• The Academic Congress of Korean Shoulder and Elbow Society
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• 1999.03a
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• pp.3-4
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• 1999

The electromyographic activity of four muscles of biceps, rotator cuffs (supraspinatus, infraspinatus and subscapularis) was measured from the non-dominant shoulders of 12 volunteers during six methods of provocative test for the biceps pathology. Any method of provocative test can not isolates the biceps activity prominently compared to the other rotator cuff muscles. But the Speed test can more isolates the activity of biceps than the other tests. Based upon this study, we think that the O'Brien's test is not a provocative maneuver by which the pain reproduced is not associated with the tension generated within the biceps tendon.

• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.186-190
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• 2001

Purpose: The aim of this study was to investigate the diagnostic accuracy of Neer, Hawkins provocative tests and supraspinatus manual muscle test for the assessment of impingement syndrome, partial tear and small complete tear of De rotator cuff. Materials and Methods: Seventy-one female and 115 male patients were included in the study. Patients were divided into four groups of no impingement, impingement without tear, partial tear and small complete tear of the rotator cuff, which were confirmed by sonogram, magnetic resonance imaging and surgery. Neer and Hawkins provocative tests and supraspinatus manual muscle test were performed respectively. SAS 6.12 version was used in statistical analysis. Results: We found that Neer test had 94% sensitivity, 54% specificity for impingement without tear and 89% sensitivity, 78% specificity for partial tear and 96% sensitivity, 23% specificity for small tear. Hawkins test revealed 95% sensitivity, 54% specificity for impingement without tear and 93% sensitivity, 78% specificity for partial tear and 100% sensitivity, 23% specificity for small tear. Supraspinatus manual muscle test revealed 27% sensitivity, 94% specificity for impingement without tear and 29% sensitivity, 82% specificity for partial tear and 48% sensitivity, 82% specificity for small tear. Conclusion: Neer and Hawkins tests have high sensitivity, low specificity for impingement syndrome, partial and small tear. Supraspinatus manual muscle test had low sensitivity and high specificity. However this test was not effective to differentiate the partial and small rotator cuff tear. We thought that more effective provocative test should be designed to detect the partial and small rotator cuff tear.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.170-177
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• 1999

The electromyographic activity of four muscles(biceps, supraspinatus, infraspinatus and subscapularis) was mea­sured from non-dominant shoulders of 12 volunteers by six different provocative test for the biceps pathology. The provocative tests were Speed, Yergason, Ludington, Heuter, O'Brien and the abduction-extension test. Each test was performed in a force of 30% of maximal voluntary contraction. The levels of activity of the biceps were higher than those of the other rotator cuff muscles only in Speed's test: 28% in the biceps, 26% in the infraspinatus, 25% in the supraspinatus and 21 % in the subscapularis. The levels of activity of the biceps as a percent of MMT(maximal manual test) were higher in Speed's(42%) and O'Brien's test with the arm supinatecl(42%). Speed's test can isolate the activity of biceps better than the other tests but it is a nonspecific test by which the biceps tendon was also activated within other rotator cuff muscles.

• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.472-475
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• 2012

Objective : The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). Methods : We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand elevation test as provocative tests for CTS. Results : We used chi-square analysis to compare Tinel's test and Phalen's test, carpal compression test with hand elevation test. The sensitivity and specificity of the hand elevation test is 86.7% and 88.9% each. Tinel's test had 82.2% sensitivity and 88.9% specificity. Phalen's test had 84.4% sensitivity and 86.7% specificity. Carpal compression test had 84.4% sensitivity 82.2% specificity. Comparisons of sensitivity and specificity between hand elevation test and Tinel's test, Phalen's test, and carpal compression test had no statistically significant differences. To compare the diagnostic accuracies of four tests, the area under the non-parametric receiver operating character curve was applied. Conclusion : The hand elevation test has higher sensitivity and specificity than Tinel's test, Phalen's test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective campared with Tinel's test, Phalen's test, and carpal compression test.

• Journal of Applied Reliability
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• v.11 no.1
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• pp.1-15
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• 2011

Automobile markets are so fierce in the world market that every major manufacturer assure the buyer of the car by give a provocative warranty plan for their cars. For instance Hyundai motor company offer 10 years and 100,000 miles of warranty whichever comes first. But in order for this effort to be successful every critical component such as window switch has to be proven to be reliable in an adverse environment. Therefore, in this article reliability assessment criteria for window switch are established in terms of basic performance test, environment test and life test.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.447-453
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• 2021

Background: Provocative discography (PD) is a test that is useful in diagnosing discogenic pain (DP). In this study, to diagnose DP, we used a posterolateral approach of needle placement and followed pressure criteria laid down by the Spine Intervention Society. The aim was to identify the correlation between magnetic resonance imaging (MRI) findings (desiccation, high intensity zone and change in shape and size of the disc) and the results of PD. Methods: Records of 50 patients who underwent PD for DP were analyzed. A total of 109 PDs were performed, with 54 suspect and 55 control discs. Alternate pain generators were ruled out. Results: A total of 35 suspect discs were positive on PD. The mean disc pressure in the suspect disc was 31.9 ± 7.9 psi (range, 15-44). Of the 50 patients who underwent PD, 35 had positive MRI findings. A significant positive correlation was found only between disc desiccation and discography result (r = 0.6, P < 0.001). Logistic regression analysis revealed that only desiccation successfully predicted the result of discography (OR = 26.5, P < 0.001); a high intensity zone and a disc protrusion/extrusion had an OR 2.3 and 1.24, respectively. Disc desiccation of Pfirmann grade 3 or more had a sensitivity and specificity of 0.93 and 0.64 respectively in identifying painful discs; the positive likelihood ratio was 2.58 while the negative likelihood ratio was 0.11. Conclusions: In patients with DP, disc desiccation is the most useful MRI feature that predicts a painful disc on PD.

