• Archives of Plastic Surgery
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• v.48 no.4
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• pp.457-461
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• 2021

Background Pedicled perforator flaps can present postoperative complications similar to those encountered in free flap surgery. Beyond a clinical evaluation, there is still no reliable technical aid for the early prediction of vascular issues. The aim of this study was to assess the support of near-infrared spectroscopy technology as an intraoperative tool to anticipate postsurgical flap ischemia. Methods We prospectively enrolled 13 consecutive patients who were referred to our hospital from March 2017 to July 2018 and required a reconstructive procedure with a pedicled fasciocutaneous perforator flap. We measured flap peripheral capillary oxygen saturation (SpO₂) in each patient with a Somanetics INVOS 5100C Cerebral/Somatic Oximeter (Medtronic), both before and after transposition. Patient demographics, operative data, and complications were then recorded during the following 6 months. We analyzed the data using the Wilcoxon signed-rank test and linear regression. Results The mean flap SpO₂ before and after transposition was 92%±3% and 78%±19%, respectively. The mean change in SpO₂ was 14%±17%, with a range of 0% to 55%. The change in saturation and mean saturation ratio were significantly different between patients with and without postoperative flap necrosis. Conclusions An immediate quantitative analysis of flap peripheral capillary SpO₂ after transposition has never before been described. In our experience, an intraoperative drop in SpO₂ equal to or greater than 15%-20% predicted vascular complications in pedicled perforator flaps. Conversely, flap size and rotation angle were not correlated with the risk of flap necrosis.

• Journal of Korean Academy of Nursing
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• v.52 no.2
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• pp.121-133
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• 2022

Purpose: This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. Methods: This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher's exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann-Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. Results: The severity of behavioral and psychological symptoms (Wald 𝛘² = 2.68, p = .102) and the care burden of caregivers (Wald 𝛘² = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald 𝛘² = 0.63, p = .426, Wald 𝛘² = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p = .041). Conclusion: The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.177-185
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• 2022

Purpose : The purpose of this study was to compare the effect of additional isometric contraction of trunk, shoulder, and hip muscles during abdominal crunch exercise on abdominal muscle thickness and to identify the most effective intervention for core muscle activation. Methods : This study was conducted on 22 healthy male adults. Subjects performed three types of crunch exercises (abdominal crunches accompanied by internal and external isometric rotation of the hip, horizontal shoulder adduction and abduction, and rotation of the trunk). The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) were evaluated using ultrasonography. The collected data used one-way repeated ANOVA statistics. Wilcoxon signed-rank test of nonparametric statistics was used for post-test analysis. Results : The IO thickness was significantly lower than general abdominal crunch when shoulder adduction was added (p<.05). The crunch with shoulder abduction, hip external rotation, and ipsilateral trunk rotation was significantly higher than the abdominal crunch (p<.05). The EO thickness was significantly greater in the crunch with hip external rotation than in the abdominal crunch (p<.05). Conclusion : The level of contraction in abdominal muscles appears to vary when isometric contractions of the trunk, shoulder, and hip muscles are added to the abdominal crunch exercise. Therefore, the use of isometric contractions of other joints to selectively induce contraction of the abdominal muscles may be considered.

• Physical Therapy Korea
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• v.29 no.1
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• pp.70-78
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• 2022

Background: Individuals with calf muscle shortening may have decreased dynamic balance. Objects: This study aimed to investigate the effect of mobilization with movement (MWM) and myofascial release (MFR) on kinematic changes in dynamic balance in individuals with calf muscle shortening. Methods: Thirteen participants were randomly assigned to the MWM or the mobilization with movement added myofascial release (MWM-MFR) group. The MWM group received treatment with only MWM, whereas the MWM-MFR group was treated with MWM and MFR. Pre- and post-intervention passive range of motion (PROM), maximum reaching lengths, and modified star excursion balance test (MSEBT) results were compared for all participants. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis. Results: The results showed significant within-group differences in ankle PROM, but no significant between-group differences. The maximum reaching length in the MWM-MFR group in the posterolateral direction was significantly different before and after the intervention (p = 0.005). This group also showed significantly reduced ankle abduction in MSEBT during the posteromedial direction section 3 (p = 0.007) and posterolateral direction section 5 (p = 0.049) compared with the MWM group. Conclusion: Combined MWM and MFR intervention improves ankle stability in the coronal plane during the posteromedial and posterolateral forward movement in dynamic balance compared with only MWM in individuals with calf shortening.

