• Title/Summary/Keyword: Multi-objectives

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The Efficacy of Percutaneous Steroid Injection via Cricothyroid Membrane for Reinke's Edema (라인케씨 부종 환자에서 경윤상 갑상막 접근을 통한 성대 내 스테로이드 주입술의 효용)

  • Nam, Woojoo;Kim, Sun Woo;Jin, Sung Min;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.101-106
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    • 2019
  • Background and Objectives Reinke's edema is a benign vocal fold disease caused by an edematous laryngeal superficial layer of lamina propria. The first line treatment is cessation of smoking and laryngeal microsurgery. The aim of the study is to evaluate the feasibility and efficacy of percutaneous steroid injection via cricothyroid membrane in patients with Reinke's edema. Materials and Method From Jan 2010 to July 2018, 33 Patients with Reinke's edema managed by vocal fold steroid injection via the cricothyroid membrane were included in this study. We compared medical records of laryngoscopy, stroboscopy and Multi-Dimensional Voice Program analysis at pre-treatment and post-treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30). Results 75.7% of the patients showed partial response and 6.06% showed complete response. 93.94% were present smokers and only 4 patients ceased smoking after the treatment. In acoustic analysis, the pre-treatment mean value of jitter, shimmer, and noise to harmonic ratio was 2.30±3.21, 9.34±10.37, 1.11±2.90 each. The post-treatment value was 2.20±1.89, 6.96±5.30, 0.20±0.09 respectively and none of the parameters were statistically significant. For subjective symptom improvement, 25 (75.8%) patients showed a better score on post-treatment VHI-30 compared to pre-treatment. Conclusion According to our study, steroid injection is a relatively safe and effective procedure for patients with Reinke's edema. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery, however cessation of smoking is necessary for effective treatment.

Development of Eyes Inspection Questionnaire(EIQ) and Regression Analysis between EIQ Items and deficiency or excess patterns of Eyes Inspection (안진(眼診) 설문지 개발 및 안진(眼診) 설문의 허실(虛實) 연관성 연구)

  • Seo, Jae-Ho;Choi, Jin-Yong;Oh, Whan-Sup;Park, Young-Bae;Park, Young-Jae
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.18 no.2
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    • pp.75-84
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    • 2014
  • Objectives Eyes, one of visual inspection regions, present important clues to pathological patterns including deficiency and excess patterns to the clinicians. The purpose of this study was to develop Eyes Inspection Questionnaire (EIQ) and to examine which items among the EIQ were more predictive of clinicians' determination for the deficiency and excess patterns. Methods Nine questionnaire items for Visual Inspection of Eyes were extracted through the literature review. These items were presented to the 4 Korean medical doctors who are specialized in visual inspection to conduct the Delphi method. The Korean medical doctors were asked to rate the importance of each items for the corresponding Visual Inspection of Eyes, using a Likert 5-point scale(the 3 points of importance as a cut-off point). Then, out of 75 photographs submitted to the Society of HyungSang Medicine in 2009, 30 portrait pictures were selected as samples. The samples were copied to make 60 sample pictures, and then randomly assigned to 4 clinicians. The 4 clinicians evaluated the 60 samples for excess and deficiency of the eyes and were asked to check the 6 questionnaire items. The results were recorded as 5-points-scale, and their average and standard deviations were calculated. Intra- class reliability test and multi regression test were performed using SPSS 13. Results Intra-class correlation coefficient (ICC) was between 0.750 to 0.841 (P<0.05). Indices for visual inspection of the eyes were: endowment of the bone structure around the eyes; brightness of the eyes; upward deviation of the eyes; eye shapes; and definition of iris. 76.92% of deficiency symptom patterns and 86.42% of the excess symptom patterns matched the patterns predicted by the visual inspection of the eyes, according to the frequency analysis. According to the multiple regression analysis, were significantly related to the excessive symptoms, and to the deficiency symptoms. Conclusion This study is the first attempt of development for checklist of excess and deficiency of Visual Inspection of Eyes and quantitative measurement of excess and deficiency using the Visual Inspection of Eyes by the visual inspection experts. Still, additional studies are needed regarding the relationship visual inspection methods have with existing standards of diagnosis.

