• Title/Summary/Keyword: Patients Value

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Clinical Evaluation of Abdominal Stab Wound Patients in the ED (복부 자상환자의 처치에 대한 응급의학에서의 고찰)

  • Park, Jong-Hak;Kim, Jung-Youn;Shin, Jun-Hyun;Yoon, Young-Hoon;Cho, Han-Jin;Moon, Sung-Woo;Choi, Sung-Hyuk;Lee, Sung-Woo;Hong, Yun-Sik
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.21-28
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    • 2010
  • Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

Estimation of nursing costs for hospitalized patients using the resource-based relative value scale (상대가치(Resource-Based Relative Value)를 이용한 간호행위별 간호원가 산정)

  • Park, Jung-Ho;Song, Mi-Sook;Sung, Young-Hee;Cho, Jung-Sook;Sim, Won-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.253-280
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    • 1999
  • A cost analysis for hospitalized patients was performed based on the RBRVS in order to determine an appropriate nursing fee schedule. The study was conducted through three phases as follows: 1) Nursing activities provided for the inpatients currently in Korea were identified and classified using a taxonomy which was developed by our research team through the Delphi process. 2) The resource-based relative points for every nursing activity according to nursing time, mental effort and judgement, technical skill, physical effort and stress were determined through a survey of 300 clinical RNs working at 5 tertiary hospitals from May 25 to July 25. 1998. 3) The nursing cost of every nursing activity for hospitalized patients was estimated based on the RBRVS. As a result, 136 nursing activities were identified and classified by nursing processes and nursing domains. However, our classification system of nursing activities should continue to be refined, and all nursing practices should be standardized. The nursing activities were given resource-based relative points ranging from 100 to 400 points, then each nursing activity was assigned a value for the RBRVS, which was determined by the exponential function of 2resource-based relative point/100. Thus, a value of 2 was calculated for 100 points, 4 for 200 points, 8 for 300 points, and 16 for 400 points. Meanwhile, the unit cost of nursing was calculated as 170 Won. The nursing cost of 136 nursing activities was estimated using the RBRVS as shown in

    . A proper nursing fee schedule for a new reimbursement system based upon the results of the above study should be prepared in the near future.

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  • Prognostic Value of Vascular Endothelial Growth Factor Expression in Patients with Prostate Cancer: a Systematic Review with Meta-analysis

    • Wang, Kai;Peng, Hong-Ling;Li, Long-Kun
      • Asian Pacific Journal of Cancer Prevention
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      • v.13 no.11
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      • pp.5665-5669
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      • 2012
    • Background: The vascular endothelial growth factor (VEGF) mediates vasculogenesis and angiogenesis through promoting endothelial cell growth, migration and mitosis, and has involvement in cancer pathogenesis, progression and metastasis. However, the prognostic value of VEGF in patients with prostate cancer remains controversial. Objectives: The aim of our study was to evaluate the prognostic value of VEGF in prostate cancer, and summarise the results of related research on VEGF. Methods: In accordance with an established search strategy, 11 studies with 1,529 patients were included in our meta-analysis. The correlation of VEGF-expression with overall survival and progression-free survival was evaluated by hazard ratio, either given or calculated. Results: The studies were categorized by introduction of the author, demographic data in each study, prostate cancer-relatived information, VEGF cut-off value, VEGF subtype, methods of hazard ratio (HR) estimation and its 95% confidence interval (CI). High VEGF-expression in prostate cancer is a poor prognostic factor with statistical significance for OS (HR=2.32, 95%CI: 1.40-3.24). However, high VEGF-expression showed no effect on poor PFS (HR=1.30, 95%CI: 0.88-1.72). Using Begg's, Egger's test and funnel plots, we confirmed lack of publication bias in our analysis. Conclusion: VEGF might be regarded as a prognostic maker for prostate cancer, as supported by our meta-analysis. To achieve a more definitive conclusion enabling the clinical use of VEGF in prostate cancer, we need more high-quality interventional original studies following agreed research approaches or standards.

