• Therapeutic Science for Rehabilitation
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• v.8 no.4
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• pp.41-51
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• 2019

Objective : The purpose of this study was to investigate the effects of virtual reality-based activities of daily living (ADL) training on ADL and rehabilitative motivation in patients with traumatic brain injury. Methods : This study was performed using a pre-post design with seven traumatically brain injured patients. Subjects were subjected to virtual reality-based ADL training for 30 minutes a day, 2 to 3 times a week for 4 weeks. Evaluation was conducted before and after the intervention using the Korean Modified Barthel Index (K-MBI), Cognitive Functional Independence Measure (C-FIM), and Volitional Questionnaire (VQ). Changes before and after intervention were analyzed by Wilcoxon signed-rank test, and correlations were analyzed using Spearman's coefficient. Results : After intervention, patients with traumatic brain injury showed significant improvements in K-MBI (p<.05). There was no significant change in total C-FIM score and VQ score (p>.05). Total C-FIM score correlated significantly with VQ score (p<.05, r=.755). The social cognition domain of C-FIM had a significant correlation with VQ score (p<.05, r=826). Conclusions : Virtual reality-based ADL training can improve ADL performance, but further research is needed to determine whether improvements in social cognition and rehabilitative motivation are possible.

• The Journal of Korean Obstetrics and Gynecology
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• v.28 no.3
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• pp.21-29
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• 2015

Objectives This study aimed to investigate therapeutic effect of Korean Medicine Steam Therapy (KMST) for leukorrhea patients. Methods From December 1st 2013 to Nov 31st 2014, 16 leukorrhea outpatients treated with KMST filled out questionnaire before and after treatments. The questionnaire was composed of 8 question items such as sleep, appetite & digestion, urination, defecation, emotion, cold hypersensitivity, menstrual pain, leukorrhea and patients were told to evaluate their symptoms as NRS score. We analyzed mean NRS score of each question item before and after KMST by using Wilcoxon's signed rank test of SPSS ver. 19. Results Mean age of participants was 40.8±13.0 years and mean value of treatment numbers per person was 3.8±1.8 times. 43.75% (n=7) of the patients had history of vaginitis caused by gardnella vaginalis, ureaplasma urealyticum or candida albicans. All patients were treated with acupuncture, moxibustion and Korean medicine. In addition, there was no side effect reported by participants. NRS score of quantity, odor of leukorrhea, perineal unpleasant sensation such as itching, dryness, burning sensation remarkably decreased (p<0.01, p<0.05, p<0.01 each). NRS score of symptoms including sleep, urination, cold hypersensitivity, menstrual pain also remarkably decreased (p<0.05). Conclusions Symptoms of leukorrhea patients including sleep, urination, cold hypersensitivity, menstrual pain, leukorrhea showed significant decrease after treated with concurrent KMST.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.561-566
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• 2019

Objective : Functional outcomes have traditionally been evaluated and compared using subjective surveys, such as visual analog scores (VAS), the Oswestry disability index (ODI), and Short Form-36 (SF-36), to assess symptoms and quality of life. However, these surveys are limited by their subjective natures and inherent bias caused by differences in patient perceptions of symptoms. The Fitbit $Charge^{(R)}$ (Fitbit Inc., San Francisco, CA, USA) provides accurate and objective measures of physical activity. The use of this device in patients after laminectomy would provide objective physical measures that define ambulatory function, activity level, and degree of recovery. Therefore, the present study was conducted to identify relationships between the number of steps taken by patients per day and VAS pain scores, prognoses, and postoperative functional outcomes. Methods : We prospectively investigated 22 consecutive patients that underwent laminectomy for spinal stenosis or a herniated lumbar disc between June 2015 and April 2016 by the same surgeon. When patients were admitted for surgery and first visited after surgery, preoperative and postoperative functional scores were recorded using VAS scores, ODI scores, and SF-36. The VAS scores and physical activities were recorded daily from postoperative day (POD) 1 to POD 7. The relationship between daily VAS scores and daily physical activities were investigated by simple correlation analysis and the relationship between mean number of steps taken and ODI scores after surgery was subjected to simple regression analysis. In addition, Wilcoxon's signed-rank test was used to investigate the significance of pre-to-postoperative differences in VAS, ODI, and SF-36 scores. Results : Pre-to-postoperative VAS (p<0.001), ODI (p<0.001), SF-36 mental composite scores (p=0.009), and SF-36 physical composite scores (p<0.001) scores were found to be significantly different. Numbers of steps taken from POD 1 to POD 7 were negatively correlated with daily VAS scores (r=-0.981, p<0.001). In addition, the mean number of steps from POD 3 to POD 7 and the decrease in ODI conducted one month after surgery were statistically significant (p=0.029). Conclusion : Wearable devices are not only being used increasingly by consumers as lifestyle devices, but are also progressively being used in the medical area. This is the first study to demonstrate the usefulness of a wearable device for checking patient physical activity and predicting pain and prognosis after laminectomy. Based on our experience, the wearable device used to provide measures of physical activity in the present study has the potential to provide objective information on pain severity and prognosis.

