• Communications for Statistical Applications and Methods
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• v.25 no.3
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• pp.321-328
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• 2018

In clinical trials with repeated measurements, the time-averaged difference (TAD) may provide a more powerful evaluation of treatment efficacy than the rate of changes over time when the treatment effect has rapid onset and repeated measurements continue across an extended period after a maximum effect is achieved (Overall and Doyle, Controlled Clinical Trials, 15, 100-123, 1994). The sample size formula has been investigated by many researchers for the evaluation of TAD in two treatment groups. For the evaluation of TAD in multi-arm trials, Zhang and Ahn (Computational Statistics & Data Analysis, 58, 283-291, 2013) and Lou et al. (Communications in Statistics-Theory and Methods, 46, 11204-11213, 2017b) developed the sample size formulas for continuous outcomes and count outcomes, respectively. In this paper, we derive a sample size formula to evaluate the TAD of the repeated binary outcomes in multi-arm trials using the generalized estimating equation approach. This proposed sample size formula accounts for various correlation structures and missing patterns (including a mixture of independent missing and monotone missing patterns) that are frequently encountered by practitioners in clinical trials. We conduct simulation studies to assess the performance of the proposed sample size formula under a wide range of design parameters. The results show that the empirical powers and the empirical Type I errors are close to nominal levels. We illustrate our proposed method using a clinical trial example.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.18-31
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• 1996

Jet-lag can be defined as the cumulative physiological and psychological effects of rapid air travel across multiple time zones. Many reports have suggested that age-related changes in sleep reflect fundamental changes in the circadian system and in significant declines in slow wave sleep. Jet lag is a dramatic situation in which the changes of the phase of circadian process and homeostatic process of sleep occur. Thus the authors evaluatead the changes of sleep-wake cycle from jet lag by age. Thirty-eight healthy travellers were studied for 3 days before and 7 days after jet-flights across seven to ten time zone. They were aged 19-70, They trareled eastbound, Seoul to North America (USA, Canada). Sleep onset time, wake-up time, sleep latency, awakening frequency on night sleep, awakening duration on night sleep, sleepiness at wake-up and nap length were evaluated. Our results suggest that by the 7 to 10 time zone shift, the old age group was significantly influenced in sleep-wake cycles. The date on which subjective physical condition was recovered was $6.23{\pm}83$ day after arrivals for old age group, while for young and middle age group, $4.46{\pm}1.50$ day and $4.83{\pm}1.52$ day, respectively. In old age group, sleep onset time was later than baselines and could not recover untill 7th day. But in other groups, the recovery was within 5th day. Nap dura fion was longer in old age group through jet lag than younger age group. In other parameters, there was no definite difference among three age groups. Our results suggested that the old age was significantly influenced by the disharmony between internal body clock and sleep-wake cycle needed at the travel site. Thus we proved that recovery ability from jet lag was age-dependent as well as travelling direction-dependent. To demonstrate more definite evidence, EEG monitoring and staging of sleep were funthun encouraged.

• Physical Therapy Korea
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• v.23 no.2
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• pp.75-83
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• 2016

Background: Several studies have discussed diverse exercise methods considered to be useful for the selective contraction of the vastus medialis oblique (VMO) muscle for the treatment of patellofemoral pain syndrome. Some studies have reported that exercise methods, including hip adduction, in closed kinetic chain exercises are more effective in terms of the muscle activation of the VMO and the timing of the muscle's initial contraction. We focused on isometric contraction during a closed kinetic chain exercise with hip adduction. Objects: The purpose of this study was to examine muscle activation in the VMO and the vastus lateralis (VL) and the onset time difference between their initial contractions via closed kinetic chain isometric quadriceps femoris exercises including hip adduction. Methods: In total, 36 healthy subjects adopted two hip positions during isometric contraction of the quadriceps femoris in a closed kinetic chain exercise (hip neutral and hip adduction position). Statistical analyses were conducted using a paired t-test (${\alpha}=.05$). Results: Isometric contraction of the quadriceps femoris in a closed kinetic chain exercise caused a greater increase in VMO muscle activity in the hip adduction position [$52.68{\pm}22.21$ percentage of maximal voluntary isometric contraction (%MVIC)]than the hip neutral position ($43.43{\pm}19.85%MVIC$). The onset time difference (VL-VMO) decreased more in the hip adduction position ($-82.14{\pm}34.2ms$) than the hip neutral position ($73.94{\pm}2.94ms$). Conclusion: We recommend this exercise as a clinically useful therapeutic method for patients with patellofemoral pain syndrome due to weakening of the VMO muscle and lateral inclination of the patella.