    Antioxidant Activity of Medicinal Plant Extracts Used as Folk Remedies by Diabetic Patients

    • Park, Min-Jung;Han, Ji-Sook
      • Preventive Nutrition and Food Science
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      • v.9 no.2
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      • pp.167-173
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      • 2004
    • The aim of this study was to investigate the antioxidant effect of medicinal plants used by diabetic patients. Fourteen medicinal plants were selected and antioxidant activity such as 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity, inhibition effect of linoleic acid autoxidation and low density lipoprotein (LDL) oxidation, thiobarbituric acid (TBA) value were measured. The Cornus officinalis had DPPH radical scavenging activity of 84.79%, which was higher than the 78.79% for $\alpha$-tocopherol. Rosa rugosa Thunberg, Pueraria thundergiana Bentham, Artemisia princeps var. orientalis and Sasamorpha purpurascens Nakai also had high values. Extracts with higher DPPH radical scavenging activities had higher total phenol concentrations, and positive correlations between these parameters were found. Inhibitory activities of linoleic acid autoxidation, LDL oxidation and TBA value, used as indices of oxidative stress, were observed in most of the selected medicinal plants. The highest inhibitory activity for TBA value was observed in the extract of Pueraria thundergiana Bentham. Rosa rugosa Thunberg (75.50 %), Sasamorpha purpurascens Nakai (74.00 %), and Cornus officinalis (73.00 %) all had high antioxidant activity against linoleic acid autoxidation, similar to that of $\alpha$-tocopherol. The same 3 plants also had high in inhibitory activity against LDL oxidation. Therefore, we demonstrated that medicinal plants used as folk remedy by diabetic patients had antioxidant activity. Especially, Rosa rugosa Thunberg, Cornus officinalis, Pueraria thundergiana Bentham, Arlemisia princeps var. orientalis, and Sasamorpha purpurascens Nakai had high phenol concentrations which resulted in high values for DPPH radical scavenging. These same plants exhibited high values for inhibitory activities for TBA value, linoleic acid autoxidation and LDL oxidation, indices associated with lipid peroxidation.

    Clinico-Radiological Study of Temporomandibular Ankylosis (악관절 강직증 환자의 임상ㆍ방사선학적 연구)

    • Choi Sun Won;Ahn Hyung Kyu
      • Journal of Korean Academy of Oral and Maxillofacial Radiology
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      • v.14 no.1
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      • pp.99-107
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      • 1984
    • The auther studied clinically and. radiologically 48 cases which had been diagnosed as TMJ ankylosis in SNUDH (1974-1984). The purpose of this study is to analyse clinical features of TMJ ankylosis and to evaluate the effect of TMJ ankylosis on the growth of the mandible. The obtained results were as follows: 1. Total 48 cases of TMJ ankylosis patients consist of 23 males and 25 females. 65 percent of all cases of TMJ ankylosis occurred in patients between 1 and 10 years of age. The awerage age at the onset of ankylosis was 11.7 and average duration at the time of examination was 11.7 years. 2. Unilateral akylosis (81.3%) was more frequent than bilateral ankylosis (18.7%). 3. Traum a (57.9%) and infection (21.2%) were main etiology. 4. Inability to open the mouth (78.3%) and facial asymmetry (17.4%) were main chief complaints. 5. Mandibular morphology through radiographic features. (a) In TMJ ankylosis patients the ramus length of the ankylosed side was shorter than that of the non-ankylosed side. Comparing with the centrol group, ramus length of the each side was shorter than normal value. (b) The partial body length of the ankylosed side was longer than that of the non-ankylosed side. Comparing with the control group, partial body length of the each side was longer than normal value. Partial body length was related with antegonial notch depth. (c) Ratio of upper and lower ramus length at the level of mandibular foramen was smaller in ankylosed side than in non-ankylosed side. (d) Antegonial notch depth and ramus posterior contour depth were deeper in ankylosed side than in non-ankylosed side and those of both sides were deeper than normal value. (e) Gonial angle in ankylosed side was larger than in non-ankylosed side and that in both sides was smaller than normal value.

