• Title/Summary/Keyword: Total Scoring Method

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Immediate Partial Breast Reconstruction with Endoscopic Latissimus Dorsi Muscle Flap Harvest

  • Yang, Chae Eun;Roh, Tai Suk;Yun, In Sik;Kim, Young Seok;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.513-519
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    • 2014
  • Background Currently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars. Methods Ten patients who underwent partial mastectomy and immediate partial breast reconstruction with endoscopic latissimus dorsi muscle flap harvest were reviewed retrospectively. The total operation time, hospital stay, and complications were reviewed. Postoperative scarring, overall shape of the reconstructed breast, and donor site deformity were assessed using a 10-point scale. Results In the mean follow-up of 11 weeks, no tumor recurrence was reported. The mean operation time was 294.5 (${\pm}38.2$) minutes. The postoperative hospital stay was 11.4 days. Donor site seroma was reported in four cases and managed by office aspiration and compressive dressing. Postoperative scarring, donor site deformity, and the overall shape of the neobreast were acceptable, scoring above 7. Conclusions Replacement of 20% to 40% of breast volume in the upper and the lower outer quadrants with a latissimus dorsi muscle flap by using endoscopic harvesting is a good alternative reconstruction technique after partial mastectomy. Short incision benefits from a very acceptable postoperative scar, less pain, and early upper extremity movement.

A study of Teacher's Perception on Selecting Mathematics Textbook (수학 교과서 선정 기준에 관한 교사들의 인식 조사)

  • Jong, Yu Hyun;Kyoung, Ko Ho
    • Journal of Science Education
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    • v.37 no.2
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    • pp.245-260
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    • 2013
  • The purpose of the research is to examine the teachers' cognition about the math textbook selecting and to provide the implications about the rational process of the textbook selection and criteria based on the research. In terms of the research result about the inner and outer criteria of the actual process of the textbook selecting, they utilized the standard selection criteria distributed by Office of Education, and they considered 'Organization of learning contents' and 'Learning evaluation' as the most important factors. The selection method was that the answer 'After scoring the grade with matching standards, selecting by adding the total score' was the highest. In case of the actual selection, the most considerable inner criteria appeared 'Learning quantity and propriety of the difficulty level'. The outer criteria showed 'Awareness', and the difficulty in the selection process was 'in sufficient time for reviewing'. Based on this research result, we draw the implication that needs to be improved in the process of the textbook selection and the criteria.

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Experimental Study Trends on the Acupuncture Moxibustion Treatment for Visceral Hypersensitivity: Based on the Data of PubMed (내장감각과민의 침구 치료에 대한 실험연구 현황: PubMed를 중심으로)

  • Han, Chang Woo;Choi, Jun-Yong;Park, Seong Ha;Kim, So Yeon
    • Korean Journal of Acupuncture
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    • v.36 no.2
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    • pp.93-103
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    • 2019
  • Objectives : The aim of this study is to review the current trends in experimental studies on the acupuncture moxibustion treatment for visceral hypersensitivity. Methods : PubMed was searched for experimental studies about visceral hypersensitivity and acupuncture/moxibustion. Data were extracted and tabulated from the selected articles about experimental method, intervention, result and mechanism. Results : Total 23 articles were reviewed. Chronic visceral hypersensitivity animal model was applied in 17 studies (74%). Visceral hypersensitivity was measured by abdominal withdrawal reflex scoring or/and abdominal electromyogram. Acupoints like ST25, ST36, ST37, BL25, LI11, BL32 and PC6 were treated by electroacupuncture or moxibustion. All articles reported that electroacupuncture or moxibustion treatment is significantly effective in reducing visceral hypersensitivity. Treatment mechanisms were studied, related to mast cell, serotonin (5-HT) and receptor (5-HT3R and 5-HT4R), substance P (SP), vasoactive intestinal polypeptide (VIP), c-fos positive cell, corticotropin-releasing hormone (CRH), purinergic 2X (P2X)2, P2X3, P2X4, P2X7, N-methyl-D-aspartate (NMDA) receptor (NR1 and NR2B), prokinectin (PK) 1 and PK2. Conclusions : Evidences on acupuncture/moxibustion treatment for visceral hypersensitivity in animal studies warrant more research on effective acupoins, electro-acupuncture methods and treatment durations.

