• Title/Summary/Keyword: Initial risk assessment

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Comparison of the Functional Recovery of Stroke Patients Treated with Eastern-Western Integrative Medical Care and Western Single Rehabilitation Therapy (뇌졸중 환자에서 한양방협진과 양방단독 재활치료의 기능 회복 비교)

  • Kim, Min-su;Yun, Jong-min
    • The Journal of Internal Korean Medicine
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    • v.37 no.4
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    • pp.645-652
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    • 2016
  • Objectives: To compare the effects of Eastern-Western integrative medical care (EWIM) and Western single rehabilitation therapy (WSRT) on the functional recovery of stroke patients.Methods: Seventy-six stroke patients were recruited retrospectively. The participants were divided into two groups: EWIM and WSRT. Data on age, sex, stroke-related risk factors, stroke type, neurological deficits according to the National Institutes of Health Stroke Scale (NIHSS), elapsed time to the initiation of rehabilitation, duration from the onset to follow up, initial functional status, and function after therapy for 3 mon were obtained from a review of the patients’ medical records. Between-group differences in functional outcomes were analyzed before and after treatment using the functional ambulation category (FAC), Fugl-Meyer assessment (FMA), modified Barthel Index-Korean version (K-MBI), and Euro-Quality of Life-5 Dimension (EQ-5D).Results: At 3-mon poststroke, all the functional outcome measures had improved in both groups (P<0.05). However, the improvements were greater in the EWIM group, and the improvement was statistically significant in the K-MBI (P=0.048) and EQ-5D (P=0.042).Conclusions: With respect to activities of daily living and health-related quality of life, EWIM is a more effective stroke therapy than WSRT.

A Model for Optimization Process of Asbestos Dismantling Work Using Simulation (시뮬레이션을 이용한 석면 해체공사의 최적화 공정계획 모델)

  • Cho, Hyeong-Jun;Noh, Jae-Yun;Lee, Ho-Hyeon;Lee, Su-Min;Han, Seung-woo
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2022.11a
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    • pp.17-18
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    • 2022
  • In Korea, asbestos removal has been actively carried out nationwide since 2015 when asbestos was completely banned as a first-class carcinogen. Since scattering dust generated in the process of removing asbestos causes fatal diseases such as asbestos lung disease and lung cancer, concerns are growing over the safety of construction workers and building users undergoing dismantling. For this reason, regulations on asbestos sites have been strengthened and prior studies on safety and risk assessment have been conducted, but research on actual site data collection and process planning is insufficient even though safety is reduced due to delay in site construction period. Therefore, it is necessary to analyze the work and delay factors of the asbestos dismantling process and develop an optimized process plan model for workers. This study is an initial step to develop an optimized process plan model that considers the safety and productivity of asbestos dismantling work, and aims to help establish an optimized process plan for asbestos dismantling process using website clone simulation.

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$^{99m}Tc$ MDP-Bone Scintigraphy for Preoperative and Follow up Assessment in Primary Breast Cancer (원발성 유방암에서 질병병기 분류 및 추적검사 $^{99m}Tc-MDP$ 골 신티그램의 의의)

  • Yi, Gang-Wook;Bang, Yung-Jue;Chung, June-Key;Lee, Myung-Chul;Cho, Bo-Youn;Kim, Noe-Kyoung;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.59-64
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    • 1988
  • Because carcinoma of breast is known to readily metastasize to the bone, early detection of metastasis spread is very important. Two hundred thirty four consecutive patients who had $^{99m}Tc-MDP$ bone scans prior to treatment and during the follow up period were studied retrospectively to determine the contribution of the scans to staging, treatment and follow up examination between Jan. 1980 and Apr. 1987 in Seoul National University Hospital. 1) Positive bone scan rates in initial clinical stage I, II, III and IV were 0%, 4%, 14% and 53%, respectively. 2) The higher clinical stage is, the more cumulative risk of conversion to positive bone scan is during the same follow up period. 3) Conversion rate to positive bone scan in patients with lymph node metastasis is higher (50%) than those without metastasis (18%) (P < 0.001). We concluded that the bone scan in primary breast cancer was very useful to evaluate initial clinical stage and to perform the follow up examination.