• Asia Marketing Journal
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• v.11 no.2
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• pp.37-51
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• 2009

Although previous studies have made significant progress in adaptive selling behavior (ASB), few studies have considered salesperson's customer orientation (CO) and learning behavior as determinants of effective sales management (ASB and relationship-making efforts), despite the discussion of important roles of these constructs. The authors test not only the relationships of salesperson's CO and market-based learning behavior to ASB and relationship-making efforts, but also the effects of ASB on relationship-making efforts and performance. The results of the study, which is done with samples of salespeople from Korean companies, indicate that salesperson's CO and market-based learning behavior are identified as significant determinants of ASB. Moreover, both salesperson's ASB and relationship-making efforts have significant effects on sales performance. On the other hand, as per salesperson's relationship-making efforts, salesperson's CO has a positive effect, but salesperson's market-based learning behavior and ASB do not influence his or her relationship-making efforts, which suggest a provocative possibility of conceptualization regarding the relationship between ASB and relationship management efforts.

• Archives of Reconstructive Microsurgery
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• v.24 no.1
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• pp.13-15
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• 2015

Purpose: Since the hand elevation test was first introduced by Ahn in 2001, it has been one of most performing provocative test for diagnosing carpal tunnel syndrome. Although many studies have been published on the hand elevation test, there are no study that can explain why false-negative results of hand elevation test appears in carpal tunnel syndrome patients diagnosed by electromyography (EMG) findings. Therefore we searched out whether hand elevation test is related with EMG severity. Materials and Methods: We made a retrospective study of 654 bilateral carpal tunnel syndrome patients. Among them 134 were studied which had different hand elevation test results on each hands. The paired samples t-test was used to compare the EMG severity of each group. The relationships between hand elevation test and EMG severity were examined using Pearson-product correlations. Comparing whether the frequency of false negative hand elevation were different between both hands, and whether the severity of EMG depends on which side of hand is, was evaluated with Mann-Whitney U-test. Results: Severity of EMG in positive group was moderate to severe on average, whereas mild to moderate on negative group, with significant difference statistically (p<0.001). Correlation between the hand elevation test results and EMG severity also showed significance statistically (p<0.001). Conclusion: Mild severity of EMG was found out to be the factor affecting the false results. However, EMG severity and hand elevation test shows a meaningful correlation, supporting the value of hand elevation test.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.235-240
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• 2013

Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a $7.1{\times}11.0$ mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.

• Strategy21
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• s.31
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• pp.57-84
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• 2013

North Korea's continuous threats and provocative behaviors have aggravated tension on the Korean peninsula particularly with the recent nuclear weapons test. South Korea's best way to cope with this situation is to maintain the balance among three policy directions: dialogue, sanctions, and deterrence. Among the three, I argue that deterrence should be prioritized. There are different sources of deterrence such as military power, economic power, and diplomatic clouts. States can build deterrence capability independently. Alternatively, they may do so through relations with other states including alliances, bilateral relations, or multilateral relations in the international community. What South Korea needs most urgently is to maintain deterrence against North Korea's local provocations through the enhancement of independent military capability particularly by addressing the asymmetric vulnerability between militaries of the South and the North. Most of all, the South Korean government should recognize the seriousness of the negative consequences that North Korea's 'Nuclear shadow strategy' would bring about for the inter-Korea relations and security situations in Northeast Asia. Based on this understanding, it should develop an 'assertive deterrence strategy' that emphasizes 'multi-purpose, multi-stage, and tailored deterrence whose main idea lies in punitive retaliation.' This deterrence strategy requires a flexible targeting policy and a variety of retaliatory measures capable of taking out all targets in North Korea. At the same time, the force structures of the army, the air force, and the navy should be improved in a way that maximizes their deterrence capability. For example, the army should work on expanding the guided missile command and the special forces command and reforming the reserve forces. The navy and the air force should increase striking capabilities including air-to-ground, ship-to-ground, and submarine-to-ground strikes to a great extent. The marine corps can enhance its deterrence capability by changing the force structure from the stationary defense-oriented one that would have to suffer some degree of troop attrition at the early stage of hostilities to the one that focuses on 'counteroffensive landing operations.' The government should continue efforts for defense reform in order to obtain these capabilities while building the 'Korean-style triad system' that consists of advanced air, ground, and surface/ subsurface weapon systems. Besides these measures, South Korea should start to acquire a minimum level of nuclear potential within the legal boundary that the international law defines. For this, South Korea should withdraw from the Nuclear Non-proliferation Treaty. Moreover, it should obtain the right to process and enrich uranium through changing the U.S.-South Korea nuclear cooperation treaty. Whether or not we should be armed with nuclear weapons should not be understood in terms of "all or nothing." We should consider an 'in-between' option as the Japanese case proves. With regard to the wartime OPCON transition, we need to re-consider the timing of the transition as an effort to demonstrate the costliness of North Korea's provocative behaviors. If impossible, South Korea should take measures to make the Strategic Alliance 2015 serve as a persisting deterrence system against North Korea. As the last point, all the following governments of South Korea should keep in mind that continuing reconciliatory efforts should always be pursued along with other security policies toward North Korea.