• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.35-39
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• 1999

Objectives: The treatment for squamous cell carcinoma of the tonsil remains controversial. Surgery or radiation therapy alone is effective in treating early tonsil cancer, but results with single treatment modality in advanced disease have been disappointing. We retrospectively analyzed 37 patients with advanced squamous cell carcinoma of the tonsil for two treatment modalities in an effort to identify more efficacious therapeutic options. Materials and Methods: From 1990 through 1997, 37 patients who were treated primarily with surgery, were retrospectively sudied. The patients were grouped into two groups according to the method of treatment, extended tonsillectomy followed by irradiation and/or postradiation neck dissection(Group I) and a combination of composite resection and postoperative radiation(Group II). Results: The three year disease-tree survival in patients with stage IV lesions was 59.09% for the Group I patients, and 56.25% for the Group II patients. This difference was not statistically significant(p=0.775). The primary tumor recurrence rate in Group I was 16.7% in contrast to 23.1% for Group II. The local recurrence rate in the neck was 16.7% for the Group I patients and 23.1% for the Group II patients. There was no significant difference in the frequency of recurrences in the primary or neck in the patients treated with extended tonsillectomy or composite resection(p=0.639). Fistula formation and aspiration occurred in four patients after composite resection. Additionally, there were three trismus, one soft tissue necrosis, and one velopharyngeal insufficiency. Major complications were not observed in the patients treated with extended tonsillectomy and irradiation: velopharyngeal insufficiency was observed in eight patients and soft tissue necrosis in two patients. Conclusion: Extended tonsillectomy followed by irradiation may be an effective therapy with low morbidity in selected patients with tonsil cancer.

• Health Policy and Management
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• v.10 no.1
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• pp.111-125
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• 2000

To compare the differences in the recognition on hospital utilization and satisfaction, 368 hospital employees and 485 patients were selected in four hospitals in Seoul and Kyung-gi do. The survey was done using a constructed form of checklist from Apr. 30 to May 10, 1999. And the results are as follows: l. Gaining knowledge of hospitals available among hospital employees differed from that of patients. When finding out about sources of information concerning hospitals, direct visit to the hospital was recognized to be the main factor for the hospital employees in contrast to the patients' recognition which were mass media, personal involvement of job related workplace and recommendations from other hospitals. There was no difference between university and general hospitals. 2. The factors that concern which hospital to choose there was a difference between hospital employees and patients. Hospital employees recommended their own hospital solely based on the reason that it was their work place. On the other hand, the patients made a choice based on the type of medical staff, transportation available and whether it was a university hospital or not. There was no difference between university and general hospitals. 3. The recognition of employees concerning hospital image of a hospital between hospital employees and patients was different. In university hospitals, the employees recognized the name value of university hospital and cooperation as most important, whereas the patients thought convenience, kindness were the main factors. Patients considered general hospitals to be more convenient. There was some difference between university and general hospitals. For university hospitals employees' recognition was higher and for the general hospital patients' recognition is higher on hospital image. 4. The recognition of employees was different from that of patients' on hospital satisfaction. The patients' satisfaction was higher than that of employees'. There was no difference between university and general hospitals. Based on the above findings, the employees' recognition on hospital utilization and satisfaction was different from that of the patients, but there was no difference between university and general hospitals. In both groups choice of hospital was associated with satisfaction. Results showing difference between employees' and patients' recognition can be applied to implement customer-oriented attitude and be used as a baseline data for internal-external marketing planning of hospital management. The study may be limited in that the results cannot be generalized due to its small sample size and not being able to reflect demographic variables and life style. Further studies to investigate the difference of hospital utilization and hospital satisfaction will be necessary to define demographic characteristics and recognition of employees which influences patients' hospital satisfaction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.293-299
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• 2008

