Earticle

본 연구는 부처님의 진산사리를 봉안한 우리나라 5대 적멸보궁(설악산 봉정암, 오대 산 중대 적멸보궁, 사자산 법흥사, 태백산 정암사, 영축산 통도사)을 중심으로 풍수지표 를 적용하여 분석한 연구이다. 적멸보궁의 진신사리는 신라 643년 자장법사(590~658년) 에 의해 창건된 사찰에 봉안된 곳이며, 지금까지 현존하고 있는 명당공간이다. 현존하는 천년고찰중 불사리를 봉안한 사찰은 지금까지 14곳에 불과한 것으로 알려져 있다. 이중 자장법사에 의해 창건된 적멸보궁과 삼국통일 후 의상대사(625~702년)에 의해 창건된 화엄십찰, 그리고 나말여초의 구산선문 사찰은 한국사찰의 역사적 배경을 갖고 있는 곳 이다. 특히 신라중기 불사리를 봉안한 적멸보궁은 오랜 세월동안 현존하고 있는 우리의 소중한 문화유산으로 남아있는 도량공간이다. 지금까지 신라시대 불국토사상을 고취하 기 위해 창건된 적멸보궁에 관한 연구는, 불교학·건축학·문화재학 분야에서 사찰의 공간 배치, 전각의 건축유형, 문화적가치 등이 진행되어 왔다. 풍수지리학분야는 불사리를 갖 고 있는 사찰의 입지에 대한 연구만 주로 이루어졌으며, 5대 적멸보궁 터에 대한 풍수지 리연구는 전혀 진행되지 않는 실정이다. 이러한 맥락에서 현존하고 있는 5대 적멸보궁에 대한 불사리가 봉안된 터는 어떠한 공간에 입지하고 있는지, 사찰내 경배법당과의 공간 배치는 어떻게 이루어져 있는지, 당시 입지선정시 풍수지리사상이 내재되어 있는지 등 을 풍수지리적 연구가 필요한 것으로 본다. 본 연구전개는 풍수지리의 형식논리를 풍 수지표(간룡, 장풍, 수세, 정혈, 좌향, 비보)로 객관화된 수치를 적용하여 적멸보궁 터의 역량에 대한 정량화(상격,중상격,중격,중하격,하격,흉격)를 도출한 것이다. 연구대상인 5대 적멸보궁의 연구결과는 설악산 봉정암, 오대산 중대, 영축산 통도사의 터는 상격이며, 태백산 정암사, 사자산 법흥사의 터는 중상격인 것으로 분석되었다. 특히 적멸보궁의 진신사리를 봉안한 터의 혈장공간분석에서는 5곳 모두 상격의 역량이 갖춘 것으로 나타 났다. 이것은 부처님의 진신사리를 불국토사상이 승화될 수 있도록 명당 혈처에 터잡이 가 이루어진 것으로 볼 수 있다. 그 당시 자장법사에 의한 적멸보궁의 입지선정시 풍수지 리사상이 내재된 공간설계가 이루어진 것을 말해준다. 이러한 연구결과를 도츨하는데 적용된 풍수지표는 입지공간을 주관적 분석에서 보다 객관적 논리로서 판단하는 방법론 이므로 학술적 가치를 갖는 것이라 할 수 있다. 향후 현존하고 있는 적멸보궁 입지에 대 한 연구에 기초자료로 활용되기를 기대한다.

This study is a study to derive quantification by applying the Feng Shui index to the location space of the five major jeogmyeolbogung. Until now, the study of feng shui has been conducted in various ways on the location of temples, but the research applying the feng shui indicator is a research methodology that we are trying to approach anew in recent years. These research attempts believe that objectivity can be achieved according to quantification by applying more objective formal logic to feng shui geography in terms of subjective and experiential aspects. In this context, five case papers were analyzed to derive the research results. In conclusion, it appears that the location of the five major Jeokjeokbogung Palaces in Korea is based on the central dragon extending from the high mountain dragon to form the Hyeonmu Peak and then re-opening it or relying on the place where it was formed by the Haengryong. These sites are to be enshrined in the site of the famous hall where the blood was formed by making Haengryong far away from the harsh terrain of Jusan, where the high mountain dragons were formed. And although the form of enshrining the Jinsinsari is different, the space is arranged to the left facing the Jeokhyeol Bogung and continuously corresponding to the main mountain of Jusan. According to the research results of the five major Jeokheungbogung, the study results, the sites of Bongjeongam in Seoraksan, Middle Mountain in Odaesan, and Tongdosa in Yeongchuksan were high, and the sites of Jeongamsa in Taebaeksan and Beopheungsa in Sasasan were analyzed to be moderate. Therefore, it is judged that the site of the Jeokjeokbogung site at that time was located in a place where the main dragon was not damaged and received strong support.

