• Title/Summary/Keyword: quality diagnosis

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Differentiation of Adductor-Type Spasmodic Dysphonia from Muscle Tension Dysphonia Using Spectrogram (스펙트로그램을 이용한 내전형 연축성 발성 장애와 근긴장성 발성 장애의 감별)

  • Noh, Seung Ho;Kim, So Yean;Cho, Jae Kyung;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.100-105
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    • 2017
  • Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

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Evaluation of Effectiveness of New Design Lead Apron during Pregnant X-ray Chest P-A (임산부 흉부 촬영중 사용할 새로 디자인된 납치마의 효율성 평가)

  • Kim, Hyeonggyun;Kwon, Soonmu;Jung, Hongmoon
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.441-445
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    • 2012
  • X-ray Chest P-A is very important and basic diagnosis examination for pregnant women. For a pregnancy period pregnant women should be treated very carefully not to be exposed to any radiation which might cause harmful damage to women and babies as well. Lead apron is one of the effective methods to protect pregnant women from the X-ray radiation. However, it is difficult to obtain the accurate position of pregnant women during X-ray Chest P-A since conventional lead apron method forces pregnant women to hold the apron by themselves only to make pregnant women very uncomfortable and hard to maintain accurate position during radiation. As a consequence, it is common to get low quality images of X-ray Chest P-A due to the overlap of apex of lung and scapular. In order to fix this problem, we made new design lead apron that allowed pregnant women to be more comfortable to maintain accurate position during X-ray Chest P-A position. Finally, with this new design lead apron, it was possible to get the best optimized images of X-ray Chest P-A of pregnant women by minimizing overlapping apex of lung and scapular.

Improvement of basic Academic Skills for Junior College Students : Based on a Case Study of D College (전문대학 기초학습능력 향상 방안: D 대학 사례를 중심으로)

  • Choi, Kil-Sung;Lee, Seung-Hee
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.468-476
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    • 2011
  • A lack of basic academic skills of junior college students has negatively impacted on the quality of vacational education and student dropout prevention, and yet it is true that there still are unclear alternatives or solutions to come up with that concern. As a way to find out the actual levels of basic academic skills of junior college students and educational efforts to improve these skills, the study investigated prior studies and benchmarked strengths and weaknesses of the related educational programs and supporting systems operated by ten junior colleges around the nation. Further, the study addressed emerging issues and challenges related to basic academic skills, based on the case study of D college. Major research methodologies included literature review, surveys for students and faculty members and focus-group interviews of faculty members in order to examine the states of students' basic academic skills in the area of language, in particular. Accordingly, the study proposed several suggestions with which educational practitioners could assist in supporting students to acquire improved basic academic skills(such as the development of a competence-based curriculum, implementation of reliable diagnosis tools and supporting educational systems for evaluating students' basic academic skills and upgrading of diverse teaching and learning resources and methods).

A Case Study on the Continuous Quality Improvement for Leadership Outcomes Education in Yeungnam University (영남대학교 리더십 학습성과 교육 CQI 방안에 대한 연구)

  • Pyun, Kyung-Hee;Song, Dong-Joo
    • Journal of Engineering Education Research
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    • v.12 no.1
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    • pp.64-72
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    • 2009
  • The objective of the current study is to establish the CQI procedure of leadership outcome education, which is emphasized in engineering education accreditation. Leadership includes many program outcomes, especially soft skills, such as communication skill, team work skill, and etc. This paper studied leadership education program in Yeungnam University. In particular, this research was conducted by using focus group interviews with experts and working level staffs of relevant organizations for the analysis of Yeungnam University curriculum and non-curriculum courses related to leadership education and for the preparation of leadership education CQI method. In addition, we conducted leadership competence diagnosis, leadership education demand survey and satisfaction level survey on the leadership camp participants. Interviews with experts, lecturers and focus group of Dale Carnegie Research Institute Daegu branch that administered the progress of leadership camp were conducted along with analysis of education contents through non-participation observation method during camp period and participant students interviews. The conclusions are summed up as follows: To educate global leaders in true meaning, first, psychological level competence strengthening method and study completing ability improvement method should be considered simultaneously. In particular, for non-capital region universities, emphasis should be given to education for self-confidence and vision establishment. Second, leadership education methods of mid/long term and systematic curricular and extra-curricular type should be pursued. For instance, with the use of engineering design subject completing system, leadership education can be consolidated to engineering subject courses with engineering design projects or the system of mentor-pupil among earlier leadership camp participants and later participants may be utilized. Third, it is determined necessary to pursue and realize practical methods of conducting various intramural leadership related education activities in mid/long term perspective by organizing leadership education advisory group consisting of major, departments and intramural and extramural relevant organization authorities that focus on leadership education.

