• Title/Summary/Keyword: Clinical observation

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Reliability and Validity of a Korean Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients Unable to Self Report (자가보고 능력이 없는 중환자의 통증사정을 위한 한국어판 Critical Care Pain Observation Tool의 신뢰도와 타당도 검증)

  • Lee, Hee Og;Kim, Yeon Su;Lee, Chang Ok;Hur, Sung Yi;Kwon, In Gak
    • Journal of Korean Critical Care Nursing
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    • v.6 no.1
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    • pp.1-10
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    • 2013
  • Purpose: The purpose of this study was to examine the reliability and validity of a Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: Data were collected from a convenience sample of 30 critically ill patients admitted to a medical ICU in a hospital. The CPOT was tested at before, during and 20 minutes after changing a position and suction. Upon establishment of content and translation equivalence between the English and Korean version of CPOT. Results: The interrater reliability was found to be acceptable with the kappa coefficients of .76-1. The construct validity of the pain scores were increased from 0.43 to 2.5 in changing a position (t=-8.60, p<.001)and 0.1 to 3.23 (t=-9.36, p<.001) in suctioning. The pain scores were decreased from 6.06 to 4.01 in changing a position (t=-10.19, p<.001) and 6.45 to 4.13 (t=-10.39, p<.001) in suctioning. The concurrent validity the correlations between pain scores and physiological indicators, and a increased in Heart rate before and after changing a position (r=.65, p<.001). Conclusion: The CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal a medical ICU patients.

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Influence of Autologous and Homologous Blood Transfusion on Interleukins and Tumor Necrosis Factor-α in Peri-operative Patients with Esophageal Cancer

  • Xing, Yue-Li;Wang, Yan-Chun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7831-7834
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    • 2014
  • Objective: To explore the influence of different ways of blood transfusion on the expression levels of interleukins (IL) and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) inperi-operative patients with esophageal cancer. Materials and Methods: A total of 80 patients with esophageal cancer who underwent radical operations were selected as study patients and randomly divided into an observation group (treated with autologous blood transfusion) and control group (with homologous blood transfusion). Changes of intra-operative indexes and peri-operative blood indexes, from hemoglobin (Hb) and hematocrit value (Hct), to levels of inflammatory factors like interleukins-6 (IL-6), IL-8, IL-10 and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) were compared. Results: Operations for patients in both groups were successfully conducted, and no significant differences in mean surgical duration and intra-operative hemorrhage volume, fluid infusion volume and blood transfusion volume were detected (p>0.05). Compared with values before surgery, Hb and Hct levels decreased significantly while white blood cell count (WBC) increased 1, 5 and 7 d after operation (p<0.05, p<0.01). In addition, WBC was apparently higher in observation group than in control group 5 and 7 d after operation (p<0.01). Compared with before surgery, in the observation group, levels of IL-6, IL-8 and IL-10 had no significant differences after operation (P>0.05), but TNF-${\alpha}$ level increased y (p<0.01), whereas in control group, IL-6 level had no significant difference (p>0.05), IL-8 level decreased obviously (p<0.05), IL-10 level increased markedly first and then decreased gradually as time passed but its level remained elevated (p<0.01), and TNF-${\alpha}$ level increased first and then decreased, and there was no significant difference 7 d after operation (p>0.05). Conclusions: Decreased IL-8 and increased IL-10 levels are two important reasons for immunosuppression after homologous blood transfusion, whereas autologous blood transfusion can alleviate this while increasing the TNF-${\alpha}$ level, which also has potential to improve anti-tumor immunity in the human body.

Spontaneous Recovery of an Intruded Tooth Bounded by Implants: a Clinical Report (임플란트에 둘러싸인 채 압하된 치아의 자연회복: 증례보고)

  • Cha, Min-Sang;Yi, Yang-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.399-406
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    • 2013
  • Reports about the intrusion of a natural tooth bounded by implants are very rare, although some concerns have been discussed on the intrusion of teeth connected to implants. A female aged 56 years received an implant (mandibular right first premolar) and post/core onto root rest (mandibular right second premolar) and was restored by single zirconia crown, respectively. Molars were implant restorations. Four month after loading, second premolar was intruded and prominent gap was shown between opposite tooth. Because nonspecific discomfort was expressed, observation was decided after explanation of prognosis of tooth without treatment. Three month later reversal to original position was detected on the periapical radiographs and fully recovered position with intimate contact was completed 11 more months later. Till now 2 years and 3 month observation is being performed. Through the observation of spontaneous recovery of a natural tooth bounded by implants, the cause of intrusion and a mechanism of spontaneous recovery could be estimated.

