• Journal of Korean Dental Science
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• 제7권1호
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• pp.6-15
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• 2014

Purpose: The purpose of this retrospective study is to investigate the degree of coincidence between the peer assessment rating (PAR) index and American Board of Orthodontics objective grading system (ABO-OGS) in the assessment of orthodontic treatment outcomes of Class I malocclusion cases. Materials and Methods: The sample consisted of 26 Class I patients. The PAR index was used for evaluation of pre-(T0) and posttreatment (T1) casts, and the ABO-OGS for assessment of T1 casts. If there was a reduction in PAR scores from T0 to T1 of more than 30%, the label 'PAR+' was given to the case, and if not, it was labeled 'PAR-'. If the ABO-OGS was less than 27, the label 'OGS+' was given to the case and if not, it was labeled 'OGS-'. 'A PAR-only qualified group' (PAR+), 'ABO-OGS-only qualified group' (OGS+), 'both indices qualified group' (PAR+/OGS+), and 'both indices disqualified group' (PAR-/OGS-) were compared with a Wilcoxon rank-sum test, sensitivity/specifi city test and Spearman's correlation test. Result: PAR scores for T0, T1, and percentage reduction were 21.1, 6.4, and 65.9%, respectively, and 35.4 for ABOOGS. The distribution of the 'PAR+/OGS+', 'PAR+', and 'PAR-/OGS-' group was 19.3%, 76.9%, and 3.8%, respectively. The T0-PAR, T1-PAR and PAR point reductions for the 'PAR+' group were significantly higher than those of 'PAR+/OGS+' groups (23.1 vs. 15.6; 6.7 vs. 4.6; and 16.5 vs. 11.0; all P<0.05). However, the PAR-percentage reduction and treatment duration between the two groups were not statistically different (70.0% vs. 67.0%, P=0.4325; 24.1 months vs. 25.0 months, P=0.4057). The T1-ABO-OGS score for 'PAR+' group was significantly higher than that of the 'PAR+/OGS+' groups (38.2 vs. 24.0, P<0.001). Conclusion: Since the fraction of the 'PAR+/OGS+' group was less than 20% and there was no significant correlation between PAR-percentage reduction and T1-ABO-OGS, development of a new index system for the accurate evaluation of treatment outcome is needed.

• 근관절건강학회지
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• 제6권2호
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• pp.197-210
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• 1999

Muscle stiffness, pain and discomfort in dally activities are cardinal symtoms on arthritis. To reduce these symtoms, a nonequivalent one-group pre & posttest experiment was carried out at a rural community health post area in Chonbuk province during eight weeks (from 25th of January to 20th of March, 1999). The subjects were sixteen rural old women(65-89yrs) with osteoarthritis. And to reduce the level of pain, discomfort in daily living and to increase that of life satisfaction, 30 minutes of flexibility exercise followed by $15{\sim}20\;minutes$ of local heat therapy were done three times a week. Pain scale from Arthritis Impact Measurement Scales developed by Meenan(1980) for pain, Jette's Daily Activity Discomfort Scales revised by Lee(1988) for discomfort and Life Satisfaction Scales developed by Youn(1982) for life satisfaction were used as research instruments. The data were collected by face-to-face interviews with Investigator and the experiments were done under demonstration and supervision of investigator in community health post. The data were analyzed in percentage and Wilcoxon sign rank sum test by SPSS/PC+ program. The result could be summarized as follows ; 1. The scores of experiment group who were applied hot bag followed by flexibility exercise were tended to be significant lower in the level of pain statistically(Z=4.949, P=0.0001). 2. The scores of experiment group who was applied hot bag followed by flexibility exercise were tended to be significant lower in the level of discomfort in daily living statistically(Z=2.7226, P=0.0279). 3. The scores of experiment group who was applied hot bag followed by flexibility exercise were tended to be higher in the level of life satisfaction, but there was no significant statistical difference(Z=-1.2087, P=0.2171). In conclusion, flexibility exercise with local heat therapy could be identified as an effective therapy to reduce pain and discomfort in daily living of the rural elderly with osteoarthritis. And as a community health practitioner, the investigator concluded that this exercise with local heat therapy could be developed as a health promotion program for the rural aged people.

