear equation (y=1.4x+0.5, x: distance). System sensitivity and planar spatial resolution at 3 cm measured using 1.0 mm aperture was 71 cps/MBq and 1.24 mm, respectively. In the SPECT image of rat brain with [I-123]FP-CIT acquired using 1.0 mm aperture, the distribution of dopamine transporter in the striatum was well identified in each hemisphere. Conclusion: We verified that this new animal SPECT system with the Phlilps ARGUS scanner and small apertures had sufficient performance for small animal imaging.

• Journal of Korean Society of Rural Planning
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• v.24 no.3
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• pp.87-96
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• 2018

While cities became bigger and bigger since 1990s, many indiscretely high buildings started to be built in the mountain areas inside a city and in the rural areas in the suburb of each city. To regulate such indiscrete developments, the government prepared for some relevant legal and institutional criteria by having enacted the "Landscape Act" and established a strong management means in the legal and institutional aspects by having introduced the natural landscape deliberation system and the landscape deliberation one into the "Natural Environment Conservation Act." However, since some uniform levels of absolute height and no. of stories are suggested legally and institutionally, it is hard to consider the effects of a real building structure onto the relevant landscape. Accordingly, this thesis is intended to grasp the contrast of the landscape elements in the allowable height section, which is presented through landscape sensitivity. As the results from the visual contrast rating on a small apartment complex located in Dangjin and a large scale of apartment complex in Seosan as the apartment complexes surrounded with natural landscapes that were selected as the subjects of this study, the following conclusion can be finalized. First, there were deducted some factors, that is, forms, lines, colors, textures and sizes as the ones with which can measure and evaluate the contrasting properties when a structure gets into a natural landscape. Second, in case of a small scale of apartment complex (in the foreground) compared to a large one (in the foreground), it was found that the contrasting properties were bigger. In addition, it was also found that the contrasting property of the landscape factor of the foreground compared to that of the middle one becomes bigger depending on a distance. Third, as the results from an evaluation on the contrasting properties of the landscape factor depending on the changes of each floor of a structure, it was found that the factors, that is, forms, lines, colors, textures and sizes are very significant. Among those factors, the factors, forms and lines in a small scale of apartment complex (in the foreground) showed each log regression. But in all of the other cases, they showed each line regression. Fourth, as the results from examining the regression coefficients of the landscape factor, the coefficients of the shapes and lines have similar coefficients and the colors and the textures have similar ones, too. In case of the sizes of apartment complexes, the colors and the textures of a large apartment complex (in the foreground) have similar coefficients, in case of that in the middle ground, the shapes and lines have similar coefficients. Fifth, as the results from estimating the contrasting properties of the landscape factor on the floors within the allowed scope of the landscape sensitivity, it was found that the contrasting property was 3.5 to 4.9 in case of a small scale of apartment complex (in the foreground), but 2.5to 3.7 in case of a small scale of one. In case of a large scale of apartment complex, the value was 3.5 to 5.3, but in case of a large one in the middle ground was 2.9 to 4.9. Sixth, it was comprehended that the contrasting properties of the landscape factor become different depending on each size of apartment complex and the distance of a view point. In this study, it is intended to find the meaning from the aspect that the results can be used as the baseline data for comprehending a proper range of heights of structures objectively during a natural landscape deliberation or a landscape deliberation.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.946-962
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• 1996

The purpose of this study was to contribute to the development of clinical instruction by students' ratings of teaching effectiveness in clinical nursing education. The subjects were comprised of graduating class 618 students from 24 nursing colleges in the nation. The instruments used in this study were "general characteristics & status of clinical nursing education" developed by the researcher and "Instrument to Measure Effectiveness of Clinical Instructors" by Reeve(1994). The 50 questions used in the questionaire were categorized into 13 components subject to factor analysis. The 13 components were interpersonal relationships, communication skills, role model, resource for students, favorable to students, encouraging to think for selves, teaching methods, evaluation, finding assignments for objectives, organization of subject matter, professional competence, knowledge of subject matter & working with agency personnel. The results of this study are as follows 1. Status of clinical nursing educaion : 1) Clinical nursing education were led by nursing professors(44.9%), a team of both nuring professor & head nurse(6.8%), instructors from specific hospital(15.1%), instuctos for a specific subject(14.6%), & head nurse(6.8%). For 3-year program students, 34.6% of the clinical nursing education were led by instructors from specific hospital & 51.4% of the education by nursing professors for Bachelor's program. 2) The contents for clinical education comprised of Conference being the most frequent of 34.5% ; a combination of Nursing skills, Orientation, Conference etc.22.0% : Nursing process 21.7% : Orientation 13.5% : Inspection(making rounds ) 6.4%, & Nursing skills of 2% being the least frequent. 3) Students' preference of clinical teachers from the highest to the lowest were instructors for a specific subject being the most desired (44.9%) followed by nursing professor, head nurse, a team of both nursing professor & head nurse, & instructors from specific hospital being the least desired. 4) Students felt that the qualification for clinical teachers should be at least a master's degree holder and 5 or more years of clinical experience. The reason they felt was because knowledge & experience are imperative for professional education. 2. Clinical teaching effectiveness : The total points for teaching effectiveness was 147.97(mean of 2.95±0.98) where the total score is considered to be an average rating. 3. Teaching effectiveness as status of clinical nursing education : 1) The score ratings for the clinical instructors from the highest to the lowest were as follows : instructors for a specific subject, instructors from specific hospitals, a team of both nursing professors & head nurses, nursing professors, head nurses, which resulted in significunt difference(F=4.53, P<0.001). 2) The rating scores based on the teaching program from the highest to the lowest were as follws ; nursing skills, nursing process, a combination of nursing skills, orientation, conference etc. , conferences, orientation, inspection, which resulted in significunt difference(F=10.97, P<0.001). 4. Based on 13 categorized components from the questionaires, questions related to communication skills scored the highest points of 3.20 where inquiries regarding resource for students scored the lowest points of 2.38. 5. Among the 13 categorial components from the questionaire, Interpersonal relationship, Communication skills, Resource for students, Encouraging to think for selves, Evaluation, Teaching method, Finding assignment for objectives, Organization of subject matter, Professional competence, & Working with agency personnel, instructors for a specific subject scored the highest points and head nurse scored the lowest, which resulted in significant difference. Favorable for students, instructors for a specific subject scored highest points and nursing professor scored the lowest, which resulted in significant deference (F=5.39, P<0.001). Role model & Professional competence, instructors for a specific subject scored the highest points and head nurse scored the lowest, with minimum variation(F=1.29, P>0.05 : F=1.64, P>0.05) 6. Based on 13 categorial components as a whole, the highest points scored among the 5 groups of clinical teachers was instructors for a specific subject and the lowest, by head nurse(F=1.94, P<0. 001). A team of both nursing professor & head nurse attained higher score in clinical education than their independent education.