Bite force is created by the force of adjacent teeth accompanied with tension of masticatory muscle. The bite force value is greater in male than in female and ha maximum value at first molar. Masseter muscle is associated with bite force and during muscle contraction the electric signal is expressed in EMG form. The aim of the study is to assess recovery time for masseter muscle activity and according to each part of bite force after open reduction with internal fixation when mandibular angle fracture and subcondyle fracture occurred. And to determine the appropriate period for mandibular fracture patients to have normal masticatory activity. 30 patients with normal bite condition was selected for control group and from April, 2007 to September, 2007, 20 patients who visited our department of oral and maxillofacial surgery of Dankook University, were selected for the study and were diagnosed as mandibular angle fracture and subcondyle fracture. For control group, the bite force for incisors, canine, premolars and molars and activity of the masseter muscle was measured and compared for 1, 2, 3, 4, 6 and 8 weeks. That was divided as fracture side and normal side. Mann-Whitney U test was performed for significant difference and the following result was obtained. 1. The maximum voluntary bite force for incisors, canine, premolars and molars portion were 0.113 kN, 0.182kN, 0.295kN and 0.486kN and the masseter muscle activity was 0.192 volts in the control group. 2. The maximum bite force at fracture side was recovered by 4th weeks for incisors, 6th weeks for canine and premolars and 8th weeks for molars and the masseter muscle activity was recovered by 6th weeks in the experimental group. 2. The maximum bite force at normal side was recovered by 4th weeks for incisors, 6th weeks for canine, premolars and molars and the masseter muscle activity was recovered by 3rd weeks in the experimental group. 3. The method for internal fixation by 2.0mm miniplates at both superior and inferior border had no complications according for twenty patients and had a satisfactory recovery. According to the result, patient with mandibular angle fracture and subcondyle fracture, 8 weeks was required for bite force recovery. Therefore, patients with open reduction and internal fixation under general anesthesis, it can be assumed that 8 weeks was needed after operation in order to have normal bite force and masseter muscle recovery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.4049-4054
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• 2014

Background: Race and ethnicity are significant factors in predicting survival time of breast cancer patients. In this study, we applied advanced statistical methods to predict the survival of White non-Hispanic female breast cancer patients, who were diagnosed between the years 1973 and 2009 in the United States (U.S.). Materials and Methods: Demographic data from the Surveillance Epidemiology and End Results (SEER) database were used for the purpose of this study. Nine states were randomly selected from 12 U.S. cancer registries. A stratified random sampling method was used to select 2,000 female breast cancer patients from these nine states. We compared four types of advanced statistical probability models to identify the best-fit model for the White non-Hispanic female breast cancer survival data. Three model building criterion were used to measure and compare goodness of fit of the models. These include Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC). In addition, we used a novel Bayesian method and the Markov Chain Monte Carlo technique to determine the posterior density function of the parameters. After evaluating the model parameters, we selected the model having the lowest DIC value. Using this Bayesian method, we derived the predictive survival density for future survival time and its related inferences. Results: The analytical sample of White non-Hispanic women included 2,000 breast cancer cases from the SEER database (1973-2009). The majority of cases were married (55.2%), the mean age of diagnosis was 63.61 years (SD = 14.24) and the mean survival time was 84 months (SD = 35.01). After comparing the four statistical models, results suggested that the exponentiated Weibull model (DIC= 19818.220) was a better fit for White non-Hispanic females' breast cancer survival data. This model predicted the survival times (in months) for White non-Hispanic women after implementation of precise estimates of the model parameters. Conclusions: By using modern model building criteria, we determined that the data best fit the exponentiated Weibull model. We incorporated precise estimates of the parameter into the predictive model and evaluated the survival inference for the White non-Hispanic female population. This method of analysis will assist researchers in making scientific and clinical conclusions when assessing survival time of breast cancer patients.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.535-542
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• 2000

The purpose of this study was to find the characteristics of the frontal natural head position(NHP) of patients with facial asymmetry, and to contribute to the diagnosis of facial asymmetry in the clinical examination of orthodontic patients. Twenty adult patients who had apparent facial asymmetry and no severe sagittal skeletal discrepancy were selected as the asymmetry group, and 21 young adults who had symmetric faces were selected as the symmetry group. Frontal cephalograms were obtained in the state of NHP using a pivot-mounted fluid level device. The degree of the menton deviation was defined as the angle between the line drawn through crista galli and anterior nasal spine and the line drawn through crista galli and menton. The following angles were measured and each of them was compared with the degree of the menton deviation one is the angle between the true vertical line and the supra-orbital line which is a tangent line to the extreme cranial point on the supra-orbital margin, and the other is the angle between the true vertical line and the cervical line drawn through the midpoint of atlas and the 4th cervical vertebra. Through the statistical analysis, following results were obtained. 1. The angle between the supra-orbital line and the true vertical line was much mote deviated from the right angle in the asymmetry group than in the symmetry group. 2. The angle between the cervical line and the true vertical line in the asymmetry group showed greater tendency than in the symmetry group, but the difference was not statistically significant. 3. In the asymmetry group, the degree of the menton deviation was positively correlated with the angle between the supraorbital line and the true vertical line. The above results suggest that racial asymmetry patients show the tendency to have the tilted NHP to compensate the deviation of menton position.

