• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.47-56
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• 2018

Background: The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. Methods: A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. Results: A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. Conclusions: The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.

• Physical Therapy Korea
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• 제8권2호
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• pp.17-27
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• 2001

The purpose of this study was to investigate the effect of donning of a hard insole in patients with hallux valgus. Fourteen subjects were selected from patient with foot pain at Lee Chang-Heon Foot Clinic from August 4, 2000 to September 15, 2000. The hallux valgus angle and the first-second intermetatarsal angle were radiographically measured before and after donning the hard insole. Based on these two kinds of angles, a mild hallux valgus deformity group was characterized by the hallux valgus angle of less than 20 degrees, and a moderate hallux valgus deformity group was characterized by the hallux valgus angle of 20 to 40 degrees. After three weeks with the hard insole donned, the foot angles of the patients with hallux valgus were measured again. The data were analyzed by Wilcoxon signed ranks test, and the following results were obtained: 1) After the trial, both mild hallux valgus deformity group and moderate hallux valgus deformity group demonstrated that the hallux valgus angles were significantly decreased. 2) After the trial, mild hallux valgus deformity group demonstrated that the first-second intermetatarsal angle was significantly decreased. 3) After the trial, moderate hallux valgus deformity group demonstrated that the first-second intermetatarsal angle was not significantly decreased. The above findings revealed that according to donning hard insole, the hallux valgus angles of mild and moderate hallux valgus deformity groups and the first-second intermetatarsal angle of mild hallux valgus deformity group were significantly decreased. The results of this study have some limitation for generalization due to the limited number of subjects. Further studies are needed to evaluate the effect of hard insole on hallux valgus with more precise laboratory equipments and measurements in patients with hallux valgus.

• Korean Journal of Biological Psychiatry
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• 제16권2호
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• pp.69-75
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• 2009

Objectives : The detrended fluctuation analysis is one of the nonlinear methods for the investigation of biological time series. It quantifies the fractal scaling properties and is known to be useful in the evaluation of long-range correlations in time series. The heart rate variability(HRV) of obstructive sleep apnea syndrome (OSAS) patients during nighttime was analyzed by detrended fluctuation analysis to assess its relationship with the severity of the symptoms. Methods : Fifty nine untreated male OSAS patients with moderate to severe symptoms(mean age=45.4${\pm}$11.7 years, apnea-hypopnea index, AHI${\geq}$15) underwent nocturnal polysomnography. Moderate(AHI=15-30, N=22) and severe(AHI>30, N=37) OSAS patients were compared for the indices derived from detrended fluctuation analysis and frequency domain analysis of HRV. Results : In the detrended fluctuation analysis, the alpha values were 0.75${\pm}$0.11 and 0.82${\pm}$0.07 for the severe and the moderate OSAS groups respectively. The difference was significant(p<.01). The alpha value had negative correlation with AHI(r=-.425, p=.001). Negative correlation coefficients were also found in the relationships between the alpha values and very low frequency(VLF)(r=-.425, p=.001), low frequency(LF)(r=-.633, p= <.001) and the LF/HF ratio(r=-.305, p=.019) respectively. LF/HF ratio(p=.005) was higher in the severe OSAS group compared to that of the moderate OSAS group. Conclusion : In this study, the detrended fluctuation analysis showed the significant difference between the two OSAS groups classified according to their severity of symptoms. The scaling exponent showed the negative correlation with AHI and indicies of frequency domain analysis. This result suggests that detrended fluctuation analysis can be helpful to estimate the severity of OSAS.

