• Title/Summary/Keyword: Clinical indicator

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Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.99-102
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    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

Oncology Advanced Nurses' Use of Outcome Indicators and Perception of Outcome Evaluation (종양전문간호사의 성과지표 사용현황 및 성과평가에 대한 인식도)

  • Sung, Young-Hee;Hwang, Moon-Sook;Yi, Young-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.18 no.2
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    • pp.189-201
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    • 2012
  • Purpose: The purpose of this study was to explore the use of outcome indicators and perception of outcome evaluation of oncology advanced practice nurses (APNs). Method: A total of 111 oncology APNs from hospitals which have over 400 beds were surveyed. The participants' use of outcome indicators and perception of outcome evaluation were collected using a questionnaire including 84 outcome indicators for APNs developed by Sung et al. and 13 items on APNs' contribution to the hospitals developed by Kleinpell (2005). Data were analyzed using descriptive statistics, t-test, and $x^2$ test. Result: Twelve items out of 84 outcome indicators were used over 50% of the time and 57 items could be used in the future by the participants. Seven of the 10 top-ranking outcome indicators in use were education related and were also expected to be used frequently in the future. The score for participants' perception of outcome evaluation was average-high, 3.82 out of 5. Conclusions: The results of the study show that the main outcome indicator for oncology APNs is education related, and thus the use of education related outcome indicators is recommended to make oncology APNs' activities be more visible.

The Usefulness of Sural/Ulnar Amplitude Ratio in the Diagnosis of Early stage of Diabetic Polyneuropathy (초기 당뇨병성 다발신경병증에서 비복/척골 감각신경활동전위 진폭 비의 진단적 유용성)

  • Chang, Young-Hee;Roh, Hakjae;Ahn, Moo-Young;Moon, Hee Soo;Bae, Jong-Seok;Kim, Byoung Joon
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.34-38
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    • 2003
  • Backgrounds and Objectives: In the length-dependent axonal polyneuropathy like diabetic polyneuropathy (DPN), the distal part of the longer axons are affected earlier. In cases of minimal distal axonal changes, nerve conduction studies (NCS) are frequently normal. If sural nerve is affected in the early stage of DPN, supportive parameters to detect the early axonal degeneration may be helpful. We investigated whether the sural/ulnar SNAP amplitude ratio (SUAR) may be a more sensitive indicator than sural amplitude alone in the diagnosis of early diabetic polyneuropathy. Methods: We analyzed medical records and electrophysiological studies of 141 patients with DM and 30 healthy subjects. The patients with early stage of DPN were defined as those having symptoms of neuropathy and normal NCS findings among the patients with DM. We compared SUAR between 57 patients with early stage of DPN and 71 agematched control subjects. Results: Fifty seven patients had an average SUAR of 0.8, compared to that of 1.1 in the 71 normal controls. The SUAR of less than 0.9 was supplementary predictor of axonal polyneuropathy, with the best balance of sensitivity and specificity (70%). The SUAR did not vary significantly with age, height or duration of DM. Conclusions: We conclude that the SUAR is a useful electrodiagnostic indicator to detect early stage of DPN.

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Evaluation of Total Parenteral Nutrition in Tertiary Hospital (3차병원에서의 TPN 사용의 적정성 점토)

  • Min, Kyoung A;Sohn, Ki Ho;Suh, Ok Kyung;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.35-46
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    • 1998
  • A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.

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Muscle Strength and Biochemical Markers as Predictors of Depression in Hemodialysis Patients: A Cross-Sectional Study

