• Journal of Chest Surgery
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• 제51권2호
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• pp.92-99
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• 2018

Background: We evaluated the early clinical outcomes of tricuspid valve annuloplasty (TAP) with the Tri-Ad annuloplasty ring for functional tricuspid regurgitation (TR). Methods: From January 2015 to March 2017, 36 patients underwent TAP with a Tri-Ad ring for functional TR. To evaluate the early clinical outcomes of TAP with the Tri-Ad ring, we conducted a propensity score-matched analysis comparing the Tri-Ad and $MC^3$ tricuspid annuloplasty rings (n=34 in each group). The follow-up duration was $11.0{\pm}7.07$ months. Results: There was 1 case of operative mortality (2.8%) and no cases of late mortality. Postoperative complications occurred in 15 patients (41%), including acute kidney injury in 6 patients (16%), bleeding requiring reoperation in 4 patients (11%), and low cardiac output syndrome in 4 patients (11%). There were no ring-related complications, such as atrioventricular block or ring dehiscence. The TR grade decreased significantly (from $2.03{\pm}1.06$ to $1.18{\pm}0.92$, p<0.01), as did the systolic pulmonary artery pressure (from $43.53{\pm}13.84$ to $38.00{\pm}9.72mm\;Hg$, p=0.03). There were no cases of severe residual TR, but moderate TR was observed in 3 patients, all of whom had severe TR preoperatively. Severe preoperative TR was also associated with moderate in the univariate analysis (p<0.01). In the propensity score-matched analysis comparing the Tri-Ad and $MC^3$ rings, there was no significant difference in early clinical outcomes. Conclusion: TAP with the Tri-Ad ring corrected functional TR effectively and provided good early clinical and echocardiographic results without ring-related complications. However, severe preoperative TR was associated with moderate or severe residual TR in the immediate postoperative period. A follow-up study is necessary to confirm the stability of this procedure.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.467-476
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• 2020

본 연구는 전문대학 비대면 온라인 수업에 대한 교육의 질, 학습정서가 학습성과에 미치는 영향을 살펴보고 이들 간의 관계를 밝혀보는 다각적인 분석을 통해 온라인 수업의 질 향상을 위한 기반연구로서의 목적이 있다. 이를 위해 2020년도 3월 1일부터 2020년도 8월31일까지 수도권 소재 H 전문대학 학생 1000명을 대상으로 설문조사를 실시하였다. 수집된 자료는 SPSS Statistics 18.0 프로그램을 사용하여 통계처리 하였으며 온라인 수업에 대한 인식, 수업의 질, 학습정서와 관련된 요인들이 학습성과에 주는 영향력과 영향관계를 밝히기 위해 t검증, 상관분석, 다중회귀 분석을 실시하였다. 연구결과는 첫째, 온라인 수업에 대해 성별, 학년별로 통계적으로 유의미한 인식 차이가 있었다. 둘째, 온라인 수업에 대한 교육의 질, 학습정서, 학습성과는 정적상관을 보이고 있었다. 셋째, 학습성과 중 성취도에 영향을 미치는 요인은 교육내용과 긍정적 정서로 나타났으며 학습성과 중 만족도에 영향을 미치는 요인은 교육내용, 학습환경으로 타나났다. 결론적으로 전문대학 비대면 온라인 수업에 대한 교육의 질, 학습 정서가 학습성과가 서로 영향을 미치고 있고, 전문대학생들의 학년, 성별에 따라 온라인 수업 만족도에 영향을 미치고 있기에 전문대학 수업의 질적 수월성을 확보하기 위해 향후 노력을 기울여야 하는 부분은 전문대학생들이 자신이 취업하고자 하는 직업 현장의 문제를 창의적으로 해결하고 탐색할 수 있도록 이끄는 학습 내용개발과 학년별, 단계별 접근이 허용되는 학습방법 개발, 학습자들이 안정적으로 수업할 수 있도록 이끄는 수업환경조성이 선행되어야 함을 시사하고 있다.