• Radiation Oncology Journal
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• v.23 no.4
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• pp.243-252
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• 2005

Purpose: Indoor air quality (IAQ) in the radiation treatment center which is generally located underground is important to the health of hospital workers and patients treated over a long period of time. this study was conducted to measure and analyze the factors related to IAQ and subjective symptoms of sick building syndrome, and to establish the causes influencing IAQ and find a solution to the problems. Methods and Materials : Self administrated questionnaire was conducted to check the workers' symptoms and understanding of the work environment. Based on a preliminary investigation, the factors related to IAQ such as temperature, humidity, fine particulate. carbon dioxide, carbon monoxide, formaldehyde, total volatile organic compounds (TVOC), and radon gas were selected and measured for a certain period of time in specific sites where hospital workers stay long in a day. And we also evaluated the surrounding environment and the efficiency of the ventilating system simultaneously, and measured the same factors at the first floor (outdoor) to compare with outdoor all quality, All collected data were assessed by the recommended standard for IAQ of the domestic and international environmental organizations. Results: Hospital workers were discontented with foul odors, humidity and particulate. They complained symptoms related to musculo-skeletal system, neurologic system, and mucosal-irritatation. Most of the factors were not greater than the recommended standard, but the level of TVOC was third or fourth times as much as the measuring level of some offices in the United States. The frequency and the amount of the ventilating system were adequate, however, the problem arising in the position of outdoor-air inlets and indoor-air outlets involved a risk of the indraft of contaminated air. A careful attention was a requirement in handling and keeping chemical substances including a developing solution which has a risk of TVOC emissions, and repositioning the ventilating system was needed to solve the contaminated-air circulation immediately Conclusion We verified that some IAQ-related factors and inadequate ventilating system could cause subjective symptoms in hospital workers. The evaluation of IAQ was surely needed to improve the underground working environments for hospital workers and patients. On the basis of these data, from now on, we should actively engage in designs of the department of radiation oncology or improvement in environments of the existing facilities.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.47-54
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• 2021

Purpose : In order to evaluate the usefulness of clinical application of the Pause & Resume methods by comparing and analyzing the data stability and dose reduction effect when repeat scan assuming irregular breathing and using the Pause & Resume method during chest 4D CT using Quasar^TM Phantom. Materials and Methods : Using the Quasar^TM Phantom, set the breathing rate per minute to 15 BPM and 7.5 BPM, and set the S15 point as an irregular breathing section, and then placed OSLD to this point and use the Pause & Resume method to measure the dose of S15. CTDIvol, DLP, and ALARA-CT were used for comparative analysis of radiation dose between Pause & Resume method and Repeat-scan. In order to evaluate the stability and usability of the data applying the Pause & Resume method, the captured images were sorted by Advanced Workstation Volume Share7 and then sent to Eclipse^TM, the diameter and volume were analyzed by forming a contour on the iron ball in the Quasar^TM Phantom Results : When using Pause & Resume, the dose of OSLD measurement increased by 1.97 times in the section of S15. As a result of image evaluation, the average value of all volumes measured with and without the Pause & Resume method at 15 BPM and 7.5 BPM was 15.2 cm3±0.5%.Allthemeasuredvaluesfor the radius of iron ball were 3.1 cm regardless of whether Pause & Resume method was used or not. In the case of using Pause & Resume, 33% decreased from the lowest DLP value and 38% decreased from the highest DLP value of repeat scan, and the effective dose also decreased 32.1% from the minimum value and 37.6% from the maximum value. Conclusion: Irradiation dose was increased by Pause & Resume method because of the repeat scan on the S15 site where assuming irregular breathing occurred, However Pause & Resume method led to a significant reduction in dose on overall scan range. It also proved the usefulness of clinical application of the Pause & Resume method as a result of similar diameters and volumes of iron ball measurement.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.163-173
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• 2013

