• 제목/요약/키워드: Diagnosis Related Groups

검색결과 323건 처리시간 0.024초

입원환자가 경험한 입원스트레스 순위에 관한 연구 (A Study on the Rank of Stressful Events Related to the Experience of Hospitalization)

  • 이소우;하양숙;박은숙
    • 대한간호학회지
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    • 제15권1호
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    • pp.17-29
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    • 1985
  • This study was to explore on the rank of stressful events related to the experience of hospitalization. 180 hospitalized patients on surgical and medical wards were asked to rate 49 stress-producing events associated with the experience of hospitalization. Two university hospitals was used as the setting for this study. Because the nature of the events in the stress scale pertain mainly to general short term hospitalizations, patients in the rehabilitation and psychiatric units of the hospital were not included. Prior to the beginning of the study, three times meeting were held with 12 head nurses and 3 investigators for discussing with the ethics subject related to the study. The pretest was done to determine whether items to use were pertinent or not. According to the result of the pretest, Volicer's Hospital Stress Rating Scale was selected as a study tool for this study. Data collection was used an interview and a card-sorting method. The interviewing was done by two authors and three graduate nursing students. A total 125 completed the card-sorting procedure. The stressful items were ordered from most to least stressful within the categories. Additional information such as: age, sex, marital status, and diagnosis was obtained from the kardex file. The ordered list of items, with mean values, as scored by the total of 125 respondents was significantly accepted at 1% level by Friedman test. (X²=1448.339) The event,“knowing you have a serious illness.”was rated highest stressful and (M=41.54) “Being awakened in the night by the nurse”least stressful. (M=14.73) Highly rated items were orderly “Thinking you might have cancer”“Thinking you might lose a kidney or some other organ”“Not being told what your diagnosis is. “Not knowing for sure what illness you have,”five lowerly rated items were orderly “Having to eat at different times than you usually do”“net being able to call family or friends on the phone”“Not having friends visit you,”“Having strangers sleep in the same room with you.”Futher analysis of the data was done to ascertain tao degree of similarity of judgment between different groups in the sample as to how events should be rated. The sample was divided into two groups according to the demographic characteristics and the degree of seriousness of illness. The rank order correlation was calculated for the two sets of ranks as a measure of consensus between the two groups. The correlations ranged from .85∼.99 all indicating a high degree of consensus.

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Clinical and Radiological Characteristics in Patients with Postoperative Maxillary Cyst: A Retrospective Study

  • Hyoung-Cheol Kim;Suk-Ja Yoon;Yeong-Gwan Im;Jae-Seo Lee
    • Journal of Oral Medicine and Pain
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    • 제48권3호
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    • pp.81-86
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    • 2023
  • Purpose: To evaluate the clinical and radiologic findings of the postoperative maxillary cysts (POMCs) and investigate the relationship between lesion size and clinical symptoms depending on the time elapsed after radical maxillary sinus surgery. Methods: A total of 29 patients who were diagnosed with POMCs at Chonnam National University Dental Hospital were selected. Clinical and radiologic findings were investigated. POMC cases were divided into two groups: those with <24 years between maxillary sinus surgery and POMC diagnosis and those with >24 years. The chi-square test was used to compare the differences between the two groups. Results: The average period from surgery to POMC detection was 24.32 years; however, the period could not be confirmed in four patients. The average patient age was 52.75 years, and 12 (41.3%) patients were in their 50s. POMC-related clinical symptoms were as follows: buccal pain and swelling, dull pain, toothache, abscess, sensory abnormality, and asymptomatic. Twenty (69.0%) cases showed unilocular radiolucency and 9 (31.0%) revealed multilocular radiolucency. Seven cases (35.0%) were misdiagnosed as odontogenic lesions, resulting in the delayed treatment of POMCs. No statistical significance was found between the two groups with respect to symptoms, expansion to the surrounding area, presence of secondary cysts, and mesiodistal length of cyst on cone-beam computed tomography (CBCT) images. However, the buccopalatal length of the cyst on CBCT images was significantly different between the two groups. Conclusions: The buccopalatal length of POMCs observed on CBCT images was related to the time elapsed since surgery. The lack of awareness of POMCs may lead to misdiagnosis as an odontogenic infection and delayed treatment. Therefore, dentists must recognize the clinical and radiologic features of POMCs to differentiate it from dental infections.