• Journal of Korean Academy of Rural Health Nursing
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• v.16 no.2
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• pp.29-36
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• 2021

Purpose: The purpose of this study is to develop a living lab program to solve the musculoskeletal health problems of rural women and analyze its effects. Methods: The subjects included eight rural women and this study involved pretest and posttest designs for a single group. The program ran from July to August 2020 and consisted of one in-person training session and three weeks of management. The effectiveness of the program was evaluated by the change in the degree of pain experienced in the wrists, shoulders, and back, along with the general health status of the subjects. The Wilcoxon Sign-Rank test was used in the analysis. In addition, the program satisfaction was analyzed with five items based on the factors of the health belief model. Results: While the program seemed to have no significant impact on the health status of the subjects, all the participants did report reduced pain in their wrists, shoulders, and lower back. The 'sensitivity' and 'cue to action' metrics also increased with participation in the program. Conclusion: This program was effective in relieving some pain associated with the musculoskeletal problems in rural women. Therefore, such programs should be sustained and spread around community organizations

• The Journal of Advanced Prosthodontics
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• v.15 no.1
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• pp.11-21
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• 2023

PURPOSE. To compare the sagittal condylar inclination (SCI) in dentate individuals measured by the different methods with mechanical articulator (MA), virtual articulator (VA), and a jaw tracking device (JTD) system. MATERIALS AND METHODS. A total of 22 healthy dentate participants were enrolled in this study. For MA workflow, the SCI was obtained by a semi-adjustable articulator with protrusive interocclusal records. The SCI was also set on a VA by aligning intraoral scan (IOS) with cone beam computed tomography (CBCT) and facial scan (FS), respectively. These virtual workflows were conducted in a dental design software, namely VAI_OS-CBCT and VAI_OS-FS. Meanwhile, a JTD system was also utilized to perform the measurement. Intraclass correlation was used to assess the repeatability within workflows. The bilateral SCI values were compared by Wilcoxon matched-pairs signed rank test for each workflow, and Kruskal-Wallis test and post hoc p-value Bonferroni correction were used to compare the differences among four workflows. The agreement of VAI_OS-CBCT, VAI_OS-FS, and JTD compared with MA was evaluated by Bland-Altman analysis. RESULTS. Intraclass correlation of the SCI revealed a high degree of repeatability for each workflow. There were no significant differences between the left and right sides (P > .05), except for VAI_OS-CBCT (P = .028). Significant differences were not found between MA and VAI_OS-FS (P > .05). Bland-Altman plots indicated VAI_OS-CBCT, VAI_OS-FS, and JTD were considered to substitute MA with high 95% limits of agreement. CONCLUSION. The workflow of VAI_OS-FS provided an alternative approach to measure the SCI compared with MA.

• The Journal of Advanced Prosthodontics
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• v.15 no.1
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• pp.44-54
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• 2023

PURPOSE. To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS. Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION. The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.

• Journal of Korean society of Dental Hygiene
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• v.23 no.2
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• pp.105-113
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• 2023