• Phonetics and Speech Sciences
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• 제3권1호
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• pp.125-134
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• 2011

The current study investigated the effects of experience of deaf speech, severity of speaker's articulation, and linguistic cues on speech intelligibility of congenitally deafened adults with cochlear implants. Speech intelligibility was judged by 28 experienced listeners and 40 inexperienced listeners using a word transcription task. A three-way (2 $\times$ 2 $\times$ 4) mixed design was used with the experience of deaf speech (experienced/inexperienced listener) as a between-subject factor, the severity of speaker's articulation (mild to moderate/moderate to severe), and linguistic cues (no/phonetic/semantic/combined) as within-subject factors. The dependent measure was the number of correctly transcribed words. Results revealed that three main effects were statistically significant. Experienced listeners showed better performance on the transcription than inexperienced listeners, and listeners were better in transcribing speakers who were mild to moderate than moderate to severe. There were significant differences in speech intelligibility among the four different types of cues, showing that the combined cues provided the greatest enhancement of the intelligibility scores (combined > semantic > phonological > no). Three two-way interactions were statistically significant, indicating that the type of cues and severity of speakers differentiated experienced listeners from inexperienced listeners. The current results suggested that the use of a combination of linguistic cues increased the speech intelligibility of congenitally deafened adults with cochlear implants, and the experience of deaf speech was critical especially in evaluating speech intelligibility of severe speakers compared to that of mild speakers.

• Journal of Service Research and Studies
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• 제7권2호
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• pp.43-51
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• 2017

The first goal of this study is to confirm validity and reliability of service innovation and service performance concepts in Chinese service industry and to verify positive relationship between the two concepts empirically. Furthermore, as the second goal of this study, we tried to check if cost leadership strategy and differentiation strategy have positive moderate effect on the relationship. Based on the results of survey on 203 Chinese service companies, we verified that service innovation and service performance are valid concepts and that the former has positive effect on the latter and, additionally, differentiation strategy, not cost leadership, showed positive moderate effect on that relationship.

• Journal of Korean Foot and Ankle Society
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• 제16권1호
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• pp.31-37
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• 2012

Purpose: The purpose of our study is the comparison of radiological and clinical outcomes between modified distal chevron osteotomy and proximal metatarsal osteotomy for the patients who had moderate to severe hallux valgus deformity. Materials and Methods: In this retrospective study, we included 54 patients (65 feets) who underwent the operation of moderate to severe hallux valgus in our hospital from May 2007 to August 2010. Our study compares two groups. For Group 1, a modified distal chevron osteotmy and a distal soft tissue procedure were done and for Group 2, a proximal metatarsal osteotmy and a distal soft tissue procedure were done. The group 1 were 29 feets; the group 2 were 36 feets, and the average follow up was 9 months. Results: The radiological results show that the hallux valgus angle and the first-second intermetatarsal angle were significantly decreased in two groups. In each parameter, the correction of the hallux valgus angle was $19.1^{\circ}$ (Group 1) and $24.3^{\circ}$ (Group 2), the correction of the first-second intermetatarsal angle was $9.6^{\circ}$ (Group 1) and $10.3^{\circ}$ (Group 2). Shortening of the first metatarsal length was 0.87 mm (Group 1) and 0.77 mm (Group 2). There are no significant clinical results (American Orthopaedic Foot and Ankle Society score, AOFAS score) in two groups. Conclusion: It is thought that a modified distal chevron osteotomy and a distal soft tissue procedure are a considerable operative treatment of moderate to severe hallux valgus deformity because of the similar cilinical results, more simple operative techniques, and less complications than a proximal metatarsal osteotomy.

• Journal of the Korea institute for structural maintenance and inspection
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• 제17권5호
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• pp.13-20
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• 2013

In order to reduce seismic responses of a structure, additional dampers and vibration control devices are generally considered. Usually, control performance of additional devices are investigated for optimal design without variation of characteristics of a structure. In this study, multi-objective integrated optimization of structure-smart control device is conducted and possibility of reduction of structural resources of a building structure with smart top-story isolation system has been investigated. To this end, 20-story example building structure was selected and an MR damper and low damping elastomeric bearings were used to compose a smart base isolation system. Artificial earthquakes generated based on design spectrum of low-to-moderate seismicity regions are used for structural analyses. Based on numerical simulation results, it has been shown that a smart top-story isolation system can effectively reduce both structural responses and isolation story drifts of the building structure in low-to-moderate seismicity regions. The integrated optimal design method proposed in this study can provide various optimal designs that presents good control performance by appropriately reducing the amount of structural material and damping device.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• 제30권4호
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• pp.97-103
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• 2017