A Longitudinal Study of the Relationship Between Health Behavior Risk Factors and Dependence in Activities of Daily Living (건강위험행태인자와 일상생활 의존성과의 관련성에 대한 추적자료 분석)

  • Jung, Sang-Hyuk;Ostbye, Truls;Park, Kyoung-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.3
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    • pp.221-228
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    • 2006
  • Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

Reliability and Data Integration of Duplicated Test Results Using Two Bioelectrical Impedence Analysis Machines in the Korean Genome and Epidemiology Study

  • Park, Bo-Young;Yang, Jae-Jeong;Yang, Ji-Hyun;Kim, Ji-Min;Cho, Lisa-Y.;Kang, Dae-Hee;Shin, Chol;Hong, Young-Seoub;Choi, Bo-Youl;Kim, Sung-Soo;Park, Man-Suck;Park, Sue-K.
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.6
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    • pp.479-485
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    • 2010
  • Objectives: The Korean Genome and Epidemiology Study (KoGES), a multicenter-based multi-cohort study, has collected information on body composition using two different bioelectrical impedence analysis (BIA) machines. The aim of the study was to evaluate the possibility of whether the test values measured from different BIA machines can be integrated through statistical adjustment algorithm under excellent inter-rater reliability. Methods: We selected two centers to measure inter-rater reliability of the two BIA machines. We set up the two machines side by side and measured subjects' body compositions between October and December 2007. Duplicated test values of 848 subjects were collected. Pearson and intra-class correlation coefficients for inter-rater reliability were estimated using results from the two machines. To detect the feasibility for data integration, we constructed statistical compensation models using linear regression models with residual analysis and R-square values. Results: All correlation coefficients indicated excellent reliability except mineral mass. However, models using only duplicated body composition values for data integration were not feasible due to relatively low $R^2$ values of 0.8 for mineral mass and target weight. To integrate body composition data, models adjusted for four empirical variables that were age, sex, weight and height were most ideal (all $R^2$ > 0.9). Conclusions: The test values measured with the two BIA machines in the KoGES have excellent reliability for the nine body composition values. Based on reliability, values can be integrated through algorithmic statistical adjustment using regression equations that includes age, sex, weight, and height.

Can Yellow Fur on the Tongue be Useful as an Index of Cardiovascular Disease in Stroke Patients over 60 Years Old? - Multi Center Trial (60세 이상 뇌경색환자에서 황태는 심혈관질환의 유용한 지표가 될 수 있는가? - 다기관임상연구)

  • Leem, Jung-Tae;Park, Su-Kyung;Woo, Su-Kyung;Kwak, Seung-Hyuk;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Park, Sung-Wook;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.31 no.3
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    • pp.569-577
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    • 2010
  • Background & Objectives : Yellow fur on the tongue is known to be associated with prognosis of disease in oriental medicine. Higher ratios of low-density lipoprotein cholesterol(LDL) to high-density lipoprotein cholesterol(HDL) & total cholesterol (TC) to high-density lipoprotein cholesterol(HDL) are associated with a greater risk of cardiovascular disease. The aim of this study was to assess the relationship between cardiovascular disease index and yellow fur - oriental medical index - in stroke patients over 60 years old. Methods & Subjects : Among 802 of the recruited patients(434 male, 368 female), 340 were yellow fur group(209 male, 131 female). We assessed their general characteristics and risk factors. We compared the cardiovascular disease index between yellow fur and non-yellow fur groups by sex. Results : On the General Characteristics males have yellow fur more often than females. In cardiovascular disease index, the male yellow fur group showed higher ratios of TC/HDL(atherogenic index), (TC-HDL)/HDL, LDL/HDL and higher LDL and showed lower HDL than the non-yellow fur group. In female patients, there were no differences between the two groups about cardiovascular disease index. There were more patients diagnosed with Fire & Heat in the male yellow fur group, and Dampness & Phlegm in the male non-yellow fur group. The male yellow fur group eat fast food more than the non-yellow fur group. Conclusions : The results indicated that yellow fur may be associated with a high risk of cardiovascular disease. We can thus use yellow fur on the tongue as a cardiovascular disease index in male stroke patients over 60 years old.