Objectives: The purpose of this study is to verify the usefulness and practicality of the program in the daily life of the elderly by performing a three-dimensional tongue muscle exercise for the elderly to identify the dysphagia, swallowing ability, and tongue pressure. Methods: The subjects of the study were 29 elderly people aged 65 or older living in Busan, divided into a oral exercises group and tongue strength training program combined with oral exercises group, and operated 16 times for 8 weeks twice a week, and the pre and post-program evaluation was conducted in the 1st and 8th weeks. For variable selection, 7 general characteristics, 5 oral health-related characteristics, 5 Likert scale for swallowing disorder, repetitive swallowing ability test for swallowing power measurement, and tongue pressure measurement was used. Data analysis was conducted using SPSS window program 25.0 version (IBM), general characteristics and homogeneity tests, oral health-related characteristics and homogeneity tests were chi-square test, swallowing disorder, swallowing ability, and change in tongue pressure were paired t-test, Wilcoxon signed rank test, t-test, Mann-Whitney U test for swallowing disorder and changes in swallowing ability and tongue pressure, and Spearman's correlation for the relationship between swallowing disorder and swallowing ability and tongue pressure. Results: As a result of tongue strength training program combined with oral exercise, both relieve swallowing disorder and improve low eating and tongue pressure than oral exercise, and the difference in improvement effects of both relieve swallowing disorder, swallowing ability, and tongue pressure is higher. Conclusions: Based on the results of this study, it is believed that simple and practical oral muscle function reinforcement products and practical use are needed, and institutional devices to seek oral health promotion programs for the elderly are needed.

• Journal of the Korean Society of Industry Convergence
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• v.26 no.4_2
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• pp.623-628
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• 2023

The purpose of this study was to evaluate the fracture strength and removal torque value (RTV) of a conventional angled abutment and a newly developed angled abutment (Beauty up abutment) with an angulated screw access hole. Each abutment was divided into a control group and an experimental group (n = 20, respectively). To measure the fracture strength, the abutment was connected to the internal hex implant with 30 Ncm torque, and a load was applied at 30 degree angle with cross-head speed of 1 mm/min using a universal testing machine according to the ISO 14801:2016 standard. To measure RTV, each abutment was fastened to the implant with 30 Ncm torque. Retightening was performed after 10 minutes, and initial RTV was measured with a digital torque gauge. After retightening, a load of 250 N was applied to the abutment at a 30 degree angle using a chewing simulator. After a total of 100,000 repeated loads, RTV was measured. Statistical analysis was performed using Wilcoxon signed rank test and Mann-Whitney U test (α = .05). The fracture strength of the experimental group was statistically significantly lower than that of the control group (P = .009). There was no significant difference between initial RTV and post-loading RTV between the experimental group and the control group (P = .753, P = .527, respectively), and cyclic loading did not significantly affect RTV in both groups (P = .078).

• Annual Conference of KIPS
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• 2010.11a
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• pp.478-481
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• 2010

본 논문에서는 경제학, 사회학, 수학 분야에서 수십년 전부터 연구해오던 죄수의 딜레마 게임의 협동진화에 대해 고찰해보고자 한다. 반복적 죄수의 딜레마 게임은 게임이론의 가장 기본적인 이론으로써, 사회적 상호작용, 경제활동, 국제관계 등 다양한 현상들을 모델링 하기 위한 하나의 방법이다. 그 중에 N명이 참가하는 반복적 죄수 딜레마 게임의 전략은 유전 알고리즘(Genetic Algorithms, GAs)을 통해 진화적으로 만들어 낼 수 있으며, 이 경우에 그 결과를 일반적인 내쉬 균형 이 아닌, 모든 개체들이 유전알고리즘을 통해 협동으로 수렴하도록 유도할 수 있다는 사실은 상당히 시사하는 바가 크다. 기존에 주로 연구되어오던 죄수의 딜레마 게임은 협동으로의 수렴과정에서 일반적으로 순위기반선택(Rank-based selection)과 1점 교배기법(1point crossover)을 사용한다. 그러나 순위기반선택은 모든 개체에 순위을 매겨야 하기 때문에, 개체수가 커질수록 성능이 저하되며, 1점 교배기법은 개체 값이 분산되어있을 경우, 최적해(Optimal solution)을 찾기 힘들다는 단점이 있어, 개체수가 많은 경우에 적용하기에는 비효율적이다. 본 논문에서는 토너먼트 선택기법(Tournament selection)과 자기 적응형 교배기법(Self-adaptive crossover)을 적용한 새로운 기법을 제안한다. 또한 기존 기법과 비교 실험을 통해 제안기법이 기존기법에 비해 평균 수렴시간과 수렴 횟수에서 뛰어난 성능을 보이고 있음을 확인하였다.