• 제목/요약/키워드: Clinical value

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Nursing Competency And Indicator Development By Emergency Nurse's Clinical Ladder (응급실 간호사의 임상 등급(clinical ladder)에 따른 간호역량 및 행동지표 개발)

  • Youk, Shin-Young
    • Journal of Korean Academy of Nursing Administration
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    • 제9권3호
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    • pp.481-494
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    • 2003
  • Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

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Clinical Course and Results of Surgery for Chronic Subdural Hematomas in Patients on Drugs Affecting Hemostasis

  • Dziedzic, Tomasz Andrzej;Kunert, Przemyslaw;Marchel, Andrzej
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.232-238
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    • 2017
  • Objective : An apparent increase of use of drugs affecting hemostasis in our neurosurgical department since the 1990s has encouraged us to investigate whether these drugs influence the clinical course and results of surgery for chronic subdural hematoma (CSDH). Methods : This retrospective analysis included 178 patients admitted for CSDH from 2007 to 2011 who were divided into two groups : on drugs affecting hemostasis (40; 22%) and no bleeding disorders (138; 78%). Medications in the first group included oral anticoagulants (33; 82.5%), antiplatelets (5; 12.5%) and low molecular weight heparins (2; 5%). Results : The patients on drugs affecting hemostasis were older ($74.3{\pm}7.4$ vs. $68.4{\pm}14.8$; p-value 0.01) and the group without bleeding disorders had more head trauma history (61% vs. 38%, p-value 0.01). The groups did not differ in bilateral hematoma rates (25% vs. 20%, p-value=NS). At diagnosis, mean hematoma thickness was lower in patients on drugs affecting hemostasis ($18.7{\pm}7.4mm$ vs. $21.9{\pm}7.9mm$, p-value<0.01). Average stay of hospital was 1 day longer in patients on drugs affecting hemostasis ($11.7{\pm}4.1$ vs.$10.9{\pm}5.3$, p-value=NS) and was related to the necessity of bleeding disorder reversal. Mean neurological status at presentation was similar between the groups (p-value=NS) as was the likelihood of hematoma recurrence (p-value=NS). Glasgow Outcome Scale results were comparable. Conclusion : Patients on drugs affecting hemostasis are less often aware of a head trauma history, possibly suggesting a higher CSDH risk after minor trauma in this group. In these patients, smaller hematomas are symptomatic, probably due to faster hematoma formation. Drugs affecting hemostasis do not affect treatment results.

Soluble Fiber Effect on Human Serum Leptin and Adiponectin: A Systematic Review and Dose-Response Meta-Analysis

  • Ali Zeinabi;Hadi Ghaedi;Seyed Ali Hosseini
    • Clinical Nutrition Research
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    • 제12권4호
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    • pp.320-335
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    • 2023
  • Literature showed that soluble fiber has beneficial effects on cardiometabolic risk factors and leptin and adiponectin serum levels. Our aim in this meta-analysis was to determine the effect of soluble fiber supplementation on leptin and adiponectin serum levels. A systematic search was conducted using PubMed, Scopus, and ISI Web of Science for eligible trials up to December 2021. A random-effects model was used to pool calculated effect sizes. Our analysis showed that soluble fiber supplementation did not significantly affect adiponectin (standardized mean difference [SMD], -0.49 Hedges's, 95% confidence interval [CI], -1.20, 0.21, p value = 0.167; I2 = 95.4, p value < 0.001) and leptin (SMD, -0.8 Hedges's, 95% CI, -1.70, 0.08, p value = 0.076; I2 = 94.6, p value < 0.001) concentrations in comparison with placebo. However, in the subgroup, soluble fiber supplementation had a significant improvement in leptin concentration in overweight and obese patients (SMD, -0.22 Hedges's, 95% CI, -0.43, -0.01, p value = 0.048) and a non-significant beneficial effect in adiponectin level in female (SMD, 0.29 Hedges's, 95% CI, -0.13, 0.71, p value = 0.183) and diabetic patients (SMD, 0.32 Hedges's, 95% CI, -0.67, 1.32, p value = 0.526). A non-linear association between soluble fiber dosage and adiponectin (pnon-linearity < 0.001) was observed. Soluble fiber supplementation could not change the circulatory leptin and adiponectin levels. However, beneficial effects were seen in overweight and obese leptin, and increases in adiponectin may also be observed in female and diabetic patients. Further studies are needed to confirm this results.

