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Bacterial cellulose matrix and acellular dermal matrix seeded with fibroblasts grown in platelet-rich plasma supplemented medium, compared to free gingival grafts: a randomized animal study

  • Abraao Moratelli Prado;Cimara Fortes Ferreira;Luismar Marques Porto;Elena Riet Correa Rivero;Ricardo de Souza Magini;Cesar Augusto Magalhaes Benfatti;Jair Rodriguez-Ivich
    • Journal of Periodontal and Implant Science
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    • v.54 no.1
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    • pp.25-36
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    • 2024
  • Purpose: Mucogingival defects (MGDs), such as dental root recessions, decreased vestibular depth, and absence of keratinized tissues, are commonly seen in dental clinics. MGDs may result in functional, aesthetic, and hygienic concerns. In these situations, autogenous soft tissue grafts are considered the gold-standard treatment. This study compares the healing process of free gingival grafts (FGGs) to bacterial cellulose matrix (BCM) and human acellular dermal matrix (ADM) seeded with fibroblasts from culture supplemented with platelet-rich plasma in a rat model. Methods: Surgical defects were made in rats, which received the following treatments in a randomized manner: group I, negative control (defect creation only); group II, positive control (FGG); group III, BCM; group IV, BCM + fibroblasts; group V, ADM; and group VI, ADM + fibroblasts. Clinical, histological, and immunological analyses were performed 15 days after grafting. Clinical examinations recorded epithelium regularity and the presence of ulcers, erythema, and/or edema. Results: The histological analysis revealed the degree of reepithelization, width, regularity, and presence of keratin. The Fisher exact statistical test was applied to the results (P<0.05). No groups showed ulcers except for group I. All groups had regular epithelium without erythema and without edema. Histologically, all groups exhibited regular epithelium with keratinization, and myofibroblasts were present in the connective tissue. The groups that received engineered grafts showed similar clinical and histological results to the FGG group. Conclusions: Within the limitations of this study, it was concluded that BCM and ADM can be used as cell scaffolds, with ADM yielding the best results. This study supports the use of this technical protocol in humans.

Voice Activity Detection Method Using Psycho-Acoustic Model Based on Speech Energy Maximization in Noisy Environments (잡음 환경에서 심리음향모델 기반 음성 에너지 최대화를 이용한 음성 검출 방법)

  • Choi, Gab-Keun;Kim, Soon-Hyob
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.5
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    • pp.447-453
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    • 2009
  • This paper introduces the method for detect voices and exact end point at low SNR by maximizing voice energy. Conventional VAD (Voice Activity Detection) algorithm estimates noise level so it tends to detect the end point inaccurately. Moreover, because it uses relatively long analysis range for reflecting temporal change of noise, computing load too high for application. In this paper, the SEM-VAD (Speech Energy Maximization-Voice Activity Detection) method which uses psycho-acoustical bark scale filter banks to maximize voice energy within frames is introduced. Stable threshold values are obtained at various noise environments (SNR 15 dB, 10 dB, 5 dB, 0 dB). At the test for voice detection in car noisy environment, PHR (Pause Hit Rate) was 100%accurate at every noise environment, and FAR (False Alarm Rate) shows 0% at SNR15 dB and 10 dB, 5.6% at SNR5 dB and 9.5% at SNR0 dB.

Surgical treatment of feline intracranial meningiomas: a retrospective study of 26 cases

  • Charles Porsmoguer;Margaux Blondel;Pierre H. M. Moissonnier
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.25.1-25.12
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    • 2024
  • Background: Surgical excision is the treatment of choice for feline intracranial meningioma. Objectives: To report clinical findings, complications, and outcomes following surgery for feline intracranial meningioma. Methods: Medical records (01/2000-01/2017) of cats that underwent surgical excision of an intracranial meningioma at our institution were reviewed. Patient data included signalment, clinical signs, surgical technique, complications, histopathologic diagnosis, survival time, and owners' answers to a satisfaction questionnaire. Survival was assessed using the Kaplan-Meier method and log-rank test. Results: Twenty-six cats were included in this study. The exact cause of death was known in 17 cases and was not related to meningioma in 9/17 cases. Overall median survival time was 881 days (95% confidence interval 518; 1248). The age of the cat did not influence survival (p = 0.94) or the occurrence of complications (p = 0.051). Complications occurred in 13/24 cats, including dramatic complications in 4/24 cats. Most complications appeared in the first 24 hours post-surgery (12/13). Males had more postoperative complications (p = 0.042), including more seizures (p = 0.016). Cats with cranioplasty had fewer complications (p = 0.021). Clinical recurrence was confirmed in 3 out of 17 cats. Recurrence-free survival time was 826 days. Most owners (12/14) were satisfied with the outcome. Conclusions: Surgical treatment of intracranial meningioma in cats was associated with a long median survival time but also with a high rate of minor and major postoperative complications, including early postoperative seizures. Cranioplasty may reduce complications. Age at the time of surgery had no effect on outcomes.