• 생물정신의학
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• 제18권2호
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• pp.95-100
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• 2011

Objectives To evaluate the drug interactions between aripiprazole and haloperidol, authors investigated plasma concentrations of those drugs by genotypes. Method Fifty six patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders 4th edition diagnosis of schizophrenia were enrolled in this eight-week, double blind, placebo-controlled study. Twenty-eight patients received adjunctive aripiprazole treatment and twenty-eight patients received placebo while being maintained on haloperidol treatment. Aripiprazole was dosed at 15 mg/day for the first 4 weeks, and then 30 mg for the next 4 weeks. The haloperidol dose remained fixed throughout the study. Plasma concentrations of haloperidol and aripiprazole were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) at baseline, week 1, 2, 4 and 8. $^*1$, $^*5$, and $^*10$ B alleles of CYP2D6 and $^*1$ and $^*3$ alleles of CYP3A5 were determined. The Student's T-test, Pearson's Chi-square test, Wilcoxon Rank Sum test and Logistic Regression analysis were used for data analysis. All tests were two-tailed and significance was defined as an alpha < 0.05. Results In the frequency of CYP2D6 genotype, $^*1/^*10$ B type was most frequent (36.5%) and $^*1/^*1$ (30.8%), $^*10B/^*10B$ (17.3%) types followed. In the frequency of CYP3A5 genotype, $^*3/^*3$ type was found in 63.5% of subjects, and $^*1/^*3$ type and $^*1/^*1$ were 30.8% and 5.8% respectively. The plasma levels of haloperidol and its metabolites did not demonstrate significant time effects and time-group interactions after adjunctive treatment of aripiprazole. The genotypes of CYP2D6 and 3A5 did not affect the plasma concentration of haloperidol in this trial. No serious adverse event was found after adding aripiprazole to haloperidol. Conclusion No significant drug interaction was found between haloperidol and aripiprazole. Genotypes of CYP2D6 and 3A5 did not affect the concentration of haloperidol after adding aripiprazole.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제10권1호
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• pp.76-90
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• 1999

자폐적인 아동은 사회적 발달의 기초인 모-아 애착에서부터 왜곡되어 있고 특히 일치적 애착 행동들이 저하되어 있음을 볼 수 있다. 이를 개선하기 위해서는 일치적 행동들의 정상적 발달양상과 관련 요소를 파악하는 것이 선행되어야 하겠기에 자폐군과 정상군 총 20쌍의 모-아 놀이를 비교분석하였다. 그 결과 자폐군의 일치적 행동들은 정상군에 비해 저하되어 있고 발달 경과도 느렸으며 특히 16개월 이상부터는 현저한 차이를 보였다. 일치성과 상관이 있는 어머니의 양육행위는 애정적 표현을 하고 적절한 행동 멈춤을 보이며 아동의 행동을 기다려주는 것이었다. 모-아 상호집중의 저해요소는 지시적이고 간섭하고 학습중심적인 어머니의 놀이 행위와 아동의 무관심, 무반응, 과제수행의 실패 등이었다. 그러나 아동의 수준을 고려해 적당히 자극적인 접근을 하였을 때 상호집중이 유발되고 지속되는 것을 볼 수 있었다.

• 한국경영과학회:학술대회논문집
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• 한국경영과학회/대한산업공학회 1999년도 춘계공동학술대회:정보화시대의 지식경영
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• pp.426-426
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• 1999

;There are many sources of uncertainty in a typical production and inventory system. There is uncertainty as to how many items customers will demand during the next day, week, month, or year. There is uncertainty about delivery times of the product. Uncertainty exacts a toll from management in a variety of ways. A spurt in a demand or a delay in production may lead to stockouts, with the potential for lost revenue and customer dissatisfaction. Firms typically hold inventory to provide protection against uncertainty. A cushion of inventory on hand allows management to face unexpected demands or delays in delivery with a reduced chance of incurring a stockout. The proposed strategies are used for the design of a probabilistic inventory system. In the traditional approach to the design of an inventory system, the goal is to find the best setting of various inventory control policy parameters such as the re-order level, review period, order quantity, etc. which would minimize the total inventory cost. The goals of the analysis need to be defined, so that robustness becomes an important design criterion. Moreover, one has to conceptualize and identify appropriate noise variables. There are two main goals for the inventory policy design. One is to minimize the average inventory cost and the stockouts. The other is to the variability for the average inventory cost and the stockouts The total average inventory cost is the sum of three components: the ordering cost, the holding cost, and the shortage costs. The shortage costs include the cost of the lost sales, cost of loss of goodwill, cost of customer dissatisfaction, etc. The noise factors for this design problem are identified to be: the mean demand rate and the mean lead time. Both the demand and the lead time are assumed to be normal random variables. Thus robustness for this inventory system is interpreted as insensitivity of the average inventory cost and the stockout to uncontrollable fluctuations in the mean demand rate and mean lead time. To make this inventory system for robustness, the concept of utility theory will be used. Utility theory is an analytical method for making a decision concerning an action to take, given a set of multiple criteria upon which the decision is to be based. Utility theory is appropriate for design having different scale such as demand rate and lead time since utility theory represents different scale across decision making attributes with zero to one ranks, higher preference modeled with a higher rank. Using utility theory, three design strategies, such as distance strategy, response strategy, and priority-based strategy. for the robust inventory system will be developed.loped.