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    Usefulness of Application of Tube Voltage Changes to Reduce Patient Dose during Abdominal CT Follow up (반복적인 복부 컴퓨터단층촬영 시행 시 환자선량 감소를 위한 관전압 변화 적용의 유용성)

    • Yoon, Joon;Kim, HyeonJu
      • Journal of the Korean Society of Radiology
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      • v.15 no.3
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      • pp.293-299
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      • 2021
    • In order to reduce the irresistible radiation exposure of patients who perform periodic examinations using a CT among various scan parameters a method to reduce patient dose was investigated through changes in the tube voltage close to X-ray penetrating power. As a result of the experiment 100 kVp was applied instead of 120 kVp which is commonly used in clinical practice and CTDI decreased by about 41% during scan. In addition the degree of change in image quality was measured as 1046.1±3.7 HU for CT value and 71.4±7.9 for Pixel value and statistical analysis showed no significant difference (0.05

    Validation of the Edmonson Psychiatric Fall Risk Assessment Tool for Psychiatric Inpatients: A Retrospective Study (정신건강의학과 입원 환자를 위한 낙상 위험 사정도구 (Edmonson Psychiatric Fall Risk Assessment Tool)의 타당도 평가: 후향적 연구)

    • Kim, Kyung Young;Son, Young Sun;Lee, You Ji;Kim, Ji Eun;Kim, Mi Kyung;YI, Young Hee
      • Journal of Korean Clinical Nursing Research
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      • v.28 no.3
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      • pp.270-276
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      • 2022
    • Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

    Red and Processed Meat Intake in Relation to Non-Alcoholic Fatty Liver Disease Risk: Results from a Case-Control Study

    • Fatemeh Rahimi-Sakak;Mahsa Maroofi;Hadi Emamat;Azita Hekmatdoost
      • Clinical Nutrition Research
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      • v.11 no.1
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      • pp.42-49
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      • 2022
    • Data on the association between dietary red meat intake and non-alcoholic fatty liver disease (NAFLD) are limited. We designed this case-control study to determine the association between red and processed meat consumption and risk of NAFLD in Iranian adults. A total of 999 eligible subjects, including 196 NAFLD patients and 803 non-NAFLD controls were recruited from hepatology clinics in Tehran, Iran. A reliable and validated food frequency questionnaire was used to evaluate the red and processed meat intakes. The analyzes performed showed that in an age- and gender-adjusted model, patients with the highest quartile of red meat intake had an approximately three-fold higher risk of NAFLD than those with the lowest quartile of intake (odds ratio [OR], 3.42; 95% confidence interval [CI], 2.16-5.43; p value < 0.001). Moreover, patients in the highest quartile of processed meat intake had a 3.28 times higher risk of NAFLD, compared to the lowest quartile(OR, 3.28; 95% CI, 1.97-5.46; p value < 0.001).Both these associations remained significant by implementing additional adjustments for body mass index, energy intake, dietary factors, diabetes, smoking, and physical activity (OR, 3.65; 95% CI, 1.85-7.18; p value < 0.001 and OR, 3.25; 95% CI, 1.57-6.73; p value = 0.002, respectively).Our findings indicate that both red and processed meat intakes are related to the increased odds of NAFLD; however, prospective studies are needed to confirm these results.

    Retrospective Study on Factors Influencing Facial Nerve Damage of Acute Peripheral Facial Palsy Patients: by Electromyography (급성 말초성 안면신경마비 환자의 안면신경 손상 정도에 영향을 미치는 요인에 대한 후향적 연구: 근전도검사를 이용하여)

