• Title/Summary/Keyword: Procedure Quality

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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

Individual Bioequivalence Tests under 3 X 2 Design (3 X 2 교차설계법에서 개인 생물학적 동등성 검정)

  • Jung, Gyu-Jin;Lim, Nam-Kyoo;Park, Sang-Gue
    • The Korean Journal of Applied Statistics
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    • v.23 no.1
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    • pp.139-150
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    • 2010
  • In recent years, more generic drug products became available. The current regulation for assessing the bioequivalence of two drug formulations is based on the concept of average bioequivalence. This approach has been indicated to be insufficient for assessing switchability between two drug formulations and US FDA has adopted individual bioequivalence as one of the bioequivalence criterion since 2001. The US FDA recommends that individual bioequivalence be assessed based on $2\;{\times}\;4$ crossover design, while a $2\;{\times}\;3$ crossover design may be used as an alternative design to reduce the length and cost of the study. In this paper, a statistical procedure for assessment of individual bioequivalence under $3\;{\times}\;2$ crossover designs is proposed and some statistical points are discussed with $2\;{\times}\;3$ crossover design and $2\;{\times}\;3$ extra-reference design through simulation studies.

A Survey of Sedation Practices in the Korean Dentistry (치과 치료 시 진정법 시행에 대한 실태 조사 연구)

  • Bae, Chi-Hoon;Kim, Hyuk;Cho, Kyoung-Ah;Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.29-39
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    • 2014
  • Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

Mixed-mode simulation of transient characteristics of 4H-SiC DMOSFETs - Impact off the interface changes (Mixde-mode simulation을 이용한 4H-SiC DMOSFETs의 계면상태에서 포획된 전하에 따른 transient 특성 분석)

  • Kang, Min-Seok;Choe, Chang-Yong;Bang, Wook;Kim, Sang-Chul;Kim, Nam-Kyun;Koo, Sang-Mo
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2009.11a
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    • pp.55-55
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    • 2009
  • Silicon Carbide (SiC) is a material with a wide bandgap (3.26eV), a high critical electric field (~2.3MV/cm), a and a high bulk electron mobility (${\sim}900cm^2/Vs$). These electronic properties allow high breakdown voltage, high frequency, and high temperature operation compared to Silicon devices. Although various SiC DMOSFET structures have been reported so far for optimizing performances. the effect of channel dimension on the switching performance of SiC DMOSFETs has not been extensively examined. In this paper, we report the effect of the interface states ($Q_s$) on the transient characteristics of SiC DMOSFETs. The key design parameters for SiC DMOSFETs have been optimized and a physics-based two-dimensional (2-D) mixed device and circuit simulator by Silvaco Inc. has been used to understand the relationship with the switching characteristics. To investigate transient characteristic of the device, mixed-mode simulation has been performed, where the solution of the basic transport equations for the 2-D device structures is directly embedded into the solution procedure for the circuit equations. The result is a low-loss transient characteristic at low $Q_s$. Based on the simulation results, the DMOSFETs exhibit the turn-on time of 10ns at short channel and 9ns at without the interface charges. By reducing $SiO_2/SiC$ interface charge, power losses and switching time also decreases, primarily due to the lowered channel mobilities. As high density interface states can result in increased carrier trapping, or recombination centers or scattering sites. Therefore, the quality of $SiO_2/SiC$ interfaces is important for both static and transient properties of SiC MOSFET devices.

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Determination of Removal Time of the Side Form in High Strength Concrete (고강도콘크리트 시공시 측면 거푸집 탈형시기의 결정)