Clinical Research Using Salviae Miltiorrhizae Radix-Pharmacopuncture for Lumbar Herniated Intervertebral Disc: Analysis of Trends

  • Kim, Seon Woo;Park, Cheol Woo;Jo, Myeong Jae;Kim, Min Wook;Yu, Jae Hee;Hee, Jeon Seok;Jang, Seung Won;Kang, Do Young;Jeong, Hyun Jin
    • Journal of Acupuncture Research
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    • v.38 no.1
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    • pp.1-7
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    • 2021
  • This review of national and international randomized controlled trials of Salviae miltiorrhizae radix pharmacopuncture for lumbar herniated intervertebral discs was performed to assess its clinical efficacy. There were 5 online databases (PubMed, EMBASE, CNKI, NDSL, OASIS, and RISS) searched on June 1st, 2020. Studies were selected according to the inclusion and exclusion criteria and were reviewed by risk of bias assessment. This review included 14 Chinese studies. The sample sizes ranged from 50 to 100. The numbers of treatments ranged from 20 to 30, with most patients receiving 20 treatments. The longest treatment periods were 10-15 and 15-20 days, of which each accounted for 29% of the studies. The most frequently used evaluation indices were the Japanese Orthopedic Association and the Visual Analog Scale scoring method. The most frequently used acupoints were EX18 and BL25, which accounted for 31% of the total number of acupoints. In 50% of the studies, the pharmacopuncture injection volume was 2 mL. Acupuncture treatment was the most common control group. Eleven studies reported that the intervention group had significantly improved symptoms. However, most of the included studies were of low quality.

Effects of Limited Dorsiflexion Range of Motion on Movement Strategies during Landing (발등굽힘 관절가동범위 제한이 착지 시 움직임 전략에 미치는 영향)

  • Inje Lee;Donggun Kim;Hyeondeukje Kim;Hyunsol Shin;Jiwon Lee;Yujin Jang;Myeongwoo Pi
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.147-154
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    • 2023
  • Objective: This study aimed 1) to compare the Landing Error Scoring System (LESS) score and movement patterns during landing of the lesser dorsiflexion range of motion (LDFROM) group to that with the greater dorsiflexion range of motion group, and 2) to identify the correlation between the weight-bearing dorsiflexion range of motion (WBDF ROM), LESS score, and movement patterns during landing. Method: Fifty health adults participated in this study. WBDF ROM was measured using the weight bearing lunge test while movement patterns during landing was assessed using the LESS. The joint angles of the ankle, knee and hip joints during landing were analyzed using the 2D video analysis. After mean value of WBDF ROM was calculated, participants were divided into two groups (GDFROM and LDFROM) based on the mean value. The Mann-Whiteny 𝒰 test was used to identify differences in movement strategies during landing between two groups and the Pearson's correlation analysis was performed to determine relationships between WBDF ROM and movement strategies. Results: The LDFROM group showed the poorer LESS score and stiffer landing kinematics during landing compared to the GDFROM group (p<0.05). In addition, DFROM was significantly related to the LESS score and landing kinematics (p<0.05) except for total hip excursion (p=0.228). Conclusion: Our main findings showed that the LDFROM group had poorer landing quality and stiffer landing movements compared to the GDFROM group. In addition, increase of WBDF ROM significantly improved landing quality and soft-landing movements. To reduce shock during landing such as ground reaction forces, individuals need to better utilize WBDF ROM and lower extremity movements based on our findings. Therefore, intervention programs for safer landings should include exercises that increase WBDF ROM and utilize eccentric contraction.

