• Title/Summary/Keyword: Single point tool

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The Role of Pectoralis Major Myocutaneous Flap in the Era of Free Flap (유리피판 시대의 대흉근피판의 역할)

  • Choi Eun-Chang;Kim Chul-Ho;Kim Se-Heon;Kim Young-Ho;Kim Kwang-Moon
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.190-193
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    • 2001
  • Background and Objectives: Reliable and versatile free flap has become a mainstay in reconstruction of the head and neck. But until now pectoralis major myocutaneous flap (PMMCF) as workhorse is useful and has some advantages such as good viability, one-stage reconstruction and carotid protection. The objective of this study was to review the role and indication of PMMCF in this era of potent free flaps for head and neck reconstruction. Patients and Methods: Sixty one PMMCF and one hundred forty six free flaps used for head and neck reconstruction between 1991 and 2001 were reviewed retrospectively. We compared the applied sites of flap, the flap failure rate and complications. Results: Contrary to the free flap, use of PMMCF has gradually decreased after the middle of 1990s. PMMCF were mainly used for mucosal defect(33cases, 54.1%) and cervical skin defect(22cases, 36.1%) and free flap were mainly used for mucosal defect(129cases, 88.4%). In point of use of PMMCF according to years, from 1991 to 1997, 30cases(70%) are used to reconstruct mucosal defect and 12cases(29%) are used to reconstruct skin defect. But from 1998 to 2001, only 2cases(10.5%) are used to reconstruct mucosal defect and 13cases(68.4%) are used to reconstruct neck skin defect. In case of free flap, from 1991 to 1997, 41cases (87%) are used to reconstruct mucosal defect and from 1998 to 2001 88cases(89%) are used as same purpose. Three major necrosis (more than 50%) deveolped in 61 PMMCF (4.9%) and three major necrosis developed in 146 free flaps(2.1%). Conclusion: PMMCF is no longer flap of choice for primary reconstruction but it is a still one of a good tool in some head and neck reconstruction such as covering single wide defect of face or neck skin, back-up procedure of free flap, postoperative status, treatment of pharyngocutaneous fistula and covering vital structure.

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MLPA Applications in Genetic Testing (유전자진단에 있어서 Multiplex Ligation Dependent Probe Amplification (MLPA)의 이론과 실제)

  • Kim, Gu-Hwan;Lee, Beom-Hee;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.146-154
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    • 2009
  • Multiplex ligation dependent probe amplification (MLPA) is a PCR-based method to detect gene dosage. Since its introduction, MLPA has been used to test a large number of genes for major deletions or duplications. Genetic testing, as a diagnostic tool for genetic disease, has been used primarily to identify point mutations, including base substitutions and small insertions/deletions, using PCR and sequence analysis. However, it is difficult to identify large deletions or duplications using routine PCR- gel based assays, especially in heterozygotes. The MLPA is a more feasible method for identification of gene dosage than another routine PCR-based methods, and better able to detect deleterious deletions or duplications. In addition to detection of gene dosage, MLPA can be applied to identify methylation patterns of target genes, aneuploidy during prenatal diagnoses, and large deletions or duplications that may be associated with various cancers. The MLPA method offers numerous advantages, as it requires only a small amount of template DNA, is applicable to a wide variety of applications, and is high-throughput. On the other hand, this method suffers from disadvantages including the possibility of false positive results affected by template DNA quality, difficulties identifying SNPs located in probe sequences, and analytical complications in quantitative aspects.

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Revisit of the Extended Indications and Clinical Utilities of Arterialized Venous Flap for Hand Reconstruction (수부 재건을 위한 동맥화 정맥 피판의 확장된 적응증과 임상적 유용성의 재조명)

  • Woo, Sang-Hyun;Kim, Kyung-Chul;Lee, Gi-Jun;Ha, Seung-Han;You, Sun-O;Kim, Joo-Sung
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.1-13
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    • 2005
  • Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

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The effectiveness of Cardiopulmonary Resuscitation training in elementary students (일부 초등학생의 심폐소생술교육의 효과)

