• 제목/요약/키워드: Wilcoxon signed rank test

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The Effect of Body Positioning on Physiologic Index in Patients with Unilateral Lung Disease (편측성 폐질환 환자의 체위변경이 생리적 지표에 미치는 영향)

  • Cho, Jee Yeon;Lee, Hyang Yeon
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.122-133
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    • 2000
  • The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

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An Empirical Comparative Study on the Clustering Measurement Using Fuzzy(Average Index Transformation) DEA and Cross-efficiency Models (퍼지(평균지수변환)DEA모형과 교차효율성모형을 이용한 클러스터링측정에 대한 실증적 비교연구)

  • Park, Ro-Kyung
    • Journal of Korea Port Economic Association
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    • v.31 no.1
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    • pp.85-110
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    • 2015
  • The purpose of this paper is to show the clustering trend and the empirical comparison and to choose the clustering ports for 3 Korean ports(Busan, Incheon and Gwangyang Ports) by using the Fuzzy(Average Index Transformation) DEA and Cross-efficiency models for 38 Asian ports during 11 years(2001-2011) with 4 input variables(birth length, depth, total area, and number of crane) and 1 output variable(container TEU). The main empirical results of this paper are as follows. First, clustering results by using Fuzzy(AIT)DEA show that 3 Korean ports[Busan(56.29%), Incheon(57.96%), and Gwangyang(66.80%) each]can increase the efficiency. Second, according to Cross-efficiency model, Busan(Hongkong, Kobe, Manila, Singapore, and Kaosiung etc.), Incheon(Aquaba, Dammam, Karachi, Mohammad Byin Oasim and Davao), and Gwangyang(Damman, Yokohama, Nogoya, Keelong, Kaosiung, and Bangkok) should be clustered with those ports in parentheses. Third, when both Fuzzy(AIT)DEA and Cross-efficiency models are mixed, the empirical result shows that 3 Korean ports[Busan(71.38%), Incheon(103.89%), and Gwangyang(168.55%) each]can increase the efficiency. The efficiency ranking comparison among the three models by using Wilcoxon Signed-rank Test was matched with the average level of 66%-67%. The policy implication of this paper is that Korean port policy planner should introduce the Fuzzy(AIT)DEA, and Cross-efficiency models with the mixed two models when clustering is needed among the Asian ports for enhancing the efficiency of inputs and outputs. Also, the results of SWOT analysis among the clustering ports should be considered.

'Part' vs. 'Whole': Comparison between the Socially Underprivileged and the Whole Population in Terms of Inter-regional Disparities in Quality of Life ('부분' 대 '전체' - 사회적 약자와 전체 인구의 삶의 질 지역 격차의 비교 -)

  • Park, In-Kwon
    • Journal of the Korean Regional Science Association
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    • v.36 no.1
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    • pp.17-36
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    • 2020
  • This study aims to compare the differences between the socially underprivileged and the population as a whole in terms of the quality of life gap between the Seoul metropolitan and non-capital regions based on the capabilities approach. To this end, we selected indicators that can measure nine dimensions of capabilities, such as income, housing, health, and social relations, calculated indicator values for the socially underprivileged and the whole population, and standardized them. The Wilcoxon signed-rank test and the SUR model were used for comparative analysis. The results show that there are significant differences in the disparities between the Seoul metropolitan and non-capital regions between the socially underprivileged and the entire population, and the differences are generally consistent in the most unfavorable direction for the socially underprivileged in the non-capital regions. In addition, the gap between the Seoul metropolitan and non-capital regions is not large from the point of view of the total population average, but the inter-regional gap is still significant from the viewpoint of the socially underprivileged. These results show the limitations of 'average' regional policies based on an analysis of the average of the total population, and the study is significant to illustrate the ecological errors that may arise in regional problem analysis.

Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions

  • Chiusolo, Fabrizio;Capriati, Teresa;Erba, Ilaria;Bianchi, Roberto;Atti, Marta Luisa Ciofi degli;Picardo, Sergio;Diamanti, Antonella
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.6
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    • pp.521-530
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    • 2020
  • Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

Radiation Dose using Chest CT for Patients with Pneumoconiosis Complication - Comparison with International Guidelines - (진폐요양환자의 흉부 CT촬영에 사용된 선량 - 국내외 진단 참고 준위와 비교 -)

  • Lee, Won-Jeong
    • Journal of Radiation Protection and Research
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    • v.39 no.4
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    • pp.206-212
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    • 2014
  • We report here on the results of evaluating the radiation doses using chest computed tomography (CT) for patients with pneumoconiosis complication. For the first time, we visited the 17 MIPs to evaluate the dose-length product (DLP, $mGy{\cdot}cm$), CT unit, and protocols of scanning and image reconstruction those is routinely used for treating patients with pneumoconiosis who have complication. All statistical analysis was performed using the Statistical Program for Social Sciences (SPSS ver. 19.0, Chicago, IL, USA). Mean of total DLP was $727.7mGy{\cdot}cm$, ranging from 272.0 to $1228.7mGy{\cdot}cm$. DLP from obtaining parenchymal lung images was significantly reduced than that from obtaining total lung images (555.9 vs. 707.2, p<0.001). Third quartile of total and pre-scanning DLP was 1036.1 and $504.1mGy{\cdot}cm$, respectively. Chest CT radiation doses for patients with pneumoconiosis complication are similar with korean diagnostic reference level as well as international guidelines.

Elliptical Centric Techniques and Tricks About the Usefulness of the Clinical Application (Elliptical Centric과 TRICKS 기법의 임상 적용에 관한 유용성 연구)

  • Kim, Sae-Ssak;Goo, Eun-Hoe;Dong, Kyung-Rae;Kweon, Dae-Chel;Lee, Jae-Seung;Cho, Jae-Hwan;Park, Chang-Hee
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.2
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    • pp.83-90
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    • 2011
  • To prospectively determine the diagnostic performance a combination of standard bolus-chase magnetic resonance (MR) angiography and MR angiography with time-resolved imaging of contrast kinetics (TRICKS) for depicting severity of the head and neck vascular diseases. Over a period of two months, A total of 100 patients(average ages : $50{\pm}8$, male : 60, female : 40) with head and neck vascular diseases were performed on the GE excite 3.0 T units with 8-channel head coil and 4-channel NV coil. Imaging parameters for a typical study were as follow: SBC(TR/ TE/ FA/ SliceThicken./ Slab/ Freq./ FOV/ BW/Scan Time) = 5.4/ min/ 30/ 2/ zip2/ 70/ $224{\times}448$/ 30/ 62.50/ 28, TRICKS(TR/ TE/ FA/ Slice Thicken/Slab/ Freq./ FOV/ BW/ Temp Res./ Scan Time = 3.6/ min/ 25/ 4/ 30/ $160{\pm}384$, zip512/ 30/ 100/ 1 to 1.5/ 23). The analysis of all MR images, which have respect-ively classified two techniques into some diseases. The results of the former were divided into two groups(SBC, TRICKS)with 4 grading of two reader, respectively. Wilcoxon signed rank test was used to determine if a significant difference between imaging techniques existed(p < 0.05). In 33 of 100 patients, arterio-venous malformation was 11% at TRICKS, subclavian vein stenosis : 8%, fistular sinus : 4%, jugular vein stenosis:6%, Middle Cerebral Artery bypass surgery : 4%, p < 0.05). The rest of 67 patients were considered as the results of SBC(14% in the basilar artery stenosis, carotid stenosis : 16%, vertebral stenosis : 17%, central neuro-cytoma : 5%, meningioma : 5%, Not appliable : 10%, p < 0.05). Sensitivity and specificity of TRICKS MR angiography in SVS, FS, JVS, MCABS were improved compared with those at standard MR angiography. In SBS MR angiography which were improved in BAS, CS, VS, CN, Meningioma. In conclusion, TRICKS MR angiography of the SVS, FS, JVS, MCABS is superior to standard MR angiography regarding the number of diagnostic grading. The SBS MR angiography were improved in BAS, CS, VS, CN, Meningioma. and assessment of the degree of luminal narrowing on both TRICKS and SBS.

