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      • KCI등재

        Bi-factor MIRT True-Score Equating for Testlet-Based Tests

        이규민(Gue min Lee),Won Chan Lee,Michael J Kolen,박인용(In Yong Park),Dong In Kim,Ji Seung Yang 한국교육평가학회 2015 교육평가연구 Vol.28 No.2

        Lee and Lee (2014) proposed bi-factor multidimensional item response theory model (BFM) "observed-score" equating procedures. The main purposes of this study were to develop BFM "true-score" equating procedures, and to investigate applicability of the proposed procedures with actual data. Eight equating methods (including both true- and observed-score) based on dichotomous IRT (2-parameter logistic model: 2PL), polytomous IRT (graded response model: GRM), testlet response model (TRM), and BFM were compared with target equipercentile equating. Data for this study were from the Reading Comprehension test for a large-scale state assessment program, which consisted of several passages and corresponding groups of items. True- and observed-score equating methods based upon 2PL and BFM produced similar equating results. The GRM true- and observed-score equating methods provided equating results somewhat different from others, and more similar to the target equipercentile equating. Lee와 Lee(2014) 연구는 혼합형 검사에서의 bi-factor 다차원 문항반응모형을 적용한 IRT "관찰점수" 동등화 절차를 제안하였다. 이 연구는 Lee와 Lee(2014) 연구의 추수연구로 단위검사를 대상으로 bi-factor 다차원 문항반응모형을 적용한 IRT "진점수" 동등화 절차를 제안하고, 그 적용 가능성을 실제 자료를 이용하여 탐색하고자 하였다. 이를 위해 단위검사로 구성된 대규모 독해 검사 자료를 이용하여, 2모수 로지스틱 모형(2-parameter logistic model: 2PL), 등급반응모형(graded response model: GRM), 단위검사모형(testlet response model: TRM), bi-factor 모형(bi-factor model: BFM)을 적용하였으며, 관찰점수 및 진점수 동등화를 시행하여 총 8개의 동등화 방법을 적용하고, 산출된 결과를 동백분위 동등화 결과와 비교하였다. 연구 결과, 2PL과 BFM을 적용한 관찰점수 및 진점수 동등화는 유사한 결과를 산출하였으며, GRM을 적용한 관찰점수 및 진점수 동등화 방법은 다른 방법들과 다소 차이를 보이는 결과를 산출하였고, 비교 기준이 된 동백분위 동등화 결과와 보다 유사한 결과를 보였다.

      • SCOPUSKCI등재

        동맥혈 채혈후 시간 경과 및 온도 변화가 가스분압 및 PH 에 미치는 영향에 관한 연구

        김동수,이승환,김건식,강화자,신광일,여민구 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.6

        Blood gas samples are highly susceptible to preanalytic error due to improper methods of obtaining or handling the sample prior to delivery to the laboratory. The errors in the measurement of blood gas analysis are currently derived from the exposure of sample to atmosphere, effects of anticoagulant itself, temperature difference between the measuring electrode and drawn blood and the delay in running the sample. To study the effects of the delay in measuring the sample and the temperature difference between the measuring electrode and drawn blood on values of blood gases and pH, we analyzed the arterial sampling from the 24 patients who were taking elective surgery or on his/her recovery period with indwelling arterial catheter. The plastic sampling syringes were kept at 4。C (refrigerator) or 22。-24。C (room temperature) and analyzed at regular intervals (1, 10, 30, 60,120 min) for 120 minutes. The following results were obtained: 1) When the arterial blood drawn from the anesthetized patients were stored 4。C, partial pressure of oxygen (PaO₂) decreased significantly after 20 min, whereas those stored at room temperature decreased significantly after 10 min. 2) When the arterial blood drawn from the recovery patients were stored at 4。C, PaO₂ did not decrease significantly through the experimental period of 120 min. Although those stored at room temperature did not decrease significantly through the period of 120 min. 3) Partial pressure of carbon dioxide in the arterial blood (PaCO₂,) drawn from the anesthetized patients increased significantly by 120 min. at 4。C, whereas those at room temperature increased significantly after 20 min. 4) PaCO₂, of the recovery patients increased signigicantly by 120 min. at 4。C, whereas those at room temperature increased significantly after 30 min. 5) pH of the arterial blood drawn from either anesthetized or recovery patients decreased significantly by 120 min. at 4。C, whereas those at room temperature decreased significantly after 60 min. 6) No significant changes al oxygen saturation (SaO₂) and content (CaO₂) were noted in either anesthetized or recovery. patients in accordance with time elapsed at 4。C or room temperature. In summary, as the changes of PO₂ in particular higher than physiologic PO₂ and PCO₂ in the arterial blood stored at room temperature are significant in accordance with the delay in measuring, it would be advisable to analyze the sample in a short period of time or to store it in a cool place when the measuring will be delayed.