The Effect of Triamcinolone Injection on the Vocal cord during Laryngeal Microsurgery in the Patient of the Vocal Polyp (성대용종환자에서 후두미세수술시에 수술부위에 Triamcinolone 국소주입이 음성에 미치는 영향에 대한 연구)

  • Yoo, Jun;Oh, Kyung Ho;Yoon, Hee Chul;Lee, Doh Young;Woo, Jeung soo;Baek, Seung Kuk;Jung, Kwang Yoon;Kwon, Soon Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.122-126
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    • 2015
  • Background and Objective : Laryngeal microscopic surgery (LMS) is popular method to treat for vocal polyp. There is not always the improvement of the voice after operation. Many methods have been developed for better outcome of the surgery. The purpose of this study is to investigate the effect of the triamcinolone injection at vocal cord during LMS. Materials and Methods : The medical records of 28 patients, received LMS under diagnosis of vocal polyp, were retrospectively reviewed. The patients were divided into two groups depending on whether triamcinolone injected or not (case group : Triamcinolone-injected group, control group : Triamcinolone-not injected group). The quality of voice was evaluated by GRBAS scale, fundamental frequency (Fo), jitter, shimmer and NHR (Noise to harmonic ratio) at previous operation, 4 weeks after operation, 8 weeks after operation. Each voice analysis factor was compared between case group and control group by Independent t-test. Results : The mean differences of each voice analysis factor. The mean difference of Jitter, Shimmer, NHR in case group were lower than in control group, and mean difference of GRBAS scale in case group were higher than in control group. These differences were not significant (p>0.05). Conclusion : Though there was a tendency of better voice outcome in patients of triamcinolone-injection, it may not be concluded that the triamcinolone injection is helpful for better voice outcome in surgery of vocal polyp due to statistical insignificance.

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The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study (요추 추간판탈출증 입원환자 72례에 대한 한의학적 복합치료 효과의 관찰 연구)

  • Kim, Sang Min;Lee, Sun Ho;Shin, You Bin;Choi, Ji Hoon;Koo, Ja Sung;Yoo, Hyung Jin;Lee, Dong Hyun
    • Journal of Acupuncture Research
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    • v.32 no.2
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    • pp.23-33
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    • 2015
  • Objectives : This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation. Methods : This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments. Results : Average admission duration was $28.00{\pm}12.85$ days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from $5.89{\pm}2.00$ to $3.42{\pm}1.87$(p<0.001) and radiating pain from $5.96{\pm}2.12$ to $3.38{\pm}1.83$(p<0.001). ODI decreased from $46.69{\pm}19.25$ to $35.69{\pm}16.67$(p<0.001), and EQ-5D index increased from $0.63{\pm}0.26$ to $0.71{\pm}0.20$(p<0.05) after treatment in lumbar disc patients. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

AN EVALUATION OF THE PRIMARY IMPLANT STABILITY AND THE IMMEDIATE LOAD-BEARING CAPACITY ACCORDING TO THE CHANGE OF CORTICAL BONE THICKNESS (치밀골 두께 변화에 따른 임플랜트 1차안정성과 즉시하중부담능 평가)

  • Yi Yang-Jin;Park Chan-Jin;Cho Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.248-257
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    • 2005
  • Statement of problem. Cortical bone plays an important role in the primary implant stability, which is essential to immediate/early loading. However, immediate load-bearing capacity and primary implant stability according to the change of the cortical bone thickness have not been reported. Purpose. The objectives of this study were (1) to measure the immediate load-bearing capacity of implant and primary implant stability according to the change of cortical bone thickness, and (2) to evaluate the correlation between them. Material and methods.48, screw-shaped implants (3.75 mm$\times$7 mm) were placed into bovine rib bone blocks with different upper cortical bone thickness (0-2.5 mm) and resonance frequency (RF) values were measured subsequently. After fastening of healing abutment. implants were subjected to a compressive load until tolerated micromotion threshold known for the osseointegration and load values at threshold were recorded. Thereafter, RF measurement after loading, CT taking and image analysis were performed serially to evaluate the cortical bone quality and quantity. Immediate load-bearing capacity and RF values were analyzed statistically with ANOVA and post-hoc method at 95% confidence level (P<0.05). Regression analysis and correlation test were also performed. Results. Existence and increase of cortical bone thickness increased the immediate load-bearing capacity and RF value (P<0.05) With the result of regression analysis, all parameter's of cortical bone thickness to immediate load-bearing capacity and resonance frequency showed significant positive values (P<0.0001). A significant high correlation was observed between the cortical bone thickness and immediate load-beating capacity (r=0.706, P<0.0001), between the cortical bone thickness and resonance frequency (r=0.753, P<0.0001) and between the immediate load-bearing capacity and resonance frequency (r=0.755, P<0.0001). Conclusion. In summary, cortical bone thickness change affected the immediate load-baring capacity and the RF value. Although RF analysis (RFA) is based on the measurement of implant/bone interfacial stiffness, when the implant is inserted stably, RFA is also considered to reflect implant/bone interfacial strength of immediately after placement from high correlation with the immediate load-baring capacity. RFA and measuring the cortical bone thickness with X-ray before and during surgery could be an effective diagnosis tool for the success of immediate loading of implant.

