• Title/Summary/Keyword: Poor-grade

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Selected Characteristics and Degree of Physical Disability of Stroke Survivors at Discharge from Five General Hospitals in Seoul, 1975 (중추 신경계 혈관질환(C. V. A)환자 중 퇴원환자의 신체기능장애정도와 그 특성에 관한 고찰)

  • 이선옥
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.23-28
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    • 1976
  • This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.

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Outcomes in the Management of Spontaneous Cerebellar Hemorrhage

  • Moon, Kang-Seok;Park, Hyung-Ki;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu;Choi, Soon-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.234-238
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    • 2006
  • Objective : The operative indications on cerebellar hemorrhage have been controversial especially when the patient condition is grave. Therefore we investigated whether it can be justifiable if we perform the surgery in poor clinical grade. Methods : Clinical records and computerized tomography[CT] films of the 89 patients, who were undergone hospital treatment due to spontaneous cerebellar hemorrhage between May 1997 and May 2004, were retrospectively researched. Results : The study population consisted of 36 males and 53 female patients. The mean age was 65years [range $23{\sim}89$]. As a result of treatment, the patients, whose Glasgow coma scale[GCS] score were higher, showed better outcomes [p=0.001]. 13 patients [14.6%] were below 5 in GCS score and 10 patients of these were operated. Among 10 patients, 4 patients [40%] showed good outcome and 5 patients [50%] had been dead. 3 patients [60%] of these dead patients had the findings of intraventricular hemorrhage, fourth ventricular obliteration and hydrocephalus in CT scan. Conclusion : This study suggests that operation may be justifiable in clinically poor grade patient with spontaneous intra cerebellar hemorrhage.

Study on the Dietary Behaviors of Some University Students in Gangwon-do using the Adult Nutrient Quotient (NQ) and Effect of Dietary Education (강원지역 일부 대학생의 식행동실태 및 식생활교육 효과에 관한 연구)

  • Choi, Young-Jin
    • Journal of the Korean Society of Food Culture
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    • v.34 no.6
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    • pp.683-696
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    • 2019
  • This study examined the nutritional status and dietary behaviors of university students in Gangwon-do as well as the effects of dietary education on them. Forty college students were recruited, and their dietary lifestyle was examined using an Adult NQ questionnaire before and after dietary education. The questionnaire items were grouped into four categories: balance, diversity, moderation, and dietary behavior. The mean NQ score out of 100 was 48.00. Among the three grades of the NQ grade criteria, most subjects (50%) were in the lowest grade, which was poor. The mean scores of the NQ factors were highest for moderation (68.76%), followed in order by diversity (50.81%), dietary behavior (45.66%), and balance (21.01%). Compared to the criterion value, moderation was only good, and balance was the worst. These results suggest that the nutritional status of the subjects is poor. On the other hand, there was a significant change in the areas of the NQ score (53.7), balance (29.22) and dietary behavior (56.77) after dietary education. Nevertheless, the 'balance' area remained lower than the average, highlighting the need for education on food intake to enable diverse food intake.

A Study of the Correlation between Subjective and Objective Evaluation of Voice Disorders (음성장애 주관적 평가와 객관적 평가 간의 상관성 연구)

  • Lee, Ok-Bun;Kim, So-Yeon
    • Phonetics and Speech Sciences
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    • v.3 no.3
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    • pp.167-172
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    • 2011
  • The purpose of this study was to examine the relationship between subjective and objective evaluation in speakers with voice disorders. Subjective evaluation indicates the self-reports of voice problems by dysphonic speakers. The relating protocol is the Voice Handicap Index (VHI) and the self-awareness index of voice problems (SAIVP-14). A total of 48 individuals with voice disorders replied to the questionnaire and participated in a voice assessment. Objective evaluations included the perceptual judgement of G grade in GRBAS, acoustic measurements (jitter, shimmer, NHR) by MDVP (CSL 4400), and aerodynamic measurements (MPT, MFR, psub) by PAS (Phonatory Aerodynamic System, KayPentax, USA). Pearson and Spearman correlations were used for the analysis. In the correlation with perceptual judgement (G grade) and VHI-Total, VHI-Physical, and SAIVP-14, there was a significant correlation, but the overall correlation was poor. NHR, jitter, and shimmer were significantly correlated with overall VHI and SAIVP-14. Specifically, the correlation with shimmer was stronger compared to the other measurements. In aerodynamic measures, MFR and MPT showed a significant correlation with VHI-Total, VHI-Emotional, and SAIVP-14, but their correlation was poor. The results of this study suggested that subjective evaluation of self voice problems is meaningfully correlated with objective evaluations, but more data in the multidimensional voice assessment should be collected and analyzed for the reliability and validity of the voice handicap questionnaire.