Association of PNPLA3 Polymorphism with Hepatocellular Carcinoma Development and Prognosis in Viral and Non-Viral Chronic Liver Diseases

  • Khlaiphuengsin, Apichaya;Kiatbumrung, Rattanaporn;Payungporn, Sunchai;Pinjaroen, Nutcha;Tangkijvanich, Pisit
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8377-8382
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    • 2016
  • Background: The aim of this study was to evaluate any association between a single nucleotide polymorphism (SNP) in the patatin-like phospholipase domain containing 3 (PNPLA3) (rs738409, C>G) and the development and prognosis in patients with hepatocellular carcinoma (HCC). Materials and Methods: Two hundred heathy controls and 388 HCC cases were included: 211 with HBV, 98 patients with HCV, 29 with alcoholic steatohepatitis (ASH) and 52 with non-alcoholic steatohepatitis (NASH). The SNP was determined by real-time PCR based on TaqMan assays. Results: The prevalence of rs738409 genotypes CC, CG and GG in controls was 91 (45.5%), 88 (44.0%), and 21 (10.5%), respectively, while the corresponding genotypes in all patients with HCC was 158 (40.7%), 178 (45.9%), and 52 (13.4%). The GG genotype had significantly higher distribution in patients with ASH/NASH-related HCC compared with controls (OR=2.34, 95% CI=1.16-4.71, P=0.018), and viral-related HCC cases (OR=2.15, 95% CI=1.13-4.08, P=0.020). However, the frequency of the GG genotype was similar between controls and patients with viral-related HCC. At initial diagnosis, HBV-related HCC were larger and at more advanced BCLC stage than the other HCC groups. There were no significant differences between the GG and non-GG groups regarding clinical characteristics, tumor stage and overall survival. Conclusions: These data suggest an influence of the PNPLA3 polymorphism on the occurrence of HCC in patients with ASH/NASH but not among those with chronic viral hepatitis. However, the polymorphism was not associated with the prognosis of HCC.

설문지를 이용한 피로 진단 지표 연구 (Indicator of Diagnosing Fatigue by Analyzing Questionnaire Data)

  • 윤탁현;박수정;최나래;김명;주종천;권영미
    • 대한한의진단학회지
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    • 제17권3호
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    • pp.179-188
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    • 2013
  • Objectives This study was designed to development the diagnosis indicators for the fatigue group without disease using analysis of questionnaire data. Methods The subjects were divided into three groups, the fatigue group with disease, the fatigue group without disease, non-fatigue group without disease. Thirteen kinds of questionnaire (Fatigue visual analogue scale, Fatigue severity scale, Pain visual analogue scale, Short-form McGill pain questionnaire score, Headache impact Test-6, Neck disability index, Oswestry low back pain disability questionnaire score, Blood stasis assessment scale, Physical activities questionnaire score, Beck depression inventory, Anger expression inventory score, Mood disability scale, Job stress scale) were carried out for the subjects. Results The results of this study are ; 1) The weight, the systolic and diastolic blood pressure were different among three groups. 2) Among nine questionnaires related to the physical or life conditions, the averages of eight questionnaires were not same one another. 3) Among four questionnaires related to the mental condition or autonomic nervous system, the averages of Beck depression inventory were not same one another. Conclusion The fatigue group without disease can be diagnosed through using the both the questionnaires related to the physical or life condition and the those related to the mental condition or autonomic nervous system.

고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB (Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study)

  • 조현주;정혜진;임사비나
    • 대한한의학회지
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    • 제40권3호
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

방사성 면역측정상의 혈청 FSH와 LH에 관한 일차성 무월경증 환자의 진단적 고찰 (Diagnostic Evaluation of Serum FSH and LH in Primary Amenorrhea by Radioimmunoassay)

  • 홍인수;김귀언;유형식;이종태;박창윤;유경자
    • 대한핵의학회지
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    • 제14권1호
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    • pp.37-44
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    • 1980
  • The usefulness of single, random measurements of serum FSH and LH in the diagnosis of primary amenorrhea by radioimmunoassay was investigated. The 16 patients were divided into 3 groups by the level of serum FSH and LH. The first group with increased level of serum FSH and LH is five patients, all of these are related to the acquired or congenital abnormality of the ovary. Further studies indicated include buccal smear, chromosome analysis, gynecography and laparosocopy. The second group with normal serum FSH and LH is nine patients, four patients of these are related to the developmental anomaly of the Mullerian duct and five patients are undo etermined origin. Further studies indicated include laparoscopy and gynecography. The third group with decreased serum FSH and normal or decreased serum LH is two patients, one of these is related to the pituitary function, isolated FSH deficiency, the other is undetermined origin. Further studies indicated include the pituitary function test, LH-RH stimulation test, skull radiography. Determination of serum FSH and LH levels does not permit a specific etiologic diagnosis of primary amenorrhea. However the serum levels of FSH and LH can be used to differentiate the principal area of the investigation and can be of assistance in choosing more specific testing procedures.