Current Trends in Intervention Studies of Hwabyung in Korean Medicine (화병의 한의학적 치료에 대한 연구동향)

  • Suh, Hyo-Weon;Choi, Eun-Ji;Kim, Sang-Ho;Kim, Dong Hee;Kim, Lak-Hyung;Kim, Jong-Woo;Lee, Jae-Hyok;Lim, Jae-Hwan;Choi, Woo-Jin;Chung, Sun-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.261-274
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    • 2016
  • Objectives: To determine the general characteristics of clinical studies about Hwabyung and assess their limitations and alternatives. Methods: Clinical studies that examined the effects of traditional Korean medicine intervention on Hwabyung were included in this study. A systematic search of English, Chinese, Japanese, and Korean databases was performed. The characteristics of included articles were described and those articles were assessed by Risk of Bias (RoB) tool or Risk of Bias for Nonrandomized Studies (RoBANS) tool. Results: Sixteen articles were selected from 1,826 articles. Most clinical studies about Hwabyung were published in Korea. The number of conducted trials was insufficient. The prevailing study design was randomized controlled trial. Traditional Korean medicine intervention used in the trials were acupuncture, herbal medicine, counselling, meditation, emotional freedom technique (EFT), music therapy, art therapy, and multi intervention program. Herbal medicine study used placebo as control while non-pharmacological intervention study mostly used no treatment as control. Most of the trials were supported by the government. Therefore, financial conflict of interest might not exist for results. We judged that some studies had a high risk of bias. In general, most of the studies with a high risk of bias were non-pharmacological intervention studies, and the risk of bias was mainly due to lack of blinding. Conclusions: More clinical studies of Hwabyung are needed. There are some issues about a suitable comparison and effective blinding strategy for non-pharmacological study. Improving methodological quality is required.

Relationship between Psychosocial Factor and Positive Health Behavior Change after Diagnosis in Breast Cancer Patients (유방암 환자에서 심리사회적 요인과 암 진단 후 건강행동 변화의 관계)

  • Jung, Dooyoung;Shim, Eun-Jung;Hwang, Jun-Won;Hahm, Bong-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.91-97
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    • 2012
  • Objectives : With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. Methods : 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. Results : In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. Conclusions : This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.

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A Structural Relation Among Self-Efficacy, Self-Esteem and Life Satisfaction of Highly Stressed University Students for Studying after Taking Swim Class in College (학업스트레스가 높은 대학생의 교양 수영 수업 수강에 따른 자기효능감, 자아존중감 및 생활만족도의 구조적 관계)

  • Lee, Young Jun
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.2
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    • pp.192-205
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    • 2020
  • The purpose of this study is to verify the structural relationship empirically among self-esteem, self-efficacy and life satisfaction of college students who answered that they had high academic stress. SPSS 23.0 and AMOS 21.0 were used to achieve the objectives of this study. In SPSS 23.0, frequency analysis to analyze demographic characteristics, correlation analysis to verify multi-collinearity among the questionnaire scales, and reliability verification to determine the reliability of questionnaire questions were conducted. In AMOS 21.0, confirmatory factor analysis was conducted to verify the construct validity of factors and to verify the causal relationship between variables. To determine the goodness of fit of the model, the 𝑥2 test and the goodness-of-fit index were used. Judging. First, the self-efficacy of college students with high academic stress group through swimming class was positively influenced on self-esteem. Second, the self-efficacy of college students with high academic stress group through swimming class was positively influenced on life satisfaction. Third, the self-esteem of college students with high academic stress group through swimming class was found to affect life satisfaction. This study has significance in demonstrating the problem of academic stress of Korean university students and in proposing expansion of the physical education class as a solution.