• 재활복지
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• v.20 no.3
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• pp.179-193
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• 2016

Chin Tuck Against Resistance Exercise(CTARE) and Shaker exercise is used to common for strengthening of suprahyoid muscle. No previous studies was compare of two exercises for patients with dyaphagia. This study investigated the effects of CTARE and Shaker exercise on suprahyoid, sternocleidomastoid muscle activity in stroke older patients with dysphagia. Ten stroke patients with dyaphagia voluntarily participated in this study. All subjects was performed in the order in the CTARE (isometric, isokinetic), Shaker (isometric, isokinetic), and repeated each ten trials. After CTARE was performed, subjects took a 5 min wash out period to minimize muscle fatigue. Activity of suprahyoid and sternocleidomastoid muscle during two training was analyzed using surface electromyography(sEMG). Wilcoxon signed rank test was used to assess differecences for muscles activity between the effects of the CTAR and Shaker exercise within group. CTARE and Shaker exercise showed no significant difference activity in suprahyoid muscle(p > .05). CTARE showed significantly lower muscle activity in sternocleidomastoid muscle than Shaker exercise(p < .05). CTARE in stroke older patients with dysphagia may be a effective intervention to improve swallowing function than Shaker exercise.

• Asian Spine Journal
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• v.12 no.6
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• pp.1060-1068
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• 2018

Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

• Journal of Periodontal and Implant Science
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• v.49 no.1
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• pp.14-24
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• 2019

Purpose: To assess the influence of using different combinations of guided bone regeneration (GBR) materials on volume changes after wound closure at peri-implant dehiscence defects. Methods: In 5 pig mandibles, standardized bone defects were created and implants were centrally placed. The defects were augmented using different combinations of GBR materials: xenogeneic granulate and collagen membrane (group 1, n=10), xenogeneic granulate and alloplastic membrane (group 2, n=10), alloplastic granulates and alloplastic membrane (group 3, n=10). The horizontal thickness was assessed using cone-beam computed tomography before and after suturing. Measurements were performed at the implant shoulder (HT0) and at 1 mm (HT1) and 2mm (HT2) below. The data were statistically analysed using the Wilcoxon signed-rank test to evaluate within-group differences. Bonferroni correction was applied when calculating statistical significance between the groups. Results: The mean horizontal thickness before suturing was $2.55{\pm}0.53mm$ (group 1), $1.94{\pm}0.56mm$ (group 2), and $2.49{\pm}0.73mm$ (group 3). Post-suturing, the values were $1.47{\pm}0.31mm$ (group 1), $1.77{\pm}0.27mm$ (group 2), and $2.00{\pm}0.48mm$ (group 3). All groups demonstrated a loss of horizontal dimension. Intragroup changes exhibited significant differences in group 1 (P<0.001) and group 3 (P<0.01). Intergroup comparisons revealed statistically significant differences of the relative changes between groups 1 and 2 (P=0.033) and groups 1 and 3 (P=0.015). Conclusions: Volume change after wound closure was minimized by using an alloplastic membrane. The stability of the augmented horizontal thickness was most ensured by using this type of membrane irrespective of the bone substitute material used for membrane support.

• Journal of Science Education
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• v.47 no.1
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• pp.11-23
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• 2023

In this study, we examined the effect of socioscientific issue (SSI) based science lessons on underachieving 9th-grade students. A total of seven lessons centered on two SSIs related to the national science curriculum were developed and implemented during the first semester of 2021. Data were collected from 185 9th-grade students in one middle school in a mid-sized city of South Korea. Among them, 37 were identified as achieving far below the standards (underachieving students hereafter). Quantitative data were collected from pre- and post-tests on basic science content and attitudes and competency measures. To supplement quantitative data, lesson observation notes were recorded, and student interviews with a selected number of students were conducted. The analysis of quantitative data was conducted through the Wilcoxon Signed Rank Test and paired t-tests. Qualitative data were analyzed to find reasons for changing attitudes. The findings showed that the SSI-based lessons were more effective on underachieving students than the others in enhancing basic academic achievement, while there was no significant effect on all in attitudes and competency. Lesson observation data showed that underachieving students were more engaged in SSI-based lessons than before. Student interviews demonstrated several reasons why they were engaged, suggesting the aspects of SSI-based lessons that facilitated underachieving students' learning. Further research topics are suggested.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.983-993
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• 2021