Surgically induced degenerative changes in the femorotibial joints by total medial meniscectomy in minipigs closely resemble late-stage osteoarthritis

  • Lee, Won-Jae;Park, Byung-Joon;Lee, Hyeon-Jeong;Jang, Si-Jung;Lee, Sung-Lim;Lee, Jae-Hoon;Rho, Gyu-Jin;Kim, Seung-Joon
    • Korean Journal of Veterinary Research
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    • v.59 no.1
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    • pp.17-24
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    • 2019
  • Animal models of osteoarthritis (OA) have played a key role in understanding the etiology of OA and in the development of new therapeutic strategies. Although pigs have an advantage as an animal disease model due to their similarity to humans, there are few studies on the induction of OA in minipigs. Therefore, this study aimed to characterize disease progression of OA in total medial meniscectomy (TMM)-operated skeletally mature minipigs, up to day 180 postoperatively. There were no significant alterations in vital signs or hematological indices throughout the observation period. However, clinical manifestations of OA in the medial femoral condyles of TMM-operated minipigs were progressive, depending on postoperative duration, with respect to osteophytes formation and roughened surfaces on radiological observation, cartilage erosion under macroscopic examination, and severe cartilage defects including fibrillation, vertical fissures, and cartilage denuding on histopathological observation, with the highest score indicating late-stage OA on day 180 and without indicating apparent variation between subjects. In particular, the lateral femoral condyles were also degenerated, possibly due to localization of weight-bearing from both menisci to the lateral meniscus. Therefore, TMM in minipigs is suitable for reproducible induction of degenerative changes in the femorotibial joints that closely resemble late-stage OA, and is suitable for use in further research.

Growth Pattern and Prognostic Factors of Untreated Nonfunctioning Pituitary Adenomas

  • Hwang, Kihwan;Kwon, Taehun;Park, Jay;Joo, Jin-Deok;Han, Jung Ho;Oh, Chang Wan;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.256-262
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    • 2019
  • Objective : Pituitary adenomas (PAs) are often detected as incidental findings. However, the natural history remains unclear. The objective of this study was to evaluate the natural history and growth pattern of untreated PAs. Methods : Between 2003 and 2014, 59 PAs were managed with clinico-radiological follow up for longer than 12 months without any kind of therapeutic intervention. Tumor volumes were calculated at initial and last follow-up visit, and tumor growth during the observation period was determined. Data were analyzed according to clinical and imaging characteristics. Results : The mean initial and last tumor volume and diameter were $1.83{\pm}2.97mL$ and $13.77{\pm}6.45mm$, $2.85{\pm}4.47mL$ and $15.75{\pm}8.08mm$, respectively. The mean annual tumor growth rate was $0.33{\pm}0.68mL/year$ during a mean observation period of $46.8{\pm}32.1months$. Sixteen (27%) PAs showed tumor growth. The initial tumor size (HR, 1.140; 95% confidence interval, 1.003-1.295; p=0.045) was the independent predictive factor that determined the tumor growth. Six patients (11%) of 56 conservatively managed non-symptomatic PAs underwent resection for aggravating visual symptoms with mean interval of 34.5 months from diagnosis. By Cox regression analysis, PAs of last longest diameter over 21.75 mm were a significant prognostic factor for eventual treatment. Conclusion : The initial tumor size of PAs was independently associated with the tumor growth. Six patients (11%) of conservatively managed PAs were likely to be treated eventually. PAs of last follow-up longest diameter over 21.75 mm were a significant prognostic factor for treatment. Further studies with a large series are required to determine treatment strategy.

Single-Dose Toxicity Study of Intramuscular Neuralgia-Pharmacopuncture Injection in Rats