• Journal of Veterinary Clinics
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• v.39 no.5
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• pp.226-234
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• 2022

To evaluate butorphanol and tramadol as adjuvants to lidocaine in dogs undergoing mandibular nerve block. Fifteen beagles were allocated to groups based on the following treatments: lidocaine alone (L group), lidocaine + butorphanol (LB group), or lidocaine + tramadol (LT group). After mandibular nerve block with opioids as an adjunct to local anesthetics, the onset time, duration of action, and depth of anesthesia were evaluated using a quantitative method through neuromuscular blockades (NMBs) monitoring. The onset time of nerve block was 4.60 ± 2.06 min, 2.00 ± 0.00 min, and 2.60 ± 1.62 min in the L, LB, and LT groups, respectively; however, there was no statistically significant difference. The duration of nerve block was 111.88 ± 34.78 min, 302.00 ± 76.72 min, and 260.40 ± 49.88 min in the L, LB, and LT groups, respectively, with a significant difference between L and LB groups. The LB group demonstrated a more profound depth of anesthesia compared to the L and LT groups. In this study, using a quantitative method through NMBs monitoring, it was demonstrated that lidocaine and butorphanol in combination can increase the duration of nerve block and more profound the depth of anesthesia rather than lidocaine alone. Additionally, the combined use of lidocaine and opioids presented an objective indicator that could provide a more clinically stable nerve block.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.605-613
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• 1999

The main purposes of this study were to determine the time interval between the onset of symptoms of myocardial infarction and treatment-seeking time and to identify the factors related to the interval time. This study used a retrospective design. The sample consisted of 45 patients aged over 30 who were diagnosed with an acute myocardial infarction at two large university affiliated medical center from September 1, 1997 to June 30, 1998. Data was collected by using questionnaries, which included demographic data, permonitory clinical signs and symtoms of myocardial infarction, and a measure of the severity of the signs and symptoms. Also semi-structured interviews and chart reviews were used to obtain information related to treatment-seeking time. The results of this study are summarized as follows ; 1. The most frequent premonitory clinical symptom was chest pain(92.9%), the second, was perspiration(81.0%), and the next were nausea(40.5%) and dyspnea(38.1%). Thirty two patients reported having more than four premonitory signs and symtoms. Patients described the characteristics of chest pain as “somethings very heavy pressing down”(26.2%), “felt like my chest would burst”(24.4%), or “sharp pain”(16.7%), Over 95% of the sample reported having chest pain. 2. Twenty two (52.4%) patients reported to have “very severe” premonitory pain. 3. The mean time interval between the onset of signs and symptoms and the arrival at the medical center was 6.39$\pm$10.80 hours in 42 samples, the mean time from the onset to arrival at a local hospital was 3.27$\pm$5.39 hours and for transfer from a local hospital to the medical center was 4.75$\pm$9.87 hours in patients who had arrived at medical center via local hospital. 4. The severity of premonitory signs and symptoms did not differ significantly according to existence of premonitory signs and symptoms. 5. There was no significant relationship between treatment-seeking time and age, gender, marital status, economic status, occupation, or residence. But education had significant relationship(r＝－0.51, p＝0.01). Analysis of difference of the time interval according to the premonitory signs and symptoms showed that the time was shorter in patients who experienced nausea or dyspnea(U＝115.50, p＝0.01, U＝132.00, p＝0.04), however the severity of premonitory signs and symptoms did not have statistical significance.

• Journal of Acupuncture Research
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• v.35 no.4
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• pp.219-225
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• 2018

Background: The purpose of this study was to review whether Korean medicine treatment was effective to maintain the spinal stability and to relieve spinal symptom by reviewing medical records of 18 vertebral compression fracture patients. Methods: The subjects were 18 thoracolumbar compression fracture patients who were taken more than two lateral view x-rays of fractured vertebra from Jan, 2010 to June, 2018. They were divided into two groups: the time admitted into Department of Acupuncture & Moxibustion Medicine, Pohang Korean Medical Hospital of Daegu Hanny University from onset (Research 1) and whether or not they have a past history of osteoporosis (Research 2). Then, they were follow-up observed and compared by compression ratio and numerical rating scale (NRS) and so on. Results: The amount of weekly compression rate increase of 18 patients was 1.76% per week. According to the result of Research 1, the patients group (14 patients) who were admitted into the hospital within 1-2 weeks from getting injury was 1.88% per week whereas the patients group(4 patients) who were admitted into the hospital within 3-4 weeks from getting injury was 1.22% per week. By Research 2 result, the patients group (7 patients) who had been diagnosed as an osteoporosis patient was 2.19% per week, and those (11 patients) who had not was 1.49% per week. There was a statistical significance in the change of the amount of compression rate increase in the case of Research 1, but there was not in the case of Research 2. NRS was decreased without significant difference regardless of the time admitted into the hospital and whether or not the patients had the past history of osteoporosis. Conclusion: Considering that there were more amount of compression rate increase at 1-4 weeks from onset, it is necessary to offer treatment more actively on early time from onset. Further research is needed into the increase of compression rate by the patients' having a past history of osteoporosis or not. Given that NRS decreased without significant difference, it is assumed that Korean medicine treatment has a meaningful effect on relieving subjective symptom of patients who are diagnosed as vertebral compression fractures.