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Effect of Electro-acupuncture on Regional Fat by Measuring Thigh Circumference (저주파 전침자극이 허벅지 둘레에 미치는 영향에 대한 연구)

  • Ahn, Soo-Jeong;Kim, Jeung-Shin;Shin, Hyun-Taeg;Kim, Yong-Suk;Lee, Kyung-Sub;Hwang, Deok-Sang
    • Journal of Korean Medicine for Obesity Research
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    • v.5 no.1
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    • pp.1-8
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    • 2005
  • Objectives: Although electro-acupuncture is being utilized to reduce weight in Korea, its usefulness in obesity management has not been fully evaluated yet. The objective of this study is to evaluate the effect of Electro-acupuncture on thigh circumference. Methods: 12 healthy volunteers participated in this study. We measured the circumference of both thighs, and treated the thicker one with transcutaneous electro-acupuncture at 8 acupoints, 10 times in total. The electrical parameters were : 1st step frequency set was at 15Hz and the treatment proceeded for 50 minutes, 2nd step at 50Hz for 10 minutes and at 3rd step the acupunctures were removed and electrodes were attached on the lower limb at 166Hz for 15 minutes. In order to evaluate the effect of the treatment, total body weight, percentage of body fat and thigh circumference were measured 4 times. Before the treatment, after 5th and 10th treatment and 1 month after completion of the whole treating procedure. Statistical significance(P<0.05) was determined using the Wilcoxon signed rank test. We did not control diet, exercise and lifestyle of the volunteers. Results: No significant change was shown in body weight after 10 times of treatment. Yet the thigh circumference of effect group significantly decreased after 5th treatment and 10th treatment. The circumference of control group that was not treated by electro-acupuncture significantly decreased too. At first, difference between the two thighs in circumference was obvious, but no difference was left after 10 times of treatments on the thicker thigh. Percentage of body fat was significantly decreased. 1 month after having completed the treatment, there was no significant difference of body weight, thigh circumferences and percentage of body fat. Conclusion: These results suggest that electro-acupuncture effectively regulates regional fat, body fat percentage and body shape.

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A Study on the Effect of Time Lapse After Position Change and Abdominal Band on Pulmonary Function in the Cervical Cord Injuries (척수손상 환자의 자세 변화 후 시간경과와 복대사용이 폐기능에 미치는 영향)

  • Lee, Jae-Ho;Park, Chang-Il;Chon, Joong-Sun
    • Physical Therapy Korea
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    • v.4 no.3
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    • pp.17-33
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    • 1997
  • The objective of this study was to identify pulmonary functional variations in relation to postural changes, lapse after changing position, and the use of abdominal band in the cervical cord injured. The subjects of this study were 19 quadriplegic patients who had been admitted to the department of the Rehabilitation Hospital, College of Medicine, Yousei University, from April, 1997 through May 3, 1997. A spiroanalyzer was used to measure pulmonary function in supine, standing, time after changing position, and recording to the position, application method, and tightness of the abdominal band. The data were analyzed by the repeated measure one-way ANOVA, and Wilcoxon signed rank test. The findings were as follows: 1. All phase of the patients' pulmonary function improved significantly in supine posture in contrast to standing (vital capacity by $0.46{\ell}$ and expiratory reserve volume by $0.09{\ell}$). 2. The longer the time lapsed from supine posture to standing, the patient's expiratory reserve volume, maximum ventilation volume, vital capacity, and forced expiratory volume increased. 3. When the patient lay in supine position, the maximum ventilation volume, vital capacity, and the forced vital capacity increased then the center line of the abdominal band was placed along iliac crest; on the other hand, when the patient was standing, placing the bottom line of the abdominal band along iliac crest increased the maximum ventilation volume, vital capacity, and forced expiratory volume. 4. In placing the abdominal band in the patients, leaving space between the top and bottom lines of the band helped increased in maximum ventilation volume, vital capacity, and forced vital capacity for patient in supine as well as in standing. 5. When placing the abdominal band to patients in supine posture, reducing the length of the band by 2.5% along the patient's waist line increased the patients' vital capacity, while reducing the length by 10% to patients in standing increased the maximum ventilation volume. The abdominal band should be placed in such a way that the bottom part of the band should be more tightly fastened while leaving enough room for a hand to be placed in between the body and the band for the top part of the hand. It should also be noted that in a supine position, the bottom line of the band should be placed along the iliac crest, while in standing, the center line should be placed along the iliac crest. The length of the band should also be reduced by 2.5% of the waist line in supine position, and in standing, the length should be reduced by 10%. It should also be noted that the pulmonary function of the patients should be measured at least 10 minutes after one position change.