Study of Hazard Materials in Yanggyeoksanhwa-tang by Decoction Method (전탕법이 양격산화탕(凉膈散火湯)의 위해물질에 미치는 연구)

  • Seo, Chang-Seob;Kim, Jung-Hoon;Ha, Hye-Kyoung;Lee, Mee-Young;Lee, Jun-Kyoung;Lee, Nam-Hun;Lee, Ho-Young;Lee, Jin-Ah;Lee, Sul-Lim;Shin, Hyeun-Kyoo
    • Journal of Sasang Constitution and Immune Medicine
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    • v.22 no.2
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    • pp.93-100
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    • 2010
  • 1. Objectives: To compare the contents of hazardous substances such as crude, washing solution, crude after washing, decoction and remnant. 2. Methods: The heavy metal contents of each step were measured by inductively coupled plasma (ICP) spectrometer and mercury analyzer (MA-2). In order to analyze pesticides in Yanggyeoksanhwa-tang we used simultaneous multi- residue analysis of pesticides by GC/ECD, which was followed by GC/MSD analysis to confirm the identity of the detected pesticide in each sample. In addition, the contents of sulfur dioxide (SO2) were performed by Monier-Williams distillation method. 3. Results: 1) The mean values of heavy metal contents (mg/kg) for each steps in Yanggeoksanhwa-tang were as follows: crude (Pb; 1.87, As; 1.29, Cd; 0.28 and Hg; N.D.), washing solution (Pb; 1.98, As; 1.13, Cd; 0.10 and Hg; N.D.), crude after washing (Pb; 1.90, As; 1.40, Cd; 0.22 and Hg; N.D.), decoction (Pb; 1.90, As; 1.14, Cd; 0.11 and Hg; N.D.) and remnant (Pb; 2.39, As; 1.29, Cd; 0.25 and Hg; 0.01). 2) Contents (mg/kg) of residual pesticides in crude and decoction were not detected. 3) Contents (mg/kg) of sulfur dioxide (SO2) in crude, crude after washing and remnant exhibited 3.00, 2.00 and 2.00 mg/kg, respectively. However, contents of sulfur dioxide in washing solution and decoction were not detected. 4. Conclusions: These Results: will be used to establish a criterion of heavy metals, residual pesticides and sulfur dioxide of each step in Yanggeoksanhwa-tang.

Bisphosphonates-related osteonecrosis of the jaw in Korea: a preliminary report

  • Lee, Jeong Keun;Kim, Kyung-Wook;Choi, Jin-Young;Moon, Seong-Yong;Kim, Su-Gwan;Kim, Chul-Hwan;Kim, Hyeon-Min;Kwon, Yong-Dae;Kim, Yong-Deok;Lee, Dong-Keun;Min, Seung-Ki;Park, In-Sook;Park, Young-Wook;Kook, Min-Suk;Park, Hong-Ju;Baek, Jin-A;Park, Jun-Woo;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.9-13
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    • 2013
  • Objectives: Bisphosphonates (BP) are widely used in medicine for inhibiting bone resorption; however bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a major side effect of BP. To date, there have been no specific reports on the incidence of BRONJ among Koreans. This study investigated the preliminary results from a nationwide survey of BRONJ in the Departments of Oral and Maxillofacial Surgery (OMFS) at individual training hospitals. Materials and Methods: A total of 15 OMFS departments (10 from dental schools, 4 from medical schools, and 1 from a dental hospital) participated in a multi-centric survey. This study assessed every BRONJ case diagnosed between January 2010 and December 2010. The patient age and BP type were evaluated. Results: A total of 254 BRONJ cases were collected. The majority of BRONJ cases were associated with oral BP therapy, while 21.8% of the cases were associated with intravenous administration. Alendronate was the drug most frequently related to BRONJ (59.2% of cases), followed by risedronate (14.3%) and zolendronate (17.0%). The average age of BRONJ patients was $70.0{\pm}10.1$ years, with a range of 38-88 years of age. With the number of BP patients in Korea reported to be around 600,000 in 2008, the estimated incidence of BRONJ is at least 0.04% or 1 per 2,300 BP patients. Conclusion: The results suggest that the estimated incidence of BRONJ in Korea is higher than the incidence of other countries. Future prospective studies should be carried out to investigate the exact epidemiological characteristics of BRONJ in Korea.