• Korean Journal of Radiology
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• 제21권5호
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• pp.582-587
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• 2020

Objective: Endovascular thrombectomy (EVT) fails in approximately 20% of anterior circulation large vessel occlusion (AC-LVO). Nonetheless, the factors that affect clinical outcomes of non-recanalized AC-LVO despite EVT are less studied. The purpose of this study was to identify the factors affecting clinical outcomes in non-recanalized AC-LVO patients despite EVT. Materials and Methods: This was a retrospective analysis of clinical and imaging data from 136 consecutive patients who demonstrated recanalization failure (modified thrombolysis in cerebral ischemia [mTICI], 0-2a) despite EVT for AC-LVO. Data were collected in prospectively maintained registries at 16 stroke centers. Collateral status was categorized into good or poor based on the CT angiogram, and the mTICI was categorized as 0-1 or 2a on the final angiogram. Patients with good (modified Rankin Scale [mRS], 0-2) and poor outcomes (mRS, 3-6) were compared in multivariate analysis to evaluate the factors associated with a good outcome. Results: Thirty-five patients (25.7%) had good outcomes. The good outcome group was younger (odds ratio [OR], 0.962; 95% confidence interval [CI], 0.932-0.992; p = 0.015), had a lower incidence of hypertension (OR, 0.380; 95% CI, 0.173-0.839; p = 0.017) and distal internal carotid artery involvement (OR, 0.149; 95% CI, 0.043-0.520; p = 0.003), lower initial National Institute of Health Stroke Scale (NIHSS) (OR, 0.789; 95% CI, 0.713-0.873; p < 0.001) and good collateral status (OR, 13.818; 95% CI, 3.971-48.090; p < 0.001). In multivariate analysis, the initial NIHSS (OR, 0.760; 95% CI, 0.638-0.905; p = 0.002), good collateral status (OR, 14.130; 95% CI, 2.264-88.212; p = 0.005) and mTICI 2a recanalization (OR, 5.636; 95% CI, 1.216-26.119; p = 0.027) remained as independent factors with good outcome in non-recanalized patients. Conclusion: Baseline NIHSS score, good collateral status, and mTICI 2a recanalization remained independently associated with clinical outcome in non-recanalized patients. mTICI 2a recanalization would benefit patients with good collaterals in non-recanalized AC-LVO patients despite EVT.

• 한국심리학회지 : 코칭
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• 제7권3호
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• pp.109-125
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• 2023

본 연구는 조직의 결과변인에 유의한 영향을 주는 것으로 알려진 권력거리를 종업원-조직 부합의 관점에서 알아보고자 하였다. 군집분석을 통해 종업원과 조직의 권력거리 조합이 현실에서 어떤 하위그룹으로 존재하는지를 알아보고자 하였으며, 조직의 긍정 결과변인과 부정 결과변인들에 있어서 도출된 하위집단들 간 차이가 있는지도 살펴보았다. 총 398명의 데이터가 수집되었으며 군집분석을 통해 총 3개 집단이 도출되었다. 군집 1은 종업원의 권력거리는 낮고 조직의 권력거리는 높은 집단이었으며(LH), 군집 2는 종업원과 조직의 권력거리가 모두 높은 집단, 군집 3은 종업원과 조직이 전반적으로 낮은 권려거리 수준을 보였으나 종업원의 권력거리가 조직의 권력거리보다 유의하게 높은 집단(HL)이었다. 조직 결과변인에 대해 세 하위 집단 간 차이를 분석한 결과, 긍정적 일 정서에서는 집단 간 차이가 없었으며 전반적으로 LH 집단이 가장 긍정적인 조직 결과를, HH 집단이 가장 부정적인 조직 결과를 보이는 것으로 나타났다. 상기 결과를 바탕으로 본 연구의 학문적, 실용적 함의 및 제한점에 대해 논의하였다.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.231-237
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• 2023

Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA. Methods: Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival. Results: At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure. Conclusions: When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.

