• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.3
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• pp.186-192
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• 2016

Purpose: To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods: Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results: The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was $0.68{\pm}0.18g/kg/d$; according to age, the dose was $0.73{\pm}0.16g/kg/d$ (<8 years), $0.53{\pm}0.12g/kg/d$ (8 to <12 years), and $0.36{\pm}0.05g/kg/d$ (12 to 15 years). The dose of lactulose was $1.99{\pm}0.43mL/kg/d$ (<8 years) or $1.26{\pm}0.25mL/kg/d$ (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion: CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.1
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• pp.38-43
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• 2016

Purpose: Each ethnic group has a unique life style, including diets. Life style affects bowel movement. The aim of this study is to describe the results of colon transit time (CTT) tests in Korean children who had chronic functional constipation based on highly refined data. Methods: One hundred ninety (86 males) out of 415 children who performed a CTT test under the diagnosis of chronic constipation according to Rome III criteria at Konkuk University Medical Center from January 2006 through March 2015 were enrolled in this study. Two hundreds twenty-five children were excluded on the basis of CTT test result, defecation diary, and clinical setting. Shapiro-Wilk and Mann-Whitney U, and chi-square tests were used for statistical analysis. Results: The median value and interquartile range (IQR) of CTT was 54 (37.5) hours in Encopresis group, and those in non-encopresis group was 40.2 (27.9) hours (p<0.001). The frequency of subtype between non-encopresis group and encopresis was statistically significant (p=0.002). The non-encopresis group (n=154, 81.1%) was divided into normal transit subgroup (n=84, 54.5%; median value and IQR of CTT=26.4 [9.6] hours), outlet obstruction subgroup (n=18, 11.7%; 62.4 [15.6] hours), and slow transit subgroup (n=52, 33.8%; 54.6 [21.0] hours]. The encopresis group (n=36, 18.9%) was divided into normal transit subgroup (n=8, 22.2%; median value and IQR of CTT=32.4 [9.9] hours), outlet obstruction subgroup (n=8, 22.2%; 67.8 [34.8] hours), and slow transit subgroup (n=20, 55.6%; 59.4 [62.7] hours). Conclusion: This study provided the basic pattern and value of the CTT test in Korean children with chronic constipation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.2
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• pp.127-133
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• 2023

Purpose: Dyssynergic defecation (DSD) is one of the important causes of chronic constipation in children. We aimed to analyze the clinical features, diagnostic test results, and treatments for DSD in children. Methods: Children diagnosed with DSD using fluoroscopic defecography were enrolled in this study. Clinical data, including the results of colon transit time (CTT) test and biofeedback (BF) therapy, were collected from medical records retrospectively. Results: Nineteen children were enrolled. The median age was 9 years (6-18 years), the median frequency of bowel movement was 1/7 days (1-10 days), the median duration of constipation was 7.0 years (2-18 years), the median age of onset of constipation was 2.5 years (1-11 years). In the CTT test, outlet obstruction type was noted in 10/18 (55.6%), slow transit type in 5/18 (27.8%), and normal transit in 1/18 (5.6%). The median CTT was 52 hours (40-142 hours). Initial medical therapy was performed with the polyethylene glycol 4000, and the response was good in 9/19 (47.4%), fair in 9/19 (47.4%), and poor in 1/19 (5.0%). BF was performed in 8/19, with good results in 6/8 (75.0%) children and failure in 2/8 (25.0%) children. After long-term medical therapy (11/19), 3/5 showed good response with medication alone, 6/8 showed good response with BF and medication combined. Conclusion: DSD should be considered as a cause of chronic constipation in children, especially in those with abnormal CTT test results. BF combined with medical therapy is effective even with age-limited cooperation.

• Journal of Korean Biological Nursing Science
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• v.20 no.1
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• pp.11-19
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• 2018

Purpose: The purposes of this study were to perform items analysis using the classical test theory (CTT) and the item response theory (IRT), and to establish the validity and reliability of the Korean version of pressure ulcer prevention knowledge. Methods: The 26-item pressure ulcer prevention knowledge instrument was translated into Korean, and the item analysis of the 22 items having an adequate content validity index (CVI), was conducted. A total of 240 registered nurses in 2 university hospitals completed the questionnaire. Each item was analyzed applying CTT and IRT according to 2-parameter logistic model. Response alternatives quality, item difficulty and item discrimination were evaluated. For testing validity and reliability, Pearson correlation coefficient and Kuder Richardson-20 (KR-20) were used. Results: Scale CVI was .90 (Item-CVI range= .75-1.00). The total correct answer rate for this study population was relatively low as 52.5%. The quality of response alternatives was found to be relatively good (range= .02-.83). The item difficulty of the questions ranged form .10 to .86 according to CTT and -12.19 to 29.92 according to the IRT. This instrument had 12-low, 2-medium and 8-high item difficulty applying IRT. The values for the item discrimination ranged .04-.57 applying CTT and .00-1.47 applying IRT. And overall internal consistency (KR-20) was .62 and stability (test-retest) was .82. Conclusion: The instrument had relatively weak construct validity, item discrimination according to the IRT. Therefore, the cautious usage of a Korean version of this instrument would be recommended for discrimination because there are so many attractive response alternatives and low internal consistency.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.26-34
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• 2020