      • SCOPUSKCI등재

        대장내시경검사의 전처치로서 항콜린제 사용에 관한 연구 : 전향적, 이중맹검법으로

        박경남,한동수,이민호,최호순,박준용,손주현,이오영,함준수,전용철,송승찬,기춘석,윤병철,이종희 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

        Background: Use of antispasmodic medication prior to colonoscopy is controversial but someone believes antispasmodic may improve visualization of colonic mucosa and ease colonoscope insertion. So, we designed a study to assess the effect of premedication with the antispasmodic, hyoscine-N-butyl bromide(Buscopan') on the performance of colonoscopy. Methods: This study was prospective, double blinded, randomized, controlled study, One hundred three consecutive patients were randomized to receive intravenous buscopan lml(n=52) or placebo(n=51) combined with our standard initial medication(me- peridine 50 mg and midazolam 2 mg). Insertion of colonoscopy was timed, and 100 mm visual analogue scales (VAS) were used for asscssing difficulty of procedure, colonic motility, frequency of positional change, frequency of external compression, difficulty of assistance and degree of discomfort experienced by the patients. Results: There were no significant differences of intubation time between buscopan group(mean time, 7.23 min., range 2~15) and placebo group(7.07 min., range 3-25), (p=0.83) and withdrawal time between buscopan group (6.46 min., range 2-22) and placebo group(6.76 min., range 2 25), (p=0.69). Also, there was no significant differences in intubation time between males and females(buscopan; males 7.00 min., females 7.60 min., p=0.34, placebo; males 7.0~5 min., females 7.08 min., p 0.44). The VAS scores checked by endoscopist(p=0.29), assistant(p=0.32) and patient (p=0.15) were not significantly different in both groups. There were no significant differences in intubation time, VAS scores nf endoscopist, assistant, and patients. Conclusion: Premedication with intravenous bu.opan has no advantage on colonoscopy procedure. Use of antispasmodic medication prior to colonoscopy was not considered as recommendable agent.

      • KCI등재후보

        2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

        이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

        목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

      • SCOPUSKCI등재
      • SCOPUSKCI등재

        개의 췌도분리에서 췌장의 팽창과 콜라겐 분해요소

        이상훈,김성주,박정환,김종성,오승훈,한진수,정인경,양태영,김동준,김광원,이문규,민용기,이명식,정재훈,함종렬 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.2

        Backgrounds: One of the main problems conditioning the outcome of islet transplantation is the ability to separate a sufficient number of viable islets with preserved function. Islet purification is critically affected by all of the isolation stages. Thus, it is necessary to set up the standard isolation method that islets are separate well from acinar without compromising islet yield and viability. Methods: Twenty three adult mongrel dogs were used for the experiment of total pancreatectomy with islet isolation. The islets were properly isolated by a modified Recordi method. The obtained islets were further purified by centrifugation on discontinuous gradients using cell separation system (Model 2991, Cobe, Lakewood Colo). We evaluated islet number (islet equivalent number, 150 um equivalents/kg of recipient body weight, IEq/kg), purity, cell volume, viabilty, recovery rate, and comparison of outcome according to the isolation conditions. Results: 1) The mean of islet numbers before purification were 13543±9431Eq/kg, digestion times were 13.8±2.6 min., digestion temperature was 37.4±0.2℃, purity was 59.7?.0%, viability was 90.0±2.1%, cell volume was 4.7±1.1 mL, islet number after purification were 4064±361 IEq/kg, and recovery rate was 29±2.9%. 2) Isolated islet numbers were different according to the degree of pancreas distension with collagenase, digestion temperature, and digestion time. 3) The best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase. 4) According to multiple regression adjusted by variable factors, the degree of pancreas distension with collagenase and digestion time were independently associated factors for successful islet isolation. Conclusions: In this study, we concluded that the degree of pancreas distension with collagenase and digestion time were independent factors for successful islet isolation and the best conditions for islet isolation were above 37.5℃ in temperature at recirculation of collagenase, within 12 min in digestion time and well distended pancreas with collagenase.