• The Journal of Korean Physical Therapy
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• v.15 no.2
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• pp.131-145
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• 2003

The purpose of this study was to evaluate effects of artificial balenotherapy on the with degenerative osteoarthritis were selected as the subject do this study among the patients with degenerative osteoarthritis having pains in their knees by the criteria of America Rheumatoid Association. And the randomly selected ten patients out of the twenty were classified as an artificial balenotherapy group and the other the Patients were in a control group. Ten individuals with degenerative osteoarthritis patients in the artificial balenotherapy group Participated in artificial balenotherapy Program four weeks from March 1st, 2003 to March 31st, 2003 in Daegu 00 hospital. Ten individuals with degenerative osteoarthritis in the control group did not receive Artificial Balenotherapy. The conclusions were as follows: 1. After 4 weeks of therapy, the score of WBC(p < 0.01), RBC(p < 0.01), HTC(p < 0.01) in the artificial blalenotherapy group were significantly decreased, compared with their scores in pre-intervention. 2.In the balenotherapy group, significantly increase $Na^{+}$ ion(P < 0.05), decrease K ion(p < 0.01), unchanged Cl ion scores were found, compared with their scores in pro-intervention. 3. The result of the substudy about the effects of artificial balenotherapy on the substances that have relations with the function of liver were following that artificial balenotherapy group, increased total bilirubin(P < 0.01), unchanged total Protein, Albumin, total cholesterol, GOT, GPT, ALP were found, compared with their score in pre-intervention. 4. The result of the substudy about the effects of artificial balenotherapy on the substances that have relations with the function of kidney were following that in the artificial balenotherapy group, reduced BUN(P < 0.05), and increased creatine were found. 5. The result of the substudy about effects of artificial balenotherapy on the knee pain visual analog score, knee's functional score, ADL score were following that in the artificial balenotherapy group, decreased VAS score(P < 0.05), increased ADL score(p < 0.01), unchanged knee's functional score were founf, compared with their scores of the pre-intervention. In conclusion, the result of this study suggest that artificial balenotherapy improved ADL score and reduced knee pain visual analog score of the patients with degenerative osteoarthritis. The result proposed that appropriate use of artificial balenotherapy improves the degenerative osteoarthritis

• Journal of Acupuncture Research
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• v.21 no.1
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• pp.111-118
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• 2004

Background and purpose: Opposing-needling technique involves selecting acupoints at unaffected limb. The aim of this study was to evaluate the effect of LI4-LI11 electrical acupuncture at unaffected limb on the cerebral blood flow in ischemic stroke patients using SPECT Methods: We selected 9 ischemic stroke patients. Baseline brain SPECT was done with triple head gamma camera(MultiSPECT3, Siemens, USA) after intravenous administration of 925 MBq of Tc-99m ECD). Fifteen-minute electro-acupuncture at Hapgok(LI 4) and Gokji(LI 11) were applied on unaffected upper limb of subjects. The same dose of Tc-99m ECD was injected during the electro-acupuncture, and the second SPECT images were obtained. Using the computer software(ICON 7.1, Siemens, USA), 3 SPECT slices(upper, middle, lower) surrounding the brain lesion were selected and each slice was divided by 10-16 brain regions. Asymmetry indexes were analyzed in each brain region. We regarded$\geq$10% changes of asymmetry index between before and after electro-acupuncture as significance. Results: Seven Patients(77.8%) had significantly increased perfusion and 2(22.2%) didn't show increased perfusion in post-acupuncture scans compared to pre-acupuncture scans(baseline). The regions of CBF improvement were mostly frontal lobes and anterior temporal lobes. Conclusions: This study demonstrated that LI4-LI11 electro-acupuncture at unaffected limb increased regional cerebral blood perfusion to the corresponding brain areas in ischemic stroke patients.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.2
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• pp.281-295
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• 1994