  • Han Cheon-Goo;Han Min-Cheol
    • Journal of the Korea Concrete Institute
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    • v.16 no.3 s.81
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    • pp.327-334
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    • 2004
  • In this paper, method for the determination of removal time of the side forms in high strength concrete are discussed using the estimation model of compressive strength development, the development of bond strength and rebound number of P type Schmidt hammer in order to review the validity of existing regulation as to side form removal and offer effective quality control method. According to the results, as W/B increases by $10\%$, the setting time is shortened by about 2 hours. In the scope of the paper, required time to gain 8MPa of compressive strength is determined about 17 ${\~}$20 hours of age and $21{\~}25^{\circ}D{\cdot}D$ of maturity. Bond strength between form and concrete shows the highest value around final setting time, but decreases drastically after that. Amount of concrete sticking on the form is large before setting completed, but after that, its amount shows decline tendency. The rebound value test with P type schmidt hammer can be started faster by 2${\~}$3 hours than compressive strength test. It is also confirmed that the removal of forms is possible when the rebound value of P type schmidt hammer is more than 32. It is found from the results that existing regulation regarding removal time of the side form of high strength concrete provided in KCI needs no revision because required time to gain the strength provided in KCI has no adverse effect on strength development at early age and surface condition during stripping the side form. Effective procedure to decide the removal time of side form can be performed by applying P type Schmidt hammer.

Pylorus-preserving Proximal Gastrectomy vs. Total Gastrectomy with Jejunal Interposition for Proximal Gastric Adenocarcinomas (상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교)

  • Noh Seung-Moo;Jeong Hyun-Yong;Lee Byong-Seok;Cho June-Sik;Shin Kyung-Sook;Song Kyu-Sang;Lee Tae-yong
    • Journal of Gastric Cancer
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    • v.2 no.3
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    • pp.145-150
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    • 2002
  • Purpose: The aim of this study was to evaluate the shortterm outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pyloruspreserving proximal gastrectomy is a common problem to be solved in the future.

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Evaluation of Stiffness Profile for a Subgrade Cross-Section by the CAP(Common-Array-Profiling)-SASW Technique (CAP SASW 기법에 의한 지반단면의 전단강성구조 평가)

  • Joh Sung-Ho;Jang Dae-Woo;Kang Tae-Ho;Lee Il-Wha
    • Journal of the Korean Geotechnical Society
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    • v.21 no.4
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    • pp.71-81
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    • 2005
  • Surface wave techniques were initially based on 2-D plane waves and were later improved to the techniques based the 3-D based cylindrical waves. However, body-wave interference, near-field effect and limited technology in surface wave measurements restricted the use of 3-D cylindrical waves to the 1-D evaluation of subgrade stiffness. In this study, by the numerical simulation of SASW measurements, the dispersion properties of surface waves including vertical, horizontal Rayleigh waves and Love waves were thoroughly investigated in the 3-D domain, and a new filter criteria to minimize the near-field effect was established, which led to CAP (common-array-profiling)-SASW technique. The CAP-SASW technique enabled the evaluation of subgrade stiffness fur a specific subgrade segment, not for a whole section of measurement array. Therefore, a contour plot of subgrade stiffness with a ground-truth quality can be obtained by the CAP-SASW technique. The procedure proposed in this study was verified by comparing the shear-wave velocity profiles with the shear-wave velocity profiles of downhole testing at two geotechnical sites.

Ultrasound-guided Core Needle Biopsy in Diagnosis of Soft Tissue Masses (연부조직 종물의 진단에서 초음파 유도하 중심부 침생검)

  • Kim, Jeung-Il;Youn, Myung-Soo;Cheon, Sang-Jin;Choi, Gyung-Un;Lee, Tae-Hong
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.113-119
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    • 2004
  • Purpose: To determine the utility of sonographically guided percutaneous core needle biopsy to diagnose musculoskeletal soft tissue masses. Methods: A prospective study was performed in 55 patients referred for image-guided needle biopsy of primary or recurrent soft tissue masses and bone lesion or suspected solitary metastasis with extraosseous masses. Tissue samples were obtained with a 14-gauge or 18-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 49 biopsies confirmed by successful clinical treatment (11 cases) or surgical resection (38 cases). Results: An accurate diagnosis was obtained in 47 (97%) of 49 biopsies; sensitivity was 95%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 6 cases. Considering all 55 biopsies, high-quality specimens were obtained in 87%. There were no serious complications. Conclusions: Sonographically guided core needle biopsy is accurate and safe, in soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.