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Metastasis Risk Reduction Related with Beta-Blocker Treatment in Mexican Women with Breast Cancer

  • Parada-Huerta, E;Alvarez-Dominguez, TP;Uribe-Escamilla, R;Rodriguez-Joya, JF;Ponce-Medrano, JA Diaz;Padron-Lucio, S;Alfaro-Rodriguez, A;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2953-2957
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    • 2016
  • Background: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ${\beta}2-adrenergic$ receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. Materials and Methods: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel-Haenszel, Student t, and ANOVA tests were performed for data analysis. Results: On average, patients were $54.8{\pm}11.8$ years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ${\beta}1$ - and ${\beta}2$ -adrenergic-receptors did not present metastasis globally, but patients treated with ${\beta}1$ BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. Conclusions: In Mexican patients with BCa and SAH treated with non-selective (${\beta}1$- and ${\beta}2-adrenergic$ receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.

비만도가 다른 출산경험여성의 신체계측, 식습관 및 영양소섭취상태 연구 (Analysis of Anthropometric Measuremetnts, Eating Habits, and Dietary Intake of Women with Child-bearing Experiences and Different Body Fat Contents)

  • 유윤희
    • Journal of Nutrition and Health
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    • 제30권2호
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    • pp.201-209
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    • 1997
  • The purpose of this study was to investigate the possible causal factors of obesity in women with child-bearing experiences in effects to provide optimal information for the prevention and/or treatment of obesity. Sventy one women with child-bearing experiences were divided into five groups based on the degree of obesity by BROCA method ; normal weight, overweight, and obesity which was further divided into three groups of light, moderate, and sever obesity. Various anthropomnetric measurements, overall eating habits, and dietery intakes were asessed for each groups. Out of eighteen anthropometric factors asociated with obesity, thirteen measurements were represented to be valid for the diagnosis of obesity. Body fat % which was analyzed by Bioelectrical Impedance fatnee Analyzer were 24.765, 28.05%, and 29.85 for normal, overweight, and obesity group respectively. WHR(waister to hip ratio) or BMI(body mass index) widely used index was also resulted to be valid as a predictor of obesity. Waist circumference which represents abdominal fat mass showed a good correlatin with body fat%. The analysis of dietary intakes suggested that the overintakes of total calorie may not be the only causal factor of obesity, rather the amount of daily protein, fat and carbohydrate intakes or the physical activity level would be more closely related with the prevalence of obesity. Further investigation considering more variety of food composition of diet and the activity level involving larger number of subjects would be needed.

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RDC/TMD Axis I 진단에 따른 측두하악장애 환자의 측두 두부방사선적 특징에 관한 연구 (Cephalometric Characteristics of TMD Patients based on RDC/TMD Axis I Diagnosis)