본 연구는 신규간호사를 대상으로 감성지능 향상프로그램을 적용 후 감성지능 및 직무스트레스에 미치는 효과를 파악하고자 시도 되었다. 혼합연구설계이며 연구대상자는 신규간호사 29명(실험군 15명, 대조군 14명)을 대상으로 감 성지능 향상프로그램을 주 1회 총 8주(20시간) 실시하였다. 양적연구는 SPSS/WIN 18.0을 이용하여 Chi-square, Fisher’s exact test, t-test, repeated measure ANOVA로 분석하였고 질적연구는 내용분석을 하였다. 실험군의 감 성지능과 직무스트레스가 대조군에 비해 통계적으로 유의한 효과가 없었다. 질적내용 분석결과 감성지능이 향상됨 임파 워링 됨, 스트레스가 줄어듬, 나에서 우리로 변함, 미래의 나를 꿈꾸게 됨으로 나타났다. 다양한 시기의 간호사를 대상 으로 감성지능 향상프로그램을 적용하고 그 효과를 검증하는 연구를 제언한다.

This study was conducted to develop and test the effects of an emotional intelligence program for new nurses. The study design was a mixed method research. Participants were 29(intervention group: 15, control group: 14) new nurse. The emotional intelligence improvement program was conducted once a week for a total of 8 weeks (20 hours).The emotional intelligence program was provided for 8 weeks (20 hours). Quantitative data were analyzed using Chi-square, Fisher’s exact test, t-test, repeated measure ANOVA with SPSS/WIN 18.0. Qualitative data were analyzed using content analysis. Quantitative results showed that emotional intelligence, Job stress were no significantly better in the experimental group compared to the control group. According to the qualitative results, the new nurse experienced improvement in emotional intelligence, empowerment, a reduction in stress, Changed from 'alone' to 'us', and as well as I dream of my future self after participation in the emotional intelligence program. A study to apply the emotional intelligence improvement program to nurses at various times and to verify its effectivene.

Most of rotating machineries supported by contact bearing accompany lowering efficiency, vibration and wear. Moreover, because of vibration, which is occurred in rotating shaft, they have the limits of driving speed and precision. The rotor system has parametric variations or external disturbances such as mass unbalance variations in long operation. Therefore, it is necessary to research about magnetic bearing, which is able to support the shaft without mechanical contact and to control rotor vibration without being affected by external disturbances or parametric changes. Magnetic bearing system in the paper is composed of position sensor, digital controller, actuating amplifier and electromagnet. This paper applied the robust control method using quantitative feedback theory (QFT) to control the magnetic bearing. It also proposed design skill of optimal controller, in case the system has structured uncertainty, unstructured uncertainty and disturbance. Reduction of vibration is verified at critical rotating speed even external disturbance exists. Unbalance response, a serious problem in rotating machinery, is improved by magnetic bearing using QFT algorithm.

