• Title/Summary/Keyword: Long-term outcome

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Anatomical Considerations in Gamma Knife Radiosurgery for Idiopathic Trigeminal Neuralgia

  • Kim, Young-Hoon;Park, Chul-Kee;Chung, Hyun-Tai;Paek, Sun-Ha;Kim, Dong-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.148-153
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    • 2006
  • Objective : The authors conducted this study to present the long-term treatment outcomes [minimum 2 years] of Gamma knife radiosurgery[GKS] for trigeminal neuralgia[TN] and to demonstrate the correlation of treatment outcomes and the anatomical characteristics of TN. Methods : From 1997 to 2003, 44 consecutive patients suffering from medically intractable pain underwent GKS for TN. A single 4mm collimator was used with a median maximum dose of 80Gy [range $75{\sim}80Gy$] prescribed to the root entry zone of the trigeminal nerve. Median follow up duration was 30 months [range $24{\sim}78\;months$]. Anatomical measurements of trigeminal nerve in magnetic resonance images during GKS planning were correlated with clinical outcome. Results : Twenty-two patients [50%] achieved an excellent outcome [BNI grade I & II], 20 patients [45.5%] a good outcome [grade IIIa & IIIb], and only 2 patients [4.5%] a poor outcome [grade IV & V]. Eleven patients [25.0%] experienced pain recurrence after initial pain relief. Smaller volume of trigeminal nerve area irradiated more than 40Gy was significantly correlated with excellent outcome in both univariate and multivariate analyses respectively [P=0.033 and 0.040]. Conclusion : Anatomical considerations during the planning of GKS would be helpful for predicting clinical outcome in TN.

Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.21-30
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    • 2014
  • Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Clinical Features and Long-Term Outcome in Adult Stroke Patient due to Moyamoya Disease : A Single Subject Study

  • Kwon, Yong Hyun;Kim, Chung Sun
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.126-131
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    • 2013
  • This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

  • Kim, Woong-Beom;Hyun, Seung-Jae;Choi, Hoyong;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.385-391
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    • 2016
  • Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.

A Study on the Supply Estimation and Allocation of Healthcare Facilities for the Elderly People in Seoul (서울시 노인의료복지시설의 공급과 배치에 관한 연구)

  • Lee, Teuk-Koo;Kim, Seok Jun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.11 no.2
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    • pp.7-16
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    • 2005
  • Recently, as the population of the elderly rapidly increases, the number of the special care facility for the elderly is a big social issue. Especially, special care facilities(nursing home, skilled nursing home, etc) for the elderly in Seoul are insufficient now. So this study quantitatively estimates nursing home beds needed in seoul in 2007, 2012 and 2017, and proposes an allocation of these facilities in Seoul. This study is to clarify problems in supply of long-term care facilities and present a solution for them. The main outcome of this study can be summarized into three parts; first, as architectural planning and supply estimation of long term care facility, an aged population of cities and countries in Seoul should be considered. Second, when the allocation of long term care facility in Seoul, the type of facilities, regional equilibrium etc. should be considered. Third, nursing home and residential care home are linked with the other area.

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The Relationship between Organizational Justice and Service Quality, and Moderating Effects of Sex and Tenure (조직공정성과 서비스품질의 관계 및 성, 재직기간의 조절효과)

  • 안관영
    • Journal of Korean Society for Quality Management
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    • v.30 no.3
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    • pp.1-19
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    • 2002
  • Greenberg(1990) suggested that organizational justice research may potentially explain many organizational behavior outcome variables. One example of nontraditional job behavior is service quality, for it is part of the spontaneous and innovative behaviors noted by Katz(1964). The first purpose of this research is to test the effects of organizational justice on service quality, and the second purpose is to test the moderating effects of sex and tenure on the relationships between organizational justice and service quality According to statistical analysis, only interactional justice had an impact on service quality. Also the results of moderating regression analysis showed that short term employees were more sensitive to distributive justice than long term employees. This result means short term employees are more interested In incentive system than long term employees.

Non-pharmacological Interventions for Chronic Pain in Older Adults in Long-term Care Facilities: A Scoping Review (장기요양시설 노인의 만성통증 관리를 위한 비약물적 중재: 주제범위 문헌고찰)

  • Kyung-Hye Hwang;Hyekyung Kim;Cho, Ok-Hee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.30 no.3
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    • pp.298-310
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    • 2023
  • Purpose: This study synthesized the literature on non-pharmacological interventions for chronic pain in older adults in long-term care facilities. Methods: Scoping review and thematic analysis methods were combined. On June 1, 2023, searches of primary electronic databases, including PubMed, Embase, PsycINFO, CINAHL DBpia, KMbase, NDSL, and RISS, were performed, restricting the publication date from January 1, 2010 to December 31, 2022. Guidelines from the Joanna Briggs Institute were used as a framework to set and conduct the scoping review. Results: The review identified 1,095 abstracts, from which 14 studies were included in the review. Consequent to the study, there were 10 randomized controlled experimental study designs, and 6 out of 14 studies were conducted in China. The numeric rating scale was widely used for pain assessment. Exercise intervention was provided in 7 studies and physiotherapy was provided in three studies. The outcome variables measured were pain self-efficacy, physical functions, and depression. Conclusion: This comprehensive overview guided nursing staff in long-term care facilities for planning and intervention of effective non-pharmacological interventions for chronic pain in the elderly.

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

  • Choi, Sun Ah;Kim, Ki Joong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.321-327
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    • 2019
  • Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

  • Michael D. Scheidt;Saleh Aiyash;Dane Salazar;Nickolas Garbis
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.191-204
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    • 2023
  • Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

The Effects of Long-term Care Insurance on the Life Satisfaction and Satisfaction in Family Relationships - The DD Method Combined with Propensity Score Matching - (노인장기요양보험제도가 대상노인 및 부양가족의 삶의 질과 가족관계 만족도에 미치는 영향 - 성향점수매칭(PSM)과 이중차이(DD) 결합모형을 이용한 분석 -)

  • Kwon, Hyun-Jung;Cho, Yong-Un;Ko, Ji-Young
    • Korean Journal of Social Welfare
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    • v.63 no.4
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    • pp.301-326
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    • 2011
  • The major purpose of this study is to evaluate the impact of the long-term care insurance program. In order to estimate the impact of policy accurately, certain bias which might hamper the validity of this study has been removed by Propensity Score Matching(PSM) and Double Difference(DD) method from the semi-experimental design. To study the effects of long-term care insurance on the elderly and their family members as social outcome variable sand the quality of life of their family and satisfaction in family relationships, the third and fourth waves of Korea Welfare Panel are used to match experimental and comparative groups by the propensity score matching. Then, DD method, using the panel fixed effects model, is applied to estimate the differences of those groups'treatment effects before and after the policy implementation. As a result, it was found that the Quality of life on the elderly and their family members is statistically meaningless, while the satisfaction in family relationships has much increased after the policy implementation. The result has a limitation in that this evaluation is performed at the point when the long-term insurance program has not been ripened enough. However, there is an important implication on the significance of realizing the main goal of the long-term care insurance to improve the quality of life of the elderly and their family members and as for the potentiality of further system improvements.

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