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The Development and Application of Multi-metric Water Quality Assessment Model for Reservoir Managements in Korea. (우리나라 인공호 관리를 위한 다변수 수질평가 모델의 개발 및 적용)

  • Lee, Hyun-Joon;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.42 no.2
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    • pp.242-252
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    • 2009
  • The purpose of this study was to develop a Multi-metric Water Quality Assessment (MWQA) model and apply it to dataset sampled from Paldang and Daechung reservoir in 2008. The various water dataset used to this study included 5 year data sets (2003${\sim}$2007) in Korean reservoirs which were obtained from the Ministry of Environment, Korea. In this study, suggested MWQA model has 4 metrics that were composed of 4 parameters such as chemical, physical, biological, and hydrological variables. And, each of the variables attributed total phosphorus (TP) concentration in water, secchi depth (SD) measure in water, chlorophyll-${\alpha}$(Chl-${\alpha}$) concentration in water and the ratio of inflow of water into lakes and efflux of water from lakes, input/output (I/O). First, we established the criteria for trophic boundaries. The boundary between oligotrophic and mesotrophic categories was defined by the lower third of the cumulative distribution of the values. The mesotrophic-eutrophic boundary was defined by the upper third of the distribution. Second, each metric was given by a point-oligo=1, meso=3, eu=5. And then, obtained total score from each metric was divided 5 grade-Excellent, Good, Fair, Poor, and Very poor. As the results of applying the proposed MWQA model, the Paldang reservoir obtained "Fair" or "Poor" grade and Daechung reservoir obtained "Excellent" or "Good" grade. The suggested MWQA model through these procedures will enable to manage efficiently the reservoir. And, more studies such as metric numbers and attributes should be done for the accurate application of the new model.

Management of Elderly Patients with Intracranial Aneurysm (고령군 뇌동맥류 환자의 치료)

  • Park, Hyeon Seon;Lee, Jae Whan;Kim, Jin Young;Shin, Yong Sam;Joo, Jin Yang;Huh, Seung Kon;Lee, Kyu Chang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.786-793
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    • 2000
  • Objectives : A clinical analysis was performed to provide management strategy and to improve management outcome of elderly patients with intracranial aneurysm. Patients and Methods : We reviewed medical records of 746 consecutive patients with intracranial aneurysm who were admitted from July 1991 to December 1996. They were divided into two age groups : elderly(120 patients aged 65 years or older) and non-elderly(626 patients aged 64 years or younger). We investigated the differences between the two groups in clinical characteristics, management outcome and surgical results. Results : Female(80.0%), internal carotid artery aneurysm(48.9%), poor clinical grade(Hunt and Hess Grade IV, V : 39.8%), postoperative subdural fluid collection(38.2%), and postoperative hydrocephalus(39.7%) were more frequent in the elderly patients. There were no significant differences in the incidence of hypertension, multiple aneurysm, unruptured aneurysm, rebleeding, delayed ischemic neurological deficits, postoperative hemorrhage, and low density on the postoperative brain CT scan. In some cases, surgical clipping of ruptured aneurysm could not be performed due to moribund state or refusal of surgery by the elderly patient's family. Both management outcome and surgical results in elderly aneurysm patients at 3 months after rupture were worse than those of the non-elderly group. The most common reason of unfavorable outcome was poor clinical grade in both groups, while serious medical illness causing unfavorable outcome was more common in the elderly group. Conclusion : Surgical treatment of a ruptured aneurysm should not be avoided in elderly patient solely on the basis of advanced age. If the patients are in good clinical grade, early aneurysm surgery followed by early ambulation should be recommended. Further improvements in outcome may be achieved by thorough knowledge of poor resilience of brain, CSF flow dynamics, and diminished cardiopulmonary reserve in elderly patients with intracranial aneurysm.