최근 들어 유전자 또는 DNA 분절의 반복수 변이 (CNV)에 관한 연구가 다수 수행되었으며, 그 분석 방법 및 기기 또한 다양하게 발달되었다. 본 연구는 Landrace 품종의 KIT 유전자 CNV 탐지를 위하여 다른 분석 방법들에 비하여 정확도가 높은 정량적 OLA 기법(qOLA)을 이용하였다. qOLA와 pyrosequencing assay의 조합하여 분석한 결과를 Landrace 44두에 대한 좌표 분석을 한 결과 I1/I1 또는 I3/i(IBe), I1/I2 또는 I3/IP, I1/I3, I1/IP 또는 I2/i(IBe), I2/I2, I2/IP의 6 genotype으로 분류되었으며, PROC FASTCLUS procedure을 이용한 통계 분석과 좌표 분석을 상호 비교한 결과 genotype의 분류가 100% 일치하였다. 기기간의 차이점을 조사하기 위해 qOLA_3100과 qOLA _3130의 관측치 비교를 실시한 결과 동일한 genotype 분류결과를 얻었다. 또한 정밀성 및 정확도 비교에서 qOLA_3100의 경우 표준편차와 변이계수의 평균이 2.33과 4.10로 qOLA_3130(2.67과 4.81)에 비하여 낮게 나타났다. qOLA 반응전 PCR 산물에 대하여 proteinase K 처리효과를 분석한 결과 pro- teinase K를 처리한 경우 전기영동 분석시 noise peak들이 제거되었으며 각 genotype의 이론적 비율에 보다 정확히 일치하였다.

Recently, copy number variations (CNV) of genes or genomic segments have been intensively studied and various analysis methods have been developed. In this study, quantitative oligonucleotide ligation assay (qOLA) was applied to investigate CNV of KIT gene in the Landrace breed. A combined assay using qOLA and pyrosequencing, 6 genotype classes, I1/I1 or I3/i (IBe), I1/I2 or I3/IP, I1/I3, I1/IP or I2/i (IBe), I2/I2and I2/IP, were identified from 44 Landrace pigs. Genotype assignment using grouping features of measurements on a scatter plot showed 100% agreement with those using a statistical assignment by PROC FASTCLUS procedure implemented in the SAS package. Two versions (3100 and 3130) of ABI sequencers gave the same genotyping results, indicating there was no influence on qOLA by different versions of instrument, however, the means of standard deviation and coefficient of variation from the qOLA on a ABI 3130 (2.33 and 4.10) was lower than those from the qOLA on a ABI 3100 (2.67 and 4.81). Effect of proteinase K treatment on the PCR product followed by qOLA was very clear because noise peaks were disappeared and the observed ration fit better to the reference ratio corresponding to each genotype.

Objective: Cervicogenic headachesare a type of secondary headache that may originate in the neck or occipital region and spread to the temporal, frontal, and orbital regions. A majority of the previous studies have described these pain patterns qualitatively and, consequently, there are currently limited quantitative data available. In this study, we sought to quantify the sites of headache onset, overall locations of pain, and major patterns of pain distribution in patients with cervicogenic headaches. Design: A cross-sectional study. Methods: A total of 170 patients with cervicogenic headache were assessed using a head and neck pain map, with the locations of pain being coded by two researchers. The sites of headache onset were analyzed as a single-response variable, whereas the overall locations of pain were analyzed as multiple-response variables to enable the calculation of frequencies and percentages. Results: The most common sites of headache onset were the upper cervical and occipital region, reported by 111 patients (65.3%), followed by the trapezius and shoulder girdle region in 19 (11.2%), temporomandibular joint region in 12 (7.1%), temporal region in nine (5.3%), orbital region in seven (4.1%), sternocleidomastoid and scalene region in five (2.9%), frontal region in three (1.8%), and parietal region in one (0.6%). The most common patterns of pain distribution were upper cervical-occipital plus temporal pain in 65 patients (38.2%), followed by upper cervical-occipital, temporal, and frontal pain in 23 patients (13.5%). Conclusions: In patients experiencing cervicogenic headaches, pain most commonly originated in the upper cervical and occipital regions, with frequent involvement of the temporal region. Pain also extended to other regions of the head and face, including the frontal, orbital, and temporomandibular joint regions.

A Distributed reflection denial of service (DRDoS) is a variant of DDoS attacks that threatens the availability of services to legitimate users. In response to this evolving threat landscape, the cybersecurity industry and service providers have intensified their efforts to develop effective countermeasures. Despite these efforts, attackers continue to innovate, developing new strategies and tools while becoming more sophisticated. Consequently, DRDoS attacks continue to be harmful. Therefore, ongoing research and development is essential to improve defense against DRDoS attacks. To advance our understanding and analysis of DRDoS attacks, this study examines the unique characteristics of DRDoS attacks and quantifies the risks involved. Additionally, it adopts a quantitative rather than traditional qualitative methods to derive and apply risk, particularly the probability of loss that can be caused by DRDoS attacks.

