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The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009 (최근 6년간 소아청소년기 급성 화농성 골관절염의 원인균과 임상 양상; 2003-2009)

  • Choi, Jin Hyoung;Choe, Young June;Hong, Ki Bae;Lee, Jina;Yoo, Won Joon;Kim, Han Soo;Park, Moon Seok;Cho, Tae Joon;Chung, Chin Youb;Lee, Hoan Jong;Choi, In Ho;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.31-39
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    • 2011
  • Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

Development of Korean Neurobehavioral Test Battery -Assessment of the Validity of Traditional and Computerized Neurobehavioral Tests- (한국형 신경행동검사 배터리의 개발 -면접과 컴퓨터 신경행동검사의 타당성 평가-)

  • Chung, Jong-Hak;Kim, Chang-Yoon;SaKong, Joon;Jeon, Man-Joong;Park, Hong-Chin
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.692-707
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    • 1998
  • Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Dig-it Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol, Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, fator analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.

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Spectral Characteristics of Sea Surface Height in the East Sea from Topex/Poseidon Altimeter Data (Topex/Poseidon에서 관측된 동해 해수면의 주기특성 연구)

  • 황종선;민경덕;이준우;원중선;김정우
    • Economic and Environmental Geology
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    • v.34 no.4
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    • pp.375-383
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    • 2001
  • We extracted sea surface heights(SSH) from the TopexJPoseidon(T/P) radar altimeter data to compare with fhe SSH estimated from in-situ lide gauges(T/G) at Ulleungdo, Pohang, and SockcholMucko sites. Selection criteria such as wet/dry troposphere, ionosphere, and ocean tide were used to estimate accurate SSH. For time series analysis, the one-hour interval tide gauge SSHs were resampled al lO-day interval of the satellite SSHs. The ocean tide model applied in the altimeter data processing showed periodic aliasings of 175.5 day, 87.8 day, 62J day, 58.5 day, 49.5 day and 46.0 day, and, hence, the ZOO-day filtering was applied to reduce these spectral noises. Wavenumber correlation analysis was also applied to extract common components between the two SSHs, resulting in enhancing the correlation coefficient(CC) dramatically. The original CCs between the satenite and tide gauge SSHs are 0.46. 0.26, and 0.]5, respectively. Ulleungdo shows the largest cc bec;luase the site is far from the coast resulting in the minimun error in the satellite observations. The CCs were then increased to 0.59, 030, and 0.30, respectively, after 200.day filtering, and to 0.69, 0.63. and 0.59 after removing inversely correlative components using wavenumber correlation analysis. The CCs were greatly increased by 87, 227, and 460% when the wavenumber correlation analysis was followed by 2oo-day filtering, resulting in the final CCs of 0.86, 0.85, 0.84, respectively. It was found that the best SSHs were estimated when the two methods were applied to the original data. The low-pass filtered TIP SSHs were found to be well correlated with the TIG SSHs from tide gauges, and the best correlation results were found when we applied both low-pass filtering and spectral correlation analysis to the original SSHs.

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A Study on Reuse of Reclaimed Water in Jeonbuk Province (전북지역 하수처리수 재이용 방안 연구)