  • 안지연;김용우;김영구;이정윤
    • Journal of Oral Medicine and Pain
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    • 제36권1호
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    • pp.39-51
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    • 2011
  • 본 연구는 측두하악장애의 연구 진단 기준(Research Diagnostic Criteria for Temporomandibular Disorder; RDC/TMD)을 이용하여 구분된 측두하악장애(Temporomandibular Disorder; TMD) 환자를 대상으로 안면의 골격적 양상과 TMD 사이의 연관성을 규명하고 교정 환자의 진단과 치료에 있어 RDC/TMD의 활용 가능성을 제시하고자 하였다. 서울대학교 치과병원 구강내과에 측두하악장애의 진단과 치료를 위해 내원한 여성 환자들의 의무 기록 및 방사선사진을 검토하였으며 환자의 연령이 18세 미만이거나 전신 질환, 골격적 기형 또는 측두하악관절 부위의 외상 병력이 있는 경우는 제외되었다. 총 96명의 여성 환자로부터 얻은 RDC/TMD Axis I 을 포함한 임상 검사 결과와 측방 두부규격방사선사진 (lateral cephalogram), 파노라마 방사선사진(panoramic radiograph) 및 횡두개 방사선사진(transcranial radiograph)을 이용한 방사선적 검사 결과를 분석하였다. RDC/TMD를 이용하여 집단을 분류한 후 측방 두부규격방사선사진의 각도 및 길이 요소들을 계측하여 안면의 골격 관계, 상하악 관계 및 치열 관계를 분석하였다. 통계적 분석법으로는 독립표본 t-검정(independent t-test), 일원분산분석(one-way Analysis of Variance; one-way ANOVA) 및 카이제곱 검정(chi-square test)을 이용하였고 다음과 같은 결과를 얻었다. 1. 근육 문제를 진단하는 RDC/TMD Axis I 의 제 1 군 측두 두부방사선적 특징에서 통계적 유의성이 인정되지 않았다. 2. 관절원판 변위를 임상적으로 진단하는 제 2 군에서는 개구 장애를 동반하지 않는 비정복성 관절원판 변위가 있는 경우 관절원판 변위가 없는 정상 집단에 비하여 articular angle이 큰 것으로 나타났다. 3. 관절통, 관절염 및 관절증을 진단하는 제 3 군에서는 articular angle, FMA, Bjork sum, posterior facial height 및 facial height ratio에서 유의한 차이가 있는 것으로 분석되었다. 4. TMD 진단군과 골격적 양상 사이의 관계를 단순화하기 위하여 RDC/TMD Axis I 각 군을 양분법적으로 분류한 뒤 동일 한 방식으로 분석을 시행하였다. 그 결과 제 1 군에서는 overjet, 제 2 군에서는 articular angle, facial height ratio 및 IMPA, 마지막으로 제 3 군에서는 articular angle, gonial angle, facial convexity, FMA, Bjork sum, posterior facial height, facial height ratio 및 ANB angle에서 유의한 차이를 보였다. 이상의 RDC/TMD Axis I 을 이용하여 진단된 측두하악장애 환자를 대상으로 안면의 골격적 양상과 TMD 사이의 연관성 을 분석한 결과로부터 RDC/TMD Axis I 임상 진단에 따라 진단한 측두하악장애 환자 중 제 2 군과 제 3 군의 환자들에서 측두하악장애와 관련된 것으로 알려진 하악골의 후하방 회전으로 인한 골격적 차이가 존재함을 확인하였다. RDC/TMD Axis I은 교정 전 혹은 교정 치료 진행 중에 임상 검사 및 일반 방사선사진으로부터의 제한된 정보를 바탕으로 교정 치료 중 고려하여야 할 TMD 환자를 감별하는데 유용한 정보를 제공할 수 있을 것이다.

폐경 전·후 성인 여성에서 근감소증과 관련된 식생활 요인 및 대사성 질환 위험도: 국민건강영양조사(2009-2011) 자료를 활용하여 (Diet and Metabolic Disease Risk Related to Sarcopenia in Pre- and Postmenopausal Adult Women: Based on the Korea National Health and Nutrition Examination Survey (2009-2011))

  • 김미현
    • 한국식생활문화학회지
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    • 제36권4호
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    • pp.401-411
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    • 2021
  • Diet is important for muscle health and offers a protective effects against the loss of skeletal muscle mass and physical functions with advancing age. We analyzed the relationship between diet, metabolic disease risk, and sarcopenia in Korean female adults using the 2009-2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 2038 adult women aged 50-64 years were classified into four groups based on the diagnosis of menopause and sarcopenia. The groups were the non-menopause and non-sarcopenia group (NMNS, n=249), the non-menopause and sarcopenia group (NMS, n=14), the menopause and non-sarcopenia group (MNS, n=1,653), and the menopause and sarcopenia group (MS, n=122). The socio-demographics, anthropometrics, blood profile, and dietary data of the subjects were collected. Those who were in both the sarcopenia groups were more obese (p<0.001), had greater waist circumferences (p<0.001), higher body mass index (p<0.001), and higher obesity rates (p<0.001) after adjustment for covariants. Both the sarcopenia groups also had higher plasma levels of total cholesterol (p<0.001), HbA1c (p=0.001), and vitamin D (p=0.020) than both the non-sarcopenia groups. Both the sarcopenia groups demonstrated a decreased intake of calcium (p=0.05), potassium (p=0.008), and niacin (p=0.008) than both the non-sarcopenia ones. Among the four groups, the NMS group showed the highest levels of total cholesterol, obesity, and lowest intake of micronutrients such as calcium, niacin, and potassium. Thus, muscle mass maintenance through weight control and adequate nutrient intake appears to demonstrate a potential association with preventing sarcopenia in Korean middle-aged women.