Bell's palsy after concomitant chemoradiotherapy: a case report and literature review

  • Sul Gi Choi;Ji Seok Oh;Hoon Myoung;Mi Hyun Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.2
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    • pp.129-135
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    • 2024
  • Concomitant chemoradiotherapy (CCRT) treated patients experience various complications. We present a rare case of post-CCRT Bell's palsy and describe its various possible causes, so as to increase awareness among clinicians about Bell's palsy being a CCRT-associated adverse effect. The patient was a 48-year-old man diagnosed with squamous cell carcinoma who presented with post-CCRT Bell's palsy. After radiotherapy for 6 weeks (overall 67.5 Gy) and four rounds of cisplatin chemotherapy, he complained of paralysis of the entire left face. A test was performed 33 days after the last CCRT session to differentiate Bell's palsy from other causative factors. Based on magnetic resonance imaging findings, facial nerve invasion due to tumor size increase was determined to not cause Bell's palsy. Inflammation of the left Eustachian tube was observed. Hence, steroids and famciclovir were administered, which markedly improved the facial paralysis symptoms within 56 days after facial paralysis development. In conclusion, patients can develop Bell's palsy owing to complex effects of various CCRT mechanisms. Although the exact cause of Bell's palsy has not been identified and the effectiveness of drug treatment was questionable in this case, unlikely causative factors should be excluded through various tests and appropriate and timely measures must be adopted.

The development and effects of an online-based community psychiatric nursing practice program with the ARCS model (ARCS모형 적용 온라인 기반 지역사회정신간호학실습 프로그램 개발 및 효과)

  • Kim, Pan Heui;Kim, Hee Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.30 no.1
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    • pp.5-18
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    • 2024
  • Purpose: This study aimed to identify whether there is a difference between an online-based community psychiatric nursing practice program with the ARCS model and a conventional community psychiatric nursing practice program in promoting nursing students' learning motivation, knowledge of community psychiatric nursing, communication skills, and learning self-efficacy. Methods: This study used a quasi-experimental design with a non-equivalent control group. The participants were 44 nursing students at three nursing colleges in Gyeongsangbuk-do. The experimental group was provided the online-based community psychiatric nursing practice program with ARCS model, while the control group was provided the conventional community psychiatric nursing practice program from July 9, to September 3, 2022. Both groups received practice training 8 hours a day, 5 days two weeks. The collected data were analyzed using the exact χ2, Mann-Whitney U-test, and Quade's two-way ANCOVA with the IBM SPSS Statistics 28.0 program. Results: The results of the comparison of an experimental group training with the online-based community psychiatric nursing practice program with ARCS model and a control group training with the conventional community psychiatric nursing practice program showed that, there was no statistically significant difference between the two groups in learning motivation knowledge of community psychiatric nursing, and learning self-efficacy. However, communication skills were statistically significantly higher in the experimental group (F=6.23, p=.017). Conclusion: The online-based community psychiatric nursing practice program with ARCS model can be used as a substitute learning to improve community psychiatric nursing capabilities in situations when clinical practice is suspended due to infectious diseases such as coronavirus disease 2019 or when is a shortage of community psychiatric nursing practice institutions.

Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea

  • Soon Ho Yoon;Kyung Hee Lee;Jin Yong Kim;Young Kyung Lee;Hongseok Ko;Ki Hwan Kim;Chang Min Park;Yun-Hyeon Kim
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.494-500
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    • 2020
  • Objective: This study presents a preliminary report on the chest radiographic and computed tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) pneumonia in Korea. Materials and Methods: As part of a multi-institutional collaboration coordinated by the Korean Society of Thoracic Radiology, we collected nine patients with COVID-19 infections who had undergone chest radiography and CT scans. We analyzed the radiographic and CT findings of COVID-19 pneumonia at baseline. Fisher's exact test was used to compare CT findings depending on the shape of pulmonary lesions. Results: Three of the nine patients (33.3%) had parenchymal abnormalities detected by chest radiography, and most of the abnormalities were peripheral consolidations. Chest CT images showed bilateral involvement in eight of the nine patients, and a unilobar reversed halo sign in the other patient. In total, 77 pulmonary lesions were found, including patchy lesions (39%), large confluent lesions (13%), and small nodular lesions (48%). The peripheral and posterior lung fields were involved in 78% and 67% of the lesions, respectively. The lesions were typically ill-defined and were composed of mixed ground-glass opacities and consolidation or pure ground-glass opacities. Patchy to confluent lesions were primarily distributed in the lower lobes (p = 0.040) and along the pleura (p < 0.001), whereas nodular lesions were primarily distributed along the bronchovascular bundles (p = 0.006). Conclusion: COVID-19 pneumonia in Korea primarily manifested as pure to mixed ground-glass opacities with a patchy to confluent or nodular shape in the bilateral peripheral posterior lungs. A considerable proportion of patients with COVID-19 pneumonia had normal chest radiographs.

Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

Bond Characteristics and Splitting Bond Stress on Steel Fiber Reinforced Reactive Powder Concrete (강섬유로 보강된 반응성 분체 콘크리트의 부착특성과 쪼갬인장강도)

  • Choi, Hyun-Ki;Bae, Baek-Il;Choi, Chang-Sik
    • Journal of the Korea Concrete Institute
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    • v.26 no.5
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    • pp.651-660
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    • 2014
  • Structural members using ultra high strength concrete which usually used with steel fiber is designed with guidelines based on several investigation of SF-RPC(steel fiber reinforced reactive powder concrete). However, there are not clear design method yet. Especially, SF-RPC member should be casted with steam(90 degree delicious) and members with SF-RPC usually used with precast members. Although the most important design parameter is development method between SF-RPC and steel reinforcement(rebar), there are no clear design method in the SF-RPC member design guidelines. There are many controversial problems on safety and economy. Therefore, in order to make design more optimum safe design, in this study, we investigated bond stress between steel rebar and SF-RPC according to test. Test results were compared with previously suggested analysis method. Test was carried out with direct pull out test using variables of compressive strength of concrete, concrete cover and inclusion ratio of steel fiber. According to test results, bond stress between steel rebar and SF-RPC increased with increase of compressive strength of concrete and concrete cover. Increasing rate of bond stress were decrease with increase of compressive strength of SF-RPC and concrete cover significantly. 1% volume fraction inclusion of steel fiber increase the bond stress between steel rebar and SF-RPC with two times but 2% volume fraction cannot affect the bond stress significantly. There are no exact or empirical equations for evaluation of SF-RPC bond stress. In order to make safe bond design of SF-RPC precast members, previously suggested analysis method for bond stress by Tepfers were evaluated. This method have shown good agreement with test results, especially for steel fiber reinforced RPC.

The Prognostic Role of B-type Natriuretic Peptide in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환의 급성 악화시 예후 인자로서의 혈중 B-type Natriuretic Peptide의 역할)

  • Lee, Ji Hyun;Oh, So Yeon;Hwang, Iljun;Kim, Okjun;Kim, Hyun Kuk;Kim, Eun Kyung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.600-610
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    • 2004
  • Background : The plasma B-type natriuretic peptide(BNP) concentration increases with the degree of pulmonary hypertension in patients with chronic respiratory disease. The aim of this study was to examine the prognostic role of BNP in the acute exacerbation of chronic obstructive lung disease (COPD). Method : We selected 67 patients who were admitted our hospital because of an acute exacerbation of COPD. Their BNP levels were checked on admission at the Emergency Department. Their medical records were analyzed retrospectively. The patients were divided into two groups according to their in-hospital mortality. The patients' medical history, comobidity, exacerbation type, blood gas analysis, pulmonary function, APACHE II severity score and plasma BNP level were compared. Results : Multiple logistic regression analysis identified three independent predictors of mortality: $FEV_1$, APACHE II score and plasma BNP level. The decedents group showed a lower $FEV_1$($28{\pm}7$ vs. $37{\pm}15%$, p=0.005), a higher APACHE II score($22.4{\pm}6.1$ vs. $15.8{\pm}4.7$, p=0.000) and a higher BNP level ($201{\pm}116$ vs. $77{\pm}80pg/mL$, p=0.000) than the sSurvivors group. When the BNP cut-off level was set to 88pg/mL using the receiver operating characteristic curve, the sensitivity was 90% and the specificity was 75% in differentiating between the survivors and decedents. On Fisher's exact test, the odds ratio for mortality was 21.2 (95% CI 2.49 to 180.4) in the patients with a BNP level > 88pg/mL. Conclusion : The plasma BNP level might be a predictor of mortality in an acute exacerbation of COPD as well as the $FEV_1$ and APACHE II score.

Comparison between 24 hr pH Monitoring and Esophageal Scintigrapy in Children Presenting with Gastroesophageal Reflux Symptoms (식도 동위 원소 검사와 24시간 식도 pH 검사와의 비교 연구)

  • Wi, Ho Sung;Kim, Yong Joo;Seol, In Joon;Choi, Yun Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.163-169
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    • 2004
  • Purpose: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. Methods: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. Results: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). Conclusion: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.

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