  • Kim, Hee-Jung;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.2
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    • pp.51-66
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    • 2007
  • Purpose: With a view to providing basic data to develop cardiopulmonary resuscitation education suitable for elementary students, the cardiopulmonary resuscitation education was conducted to grasp students' knowledge, skills accuracy and the attitude change before and after the education. Methods: Convenience sampling was made on fourth and fifth graders(total-35 students) of S elementary school located in K city, Chungcheongnam-do, and this was a pre-experiment research designed before and after choosing a single group. In terms of methods, specifically we, researchers ; 1) Handed out questionnaires to students directly to make them fill in firsthand and collected the questionnaires. 2) Utilized PPT materials based on 2005 AHA guideline and DVD materials of AHA, to give students theoretical education of cardiopulmonary resuscitation. We used Anne/SkillReporter$^{(R)}$ torso produced by Leardal Inc, and Little Anne to conduct practical education individually. 3) Asked students to give Anne/SkillReporter$^{(R)}$ torso cardiopulmonary resuscitation five times with the ratio of 30 : 2, and then one of researchers filled in the evaluation sheet individually. 4) Evaluated the accuracy of students' ability to perform the resuscitation based on the record of Anne/SkillReporter$^{(R)}$ integrated printer(which was the objective tool to grasp students' skills accuracy). 5) Gave out questionnaires to make students fill them in and then collected them. after completing the practical evaluation. Results: 1) In case of the attitude about cardiopulmonary resuscitation, Students' confidency rose from 19.28%(before the education) to 93.57(after the education)- which is a positive change. 2) As the result of the education, some elementary students scored 11 points (full score-16 points), up from 5 points before the education, in terms of the knowledge about cardiopulmonary resuscitation. The average point also reached 13.14 points(after the education), jump from 8.37(before the education), which was the rise of 29.8%. 3) When it comes to the practical performance, the skills accuracy was 80.93% on average, and the calculation method was as follows: total items were 16, and each item was marked form 0 to 2 points, meaning the full score was 32 points. The minimum score was 19 points and the maximum was 32($M{\pm}SD=25.90{\pm}2.88$), which was calculated based on percentage. 4) Regarding skills accuracy, respiration accuracy(%)($M{\pm}SD=30.20{\pm}27.16$) was higher than pressure accuracy(%) ($M{\pm}SD=15.34{\pm}25.27$). Conclusion: The result showed that students' attitude on cardiopulmonary resuscitation changed positively. and meaningful difference(p = .00) existed in the change of students' knowledge. In terms of skills accuracy. chest compression and airway control showed high accuracy, but the result of Anne/SkillReporter$^{(R)}$ performance showed that the accuracy of chest compression was lower than that of mouth-to-mouth resuscitation.

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The Cumulative Recurrence Rate of Colonic Adenomatous Polyps After Colon Polypectomy in a Single University Hospital Health Check-up Examinees (일개 대학병원 건강검진 수진자를 대상으로 한 선종성 대장용종절제술 후 대장용종의 누적재발률)

  • Hwang, Hye-Lim;Jung, Woo-Geun;Kim, Yun-Jin;Lee, Sang-Yeoup;Cho, Byung-Mann;Yi, Yu-Hyeon;Cho, Young-Hye;Tak, Young-Jin;Jeong, Dong-Wook;Lee, Jeong-Gyu
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.137-145
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    • 2014
  • Objectives: Colonoscopy is a popular tool for screening for colon cancer throughout the world. The incidence of polypectomy and follow-up colonoscopy are persistently increasing but the studies about follow-up test after polypectomy are still lack of its domestic sources. This study is designed to look into the recurrence rate of colon polyps and risk factors after polypectomy. Methods: This is a retrospective study by reviewing medical charts of 147 patients who underwent polypectomy and follow-up colonoscopy from Jan. 2000 to Mar. 2008. The Kudo classification was used to describe the polyps found in the colonoscopy. The follow-up period was defined as the term between polypectomy and the first colonoscopy follow up. Results: Seventy six point two percent of the enrolled patient were male and the mean age was $56.5{\pm}8.1$. Mean follow-up period was $24.9{\pm}13.7$ (6 - 65) months. The cumulative recurrence rate of 1 year was 11.6%. The rate of 2 years was 36.7% and that of 3 years was 55.8%. The number of polyps was the factor which statistically showed significant relation of its recurrence rate. The histological morphology characteristic of polyps could be one independent factor which may be associated to the recurrence of polyps. Conclusions: The importance of colonoscopy follow up after polypectomy was clearly emphasized through the cumulative recurrence rate of 55.8%. Therefore, there is a need for more domestic studies with a large number of patients about the recurrence of polyps after polypectomy.

Preliminary Study for Imaging of Therapy Region from Boron Neutron Capture Therapy (붕소 중성자 포획 치료에서 치료 영역 영상화를 위한 예비 연구)