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The Outcome of Urgent Surgery for Hunt-Hess Grade IV Patients with Ruptured Intracranial Aneurysm (두개강내 동맥류 파열로 인한 Hunt-Hess Grade IV 환자에서의 응급수술의 결과)

  • Oh, Jun Gyu;Kang, Hee In;Moon, Byung Gwan;Lee, Seung Jin;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1013-1018
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    • 2001
  • Objective : About 40% of patients who admit to the hospital after subarachnoid hemorrhage are poor clinical grade(Hunt-Hess grade IV, V). The majority of these patients have been excluded from early, aggressive treatment. The current study was undertaken to evaluate the outcome of urgent surgery for Hunt-Hess grade IV aneurysmal subarachnoid hemorrhage. Materials and Methods : We reviewed hospital records and radiographic studies of 36 patients who were Hunt-Hess grade IV among 201 cases with ruptured intracranial aneurysm admitted between Sep. 1995 and Dec. 2000. Operated patients were treated with urgent angiography and surgery within 24 hours of presentation, except six patients, and medical records of these patients were reviewed for the clinical course and Glasgow outcome scale(GOS). Results : Overall management results of the 36 patients were good recovery in 13(36.1%), moderate disability in 12 (33.3%), severe disability in 1(2.8%), vegetative state in 1(2.8%) and 9(25.0%) of surgically treated patients had died. Conclusion : Although with limited number of patients, we conclude that urgent surgery for Hunt-Hess grade IV patients results in a better neurologic outcome and urgent surgery combined with aggressive postoperative management can minimize mortality.

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Emergent Clipping without Prophylactic Decompressive Craniectomy in Patients with a Large Aneurysmal Intracerebral Hematoma

  • Kang, Sung-Don
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.353-357
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    • 2008
  • Objective : Many vascular neurosurgeons tend to remove bone flap in patients with large aneurysmal intracerebral hematomas (ICH). However, relatively little work has been done regarding the effectiveness of prophylactic decompressive craniectomy in a patient with a large aneurysmal ICH. Methods : Large ICH was defined as hematoma when its volume exceeded 25 mL, ipsilateral to aneurysms. The patients were divided into two groups; aneurysmal subarachnoid hemorrhage (SAH) associated with large ICH, January, 1994 - December, 1999 (Group A, 41 patients), aneurysmal SAH associated with large ICH, January, 2000 - May, 2005 (Group 8, 27 patients). Demographic and clinical variables including age, sex, hypertension, vasospasm, rebleeding, Hunt-Hess grade, aneurysm location, aneurysm size, and outcome were compared between two groups, and also compared between craniotomy and craniectomy patients in Group A. Results : In Group A. 21 of 41 patients underwent prophylactic decompressive craniectomy. In Group 8, only two patients underwent craniectomy. Surgical outcome in Group A (good 23, poor 18) was statistically not different from Group 8 (good 15, poor 12). Surgical outcomes between craniectomy (good 12, poor 9) and craniotomy cases (good 11, poor 9) in Group A were also comparable. Conclusion : We recommend that a craniotomy can be carried out safely without prophylactic craniectomy in patients with a large aneurysmal ICH if intracranial pressure is controllable with hematoma evacuation.

