• Title/Summary/Keyword: 환자 선호도

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A simulation study of speech perception enhancement for cochlear implant patients using companding in noisy environment (잡음 환경에서 압신을 이용한 인공 와우 환자의 언어 인지 향상 시뮬레이션 연구)

  • Lee Young-Woo;Ji Yoon-Sang;Lee Jong-Shil;Kim In-Young;Kim Sun-I.;Hong Sung-Hwa;Lee Sang-Min
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.43 no.5 s.311
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    • pp.79-87
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    • 2006
  • In this study, we evaluated the performance of a companding strategy as a preprocessing for speech enhancement and noise reduction. The proposed algorithm is based on two tone suppression that is human's hearing characteristics. This algorithm enhances spectral peak of speech signal and reduces background noise, however it has tradeoff characteristics between speech distortion and noise reduction due to limited channel number and nonlinear block. Therefore, we designed two different companding structures that have relative characteristics of noise reduction and speech distortion and found suitable companding structures by difference of individual speech perception ability in noise environment. Thus we proposed speech perception enhancement of cochlear implant user in noise environment with low SNR. The performance of the proposed algorithm was evaluated through 5 normal hearing listeners using noise band simulation. Improvement of speech perception was observed for all subjects and each subject preferred the different type of companding structure.

Evaluation of root and root canal morphology of elderly Korean patients maxillary molars using cone-beam computed tomography (CBCT를 이용한 한국인 고령환자의 상악 대구치에서 치근 및 근관형태의 분석)

  • Lee, Tae-Yong;Kim, Mi-Yeon;Kim, Sun-Ho;Kim, Jeong-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.95-102
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    • 2020
  • Purpose:The aim of the present study was to evaluate the incidence of the second mesiobuccal (MB2) canal, root fusion, and C-shaped root canal configuration in the Korean maxillary first (MM1) and second (MM2) molars by analyzing cone-beam computed tomographic (CBCT) images. Materials and methods: Patients undergoing presurgical CBCT examination were included in the current study. The CBCT images of 1498 MM1 and 1742 MM2 from 1658 Korean patients were assessed to determine the incidence of a MB2 canal, the types of canal configurations, root fusion, and C-shaped root canal configurations. Further, the correlations between the incidence of MB2 canal and age, gender, and tooth position were analyzed. Results: The study population was relatively old (mean age: 66.1 years). The percentage of MB2 canals in MB roots was 60.1% and 28.0% in MM1 and MM2, respectively, with the most common configurations being Weine type III in MM1 and Weine type II in MM2. Additionally, the frequency of a MB2 canal decreased with age in both molars and was higher in men than in women in the MM1 only. Furthermore, root fusion was present in 2.3% and 26.2% of the MM1 and MM2, respectively, whereas C-shaped root canals were observed in 0.4% and 2.7% of the MM1 and MM2, respectively. Conclusion: The MB2 canal was found more frequently in the MM1, whereas root fusion and C-shaped root canals were both seen more frequently in the MM2.

The Effect of Symmetrical and Asymmetric Bilateral Training for Chronic Stroke Patients in Upper Extremity Recovery (만성 뇌졸중 환자의 대칭적, 비대칭적 양측성 상지훈련의 상지기능회복 효과)

  • Kim, Sun Ho;Han, Dae Sung
    • Therapeutic Science for Rehabilitation
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    • v.6 no.1
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    • pp.35-43
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    • 2017
  • Objective : To identify the effect of symmetrical and asymmetric bilateral training For stroke patients in upper extremity recovery. Methods : 15 patients with stroke, randomized to an in- phase group(n =7) and anti-phase group(n =8). Each groups received symmetrical and asymmetric bilateral training, 30-min sessions per a day for 5 weeks, total 20 session.Accelerometer was used to evaluate the amount used for both groups. Y-BAT was used to evaluate performance status and satisfaction, ARAT was used to evaluate hand function. Results : the amount used of symmetrical movement training showed significant changes in affected and unaffected side. asymmetric bilateral training. there is a significant difference in affected side before and after receiving asymmetric bilateral training. Also, There was a significant difference between the groups on the affected side. Both training, there was no significant difference in performance, satisfaction, and upper limb function between group but, there was significant differences within-groups, Conclusions : Symmetric training showed higher motor performance than asymmetric training, but, To obtain a clearer difference, it would be necessary to use a neuromuscular assessment tool such as fMRI. Also, need a clearer training protocol and the need for follow-up studies on more stroke patients is suggested.

