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편도암 절제술후 전완유리피판술을 이용한 연구개 결손부 재건의 기능적 결과
김민식,선동일,박해섭,조승호,제현순,Kim, Min-Sik,Sun, Dong-Il,Park, Hae-Sup,Cho, Seung-Ho,Jai, Hyeon-Soon 대한기관식도과학회 1999 大韓氣管食道科學會誌 Vol.5 No.2
Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.
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Validity and Sensitivity· Specificity of Quick Assessment of Childhood Reading & Writing
김영태(Young Tae Kim),제현순(Hyeonsoon Jai),정경희(Kyunghee Jung),김영란(Young Ran Kim),배소영(Soyeong Pae),최은정(Eun Jung Choi),정상임(Sang-Im Jung),김효창(Hyo Chang Kim) 한국언어청각임상학회 2020 Communication Sciences and Disorders Vol.25 No.1
배경 및 목적: 본 연구는 만 5세에서 초등학교 4학년 아동의 읽기 및 쓰기능력을 평가하기 위해 개발 중인 QRW의 타당도 및 민감도와 특이도를 분석하기 위한 것이다. 방법: 서울, 경기도, 충청도, 경상도, 전라도에 거주하는 아동 426명의 QRW 검사결과를 분석하였다. 타당도 검증을 위해 내용타당도, 공인타당도, 발달적 타당도를 평가하였고, 검사-재검사 신뢰도와 민감도 및 특이도를 평가하였다. 결과: 내용타당도는 하위 영역별로 각각 평균 4.85, 4.71, 4.79점으로 평가되어, 검사내용의 적절성이 ‘매우 그렇다’에 가깝게 평가되었다. 공인타당도의 평가를 위해 QRW의 각 하위영역과 KOLRA 혹은 KISE-BAAT와의 상관을 분석한 결과 모두 유의한 상관관계를 보였으며, 연령 및 학년에 따라 모든 영역의 점수가 유의한 차이를 나타내 발달적 타당성이 있는 것으로 분석되었다. 또한 검사-재검사 신뢰도와 민감도 및 특이도가 유의한 것으로 나타났다. 논의 및 결론: QRW는 학령전기 및 학령기 아동의 읽기 및 쓰기능력을 평가하는 선별 검사도구로서 타당도 및 민감도와 특이도가 높으며, 기존 검사도구들에 비해 상대적으로 소요시간이 짧고 효율적인 평가도구로 활용될 수 있다. Objectives: This study investigated the validity and sensitivity·specificity of the Quick Assessment of Childhood Reading and Writing (QRW). The QRW has been developed to screen 5-year-old to 4th grade children’s reading and writing ability. The QRW consists of three subtests: phonological awareness, reading and writing. Methods: Four hundred and twenty-six typically developing children participated in this study. For content validity, a 5-score-scale was used for each item and 10 speech-language pathologists served as assessors. Content validity and concurrent validity were analyzed for validity; and test-retest reliability, sensitivity and specificity were analyzed. Results: For content validity, the mean scores of subtests were 4.78, 4.71, and 4.79 respectively. For concurrent validity, the correlation coefficient between the results of the QRW and the subtests of KOLRA and KISE-BAAT was calculated. The results revealed significant correlation. Additionally, the scores of QRW were significantly different by age and grade. Finally, the test-retest reliability, sensitivity and specificity were significantly high. Conclusion: The results of this study revealed that the QRW is a valid and reliable tool for assessing reading and writing skills of Korean children, and that it takes relatively short time and can be used as an efficient screening tool.
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