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CT Observation of Alloplastic Materials Used in Blow Out Fracture (안와골절 정복술에 사용된 인공삽입물의 전산화단층촬영 추적관찰)

  • Lee, Won;Kang, Dong-Hee
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.380-384
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    • 2010
  • Purpose: Distinguishing different types of implants and assessing the position and size of implants by radiologic exam after orbital wall reconstruction is important in determining the surgery outcome and forecasting prognosis. We observed time-dependent density changes in three types of implants (porous polyethylene, resorbing plate and titanium mesh plate) by performing facial bone CT after orbital wall reconstructions. Methods: A total of 32 patients, who had underwent orbital wall fracture surgery from October 2006 to March 2009 and received facial bone CT as outpatients at 1 postoperative year were included in the study. Follow-up facial bone CT was performed on the patients pre- operatively, 1 month post-operatively, and 1 year post-operatively to observe the status of the orbital implants. Medpor $^{(R)}$ (Porex Surgical, Inc., Newnan, Ga.) was used as porous polyethylene and followed-up in 14 cases; for resorbing plate, Synthes mesh plate (Synthes, Oberdorf, Switzerland) was used in the reconstruction, and followed-up in 11 cases; and titanium mesh plate usage was followed-up in 7 cases. Computed tomographic scan (CT) and water's view were done for radiography, and hounsfield unit (HU) was used to compare density of those facial bone CT. Wilcoxon signed rank test was applied to statistically verify measurement difference in each group of hounsfield units. Results: Facial bone CT examination performed in 1 month post-operative showed that the density of porous polyethylene, resorbing plate and titanium mesh plate were -42.07, 105.67 and 539.48 on average, respectively. Among the three types of implants, titanium mesh plate showed the highest density due to its radiopaque feature. Following up the density of three types of implants in CT during 1 year after the orbital wall fracture surgery, the density of porous polyethylene increased in 10.52 House Field Units and the resorbing plate was decreased in 26.87 HouseField Units. There were no significant differences between densities in 1 month post-operatively and 1 year post-operatively in each group ($p{\geq}0.05$). Conclusion: We performed facial bone CT on patients with orbital fractures during follow-up period, distinguishing the types of implants by the different concentration of implant density, and the densities showed little change even at 1 year post-operative. To observe how implant densities change in facial bone CT, further studies with longer follow-up periods should be carried out.

Effectiveness and Learning Experience of Dental Communication Course Training in Dental Hygiene Schools (치위생학과 교육과정에서의 치과의료커뮤니케이션 교과목 운영 사례연구)

  • Choi, Yong-Keum;Shin, Bo-Mi;Son, Jung-Hui;Park, Deok-Young
    • Journal of dental hygiene science
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    • v.16 no.2
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    • pp.134-141
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    • 2016
  • The purpose of this study was to develop a dental communication course in dental hygiene schools that included theory, practice, and skill for effective dental communication. Thirty-six senior dental hygiene students in a dental hygiene school took a dental communication course and responded to a questionnaire. The instrument used in the study was a modified form of Kim's communication skill self-assessment sheet. The self-assessment questionnaire about communication competencies was administered before and after the class, and the difference between scores at each time point was analyzed using the Wilcoxon signed rank sum test. Among seven elements of dental communication competencies, the competency of "information gathering" was significantly improved (p=0.008). Students' scores on perception of the importance (p=0.019) and necessity (0.016) of a communication course significantly increased after the course. Competencies in communication are essential requirement for dental hygienists. This study showed the possibility of communication skill training. An objective evaluation tool regarding students' communication competencies should be developed. Further studies with larger samples size are needed to develop a standardized comprehensive communication course in dental hygiene schools.