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Development of a Occupation-Based Bilateral Upper Extremity Training Protocol in a Medical Setting for Stroke Patients (뇌졸중 환자를 대상으로 한 병원 환경에서의 작업 기반 양측성 상지 훈련 프로토콜 개발)

  • Kim, Sun-Ho;Kim, Jung Ran;Park, Hae Yean;Han, A-Reum;Kim, Jong-Bae;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.24-44
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    • 2020
  • Objective : To develop an occupation-based bilateral upper extremity training protocol that can be effectively applied in a medical setting Methods : The research process using the delphi technique was carried out in 3 stages. The first stage was an open questionnaire development stage, The first draft is prepared through literature review and open questions were developed through preliminary research based on the draft. The second stage was the delphi survey. Based on the responses of the experts obtained through the open Delphi survey, the adequacy of the training protocol was shown on a Likert 5 point scale. The items were edited and deleted, reconstructed by analyzing the mean and standard deviation, stability, convergence degree, consensus, and content validity ratio through the questionnaire. The third step was the completion of the protocol. After discussions between researchers, the finalized protocol contents were reorganized to complete the occupation-based bilateral upper extremity training protocol for medical setting. Results : The final protocol consisted of 9 items across 3 areas in the occupation-based intervention selection domain and 81 items across 4 areas in the bilateral upper extremity training domain, intervention period, and evaluation. Conclusions : This study suggests an evidence-based method that collects the opinions of occupational therapists in order to use occupation-based activities as interventions in a situation that currently sees occupational therapy primarily performed in hospitals. It is also meaningful that the bilateral upper extremity training can be applied effectively in clinical situations by concretely presenting.

The Surgical Outcome for Gastric Submucosal Tumors: Laparoscopy vs. Open Surgery (위 점막하 종양에 대한 개복 및 복강경 위 절제술의 비교)

  • Lim, Chai-Sun;Lee, Sang-Lim;Park, Jong-Min;Jin, Sung-Ho;Jung, In-Ho;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.225-231
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    • 2008
  • Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

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Effects of Modified Ultrafiltration in Pediatric Open Heart Surgery (소아 개심술에 있어서 변형초여과법의 효과)

  • 전태국;박표원
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.591-597
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    • 1997
  • Cardiopulmonary bypass in children is associated with capillary leak which results in an increase in total body water after open heart surgery The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery Study h: Twenty-six consecutive children aged 0.1 ~ 10 years(median 7 months) underwent cardiac operation inc rporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~ 15011min for 3 ~ 14 min. After modified ultrafiltration, elevation of hematocrit(28.3% $\pm$ 3.6% vs. 33.8olo $\pm$ 4.Ooloi p < 0.001), increased systolic 1)loots Pressure(66.7 $\pm$ 11.2mmHg vs. 76.2$\pm$ 11.BmmHg, p < 0.02), and decreased central venous pressure(7.8 $\pm$ 3.7mmHg vs. 6.9$\pm$ 2.gmmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n= 14) or modified ultrafiltration(n= 12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0$\pm$ 2.4 cmH20 vs.22.4$\pm$ 2.3cmH20, p < 0.03). Modified ultrafiltration after cardiopillmonary bypass in children improves early homodynamics and pulmonary mechanics, and represents an excellent option for perioperative managemen of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.

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The Effect of the Characteristics of Agri-Food Open Market on the Repurchase Intention: Focusing on the Moderating Effect of Innovation (농식품 오픈 마켓 특성이 재구매 의도에 미치는 영향: 혁신성의 조절효과를 중심으로)