Prevalence of JAK2 V617F, CALR, and MPL W515L Gene Mutations in Patients with Essential Thrombocythemia in Kurdistan Region of Iraq

  • Saeed, Bestoon Muhammad;Getta, Hisham Arif;Khoshnaw, Najmaddin;Abdulqader, Goran;Abdulqader, Aveen M. Raouf;Mohammed, Ali Ibrahim
    • Korean Journal of Clinical Laboratory Science
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    • 제53권1호
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    • pp.41-48
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    • 2021
  • Essential thrombocythemia (ET) is a clonal bone marrow stem cell disorder, primarily involving the megakaryocytic lineage. The WHO 2016 guidelines include the molecular detection of JAK2, MPL, and CALR mutations as a major diagnostic criterion for ET. This study aimed to determine the frequency of JAK2 V617F, MPL W515L, and CALR mutations in Iraqi Kurdish patients afflicted with ET, and to analyze their clinical and hematological features. A total of 73 Iraqi Kurdish patients with ET were enrolled as subjects, and analysis was achieved utilizing real-time PCR. The frequency of JAK2 V617F, CALR, and MPL W515L mutations was determined to be 50.7%, 22%, and 16.4%, respectively. No statistically significant difference was obtained when considering the age and gender among different genotypes. The JAK2 V617F mutated patients had significantly higher white blood cell counts and hemoglobin levels than the CALR-positive patients (P-value=0.000, 0.007, respectively), MPL W515L-positive patients (P-value=0.000, 0.000, respectively), and triple negative patients (P-value=0.000, 0.000, respectively). Also, the JAK2 V617F mutated patients showed higher platelet count as compared to the MPL W515L-positive patients (P-value=0.02) and triple negative patients (P-value=0.04). Furthermore, significantly lower white blood cell count and hemoglobin levels were associated with CALR positivity (P-value=0.000, 0.01, respectively), MPL W515L-positivity (P-value=0.001, 0.000, respectively), and triple negativity (P-value=0.000, 0.000, respectively), as compared to patients with combined mutations. In conclusion, apart from a relatively high frequency of MPL W515L mutation, our data is comparable to earlier reports, and highlights the importance of genotyping the JAK2 V617F, MPL W515L, and CALR mutations for accurate diagnosis of patients with ET.

A RADIOGRAPHICAL AND CLINICAL STUDY OF ANTERIOR TOOTH MOBILITY (전치부 치아동요에 관한 방사선학적 및 임상적 연구)

  • Lee, Kwang-Ho;Kim, Byung-Ok;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • 제25권2호
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    • pp.290-300
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    • 1995
  • Tooth mobility is one of the most important clinical parameters in examination, diagnosis, prognosis and treatment planning procedure. In order to determine the differences of tooth mobility according to radiographical bone level, clinical root length, clinical crown/root ratio, and bleeding on probing, 90 male adults with periodontal disease and 10 male adults with periodontal health($25{\sim}45$ years old) were selected through clinical examinations including occlusal relationship, probing depth, attachment level, and bleeding on probing. On the mandibular anterior teeth, standard periapical radiographs were taken, and tooth mobility was measured by Periotest(Siemens Co., Germany). The radiographic bone level of individual tooth was evaluated as coronal 1/3, middle 1/3, and apical 1/3 to anatomical root length, and clinical crown length from incisal edge to bone level and clinical root length from bone level to root apex were measured with Boley gauge, and subsquently clinical crown/root ratio was calculated. The difference of tooth mobility(Periotest value) according to radiographical bone level, clinical root length, clinical crown/root ratio, and bleeding on probing was statistically analyzed by unpaired Student t-test. Tooth mobility was significantly higher in bleeding group than non-bleeding group on probing in the teeth radiographic bone level of middle 1/3, with clinical root length longer than 6mm, and with clinical crown/root ratio over 0.3(p<0.01). But there was no statistical difference in tooth mobility between bleeding group and non-bleeding group on probing in the teeth with radiographic bone level of apical 1/3, with short clinical root length less than 5mm, and with clinical crown/root ratio under 0.2(p>0.05). The results note that the tooth mobility depends on clinical root length, clinical crown/root ratio and gingival inflammation, and in the teeth with relatively good alveolar bone support gingival inflammation is one of the most important factors that affect tooth mobility.

