• Title/Summary/Keyword: Outcome Assessment

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Morphological Analysis of the Mental Foramen and Anterior Loop of the Mandibular Canal using Computed Tomography (전산화단층촬영 방사선영상을 이용한 이공과 하악관 전방고리의 형태학적 분석)

  • Kim, Yong-Gun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.317-326
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    • 2011
  • The mental foramen and anterior loop of the mandibular canal are important landmarks for mandibular surgical procedures. The purpose of this study was to analyze the shape and position of the mental foramen and anterior loop of the mandibular canal on the computed tomography (CT) images, and apply the results clinically. CT images of 96 patients (33 male, 36 female, age range 17~43 years, mean $24.6{\pm}4.99$ years) were enrolled. The horizontal and vertical position of the mental foramen, as well as the distance from the root apices were measured. The distance of the anterior loop of the mandibular canal to the root apices, and the buccal angle were measured. The mental foramen was found mostly below the second premolar observed in 81 cases (46.0%), between the first and second premolars in 67 cases (38.0%), and between the second premolar and first molar in 19 cases (10.2%). The mean distance between the mental foramen and the lower border of the mandible was $12.20{\pm}1.77$ mm, the mean distance between the mental foramen and root apex was $5.16{\pm}0.98$ mm. The mean distance of the anterior loop of the mandibular canal was $5.80{\pm}2.00$ mm. The buccal angle measured at $47.7{\pm}9.07^{\circ}$. The distance between the root apex and mental foramen measured as $5.16{\pm}0.98$ mm on panoramic radiography, and $6.2{\pm}3.07$ mm on CT. The mean distance between the mental foramen and mandibular canal was $5.39{\pm}1.62$ mm. When performing surgical procedures such as installing dental implants, it is important to minimize surgical trauma, especially the risk of damage to the mental nerve. To optimize the surgical outcome, a careful assessment of the shape and position of the mental foramen and the anterior loop of the mandibular canal must be made. CT images are useful for finding such anatomic structures.

Occupation-based Occupational Therapy for an Youth With Sensory Integrative Dysfunction - A Single Case Study (감각통합기능장애를 가진 청소년의 작업수행에 초점을 맞춘 작업치료 사례)

  • Ji, Seok-Yeon;Lee, Kyoung-Min;Kim, Mi-Sun
    • The Journal of Korean Academy of Sensory Integration
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    • v.6 no.1
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    • pp.47-62
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    • 2008
  • Introduction : Sensory Integration(SI) theory, science it is developed by an occupational therapist A. Jean Ayres, is the one of the most popular frames of reference used in occupational therapy(OT) intervention. It has been proved as a scientific theory especially in neuroscience discipline through abundant research and practice. Occupational therapists apply the SI therapy with strong clinical reasoning to improve adaptive behaviors of their clients and try to link the adaptive behaviors with occupational performance in the clients' everyday life. One of the manners regarding clinical reasoning is Top-down approach. In occupational therapy discipline, Top-down approach is well-reflected within two evaluation tools; Canadian Occupational Performance Measure(COPM) and Assessment of Motor and Process Skills(AMPS) and two models of practice; Canadian Model of Occupational Performance(CMOP) and Occupational therapy intervention process model(OTIPM). Objective : The purpose of this paper demonstrates how SI therapy can be employed within OTIPM and how the OT process (evaluation-intervention-outcome) can be structuralized based on the Top-down approach. This single-case study recognizes the impact of a SI therapy for a male adolescent on his occupational performance. Intervention Examined : "P" was 16 years old male adolescent with no diagnosis and junior of the high school when he was referred. P was always with mouth opened, showed difficulties in gathering things need to be prepared and managing and paying money for shopping, and his colleges dislike getting close to him because he can't was his body well. AMPS was administrated in initial evaluation and reevaluation of P's occupation performance, Bruininks-Oserestky Test of Motor Proficiency-2(BOT-2) was carried out to assess motor functions and perception skills related in sensory integration, and occupational therapist performed clinical observation in order to complement the evaluation quantitatively and quantitatively. Based on the evaluation, it is concluded that the SI therapy is primary means to improve P's occupational performance, and three therapeutic approaches were constructed; restorative, acquired and compensatory approach. P showed improved motor and process skills in occupational performance after undergone the occupational therapy. Conclusions : The sensory integration therapy was practical enough to build the bridge between the occupational performance(Top) and the underlying component problems (Bottom). The OTIPM was helpful to identify meaningful occupation for P and P's family within P's contexts, and the AMPS was valuable to analyze and clarify the cause of difficulties in the chosen occupational performance.