Purpose: Myofascial syndrome is a chronic muscle pain caused by repetitive motions with stress-related muscle tension. This study aimed to investigate the validity and reliability of the evidence for diagnosing myofascial pain syndrome in trapezius muscle using a pressure algometer and surface electromyography. Methods: The experiments were performed using a total of 10 subjects, and the target locations were determined by means of a pressure algometer in the right upper trapezius muscle. The part with the lowest pain value as the trigger point and the part with the highest pain value as the non-pain trigger point were selected for measuring the locations. The median frequency and average frequency were measured in those locations with electromyography. To check the muscle fatigue, the upper trapezius muscle was moved up and down for 2 seconds at 5-second intervals in 30 seconds. The measured values were evaluated using the independent paired t-test and MannWhitney U-test. Results: The median frequency at the non-trigger point (13.7) was significantly higher than that at the trigger point (7.3). Furthermore, the mean frequency (14.7) at the non-trigger point was significantly higher than that at the trigger point (6.3). Conclusion: The results showed the correlations between the trigger points of the muscle pain and frequency analysis of surface electromyography. Thus, this study may be possible to use as a diagnostic tool for myofascial pain syndrome.

Six polyphenolic compounds, such as chlorogenic acid (CA), rutin (RT), isoquercitrin (IQT), quercetin-3-O-(6-O-malonyl)-${\beta}$-D-glucoside (QMG), astragalin (AG), kaempferol-3-O-(6-O-malonyl)-${\beta}$-D-glucoside (KMG), were isolated from mulberry leaves by a series of isolation procedures, such as Diaion HP-20, silica-gel, Sephadex LH-20, and ODS-A column chromatographies. The chemical structures of the phenolic compounds were identified by UV and NMR spectral analyses. Levels of polyphenols in mulberry leaves from six different mulberry cultivars ranged from 1,042.16 to 1,871.97 mg% per dry weight; Guksang cultivar showed the highest levels of polyphenols, whereas Gaeryangdaehwa contained the least polyphenol contents. Generally, levels of polyphenols in mulberry leaves decreased with increasing harvest time, except for Yoolmok, but increased with heat processing time, except QMG and KMG. These results suggest that the heat processed mulberry leaves of Guksang cultivar harvested in early May can be potentially useful sources for production of high quality mulberry leaf teas.

Phenolic compounds in safflower seeds were recently found to stimulate bone formation and increase plasma HDL cholesterol levels in estrogen deficient rats, and to inhibit melanin synthesis. Nine phenolic compounds: $N-feruloylserotonin-5-O-{\beta}-D-glucoside,\;8'-hydroxyarctigenin-4'-O-{\beta}-D-glucoside,\;luteolin-7-O-{\beta}-D-glucoside$, N-(p-coumaroyl)serotonin, N-feruloylserotonin, 8'-hydroxy arctigenin (HAG), luteolin (LT), $acacetin-7-O-{\beta}-D-glucuronide$ (ATG) and acacetin (AT), were quantified by HPLC in safflower (Carthamus tinctorius L.) seeds during growth and processing. During growth, levels of the nine phenolic compounds in the seeds increased progressively with increasing growth stages, reached a maximum on July 30 (42nd day after flowering), and then remained relatively constant. During the roasting process, levels of phenolic compounds, except HAG, LT and AT, generally decreased with increased roasting temperature and time, whereas those of HAG, LT and AT increased progressively with increased roasting temperature and time. During the steaming process, levels of other phenolic compounds except HAG and AT generally tended to increase with increased steaming time, whereas those of HAG and AT were scarcely changed. During the microwave treatment, quantitative changes of phenolic compounds were similar to the roasting process, although there were some differences in levels of phenolic compounds between two heat treatments. These results suggest that the steamed safflower seeds after harvesting on late July may be useful as potential dietary supplement source of phenolic compounds for prevention of several pathological disorders, such as atherosclerosis and osteoporosis and aging.

