Job hazard analyses were conducted to assess exposure to musculoskeletal disorder (MSD) risk factors in seven workers of three dry-cleaning establishments. In accordance with the Washington State Ergonomics Rule, the analyses were performed in two separate steps: (1) observation and checklist approaches were made to identify a “caution zone job” in the seven workers' pressing operations across the three shops; and (2) detailed posture and motion analyses were undertaken to determine a “MSD hazard” in one worker's operation using a video technique. One “caution zone job” was identified and it was the pressing operation job in which five physical risk factors were found in the pressing operations. The detailed analyses confirmed that one “MSD hazard”, i.e., awkward posture in shoulders, was prevalent in the pressing operations of the three dry-cleaning facilities. It would be desirable to reduce MSD risk factors including awkward shoulder posture in the dry-cleaning industry.
Checklist ; Human Engineering ; Posture ; Risk Factors* ; Shoulder ; Washington

The purpose of this study was to identify the influencing factor on Symptoms of Stress of Middle Aged Women. The subjects of this study were 35 middle aged women who lives in Seattle, Washington in U.S, and 74 middle aged women who lives in Seoul. Data collection was performed at the University of Washington and Seoul from Oct. 1998 to May. 1999. Data collected through 4 types of questionnaires : SOS, Ways of Coping, Mood Status, Perceived Stress. The results of this study are as follows: 1. The stress symptoms showed positive correlation with emotion-oriented coping, mood status, and perceives stress. 2. Stepwised multiple regression analysis revealed that most powerful predictor of Stress Symptoms was mood status. A combination of perceived stress, mood status and ways of coping account for 64% of the variance in Symptoms of stress in Middle aged women. From the results of the study, the following recommendations are presented as follow: 1. It is necessary to replicate this study with a larger sample. 2. It is necessary to develop a stress management program focused on ways of coping, mood status, perceived stress for middle aged women.
Surveys and Questionnaires ; Female ; Humans ; Middle Aged* ; Seoul ; Washington

Segmentation of fundamental heart sounds–S1 and S2 is important for automated monitoring of cardiac activity including diagnosis of the heart diseases. This pa-per proposes a novel hybrid method for S1 and S2 heart sound segmentation using group sparsity denoising and variation mode decomposition (VMD) technique. In the proposed method, the measured phonocardiogram (PCG) signals are denoised using group sparsity algorithm by exploiting the group sparse (GS) property of PCG signals. The denoised GS-PCG signals are then decomposed into subsequent modes with specific spectral characteristics using VMD algorithm. The appropriate mode for further processing is selected based on mode central frequencies and mode energy. It is then followed by the extraction of Hilbert envelope (HEnv) and a thresholding on the selected mode to segment S1 and S2 heart sounds. The performance advantage of the proposed method is verified using PCG signals from benchmark databases namely eGeneralMedical, Littmann, Washington, and Michigan. The proposed hybrid algorithm has achieved a sensitivity of 100%, positive predictivity of 98%, accuracy of 98% and detection error rate of 1.5%. The promising results obtained suggest that proposed approach can be considered for automated heart sound segmentation.
Benchmarking ; Diagnosis ; Heart Diseases ; Heart Sounds ; Heart ; Methods ; Michigan ; Washington

BACKGROUND: Use of universal leukoreduction for prevention of leukocyte associated transfusion reactions is common practice in many countries. This study was conducted in order to evaluate the performance of a newly developed leukoreduction filter for red blood cells (RBCs), the RF300 (Kolon Industries, Inc, Gumi, Korea). METHODS: Filtration time, RBC recovery, residual leukocyte count, and leukocyte removal rate were evaluated. To assess the quality of RBCs after filtration, percent hemolysis was monitored for a period of 21 days. Performance of the RF300 (N=78) was compared with that of the Bio-R O2 plus (Fresenius, Hamburg, Germany), the Pall Purecell RC (Pall Co., Washington, USA), and the Sepacell R-500N (Asahi, Tokyo, Japan). RESULTS: The shortest filtration time was observed using the RF300 (P<0.05). Using the RF300, recovery of RBC was 96.5%, which was higher than that of two filters (P<0.05). Mean residual leukocyte count was 0.26x10(6)/unit, with a leukocyte removal rate of 3 log. Using the RF300, mean percent hemolysis was 0.32% at day 21, which was comparable with that of two filters, but lower than that of one filter (P<0.05). CONCLUSION: The RF300 meets all established quality requirements for conduct of safe and effective leukoreduction of RBCs.
Blood Group Incompatibility ; Collodion ; Erythrocytes ; Filtration ; Hemolysis ; Leukocyte Count ; Leukocytes ; Tokyo ; Washington