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Critical Pathway Development for the Hysterectomy Patients and its applied Effect (자궁적출술 환자를 위한 critical pathway 개발과 적용효과)

  • Noh, Gi-Ok;Park, Kyung-Sook
    • Women's Health Nursing
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    • v.6 no.2
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    • pp.234-257
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    • 2000
  • At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

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Induction of Apoptosis and Expression of Apoptosis-related Gene Products in Response to Radiation in Murine Tumors (방사선에 대한 종양의 반응에서 아포프토시스의 유도와 이에 관련되는 유전자 발현)

  • Seong, Jin-Sil;Hunter, Nancv;Milas, Luka
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.187-195
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    • 1997
  • Purpose : To analyze the involvement of apoptosis regulatory genes p53, $p21^{wart/cip1}$ bax and bcl-2 in induction of apoptosis by radiation in murine tumors. Materials and methods : The radiation-sensitive ovarian carcinoma OCa-1, and the radiation-resistant hepatocarcinorna HCa-I were used. Tumors, 8 mm in diameter, were irradiated with 25 Gy and at various times after irradiation, ranging from 1 to 48 h, were analyzed histologically for apoptosis and by western blot for alterations in the expression of these genes. The p53 status of the tumors were determined by the polymerase chain reaction-single strand conformation polymorphism assay. Results : Both tumors were positive for wild-type p53. Radiation inducesd apoptosis in OCa-1 but not in HCa-1. Apoptosis developed rapidly, peaked at 2 h after irradiation and returned to almost the background level at 48 h In OCa-1 radiation upregulated the expression of p53, $p21^{wart/cip1}$. and the bcl-2/bax ratio was decreased. In HCa-1 radiation increased the expression of both p53 and $p21^{wart/cip1}$, although the increase of the latter was small The bcl-2/bax ratio was greatly increased. In general the observed changes occurred within a few hours after irradiation, and either preceded or coincided with development of apoptosis Conclusions : The development of apoptosis required upregulation of both p53 and $p21^{wart/cip1}$ as well as a decrease in bcl-2/bax ratio. In contrast, an increase in bcl-2/bax ratio Prevented apoptosis in the presence of upregulated p53 and $p21^{wart/cip1}$ . These findings indentified the involvement of multiple oncogenes in apoptosis regulation in vivo and demonstrate the complexity that may be associated with the use of a single oncogene assessment for Predicting the outcome of cancer therapy with cytotoxic agents.

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The Influence of Gender on the Long-term Outcome of Coronary Artery Bypass Surgery (성별에 따른 관상동맥 우회술의 장기 결과)

  • Choi Jong-Bum;Lee Mi-Kyung;Cha Byoung-Ki;Lee Sam-Youn
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.449-455
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    • 2006
  • Background: Female sex was known to be a risk factor for mortality after coronary bypass grafting (CABG), and women showed higher in-hospital mortality than men. Material and Method: Between 1992 and 1996, 147 consecutive patients (98 men and 49 women) undergoing CABG were included in the study. Most patients had undergone CABG with left internal thoracic artery and saphenous vein under cardiopulmonary bypass. We examined the influence of gender on survival after CABG and looked for risk factors for survival. Result: There was no in-hospital mortality in women, but 3 death (3.0%) in men. During the mean follow-up period of $138.5{\pm}23.0$ months, mortality was lower in women than in men (20.4% vs 44.9%, p=0.004), and the most common cause of death in women was chronic renal failure (40%). Survival in women at 1, 5, 10, and f4 years was 100%, $98.0{\pm}2.0%,\;81.2{\pm}5.6%,\;and\;78.4{\pm}6.1%$, respectively, which was better than in men (p=0.004). Although preoperative left ventricular ejection fraction was higher in women than in men, this did not affect early and long-term survival difference between two sexes (p=0.15). Risk factor for long-term survival in women was diabetes (p=0.033) and in men number of diseased coronary artery (p=0.006). Conclusion: Long-term survival after CABG was better in women than men. Risk factor for long-term survival in women was morbid disease rather than cardiac disease.

Estimation of Fresh Weight, Dry Weight, and Leaf Area Index of Soybean Plant using Multispectral Camera Mounted on Rotor-wing UAV (회전익 무인기에 탑재된 다중분광 센서를 이용한 콩의 생체중, 건물중, 엽면적 지수 추정)