  • Jung, Joo-Young;Yoon, Do-Kun;Han, Seong-Min;Jang, HongSeok;Suh, Tae Suk
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.151-156
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    • 2014
  • The purpose of this study was to confirm the feasibility of imaging of therapy region from the boron neutron capture therapy (BNCT) using the measurement of the prompt gamma ray depending on the neutron flux. Through the Monte Carlo simulation, we performed the verification of physical phenomena from the BNCT; (1) the effects of neutron according to the existence of boron uptake region (BUR), (2) the internal and external measurement of prompt gamma ray dose, (3) the energy spectrum by the prompt gamma ray. All simulation results were deducted using the Monte Carlo n-particle extended (MCNPX, Ver.2.6.0, Los Alamos National Laboratory, Los Alamos, NM, USA) simulation tool. The virtual water phantom, thermal neutron source, and BURs were simulated using the MCNPX. The energy of the thermal neutron source was defined as below 1 eV with 2,000,000 n/sec flux. The prompt gamma ray was measured with the direction of beam path in the water phantom. The detector material was defined as the lutetium-yttrium oxyorthosilicate (Lu0,6Y1,4Si0,5:Ce; LYSO) scintillator with lead shielding for the collimation. The BUR's height was 5 cm with the 28 frames (bin: 0.18 cm) for the dose calculation. The neutron flux was decreased dramatically at the shallow region of BUR. In addition, the dose of prompt gamma ray was confirmed at the 9 cm depth from water surface, which is the start point of the BUR. In the energy spectrum, the prompt gamma ray peak of the 478 keV was appeared clearly with full width at half maximum (FWHM) of the 41 keV (energy resolution: 8.5%). In conclusion, the therapy region can be monitored by the gamma camera and single photon emission computed tomography (SPECT) using the measurement of the prompt gamma ray during the BNCT.

A Hybrid Recommender System based on Collaborative Filtering with Selective Use of Overall and Multicriteria Ratings (종합 평점과 다기준 평점을 선택적으로 활용하는 협업필터링 기반 하이브리드 추천 시스템)

  • Ku, Min Jung;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.85-109
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    • 2018
  • Recommender system recommends the items expected to be purchased by a customer in the future according to his or her previous purchase behaviors. It has been served as a tool for realizing one-to-one personalization for an e-commerce service company. Traditional recommender systems, especially the recommender systems based on collaborative filtering (CF), which is the most popular recommendation algorithm in both academy and industry, are designed to generate the items list for recommendation by using 'overall rating' - a single criterion. However, it has critical limitations in understanding the customers' preferences in detail. Recently, to mitigate these limitations, some leading e-commerce companies have begun to get feedback from their customers in a form of 'multicritera ratings'. Multicriteria ratings enable the companies to understand their customers' preferences from the multidimensional viewpoints. Moreover, it is easy to handle and analyze the multidimensional ratings because they are quantitative. But, the recommendation using multicritera ratings also has limitation that it may omit detail information on a user's preference because it only considers three-to-five predetermined criteria in most cases. Under this background, this study proposes a novel hybrid recommendation system, which selectively uses the results from 'traditional CF' and 'CF using multicriteria ratings'. Our proposed system is based on the premise that some people have holistic preference scheme, whereas others have composite preference scheme. Thus, our system is designed to use traditional CF using overall rating for the users with holistic preference, and to use CF using multicriteria ratings for the users with composite preference. To validate the usefulness of the proposed system, we applied it to a real-world dataset regarding the recommendation for POI (point-of-interests). Providing personalized POI recommendation is getting more attentions as the popularity of the location-based services such as Yelp and Foursquare increases. The dataset was collected from university students via a Web-based online survey system. Using the survey system, we collected the overall ratings as well as the ratings for each criterion for 48 POIs that are located near K university in Seoul, South Korea. The criteria include 'food or taste', 'price' and 'service or mood'. As a result, we obtain 2,878 valid ratings from 112 users. Among 48 items, 38 items (80%) are used as training dataset, and the remaining 10 items (20%) are used as validation dataset. To examine the effectiveness of the proposed system (i.e. hybrid selective model), we compared its performance to the performances of two comparison models - the traditional CF and the CF with multicriteria ratings. The performances of recommender systems were evaluated by using two metrics - average MAE(mean absolute error) and precision-in-top-N. Precision-in-top-N represents the percentage of truly high overall ratings among those that the model predicted would be the N most relevant items for each user. The experimental system was developed using Microsoft Visual Basic for Applications (VBA). The experimental results showed that our proposed system (avg. MAE = 0.584) outperformed traditional CF (avg. MAE = 0.591) as well as multicriteria CF (avg. AVE = 0.608). We also found that multicriteria CF showed worse performance compared to traditional CF in our data set, which is contradictory to the results in the most previous studies. This result supports the premise of our study that people have two different types of preference schemes - holistic and composite. Besides MAE, the proposed system outperformed all the comparison models in precision-in-top-3, precision-in-top-5, and precision-in-top-7. The results from the paired samples t-test presented that our proposed system outperformed traditional CF with 10% statistical significance level, and multicriteria CF with 1% statistical significance level from the perspective of average MAE. The proposed system sheds light on how to understand and utilize user's preference schemes in recommender systems domain.