  • Soudabeh Zare;Motahareh Hasani;M. Dulce Estevao;Rahim Tahmasebi;Leila Azadbakht;Farzad Shidfar;Javad Heshmati;Somayeh Ziaei
    • Clinical Nutrition Research
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    • v.12 no.4
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    • pp.293-303
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    • 2023
  • Patients with chronic renal failure, many of which treated with hemodialysis, present a high prevalence of impaired muscle strength which suggest that muscle mass parameters may be used as markers for changes in muscle in these patients. Measurement of handgrip strength (HGS) is a common, simple, and quick measure of muscle function an indicator of overall muscle strength which has been associated with physical activity and several anthropometric traits. Intercellular adhesion molecule-1 (ICAM-1) and insulin-like growth factor-1 (IGF-1) are biochemical markers associated with inflammatory processes which are a common consequence of dialysis. Additionally, hemodialysis patients frequently present signs of malnutrition and depression. This cross-sectional study aimed to evaluate if muscle and biochemical markers could be used to predict the risk of depression in hemodialysis patients. Several anthropometric parameters, nutrient intake, depression state and the serum levels of ICAM-1 and IGF-1 were determined and Pearson's correlation coefficient and/or Spearman's correlation coefficient were used to test the correlation between them. Our results do not show a correlation between HGF, IGF-1 and ICAM-1 with the depression status of the patients, but mid-arm muscle circumference (MAMC) was statistically and positively correlated with depression. Additionally, ICAM-1 levels were negatively correlated with HGS, MAMC, and IGF-1. Overall, the results of the present study suggest that HGS may be used as an indicator of cardiovascular diseases and MAMC may be a good predictor of the level of depression in hemodialysis patients, although further studies are required.

Correlation of Overexpression of Nestin with Expression of Epithelial-Mesenchymal Transition-Related Proteins in Gastric Adenocarcinoma

  • Liu, Jin-Kai;Chen, Wan-Cheng;Ji, Xiao-Zhen;Zheng, Wen-Hong;Han, Wei;An, Jing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2777-2783
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    • 2015
  • Background: Nestin is associated with neoplastic transformation. However, the mechanisms by which nestin contributes regarding invasion and malignancy of gastric adenocarcinoma (GAC) remain unknown. Recent studies have shown that the epithelial-mesenchymal transition (EMT) is important in invasion and migration of cancer cells. In the present study, we aimed to investigate the expression of nestin and its correlation with EMT-related proteins in GAC. Materials and Methods: The expression of nestin and EMT-related proteins was examined in GAC specimens and cell lines by immunohistochemistry and Western blotting. Clinicopathological features and survival outcomes were retrospectively analyzed. Results: Positive nestin immunostaining was most obviously detected in the cytoplasm, nucleus or both cytoplasm and nucleus of tumor cells in 19.2% (24/125) of GAC tissues, which was significantly higher than that in normal gastric mucosa tissues (1.7%, 1/60) (p=0.001). Nestin expression was closely related to several clinicopathological factors and EMT-related proteins (E-cadherin, vimentin and Snail) and displayed a poor prognosis. Interestingly, simultaneous cytoplasmic and nuclear nestin expression correlated with EMT-related proteins (E-cadherin, vimentin and Snail) (p<0.05) and lymph node metastasis (p=0.041) and a shorter survival time (p<0.05), but this was not the case with cytoplasmic or nuclear nestin expression. Conclusions: Nestin, particularly expression in both cytoplasm and nucleus, might be involved in regulating EMT and malignant progression in GAC, with potential as an unfavorable indicator in tumor diagnosis and a target for clinical therapy.

The determinants of vertical overbite and overbite depth indicator(ODI) (수직피개의 결정요인과 수직피개 심도지수(ODI)의 상호관계)

  • Yang, Sang-Duk
    • The korean journal of orthodontics
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    • v.29 no.3 s.74
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    • pp.349-360
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    • 1999
  • The concept of denture frame, both the vertical and horizontal relationship of the dentitions are ultimately related to a skeletal configuration, leads to postulate that the vertical overbite will be determined by the jaw rotations and anteroposterior jaw relationship. Also, ODI is analyzed to be composed of the determinant factors of overbite such as FMA PPA and FABA. From the geometric analyses of an interrelationship between the ODT and the overbite determinants, the following formula can be induced. ODI norm=$85^{\circ} - 0.5 PMA-(1.08 - 0.01 FMA)(FABA - 81^{\circ})$. This formula indicates that the norm of ODI is not constant value but variable one according to the individual skeletal frames. Through the application of the formula to the various clinical cases, it is proved that the new concept, relativity of the ODI norm, is very diagnostically useful.