  • Ji Hye Hwang
    • Journal of Pharmacopuncture
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    • v.26 no.4
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    • pp.348-356
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    • 2023
  • Objectives: Neuralgia-pharmacopuncture (NP) was recently developed as a water-soluble type of pharmacopuncture inspired by CS (care special pain)-pharmacopuncture. I aimed to evaluate the toxic response and approximate lethal dose of when NP when administered intramuscularly to Sprague Dawley rats. Methods: The experimental group was divided into the NP test substance group and the saline control group and administered at a dose of 1.0 mL/animal to the posterior thigh muscles on both sides using a 1 mL syringe; each group consisted of five males and five females. Each rat was monitored for clinical signs and changes in body weight for 14 days after a single intramuscular injection. After completing observation, necropsy findings and localized tolerance at the injection site were assessed via gross necropsy and histopathological examination. Results: No deaths occurred in the NP or control group, regardless of sex. During the observation period, no changes (such as general symptoms, weight change, or visual observation results at the time of autopsy) were judged to be due to the test substance. Histopathological examination showed no changes at the administration site judged to be caused by the test substance in either the male or female test substance administration groups. In addition, mononuclear cell infiltration of the outer membrane of the femoris muscle at the administration site was observed at the same frequency and extent in the control and NP groups, and was judged to be caused by physical stimulation by the injection needle; therefore, it had no toxicological significance. Conclusion: Based on the above results, the approximate lethal dose for a single intramuscular administration of the test substance NP in Sprague-Dawley rats was judged to be > 1.0 mL/animal, and there were no findings that were judged to be due to the test substance at the administration site.

CLINICAL STUDY ON THE POSITIONAL CHANCE OF THE MANDIBLE AFTER TREATMENT OF CLASS III MALOCCLUSION(Permanent Dentition) (III급 부정교합 치료후의 하악골의 위치변화에 관한 임상적 고찰(영구치열에서))

  • Park, Hyo-Sang
    • The korean journal of orthodontics
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    • v.24 no.1 s.44
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    • pp.63-86
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    • 1994
  • The purpose of this study was to find out some relationship between the positional change of mandible during treatment and the prognosis after treatment of ClassIII malocclusion. The patients selected for this study were sucessfully treated two patients, and three patients who wert also sucessful in active treatment but showed relapse during observation. Serial Cephalograms, photos, models, treatment record of these patients were analysed in each term of treatment and observation period. The results might be summarized as follows: The patient with swing back type in which mandible rotated posteroinferiorly during active treatment showed good dental md skeletal relationship during observation. Among the patients with Y-axis type, one who had harmonious growth between maxilla and mandible showed stable dental relationship during observation, the other who had not showed relapse. The swing back type was not changed during and after treatment but the patients who had Y-axis type were unchanged in some patients, and changed into forward type in the others. During active treatment, was lower facial height(ANS-Me) increased in all 5 patients, and in observation period the patients showing increase in lower facial height had stable occlusion but the others having decrease showed unstable dental relationship.

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28days Repeat Oral Dose Toxicity Test of 'Hyeonggaeyeongyotang' extract in SD Rats (형개련교탕(荊芥連翹湯) 추출물(抽出物)의 SD Rats에서 28일 경구(經口) 반복투여 독성시험)

  • An, Hyun-Jue;Hwang, Sun-Yi;Lee, Jong-Rok;Kim, Sang-Chan;Jee, Seon-Young
    • Herbal Formula Science
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    • v.16 no.1
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    • pp.147-168
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    • 2008
  • HYTE (Hyeonggaeyeongyotang Extract), a polyherbal formula has been used as folk medicine, 28days repeat oral dose toxicity was tested in SD rats according to KFDA Guideline[2005-60]. Methods : In this study, mortality, clinical signs, body weight and gains, food and water consumption, ophthalmologic observation, urinalysis, hematology, serum biochemistry, gross findings, organ weight and histopathological observations were conducted during 28days of dosing periods. Results: 1. No HYTE treatment-related mortalities and clinical signs were detected in all dosing levels tested in male and female rats during the whole experimental periods. 2. No HYTE treatment-related changes on body weight, gains and food consumption were detected in all dosing levels tested in male and female rats during the whole experimental periods except for 2000mg/kg-dosing female groups in which significantly increase of body weight, gains, food and water consumption were detected compared to that of vehicle control in some points. 3. No HYTE treatment-related changes on ophthalmologic examination were detected in all dosing levels tested in male and female rats. 4. No HYTE treatment-related changes on urinalysis were detected in all dosing levels tested in male and female rats except for 2000mg/kg-dosing female groups in which, significantly increase of urine volume and related decrease on the urine specific gravity were detected as secondary effects of increase on the water consumptions not HYTE treatment-related toxicological signs. 5. No HYTE treatment-related changes on hematology were detected in all dosing levels tested in male and female rats except for increases in the total WBC count and lymphocytes of 2000mg/kg-dosing male and female groups with decrease of large unstained cells as pharmacological effects of immune enhancements not HYTE treatment-related toxicological signs. 6. No HYTE treatment-related changes on serum biochemistry were detected in all dosing levels tested in male and female rats. 7. No HYTE treatment-related changes on gross findings, organ weight and histopathology were detected in all dosing levels tested in male and female rats except for 2000mg/kg-dosing male and female groups in which, spleen and thymus organ weights, hypertrophy at gross observation and hyperpalsia of lymphoid cells and follicles at histopathological observation in spleen and thymus were detected as pharmacological effects of immune enhancements not HYTE treatment-related toxicological signs. Conclusions : Based on these results, the NOAEL and MTD of HYTE in SD rats were considered as over 2000mg/kg, respectively at 28days repeat oral dose toxicity test because most of these findings were considered as results of pharmacological effects of immune enhancements not HYTE treatment-related toxicological signs or secondary effects.