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Congenital Malformations in Infants of Mothers Undergoing Assisted Reproductive Technologies: A Systematic Review and Meta-analysis Study

  • Hoorsan, Hayedeh;Mirmiran, Parvin;Chaichian, Shahla;Moradi, Yousef;Hoorsan, Roza;Jesmi, Fatemeh
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.6
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    • pp.347-360
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    • 2017
  • Objectives: This meta-analysis aimed to evaluate congenital malformations in infants conceived by assisted reproductive techniques (ART), compared with infants conceived spontaneously. Methods: In this study, available resources searched to find relevant articles included PubMed, ScienceDirect, Scopus, Google Scholar, Cochrane, ProQuest, Iranmedex, Magiran, and Scientific Information Database. After extracting the necessary information from evaluated articles, meta-analysis on the articles' data was performed using Stata version 11.2. Results: In this study, from a total of 339 articles, extracted from the initial investigation, ultimately 30 articles were selected for meta-analysis that assessed the use of ART on the risk of congenital abnormalities and some birth complications on 5 470 181 infants (315 402 cases and 5 154 779 controls). The odds ratio (95% confidence interval [CI]) for low birth weight was 1.89 (95% CI, 1.36 to 2.62), preterm labor 1.79 (95% CI, 1.21 to 2.63), cardiac abnormalities 1.43 (95% CI, 1.27 to 1.62), central nervous system abnormalities 1.36 (95% CI, 1.10 to 1.70), urogenital system abnormalities 1.58 (95% CI, 1.28 to 1.94), musculoskeletal disorders 1.35 (95% CI, 1.12 to 1.64), and chromosomal abnormalities in infants conceived by ART was 1.14 (95% CI, 0.90 to 1.44), which were all statistically significant, except chromosomal abnormalities. Conclusions: The risk of congenital abnormalities and some birth complications were significantly higher in ART than normal conception, while chromosomal abnormalities were not; therefore, the application of ART should be selected individually for patients by detailed assessment to reduce such risks in the population.

Assessment of push-pull forces of yarn-carrying carts at some fiber-twisting factories (일부 섬유제품제조업의 밀기-당기기 작업 평가)

  • Lee, Sang-Man;Kim, Sung-Whan;Kim, Seung-Gon;Lee, Chae-Yong
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.21 no.4
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    • pp.209-214
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    • 2011
  • Objectives: To assess the risk of pushing or pulling the yarn-carrying cart, the survey was performed in some fiber manufacturing factories. Methods: We selected 6 fiber-twisting factories which agreed to in-site survey of their workplace. To measure both initial and sustained forces of the push-pull tasks, Chatillon CSD500 dynamometer(2004, Ametek, USA) was used. The mean of 3 tests for the same cart was adopted as the measured forces. Height and width of cart, weight of spooled yarns, and distance of movement were also measured. Inspection of cart wheel, moving path, and the actual hand position while moving was done. Results: More than one pushing or pulling task exceeded the push-pull force limits of design goal in 5 factories. Though the cart was not loaded the heaviest weight in the factory, the measured push or pull force exceeded the limits several times. A few cart wheels were worn out and tangled with pieces of yarn. It was also observed some holes in the moving path. Conclusions: While the push-pull task is not included in the 11 scopes of over-burdened work notified by Korean government, it should be recognized as risk factor of work-related musculoskeletal disorders. The maintenance work such as regular change and frequent cleaning of cart wheel, the use of fitting wheel, and flattening of bumpy floor through the moving path should be advised importantly in the worksite management of work-related musculoskeletal disorders.

Managing Mental Health during the COVID-19 Pandemic: Recommendations from the Korean Medicine Mental Health Center

  • Hyo-Weon Suh;Sunggyu Hong;Hyun Woo Lee;Seok-In Yoon;Misun Lee;Sun-Yong Chung;Jong Woo Kim
    • The Journal of Korean Medicine
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    • v.43 no.4
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    • pp.102-130
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    • 2022
  • Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

Characteristics of Pesticide residue in/on cucurbitaceous fruit vegetables applied with foliar spraying under greenhouse (시설재배에서의 박과 과채류 중 살포농약의 잔류특성)

  • Lee, Hee-Dong;Ihm, Yang-Bin;Kwon, Hye-Young;Kim, Jin-Bae;Kyung, Kee-Sung;Park, Seung-Soon;Oh, Byung-Youl;Im, Geon-Jae;Kim, Jang-Eok
    • The Korean Journal of Pesticide Science
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    • v.9 no.4
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    • pp.359-364
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    • 2005
  • Comparison of pesticide residue dissipation in/on cucurbitaceous fruit vegetables applied by foliar spraying under greenhouse was carried out to give information on crop grouping for assessment of pesticide risk. Even though the initial deposit of spayed pesticide on the target vegetables were somewhat different from the varieties, the dissipation patterns of the residues gave a similar tendency. In case sub-groupings of cucurbitaceous fruit vegetables are carefully arranged, the residue data among the vegetables are able to be taken for pre-harvest interval (PHI) settings or food safety assessment.