The growth of solid particles in TiC-XC-2vo1.% and TiC-XC-30vo1.% Ni alloys, (where X=Zr, W or Mo) was fitted to the equation of the form $d^3$-${do}^3$=Kt during the liquid phase sintering at 1,673K. Also, the grain growth behavior decreased markedly with the addition of ${MO}_2$C or WC and increased with the addition of zrC. The contiguity was greater in the alloys with a smaller growth rate constant and especially, decreased by increasing the Ni content in the TiC-${MO}_2$C-Ni alloy. In addition, the effect of the addition of carbide on the grain growth of 2 vo1.% Ni alloys was found to be similar to that of 30vo1.% Ni alloys. Consequently, the grain growth mechanism cannot be explained by the usual solution / reprecipitation process, but can be explained in terms of a new growth velocity equation, which includes the effects of contiguous carbide grain boundaries in restricting the overall grain growth, as well as the area of the solid / liquid interface in the alloy.

Gamma-irradiated chicken at dose levels of 0.1 to 10 kGy was subjected to detection of radiation-induced hydrocarbons whether irradiated or not. The hydrocarbons extracted from chicken fat were separated by florishil column chromatography and identified with GC-FID and GC/MS methods. Eight kinds of hydrocarbons were identified from irradiated chicken, among which 1, 7-hexadecadiene and 8-heptadencene were detected as major compounds , Remarkably radiation-induced hydrocarbons in irradiated chiken were detected at 0.5kGy and over. The concentration of radiation-induced hydrocarbons was relatively constant during 16 weeks.

In this study, we performed a quantitative microbial risk assessment (QMRA) of Salmonella through intake of egg consumption after cooking (dry-heat, moist-heat, and raw consumption). Egg samples (n = 201) from retail markets were analyzed for the presence of Salmonella. In addition, temperature and time were investigated during egg transit, storage, and display. A predictive model was developed to characterize the kinetic behavior of Salmonella in eggs, and data on egg consumption and frequency were collected. Eventually, the data was simulated to estimate egg-related foodborne illnesses. Salmonella was not found in any of the 201 egg samples. Thus, the estimated initial contamination level was ?4.0 Log CFU/ g. With R2 values of 0.898 and 0.922, the constructed predictive models were adequate for describing the fate of Salmonella in eggs throughout distribution and storage. Eggs were consumed raw (1.5%, 39.2 g), dry-heated (57.5%, 43.0 g), and moist-heated (41%, 36.1 g). The probability of foodborne Salmonella illness from the consumption of cooked eggs was evaluated to be 6.8×10?10. Additionally, the probability of foodborne illness not applied cooking methods was 1.9×10?7, indicating that Salmonella can be reduced by cooking. Therefore, the risk of Salmonella infection through consumption of eggs after cooking might be low in S. Korea.

The aim of the research is to identify that porcine oocytes can function as recipients for interspecies cloning and have the ability to develop to blastocysts. Furthermore each mitochondrial DNA (mtDNA) in interspecises cloned embryos was analyzed. For the study, mouse-porcine and porcine-porcine cloned embryos were produced with mouse fetal fibroblasts (MFF) and porcine fetal fibroblasts (PFF), respectively, introduced as donor cells into enucleated porcine oocytes. The developmental rate and cell numbers of blastocysts between intraspecies porcine-porcine and interspecies mouse-porcine cloned embryos were compared and real-time polymerase chain reaction (PCR) was performed for the estimate of mouse and porcine mtDNA copy number in mouse-porcine cloned embryos at different stages.There was no significant difference in the developmental rate or total blastocyst number between mouse-porcine cloned embryos and porcine-porcine cloned embryos (11.1 ± 0.9%, 25 ± 3.5 vs. 10.1 ± 1.2%, 24 ± 6.3). In mouse-porcine reconstructed embryos, the copy numbers of mouse somatic cell-derived mtDNA decreased between the 1-cell and blastocyst stages, whereas the copy number of porcine oocyte-derived mtDNA significantly increased during this period, as assessed by real-time PCR analysis. In our real-time PCR analysis, we improved the standard curve construction-based method to analyze the level of mtDNA between mouse donor cells and porcine oocytes using the copy number of mouse beta-actin DNA as a standard. Our findings suggest that mouse-porcine cloned embryos have the ability to develop to blastocysts in vitro and exhibit mitochondrial heteroplasmy from the 1-cell to blastocyst stages and the mouse-derived mitochondria can be gradually replaced with those of the porcine oocyte in the early developmental stages of mouse-porcine cloned embryos.

