• Archives of Plastic Surgery
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• 제37권4호
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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.

• 치위생과학회지
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• 제16권2호
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• pp.134-141
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• 2016

이번 연구는 치위생학과 교육과정에서 이론과 실습으로 구성된 효과적인 치과의료커뮤니케이션의 교육과정을 개발하기 위한 목적으로 운영되었으며, 다음과 같은 결론을 얻었다. '관계 형성하기', '대화 열기', '정보 수집하기', '상대방의 시각 이해하기', '정보 공유하기', '의견일치 보기', '마무리짓기' 등 7가지 평가항목에서 교육 전보다 교육 후 모든 점수가 상승되었다. 이 중 '정보 수집하기'의 자가평가 수준은 수업 후 통계적으로 유의한 변화가 있었다(p=0.008). 치과의료커뮤니케이션 수업에 참여한 학생들은 교과목에 대한 중요성과 필요성에 대해 수업운영 전보다 후에 높게 인식하는 것으로 조사되었는데, '치과의료커뮤니케이션 수업은 치과위생사의 전문성을 키우는 데 중요하다고 생각하나요', '치과의료커뮤니케이션 수업이 교육과정에서 필요하다고 생각하나요' 라는 항목에서는 수업 전후 각각 통계적 유의한 차이를 보였다(p=0.019, p=0.016). 이러한 결과로 볼 때 치과위생사에게 필요한 핵심역량인 치과의료커뮤니케이션 역량을 향상시킬 수 있는 교육과정은 치위생(학) 교육과정으로 반드시 포함되어야 한다. 치과의료커뮤니케이션 역량은 교육과 학습을 통해 계발 및 향상될 수 있다. 따라서 치과의료현장에서 필요한 치과의료커뮤니케이션 요소들을 보다 구체적으로 정리하고, 이론 교육만이 아닌 실습 교육을 포함한 체계적이고, 학년 간 연계 가능한 교육과정의 개발이 시급한 것으로 판단된다. 또한 연구 대상자 수를 늘리고, 자가수준의 평가가 아닌 학생들의 커뮤니케이션 역량을 객관적으로 측정할 수 있는 평가도구 개발과 표준화된 치과의료커뮤니케이션 교육과정이 필요할 것으로 본다.

• 재활치료과학
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• 제8권4호
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• pp.41-51
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• 2019

목적 : 본 예비 연구는 가상현실 기반의 일상생활활동 훈련이 외상성 뇌손상 환자의 일상생활활동 및 재활동기에 미치는 영향을 알아보고자 한다. 연구방법 : 본 연구는 7명의 외상성 뇌손상 환자를 대상으로 중재 전-후 설계를 수행하였다. 대상자들은 하루 30분, 주 2~3회, 4주간 가상현실 기반의 일상생활활동 훈련을 수행하였다. 중재 전과 후로 평가를 수행하였다. 측정은 수정바델지수, 기능적 독립척도(인지), 의지 설문지가 평가되었다. 중재 전과 후의 변화는 윌콕슨 부호순위 검정으로 분석하였고, 상관관계는 스피어만 상관분석을 이용하였다. 결과 : 중재 후, 외상성 뇌손상 환자는 한국판 수정바델지수에서 유의한 향상을 보였다(p<.05). 기능적 독립척도(인지)와 재활동기는 유의한 변화가 없었다(p>.05). 기능적 독립척도(인지)는 재활동기와 유의한 상관이 있었다(p<.05, r=.755). 기능적 독립척도(인지)의 사회인지영역은 재활동기와 유의한 상관이 있었다(p<.05, r=826). 결론 : 가상현실 기반의 일상생활활동 훈련은 일상생활활동 수행능력을 향상시킬 수 있으나, 사회인지와 재활동기의 개선여부가 가능한지에 대해서는 연구가 더 필요하다.

• 대한한방부인과학회지
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• 제28권3호
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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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• 제62권5호
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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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• 제20권3호
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• pp.179-193
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• 2016

저항성 고개 숙이기 운동과 shaker 운동은 목뿔위근의 강화를 사용되는 중재법이다. 이전의 연구들에서는 삼킴 장애가 있는 환자들 대상으로 두 운동을 비교하지 않았다. 본 연구는 삼킴장애를 가진 뇌졸중 노인 환자에게 저항성 고개 숙이기 운동과 shaker 운동이 목뿔위근, 목빗근에 미치는 효과를 알아보고자 하였다. 10명의 삼킴 장애가 있는 뇌졸중 노인 환자가 자발적으로 연구에 참가하였다. 모든 대상자들은 저항성 고개 숙이기 운동(등척성, 등속성), shaker 운동(등척성, 등속성)을 순서대로 수행하였으며, 10회 반복하였다. 저항성 고개 숙이기를 수행한 후, 대상자들은 근피로를 최소화하기 위하여 5분간 휴식을 하였다. 두 운동 동안 목뿔위근과 목빗근의 활성을 표면 근전도를 이용하여 분석하였다. 윌콕슨 부호 순위 검정은 그룹 내 저항성 고개 숙이기와 shaker 운동에서 근활성에 대한 차이를 평가하기 위하여 사용하였다. 저항성 고개 숙이기 운동과 shaker 운동은 목뿔위근에서 유의한 차이를 보이지 않았다(p>.05). 저항성 고개 숙이기 운동은 shaker 운동보다 목빗근에서 유의하게 낮은 활성을 보였다(p<.05). 삼킴 장애가 있는 뇌졸중 노인환자에게 저항성 고개 숙이기 운동이 shaker 운동보다 삼킴 기능 향상을 위한 더 효과적인 치료방법으로 사용될 수 있을 것이다.

• Asian Spine Journal
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• 제12권6호
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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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• 제49권1호
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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.

• 과학교육연구지
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• 제47권1호
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• pp.11-23
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• 2023

이 연구에서는 과학기술 관련 사회쟁점(SSI) 기반 과학 수업이 중학교 3학년 과학 학습부진 학생들에게 미치는 효과를 조사하였다. 연구를 위해 과학 교육과정과 연계된 2개의 SSI를 중심으로 총 7차시의 수업을 개발하여 실시하고, 그 효과를 진단하였다. 연구 자료는 광역시의 한 중학교 3학년 학생 185명을 대상으로 수집하였다. 그중 37명을 과학 학습부진 학생으로 판별하여 연구의 초점으로 하였다. 양적 자료는 과학성취, 태도 및 역량 측정에 대한 사전 및 사후 검사로 수집하였다. 정량적 데이터를 보완하기 위해 교사의 수업 관찰지, 일부 학생과의 면담을 통해 정성적 자료를 수집하였다. 정량적 자료 분석은 윌콕슨 부호순위 검정과 대응 표본 t 검정으로 진행하였다. 분석 결과 SSI 기반 수업이 과학 성취도에서는 학습부진 학생집단에 유의한 효과를 보이는 것으로 드러났지만 태도와 역량의 변화에는 유의한 영향이 없는 것으로 나타났다. 수업 관찰 자료는 학습부진 학생들이 SSI 기반 수업에 더 적극적으로 참여하는 모습을 보여줬으며, 학생의 면담에서 과학 학습부진 학생의 성취에 긍정적 영향을 미치는 수업의 성격을 밝힐 수 있었다. 이러한 연구 결과를 바탕으로 추가 연구 주제를 제안하였다.

• Korean Journal of Radiology
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• 제22권6호
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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.