Purpose: To compare the clinical features, diagnostic findings, and medications of children with infrequent bowel movements or fecal soiling. Methods: This study enrolled 333 children (189 male; age range, 1 month to 18 years) diagnosed with functional constipation by Rome III or IV criteria. We classified them into 3 groups (infrequent bowel movement without fecal soiling [G3-a], infrequent bowel movement with fecal soiling [G3-b], and fecal soiling only [G3-c]) and into 2 subgroups of fecal soiling (G2-b) or not (G2-a). Retrospective data on clinical characteristics, colon transit time (CTT) test results, and medications were collected. The Wilcoxon rank-sum test, Kruskal-Wallis test, Chi-square test, and Fisher's exact test were used for the statistical analysis. Results: The median age (months) and interquartile range (IQR) was 33 (45) in G3-a, 54 (40) in G3-b, and 73 (48) in G3-c (p<0.0001). G3-c had the latest onset (median, 18; IQR, 18; p=0.0219) and longest symptom duration (24 [24], p=0.0148). PEG 4000 was used in 60.6% (G3-a), 96.8% (G3-b), and 83.2% (G3-c) of patients (p<0.0001). The median age (months) and IQR were 33.0 (45.0) in G2-a and 63.5 (52.5) in G2-b (p<0.0001). G2-b had later onset (median, 12; IQR, 19.5; p=0.0062) and longer symptom duration than G2-a (24 [12], p=0.0070). PEG 4000 was used in 60.6% (G2-a) and 88.3% (G2-b) of children (p<0.0001). No statistically significant intergroup differences were seen in maintenance laxative dose, CTT, or CTT type. Conclusion: Infrequent bowel movement and fecal soiling represent the advanced stage of chronic functional constipation.

• Structural Engineering and Mechanics
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• v.60 no.6
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• pp.939-952
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• 2016

A compression to tensile load transforming (CTT) device was developed to determine indirect tensile strength of concrete material. Before CTT test, Particle flow code was used for the determination of the standard dimension of physical samples. Four numerical models with different dimensions were made and were subjected to tensile loading. The geometry of the model with ideal failure pattern was selected for physical sample preparation. A concrete slab with dimensions of $15{\times}19{\times}6cm$ and a hole at its center was prepared and subjected to tensile loading using this special loading device. The ratio of hole diameter to sample width was 0.5. The samples were made from a mixture of water, fine sand and cement with a ratio of 1-0.5-1, respectively. A 30-ton hydraulic jack with a load cell applied compressive loading to CTT with the compressive pressure rate of 0.02 MPa per second. The compressive loading was converted to tensile stress on the sample because of the overall test design. A numerical modeling was also done to analyze the effect of the hole diameter on stress concentrations of the hole side along its horizontal axis to provide a suitable criterion for determining the real tensile strength of concrete. Concurrent with indirect tensile test, the Brazilian test was performed to compare the results from two methods and also to perform numerical calibration. The numerical modeling shows that the models have tensile failure in the sides of the hole along the horizontal axis before any failure under shear loading. Also the stress concentration at the edge of the hole was 1.4 times more than the applied stress registered by the machine. Experimental Results showed that, the indirect tensile strength was clearly lower than the Brazilian test strength.

• Computers and Concrete
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• v.18 no.1
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• pp.39-51
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• 2016

This paper considers the tensile strength of concrete samples in direct, CTT, modified tension, splitting and ring tests using both of the experimental tests and numerical simulation (particle flow code 2D). It determined that which one of indirect tensile strength is close to direct tensile strength. Initially calibration of PFC was undertaken with respect to the data obtained from Brazilian laboratory tests to ensure the conformity of the simulated numerical models response. Furthermore, validation of the simulated models in four introduced tests was also cross checked with the results from experimental tests. By using numerical testing, the failure process was visually observed and failure patterns were watched to be reasonable in accordance with experimental results. Discrete element simulations demonstrated that the macro fractures in models are caused by microscopic tensile breakages on large numbers of bonded discs. Tensile strength of concrete in direct test was less than other tests results. Tensile strength resulted from modified tension test was close to direct test results. So modified tension test can be a proper test for determination of tensile strength of concrete in absence of direct test. Other advantages shown by modified tension tests are: (1) sample preparation is easy and (2) the use of a simple conventional compression press controlled by displacement compared with complicate device in other tests.