Objective To investigate the clinical usefulness of diffusion tensor imaging (DTI) and tractography in the prediction of outcomes after traumatic cervical spinal cord injury (SCI) and to assess whether the predictability is different between DTI and tractography administered before and after surgery.Methods Sixty-one subjects with traumatic cervical SCI were randomly assigned to preop or postop groups and received DTI accordingly. Among the patients who had DTI before surgery, we assigned 10 patients who had received repeated DTI examinations at 8 weeks after injury to the follow-up group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained from DTI, and imaginary fiber and crossing fiber numbers were calculated from the tractography. Neurological status and functional status were assessed at 4 and 8 weeks after SCI.Results The neurologic and functional statuses of both groups improved after 4 weeks. Out of the initial 61 patients who were enrolled in the study, the failure rate of DTI image analysis was significantly higher in the postop group (n=17, 41.5%) than in the preop group (n=6, 20%). The FA values and fiber numbers in the preop group tended to be higher than those in the postop group, whereas ADC values were lower in the preop group. When comparing the tractographic findings in the follow-up group, imaginary fiber numbers at the C6 and C7 levels and crossing fiber numbers from the C3 to C6 levels were significantly decreased after surgery. Several DTI and tractographic parameters (especially the ADC value at the C4 level and imaginary fiber numbers at the C6 level) showed significant correlations with neurologic and functional statuses in both the preop and postop groups. These findings were most prominent when DTI and physical examination were simultaneously performed.Conclusion Preoperative DTI and tractography demonstrated better FA and ADC values with lower interpretation failure rates than those obtained after surgery, whereas postoperative data significantly reflected the patient’s clinical state at the time of evaluation. Therefore, DTI and tractography could be useful in predicting clinical outcomes after traumatic cervical SCI and should be interpreted separately before and after spine surgery.

Objective To determine the possibility of a new measurement tool using electromyography and ultrasonography for quantitative spasticity assessment in post-stroke patients. Methods Eight hemiplegic stroke patients with ankle plantarflexor spasticity confirmed by a Modified Ashworth Scale (MAS) were enrolled. Spasticity was evaluated using the MAS and Modified Tardieu Scale (MTS). Each subject underwent surface electromyography (sEMG) using the Brain Motor Control Assessment (BMCA) protocol and was compared with a healthy control group. Using ultrasonography, muscle architecture and elasticity index were measured from the medial gastrocnemius muscle (GCM) on the affected and unaffected sides. Results MAS and MTS revealed significant correlation with sEMG activity. The fascicle length and pennation angle were significantly decreased in the medial GCM on the hemiplegic side compared with the unaffected side. The elasticity index of the spastic medial GCM was significantly increased compared with the unaffected side. The MTS X and R2?R1 values were significantly correlated with the elasticity index in the hemiplegic GCM. The relationship between clinical evaluation tools and both BMCA and sonoelastography was linear, but not statistically significant in the multiple regression analysis. Conclusion The BMCA protocol and ultrasonographic evaluation provide objective assessment of post-stroke spasticity. Further studies are necessary to conduct accurate assessment and treatment of spasticity.