      • KCI등재

        치면열구전색제의 조건에 따른 법랑질 결합강도에 관한 연구

        이용근,이흥수,이성재,방기숙,최정민,류승호,강민석 대한치과기재학회 1997 대한치과재료학회지 Vol.24 No.1

        In this study, the shear bond strengths and accompanying elastic modulus ratio, displacement at bond failure and work up to fracture of pit and fissure sealants to toothe enamel were analyzed by the following variables, those were acid etching, moisture content of the surface of enamel, dentin bonding agent(species and method), thermocycling, saliva contamination. One kind of chemically cured resin based pit and fissure sealant, two kinds of light cured resin based pit and fissure sealants and one kind of glass ionomer based pit and fissure sealant, and two kinds of dentin bonding agents were studied. The buccal surface of extracted premolars were ground flat with # 600 silicone carbide papers, and the ground surface was treated depending on the experimental conditions. After each treatment, each pit and fissure sealant was filled into plastic tube of 3mm diameter, which were laid on the surface of ground enamel surface, and were cured. Sealant bonded teeth specimens were immersed in 37℃ distilled water form 24 hours. The shear bond strength of sealant to enamel surface was measured with Universal testing machine with the cross head speed of 1mm/min. From the obtained load-deflection curves, modulus ratio, bond strength, displacement at bond failure and work up to fracture were analyzed. From this experiment, the following results were obtained : 1. Comparing the results of standard condition(i. e. acid etching, dry surface, no dentin bonding agent and 300 thermocyling), the elastic modulus ratio of chemically cured resinbased pit and fissure sealant was significantly higher than those of other materials(P<0.05), and the bond strength, displacement at bond failure and work up to fracture of glass ionomer based pit and fissure sealant were significantly lower than those of other materials(P<0.05). 2. The results of ANOVA with the variables of type of material, acid etching, moisture condition of the enamel surface, dentin bonding agents were as follows ; 1) variables showed significant main effect on the shear bond strength of pit and fissure sealant to enamel(P<0.01), 2) type of material, acid etching and moisture condition of enamel influenced the bond strength significantly(P<0.01), 3) type and application methods of dentin bonding agents influenced on the bond strength significantly(P<0.05). 3. There were statistically significant correlation between the work up to fracture and the bond strength, and between the work up to fracture and the displacement at bond failure(P<0.01), and in these cases the correlation coefficient was 0.87.

      • KCI등재

        관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

        이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

        목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

      • SCOPUSKCI등재

        A comparison of Min’s glasses and conventional occlusion therapy in the treatment of amblyopic children: a prospective study

        Byung Moo Min,Seung Young Kim,Kil Hwan Ko,Seong Bok Lee 대한안과학회 2000 Korean Journal of Ophthalmology Vol.14 No.1

        Min’s glasses are specially manufactured in order to enhance the satisfaction of the wearer and increase treatment effectiveness. We compared the effectiveness of Min’s glasses with that of conventional occlusion therapy in amblyopic pediatric patients. We prospectively studied 60 amblyopic patients. For four to 30 months, 24 of the patients were treated with conventional patch occlusion (patch group) and 36 of them were treated with Min’s glasses (glasses group). We compared the improvement in visual acuity and the treatment compliance between both groups, according to age (over six and less than six), sex, type of amblyopia, and the duration of treatment. Sixteen patients (66.7%) in the patch group and 32 patients (88.9%) in glasses group showed improvement in visual acuity (p=0.002). The pre-treatment average log MAR acuity was 0.56±0.25 in the patch group, and 0.59 ±0.25 in the glasses group. The average improvement in visual acuity was a 0.17 log MAR score in the patch group, and a 0.31 log MAR score in the glasses group (p=0.004). Compliance was 59.54% in the patch group and 83.44% in the glasses group (p=0.012). The pre-treatment average log MAR acuity was 0.49 ± 0.23 for children over six years of age in the patch group, and 0.58±0.28 for children over six years of age in the glasses group. For children over six years of age in the glasses group the improvement in visual acuity (0.29 log MAR score) was greater than for children over six years of age in the patch group (0.06 log MAR score) (p=0.0003). The pre-treatment average log MAR acuity was 0.55±0.22 for female patients in the patch group, and 0.60±0.25 for female patients in the glasses group. Female patients in the glasses group also showed a greater visual acuity improvement (0.29 log MAR score) than female patients in the patch group (0.14 log MAR score) (p=0.0028). However, there were no differences between the groups in patients less than six years of age and in male patients. In conclusion, Min’s glasses were more effective than conventional treatment with a patch in improving visual acuity and encouraging compliance in pediatric amblyopic patients, especially in children over six years of age and in girls.

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