Risk Ranking Analysis for the City-Gas Pipelines in the Underground Laying Facilities (지하매설물 중 도시가스 지하배관에 대한 위험성 서열화 분석)

  • Ko, Jae-Sun;Kim, Hyo
    • Fire Science and Engineering
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    • v.18 no.1
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    • pp.54-66
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    • 2004
  • In this article, we are to suggest the hazard-assessing method for the underground pipelines, and find out the pipeline-maintenance schemes of high efficiency in cost. Three kinds of methods are applied in order to refer to the approaching methods of listing the hazards for the underground pipelines: the first is RBI(Risk Based Inspection), which firstly assess the effect of the neighboring population, the dimension, thickness of pipe, and working time. It enables us to estimate quantitatively the risk exposure. The second is the scoring system which is based on the environmental factors of the buried pipelines. Last we quantify the frequency of the releases using the present THOMAS' theory. In this work, as a result of assessing the hazard of it using SPC scheme, the hazard score related to how the gas pipelines erodes indicate the numbers from 30 to 70, which means that the assessing criteria define well the relative hazards of actual pipelines. Therefore. even if one pipeline region is relatively low score, it can have the high frequency of leakage due to its longer length. The acceptable limit of the release frequency of pipeline shows 2.50E-2 to 1.00E-l/yr, from which we must take the appropriate actions to have the consequence to be less than the acceptable region. The prediction of total frequency using regression analysis shows the limit operating time of pipeline is the range of 11 to 13 years, which is well consistent with that of the actual pipeline. Concludingly, the hazard-listing scheme suggested in this research will be very effectively applied to maintaining the underground pipelines.

The SOFA Score to Evaluate Organ Failure and Prognosis in the Intensive Care Unit Patients (중환자실에 입원한 환자의 장기부전 및 예후 평가를 위한 SOFA 점수체계의 의의)

  • Kim, Su Ho;Lee, Myung Goo;Park, Sang Myeon;Park, Young Bum;Jang, Seung Hun;Kim, Cheol Hong;Jeon, Man Jo;Shin, Tae Rim;Eom, Kwang Seok;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Seung-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.329-335
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    • 2004
  • Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

Risk Assessment of Highly Pathogenic Avian Influenza by Comparison of Biosecurity Level in Domestic Poultry Farms (국내 가금농장의 차단방역수준비교에 따른 고병원성 조류인플루엔자 발생 위험도 평가)

  • So, Hyun Hee;Bae, Yeonji;Mo, Inpil
    • Korean Journal of Poultry Science
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    • v.46 no.4
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    • pp.313-325
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    • 2019
  • In most cases of HPAI (highly pathogenic avian influenza) outbreaks, stamping-out operations are initiated by officially designating the affected premise, which is subsequently followed by depopulation of infected flocks. The primary objective of this study was to develop an evaluation method that correlates the level of biosecurity and the risk of having an HPAI outbreak in domestic poultry farms. A total of eight farms were selected nationwide, including layer farms, broiler farms, and an animal welfare type farm. The biosecurity level of the chosen poultry farms was assessed based on a total scoring index of 183 divided into three categories, general management (51), quarantine management (106), and sanitation management (26). Conclusively, the five layer farms (JS, GE, CS, HS, OE), scored higher overall scores compared to the animal welfare farm (CH) and broiler farms (JG, LB). In terms of scoring, which adds up to a total of 183 points, most layer farms scored between 130 and 157, while the two broiler farms and the welfare farm scored 45, 75 and 70, respectively. Next, an independent HPAI risk assessment of the farms was carried out. Regarding the correlation between biosecurity levels and HPAI risks, in the farms that presented a higher overall score in terms of biosecurity and outweighed the risks of HPAI, they tended to earn more points in the quarantine management category. The results of this study suggest that a viable system for evaluating biosecurity levels can establish strong correlations with the risk of having HPAI.

A Study on the Improvement of Nurses' Morale (보건간호사의 사기진작(士氣振作)에 관한 연구)