Dual Path Model in Store Loyalty of Discount Store (대형마트 충성도의 이중경로모형)

  • Ji, Seong-Goo;Lee, Ihn-Goo
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.1-24
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    • 2010
  • I. Introduction The industry of domestic discount store was reorganized with 2 bigs and 1 middle, and then Home Plus took over Home Ever in 2008. In present, Oct, 2008, E-Mart has 118 outlets, Home Plus 112 outlets, and Lotte Mart 60 stores. With total number of 403 outlets, they are getting closer to a saturation point. We know that the industry of discount store has been getting through the mature stage in retail life cycle. There are many efforts to maintain existing customers rather than to get new customers. These competitions in this industry lead firms to acknowledge 'store loyalty' to be the first strategic tool for their sustainable competitiveness. In other words, the strategic goal of discount store is to boost up the repurchase rate of customers throughout increasing store loyalty. If owners of retail shops can figure out main factors for store loyalty, they can easily make more efficient and effective retail strategies which bring about more sales and profits. In this practical sense, there are many papers which are focusing on the antecedents of store loyalty. Many researchers have been inspecting causal relationships between antecedents and store loyalty; store characteristics, store image, atmosphere in store, sales promotion in store, service quality, customer characteristics, crowding, switching cost, trust, satisfaction, commitment, etc., In recent times, many academic researchers and practitioners have been interested in 'dual path model for service loyalty'. There are two paths in store loyalty. First path has an emphasis on symbolic and emotional dimension of service brand, and second path focuses on quality of product and service. We will call the former an extrinsic path and call the latter an intrinsic path. This means that consumers' cognitive path for store loyalty is not single but dual. Existing studies for dual path model are as follows; First, in extrinsic path, some papers in domestic settings show that there is 'store personality-identification-loyalty' path. Second, service quality has an effect on loyalty, which is a behavioral variable, in the mediation of customer satisfaction. But, it's very difficult to find out an empirical paper applied to domestic discount store based on this mediating model. The domestic research for store loyalty concentrates on not only intrinsic path but also extrinsic path. Relatively, an attention for intrinsic path is scarce. And then, we acknowledge that there should be a need for integrating extrinsic and intrinsic path. Also, in terms of retail industry, this study is meaningful because retailers want to achieve their competitiveness by using store loyalty. And so, the purpose of this paper is to integrate and complement two existing paths into one specific model, dual path model. This model includes both intrinsic and extrinsic path for store loyalty. With this research, we would expect to understand the full process of forming customers' store loyalty which had not been clearly explained. In other words, we propose the dual path model for discount store loyalty which has been originated from store personality and service quality. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. II. Research Model Dual path model integrates intrinsic path and extrinsic path into one specific model. Intrinsic path put an emphasis on quality characteristics and extrinsic path focuses on brand characteristics. Intrinsic path is based on information processing perspective, and extrinsic path emphasizes symbolic and emotional dimension of brand. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. Hypotheses are as follows; Hypothesis 1: Service quality perceived by customers in discount store has an positive effect on customer satisfaction Hypothesis 2: Store personality perceived by customers in discount store has an positive effect on store identification Hypothesis 3: Customer satisfaction in discount store has an positive effect on store loyalty. Hypothesis 4: Store identification has an positive effect on store loyalty. III. Results and Implications We examined consumers who patronize discount stores for samples of this study. With the structural equation model(SEM) analysis, we empirically tested the validity and fitness of the dual path model for store loyalty in discount stores. As results, the fitness indices of this model were well fitted to data obtained. In an intrinsic path, service quality(SQ) is positively related to customer satisfaction(CS), customer satisfaction(CS) has very significantly positive effect on store loyalty(SL). Also, in an extrinsic path, the store personality(SP) is positively related to store identification(SI), it shows significant effect on store loyalty. Table 1 shows the results as follows; There are some theoretical and practical implications. First, Many studies on discount store loyalty have been executed from various perspectives. But there has been no integrative view on this issue. And so, this research was theoretically designed to integrate various and controversial arguments into one systematic model. We empirically tested dual path model forming store loyalty, and brought up a systematic and integrative framework for future studies. We want to expect creative and aggressive research activities. Second, a few established papers are focused on the relationship between antecedents and store loyalty; store characteristics, atmosphere, sales promotion in store, service quality, trust, commitment, etc., There has been some limits in understanding thoroughly the formation process of store loyalty with a singular path, intrinsic or extrinsic. Beyond these limits in single path, we could propose the new path for store loyalty. This is meaningful. Third, discount store firms make and execute marketing strategies for increasing store loyalty. This research provides real practitioners with reference framework needed for actual strategy formation. Because this paper shows integrated and systematic path for store loyalty. A special feature of this study is to represent 6 sub dimensions of service quality in intrinsic path and 4 sub dimensions of store personality in extrinsic path. Marketers can make more analytic marketing planning with concrete sub dimensions of service quality and store personality. When marketers of discount stores make strategic planning like MPR, Ads, campaign, sales promotion, they can use many items which are more competitive than competitors.

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