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A STUDY ON THE MEASUREMENT OF THE IMPLANT STABILITY USING RESONANCE FREQUENCY ANALYSIS (공진 주파수 분석법에 의한 임플랜트의 안정성 측정에 관한 연구)

  • Park Cheol;Lim Ju-Hwan;Cho In-Ho;Lim Heon-Song
    • The Journal of Korean Academy of Prosthodontics
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    • 제41권2호
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    • pp.182-206
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    • 2003
  • Statement of problem : Successful osseointegration of endosseous threaded implants is dependent on many factors. These may include the surface characteristics and gross geometry of implants, the quality and quantity of bone where implants are placed, and the magnitude and direction of stress in functional occlusion. Therefore clinical quantitative measurement of primary stability at placement and functional state of implant may play a role in prediction of possible clinical symptoms and the renovation of implant geometry, types and surface characteristic according to each patients conditions. Ultimately, it may increase success rate of implants. Purpose : Many available non-invasive techniques used for the clinical measurement of implant stability and osseointegration include percussion, radiography, the $Periotest^{(R)}$, Dental Fine $Tester^{(R)}$ and so on. There is, however, relatively little research undertaken to standardize quantitative measurement of stability of implant and osseointegration due to the various clinical applications performed by each individual operator. Therefore, in order to develop non-invasive experimental method to measure stability of implant quantitatively, the resonance frequency analyzer to measure the natural frequency of specific substance was developed in the procedure of this study. Material & method : To test the stability of the resonance frequency analyzer developed in this study, following methods and materials were used : 1) In-vitro study: the implant was placed in both epoxy resin of which physical properties are similar to the bone stiffness of human and fresh cow rib bone specimen. Then the resonance frequency values of them were measured and analyzed. In an attempt to test the reliability of the data gathered with the resonance frequency analyzer, comparative analysis with the data from the Periotest was conducted. 2) In-vivo study: the implants were inserted into the tibiae of 10 New Zealand rabbits and the resonance frequency value of them with connected abutments at healing time are measured immediately after insertion and gauged every 4 weeks for 16 weeks. Results : Results from these studies were such as follows : The same length implants placed in Hot Melt showed the repetitive resonance frequency values. As the length of abutment increased, the resonance frequency value changed significantly (p<0.01). As the thickness of transducer increased in order of 0.5, 1.0 and 2.0 mm, the resonance frequency value significantly increased (p<0.05). The implants placed in PL-2 and epoxy resin with different exposure degree resulted in the increase of resonance frequency value as the exposure degree of implants and the length of abutment decreased. In comparative experiment based on physical properties, as the thickness of transducer increased, the resonance frequency value increased significantly(p<0.01). As the stiffness of substances where implants were placed increased, and the effective length of implants decreased, the resonance frequencies value increased significantly (p<0.05). In the experiment with cow rib bone specimen, the increase of the length of abutment resulted in significant difference between the results from resonance frequency analyzer and the $Periotest^{(R)}$. There was no difference with significant meaning in the comparison based on the direction of measurement between the resonance frequency value and the $Periotest^{(R)}$ value (p<0.05). In-vivo experiment resulted in repetitive patternes of resonance frequency. As the time elapsed, the resonance frequency value increased significantly with the exception of 4th and 8th week (p<0.05). Conclusion : The development of resonance frequency analyzer is an attempt to standardize the quantitative measurement of stability of implant and osseointegration and compensate for the reliability of data from other non-invasive measuring devices It is considered that further research is needed to improve the efficiency of clinical application of resonance frequency analyzer. In addition, further investigation is warranted on the standardized quantitative analysis of the stability of implant.