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Serum Pleiotrophin Could Be an Early Indicator for Diagnosis and Prognosis of Non-Small Cell Lung Cancer

  • Du, Zi-Yan;Shi, Min-Hua;Ji, Cheng-Hong;Yu, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1421-1425
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    • 2015
  • Aims: Pleiotrophin (PTN), an angiogenic factor, is associated with various types of cancer, including lung cancer. Our aim was to investigate the possibility of using serum PTN as an early indicator regarding disease diagnosis, classification and prognosis, for patients with non-small cell lung cancer (NSCLC). Methods: Significant differences among PTN levels in patients with small cell lung cancer (SCLC, n=40), NSCLC (n=136), and control subjects with benign pulmonary lesions (n=21), as well as patients with different pathological subtypes of NSCLC were observed. Results: A serum level of PTN of 300.1 ng/ml, was determined as the cutoff value differentiating lung cancer patients and controls, with a sensitivity and specificity of 78.4% and 66.7%, respectively. Negative correlations between serum PTN level and pathological differentiation level, stage, and survival time were observed in our cohort of patients with NSCLC. In addition, specific elevation of PTN levels in pulmonary tissue in and around NSCLC lesions in comparison to normal pulmonary tissue obtained from the same subjects was also observed (n=2). Conclusion: This study suggests that the serum PTN level of patients with NSCLC could be an early indicator for diagnosis and prognosis. This conclusion should be further assessed in randomized clinical trials.

A Study on Association of DSOM Symptom Scores for Women infertility in Oriental Medicine (한방진단시스템을 이용한 여성불임(女性不姙)의 한의학적 인자(因子) 연구)

  • Cho, Hye-Sook;Um, Yun-Kyung;Yu, Ju-Hee;Kang, Jong-Geun;Kim, Kyu-Kon;Lee, In-Sun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.1
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    • pp.214-238
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    • 2007
  • Purpose : We have carried out this study to investigate association of DSOM scores and women infertility in oriental medicine for systematization diagnosis and treatment of women infertility. Methods : We analyzed the results of medical records for 151 patients who were diagnosed as women infertility. We investigated the possession of symptom index of women infertility, recognition association of DSOM. Results : 1. In comparison with 151 clinical trial's data. deficiency of Yin(陰虛), coldness(寒), spleen(脾) are associated positively and deficiency of Yang(陽虛), phlegm(痰) are associated negatively. 2. In pathogenesis(病機) indicator of average, cold inside the body is associated positively and diarrhea, kidney are associated negatively. 3. In pathogenesis five score-point of value, Heat(熱), kidney(腎) are associated negatively. 4. In pathogenesis(病機) indicator. constipation(便秘) is associated positively and hardness of lower abdomen, tingly weakness of lower back and knee question are associated negatively. 5. In 140 questions, nine questions are associated positively and ten question are associated negatively.

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The Effect of a Video Dietary Instruction Program for Hemodialysis Patients (혈액투석환자를 위한 동영상 식사교육 프로그램의 적용 효과)

  • Kim, So Yeun;Kim, Jin Dong;Park, Ae Kyung;Koo, Ja Sun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.134-145
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    • 2014
  • Purpose: The purpose of this study was to develop and apply a video dietary instruction program for hemodialysis patients to understand dietary compliance as well as the effect on the physiological indicator. Methods: This is a quasi-experimental study of a nonequivalent control group pre-post test design. Data were collected from August 6, 2012 to January 10, 2013. Twenty patients were assigned to an experimental group and twenty-one patients were assigned to a control group. A video dietary instruction program was developed and applied only to the experimental group once a week for a total of 8 weeks. Dietary compliance and physiological indicators were subsequently measured. Results: Dietary compliance was improved in both groups over time. There was no significant change in the physiological indicator value in both groups, indicating that there was no correlation between the treatment type and time. Conclusion: The video dietary instruction program could not make a statistically significant change on the physiological indicator value of the experimental group; however, this change was maintained within the allowable limits. Therefore, the video dietary instruction program can be utilized continuously as a standardized nursing intervention program in order to maintain the dietary compliance of hemodialysis patients.