• Title/Summary/Keyword: Clinical Evaluation Tool

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Effectiveness of Acupotomy for Migraine: A Systematic Review (편두통의 침도 치료에 대한 체계적 문헌고찰)

  • Seok-Hee Jeon;Soo-Min Jeong;Jeong-Cheol Shin
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.62-78
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    • 2023
  • Objectives : This study aims to assess the impact of acupotomy on migraine through an examination of clinical studies conducted since 2015. Methods : We conducted a comprehensive search for randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) related to acupotomy treatment for migraine, utilizing five Korean online databases (OASIS, Science ON, DBPIA, KISS, RISS), as well as four foreign online databases (CNKI, PubMed, EMBASE, Cochrane Library). We identified a total of 10 relevant studies for analysis. Participants characteristics, treatment points, combination treatments, treatment cycles or frequencies, evaluation indices, efficacy, and adverse events were analyzed. The risk of bias in the 10 RCTs was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). Results : A total of 931 participants were included in 10 studies. In the intervention group, the average duration of migraine morbidity ranged from 15.5±4.5 months to 15.9±4.2 years. Six studies based their diagnoses on the International Classification of Headache Disorders (ICHD), while five studies relied on Chinese diagnostic criteria. All studies specified the treatment area as the region exhibiting tenderness or induration on the head and neck. Treatment cycles ranged from a minimum of 2 days to a maximum of 1 week, with the number of days per treatment course varied from 5 days to 4 weeks. The diameter of acupuncture needles used varied between 0.3 mm and 1 mm. Of the eight studies specifying needle length, the shortest was 20 mm, and the longest was 40 mm. A total of eight evaluation indices were employed, with total efficacy rate (TER) and visual analogue scale (VAS) being the most frequently used. Statistically, all intervention groups showed more significant results compared to the control groups. Adverse events were reported in only two studies within the intervention group. Overall, the risk of bias assessment for the selected RCTs ranged from 'some concerns' to 'high risk of bias.' Conclusions : This study showed that acupotomy treatments for migraine were effective.

The effects of out of hospital ACLS simulation training on the paramedic's duty ability (구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향)

  • Park, Yoo-Na;Cho, Byung-Jun;Kim, Gyoung-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.99-106
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    • 2019
  • The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.

A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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The Clinical Study of Hemoptysis in Lung Disease (객혈을 주소로 입원한 환자의 임상적 고찰)

  • Lee, Hyang-Ju;Um, Hye-Suk;Kim, Jung-Tae;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.760-773
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    • 2000
  • Background : Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treament treatment of hemoptysis Methods : We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. Results : The mean age at diagnosis was 49.3 years and male to female ratio was 2.1 : 1. The main causes were active pulmonary pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronic bronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. Sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial arteη embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases(43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. Conculsion : The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

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THE EVALUATION OF THE PATIENTS TAKING CBCT IN DEPARTMENT OF PEDIATRIC DENTISTRY (소아치과에서 Cone beam형 전산화단층영상을 이용한 환자의 평가)

  • Jeon, Hye-Jin;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.249-256
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    • 2012
  • Cone beam computed tomography (CBCT) has become widely available in recent years and is recognized as an important diagnostic tool for varies disease and condition of the orofacial structure. Clinician is easy to determine adequate treatment plan for pediatric patients by using CBCT. CBCT is used in Chonbuk National University Dental Hospital since 2005. This research presents clinical application of CBCT on patients visiting department of pediatric dentistry in Chonbuk National University Dental Hospital from Jan, 2005 to July, 2011. 1. Total number of patients taken CBCT is 252, and total number of area taken CBCT is 279. 2. An age group form 9 years to 12 years showing 53% was highest and percentage of 6~8 years showed 24%. 3. Chief complaints for CBCT taking are position and shape of impacted teeth (49.1%), mesiodens (19.4%), supernumerary teeth (7.9%), position and root canal shape of erupting teeth (7.2%), cyst (5.4%), inflammatory lesion (3.9%), odontoma (3.9%), tumor (2.2%), and et al. 4. Treatments are extraction (29.7%), orthodontic traction and leveling (24.0%), follow up (16.5%), refer to other professional part (11.5%), endodontic treatment (3.9%), surgical removal (2.9%), malsupialization (3.9%), enucleation (1.1%), and fail to follow up (5.0%), and et al.