  • Kim, Sangmi;Ha, Gyusu
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.4
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    • pp.153-165
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    • 2021
  • With the disappearance of boundaries between online and offline, the O2O(online to offline) platform service is rapidly growing. Unlike general products, freshness is an important decision-making factor for agri-food, and there are many limiting factors for growth as an open market among O2O platforms due to the characteristics of difficult refunds and exchanges compared to other items and new transaction methods. In order to overcome these obstacles, consumer innovation must be considered. The purpose of this study was to investigate the influence of O2O(online to offline) platform characteristics perception on agri-food repurchase intentions. And an empirical survey of the hypothesis is made that innovation will show a moderating effect between agri-food O2O platform characteristics and repurchase intention. And an empirical survey of the hypothesis is made that innovation will show a moderating effect between agri-food O2O platform characteristics and repurchase intention. For this purpose, Using a convenience sampling technique, an online survey was conducted through Google survey from April 1 to April 15, 2021. A total of final analysis data were collected from a total of 270 purchase experienced of agri-food O2O(online to offline) platform. The SPSS program was used for analysis, and multiple regression analysis was used for hypothesis verification. The results showed that Economic, Interaction, and Playfulness had a significant positive effect on agri-food repurchase intend. Also, Interactivity × innovation, playfulness × innovation were found to have a significant positive (+) effect on repurchase intention. The results of this study show that innovation reduces the burden on consumers for new systems and mobile transactions. The results of this study suggest that convenient interface design is important for activating O2O transactions of agri-food. In addition, education and support are needed to strengthen the IT competency of farmers. The results of this study will be able to contribute to the establishment of infrastructure for agri-food open market shopping malls. In future studies, the influence of the O2O platform type on the purchase intention should be studied continuously.

Evaluation of Seasonal Landscape Images and Preference of Streetscapes - Focusing on Street of Prunus Species - (계절별 가로 경관이미지 및 선호도 평가 - 벚나무류 가로를 대상으로 -)

  • Shin, Jae-Yun;Jung, Sung-Gwan;Kim, Kyung-Tae;Lee, Woo-Sung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.3
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    • pp.51-63
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    • 2011
  • The purpose of this study is to create a landscape image that considers the selection of techniques that can enhance landscape reproduction in streetscape evaluation using 3 dimensional simulations and to evaluate ways to verify similarities and the psychological changes on the part of users by season. In the comparison of technique, the Low(apply normal map) technique was selected for the natural representation of trees in a near and middle view and the Plane technique was selected for the distant view. As the result of the verification, all indicators of physical similarity were evaluated over 4.50 points and most indicators of psychological similarity were found to have no difference except for indicators of 'disordered orderly' and 'dirty - clean'. According to the results of analyzing the landscape simulation by season, images of 'bright', 'beautiful', and 'static', etc., were evaluated high for the spring streetscape. The images of 'open', 'refresh', and 'animate' appeared high in summer and images of 'warm' and 'dark' were found to be high in fall. On the other hand, all images were evaluated as low except for the 'orderly' image. In the preference of streetscape by season, summer and spring were highly preferred at 5.01 and 4.98 with winter as the lowest at 3.48. As the results of the analysis of preference factor, the spring streetscape was found to be a major influence in preference by 0.540 in 'aesthetics'. In the case of summer, 'order' was found to be high at 0.417 while influences in preference included 'variety' and 'aesthetics' in fall and 'variety', 'aesthetics', and 'order' in winter. A determination of suitable spatial planning using a comparative analysis of various city streets will be enabled through the methods of this study.

Development and Feasibility Study for Phase Contrast MR Angiography at Low Tesla Open-MRI System (저자장 자기공명영상 시스템에서의 위상대조도 혈관조영기법의 개발과 그 유용성에 대한 연구)

  • Lee, Dong-Hoon;Hong, Cheol-Pyo;Lee, Man-Woo;Han, Bong-Soo
    • Progress in Medical Physics
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    • v.23 no.3
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    • pp.177-187
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    • 2012
  • Magnetic resonance angiography (MRA) techniques are widely used in diagnosis of vascular disorders such as hemadostenosis and aneurism. Especially, phase contrast (PC) MRA technique, which is a typical non contrast-enhanced MRA technique, provides not only the anatomy of blood vessels but also flow velocity. In this study, we developed the 2- and 3-dimensional PC MRA pulse sequences for a low magnetic field MRI system. Vessel images were acquired using 2D and 3D PC MRA and the velocities of the blood flow were measured in the superior sagittal sinus, straight sinus and the confluence of the two. The 2D PC MRA provided the good quality of vascular images for large vessels but the poor quality for small ones. Although 3D PC MRA gave more improved visualization of small vessels than 2D PC MRA, the image quality was not enough to be used for diagnosis of the small vessels due to the low SNR and field homogeneity of the low field MRI system. The measured blood velocities were $25.46{\pm}0.73cm/sec$, $24.02{\pm}0.34cm/sec$ and $26.15{\pm}1.50cm/sec$ in the superior sagittal sinus, straight sinus and the confluence of the two, respectively, which showed good agreement with the previous experimental values. Thus, the developed PC MRA technique for low field MRI system is expected to provide the useful velocity information to diagnose the large brain vessels.