• 대한간호학회지
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• 제30권3호
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• pp.549-559
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• 2000

The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

• Restorative Dentistry and Endodontics
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• 제27권1호
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• pp.34-43
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• 2002

The purpose of this study was to compare microleakage and marginal hybrid layer in class V restorations using two one-bottle adhesives and one self-etching adhesive. Class V cavity preparations with occlusal margins in enamel and gingival margins in dentin were pre-pared on buccal and lingual surfaces of 30 extracted human molar teeth. Prepared teeth were randomly divided into three treatment groups (n=30) and restored with three adhesives and composites: Single Bond/Filtek Z-250 (Group 1), Prime&BondNT/Esthet.X (Group 2), UniFil Bond/UniFil F (Group 3). For microleakage, samples were stored in room temperature water for 24 hours, thermocycled stained with 2% methylene blue dye, sectioned into halves, scored and analysed using Mann-whitney test and Wilcoxon signed rank sum test. For marginal hybrid layer, samples were sectioned into halves, treated with 10% phosphoric acid for 5 seconds, stored in 5% NaOCL solution for 24 hours, dried and gold coated. Occlusal and gingival margins of each sample were inspected under SEM. The results of this study were as follows ; 1. Microleakage at the occlusal margins was not evident in group 1 and group 2, but it showed in group 3 (p<0.05). 2. Microleakage in group 1 and group 3 was significantly lower than in group 2 at gingival margins (p<0.05). 3. Microleakage at gingival margins was greater than at occlusal margins in group 1 and group 2, but microleakage at occlusal margins was greater than at gingival margins in group 3 (p<0.05). 4. In group 1 and group 2, no gaps at occlusal margins showed. But gaps showed in group 3. Occlusal margins were free from a hybrid layer in all groups 5. The thickness of the marginal hybrid layers was 2.5~5 $\mu\textrm{m}$ thick in group 5 $\mu\textrm{m}$ thick in group 2 and 1.5 $\mu\textrm{m}$ thick in group 3. 6 There was no corelation between microleakage and thickness of marginal hybrid layer. In coclusion, the effect of dentin adhesives on microleakge in class V composite restorations was excellent when one-bottle adhesives were applied on enamel margin, and it was good when a self-etching adhesive was applied on dentinal margin. There was no corelation between microleakage and thickness of marginal hybrid layer.

• 임상간호연구
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• 제18권2호
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• pp.284-295
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• 2012

Purpose: This study was done to clarify effects of bispectral index monitoring sedative administration, compared to MOAA/S (Modified Observer's Assessment of Alertness and Sedation), on conscious sedation, physiological stability and recovery time for patients undergoing endoscopic submucosal dissection. Methods: Participants In this study were patients who underwent endoscopic submucosal dissection because of early gastric cancer. Participants were assigned randomly to an experimental group receiving sedatives based on bispectral index monitoring or to a control group with the MOAA/S instrument. Movements, belching, memory, pain, discomfort, physiological stability (MBP, PR, $SpO_2$), and recovery time were measured during the treatment and recovery. Data were analyzed using Spearman partial correlation coefficient analysis, Mixed model and Wilcoxon rank sum test to determine differences in the parameters. Results: There were no statistically significant differences between the two groups for conscious sedation(movement, belching, memory, pain, or discomfort), physiological stability and recovery time. Conclusion: The results of this study indicate that no differences were found between the two types of monitoring. Thus, use of a bispectral index monitor in clinical practice enabling medical staff to readily assess the conscious sedation of for these patients is expected to be increasingly used as an objective assessment tool for conscious sedation for patient safety.