Development of a Stereotactic Radiosurgery Planning System (뇌정위 방사선수술을 위한 컴퓨터 치료계획시스템의 개발)

  • 조병철;오도훈;배훈식
    • Progress in Medical Physics
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    • v.8 no.1
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    • pp.17-24
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    • 1997
  • We developed PC-based planning system for linear accelerator based stereotactic radiosurgery. The system was developed under Windows 95 on Pentium Pro$\^$(R) 200 ㎒ IBM PC with 128 MB RAM. It was programed using IDL$\^$(R)/ of Research Systems, Inc. as a programing tool. CT image data obtained with BRW stereotactic frame is transferred to PC through magnetoptical disk. As loading the image, the system automatically recognizes the location of rods and establishes stereotactic coordinates. It accurately calculates and corrects the coordinates, degree of tilting, and magnification rate of axial images. After the coordinates is defined we can delineate and edit the contours of target and organs of interest on axial images. Upon delineating contours of target, isocenter is determined automatically and we can set up the beam configuration for radiosurgery. The system provides beam's eye view and room's eye view for efficient confuguring of beams. The system calculates dose distribution 3-dimensionally. It takes 1 to 2 minutes to calculate dose distribution for 5 arcs. We can verify the dose distribution on serial axial images. We can analyze the dose distribution quantitatively by evaluation of dose-volume histogram of target and organ of interest. This system, PC-based radiosurgery planning system, includes the basic features for radiosurgery planning and calculates dose distribution within reasonable time for clinical application.

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Ultrasensitive serum thyroglobulin the usefulness of evaluation (Ultrasensitive serum thyroglobulin의 유용성 평가)

  • Lee, Sun Ho;Cho, Eun Bit;Shin, Young Kyun;Lee, Young Ji;Yoo, Seun Hee;Kim, Nyun Ok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.102-107
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    • 2015
  • Purpose Serum Thyroglobulin measurement is a major tool for the follow-up of differentiated thyroid cancer (DTC) patients. Thyroglobulin is Normal thyroid tissue, or thyroid cancer tissue produced only. Thyroid hormone to a halt without Tg differentiation of thyroid cancer recurrence just by measuring how to decide whether there was increasing expectations if I can do it instead. Therefore, in excellent sensitivity Tg new inspection of the functional sensitivity by measuring the looked to evaluate the usefulness of reagents. Thyroidectomy is measuring the numbers Tg (total thyroidectomy) remaining thyroid ablation and radioactive iodine (radioactive iodine remnant ablation, RRA) DTC in patients being diagnosed with or help predict the remaining early detection of thyroid cancer recurrence. Materials and Methods Agent that I'm currently using Tg of the measurements of low clinical specimen for a second drainage of the three (0.08 0.17, 0.98, ng/mL) within the scope of the dilute magnification (2, 4, 8, 16, 32 times) by dilute Intraassy (n=10) and Interassay (n=10) out in no time. Concentration value according to the coefficient of variation and the mean and standard deviation of each measurement (Coefficient of variation, CV) the absolute value of the measured values that corresponds to 20 percent target a coefficient of variation of CV Find the value of the concentration of the functional sensitivity measurement did. Also, analytical sensitivity with recovery rates, Dilution test inspections, and interrelationship, compared. Results Sensitivity is an excellent analytical sensitivity within the prosecutor kit Tg 0.006 ng/mL, and core analytical sensitivity, conducted by the 0.006 ng/mL to same conclusion. Be rather high to 142 percent recovery rate was 60 to measurement and functional sensitivity, 0.01766 ng/mL(Intraassay n=10) was measured at. CBC is relatively good correlation as ($R^2=0.949$) the correlation. Conclusion Recently ultrasensitive thyroglobulin this clinically important indicators of the previous kit and demands are lower than sensitivity to the measurement results. Therefore, ultrasensitive thyroglobulin test is correlated that there would be useful in value in nuclear medicine the thyroid gland.