Objective: To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. Materials and Methods: Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signed-rank test were performed to compare the objective measurements and the subjective image quality scores, respectively. Results: With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p < 0.001) and a similar noise level to model-based iterative reconstruction (19.6 ± 2.6 HU, p > 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. Conclusion: The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1044-1053
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• 2021

Objective: Motion-corrected averaging with a single-shot technique was introduced for faster acquisition of late-gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging while free-breathing. We aimed to evaluate the image quality (IQ) of free-breathing motion-corrected single-shot LGE (moco-ss-LGE) in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: Between April and December 2019, 30 patients (23 men; median age, 48.5; interquartile range [IQR], 36.5-61.3) with HCM were prospectively enrolled. Breath-held single-shot LGE (bh-ss-LGE) and free-breathing moco-ss-LGE images were acquired in random order on a 3T MR system. Semi-quantitative IQ scores, contrast-to-noise ratios (CNRs), and quantitative size of myocardial scar were assessed on pairs of bh-ss-LGE and moco-ss-LGE. The mean ± standard deviation of the parameters was obtained. The results were compared using the Wilcoxon signed-rank test. Results: The moco-ss-LGE images had better IQ scores than the bh-ss-LGE images (4.55 ± 0.55 vs. 3.68 ± 0.45, p < 0.001). The CNR of the scar to the remote myocardium (34.46 ± 11.85 vs. 26.13 ± 10.04, p < 0.001), scar to left ventricle (LV) cavity (13.09 ± 7.95 vs. 9.84 ± 6.65, p = 0.030), and LV cavity to remote myocardium (33.12 ± 15.53 vs. 22.69 ± 11.27, p < 0.001) were consistently greater for moco-ss-LGE images than for bh-ss-LGE images. Measurements of scar size did not differ significantly between LGE pairs using the following three different quantification methods: 1) full width at half-maximum method; 23.84 ± 12.88% vs. 24.05 ± 12.81% (p = 0.820), 2) 6-standard deviation method, 15.14 ± 10.78% vs. 15.99 ± 10.99% (p = 0.186), and 3) 3-standard deviation method; 36.51 ± 17.60% vs. 37.50 ± 17.90% (p = 0.785). Conclusion: Motion-corrected averaging may allow for superior IQ and CNRs with free-breathing in single-shot LGE imaging, with a herald of free-breathing moco-ss-LGE as the scar imaging technique of choice for clinical practice.

• Journal of Korean Elementary Science Education
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• v.41 no.4
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• pp.701-724
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• 2022

In this study, the Nature of Science (NOS) instrument for elementary school students in the form of open questionnaires was developed specifically to reveal elementary school students' perceptions of the NOS, and its validity and effectiveness were investigated. To develop a NOS instrument for elementary school students, problems that may occur when applying the existing NOS instruments to elementary school students were analyzed and based on this, the development direction of the NOS instrument was established. In addition, after selecting seven NOS types suitable for the level of elementary school students, the preliminary instrument was produced by modifying and supplementing the items in the existing instruments for each type or by developing new items. Finally, the NOS instrument consisting of eight questions was developed by adding one question asking for a comprehensive understanding of science to seven questions related to each type of NOS after a content validity test of the science education expert group. To verify the practical effect of the developed instrument, pre- and post-tests were conducted on 50 students in two classes of sixth grade at two elementary schools in Seoul: 'existing instrument → development instrument' in one class, and 'development instrument → existing instrument' in the other class. The collected data were then compared and evaluated through summary content analysis and analyzed by executing the Wilcoxon signed-rank test. As a result of comparing and analyzing students' responses to the existing NOS instrument and the developed NOS instrument, students' perspectives on the NOS were more diverse when using the developed instrument, and the level of error in the response caused by misinterpreting the intention of the question was reduced. In addition, when using the developed instrument, the responses of the majority of students at a statistically significant level changed more specifically. In this study, the implications for the development of NOS instruments suitable for elementary school students were discussed based on these results.