The clinical study on 37 cases of whiplash injury patients which caused by traffic accident (교통사고(交通事故)로 인한 편타성(鞭打性) 손상(損傷) 환자(患者) 37례(例)에 대한 임상연구(臨床硏究))

  • Kang, Jae-Hui;Jang, Suk-Geun;Lee, Hyun;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.180-191
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    • 2002
  • Objective : This study was performed to evaluate the effect of oriental medical treatment in whiplash injury patients which caused by traffic accident. Methods : The clinical study was carried out 37 cases of whiplash injury patients which had been admitted in Daejon university Cheon-an oriental hospital from June, 2001 to December, 2001. Results : l. In the distribution of sex distinction was female much more than male in the ratio of 3:2 and thirties was most in age distribution. 2. In situation of traffic accident, The most case was rear-ending(70.27%). 3. Except cervical pain or it's reffered pain, there were whole body symptoms as fallow, insomnia in 11cases(29.73%), night pain in 10 cases(27.03%), general body pain in 8cases(21.62), dizziness in 6cases(16.22%). 4. According to Meridian Muscle theory, a injured parts of patient were devided as follows. There were 22cases(59.46%) which have injury in Bladder, Small Intestine Meridian Muscle, 10cases(27.03%) in Gallblader, Triple Energizer Meridian Muscle, 5cases(13.51%) in Stomach, Large Intestine Meridian Muscle. 5. There were 6cases(16.22%) of the grade of complete recovery, 10cases(27.03%) of the grade of excellent, 12cases(32.43%) of the grade of improvement, 6cases(16.22%) of the grade of disimprovement and 3cases(8.11%) of the grade of poor. So 28cases(75.68%) were efficacious. 6. Generally Herb-meds that have efficacy of Geo-Eohyeol were most used(27cases, 72.97%) in early stage. Secondly Herb-med that have efficacy of Yiqi-sunqi were used(20case, 54,05%) in middle stage and Herb-med of Bo-Qiheol were used(l0cases, 27.03%) in latter term. The most used Herb-med was Hoisu-san, Oyaksungi-san(22cases, 54.96%). 7. In l5cases which have Aqua-Acupuncture treatment, There were 3cases of Complete recovery, 5cases of Excellent, 4cases of Improvement, 2cases of Disimprovement, 1cases of Poor. 8cases(53.33%) were above Excellent grade, so it is more efficatious Than simple treatment without Aqua-Acupuncture(36.37%). 8. The improvement of Bladder, Small Intestine Meridian Muscle was 77.27%, Gallblader, Triple Energizer Meridian Muscle was 70% and Stomach, Large Intestine Meridian Muscle was 80%. Additional Aqua-Acupuncture treatment improved to be effective in Bladder, Small Intestine Meridian Muscle(77.78%), in Gallblader, Triple Energizer Meridian Muscle(75%), in Stomach, Large Intestine Meridian Muscle(100%). Conclusions : In this study, Oriental treatment especially Aqua-Acupuncture was effective in whiplash injury patients which caused by traffic accident.

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Clinical features and prognostic factors in drowning children: a regional experience

  • Son, Kyung Lae;Hwang, Su Kyeong;Choi, Hee Joung
    • Clinical and Experimental Pediatrics
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    • v.59 no.5
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    • pp.212-217
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    • 2016
  • Purpose: This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis. Methods: We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated. Results: During the study period, 29 children experienced submersion (20 boys and 9 girls; mean age, $83.8{\pm}46.4$ months). Submersion occurred most commonly in the summer, with the peak incidence in August. The most frequent Szpilman clinical score was grade 5 (13 patients; 44.8%), followed by grade 6 (7 patients; 24.1%), and grades 1 or 2 (3 patients; 10.3%). Five children (17.2%) in the poor prognosis group died or had hypoxic ischemic encephalopathy, and the overall mortality rate was 6.9%. Poor prognosis after submersion was associated with lower consciousness levels (P=0.003), higher Szpilman scores (P=0.007), greater need for intubation and mechanical ventilator support (P=0.001), and longer duration of oxygen therapy (P=0.015). Poor prognosis was also associated with lower bicarbonate levels (P=0.038), as well as higher sodium, aspartate transaminase (AST), and alanine transaminase (ALT) levels (P=0.034, P=0.006, and P=0.005, respectively). Szpilman clinical scores were positively correlated with consciousness levels (r=0.489, P=0.002) and serum liver enzyme levels (AST and ALT; r=0.521, P=0.004). Conclusion: We characterized the prognostic factors associated with submersion outcomes, using the Szpilman clinical score, which is comparable to consciousness level for predicting mortality.