Development of Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology - Purpose, Development Strategy and Procedure - (사상체질병증 임상진료지침 개발 연구 - 목적, 개발 전략 및 절차 -)

  • Kim, Je-Shin;Hwang, Min-Woo;Lee, Jun-Hee;Lee, Eui-Ju;Koh, Byung-Hee;Yoo, Jung-Hee;Bae, Na-Young;Kim, Yun-Hee;Bae, Hyo-Sang;Joo, Jong-Cheon;Park, Hye-Sun;Shin, Mi-Ran;Yoo, Jun-Sang
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.1
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    • pp.23-33
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    • 2013
  • Objectives This study was aimed to develop the clinical practice guidelines, which focuses on Sasang Constitutional Medicine symptomology. By developing clinical practice guidelines, we should present prevention, diagnosis, treatment and assessment of Sasang Constitutional Medicine. Methods We used the method of University of Michigan Health System Guidelines model. Electronic databases including English, Korean databases were systematically searched for clinical articles investigating Sasang Constitutional Medicine symptomology up to March 2010. And "Donguisusebowon-ShinChukbon" was basically used to develop clinical guidelines. Results and Conclusions 12,694 Articles were reviewed. Only 25 articles described adequate methods of this study. Using clinical practice guidelines, we can manage th quality of medicine, emphasis treatment appropriacy and educate patients and doctors. Finally We can get the Sasang Constitutional Medicine standardization and socioeconomic benefit.

Determinants for further wishes for cosmetic and reconstructive interventions in 1652 patients with surgical treated carcinomas of the oral cavity

  • Holtmann, Henrik;Spalthoff, Simon;Gellrich, Nils-Claudius;Handschel, Jorg;Lommen, Julian;Kubler, Norbert R.;Kruskemper, Gertrud;Rana, Majeed;Sander, Karoline
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.26.1-26.10
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    • 2017
  • Background: The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. Method: The desire of patients for CRS (N = 410; 26%) has been acquired in this $D{\ddot{O}}SAK$ rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient's views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician's questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22. Results: The patient's assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related. Conclusion: The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients' needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.

Digital imaging of film-based cephalograms using a digital camera (디지털 카메라를 이용한 필름 두부방사선사진의 디지털 이미지 전환)

  • Wang, Sung-Jin;Kim, Kyung-Ho;Choy, Kwang-Chul
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.448-457
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    • 2004
  • As computer Programs for cephalometric analysis were developed in diagnosis & treatment planning, digital imaging of film-based cephalograms came to be needed. When a digital camera is used, a problem encountered the image distortion produced according to the focal length, which causes errors in indentifying landmarks. In addition, changes in the image size and compression ratio will inevitably produce a low quality image, causing errors in identifying landmarks. Hence. we have found the focal length producing the least image distortion when digital imaging the film-based cephalograms and the minimal digital camera setting which helps to identify the correct landmarks using the COOLPIX4500 digital camera (Nikon, Japan). The results were as follows The image distortion was minimized at a focal length of 16.4mm (79.4mm when converted into a 35mm film camera) when digital imaging the film-based cephalograms. When wide imaging, with a focal length of under IS.4mm, barrel distortion was found and when tole imaging. with a focal length of over 15.4mm pincushion distortion was found. The minimal digital camera setting was $2272{\times}1704$ pixel at normal (1/8) compression from which we can identify the correct landmarks at the same level as tracing the film-based cephalograms manually. As a result. when digital imaging the film-based cephalograms, using a COOLPIX4500 digital camera (Nikon, Japan), the focal length should be 16.4mm the pixel image size over $2272{\times}1704$, and the compression ratio over normal (1/8).