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중풍후우울증에 대한 반하후박탕의 유효성 및 적응증 평가 (Effects of Banhahubak-tang(Banxiahoupotang) on patients with poststroke depression)

  • 정재한;최창민;홍진우;김태훈;이준우;이차로;반건호;정우상;문상관;배형섭;나병조
    • 대한한방내과학회지
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    • 제26권3호
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    • pp.563-574
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    • 2005
  • Objectives : Poststroke depression is a frequent and specific entity that impaires the rehabilliation and functional recovery of patients with hemiplegia. The author evaluated the effect of Banhahubak-tang(Banxiahoupotang) in patients with poststroke depression. Methods : 38 patients suffering from poststroke depression(determined by Diagnostic and Statistical Manual of Mental Disorders, revised. 3rd edition. and Beck Depression Inventory[BDI] cutoff $point{\geqq}10$) in Kyunghee Oriental hospital were randomized into two groups; treatment group(n=19) and control group(n=19). The treatment group was prescribed with Banhahubak-tang(Banxiahoupotang) three times a day fur a week. Control troop was prescribed with other herbal medicines used for stroke Patients three times a day for a week. Patients were evaluated by use of BDI scale, Modified Barthel Index, Depression of Ki score, Yin syndrome score, and Yang syndrome score. Among 38 patients, 24 patients got BDI scores above 21, which is the cut-off score for depression in Korean. The same procedures and assessments described above were applied. Results : Treatment group did not significantly improve compared with control group. Results yielded only slight significance (P=0.086). Especially. patients with poststroke depression as yin syndrome improved more significantly on BDI than those classified as yang syndrome. When BDI cutoff point for depression was defined as being ${\geq}\;21$, treatment group did not significantly improve compared with control group(P=0.114). However, patients with poststroke depression classified as yin syndrome were also significantly improved on BDI than those classified as yang syndrome. Conclusions : This study suggests that Banhahubak-tang(Banxiahoupotang) is significantly effective in patients with poststroke depression classified as yin syndrome.

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Relationship between Quantitative Sonographic Measurements and Serum Biochemical Parameters in Childhood Obesity

  • Damar, Cagri;ISik, Emregul;Gungor, Sukru
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권5호
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    • pp.470-482
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    • 2021
  • Purpose: We investigated the relationship between sonographic measurements of fatty liver and body mass index standard deviation score (BMI-Z score), abdominal wall fat thickness (AWFT), and serum biochemical parameters in childhood obesity. Methods: Anthropometric, laboratory, and ultrasonography data were obtained from 174 children with BMI-Z score >1. After the qualitative grading of hepatosteatosis (grades 0-3), the quantitative liver-kidney echogenicity ratio (LKER) was calculated using a software tool. Groups according to sex, age (AG-I to AG-III), BMI-Z score (BMG-I to BMG-III), and hepatosteatosis degree (HS-I and HS-II) were formed. The differences and distributions of the variables were statistically analyzed and compared among the groups. Results: Serum transaminase and glucose levels showed a positive correlation with LKER, whereas the HDL level showed a negative correlation. BMI-Z score and AWFT showed a positive correlation with fasting insulin level and HOMA-IR value. LKER was significantly higher in girls than in boys (p=0.008). In the AG-I group (age 3-8.9 years), the BMI-Z score was significantly higher, whereas AWFT was significantly lower than in the other age groups (p<0.001). The cutoff point of LKER for predicting grade 2 or higher steatosis (HS-II group) was determined to be 1.83. Cardiovascular disease risk was significantly higher in the HS-II group (p=0.035). Conclusion: As a valuable quantitative measurement tool, LKER can be used for the sonographic screening of fatty liver. AWFT, on the basis of its correlation with fasting insulin level and HOMA-IR value, may be a useful sonographic parameter in the management of childhood obesity.

Is It Possible to Predict the Iron Status from an Infant's Diet History?

  • Kim, Hyung Jin;Kim, Dong Hyun;Lee, Ji Eun;Kwon, Young Se;Jun, Yong Hoon;Hong, Young Jin;Kim, Soon Ki
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권2호
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    • pp.95-103
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    • 2013
  • Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.

한국형 낙상 위험 사정도구의 타당성 평가연구 (Validation of Adult Fall Assessment Scale Korean Version for Adult Patients in General Hospitals in Korea)