Correlation between Balance and Lower Extremity Muscle Activity in Stroke Patients (뇌졸중 환자의 균형과 하지 근활성도와의 상관관계 연구)

  • Yang, Dae-Jung;Kim, Je-Ho;Jung, Yong-Sik;Uhm, Yo-Han;Park, Seung-Kyu
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • 제10권1호
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    • pp.1-5
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    • 2012
  • Purpose : In this study, stroke patients' limits of stability and functional reach test and tibialis anterior, gastrocnemius muscle of lower extremity muscle activities to evaluate the correlation. Methods : 30 adult stroke patients to participate in this study. Limits of stability were measured using biorescue, tibialis anterior and gastrocnemius muscle of muscles activities were measured with functional reach test when there was movement. Results : Limits of stability and functional reach test (r=0.753, p<0.01), RMS value of the limits of stability and tibialis anterior muscle (r=0.706, p<0.01), RMS value of the limits of stability and gastrocnemius muscle (r=0.766, p<0.01), RMS value of the functional reach test and tibialis anterior muscle (r=0.835, p<0.01), RMS value of the functional reach test and gastrocnemius muscle (r=0.663, p<0.01), RMS value of the tibialis anterior and gastrocnemius muscle (r=0.816, p<0.01) correlations are shown as statistically significant. Conclusion : The balance and lower extremity muscle activities of stroke patients were studied, and were positively correlated with the RMS value of the limits of stability and functional reach test, tibialis anterior muscle, and gastrocnemius muscle. This study has shown that stroke patients' ankle joint muscle activity can greatly.

Test turnaround Time for Complete Blood Cell Count using Delta and Panic Value Checks and the Q-flag Limit

  • Koo, Bon-Kyung;Ryu, Kwang-Hyun;Lim, Dae-Jin;Cho, Young-Kuk;Kim, Hee-Jin
    • Korean Journal of Clinical Laboratory Science
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    • 제44권2호
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    • pp.66-74
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    • 2012
  • Test turnaround time (TAT) is the lead time from reception to reporting. In the complete blood cell count (CBC), 4 units of the XE-2100 (Sysmex Corp., Japan) processed around 80% of quantity, 1 unit of the LH-780 (Beckman-Coulter Incorp., USA) processed around 10% and 1 unit of ADVIA-2120 (Siemens AG, Munich, Germany) processed around 10%. We analyzed the change in the TAT for the CBC for over 7 years, from January of 2005 to December of 2011. The delta check made alterations of delta to WBC, hemoglobin, hematocrit, platelet and metamyelocyte, however, did not made them to band neutrophil, eosinophil, basophil and monocyte. The panic value check made alterations of panic value to hemoglobin, hematocrit, platelet and monocyte. In the criteria of currently slide review, LH-780 and ADVI-2120 analyzers prepared suspect flags of "Blast, Imm NE2, Immature granulocyte, Imm NE1, Left shift, Variant lymphocyte, Atypical lymphocyte, Platelet clumps and NRBC". The New slide review in the XE-2100 analyzer altered the preparations of a smear slide more than a "Platelet clumps flag(${\geq}200unit$), a single flag excluding the "Platelet clumps flag (${\geq}250unit$) and a multiple flag (${\geq}200unit$)". Also, below the 240 unit, medical technologists prepared manual slides selectively according to their evaluations. The automatic reporting rate was 33.4% without alterations, whereas it was 41.0% without alterations, and was thus improved by 7.6%. The slide review rate was 15.2% before using the Q-flag limit, whereas it was 12.1% for a reduce 3.1%. TAT was 45 minutes without the creation alterations of the delta and panic value checks, whereas it was 35 minutes after making alterations of the delta and panic value checks and thus was shortened by 10 minutes. We came to the conclusion that the establishment and operation of delta and panic value checks and slide review criteria suitable for laboratory environment can reduce unnecessary smear slides, re-checking, re-sampling, re-testing, telephone inquiries and concentrated workloads during specific times of the day.

