• 한국농공학회논문집
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• 제55권4호
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• pp.95-106
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• 2013

It is now generally known that dynamical climate modeling outputs include systematic biases in reproducing the properties of atmospheric variables such as, preciptation and temerature. There is thus, general consensus among the researchers about the need of bias-correction process prior to using climate model results especially for hydrologic applications. Among the number of bias-correction methods, distribution (e.g., cumulative distribution fuction, CDF) mapping based approach has been evaluated as one of the skillful techniques. This study investigates the uncertainty of using various CDF mapping-based methods for bias-correciton in assessing regional climate change Impacts. Two different dynamicailly-downscaled Global Circulation Model results (CCSM and GFDL under ARES4 A2 scenario) using Regional Spectial Model for retrospective peiod (1969-2000) and future period (2039-2069) were collected over the west central Florida. Total 12 possible methods (i.e., 3 for developing distribution by each of 4 for estimating biases in future projections) were examined and the variations among the results using different methods were evaluated in various ways. The results for daily temperature showed that while mean and standard deviation of Tmax and Tmin has relatively small variation among the bias-correction methods, monthly maximum values showed as significant variation (~2'C) as the mean differences between the retrospective simulations and future projections. The accuracy of raw preciptiation predictions was much worse than temerature and bias-corrected results appreared to be more significantly influenced by the methodologies. Furthermore the uncertainty of bias-correction was found to be relevant to the performance of climate model (i.e., CCSM results which showed relatively worse accuracy showed larger variation among the bias-correction methods). Concludingly bias-correction methodology is an important sourse of uncertainty among other processes that may be required for cliamte change impact assessment. This study underscores the need to carefully select a bias-correction method and that the approach for any given analysis should depend on the research question being asked.

• Journal of the Korean Data and Information Science Society
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• 제26권6호
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• pp.1317-1325
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• 2015

두 집단간을 비교하는 다양한 임상연구에서 수집된 데이터를 분석할 때 질환에 미치는 영향을 알아보는 방법으로는 현 시점에서 어떤 특정 질환을 일으킬 수 있는 위험요인포함 우, 무에 띠라 연구대상자를 나누어, 추적 관찰하는 전향적 임상연구에서의 분석과 현 시점에서 질환 유, 무에 따라 위험요인을 과거의 연구대상자의 관찰기록을 바탕으로 확인하는 후향적 임상연구에서의 분석이 있다. 접근 방법과 연구 설계는 다르지만 두 가지 연구의 목적은 두 집단 간 명확한 차이를 확인하는데 있으며, 나아가 두집단의 분류에 영향을 주는 변수가 무엇인지를 알아보는 방법이다. 특히 임상연구에서 두 집단을 비교할 때 성별과 나이와 같은 기본적 특성변수의 영향을 통제한 상태에서 임상적 변수들의 집단 간 차이와 영향을 살펴보아야 한다. 하지만 후향적 연구에서는 과거의 관찰기록을 바탕으로 분석이 진행되는 연구이므로 연구대상자를 두 집단으로 무작위 할당하지 못했기 때문에 기본적인 특성변수들이 차이가 나는 경우가 빈번하게 발생할 수 있다. 이를 해결하기 위하여 임상자료를 분석하는 방법으로 공변량을 사용한다. 대표적으로 공변량을 사용하는 분석방법으로는 공분산분석, 수정회귀모형, propensity score matching 방법 등이 있다. 본 연구는 후향적 임상연구에서 공변량을 이용한 자료 분석 방법 및 propensity score matching 방법을 소개하고, 실제 위암 환자들의 재발관련 자료에 적용하여, 그 필요성을 확인한다.

• Journal of Periodontal and Implant Science
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• 제51권5호
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• pp.364-372
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• 2021

Purpose: This study aimed to clinically evaluate the efficacy of vestibuloplasty around lower molar implants using 3 different modalities: apically positioned flap alone (APF), APF with a free gingival graft (FGG), and APF with modified periosteal fenestration (mPF). Methods: Three different vestibuloplasty procedures during second-stage implant surgery were performed at the mandibular molar area in 61 patients with a shallow vestibule and insufficient keratinized tissue (KT). The clinical measurements of KT width were recorded at baseline, immediately after surgery (T0), 6 months after surgery (T6), and 12 months after surgery (T12). Soft tissue esthetic scores were measured. Results: An additional KT width gain from baseline to T12 of approximately 2 mm was obtained with FGG and mPF compared to that with APF. Shrinkage of the re-established tissue was lower with mPF and FGG than with APF, whereas the esthetic profile was better with APF and mPF than with FGG. Conclusions: Within the limitations of this study, mPF showed potential as a promising approach for vestibuloplasty around the lower molar implants compared to the traditional APF and FGG.