  • Cho, Changwoo;Kim, Jintae;Park, Jeongjae;Song, Juhoon;Lee, Miseon;Jeong, Juri;Ryou, Jaewoong
    • Journal of Korean Society of Environmental Engineers
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    • v.39 no.5
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    • pp.237-245
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    • 2017
  • This study was aimed at investigating effluent water quality and proposing reuse possibilities for 12 sewage treatment plants discharged more than $5,000m^3/day$ in order to recycle the sewage treatment plant effluent of Jeollabuk-do effectively. Additionally, a laboratory scale test for reprocessing water discharge was performed. Categories of reclaimed sewage water reuse were divided into 7 topics and analyzed a total of 28 items including 16 heavy metals based on water quality standard. As a results, color, BOD, TN, chloride and Electrical Conductivity (EC) exceeded reused water quality standard. In particular, color and TN exceeded in 8 and 5 sewage treatment plants, respectively. The value of chloride and EC were high in sewage treatment plants including the food and industrial wastewater. At 4 sewage treatment plants were possible to reuse without re-treatment. The laboratory scale test was conducted to SandFilter (SF)-Granular Activated Carbon (GAC)-MicroFiltraion (MF)-Reverse Osmosis (RO). Both the removal efficiencies and economic feasibility of total E. coli., color and Suspended Solid (SS) suited in case using the SF-GAC treatment method. The removal of chloride and EC had little effect in the case of SF-GAC-MF system, but RO showed over 90% of removal efficiency. After using SF-GAC process only, the concentration of $UV_{254}$ decreased sharply from 0.3651 /cm to 0.0306 /cm and it showed over 92% of removal efficiency rate. In conclusion, for the effective reuse of sewage discharged water, water quality and the surrounding terrain of treatment plants should be all taken into account. If it needed for the reprocessing, both the selection for treatment and economic combination treatment methods will have to be considered.

Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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Clinical Outcome after Surgical Treatment of Intra-articular Comminuted Fracture of the Distal Humerus in the Elderly: Open Reduction and Internal Fixation Versus Total Elbow Arthroplasty (고령의 상완골 원위부 관절내 분쇄골절의 수술적 치료: 관혈적 정복술 및 내고정술과 일차적 주관절 전치환술의 임상적 결과)

  • Kim, Doo-Sup;Yoon, Yeu-Seung;Yi, Chang-Ho;Woo, Ju-Hyung;Rah, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.130-137
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    • 2012
  • Purpose: To evaluate and report the clinical outcome after surgical treatment of intra-articular comminuted fracture of distal humerus in the elderly with osteoporosis. Materials and Methods: From January 2007 to October 2009, 24 patients aged older than 65 years with intra-articular comminuted fracture of distal humerus underwent surgical treatment. 18 patients (Group I) were managed using primary open reduction and internal fixation (OR IF) through the modified posterior approach and 6 patients (Group II) were taken primary total elbow arthroplasty. The average follow up period was 17.2 months. According to the AO classification, there were 8 C2, 16 C3 type fractures. All enrolled patients were evaluated radiographically and clinically. Clinical outcomes were assessed with the Mayo Elbow Performance, Disabilities of Arm and Shoulder and Hand, and Musculoskeletal Functional Assessment functional questionnaires. Results: The bony union was observed in 18 patients in group I at average 14 weeks. There were 2 patients with neurapraxia of whom the ulnar nerve symptom did not improve despite of anterior transposition. And non-union at osteotomy sites was seen in 2 patients. The mean Mayo Elbow Performance score was 87.0. The mean DASH score was 32.4. The average arc of elbow flexion was $121.0^{\circ}$ (range, $95{\sim}145^{\circ}$) with mean flexion-contracture of $12.0^{\circ}$ (range, 0 to 35). 6 patients in Group II showed no complication during follow up periods. The mean Mayo Elbow Performance score was 89.1. The mean DASH score was 44.3. The average arc of elbow flexion was $125.1^{\circ}$ (range, $100{\sim}145^{\circ}$) with mean flexion-contracture of $12.6^{\circ}$ (range, 0 to 30). Conclusions: With careful patient selection, Total elbow arthroplasty as well as OR IF could achieve good outcomes in elderly of comminuted intra-articular distal humerus fracture with osteoporosis.