PURPOSE: The purpose of this study is to understand the relations of demographic and clinical characteristics, psychopathology and ways of coping with psychosocial adjustment of epileptic patients. METHODS: The participants were 200 epileptic outpatients. They completed Korean version of Washington Psychosocial Seizure Inventory (K-WPSI), Symptom Check List-90-Revised (SCL-90-R) and The Ways of Coping Checklist (WCC). RESULTS: The results showed that frequency of seizure, education level, socioeconomic level, occupation, all of subscales in SCL-90-R and passive coping styles were significantly related to overall psychosocial functioning of epileptic patients. The global severity index score that indicated present psychopathology of SCL-90-R best explained overall psychosocial functioning. And the frequency of seizure, education level, socioeconomic level, occupation, and somatization were also significant factors. The global severity index score was explained by emotional focused coping, socioeconomic level, frequency of seizure, and problem focused coping. CONCLUSIONS: The results of this study suggested that psychosocial adjustment of epileptic patients showed a significant relations with psychopathology, clinical and socioeconomic factors and the ways of coping.
Checklist ; Education ; Epilepsy ; Humans ; Occupations ; Outpatients ; Psychopathology ; Seizures ; Socioeconomic Factors ; Washington

As the International Human Epigenome Consortium (IHEC) launched officially at the 2010 Washington meeting, a giant step toward the conquest of unexplored regions of the human genome has begun. IHEC aims at the production of 1,000 reference epigenomes to the international scientific community for next 7-10 years. Seven member institutions, including South Korea, Korea National Institute of Health (KNIH), will produce 25-200 reference epigenomes individually, and the produced data will be publically available by using a data center. Epigenome data will cover from whole genome bisulfite sequencing, histone modification, and chromatin access information to miRNA-seq. The final goal of IHEC is the production of reference maps of human epigenomes for key cellular status relevant to health and disease.
Chromatin ; Genome ; Genome, Human ; Histones ; Humans ; Korea ; MicroRNAs ; Republic of Korea ; Sulfites ; Washington

OBJECTIVE: To evaluate whether less pulsatile levodopa therapy (LPT) can reduce the development of levodopa-induced dyskinesia (LID). METHODS: This is a retrospective cohort study of patients with Parkinson’s disease at the movement disorders clinic of Medstar Washington Hospital Center. The study was not blinded or randomized. Patients were seen between August 2002 and August 2018. During these years, we treated patients with less pulsatile (6 doses daily) levodopa treatment to reduce LID. Occurrence of LID was recorded. RESULTS: Ninety-five patients with Parkinson’s disease taking levodopa were divided into two groups: 1) patients who were initially managed on LPT or who switched from traditional therapy (TT) (n = 61) (mean disease duration: 7.7 ± 4.8 years, mean levodopa duration: 5.6 ± 4.5 years and mean observation time: 4.3 ± 3.4 years), and 2) patients on TT throughout the observation period or until they developed dyskinesia (n = 34) (mean disease duration: 8.3 ± 3.8 years, mean levodopa duration: 6.2 ± 4.2 years and mean observation time: 4.1 ± 3.4 years). Three of the 61 LPT patients developed dyskinesia during the observation period. One of the patients developed dyskinesia after being switched to pulsatile doses by another doctor. In the other two, dyskinesia was minimal. In contrast to this 4.9% cumulative incidence, dyskinesia occurred in 50% (17/34) of TT patients, an incidence similar to that in published data (p < 0.001). CONCLUSION: Less pulsatile levodopa with 6 daily doses was associated with a low incidence of LID. Further study of this method of treatment is warranted.
Cohort Studies ; Dyskinesias ; Humans ; Incidence ; Levodopa ; Methods ; Movement Disorders ; Parkinson Disease ; Retrospective Studies ; Washington

INTRODUCTION: Quality of life (QoL) studies provide information about the impact of disease, the treatment of symptoms, and outcomes following treatment. The present study aims to evaluate the postoperative QoL of patients treated for oral cancer in a Nigerian government tertiary hospital. MATERIALS AND METHODS: A prospective study on consenting patients with oral cancer was undertaken at Aminu Kano Teaching Hospital, Kano, Nigeria. The subjects completed the University of Washington QoL (UW-QoL) questionnaire one day prior to surgery and postoperatively after 7 days, 1 month, 3 months, and 6 months. RESULTS: Sixty-eight patients with oral cancer were recruited. Of these, 38 were males, and 30 were females (male : female, 1.3 : 1). Twenty-four patients (12 males and 12 females) underwent surgery and completed postoperative QoL assessment using the UW-QoL questionnaire. Preoperative QoL mean score was 2.21, while postoperative mean scores after 1 week, 1 month, 3 months, and 6 months were 3.67, 3.46, 2.82, and 2.61, respectively. CONCLUSION: An improvement in QoL following surgical treatment for patients with oral cancer was observed. 'Appearance,' 'recreation,' and 'chewing' were identified as the most important determinants of postoperative QoL in patients with oral cancer in our study.
Female ; Hospitals, Teaching ; Humans ; Male ; Mouth Neoplasms* ; Nigeria ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires ; Tertiary Care Centers ; Washington