  • Jang, Si-Hyeong;Ryu, Chan-Seok;Kang, Ye-Seong;Jun, Sae-Rom;Park, Jun-Woo;Song, Hye-Young;Kang, Kyeong-Suk;Kang, Dong-Woo;Zou, Kunyan;Jun, Tae-Hwan
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.21 no.4
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    • pp.327-336
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    • 2019
  • Soybean is one of the most important crops of which the grains contain high protein content and has been consumed in various forms of food. Soybean plants are generally cultivated on the field and their yield and quality are strongly affected by climate change. Recently, the abnormal climate conditions, including heat wave and heavy rainfall, frequently occurs which would increase the risk of the farm management. The real-time assessment techniques for quality and growth of soybean would reduce the losses of the crop in terms of quantity and quality. The objective of this work was to develop a simple model to estimate the growth of soybean plant using a multispectral sensor mounted on a rotor-wing unmanned aerial vehicle(UAV). The soybean growth model was developed by using simple linear regression analysis with three phenotypic data (fresh weight, dry weight, leaf area index) and two types of vegetation indices (VIs). It was found that the accuracy and precision of LAI model using GNDVI (R2= 0.789, RMSE=0.73 ㎡/㎡, RE=34.91%) was greater than those of the model using NDVI (R2= 0.587, RMSE=1.01 ㎡/㎡, RE=48.98%). The accuracy and precision based on the simple ratio indices were better than those based on the normalized vegetation indices, such as RRVI (R2= 0.760, RMSE=0.78 ㎡/㎡, RE=37.26%) and GRVI (R2= 0.828, RMSE=0.66 ㎡/㎡, RE=31.59%). The outcome of this study could aid the production of soybeans with high and uniform quality when a variable rate fertilization system is introduced to cope with the adverse climate conditions.

A Study on the Development of an Instrument for Knowledge Contribution Assessment (조직 구성원의 지식기여도 평가 도구 개발에 관한 연구)

  • Na, Mi-Ja;Kym, Hyo-Gun
    • Information Systems Review
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    • v.6 no.2
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    • pp.113-135
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    • 2004
  • This paper defines appraisal items and weights of the items for the purpose of developing an appraisal instrument that objectively measures employee's effectiveness of knowledge contribution. Deductive research is used for the development of appraisal items and delphi method for the development of weights of the items. In the deductive research the term, "effectiveness of knowledge contribution" is first defined. Then knowledge contribution activities are classified as "dimension of explicit contribution" and " dimension of tacit contribution" due to the characteristics of knowledge. Each dimension is divided again by components. The dimension of explicit contribution is divided according to the content of knowledge, and the dimension of tacit contribution is divided according to the extent of tacitness of knowledge contribution. The total components of dimensions are 7. The dimension of explicit contribution is composed of factual knowledge and procedural knowledge. The factual knowledge is made up of "procedural knowledge outcome" and "other factual knowledge". The procedural knowledge is made up of "procedural knowledge manual" and "lessons-learned procedural knowledge". The dimension of tacit contribution is composed of "agency", "model" and "Q&A". The basic framework for measuring 7 components of knowledge contribution is quantitative and qualitative approach. This paper is premised on the assumption that the outcomes of employee's knowledge contribution activities are recorded in the knowledge management systems in order to evaluate them objectively. The appraisal items are defined as follows: at the dimension of explicit contribution, in quantitative approach, "the upload number" or "performance number", and in qualitative approach, other employee's "referred number" and other employee's "content and format satisfaction evaluation"; at the dimension of tacit contribution, "demanded number of performance" After the development of appraisal items by the deductive method, delphi method was used for the analysis of the weights of the items with the total degree of knowledge contribution, 100. This research does not include the standard marks of the appraisal items. It is because when companies apply this appraisal instrument, they could use their own standard appraisal marks of the appraisal items considering their present situations and companies' goals. Through this almost desert-like research about the appraisal instrument of employee's knowledge contribution effectiveness, it proposes a cornerstone in the research field of appraisal instrument, which provides a standard for employee's knowledge contribution appraisal, and appraisal items that make organizational knowledge to be managed more systemically in business sites.

Assessment of Nutrition Status and Quality of Life after Curative Resection in Patients with Upper Gastric Cancer: Comparison of Total Gastrectomy and Proximal Gastrectomy (상부 위암에 대한 근위부 위절제술 뜻 위전절제술을 시행한 환자의 영양상태와 삶의 질 비교)

  • Lee, Hyun-Soo;Park, Jong-Hyun;Choi, Hun;Kim, Jae-Hee;Min, Lac-Kee;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.152-157
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    • 2005
  • Purpose: A total gastrectomy is generally peformed for the treatment of upper third gastric cancer. However, the optimal extent of resection for early-stage upper third gastric cancer is still controversial. In this research, we compared the nutritional status and the quality of life in patients who underwent a total gastrectomy with uncut Roux en Y esophagojejunostomy with those in patients who underwent a proximal gastrectomy with esophagogastrostomy for treatment of upper third gastric cancer. Materials and Methods: We reviewed 50 patients with no evidence of recurrent disease following curative surgery for upper third gastric cancer. Among this group, 25 patients underwent a total gastrectomy (TG) and 25 patients a proximal gastrectomy (PG). 8 TG and 4 PG patients were excluded from this study because of death, refusal to interview etc. The nutritional status was assessed by measuring body weight, serum albumin, serum hemoglobin, and serum total protein. The gastrointestinal function and the quality of life were assessed by Cuschieri grading and modified Visick qrading. Results: In analysis of covariance of age and preoperative serum albumin, PG patients demonstrated lower weight loss (P=0.038), elevated serum albumin (P=0.049), and better outcome based on modified Visick grading (P=0.016) than TG, but there were no significant differences in the serum hemoglobin change (P=0.165), serum total protein change (P=0.435), and Cuschieri grading (P=0.064) between the preoperative and the postoperative data. Conclusion: In this study, a proximal gastrectomy led to a better nutritional status and quality of life than a total gastrectomy, as judged from the low weight loss, elevated serum albumin and better modified Visick grade.