A Plan to Improve Consumer Satisfaction and Reliability of Opticians by Analyzing Consumers' Spectacles Purchasing Behavior (소비자의 안경 구매 행태 분석을 통한 만족도 및 신뢰도의 향상 방안)

  • Park, Jee-Hyun;Lee, Eun-Hee;Koo, Eun-Hye;Kim, Hee-A;Song, Da-Hye;Hyun, Jin-Hee;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.1-7
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    • 2010
  • Purpose: To plan and improve consumers' satisfaction by analyzing consumers' purchasing behavior of spectacles. Also this will show the need of improvement in reliance of an optician. Methods: A total of 307 people (10 to 60 years) participated in individual questionnaires. Questionnaires comprised of general characteristic of surveyed people, purchasing spectacles behavior, satisfaction after purchasing spectacles, reliability of optician, and improvement points of optician. Results: Most important points in selecting the product were the design and the price of the spectacles. 142 people (46.3%) replied "average" and 140 people (45.6%) replied "satisfying" out of maximum point of satisfaction level which was 5 points. 72.3% of people have regularly visiting optical shop due to the high accessibility, after-sales care, and courteous optician. On the contrary, 27.7% replied "never visit same optician shop again" because of the low accessibility, minimal range of products, and high price. Data showed that people had high re liability about the opticians' knowledge of product, and their technique of eye refraction. Data revealed that people did not show high satisfaction about opticians' knowledge of ophthalmology, and price of products. Most important improvement points were accurate spectacle prescription by Opticians rating 42% of reply. Factors most considered during spectacle selection among the 10 to 20 age group were design by 34.8% and price by 10.1%. Among the 40 to 50 age group, most considered factors were design by 14% and spectacle frame material by 10.1%. Conclusions: Satisfaction rate of purchasing spectacles for the total participant group was 4.2 average grades. Reliability of opticians' eye refraction result and prescription was 50.5%. However consumers wanted to obtain more accurate eye refraction result and prescription with more comprehensive explanations. Also, consumers wanted opticians to be sensitive and have appreciative eye in select spectacles for customers, and to offer precise spectacle dispensing services and courteous after-sales care.

The Effect of Color Filter on the Reading Ability in Teenager with Irlen-Syndrome (얼렌증후군에서 컬러필터가 읽기능력에 미치는 영향)

  • Lee, Dong-Joon;Leem, Hyun-Sung
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.2
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    • pp.125-136
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    • 2013
  • Purpose: The aim of this study was to investigate the effect of improving read speed with color filter or without color filter to improve reading disorder of teenager who were diagnosed as Meares-Irlen syndrome through survey inspection with Meares-Irlen syndrome visual stress (MISViS) score. Methods: MISViS subjects were selected from screening survey MISViS results given above 2.13 in the clinical criteria scores (MISViS score). Reading speed were measured quickly and efficiently the rate of reading via test in which randomly ordered common words are read aloud during a minute. Each of the subjects were worn a filter of the lowest concentration in each color filter group composed of 15 groups. Results: MISViS score of MISViS group and control group were 2.57 and 0.66, respectively. Results of reading speed with filter and without filter in MISViS group were $102.27{\pm}27.86$ wpm and $118.87{\pm}26.99$ wpm (p=0.001), respectively, as well as were $132.93{\pm}6.88$ wpm and $133.43{\pm}6.64$ wpm (p=0.131) in the normal group. Associated with error changes with filter and without filter between two groups, skipping in MISViS Group were from $0.25{\pm}0.62$ times to 0 times (p=0.191), Errors were from $1.83{\pm}1.69$ times to $0.17{\pm}0.38$ times (p = 0.004) and, repetitions were 0. skipping in control group were 0 times, errors were from $0.21{\pm}0.43$ times to $0.07{\pm}0.27$ times (p=0.336) and, repetitions were from $0.14{\pm}0.36$ times to 0 (p=0.165). The filter of blue series chosen in MISViS group had higher percentage (40%), whereas, subjects in normal group were more likely to prefer the filter of gray color (29%). Conclusions: This study showed that MISViS score have been used as a significant diagnosis for Irlen syndrome screening. This study found that wearing suitable color filter for MISViS patients were useful to improve learning with regard to reading. Unique color filter selection for MISViS subjects must be carefully considered since fit color filter are different personally.