Objectives : To identify whether pattern identification using nasal endoscopy for rhinitis can be applied as a tool for evaluating rhinitis in routine care setting, we performed a inter-rater reliability study on this pattern identification. Methods : Two Korean medicine doctors assessed 290 left/right nasal endoscopy photograph cases of rhinitis patients with pattern identification using nasal endoscopy. This pattern identification consist of four assessment items, nasal membrane color(pale/hyperemia), nasal membrane humidity(dryness/dampness), rhinorrhea(watery/yellow), and turbinate membrane edema(atrophic/edematous). Cohen's kappa statistic and Percentage agreement were used to evaluate the inter-rater reliability. Results : Inter-rater percentage agreement and Kappa coefficient for left nasal endoscopy photograph cases was from 'slight' to 'moderate'(% agreement: 40.00-67.59%/Kappa: 0.06-0.407). Only the agreement of 'rhinorrhea (watery/yellow)' item was moderate(% agreement: 67.59%/Kappa: 0.407). Inter-rater percentage agreement and Kappa coefficient for right nasal endoscopy photograph cases was also from 'slight' to 'moderate'(% agreement: 42.41-68.97%/Kappa: 0.109-0.465). Only the agreement of 'rhinorrhea(watery/yellow)' item was moderate(% agreement: 68.97%/Kappa: 0.465). Conclusions : It is necessary to resolve problems such as cut-off value setting, bipolar evaluation values(pale/hyperemia, dryness/dampness, watery/yellow, atrophic/edematous) and weighting items. Further rigorous studies that overcome the limitations of the current research are warranted.

• Archives of Craniofacial Surgery
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• 제14권1호
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• pp.30-35
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• 2013

Background: For reconstruction of the mild to moderate medial orbital wall fractures, various surgical approaches have been used. Prior existing W-shaped incision was a direct local approach through a 3 cm incision on the superior medial orbital area with a titanium mesh implant. In this study, the authors modified W-shaped incision and reconstructed the defect with silastic sheet to improve the result and the postoperative scar. Methods: This study included 20 patients who had mild to moderate size of medial wall defect and therefore relatively suitable for reconstruction with silastic sheets from July, 2009 to December, 2011. A modified W-shaped skin incision approximately 1.2 to 1.5 cm in length was made along the superior medial orbital rim from approximately 1 cm medial to the medial canthus to the lower border of the medial eyebrow. The angles of the limbs of the W ranged from 150 to 160 degrees. Results: By using soft flexible silastic sheet, the authors reduced the incision from 3 to 1.5 cm, and by widening the angle of the W limbs, scars were more effectively hided in the relaxed skin tension line. Scar assessment was done with modified patient and observer scar assessment scale and mean score from patients was 2.08 and mean score from observers was 2.12. Conclusion: Although this method will not be suitable for every case, it can be a consistent method to obtain the surgical goal in treatment of mild to moderate blowout fractures of the medial orbital wall.

• Journal of Lipid and Atherosclerosis
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• 제3권2호
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• pp.97-104
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• 2014

Objective: The aim of this study is to compare the clinical benefits between high-intensity and low-to moderate-intensity statin therapy in patients with acute myocardial infarction (AMI). Methods: A total of 1,230 patients in the Korea AMI Registry (KAMIR) were enrolled. Patients were divided into two groups according to the dosage of statin for the secondary prevention after AMI. The primary endpoint was composite of major adverse cardiac events (MACEs) including cardiac death, non-fatal MI, repeat revascularization during the 12 months of clinical follow-up. Result: The primary endpoint occurred in 101 patients (11.3%) from the low-to moderate-intensity statin group and 45 patients (13.4%) from the high-intensity statin group. The cumulative incidence of MACEs during 12-month follow-up was not significantly different between the two groups (p=0.323). After multi-variate analysis, MACEs-free survival rate was not significantly different between the two groups. Conclusion: High-intensity statin therapy did not show additional clinical benefit over low-to moderate-intensity statin therapy after AMI.