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The Teaching Efficiency of the Ordered Clinical Nursing Education by Preceptors (실습지도자(preceptor)를 활용한 주문식 실습교육의 교수효율성(teaching efficiency))

  • Kang, Ik-Wha
    • Journal of Korean Academy of Nursing Administration
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    • 제10권1호
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    • pp.11-23
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    • 2004
  • Purpose: The objective of this study was to collect the basic data for improving the quality of nursing education by identifying the teaching efficiency of the ordered clinical nursing education by preceptor which was accepted by Gachongil College since 2001. Method: The data was collected from 30 Sept to 20 Oct 2002. The subjects of this study were 240 nursing students, junior 2nd term trained by the preceptors and 137 preceptors of 12 hospitals located in Inchon, Gyong Ki-do, and Seoul. The scale for measuring the teaching effectiveness, developed by Kim Miae et al.(1998), was employed as a tool for me study. The data was analysed by SPSS using mean value(SD), and ANOVA. Results: Mean value of teaching efficiency of preceptors evaluated by me nursing students scored 3.68(maximum 5). For 5 causal factors classified en the teaching efficiency, the factor of "teaching method and evaluation" showed the highest score, but "available as resource person" get the lowest. Items showing high score en teaching efficiency were "overall effectiveness of teacher", "was able to work with staff in cooperative manner", but the item of was unclear in instructions given to me showed the lowest. The psychiatric ward get the highest score, but cardiac catheterization room showed the lowest. The hospital 10 showed the highest score, but the hospital 8 get the lowest. Conclusion: As the findings from this study, the ordered clinical nursing education by preceptor showed higher teaching efficiency than the conventional education. Thus, cooperative relationship between nursing colleges and hospitals shall be suggested for improving the quality of clinical nursing education, and ordered clinical nursing education system.

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EA-D p45-IgG as a Potential Biomarker for Nasopharyngeal Carcinoma Diagnosis

  • Chen, Hao;Luo, Yao-Ling;Zhang, Lin;Tian, Li-Zhen;Feng, Zhi-Ting;Liu, Wan-Li
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7433-7438
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    • 2013
  • Aim: To identify new biomarkers for NPC diagnosis with an anti-EBV Western blot test kit. Methods: Serum samples from 64 NPC patients and healthy subjects with four specific VCA-IgA/EA-IgA profiles were tested with an anti-EBV Western blot test kit from EUROIMMUN AG. Proteins were quantified with scores of intensity visually assigned to the protein bands. The markers which showed statistical differences between the NPC and non-NPC subjects were further evaluated in another 32 NPC patients and 32 controls in comparison with established biomarkers including VCA-IgA, EA-IgA, EBV-related protein IgG, and EBV DNA. Results: Among the markers screened, EA-D p45-IgG showed a statistically significant difference (p < 0.05) between NPC and non-NPC subjects with VCA-IgA positivy. In 32 VCA-IgA positive NPC patients and 32 control subjects, the diagnostic accuracy of EA-D p45-IgG was 78.1% with a positive predictive value of 77.8% and a negative predictive value of 78.6%. In the verification experiment, the specificity and sensitivity of EA-D p45-IgG were 75.0% and 90.6 %, respectively. Conclusions: EA-D p45-IgG might be a potential biomarker for NPC diagnosis, especially among VCA-IgA positive subjects.