Accuracy of the Glenohumeral Joint Injection According to the Approach (도달 방법에 따른 관절와상완 관절내 주사의 정확도)

  • Choi, Nam Yong;Lee, Kang Wook;Kim, Hyung Seok;Song, Hyun Seok
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.45-52
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    • 2013
  • Purpose: We wanted to compare the accuracy between the blind anterior approach and ultrasound guided posterior approach, which are preferred in the present clinical practice for the glenohumeral joint injection. Materials and Methods: The consecutive 95 cases were included in that the glenohumeral joint injection was done in the university hospital and the medical record and ultrasonography were available. There were 52 cases which were injected by blind anterior approach (group I) and 43 cases who were injected by ultrasound guided posterior approach (group II). The injection was decided as accurate if the fluid was visualized in the posterior joint under the ultrasound. We evaluated the range of motion before and after 2 weeks of injection. A subjective satisfaction of the patients was interviewed at the 2 weeks after injection. Results: The accuracy of the glenohumeral joint injections of the group I and group II was 80.8% and 90.7%, respectively. The range of motion was improved for the all cases regardless of the approaches. At the 2 weeks after injection, the subjective satisfaction (better than good) was achieved in 73.7%. Conclusion: The accuracy of the blind anterior approach for the glenohumeral joint injection was 80.8%. The accuracy of the ultrasound guided posterior approach was 90.7%. In this comparative study by the one physician, the ultrasound guided posterior approach showed the better accuracy.

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Impact of Transcranial Direct Current Stimulation Combined With Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Systematic Review (뇌졸중 환자의 상지기능 향상을 위한 경두개 직류 자극과 강제 유도 운동 치료의 결합 중재 효과에 대한 체계적 고찰)

  • Kim, Sun-Ho
    • Therapeutic Science for Rehabilitation
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    • v.8 no.4
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    • pp.7-18
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    • 2019
  • Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and December 2018. The main search terms were "Transcranial direct current stimulation" or "tDCS," "Constraint-induced movement therapy" or "CIMT," "Upper extremity function," "Upper limb," and "Stroke." Based on the inclusion and exclusion criteria, 6 articles were selected. Furthermore, intervention effects on upper extremity function, activities of daily living, and cortical activity were assessed. Results : The current intensity, application time, and protocol of the CIMT varied the between studies. However, the intervention procedures to perform CIMT immediately after transcranial direct current stimulation was the same. Transcranial direct current stimulation combined with CIMT was effective in improving upper limb function and activities of daily living in patients with stoke and had a significant effect on cerebral cortex activation. Conclusions : This study provides information on transcranial direct current stimulation combined with CIMT for use by clinical therapists. Further studies are needed to standardize the stimulation time, current intensity, and electrode attachment position. Furthermore, randomized controlled trials, including long-term follow up, are needed for larger populations using the most appropriate CIMT protocol.

A Study on Self-reliance and Residential Service Needs of Patients with Chronic Mental Illness (만성정신질환자의 자립 및 주거 서비스에 대한 요구도 조사)

  • Jeon, Hyun Ju;Huh, Yu Jeong;Ko, Young-Hoon;Lee, Jae-Hon
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.145-151
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    • 2018
  • Objectives : Residential services are provided to help patients with chronic mental illness, but those have some problems because of provider focused services and uniformized training. So the purpose of the study was to explore residential needs of patients with the chronic mental illness such as chronic schizophrenia. Methods : A survey was conducted on 139 mental illness patients using mental health facilities at Ansan city area in South Korea. We investigated their demographic and social characteristics, the degree of self- reliance and residential service needs. Results : More than half of them had the desire for self-reliance, and they needed job support mostly. They were positive about the use of residential facilities and needed daily living skill and social skill training. Also they preferred day rehabilitation in type of facility. And they wanted to operate in a way that they returned home at the weekend after group home. Conclusions : For facilitating the recovery of patients with chronic mental illness, it would be necessary to provide individualized residential rehabilitation services and to improve existing residential facilities and programs reflected on the patients' needs.