Objective To investigate the utility of ultrasonography to objectively examine morphological changes (i.e., muscle atrophy and fatty infiltration) of the supraspinatus muscle. Methods Thirty-four patients were prospectively enrolled in this study. The degrees of muscle atrophy and fat infiltration were measured using ultrasonography 3?4 months after arthroscopic supraspinatus tendon repair. Shoulder function (i.e., shoulder active range of motion, visual analogue scale, and constant score) was examined. Using the symmetricity of the muscles in the human body, the degrees of morphological changes of the supraspinatus muscle were quantitatively measured. The associations between the morphological changes of the supraspinatus muscle and shoulder function were identified. Results There were statistically significant differences in the cross-sectional area (CSA) and echogenicity between the surgery and non-surgery sides (p<0.001). The CSA ratio, which represents the degree of muscle atrophy, was associated with shoulder forward flexion, external rotation, and constant score; however, the echogenicity ratio, which represents the degree of fat infiltration, was not associated with shoulder function after surgery. Conclusion This study demonstrated that shoulder function could be predicted by evaluating the morphological changes of the supraspinatus muscle using ultrasonography and that objective evaluation is possible through quantitative measurement using the symmetricity of the human body.

Objective To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment.Methods This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups.Results Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04?0.46; p=0.001).Conclusion In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

Objective To compare swallowing function between healthy subjects and patients with pharyngeal dysphagia using high resolution manometry (HRM) and to evaluate the usefulness of HRM for detecting pharyngeal dysphagia.Methods Seventy-five patients with dysphagia and 28 healthy subjects were included in this study. Diagnosis of dysphagia was confirmed by a videofluoroscopy. HRM was performed to measure pressure and timing information at the velopharynx (VP), tongue base (TB), and upper esophageal sphincter (UES). HRM parameters were compared between dysphagia and healthy groups. Optimal threshold values of significant HRM parameters for dysphagia were determined.Results VP maximal pressure, TB maximal pressure, UES relaxation duration, and UES resting pressure were lower in the dysphagia group than those in healthy group. UES minimal pressure was higher in dysphagia group than in the healthy group. Receiver operating characteristic (ROC) analyses were conducted to validate optimal threshold values for significant HRM parameters to identify patients with pharyngeal dysphagia. With maximal VP pressure at a threshold value of 144.0 mmHg, dysphagia was identified with 96.4% sensitivity and 74.7% specificity. With maximal TB pressure at a threshold value of 158.0 mmHg, dysphagia was identified with 96.4% sensitivity and 77.3% specificity. At a threshold value of 2.0 mmHg for UES minimal pressure, dysphagia was diagnosed at 74.7% sensitivity and 60.7% specificity. Lastly, UES relaxation duration of <0.58 seconds had 85.7% sensitivity and 65.3% specificity, and UES resting pressure of <75.0 mmHg had 89.3% sensitivity and 90.7% specificity for identifying dysphagia.Conclusion We present evidence that HRM could be a useful evaluation tool for detecting pharyngeal dysphagia.

Objective To investigate the feasibility of a knee proprioception evaluation using a dynamometer as a tool for evaluating proprioception of the lower extremities in patients with incomplete spinal cord injury (SCI), and to explore its usefulness in predicting the ambulatory outcome. Methods A total of 14 SCI patients (10 tetraplegic, 4 paraplegic; all AIS D) were included in this study. The passive repositioning error (PRE) and active repositioning error (ARE) were measured with a dynamometer, along with tibial somatosensory evoked potential (SSEP) and abductor hallucis motor-evoked potential (MEP). Ambulatory capacity was assessed with the Walking Index for Spinal Cord Injury II (WISCI-II), both at the time of the proprioception test (WISCI_i) and at least 6 months after the test (WISCI_6mo). Results The PRE showed a negative correlation with WISCI_i (r=-0.440, p=0.034) and WISCI_6mo (r=-0.568, p=0.010). Linear multiple regression showed the type of injury, lower extremities motor score, MEP, and PRE accounted for 75.4% of the WISCI_6mo variance (p=0.080). Conclusion Proprioception of the knee can be measured quantitatively with a dynamometer in patients with incomplete SCI, and PRE was related to the outcome of the ambulatory capacity. Along with the neurological and electrophysiological examinations, a proprioception test using a dynamometer may have supplementary value in predicting the ambulatory capacity in patients with incomplete SCI.

Objective To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed. Methods Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated. Results Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all p<0.05). EI demonstrated a significant positive correlation with latency of the median motor and sensory NCS in CTS patients (p<0.05). Conclusion These findings suggest that quantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US.