• Phonetics and Speech Sciences
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• v.2 no.3
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• pp.65-73
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• 2010

No systematic study has examined the relationship between acoustic variability and /w/-deletion in Korean. Most previous studies on /w/-deletion have described /w/-variants in categorical terms, i.e., /w/-deletion or a full glide (Silva 1991; Kang 1997; Yun 2005). These studies are based either on impressionistic judgements without a systematic acoustic analysis or on an exclusive examination of internal acoustic variability of /w/ such as F2, without examining the availability of external acoustic cues such as voice onset time (VOT) of a consonant. However, given the important influence of the adjacent sounds for segmental realizations, it is necessary to examine possible acoustic variability in the differentiation of /w/-variants. The present study aims to address this issue by evaluating the acoustic properties of /CwV/, including VOT and formant transitions. In the analysis, 432 tokens in word-initial position (216 /CwV/ words and 216 /CV/ words) were examined. The results indicated that /w/ exhibits four different variants. Firstly, /w/ is realized as a full glide. Such a variant is characterized by a VOT difference and significant differences in F1 and F2 at voicing onset compared with /CwV/ and /CV/. Secondly, /w/ can be maintained but coarticulated with the following vowel. Such a variant is demonstrated by differences in VOT and F2. Thirdly, /w/ is categorically deleted, which is indicated by the absence of any differences in VOT, F1, and F2. Fourthly, /w/ overlaps a consonant. The F2 difference without VOT difference is manifested in the variant. In contrast to VOT, F1, and F2 differences, pitch plays little role in determining /w/-variants in Korean. These findings suggest that allophones can be produced along a gradient continuum of acoustic cues, exhibiting sounds intermediate between the full realization of a given category and its deletion. Furthermore, each variant can be cued by a set of internal and external acoustic cues.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.3
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• pp.107-116
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• 2013

Objectives The purpose of this study was to evaluate the most effective stimulating electrode in Microcurrent electrical neuromuscular stimulation (MENS) for pain relief, and to apply to the treatment of Delayed onset muscle soreness (DOMS). Methods We included 45 participants who met the inclusion criteria. DOMS of both Triceps Surae Muscles were experimentally induced through eccentric contractions. 24-hours after induction of DOMS, who scored more than 40 mm in visual analogue scale (VAS) were randomly assigned into three groups (n=44). In 15 of them, needle electrodes were inserted into BL57, BL56. In 15 of them, surface electrodes were applied on the same points and the others were treated with manual acupuncture. The effects of pain relief were assessed by visual analogue scale (VAS), mechanical pain threshold (MPT), surface electromyography (SEMG). Results In VAS, group comparison had no significant difference after all treatments had done. The difference in VAS between the time before the treatment was started (Day 2) and after all treatments were completed was greater in Acupuncture group than that of needle-electrode group. In MPT, there was no significant difference among groups. Electrical contraction decreased significantly at 2nd before-after treatment comparison in needle-electrode MENS group. But fatigue scores were not significantly different between groups. Conclusions The results suggest that the types of electrodes has no significant effect on microcurrent therapy in DOMS.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.7 no.1
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• pp.13-19
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• 2013

The aim of this study was to investigate difference of the muscle activation patterns of the upper body during wheelchair cycle ramps ascent of different slopes for disabled with spinal cord injury. Three subjects who is disabled with spinal cord injury participated in this study. Surface electromyography (EMG) data (reaction time [RT], onset-offset time, and peak value of muscle activation) were collected biceps, triceps, upper trapezius, anterior deltoid, latissimus dorsi, and upper rectus abdominal muscles during wheelchair cycle ramps ascent ($0^{\circ}$, $3^{\circ}$, and $6^{\circ}$). For latissimus dorsi muscle, RT and peak value of muscle activation was were increased and offset time was delayed as the slope increased (p < 0.05). These results indicate that wheelchair cycle ramps ascent might cause excessive overuse of latissimus dorsi muscle.

• Korean Journal of Animal Reproduction
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• v.8 no.2
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• pp.87-91
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• 1984

This study was conducted to determine the optimum time and the insemination site of frozen in Cheju native cows, and 660 cows first service inseminated with rectovaginal methods by 3 skillful technicians as 3 districts near Cheju City and Sogwipo City areas obtained the following results. Optimum time for insemination was 16-20 hours after the onset of estrus and 80.6% of 67 conceived to first insemination. In the rectovaginal technique used widely at present conception rate for the palpation of ovaries showed 6.6% (index) higher than that of non-palpation. Conception rate of the insemination site; the intra-uterine horn, intra-uterus, just inside the cervix and depositing in mid-cervix were 62.5, 78.4, 74.6, and 80.9% respectively, however, there was no difference in conception rate between cervical and uterine deposition of forzon semen except for the intra-uterine horn.