The purpose of this study was to determine the effects of the music therapy, one of the dementia treatment programs, on patients' cognition, behaviors and affection, and thereby, developing a nursing intervention to help them live a quality of life. The subjects of the study were 37 dementia senial people who admitted the mental hospital at K city in chungnam province. The study was designed as repeated measures design for a single test group. The subjects were received music therapy for 40 minutes 2 times a day during 6 weeks from February 16 to March 29, 2000. The tools of study were K-MMSE developed by Park, J. H. and Kuen, Y. C.(1989), Clinical Dementia Rating developed by Morris, J(1993) at Washington university, and A fourteen symptom behavior and mood rating scale developed by Wyatt and Kupfer(1968). For the tools of music therapy, elderly favorite songs (changs, folk songs, old popular songs and children's songs) were recorded. These tapes and other tools were edited according to experts' advices. The music therapy consisted of music listening, rhythmic instrument playing and following-up singing. The therapy was performed at the lounge of the center to which the sample people could get access conveniently. A nurse was asked to observe sample people's cognition, dementia behaviors and affection, evaluated them according to the checklist scale. The collected data were processed using the SPSS WIN 7.5 program for absolute values, percentiles, mean, SD, ANOVA, GLM-repeated measure method. The items of scale and its reliability analyzed were Cronbach's alpha. The results of this study were as follows: 1. As a result of analyzing dementia elderly cognition, behaviors and affection before the music therapy, it was found that the disorder of cognition, behavior and affection was most outstanding. 2. After the therapy, the average scores of subjects' overall cognition, behavior and affection were lowered significantly. It was conceived that the music therapy should continue for 3-4 weeks. 3. Difference of cognition in test groups was significant statistically between pre-test and 2 weeks, 4 weeks, 6 weeks after test (df=3, F=6.39, p=.000), pretest and 4, 6 weeks after test (p=.01, p=.001), which suggests that a continued music therapy would be desirable to treat dementia. Difference of behaviors and affection in test groups was significant statistically between pre-test and 1-6 weeks after test (F=52.01, p = .000), pretest and 3-6 weeks after test (p=.000), which suggests that a continued music therapy would be desirable to treat dementia. 5. It was found that the music therapy was more effective in treating moderate dementia (MMSE-K score 16-23) than severe one (MMSE-K score 15 or lower), and vascular type of dementia than Alzheimer's type of one. After all, it may well be concluded that the musical therapy is an effective nursing intervention to provide the dementia elderly with a quality service and thereby, increase cognition and reduce the problematic behaviors and affection of dementia senile people.
Aged ; Checklist ; Chungcheongnam-do ; Cognition* ; Dementia* ; Hospitals, Psychiatric ; Humans ; Music Therapy* ; Music* ; Nursing ; Quality of Life ; Singing ; Washington

PURPOSE: Maxillectomy for malignant tumor resection often leads to functional and aesthetic sequalae. Reconstruction following maxillectomy has been a challenging problem in the field of head and neck cancer surgery. In this article, we described three dimensional midface reconstructions using free flaps and their functional and aesthetic outcomes. METHODS: We reconstructed 35 cases of maxillectomy defects using 9 radial forearm free flaps, 7 lattisimus dorsi musculocutaneous free flaps, 6 rectus abdominis musculocutaneous free flaps, 4 fibular osteocutaneous free flaps, and 9 anterolateral thigh free flaps, respectively. We classified post-maxillectomy defects by Brown's classification.1 Articulation clarity was measured with picture consonant articulation test. Swallowing function was evaluated with the University of Washington quality-of-life Head and Neck questionnaire by 4 steps. Aesthetic outcomes were checked to compare preoperative with postoperative full face photographs by 5 medical doctors who did not involve in our operation. RESULTS: The average articulation clarity was 92.4% (100-41.9%). 27 (81.9%) patients were able to eat an unrestricted diet. Aesthetic results were considered excellent in 18 patients (51.4%). Functional results were best in the group reconstructed with fibular osteocutaneous free flap. Considering the range of wide excision, aesthetic results is best in the group reconstructed with anterolateral thigh free flap. CONCLUSION: The free flap is a useful technique for the reconstruction of the midface leading to good results, both functionally and aesthetically. Especially, because osteocutaneous flap such as fibular osteocutaneous free flap offered bone source for osteointegrated implant, It produces the best functional results. And perforator flap like as anterolateral thigh free flap reliably provides the best aesthetic results, because it provides sufficient volume and has no postoperative volume diminution.
Deglutition ; Diet ; Forearm ; Free Tissue Flaps ; Head ; Head and Neck Neoplasms ; Humans ; Neck ; Perforator Flap ; Surveys and Questionnaires ; Rectus Abdominis ; Thigh ; Washington