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Changes of Facial Wrinkle after Topical Application of On Emulsion Containing Medimin A (Medimin A를 함유한 O/W 에멀전의 주름 개선 효과)

  • 박선규;장민열;김영득;정봉열;원영호;김진준;강세훈
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.25 no.1
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    • pp.23-36
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    • 1999
  • Medimin A is a derivative of vitamin A which has been developed by coupling retinoic acid with polyethylene glycol(PEG) to enhance skin permeability and stability. We carried out the collagen synthesis and clinical test to examine the reducing effect of wrinkles by Medimin A. In vitro collagen synthesis was evaluated by quantitative assay of ($^3$H)-proline incorporation into collagenase sensitive protein in fibroblast cultures. Clinical test was evaluated by image analysis of skin replica, visual observation and self-estimated response of volunteers for 10 weeks. Medimin A stimulated about 40% in collagen synthesis. The area of main deep wrinkle on the skin replica was reduced 38.4% with topical application of O/W emulsion containing 0.2% Medimin A. The wrinkles on the eye region was also reduced 25.4%-44.1% by the visual observation and 93% of all volunteers responded that topical application of the O/W emulsion was showed some reducing effect of wrinkles after 10 weeks. From these results, we suggest that Medimin A is a potent anti-wrinkle agent by objective evaluation methods(in vitro collagen synthesis and image analysis of skin replica) and subjective evaluation methods(visual observation and self-estimated response of volunteers).

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Clinical Observation on Apgar Score Changing of the Newborn Infants (신생아 Apgar Score의 시간적 변동에 관한 임상적 관찰)

  • 박희정
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.57-66
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    • 1974
  • This study was attempted for clinical investigation regarding with Apgar score changing phase of newborns and their sucking power related the score and weight. The data for this study obtained from 545 newborns who were born at Dept. of obstetric WooSok Hospital, Korea University from Jan. to Sept.. 1373. It is hoped that this study will contribute to nursing care planning of newborns in nursery. The Apgar score was checked in the delivery room at 1 minute after delivery by Doctor and rechecked at 30 minutes and 1 hour after delivery by nurses. The results obtained were as follows: 1. The total newborn numbers at 1 minute after delivery were 545, at 30 minutes were 542 (3 dead) and at 1 hour were 540. The babies were divided into 3 groups by the Apgar score. The frequency of group 1 (score 1 to 4) at each times were 5.0%, 0.9%, 0.4%, group 2 (score 5 to 7) 11.2%, 4.1%, 1.7% and group 3 (score 8 to 10) 83.8%, 95.0%, 97.9%. 2. The group I was found most frequently among the cases of less than 2, 500g and group 3 was found among the cases over 2.500g. It was found that there was a tendency of delaying in recovery process of low score among the premature and low birth weight newborns. 3. The type of delivery, breech and other I e was found worst and C-Section was the second, however normal spontaneous delivery was found the best. 4. In observation of sucking power of the newborn related its score and weight, good, fair, poor marks were given. But for convenience of statistical analysis. good and fair was collected together and poor alone evaluated. The result of group 1.2 examined statistically by F.E.T shown no relation between newborn weight and sucking power. however group 3, examined by X$^2$test shown very significant relation between newborn weight and sucking power. 5. The mortality rate of newborn while they were in hospital was found 2.6% to 545 of birth and all cases of dead belonged to group 1 at 1 minutes after delivery. 64.3% of the dead was found among the cases less than 2, 500g. 6. It was found that in this observation premature and Newborn asphyxia had influence to low score at birth. Conclusively, good anthemata carr should be emphasized in order to prevent main causes of these and should avoid abnormal delivery as possible.

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