Risk Factors in Stability after Immobilization of the Distal Radius in Unstable Fractures in Children (소아 요골 원위부 불안정 골절의 캐스트 후 안정성에 영향을 미치는 요소)

  • Shin, Yong-Woon;Sohn, Jong Min;Park, Sang-Yoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.215-223
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    • 2021
  • Purpose: Distal radius fractures in youth are treated conservatively in most cases, but there are some cases of redisplacement in the follow-up period after cast immobilization, even after complete reduction. This study examined the risk factors of redisplacement in reduced unstable distal radius fractures. Materials and Methods: From February 2011 to June 2018, 44 unstable distal radius fractures were managed with a closed reduction and cast immobilization. The patients were aged between 6 and 14 years. The cases of redisplacement were analyzed with the fracture characteristics (fracture obliquity, fracture level ratio, ulnar fracture combined), cast qualities (gap index, cast index, 3 point index, and radius-2nd metacarpal angle) and host factors (age, sex). Results: The mean angulation in the union was 9.2° (0°-32.8°). In the categorical grouping 29 cases were within 10° angulation, and 15 cases were more than 10°. No significant differences in the factors of the cast indices or host factors were noted. The meaningful factor was the fracture level calculated by the relative width of the fracture site divided by the sum of width of diaphysis and epiphysis (p=0.001) and combined ulnar fracture (p=0.019). Conclusion: Unstable distal radius fractures should be treated with more stubborn guidelines lest the fracture loses its anatomical alignment. In particular, in patients with less remodeling power, operative treatment would secure a better result if the fracture occurs in a more proximal location.

The Effect of Transcranial Direct Current Stimulation over the Primary Somatosensory Cortex in Patients with Chronic Stroke on Somatosensory and Upper Limb Function for Improving Life Care (만성 뇌졸중 환자를 대상으로 한 일차 체성 감각 피질을 자극한 경두개 직류 전류 자극이 라이프 케어 증진을 위한 체성감각과 상지기능에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.269-277
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    • 2020
  • The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.

Radiologic Features and Surgical Outcome of Juxtafacet Cyst Associated with Degenerative Lumbar Disease (퇴행성 요추 질환에서 발생한 후관절 근접 낭종의 방사선적 특징 및 수술의 결과)

  • Kim, Whoan Jeang;Chang, Shann Haw;Yang, Hwa Yeol;Kwon, Won Jo;Sung, Hwan Il;Park, Kyung Hoon;Choy, Won Sik
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.65-72
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    • 2017
  • Purpose: The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome. Materials and Methods: We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale. Results: The L4-5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods. Conclusion: Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment-not just simple cyst excision-should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

A Study on the Change of Corneal Refractive Power before and after Wearing RGP Contact Lenses by Flat Fitting and Alingment Fitting with Diagnostic Method (RGP 콘택트렌즈의 진단적 피팅법에 의한 플랫한 피팅과 얼라인먼트 피팅 착용 전·후 각막 굴절력의 변화에 관한 연구)

  • Lee, Dae-Won;Kim, In-Suk
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.2
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    • pp.163-169
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    • 2014
  • Purpose: This study is for compared the change of corneal refractive power before and after wearing of rigid gas permeable contact lense with diagnostic method which is 1 D flatter than alignment fitting on right eye and alignment fitting on left eye for 2 months and investigate the preference. Methods: Twenty middle school and high school students (40 eyes) who had never worn a contact lense before for no corneal topographical change, no ocular disease, no experience of ophthalmic surgery and have normal tear amount were selected for this study and corneal refractive power were examined before wearing rigid gas permeable contact lense and adaptation status and corneal examination were performed after 10 days of wearing and after cheking up the continuation of wearing, all candidate wear contact lens 8 hours per day for 2 month and corneal refractive power were compared. Results: After 2 months of wearing with 1 D flatter than the alignment fitting on right eyes, there was significant difference in the central corneal refractive power was $43.84{\pm}1.33D$, flat K power was $43.05{\pm}1.29D$, and steep K power was $44.61{\pm}1.42D$ decreased than before wearing (p<0.001, 0.001, 0.047). The e-value of the principal meridians also shows statistically significant difference (p=0.037, 0.015). After 2 months of wearing with alignment fitting on left eyes, the central corneal refractive power was $44.40{\pm}1.26D$, flat K power was $43.57{\pm}1.23D$. and flat K e-value was $0.58{\pm}0.05$ which showed no statistically significant difference (p = 0.769, 0.614, 0.181). But steep K power was $45.25{\pm}1.36$, and steep K e-value was $0.45{\pm}0.18$ which shows statistically significant difference (p=0.018, 0.027). Conclusions: Consider the comfort, clear vision, dryness for preference fitting investment, 6 students (30%) prefer right eye which is 1 D flatter fitting, 14 students (70%) prefer left eye which is alignment fitting. For rigid gas permeable fitting needed for accurate examination and should prescribe the alignment fitting which is suitable for each cornea.