    • Kim, Pil Kun;Sung, Won Suk;Goo, Bon Hyuk;Ryu, Hee Kyung;Suk, Kyung Hwan;Lee, Ju Hyeon;Kim, Min Jeong;Park, Yeon Cheol;Seo, Byung Kwan;Baek, Yong Hyeon;Park, Dong Suk
      • Journal of Acupuncture Research
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      • v.30 no.5
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      • pp.155-167
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      • 2013
    • Objectives : This research was conducted to investigate the factors that affect the level of facial nerve damage. Methods : From October 2009 to September 2013, the total number of 581 patients of Bell's palsy and Ramsay-Hunt syndrome visited Facial Palsy Center in Kyung Hee University Hospital at Gangdong for Traditional Korean and Western combined medical treatment. Of these, 453 patients of peripheral facial nerve palsy were selected for the research. After reviewing the medical records that have details of age, gender, diagnosis(Bell's palsy and Ramsay-Hunt syndrome), onset, underlying diseases(DM, HTN), and HbAlc value, the analysis on the influence factors on the level of facial nerve damage was drew out. Results : The axonal loss rate of oris branch and nasal branch were significantly higher than the axonal loss rate of frontal branch and oculi branch. In addition, the frequency of becoming a major damaged branch was also high in the oris branch nasal branch. The factors by month, weather, smoking, and alcohol did not influence EMG axonal loss rate. Male rather than female and patient with Rasmay-Hut syndrome rather than Bell's palsy had a higher axonal loss rate in all branches. Of those, front of branch of male was remarkably higher than female. Patient with DM as P/H had high axonal loss rate in all branches. Patient with HTN as P/H had high axonal loss rate in all branches except for oris branches. Patients with DM and HTN group had significantly higher value from the average of axonal loss rate than patients who are only with HTN and without DM/HTN. DM alone group had significantly higher value than patients who are without DM/HTN. However, HTN alone was not significantly high. By analysing HbAlc of the patients who were hospitalised regardless DM, axonal loss rate was high in the order of DM group, preDM group, normal group. Nevertheless, only DM group showed higher axonal rate statistically than normal group. Considering DM and HbA1c value, the patients can be divided into 4 different groups of hkDM, lkDM, hfDM and nDM. By analysing those groups, the average damaged value of the groups with diagnosis followed by treatment(lkDM, hkDM) were higher than the average rate of hfDM and statistically higher than the rate of the nDM. Conclusions : The influential factors of increasing the level of EMG damage are male(only for the frontal branch), age above sixties, HTN, DM, and HbAlc value above 6.5. Besides, the negligible factors are month, season, diagnosis, alcohol, and smoking. Further research including clinical prognosis should be conducted.

    Comparison of Clinical Characteristics between Pulmonary Tuberculosis Patients with Extensively Drug-resistance and Multi-drug Resistance at National Medical Center in Korea (국립의료원에 내원한 광역내성 폐결핵 환자와 다제내성 폐결핵 환자의 임상적 특성 비교)

    • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
      • Tuberculosis and Respiratory Diseases
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      • v.64 no.6
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      • pp.414-421
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      • 2008
    • Background: Recently, in addition to multi-drug resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) has become rapidly growing public health threat. This study examined the clinical differences between pulmonary TB patients with extensively drug resistance (XDR) and multi-drug resistance (MDR) at the National Medical Center in Korea in order to determine the clinical characteristics associated more with XDR-TB than MDR-TB. Methods: Patients who received a diagnosis of culture-confirmed pulmonary TB and a drug sensitivity test (DST) for anti-TB drugs at the National Medical Center between January 2000 and August 2007 were enrolled in this study. The patients were identified into the XDR-TB or MDR-TB group according to the DST results. The clinical characteristics were reviewed retrospectively from the medical records. Statistical analysis for the comparisons was performed using a ${\chi}^2$-test, independent samples t-test or binary logistic regression where appropriate. Results: A total 314 patients with culture-confirmed pulmonary TB were included. Among them, 18 patients (5.7%) had XDR-TB and 69 patients (22%) had MDR-TB excluding XDR-TB. A comparison of the clinical characteristics, revealed the XDR-TB group to have a higher frequency of a prior pulmonary resection for the treatment of TB (odds ratio [OR], 3.974; 95% confidence interval [CI], 1.052~15.011; P value 0.032) and longer average previous treatment duration with anti-TB drugs, including a treatment interruption period prior to the diagnosis of XDR, than the MDR-TB group (XDR-TB group, 72.67 months; MDR-TB group, 13.09 months; average treatment duration difference between two groups, 59.582 months; 95% CI, 31.743~87.420; P value, 0.000). In addition, a longer previous treatment duration with anti-TB drugs was significantly associated with XDR-TB (OR, 1.076; 95% CI, 1.038~1.117; P value, 0.000). A comparison of the other clinical characteristics revealed the XDR-TB group to have a higher frequency of male gender, diabetes mellitus (DM), age under 45, treatment interruption history, cavitations on simple chest radiograph and positive result of sputum AFB staining at the time of diagnosis of XDR. However, the association was not statistically significant. Conclusion: Pulmonary TB patients with XDR have a higher frequency of a prior pulmonary resection and longer previous treatment duration with anti-TB drugs than those with MDR. In addition, a longer previous treatment duration with anti-TB drugs is significantly associated with XDR-TB.


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