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A Whole Genome Association Study to Detect Single Nucleotide Polymorphisms for Carcass Traits in Hanwoo Populations

  • Lee, Y.-M.;Han, C.-M.;Li, Yi;Lee, J.-J.;Kim, L.H.;Kim, J.-H.;Kim, D.-I.;Lee, S.-S.;Park, B.-L.;Shin, H.-D.;Kim, K.-S.;Kim, N.-S.;Kim, Jong-Joo
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.4
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    • pp.417-424
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    • 2010
  • The purpose of this study was to detect significant SNPs for carcass quality traits using DNA chips of high SNP density in Hanwoo populations. Carcass data of two hundred and eighty nine steers sired by 30 Korean proven sires were collected from two regions; the Hanwoo Improvement Center of National Agricultural Cooperative Federation in Seosan, Chungnam province and the commercial farms in Gyeongbuk province. The steers in Seosan were born between spring and fall of 2006 and those in Gyeonbuk between falls of 2004 and 2005. The former steers were slaughtered at approximately 24 months, while the latter steers were fed six months longer before slaughter. Among the 55,074 SNPs in the Illumina bovine 50K chip, a total of 32,756 available SNPs were selected for whole genome association study. After adjusting for the effects of sire, region and slaughter age, phenotypes were regressed on each SNP using a simple linear regression model. For the significance threshold, 0.1% point-wise p value from F distribution was used for each SNP test. Among the significant SNPs for a trait, the best set of SNP markers were selected using a stepwise regression procedure, and inclusion and exclusion of each SNP out of the model was determined at the p<0.001 level. A total of 118 SNPs were detected; 15, 20, 22, 28, 20, and 13 SNPs for final weight before slaughter, carcass weight, backfat thickness, weight index, longissimus dorsi muscle area, and marbling score, respectively. Among the significant SNPs, the best set of 44 SNPs was determined by stepwise regression procedures with 7, 9, 6, 9, 7, and 6 SNPs for the respective traits. Each set of SNPs per trait explained 20-40% of phenotypic variance. The number of detected SNPs per trait was not great in whole genome association tests, suggesting additional phenotype and genotype data are required to get more power to detect the trait-related SNPs with high accuracy for estimation of the SNP effect. These SNP markers could be applied to commercial Hanwoo populations via marker-assisted selection to verify the SNP effects and to improve genetic potentials in successive generations of the Hanwoo populations.

Development of Habitat Suitability Index for Habitat Restoration of Narrow-mouth Frog(Kaloula borealis) (맹꽁이 서식처 복원을 위한 서식처 적합성 지수(HSI) 개발)

  • Shim, Yun-Jin;Cho, Dong-Gil;Park, Sohyun;Lee, Dong-Jin;Seo, Yun-Hee;Kim, Sang-Hyuk;Kim, Duck-Ho;Ko, Sang-Beom;Cha, Jin-Yeol;Sung, Hyun-Chan
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.17 no.2
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    • pp.109-123
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    • 2014
  • Kaloula borealis is the species of Amphibia which belongs to Kaloula genus and it is the only species inhabiting in Korea. The population size and habitat of Kaloula borealis have been significantly decreased on a national scale due to the diversified developments and the uses of agricultural pesticides. Accordingly, the Ministry of Environment has designated and managed them as the class II of endangered species, in accordance with "Endangered Species Protection and Management Act"; however, a particular study focused on the ecological restoration of Kaloula borealis is desperately needed to prevent their extinction. This study was conducted to propose the HSI (Habit Suitability Index) of Kaloula borealis based on literature survey on ecology and habitats of Kaloula borealis, as well as their HSI. Factors to be investigated in HSI include: space, feed, cover, water(breeding) and threatening factors and the variables of each factor were also proposed. The distance from wetland, grassland, farm, stream and rice paddy, as well as the altitude of spawning pond were proposed as the variables of space, whereas the bed structure of forest and low-rise grassland were proposed as the variables of feeding. The variables of water (breeding) include the area of permanent and temporary wetlands, coverage of emerged pants (ratio of open water), water depth, water temperature, water quality, pH level, etc., whereas the presence of predator, distance from street and pollutants were proposed as the variables of threatening factor. The sub-standards by HSI factor of Kaloula borealis have been drawn from in-depth consultation with experts and based on this, the final HSI of Kaloula borealis was developed.