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The Value of ICAM-1 Expression and the Soluble ICAM-1(sICAM-1) Level as a Marker of Activity in Sarcoidosis: The Relationship Between the ICAM-1 Level and the Clinical Course of the Disease (유육종증의 활동성 지표로서의 ICAM-1)

  • Kim, Dong-Soon;Paik, Sang-Hoon;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.116-127
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    • 1998
  • Background: The natural course of sarcoidosis is variable from spontaneous remission to significant morbidity or death. So the assessment of disease activity is important but no single parameter was generally accepted as a good marker. Recently several studies suggested that adhesion molecules, especially ICAM-1 can be a marker, but there are some controversies. And only few data are available about the relationship of ICAM-1 with clinical follow-up course. Methods: We measured the expression of adhesion molecules on BAL cells by flow cytometry and the level of soluble ICAM-1(sICAM-1) in serum and BALF at the time of diagnosis in 12 patients with active disease and 7 inactive sarcoidosis(5 male, 14 female, mean age: $39.4{\pm}10.7$ years, mean follow-up : $20{\pm}15$ months). Follow-up clinical course were compared with the changes in serum sICAMA-1 level and the adhesion molecule on BAL cells. Results: In the patients with active disease, the ICAM-1 on AM(RMFI: $3.68{\pm}1.71$) and sICAM-1 level in serum($582{\pm}193$ng/ml) and BAL fluid($47.8{\pm}16.5$ng/ml) were all higher than those of 7 inactive disease(RMFI: $1.89{\pm}0.75$, p=0.0298, serum: $294{\pm}117$ ng/ml, p=0.0049, BALF: $20.9{\pm}8.3$ ng/ml). In the active sarcoidosis, ICAM-1 on AM(RMFI : $1.51{\pm}0.84$) and serum sICAM-1 were decreased after the therapy($250{\pm}147$ ng/ml) but no significant change was noted in inactive disease. Also we found the initial ICAM-1 on AM and serum sICAM-1 had a significant correlation with the degree of improvement in PFT after the therapy. During the follow-up, the disease relapsed in 4 patients after the discontinuation of steroid and the serum sICAM-1 level went-up again at the time of relapse. Conclusion: Our data suggest that the serum sICAM-1 level and the ICAM-1 expression on AM can be a good marker of disease activity and also a predictor of outcome in sarcoidosis.

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A Study on Location Selection for Rainwater Circulation System Elements at a City Level - Focusing on the Application of the Environmental and Ecological Plan of a Development - (도시차원의 빗물순환체계 요소별 입지선정에 관한 연구 - 개발예정지역의 환경생태계획 적용방안을 중심으로 -)

  • Kim, Hyo-Min;Kim, Kwi-Gon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.3
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    • pp.1-11
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    • 2012
  • This study focused on establishing a natural rainwater circulation system using rainwater meant for relatively large urban development projects such as a new town development. In particular, when the location selection techniques for individual elements of a natural rainwater circulation system are developed for the integrated rainwater management, changes in hydrological environment will be minimized and the natural water circulation would be restored to realize the low impact development (LID). In that case, not only the excess will be reduced but water space and green areas in a city would also increase to improve the urban sustainability. First of all, there were five elements selected for the location selection of a rainwater circulation system intended for the integrated rainwater management: rainwater collection, infiltration, filtration, retention and movement spaces. After generating these items, the location selection items and criteria were defined for each of the five elements. For a technique to apply the generated evaluation items and criteria, a grid cell analysis was conducted based m the suitability index theory, and thematic maps were overlapped through suitability assessment of each element and graded based on the suitability index. The priority areas were identified for each element. The developed technique was applied to a site where Gim-cheon Innovation City development is planned to review its feasibility and limitations. The combined score of the overlapped map for each element was separated into five levels: very low, low, moderate, high and very high. Finally, it was concluded that creating a rainwater circulation system conceptual map m the current land use plan based on the outcome of the application would be useful in building a water circulation system at the de1ailed space planning stage after environmental and ecological planning. Furthermore, we use the results of this study as a means for environment-friendly urban planning for sustainable urban development.