• Journal of Periodontal and Implant Science
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• 제51권6호
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• pp.433-443
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• 2021

Purpose: This study aimed to evaluate the effectiveness of the partial split-flap technique with a K-incision on vertical guided bone regeneration (vGBR) and to retrospectively analyze the clinical and radiographic outcomes of dental implantation using this approach. Methods: In total, 78 patients who received 104 dental implants with vGBR, categorized as (1) pre-GBR and post-implantation and (2) simultaneous GBR and implantation, were enrolled. Data analysis was based on periapical radiographs, clinical photos, and dental records. The 2-sample t-test was used to compare the 2 surgical procedures. Results: The baseline vertical bone level, augmented bone height (ABH), and treatment duration were significantly higher in the pre-GBR procedure group. The survival rates of the implants were 96.1% and 94.8% in implant- and patient-based analyses, respectively. In Cox regression analysis, high rates of implant failure were found in the presence of ABH of ≥4 mm, smoking, and diabetes. Conclusions: Within the limitations of this retrospective study, the partial split-flap technique using a K-incision for vGBR showed stable clinical outcomes and favorable dental implant survival.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.502-508
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• 2022

Objective: Contralateral seventh cervical nerve transfer (contralateral C7 transfer) is a newly attempted method to restore upper extremity motor function in the patients with spastic arm paralysis. The aim of this study was to investigate the effects of contralateral C7 transfer on upper extremity motor function in the patients with spastic hemiplegia after stroke. Design: A retrospective cohort study. Methods: Thirty-four patients with spastic hemiplegia after stroke was investigated. All patients registered between January 2020 and February 2021. The subjects were assessed on upper extremity motor function, cognition, and spasticity before and after contralateral C7 transfer. The upper extremity motor function was measured using the Fugl-Meyer upper extremity scale and box & block test. The cognition and spasticity were assessed by Korean version mini mental state examination (K-MMSE) and modified Ashworth scale from baseline to 8 weeks after the surgery. Results: The Fugl-Meyer upper extremity scale and modified Ashworth scale were significantly improved after contralateral C7 transfer (p<0.05). However, box & block test and K-MMSE were no significant changes after the surgery (p>0.05). Conclusions: This study suggested that the contralateral C7 transfer was a feasible and practical approach to improve upper extremity motor function in the patients with spastic hemiplegia after stroke, but further study is required to identify the long-term effects after the contralateral C7 transfer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3483-3486
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• 2014

Background: To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology. Materials and Methods: A retrospective review of patients with abnormal cervical cytology who underwent S&T at MSMC between January 2008 and December 2012 was conducted. Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors. Results: Average age of S&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%. Conclusions: S&T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.191-199
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• 2019

Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.

• Archives of Plastic Surgery
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• 제48권3호
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• pp.287-292
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• 2021

Background We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis. Methods A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications. Results The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure. Conclusions A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.86-90
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• 2009

Purpose: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The purpose of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of $Medpor^{(R)}$ through subciliary approach. Methods: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of $Medpor^{(R)}$ through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient's charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. Results: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. Conclusion: The ballooning of foley catheter through endoscopic transnasal approach with implantation of $Medpor^{(R)}$ through subciliary approach can be considered one of the appropriate technique for extensive inferior blowout fracture.

• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.136-143
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• 2020

Background: The purpose of this study was to investigate the clinical differences between open reduction and plate fixation via a deltopectoral approach with allogenous fibular bone graft and a minimally invasive plate osteosynthesis (MIPO), in Neer's classification two-, threepart proximal humeral fractures. Methods: In this retrospective study, 77 patients with two-, three-part proximal humeral fractures were treated at two different institutions. Clinical and radiological evaluations were performed in 39 patients, who underwent MIPO at one institution (group A), and 38 patients, who underwent a deltopectoral approach with allo-fibular bone graft (group B) at another institution. The results between the groups were compared. Results: The MIPO technique was significantly less time consuming and caused less bleeding than the deltopectoral approach with allo-fibular bone graft (P<0.05). The duration of the fracture union was significantly reduced in group A (14.5±3.4; range, 10-22 weeks) compared to group B (16.4±4.3; range, 12-28) weeks (P<0.05). There were no statistically significant differences between the two groups when evaluating the visual analog scale and Constant scores between the two groups, 1 year postoperatively. In radiological evaluation, there was no difference in radiological outcomes between the two groups. There were no statistically significant differences in malunion between the two groups. Conclusions: The MIPO technique and deltopectoral approach with allo-fibular bone graft for two-, three-part proximal humeral fractures, show similar clinical and radiological results. However, allogenous fibular grafts require longer surgery, cause more bleeding, and result in longer fracture healing time than MIPO technique.