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The Motivation of selecting major, the satisfaction of major and view of occupation for EMT students (응급구조(학)과 학생의 전공선택 동기와 전공만족도 및 직업관)

  • Kim, Mi-Sook;Park, So-Mi;Wang, Chengying;Seo, Ha-Yan;Joo, Young-Ju;Lee, Kyoung-Youl;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.3
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    • pp.29-40
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    • 2010
  • Purpose: We investigated the motivation of selecting major, the satisfaction of major and the view on occupation of emergency medical technology (EMT) students. The results of study will be used to increase the satisfaction of major of university students. Also, it can be used to support decision of major for high school students. Method: We conducted 1,586 surveys from 665 students at six four-year colleges and 921 students at seven three-year colleges. Our research period was from Aug. 27th to Oct. 31st in 2010. The surveys were analyzed by SPSS 18.0 using description statistics, t-test, ANOVA, Scheffe and Pearson correlation coefficient. Result: In our study, the motivation of selecting major is 35.8% of students selected 'good employment prospects', satisfaction of major's $M{\pm}SD$ is $3.15{\pm}.486$, adaptation of major's $M{\pm}SD$ is $3.11{\pm}.472$. The satisfaction of major show difference (t = 4.548 p = .000) by sex, also the adaptation of major show difference (t = 2.279, p = .023) by sex. The satisfaction of major show first grade students higher (F = 3.605, p = .013) than fourth grade students at four-year colleges. If satisfaction of major is high, accumulation evaluation score is high (F = 3.276, p = .011), too. Clinical practice experienced students was higher (t = -2.878, p = .004) than non experienced it satisfaction. In view of occupation, ideal job's factors and actual job's factors a lot of students selected 'aptitude'. Also, there is a statistically significant correlation (r = .618, p = .000) between the satisfaction of major and the adaptation of major. High satisfaction indicates high adaptation of major. Conclusion: In our study satisfaction of major and adaptation of major was very high score. EMT students concern about employment prospects at most. It is inferred that they select job which match with one's aptitude. We can suppose that students select major as a tool for employment by seeing result that a lot of students consider employment prospects at most when they select major. A method to improve the satisfaction and adaptation of major should be developed by realizing problems which occur the dissatisfaction of major. Also, there as on why students conflict between ideal and actual job should be revealed. There as on seems students want stable occupation in unstable job market situation. Therefore, the expansion of job matching aptitude and being stable should be processed. Finally, university should actively support the method that help to finding jobs for student by identifying job preparation of students.

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Intraoperative Neurophysiological Monitoring : A Review of Techniques Used for Brain Tumor Surgery in Children

  • Kim, Keewon;Cho, Charles;Bang, Moon-suk;Shin, Hyung-ik;Phi, Ji-Hoon;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.363-375
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    • 2018
  • Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.

Recent Advances in Cancer Diagnosis: On an Overview of Diagnostic Cytopathologic Modalities and Ancillary Techniques (세포병리학적 기초에 의한 암진단의 발전: 진단방법과 보조기법)

  • Kim, Ki-Tai;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.1-11
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    • 1996
  • From the concepts of cellular pathology and of exfoliative cytology, as elucidated by Virchow and Papanicolaou respectively in the late 19th and early 20th century, have evolved the primary methods for the diagnosis of cancer today. From Papanicolaou's concept of exfoliative cytology developed fine needle aspiration biopsy in the early 1960's, this has become a major diagnostic procedure and has contributed to a significant reduction in open biopsies and, therefore, to medical cost-effectiveness immunobiochemical techniques provided us with a supplement to cancer diagnosis in the 1980's. The immunoperoxidase method, using monoclonal antibodies, is applied primarily as an ancillary measure to elucidate the nature of cancers The availability of specific monoclonal antibodies has greatly facilitated the identification of cell products or surface markers. For example, antibodies directed against intermediate filaments have proved to be of value in determining the histogenesis oi poorly differentiated neoplasms. Tumor markers may serve as biochemical indicators of the presence of a neoplasm. They can be detected In plasma and other body fluids. Their concentration can be applied as a diagnostic test, for monitoring the clinical course of known cancer, and as a screening measure to detect certain cancers in a population at risk. Flow cytometry is a useful tool for distinguishing several cell characteristics, such as the immunophenotype of leukemia-lymphoma cells, the DNA content of neoplastic cells, and cell proliferation rate. Molecular biologic techniques provided a giant step for the management of cancer patients encompassing diagnosis, prognostic evaluation, and therapy. Nucleic acid hybridization techniques are utilized as Southern, Northern, and dot blots and in situ hybridization. Molecular biology and its techniques may bring a blight new horizon for understanding cancer biology and in designing therapy on the basis of gene manipulation.

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