  • 최은희;고미숙;이신애;박정하
    • 임상간호연구
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    • 제26권2호
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    • pp.265-273
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    • 2020
  • Purpose: The purpose of this study was to test the predictive validity of the Fall Assessment Scale-Korean version (FAS-K) and to find the most appropriate cutoff score to screen high-risk fall groups in adult patients in general hospitals in Korea. Methods: We performed a prospective evaluation study in medical and surgical ward patients at two major general hospitals in Seoul. Data were collected from Nov. 1, 2018 to Feb. 28, 2019, nurses performed 651 observation series. The researcher measured the fall risk assessment score by applying FAS-K, MFS (Morse Fall Scale), and JHFRAT (Johns Hopkins Hospital Fall Risk Assessment tool) to the patients twice a week between 10 am and 12 noon. Data were analyzed using Pearson's corelation coefficients, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The FAS-K was positively correlated with the MFS (r=.70, p<.001) and the JHFRAT (r=.82, p<.001). According to the receiver operating characteristics (ROC) curve analysis of the FAS-K, sensitivity, specificity, and positive and negative prediction values were 85.3%, 49.4%, 8.5%, and 98.4%, respectively, when the FAS-K score was 4. Therefore, the cut-off score of the FAS-K to identify groups with high fall risk was 4. Conclusion: The FAS-K is a valid tool for measuring fall risk in adult inpatients. In addition, the FAS-K score, 4, can be used to identify high-risk fall groups and know specific points in time to provide active interventions to prevent falls.

Elective tracheostomy scoring system for severe oral disease patients

  • Kim, Yong-Hwan;Kim, Moon-Young;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권5호
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    • pp.211-219
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    • 2014
  • Objectives: The purpose of this research was to create a scoring system that provides comprehensive assessment of patients with oromaxillofacial cancer or odontogenic infection, and to statistically reevaluate the results in order to provide specific criteria for elective tracheostomy. Materials and Methods: All patients that had oral cancer surgery (group A) or odontogenic infection surgery (group B) during a period of 10 years (2003 to 2013) were subgrouped according to whether or not the patient received a tracheostomy. After a random sampling (group A: total of 56, group B: total of 60), evaulation procedures were observed based on the group classifications. For group A, four factors were evaluated: TNM stage, reconstruction methods, presence of pathologic findings on chest posterior-anterior (PA), and the number of systemic diseases. Scores were given to each item based on the scoring system suggested in this research and the scores were added together. Similarly, the sum score of group B was counted using 5 categories, including infection site, C-reactive protein level on first visit, age, presence of pathologic findings on chest PA, and number of systemic diseases. Results: The scoring system rendered from this research shows that there is a high correlation between the scores and TNM stage in oral cancer patients, or infection sites in odontogenic infection patients. However, no correlation between pathologic findings on chest PA could be found in either group. The results also indicated that for both groups, the hospital day increased with the tracheostomy score. The tracheostomy score cutoff value was 5 in oral cancer patients and 6 in odontogenic infection patients which was used for elective tracheostomy indication. Conclusion: The elective tracheostomy score system suggested by this research is a method that considers both the surgical and general conditions of the patient, and can be very useful for managing patients with severe oral disease.

전신성 활동불능증(Systemic Exertion Intolerance Disease) 진단 기준을 바탕으로 한 만성 피로 증후군(Chronic Fatigue Syndrome) 진단 설문지 개발 및 신뢰도 평가 (Development and Validation of Questionnaire for Chronic Fatigue Syndrome (CFS) Diagnosis Based on Systemic Exertion Intolerance Disease (SEID) Criteria)

  • 임은진;손창규;장은수
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.293-305
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    • 2020
  • Purpose: This study aimed to develop a questionnaire for the diagnosis of chronic fatigue syndrome (CFS) designed based on the systematic exertion intolerance disorder (SEID) criteria, and to validate the reliability of the questionnaire. Methods: A literature search on questionnaires for CFS diagnosis was conducted to develop a SEID questionnaire (SEID-Q27), followed by a pilot survey to identify the reliability of the questionnaire. Adults (Daejeon university personnel) with a Chalder fatigue scale (CFQ) score ≥15 were invited for the survey. We commenced the survey in November 2019 with a two weeks of interval for the test and retest method. The reliability of the questionnaire was investigated in three angles: 1. Cronbach's α, 2. correlations (r) of the questions, numerical rating scale (NRS), and visual analog scale (VAS), and 3. kappa (k) analysis. Results: Among the total 275 adults registered, 55 (20%) participants with a CFQ score ≥15 were invited, and 31 (11%) [15 male, 16 female] completed the questionnaire. The total Cronbach's α was 0.944 for the test and 0.949 for the retest. The reliability (r) of questions by CFQ score (≥15, ≥18, ≥20) ranged from 0.533-0.928 (p <0.05), and the r score of the NRS and VAS were the highest in CFQ scores ≥20, at 0.933 (p<0.001). The agreement rate of the SEID-Q27 between the test and retest was 87% (kappa k=0.743). Conclusions: The SEID-Q27 seems to be reliable. Further studies are needed to measure the validity of the tool and the cutoff point.

소아 낙상위험 측정도구 (Humpty Dumpty Falls Scale) 평가: 전자의무기록을 이용하여 (Evaluation of the Humpty Dumpty Falls Scale: An Analysis of Electronic Medical Records)

  • 조윤희;김영주
    • 임상간호연구
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    • 제25권2호
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    • pp.142-150
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    • 2019
  • Purpose: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. Methods: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. Results: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. Conclusion: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.