• Therapeutic Science for Rehabilitation
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• v.10 no.3
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• pp.23-41
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• 2021

Objective : The purpose of this study was to analyze the effects of simultaneous dual-task training to assess executive function in older adults. Methods : We searched the PubMed, EMBASE, Cochrane, Web of Science, and RISS databases of publicated studies in the past decade. Seven studies were selected based on the inclusion and exclusion criteria. Qualitative assessment and meta-analysis were performed for the seven studies. Results : A randomized controlled trial design was used in the selected studies, and PEDro Scores above seven were obtained. The Trial Making Test (TMT) evaluated the effects of dual-task training on executive function in four studies. The Color Trail Test (CTT) was used in two studies, and Stroop test was used in three studies. The effect size for total executive function was 0.38, which was small. The effect sizes for TMT and CTT were 0.37. Stroop Test was 0.34, demonstrating that their effect sizes were also small. Only significant effects in total executive function, TMT, and CTT showed significant effects (all p<0.05). Conclusion : This study confirmed that dual-task training was effective in improving executive function in older adults. To improve the effectiveness of dual-task training, the difficulty of the dual-task training should be considered. It is also necessary to implement assessments that can evaluate performance under dual-task conditions as well as conventional test tools for executive function. In the future, dual-task training could be used as an appropriate intervention for executive function in older adults to delay the onset of dementia.

• The Korea Journal of Herbology
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• v.37 no.2
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• pp.13-21
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• 2022

Objectives : The evaluation of academic achievement is pivotal for establishing accurate direction and adequate level of medical education. The purpose of this study was to firstly establish innovative item analysis technique of Item Response Theory (IRT) for analyzing multiple-choice test of herbology in the traditional Korean medicine education which has not been available for the difficulty of test theory and statistical calculation. Methods : The answers of 390 students (2012-2018) to the 14 item herbology test in college of Korean medicine were used for the item analysis. As for the multidimensional analysis of item characteristics, difficulty, discrimination, and guessing parameters along with item-total correlation and percentage of correct answer were calculated using Classical Test Theory (CTT) and IRT. Results : The validity parameters of strong and weak items were illustrated in multiple perspectives. There were 4 items with six acceptable index scores, and 5 items with only one acceptable index score. The item discrimination of IRT was found to have no significant correlation with difficulty and discrimination indices of CTT emphasizing attention of professionals of medical education as for the test credibility. Conclusion : The critical suggestions for the development, utilization and revision of test items in the e-learning and evidence-based Teaching era were made based on the results of item analysis using IRT. The current study would firstly provide foundation for upgrading the quality of Korean medicine education using test theory.

• International journal of advanced smart convergence
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• v.11 no.4
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• pp.227-239
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• 2022

Purpose: In our study, in order to find lactic acid bacteria (LAB) with multi-drug resistance to antibiotics, we isolated 140 strains from 15 types of kimchi commercially available in Korea and 20 types of Kimchi made at home from January to December in 2016, and investigated their H₂O₂ generating ability and multi-drug resistance to antibiotics. Methods: In order to observe the H₂O₂ generation ability of LAB, we performed the experiment with methods such as Rabe, Hillier, and Kang. To test the antibacterial susceptibility of LAB, we used the disc agar diffusion method using MRS agar (Difco, USA) according to the CLSI and WHO test methods. There are 18 types of antibiotic discs used. Results: Out of the total numbers of 140 strains, 6 strains of Ent. Faecium, 25 strains of L. plantarum, 1 strain of L. rhamnosus, 3 strains of L. sakei, 1 strain of L. acidophilus, 1 strains St. thermophilus, and 7 of unidentified strains generated H₂O₂. The antibiotic susceptibility of Ent. Faecium indicated SXT, OX, NA, and E; and the antibiotic susceptibility of L. plantarum indicated NA; and the antibiotic susceptibility of St. thermophilus indicated NA, CC, RA, CTT, CM, and P ; and the antibiotic susceptibility of L. rhamnosus indicated SXT, VA, NA and CTT; and the antibiotic susceptibility of 6 strains of L. sakei indicated SXT, OX, NOR, NA, CTT and CIP, all indicating antibiotic resistance. In the case of multi-drug resistance to antibiotics for 53 strains of L. antarum, 8-drug resistance was the most common with 25 strains, followed by 7-drug-resistant strains with 18 strains, 9-drug-resistant strains with 4 strains, 6-drug-resistant strains with 3 strains, 5-drug-resistant strains with 2 strains, and 17-drug-resistant strains with 1 strain. In the case of multi-drug resistance to antibiotics for Ent. Faecium 27 strains, 9-drug resistance was most commonly identified as 9 strains, 8-drug resistance was identified as 6 strains, 7- and 11 drug resistances were identified as 4 strains each, and 4- and 6-drug resistances were identified as 1 strain each. Conclusion: Ent. Faecium, L. plantarum, L. rhamnosus, L. sakei, and St. thermophilus, shown to have anantibacterial activity in previous studies on LAB and shown to have and H₂O₂ generating ability, antibiotic resistance and multi-drug resistance in this study, are expected to be able to play an excellent role for long-term inpatients to use as an alternative to antibiotics and to cope with emerging antibiotic resistance.