Composite valve graft Replacement of the Aortic Root (Composite valve graft를 이용한 대동맥근부 치환술)

  • 백만종;나찬영;김웅한;오삼세;김수철
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.102-112
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    • 2002
  • This study was undertaken to analyze the outcome of composite valve graftreplacement(CVGR) for the treatment of aneurysms of the ascending aorta involving the aortic root. Material and Method: Between April 1995 and June 2001, 56 patients had replacement of the ascending aorta and aortic root with a composite graft valve and were reviewed retrospectively. Aortic regurgitation was present in 50 patients(89%), Marfan's syndrome in 18 patients(32%), and bicuspid aortic valve in 7(12.5%). The indications for operation were annuloaortic ectasia(AAE) in 30 patients(53.6%), aortic dissection in 13(23.2%), aneurysms of the ascending aorta involving aortic root in 11(19.6%), and aortitis in 2(3.6%). Cardiogenic shock due to the aortic rupture was present in 2 patients. Nine patients(16%) had previous operations on the ascending aorta or open heart surgery. The operative techniques used for CVGR were the aortic button technique in 51 patients(91%), the modified Cabrol technique in 4, and the classic Bentall technique in 1. The concomitant procedures were aortic arch replacement in 24 patients(43%), coronary artery bypass graft in 8(14.3%), mitral valve repair in 2, redo mitral valve replacement in 1, and the others in 7 The mean time of circulatory arrest, total bypass, and aortic crossclamp were 21$\pm$14 minutes, 186$\pm$68 minutes, and 132$\pm$42 minutes, respectively. Result: Early mortality was 1.8%(1/56). The postoperative complications were left ventricular dysfunction in 16 patients(28.6%), reoperation for bleeding in 7(12.5%), pericardial effusion in 2, and the others in 7. Fifty-three patients out of 55 hospital survivors were followed up for a mean of 23.2 $\pm$ 18.7 months(1-75 months). There were two late deaths(3.8%) including one death due to the traumatic cerebral hemorrhage, and CVGR-related late mortality was 1.9%. The 1- and 6-year actuarial survival was 98.1$\pm$1.9% and 93.2$\pm$5.1%, respectively. Two patients required reoperation for complication of CYGR(3.8%) and two other patients required subsequent operations for dissection of the remaining thoracoabdominal aorta. The 1- and 6-year actuarial freedom from reoperation was 97.8$\pm$2.0% and 65.3$\pm$26.7%, respectively.

Effect of Barley, Italian ryegrass and Legume Mixture on Nitrogen Fixation and Transfer to Grasses on Spring Paddy Field using Isotope Dilution and Difference Method (답리작 춘계포장에서 보리 및 이탈리안 라이그라스와 두과의 혼파비율이 동위원소 희석법 및 차이법을 이용한 질소고정 및 이동에 미치는 영향)