The effect of Rigid Tape in Conjunction with Elastic Tape and Elastic tape only on Shoulder Pain, Proprioceptor and Function of Chronic Stroke Patients with Scapular Dyskinesis (탄력 및 비탄력과 탄력을 결합한 테이프 적용이 견갑골 운동이상증을 가진 만성 뇌졸중 환자의 어깨 통증과 고유수용감각, 상지 기능 수준에 미치는 영향)

  • Yang, Seong-hwa;Han, Hyo-jin;Hyun, Ki-hoon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.25 no.1
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    • pp.45-52
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    • 2019
  • Background: Scapular dyskinesis is one of the risk factors for upper extremity injury in patients with chronic stroke. Taping can used as an adjunctive treatment for this. The aim of this study was to investigate the effects of rigid tape in conjunction with elastic tape and elastic tape only on shoulder pain, proprioceptor, and function of chronic stroke patients with scapular dyskinesis. Methods: Participants were randomly assigned to elastic tape (ET) group (n=10) and both tape (BT) group (n=10). Both ET and BT groups performed therapeutic exercise on the upper extremity with taping applied for 4 weeks. Therapeutic exercise was performed 30min/day, 5 times/week. Clinical outcome measures used Numerical pain rating scale with a faces pain scale for pain, angle at shoulder join position sense (JPS) for proprioceptor, and Fugl-meyer assessment upper extremity for function. Results: Clinical outcomes were measured at initial baseline, after 4weeks. There were statistically significant differences in pain, JPS, and function after 4 weeks in both groups (p<.05). There was no significant difference in pain and JPS between the groups, and There was a statistically significant difference in function in the BT group compared to the ET group (p<.05). Conclusions: This results suggest that accurate clinical assessment and appropriate taping can improve proprioceptor and function of the upper extremity in patients with chronic stroke.

A NEW FEEDBACK TECHNIQUE FOR TUNNEL SAFETY BY USING MEASURED DISPLACEMENTS DURING TUNNEL EXCAVATION

  • Sihyun PARK;Yongsuk SHIN;Sungkun PARK
    • International conference on construction engineering and project management
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    • 2009.05a
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    • pp.432-439
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    • 2009
  • This research project was carried out to develop the technique to assess quantitatively and rapidly the stability of a tunnel by using the measured displacement at the tunnel construction site under excavation. To achieve this purpose, a critical strain concept was introduced and applied to an assessment of a tunnel under construction. The new technique calculates numerically the strains of the surrounding ground by using the measured displacements during excavation. A numerical practical system was developed based on the proposed analysis technique in this study. The feasibility of the developed analysis module was verified by incorporating the analysis results obtained by commercial programs into the developed analysis module. To verify the feasibility of the developed analysis module, analysis results of models both elastic and elasto-plastic grounds were investigated for the circular tunnel design. Then the measured displacements obtained in the field are utilized practically to assess the safety of tunnels using critical strain concept. It was verified that stress conditions of in-situ ground and ground material properties were accurately assessed by inputting the calculated displacement obtained by commercial program into this module for the elastic ground. However for the elasto-plastic ground, analysis module can reproduce the initial conditions more closely for the soft rock ground than for the weathered soil ground. The stability of tunnels evaluated with two types of strains, that is, the strains obtained by dividing the crown displacement into a tunnel size and the strains obtained by using the analysis module. From this study, it is confirmed that the critical strain concept can be fully adopted within the engineering judgment in practical tunnel problems and the developed module can be used as a reasonable tool for the assessment of the tunnel stability in the field.

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Clinical Trial Protocol Development of Acupuncture for Disaster Survivors: Results from an Expert Survey (전문가 설문조사에 기반한 재난 경험자에 대한 침치료 임상연구 프로토콜 개발)

  • Huiyong Kwak;Chanyoung Kwon;Jungtae Leem;Sang-Ho Kim
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.1
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    • pp.15-26
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    • 2024
  • Objectives: The objective of this study is to develop a specialized clinical research protocol for acupuncture treatment specifically designed for disaster survivors based on insights from an expert survey. Methods: An expert panel comprising specialists in neuropsychiatry, acupuncture, and clinical research methodology was assembled. Initial data to inform the clinical research protocol design was collected utilizing open-ended responses, multiple-choice questions, and a 5-point Likert scale to gauge agreement levels. Next, this data was disseminated to a panel of experts. A cohesive clinical research protocol was then formulated during a core panel meeting by integrating insights from a panel of 10 experts. Results: The protocol developed herein entails a non-randomized controlled study involving participants aged 19~64 years old who have been identified as high-risk or cautious according to the National Trauma Center screening test. The study design includes the establishment of an active control group, which allows for the assessment of an additional effect through comparison with conventional therapy. The selected acupuncture approach involves a combination of manual acupuncture and ear acupuncture. For clinical outcome assessment, the Clinician-Administered Posttraumatic Stress Disorder Scale for DSM-5 was proposed to gauge trauma symptoms. Representative scales for various domains such as depression, anxiety, anger, insomnia, pain, and quality of life were also provided for reference. Conclusions: The developed protocol is anticipated to streamline the swift design and initiation of clinical trials during disaster scenarios. It is also designed to be scalable, thereby enabling its application in both non-randomized control group studies and single-group before-and-after comparisons.