When the mandible performs opening movement, the condyle-disk complex conducts sliding movement along the articular eminence. Thus, anatomic configuration of articular eminence is very important to normal movement of TMJ. The purpose of this study was to measure the posterior slope of the articular eminence and evaluate the effect of a pathologic bone change in the condylar head on the stiffness of articular eminence, and compare the differences of the articular eminence slope by gender and age using dental cone-beam CT. As using i-CAT Cone-Beam Computed Tomography, the CT images of 204 TMJs of 102 patients(43 men and 59 women, mean age: 37.7 years) who were diagnosed at Wonkwang University Sanbon Dental Hospital were evaluated. All images were converted into a TMJ analysis mode to observe the continuous sagittal section images and coronal section images of the joints. To observe and assess bone changes in the condyle, three dentists measured the stiffness of the articular eminence on the same images, and when two of the three dentists agreed on their reading, these results were adopted and recorded. The articular eminence slope, considering the condylar anatomic configuration, was measured in three regions, namely, lateral part, central part, and medial part of the condyle. In the cases of a normal condyle(NCBC) and a condyle(CBC) with bone change, the articular eminence slopes were $57.0^{\circ}$(NCBC) and $51.8^{\circ}$(CBC) at the medial part, $57.9^{\circ}$(NCBC) and $52.4^{\circ}$(CBC) at the central part, and $55.1^{\circ}$(NCBC) and $49.5^{\circ}$(CBC) at the lateral part of the condyle. And the articular eminence slope of the condyle with bone change demonstrated less steepness than that of normal condyle (p<0.05). The articular eminence slope showed mediolaterally that it was the steepest at the central, followed by at the medial, and at the lateral (p<0.05). There were no significant differences by the gender and the age (p.0.05).

• Progress in Medical Physics
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• v.23 no.1
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• pp.33-41
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• 2012

For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, $360^{\circ}$. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of $360^{\circ}$ directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.

• The Journal of Engineering Geology
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• v.25 no.1
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• pp.93-102
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• 2015

The characteristics of frozen soils are one of most important factors for foundation design in cold region. The objective of this study is to evaluate the shear strength and stiffness of frozen soils according to the confining conditions during the freezing and shearing phase. A direct shear box is constructed for the frozen specimens and bender elements are mounted on the wall of the shear box to measure shear wave velocities. Specimens are prepared by mixing sand and silt with a silt fraction of 30% in weight and the degree of saturation of 10%, giving a relative density of 60% for all tests. The temperature of the specimens in the freezer is allowed to fall below -5℃, and then direct shear tests are performed. A series of vertical stresses are applied during the freezing and shearing phase. Shear stress, vertical displacement, and shear wave along the horizontal displacement are measured. Experimental results show that in all the tests, shear strength increases with increasing vertical stress applied during the freezing and shearing phases. The magnitude of the increase in shear strength with increasing vertical stress during shearing under fixed vertical stress in the frozen state is smaller than the magnitude of the increase in vertical stress during freezing and shearing. In addition, the change in shear wave velocities varies with the position of the bender elements. In the case of shear waves passing through the shear plane, the shear wave velocities decrease with increasing horizontal displacement. This study provides an evaluation of the properties of shear strength and stiffness of frozen soils under varied confining condition.

• Journal of Oral Medicine and Pain
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• v.30 no.3
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• pp.337-344
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• 2005

A tactile sensor employs a piezoelectric element to detect contact frequency shifts and thereby measure the stiffness or softness of material such as tissue, which allows the sensor to be used in many fields of research for urology, cardiology, gynecology, sports medicine and caner detection and especially for cosmetics and skin care. In this study, reliability of the tactile sensor system was investigated with its manual application to the muscles susceptible to temporomandibular disorders. Stiffness and elasticity of anterior temporalis, masseter and trapezius muscles were calibrated bilaterally from 5 healthy men with an average of 24.5$\pm$0.94 years. The tactile sensor used in this study had a computer-controlled and motor-driven sensor unit which automatically pressed down on the skin surface over the muscles being measured and retracted, thereby providing the hysteresis curve. The slope of the tangent of the hysteresis curve (${\Delta}f/{\Delta}x$) is defined as stiffness of the muscle being measured and the distance between the two parts of the curve as its elasticity. To determine inter-examiner reliability, all the measurements were performed by the two examiners A and B, respectively and the same examination were repeated with an interval of 2 days for intra-examiner reliability. The results from this study demonstrated high reliability in measuring stiffness and elasticity of anterior temporalis, masseter and upper trapezius muscles using a tactile sensor system. It is suggested that the tactile sensor system can be a highly reproducible and effective instrument for quantitative evaluation of the muscle in head and neck region.