  • Lee, Hyo-Won;Lee, Hyo-Jin;Kim, Won Ho;Yoon, Bong Ki;Ko, Han Jong
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.36 no.4
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    • pp.318-324
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    • 2016
  • In order to study the effect of barley, Italian ryegrass (IRG), and legume mixture on nitrogen fixation and transfer to grasses on spring paddy field, an experiment was carried out from Oct. 2006 to June 2007 in Naju, Korea. A split plot design with three replications was used for the experiment. One reference plot was assigned for each treatment to determine nitrogen fixation. Main plots consisted of Chinese milk vetch, crimson clover, forage pea, and hairy vetch with barley, respectively. Subplot treatment were barley or IRG with four seeding ratio of legumes (50:50, 60:40, 70:30, and 80:20). To estimate N fixation by legumes, $^{15}N$ isotope dilution technique was used. $^{15}N$ fertilizer [$(^{15}NH_4)_2SO_4$ solution at 99.8 atom N] was uniformly applied to $600cm^2$ in the middle of each plot on April 15, 2007. Plots were harvest by hand on June 8, 2007. Dried sample were ground to a fine power and analyzed for total N isotope N. $^{15}N$ was determined using elemental analyzer-isotope ratio mass spectrometry. The calculation of N transfer was determined with the isotope dilution method. The content of N was higher in legumes than that in barley or Italian ryegrass. Nitrogen level in forage pea was significantly higher than that of other legumes. There were significantly differences in N content between legumes in IRG mixture. Atom % $^{15}N$ excess was significantly different in legumes with barley. The 60:40 sub plot had higher (p<0.05) atom % $^{15}N$ than other seeding ratio treatments. The enrichment ranged from 0 to 0.58. Compared to barley, the enrichment of IRG with its accompanied legumes was higher, ranging from 0.38 to 1.0. The N derived from the atmosphere (Ndfa) ranged from 0% to 49.5% with barley-legume mixture. It ranged from 0 to 60.5% in IRG-legume plots. N transfer from legumes to neighboring grasses was 12.3 to 90.9 kg/ha for barley-legume mixture and 31.7 to 107.8 kg/ha for IRG plots. IRG plots showed higher N transfer for IRG-legume mixture in general based on difference method. Based on $^{15}N$ dilution method, the N transfer was 0 to 36.1 kg/ha for barley-legume mixture and 0 to 50.6 kg/ha for IRG plots. There was a tendency toward higher N transfer on the difference method than that of the $^{15}N$ dilution method.

SCANNING ELECTRON MICROSCOPIC STUDY ON THE EFFICACY OF ROOT CANAL WALL DEBRIDEMENT OF ROTARY NI-TI INSTRUMENTS WITH DIFFERENT CUTTING ANGLE (엔진 구동형 니켈-타이타늄 합금파일의 절삭각에 따른 근관성형 효과에 관한 전자현미경적 연구)

  • Jeon, In-Soo;Yoon, Tai-Cheol;Park, Seong-Ho;Kum, Kee-Yeon
    • Restorative Dentistry and Endodontics
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    • v.27 no.6
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    • pp.577-586
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    • 2002
  • The purpose of this in vitro study was to compare the effects of root canal cleanness following two Ni-Ti rotary instruments with different rake angle. Thirty-six sound, extracted human premolars with single root were randomly divided into three groups. The used rotary instruments were HEROShaper (Group 1, Micro-Mega, Besancon, France, n=12) and ProFile (Group 2, Maillefer, Ballaigues, Switzerland, n=12). Control group (n=12) was only extirpated with barbed broach (Mani, Matsutani Seisakusho Co., Japan) Group 1 & 2 teeth were prepared to a #40/.04 taper at the apex followed by 1 mm using crown-down technique. After canal preparation and frequent irrigation with 5.25% sodium hypochlorite, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. All root specimens were processed for SEM investigation and photographed. Separate evaluations by one endodontist were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. The penetration depth of smear layer into dentinal tubules was also estimated in the other halves. Following results were obtained: 1. Smear layer was observed on all the prepared walls with two experimental groups except control group. 2. Smear layer characteristics in two experimental groups; 1) HEROShaper group showed snowy, dusty appearance and were shown open dentinal tubuli on the prepared walls of almost specimens, and the thickness of smear layer covering onto dentinal surfaces was within 1-2 ${\mu}m$ in a few specimens. 2) ProFile group showed shiny, burnished appearance and complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli in all specimens. The penetration of smear layer into dentinal tubules was found in all specimens and the thickness was at 2-4 ${\mu}m$ in all specimens. These results demonstrated that a completely clean root canal could not be achieved regardless of positive or negative rake angle, which is in accordance with the majority of previous studies on root canal cleanliness In conclusion, through irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal wall in spite of Ni-Ti instrumentation.

A Study of Content Analysis on ICU(Intensive Care Unit) Nurses' Knowledge of Basic Nursing Sciences (중환자실 간호사의 기초간호과학 지식의 필요성 분석)

  • Byeon, Young-Soon;Choe, Myoung-Ae;Kim, Hee-Seung;Park, Mi-Jung;Seo, Wha-Sook;Lee, Kyung-Sook;Choi, S-Mi;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.41-49
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    • 2002
  • The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

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