Development and Validation of a Screening Questionnaire for Dementia With Lewy Bodies (DLB): the DLB Screening Questionnaire (DLBSQ)

  • Mincheol Park;Kyoungwon Baik;Young H. Sohn;Byoung Seok Ye
    • 대한치매학회지
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    • 제23권1호
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    • pp.11-21
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    • 2024
  • Background and Purpose: Although dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, its clinical prevalence is low. We developed a short and easy-to-complete DLB screening questionnaire (DLBSQ) to raise diagnostic sensitivity in routine clinical settings. Methods: A total of 501 participants were retrospectively enrolled, including 71 controls, 184 patients without DLB, and 246 patients with probable DLB. All patients underwent clinical evaluation, including core features of DLB, the DLBSQ, brain magnetic resonance imaging, and detailed neuropsychological assessments. The diagnostic performance of the DLBSQ for probable DLB was investigated using a receiver operating characteristic curve analysis. Results: Total DLBSQ score was associated with visuospatial and frontal/executive dysfunction and the diagnosis of probable DLB. The area under the receiver operating characteristic curve for total DLBSQ score was 0.727. Youden's method revealed an optimal cutoff value of 3. The sensitivity and specificity of the DLBSQ were 68.7% and 62.4%, respectively. Its discriminating performance improved when cognitive test profiles were additionally considered (area under the curve: 0.822, sensitivity: 80.6%, and specificity: 70.4%). Conclusions: The DLBSQ might be a useful screening tool for DLB in routine clinical practice with good sensitivity and specificity.

Application of Data Mining Techniques to Explore Predictors of HCC in Egyptian Patients with HCV-related Chronic Liver Disease

  • Omran, Dalia Abd El Hamid;Awad, AbuBakr Hussein;Mabrouk, Mahasen Abd El Rahman;Soliman, Ahmad Fouad;Aziz, Ashraf Omar Abdel
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.381-385
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    • 2015
  • Background:Hepatocellular carcinoma (HCC) is the second most common malignancy in Egypt. Data mining is a method of predictive analysis which can explore tremendous volumes of information to discover hidden patterns and relationships. Our aim here was to develop a non-invasive algorithm for prediction of HCC. Such an algorithm should be economical, reliable, easy to apply and acceptable by domain experts. Methods: This cross-sectional study enrolled 315 patients with hepatitis C virus (HCV) related chronic liver disease (CLD); 135 HCC, 116 cirrhotic patients without HCC and 64 patients with chronic hepatitis C. Using data mining analysis, we constructed a decision tree learning algorithm to predict HCC. Results: The decision tree algorithm was able to predict HCC with recall (sensitivity) of 83.5% and precession (specificity) of 83.3% using only routine data. The correctly classified instances were 259 (82.2%), and the incorrectly classified instances were 56 (17.8%). Out of 29 attributes, serum alpha fetoprotein (AFP), with an optimal cutoff value of ${\geq}50.3ng/ml$ was selected as the best predictor of HCC. To a lesser extent, male sex, presence of cirrhosis, AST>64U/L, and ascites were variables associated with HCC. Conclusion: Data mining analysis allows discovery of hidden patterns and enables the development of models to predict HCC, utilizing routine data as an alternative to CT and liver biopsy. This study has highlighted a new cutoff for AFP (${\geq}50.3ng/ml$). Presence of a score of >2 risk variables (out of 5) can successfully predict HCC with a sensitivity of 96% and specificity of 82%.

암 환자에서 우울증의 선별도구로서 단축형 에딘버러 우울증 척도의 한국 표준화 (The Standardization of the Korean Version of Brief Edinburgh Depression Scale as a Screening Tool for Depression in Cancer Patients)

  • 이정현;김태석;고윤호;윤수정;류인균;전태연;이철
    • 생물정신의학
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    • 제16권2호
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    • pp.112-120
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    • 2009
  • Objectives : Depression is a common psychiatric disorder in cancer patients. The Brief Edinburgh Depression Scale(BEDS), which is an abbreviated version of the Edinburgh Depression Scale, may serve as a useful tool in screening for the depression in patients with the medical illnesses. This report investigated the reliability and validity of the Korean Version of the BEDS(K-BEDS) for the depression in cancer patients. Methods : One-hundred cancer patients were enrolled in this study. All subjects completed the K-BEDS, the Hospital Anxiety Depression Scale(HADS), and the Karnofsky Performance Status Scale(KPSS). Reliability, validity and Receiver Operating Characteristic(ROC) curve analysis measures were assessed. Results : The K-BEDS showed good internal consistency(Cronbach ${\alpha}$=0.77) and test-retest reliability(0.94, p<0.001). All item-total correlations were above 0.3. Also, it revealed moderate correlation with the depression subscale of the HADS(r=0.617), but no correlation with the KPSS. Exploratory factor analysis produced only one factor, accounting for 47.1% of the total variance. The most valid cutoff value to screen for depression was a total score of 5 on the K-BEDS, which showed sensitivity of 62.5% and specificity of 86.4% with a positive predictive value of 4.60 and a negative predictive value of 0.43.

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