• Journal of Chest Surgery
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• 제25권1호
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• pp.1-16
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• 1992

The quantitatively measured local myocardial perfusion rates with microspheres are used as an objective indicator of even distribution of cardioplegic solution, and the efficacy of the retrograde right atrial route of cardioplegia is evaluated in hearts with various levels of coronary arterial obstruction. After initial antegrade cardioplegia under the median sternotomy and aortic cannulation, 60 hearts from anesthetized New Zealand white rabbits are divided in random order as normal group [ligated left main coronary artery ; MA, MR] and diagonal group [ligated proximal diagonal artery ; LA, LR]. Half of each group [N=10] are perfused with antegrade cardioplegia[A] under the pressure of 100 cmH2O and the other half with retrograde right atrial route[R] under the pressure of 60 cmH2O[St. Thomas cardioplegic solution mixed with measured amount of microspheres]. The myocardium is subdivided into segments as A[atria], RV[right ventricle]. S[septum], LV[normally perfused left ventricular free wall], ROI[ischemic myocardium of left ventricular free wall]. LV and RQI are further divided into N[subendocardium] and P[subepicardium]. The resulting local myocardial perfusion rates and N /P of each group are compared with Wilcoxon rank sum test. The weight of the hearts is 5.94$\pm$0.66g, and there are no statistically significant dif-ferences[p>0.05, ANOVA] between six compared group. The mean flow rate[F: ml /g / min] of MR group is comparable with MA group[p>0.05], but in N and L group, there are significantly depressed F with right atrial route of cardioplegia, which means elevated perfusion resistance with this route. In spite of no significant differences in delivered doses of microsphere[DEL] between compared groups[p>0.05, ANOVA], there are significantly depressed REC and NF in hearts with right atrial cardioplegia which suggests increased requirement of cardioplegic solution with this route. The interventricular septum shows poor perfusion with right atrial route of cardioplegia without obstruction of supplying coronary arteries. But, with obstruction of coronary artery supplying septum as in M group, the flow rate is superior with right atrial route of infusion. The left ventricular free wall perfusion rates of every RQI with R route are superior to that of A route[p<0.05]. But, in LV segments, there are unfavorable effects of right atrial cardioplegia in L group, although the subendocardial perfusion is well maintained in N group. The LV free wall of left main group shows depressed perfusion rates with antegrade route as compared with RQI segments of diagonal group. But, by contraries, there are increased perfusion rates and superior N /P ratio with retrograde right atrial route. It implies more effective perfusion with right atrial route of cardioplegia in more proximal coronary arterial obstruction[i.e., M group as compared with L group]. As a conclusion, all region of ischemia have superior perfusion rates with right atrial car-dioplegia as compared with antegrade route, and especially excellent results can be obtained in hearts with more proximal obstruction of coronary arteries which would otherwise result in more severe ischemic damage. But, the depressed perfusion rates of the segments with normal coronary artery in hearts with coronary arterial obstruction may be a problem of concern with right atrial cardioplegia and needs solution.

• Journal of Hospice and Palliative Care
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• 제15권2호
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• pp.99-107
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• 2012

목적: 말기암환자의 여명 예측은 치료의 이득과 위해를 판단하는 잣대가 되고, 적절한 의료 중재 제공 및 환자의 자율성에 기초한 의사결정에 중요한 기준이 된다. 특히 많은 수의 말기암환자는 암성 식욕부진-악액질 증후군으로 사망에 이르기 때문에 본 연구에서는 이를 반영할 수 있는 혈장 렙틴 농도와 생존기간과의 연관성을 알아보고자 하였다. 방법: 2009년 7월부터 2010년 7월까지 13개월 동안, 만 20세 이상의 말기암환자 69명을 대상으로 혈장 렙틴 농도를 측정하고, 생존기간을 조사하였다. 나이, 성별, 원발암 부위, 암 치료 경력, 전이여부, 투약상황 및 활력증후, 백혈구 수, 혈색소, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), C-반응성 단백질, 총 빌리루빈, 총 콜레스테롤, 알부민, 렙틴 등의 혈액검사를 시행하였다. 결과: 혈장 렙틴 농도와 성별, 나이, 백혈구 수, 혈색소, AST, ALT, 총 빌리루빈, C-반응성 단백질, 통증강도 등의 상관 관계 분석 결과 렙틴과 생존기간에는 통계적으로 유의한 양의 상관 관계를 보였으며, 단변량 분석한 결과 혈장 렙틴 농도는 생존기간과 통계적으로 경계수준의 유의한 관계를 보였으나, 단변량 분석에서 생존 기간에 유의한 영향을 미치는 성별, 백혈구 수, AST, ALT, 총 빌리루빈, 알부민, C-반응성 단백질을 포함하여 시행한 다변량 분석에서 혈장 렙틴 농도는 생존기간과 통계적으로 유의한 관계가 없는 것으로 나타났다. 결론: 암성 식욕부진-악액질 증후군과 관련이 있는 혈장 렙틴 농도와 말기암환자의 생존기간과는 통계적으로 유의한 연관성을 보이지는 않았다. 그러나, 소화기계암환자에 있어서는 혈장 렙틴 농도가 생존기간 예측인자로서 쓰일 수 있는 가능성을 보여주었다.