• 대한두개안면성형외과학회지
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• 제17권1호
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• pp.14-19
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• 2016

Background: Most nasal bone fractures are corrected using non-invasive methods. Often, patients are dissatisfied with surgical outcomes following such closed approach. In this study, we compare surgical outcomes following blind closed reduction to that of ultrasound-guided reduction. Methods: A single-institutional prospective study was performed for all nasal fracture patients (n=28) presenting between May 2013 and November 2013. Upon research consent, patients were randomly assigned to either the control group (n=14, blind reduction) or the experimental group (n=14, ultrasound-guided reduction). Surgical outcomes were evaluated using preoperative and 3-month postoperative X-ray images by two independent surgeons. Patient satisfaction was evaluated using a questionnaire survey. Results: The experimental group consisted of 4 patients with Plane I fracture and 10 patients with Plane II fracture. The control group consisted of 3 patients with Plane I fracture and 11 patients with Plane II fracture. The mean surgical outcomes score and the mean patient dissatisfaction score were found not to differ between the experimental and the control group in Plane I fracture (p=0.755, 0.578, respectively). In a subgroup analysis consisting of Plane II fractures only, surgeons graded outcomes for ultrasound-guided reduction higher than that for the control group (p=0.007). Likewise, among the Plane II fracture patients, those who underwent ultrasound-guided reduction were less dissatisfied than those who underwent blind reduction (p=0.043). Conclusion: Our study result suggests that ultrasound-guided closed reduction is superior to blind closed reduction in those patients with Plane II nasal fractures.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.97-104
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• 2018

Objective : Diffusion-weighted magnetic resonance imaging (DW-MRI) has proven useful in the study of the natural history of ischemic stroke. However, the potential of DW-MRI for the evaluation of chronic subdural hematoma (CSDH) has not been established. In this study, we investigated DW-MRI findings of CSDH and evaluated the impact of the image findings on postoperative outcomes of CSDH. Methods : We studied 131 CSDH patients who had undergone single burr hole drainage surgery. The images of the subdural hematomas on preoperative DW-MRI and computed tomography (CT) were divided into three groups based on their signal intensity and density : 1) homogeneous (iso or low) density on CT and homogeneous low signal intensity on DW-MRI; 2) homogeneous (iso or low) density on CT and mixed signal intensity on DW-MRI; and 3) heterogeneous density on CT and mixed signal intensity on DW-MRI. On the basis of postoperative CT, we also divided the patients into 3 groups of surgical outcomes according to residual hematoma and mass effect. Results : Analysis showed statistically significant differences in surgical (A to B : p<0.001, A to C : p<0.001, B to C : p=0.129) and functional (A to B : p=0.039, A to C : p<0.001, B to C : p=0.108) outcomes and treatment failure rates (A to B : p=0.037, A to C : p=0.03, B to C : p=1) between the study groups. In particular, group B and group C showed worse outcomes and higher treatment failure rates than group A. Conclusion : CSDH with homogeneous density on CT was characterized by signal intensity on DW-MRI. In CSDH patients, performing DW-MRI as well as CT helps to predict postoperative treatment failure or complications.

• Journal of Korean Neurosurgical Society
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• 제40권2호
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• pp.84-89
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• 2006