  • Kwon Dong Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.225-238
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    • 2001
  • The purpose of this study is to examine public health nurses for their morale, test the effect of each factor on the morale, determine the variables affecting the morale, and thereby, provide for some basic data useful to the development of personnel affair administration for nurses. The survey on the nurses for public health centers was conducted for 10 days from April 23 to May 2, 2001; 96 nurses from Pusan, 101 from Kyonggi-do and 108 from Kangwon-do. The results of the study are as follows; 1. For the demographic variables, those aged between 31 and 39 accounted for the majority $(50.2\%)$ of the sample. $90.8\%$ was married, and $67.9\%$ of the sample graduated from junior colleges. $29.6\%$ of them had worked for 10-14 years and $62.5\%$ was of the seventh rank. $62.3\%$ of the nurses was recruited, and $59.4\%$ had chosen the public job for its guaranteed status. Half the nurses were working for the county population of which was more than 260 thousands, and $53\%$ of the nurses was serving the public health centers with 11-15 members. $47.3\%$ of them perceived that their living standard is middle or lower. 2. The degree of the moral was found as mean score. 2.65, which is interpreted as low. It has 11 factors. The rank of mean score of the factors is job satisfaction (3.36), sense of belonging (3.36), sense of recognition (3.30), stress due to supervision (3.13), degree of participation (3.05) and self-achievement (3.04), while those scoring lower points were assurance of status (2.58), pay level (2.53), working conditions (2.35) and promotion opportunity (2.31). 3. The degree of moral depending on the demographic variables was significantly affected by such variables as age. academic background, career, rank, employment method, motive for the job, size of the population served and living standards. 4. The result of the Stepwise multiple regression analysis for the morale factors, it was found that self-achievement accounted for $61\%$ of the total variance of the degree of morale, followed by stable status $(18\%)$, working conditions $(8\%)$, job requirements $(4\%)$ and promotion opportunities $(2\%)$; these five factors explained about $94.6\%$ of total variance of the degree of nurses' morale. On the other hand. age $(8\%)$ and academic background $(2\%)$ accounted for $10\%$ of the total variance of the degree of morale. 5. The factors affecting nurses' job life was economic need $(26.7\%)$, personnel management $(17.5\%)$, sense of recognition $(13.2\%)$, human relationship $(11.0\%)$, stable status and personal development in rank. On the other hand, the factors influencing on their possible resignation were children's bringing-up $(27.8\%)$, poor personnel management and promotion $(13.3\%)$, workload $(11.1\%)$ and little personal development $(8.9\%)$, Since such morale factors as promotion opportunity, working condition. pay level and stable status scored lower, it is required to reconsider those factors to improve nurses' morale.

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Application of peak based-Bayesian statistical method for isotope identification and categorization of depleted, natural and low enriched uranium measured by LaBr3:Ce scintillation detector

  • Haluk Yucel;Selin Saatci Tuzuner;Charles Massey
    • Nuclear Engineering and Technology
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    • v.55 no.10
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    • pp.3913-3923
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    • 2023
  • Todays, medium energy resolution detectors are preferably used in radioisotope identification devices(RID) in nuclear and radioactive material categorization. However, there is still a need to develop or enhance « automated identifiers » for the useful RID algorithms. To decide whether any material is SNM or NORM, a key parameter is the better energy resolution of the detector. Although masking, shielding and gain shift/stabilization and other affecting parameters on site are also important for successful operations, the suitability of the RID algorithm is also a critical point to enhance the identification reliability while extracting the features from the spectral analysis. In this study, a RID algorithm based on Bayesian statistical method has been modified for medium energy resolution detectors and applied to the uranium gamma-ray spectra taken by a LaBr3:Ce detector. The present Bayesian RID algorithm covers up to 2000 keV energy range. It uses the peak centroids, the peak areas from the measured gamma-ray spectra. The extraction features are derived from the peak-based Bayesian classifiers to estimate a posterior probability for each isotope in the ANSI library. The program operations were tested under a MATLAB platform. The present peak based Bayesian RID algorithm was validated by using single isotopes(241Am, 57Co, 137Cs, 54Mn, 60Co), and then applied to five standard nuclear materials(0.32-4.51% at.235U), as well as natural U- and Th-ores. The ID performance of the RID algorithm was quantified in terms of F-score for each isotope. The posterior probability is calculated to be 54.5-74.4% for 238U and 4.7-10.5% for 235U in EC-NRM171 uranium materials. For the case of the more complex gamma-ray spectra from CRMs, the total scoring (ST) method was preferred for its ID performance evaluation. It was shown that the present peak based Bayesian RID algorithm can be applied to identify 235U and 238U isotopes in LEU or natural U-Th samples if a medium energy resolution detector is was in the measurements.