It is very important for the ideal restorations of anterior openbite patients to record the mandibular movement and to harmonize mandibular movement with other organs in stomatognathic systems. This study was designed to compare the mandibular movement of anterior openbite patients with that of normal bite(Angle Class I) patients, to ascertain which components of mandibular movement have differences between two groups, and to use for occlusal treatment of mandibular movement. Saphon Visi-trainer Model 3(Tokyo Shizaisha Co. Japan) and Denar Pantronic(Denar Corp.,U.S.A.) were used to record mandibular movement. Pantronic survey was peformed by using an arbitrary hinge axis according to manufacturer's direction. Twenty-eight adult who have physiologically normal occlusion(Angle Class I) and are free of TM dysfunction were selected as a control group(Group 1). Fifteen adult who are anterior openbite patient and have not anterior guidance function and have posterior interference at protrusion were selected as a experimental group(Group 2). The results are as follows : 1. There was no statistically significant difference between the average immediate and progressive side shift of anterior openbite patients(0.54mm, $7.57^{\circ}$) and those of normal group(0.49mm, $5.96^{\circ}$). 2. The average protrusive and orbiting condylar inclination of anterior openbite patient$(30.87^{\circ},\;32.27^{\circ})$ were significantly lower than those of normal group$(36.11^{\circ},\;39.04^{\circ})$ (P<0.05). 3. In the results of Visi-trainer recordings, the mean for the maximum protrusion, the maximum laterotrusion, the angle of laterotrusion and the angle of protrusion in the horizontal trajectory between group 1 and 2 did not differ significantly. 4. The mean for the angle of protrusion, the maximum opening in the frontal trajectory, the ICP-RCP(A-P) distance and the angle of protrusion in the sagittal trajectory differ significantly(P<0.05). 5. The significant correlation was found between orbiting condylar inclination and protrusive condylar inclination.

• Therapeutic Science for Rehabilitation
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• v.5 no.2
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• pp.57-69
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• 2016

Objective: The purpose of this study was to systematically review the articles using accelerometer to measure activity of daily living of patients with stroke. Methods: Depending on selection criteria, 13 studies were searched for PubMed, EMBASE, and Cochrane library database from February 2014 to March 2014. A total of 331 papers were searched, and 13 of these were selected. Results: In studies of 13 selected, acute, subacute, and chronic patients with stroke were enrolled. The kind of accelerometer was uniaxial, biaxial, and triaxial, activity monitor. Measurement activities were mainly arm activity, walking activity, and attachment sites were also various depending on the measurement activities. A measured variable was the total number of activities, the movement speed of the patients, ratio between affected and non-affected, and motion analysis. The result indicated that significant correlation with the other assessment tools in all studies. Conclusions: Accelerometer will be applied with a tool for measuring activity of daily living of patients with stroke, depending on activities characteristics. Further, we need accelerometer studies to apply with a variety of assessment in clinical practice or community settings.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.650-660
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• 1992

To elucidate a potential contribution of endotheline-1[ET-1] to the genesis of pulmonary hypertension and postoperative pulmonary hypertensive crisis in the patients with heart disease, we measured plasma levels of the ET-1 during perioperative period of open heart surgery. In addition, we examined changes of ET-1 during perioperative period and correlations between ET-1 levels and hemodynamic variables. 12 patients including 5 acquired heart disease and 7 congenital heart disease patients were selected randomly as a study group, Group A and B, respectively. 6 patients proved not having heart or hemodynamic problem were selected as a control, Group C. 110 blood samples from pulmonary artery[ET-P] and radial artery[ET-S] were taken and assayed by Sep-pak extraction and RIA. ET-1 levels of Group A were ET-P, 3.94$\pm$5.31pg /ml, ET-S, 3.10$\pm$2.90pg/ml[p>0.05], Group B were ET-P, 1.63$\pm$0.62pg/ml, ET-S, 1.99$\pm$2.45pg/ml[p>0.05], Group C were ET-P, 1.97$\pm$2.02pg/ml, ET-S, 1.72$\pm$0.77pg/ml[p>0.05]. There were no statistically significant differences of ET-1 levels among the Group A, B, C[p>0.05]. There was no correlation between pulmonary artery pressure[PAP] and ET-1 level[p>0.05], and ET-1 levels were not increased even in the cases of pulmonary hypertensive criwis or low cardiac output syndrome, whereas significant correlation between ET-S and pulmonary vascular res-istance[Rp] [r=0.36, p<0.05], and negative correlation between ET-S and OS saturation of pulmonary artery[OS-P][r= -0.49, p<0.01] were identified. Another significant finding was peak increase of ET-1 levels in the postoperative period 1 hour[p<0.05] and then gra-dualy decrease through the postoperative period. In conclusion, ET-1 has no correlation with PAP, whereas correlation with Rp, and inverse correlation with OS-P. It is suggested that ET-1 is neither the direct causative substance of pulmonary hypertension nor pulmonary vasospasm but there must be increased production of ET-1 in chronic pulmonary hypertensive state. Counter-regulatory mechanism to ET-1 is speculated during the pulmonary vasospasm.