• 제목/요약/키워드: Exact test

검색결과 1,479건 처리시간 0.031초

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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    • 제54권1호
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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.

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

  • 최갑근;김순협
    • 한국음향학회지
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    • 제28권5호
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    • pp.447-453
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    • 2009
  • 이 논문은 음성 에너지를 최대화 하여 낮은 SNR환경에서 음성 존재 여부를 판단하고 정확한 끝점을 검출하는 방법에 대한 것이다. 전통적인 VAD (Voice Activity Detection) 알고리듬은 잡음의 추정치를 이용해 음성과 비음성 구간을 선택하여 낮은 SNR환경이나 비안정 잡음환경에서는 정확하지 못한 문턱값으로 인해 부정확한 끝점검출을 하였다. 또한 잡음의 시간적 변화를 반영하기 위해 비교적 큰 분석 구간을 두어 계산량이 증가함에 따라 실제 응용에 적합하지 않은 단점이 있다. 이 논문은 잡음환경에서 정확한 음성 구간의 검출을 위해 심리음향 모델에 기반 한 바크 스케일 필터 뱅크를 이용하여 주어진 프레임에서 음성 에너지를 최대화 시키고 잡음을 억제하는 SEM-VAD (Speech Energy Maximization-Voice Activity Detection) 방법을 제안하였다. 다양한 잡음환경, SNR 15 dB, 10 dB 5 dB 0 dB 상황에서 실험한 결과 SNR의 변화에 안정적인 문턱값을 얻었고, 음성 검출을 위한 실험에서 자동차 잡음 환경에 대한 PHR (Pause Hit Rate)은 모든 잡음 환경에서 100%의 정확도를 보였고, FAR (False Alarm Rate)는 SNR 15 dB와 10 dB에서는 0%, SNR 5 dB에서 5.6% SNR 0 dB에서 9.5%의 성능을 보였다.

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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    • 제25권2호
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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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    • 제24권2호
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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.

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

  • 김판희;김희숙
    • 한국간호교육학회지
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    • 제30권1호
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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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    • 제21권4호
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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.

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

  • 이재영;이창재;이형주;정태녕;김의중;최성욱;김옥준;조윤경
    • Journal of Trauma and Injury
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    • 제25권2호
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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.

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

  • 최현기;배백일;최창식
    • 콘크리트학회논문집
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    • 제26권5호
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    • pp.651-660
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    • 2014
  • 강섬유로 보강되어 SF-RPC (Steel-Fiber reinforced Reactive Powder Concrete)로 불리는 초고성능 콘크리트의 설계는 이에 대한 연구결과를 기반으로 한 가이드라인을 통해 수행되고 있으나, 명확한 설계기준은 확립되지 않은 상태이다. 특히 SF-RPC 일반적으로 고온($90^{\circ}C$)의 증기양생을 필요로 하므로 프리캐스트 부재 형태로 사용되고 있어 부재간 접합 방법이 중요한 설계 요소로 간주됨에도 불구하고 명확한 설계기준이 존재하지 않음에 따라 현재 안전성 및 경제성 측면에서 많은 의문이 있는 상태이다. 본 연구에서는 SF-RPC의 명확한 정착 설계를 위한 기반으로 SF-RPC와 철근 사이의 부착강도를 실험적으로 파악하고, 기존에 사용하였던 평가 방법의 적용성을 검토하고자 한다. 이를 위해, 콘크리트의 압축강도, 피복두께, 섬유의 혼입량을 변수로 가진 직접 뽑힘 실험을 계획 및 수행하였다. 실험 결과 SF-RPC의 부착강도는 압축강도의 증가량에 따라 증가하고 있으나 그 증가율은 크게 나타나지 않음을 확인할 수 있으며, 피복두께의 증가에 따라 부착강도가 증가하며 $5.2d_b$ 이상의 피복을 가질 경우 매우 짧은 매입깊이인 $3d_b$의 매입깊이에서도 철근을 항복시킬 수 있는 것을 확인하였다. 또한, 섬유의 보강에 의해 부착강도가 두배 이상 증가하는 것을 확인하였다. 안전하고 경제적인 설계를 위해서는 SF-RPC의 부착강도를 추정할 수 있어야 하나, 현재까지는 이에 대한 추정식이 제시되고 있지 않으며, SF-RPC의 거동이 압축응력하에서는 큰 탄성 거동을 하며, 인장응력하에서는 소성거동을 함에 기인하여 Tepfers의 응력 해석 방법을 적용한 결과 실험 결과와 유사한 추정치를 기대할 수 있는 것을 확인하였다.