Objective : The purpose of this study is to compare the outcomes of two methods for stabilization and fusion : Postero-Lateral Fusion [PLF, pedicle screw fixation with bone graft] and Posterior Lumbar Interbody Fusion [PLIF, cage insertion] for spinal stenosis and recurred disc herniation except degenerative spondylolisthesis. Methods : Seventy one patients who underwent PLF [n=36] or PLIF [n=35] between 1997 and 2001 were evaluated prospectively. These two groups were compared for the change of interbody space, the range of segmental angle, the angle of lumbar motion, and clinical outcomes by Prolo scale. Results : The mean follow-up period was 32.6 months. The PLIF group showed statistically significant increase of the interbody space after surgery. However, the difference in the change of interbody space between two groups was insignificant [P value=0.05]. The range of segmental angle was better in the PLIF group, but the difference in the change of segmental angle was not statistically significant [P value=0.0l7]. Angle of lumbar motion was similar in the two groups. Changes of Prolo economic scale were not statistically significant [P value=0.193]. The PLIF group showed statistically significant improvement in Prolo functional scale [P value=0.003]. In Prolo economic and functional scale, there were statistically significant relationships between follow-up duration [P value<0.001]. change of interbody space [P value<0.001], and range of segmental angle [P value<0.001]. Conclusion : Results of this study indicate that PLIF is superior to PLF in interbody space augmentation and clinical outcomes by Prolo functional scale. Analysis of clinical outcomes showed significant relationships among various factors [fusion type, follow-up duration, change of interbody space, and range of segmental angle]. Therefore, the authors recommend instrumented PLIF to offer better clinical outcomes in patients who needed instrumented lumbar fusion for spinal stenosis and recurred disc herniation.

• 정보교육학회논문지
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• 제17권3호
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• pp.305-316
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• 2013

페이스북의 교육적 잠재력에도 불구하고, 아직 실증적인 연구나 이를 통한 실천적인 설계전략은 매우 부족하다. 따라서 본 연구에서는 페이스북을 활용한 협력학습에서 학습자들이 인식한 학습실재감이 학습성과를 예측하는지 검증하여, 페이스북 기반 협력학습 환경에서 학습성과를 높이기 위한 실재감 전략을 제시하고자 하였다. 이를 위해 서울소재 A 대학교의 전공과목을 수강하는 39명의 대학생을 대상으로 4주 동안 페이스북 상에서 프로젝트 과제를 수행하기 위한 협력학습을 진행하였다. 학습활동을 마친 후 학생들은 학습실재감에 대한 설문에 응답하였고, 지필평가와 과제평가를 합산하여 학습성과를 산출하여 단계선택 다중회귀분석을 통해 데이터를 분석하였다. 또한 포커스 그룹인터뷰를 통하여 학습자들이 페이스북기반 협력학습에서 느낀 학습실재감과, 실재감이 학습성과에 어떠한 도움이 되었는지 심층적으로 분석하고자 하였다. 연구결과, 인지실재감은 학습성과를 유의미하게 예측하는 것으로 나타났지만, 사회실재감과 감성실재감의 학습성과에 대한 예측은 통계적으로 유의하지 않았다. 이러한 결과를 토대로, 본 연구는 페이스북에서 학습자가 인식하는 학습실재감과 교육적 잠재력에 대하여 논의하였다.

• Journal of the Korean Data and Information Science Society
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• 제26권3호
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• pp.715-727
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• 2015

본 연구는 우리나라 요양병원의 간호인력 확보수준과 간호결과의 관련성을 파악하고 간호에 민감한 환자 결과를 알아봄으로써 요양병원의 적정 간호인력 확보에 대한 근거를 제공하기 위해 시행되었다. 자료는 건강보험심사평가원의 2012년 '요양병원 병원평가정보'를 바탕으로 분석하였다. 연구결과, 간호사 1인당 환자 수가 평균보다 많은 그룹에서 유치도뇨관 비율 (고위험군/저위험군)이 통계적으로 유의하게 높았다. 간호인력 1인당 환자 수가 평균보다 많은 그룹에서 일상생활수행능력이 감퇴한 환자비율 (치매환자군/비치매환자군), 요실금, 욕창이 새로 발생한 환자 (고위험군)비율이 통계적으로 유의하게 더 높았다. 그리고 요양병원의 등급이 향상될수록 입원환자의 간호결과가 더 좋아지는 것으로 나타났다. 이는 간호인력 확보수준이 높을수록 그리고 요양등급이 높을수록 환자의 간호결과에 긍정적인 영향이 나타난다는 결과이다. 따라서 요양병원에서 간호인력 수를 적정화시킬 수 있는 보다 강력한 정책적 접근이 필요하다는 것을 제안하는 바이다.