Etiology of Community-acquired Bacteremia in Healthy Children (건강한 소아에서 지역사회 획득 균혈증의 원인균)

  • Kim, Hyung Tae;Jang, Hyun Oh;Moon, Jin Soo;Nam, Seung Yeon;Kim, Dong Wook;Lee, Chong Guk;Cho, Chong Rae
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.716-722
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    • 2005
  • Purpose : A full view of the spectrum of all bacterial diseases in healthy children is essential to the establishment of public health priorities. Accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection and the case fatality rate are valuable to the clinician in choosing antimicrobial treatments. Methods : Fifty-nine episodes of bacteremia were analysed. Data were collected at Ilsan Paik Hospital from January 2000 to December 2003. Analysis of each collected episode included isolating pathogen from blood culture, diagnosis, hospital course, isolating pathogens from other tissue sites, and studying results of antimicrobial sensitivity tests. Results : Fifty-nine cases of community-acquired bacteremia were reviewed. The most common pathogen was Staphylococcus aureus(11 cases, 18.6 percent), followed by Salmonella(10 cases, 16.9 percent), E. coli(7 cases, 11.9 percent), Streptococcus pneumoniae(five cases, 8.5 percent), Streptococcus viridans(5 cases 8.5 percent). The most common diagnosis was bacteremia without an indentified focus(61 percent), followed by meningitis(12 percent), bacteremia with enteritis(10.2 percent) and bacteremia with urinary tract infection(8.5 percent). Salmonella was still an important causative agent of bacteremia. The relative importance of Haemophilus influenza and Streptococcus pneumoniae was lower than in other studies. The most common organism responsible for bacteremia without an identified focus was Staphylococcus aureus. The case-fatality was 3.4 percent for all cases of bacteremia. Conclusion : We reviewed the etiology of community-acquired bacteremia. These data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infection.

Removal of 1,4-dioxane in Ozone and Activated Carbon Process (오존과 활성탄 공정해서의 1,4-Dioxane 제거 특성)

  • Son, Hee-Jong;Choi, Young-Ik;Bae, Sang-Dae;Jung, Chul-Woo
    • Journal of Korean Society of Environmental Engineers
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    • v.28 no.12
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    • pp.1280-1286
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    • 2006
  • Three different virgin activated carbons made of each coal(Calgon), coconut(Samchully) and wood(Picabiol) based activated carbon(AC) were tested for an adsorption performance of 1,4-dioxane in a continuous adsorption column. Breakthrough behavior was Investigated that the breakthrough points of coal, coconut and wood based AC were observed as 3600 bed volumn(BV), 1440 BV and 144 BV respectively. Adsorption capacity(X/M) of coal, coconut and wood based AC was observed. The reported results of adsorption capacity showed that coal based AC was highest(578.9 ${\mu}g/g$), coconut based AC was intermediate(142.3 ${\mu}g/g$) and wood based AC was lowest(7.4 ${\mu}g/g$) due to increasing specific surface area. Moreover, carbon usage rates(CURs) for coal, coconut and wood based AC had been shown as 0.48 g/day, 1.41 g/day and 6.9 g/day respectively. The constant characteristic of the system, k of coal based AC was found to be 91.5 and k of coconut based AC was found to be 17.9. Removal efficiencies of 1,4-dioxane with different ozonation dosages(2 and 5 mg/L) for 20 min ozonation had been shown 38% and 87% respectively. There was no observation for biological removal of 1.4-dioxane by attached micro-organisms when used(3.1 years and over 5 years) biological activated carbon(BAC) without pretreatment of oxidation were employed. When a combination of ozonation(2 mg/L and 5 mg/L) and BAC process for $10{\sim}30$ min was applied, removal efficiency for 1,4-dioxine increased only $2{\sim}6%$ compared to only applying ozonation. Therefore removal efficiency of BAC process prior to using oxidation was proven to negligible. Consequently, the results presented in this paper provide a better insight into the adsorption performance of 1,4-dioxane. This observation suggests that using virgin activated carbon made of coal is the best selection for removal of 1,4-dioxane in the water treatment for an advanced treatment. It is clear from this research that longer EBCT for ozonation or higher ozone concentration are more effective operation methods for removal of 1,4-dioxane than longer EBCT in the BAC process.