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

  • 이지현;황일준;오소연;김옥준;김현국;김은경;이지현
    • Tuberculosis and Respiratory Diseases
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    • 제56권6호
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    • pp.600-610
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    • 2004
  • 연구배경 : 혈중 BNP 의 측정은 간단한 혈액검사로 바로 시행할 수 있고 우심부하의 정도에 비례하여 증가하므로, 혈액 검사 당시의 혈역학적 상태를 잘 반영할 수 있다. 이에 저자들은 급성 악화로 응급실에 내원한 만성폐쇄성폐질환 환자의 혈역학적 불안정 정도가 환자의 예후와 상관이 있을 것으로 생각하였고, 이를 반영하는 지표로 혈중 BNP 검사를 이용하였다. 대상 및 방법 : 2002년 6월부터 2003년 12월까지 본원 응급실을 통해 만성폐쇄성폐질환의 급성악화로 입원한 환자 중 응급실 내원 당시 혈중 BNP 검사를 시행 받았던 환자를 대상으로 하여 입원 중이나 퇴원 후 24시간 이내에 사망한 환자와 생존한 환자를 두군으로 나누고 후향적으로 비교하였다. 결 과 : 다중회귀분석상 생존군과 사망군간에는 $FEV_1$(% of predicted), APACHE II score, BNP 수치만이 의미 있는 차이를 보였다(p=0.043, 0.025, 0.024). ROC curve 상 BNP 88pg/mL 이상에서 사망을 예측하는 민감도는 90%, 특이도는 75%를 보였고, BNP 88pg/mL를 기준으로 사망에 대한 Fisher's exact test를 시행하였을 때 교차비는 21.2였다. 결 론 : 본 연구 결과 혈중 BNP 값은 만성폐쇄성폐질환의 급성 악화 시에 예후를 예측할 수 있는 인자일 가능성이 있으며, 내원 당시 BNP 값이 높은 환자들에 대한 적극적인 처치가 필요할 것으로 사료되었다.

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

  • 위호성;김용주;설인준;최윤영
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제7권2호
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    • pp.163-169
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    • 2004
  • 목적: 위식도 역류는 소아에 있어서 흔한 질환으로 이를 진단하기 위해서는 여러 방법들이 사용되고 있다. 24시간 식도 pH 검사는 음식물에 의해 그 결과가 달라질 수 있으며 알칼리성 역류를 진단할 수 없다. 이 연구의 목적은 위식도 역류를 가진 환아에서 식도 동위 원소 검사가 24시간 pH 검사를 대체할 수 있는 지를 알아보기 위함이다. 방법: 2002년 3월부터 2003년 6월까지 반복성 구토, 기침, 흉통, 보챔 등 위식도 역류가 의심되어 한양대 병원 소아과에 입원한 환아 23명(남 : 여=12 : 11, 평균연령 27개월)을 대상으로 24시간 pH 검사와 식도 동위 원소 검사를 시행하였다. 결과: 24시간 식도 pH 검사 결과 23명의 환아 중 6명(26.1%)에서 유의한 위식도 역류가 관찰되었으며 2명의 환아는 보채서 결과를 얻을 수 없었다. 식도 동위 원소 검사 결과 23명 중 9명(39.2%)의 환아에서 위식도 역류가 영상학적으로 관찰되었다. 24시간 식도 pH 검사와 식도 동위 검사 모두에서 양성으로 나온 환아는 3명(14.3%), 모두 음성으로 나온 환아는 9명(42.9%)이었으며 24시간 식도 pH 검사만 양성으로 나온 환아는 3명(14.3%), 식도 동위 원소 검사에서만 양성으로 나온 환아는 6명(28.6%)이었다. 두 검사의 결과를 Fisher's exact test와(p=0.523) Kendall의 타우(근사 유의 확률=0.678)로 비교하였고 두 검사 간의 결과의 연관성은 관찰되지 않았다. 결론: 24시간 식도 pH검사와 식도 동위 원소 검사는 연관성이 없고 서로 다른 방법의 검사이므로 이 두 검사는 상호 보완적으로 시행하는 것이 위식도 역류 환자를 진단할 때 유용하다.

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