• 제목/요약/키워드: clinical grading

검색결과 296건 처리시간 0.028초

The Association between Blood Pressure and Obstructive Sleep Apnea-Hypopnea Syndrome

  • Kim, Cheon-Sik
    • 대한임상검사과학회지
    • /
    • 제46권3호
    • /
    • pp.106-110
    • /
    • 2014
  • Obstructive sleep apnea-hypopnea (OSAH) is known to be related to nocturnal blood pressure (BP) and hypertension. The aim of this study was to evaluate the prevalence of hypertension according to the apnea-hypopnea grading. A total of 2,210 adults with snoring and obstructive sleep apnea were referred to our sleep center from July 2009 to May 2013. Clinical blood pressure (BP) was measured before sleeping (bedtime BP) and immediately after waking up in the next morning (morning BP). Subjects were classified into four groups based on the apnea-hypopnea index (AHI) from PSG as follows: control group (n=470) simple snoring and with AHI<5; mild group (n=577) with $AHI{\geq}5$ and <15; moderate group (n=508) $AHI{\geq}15$ and <30; and severe group (n=655) with $AHI{\geq}30$. The differences and correlations between BP and PSG parameters according to the AHI groups were analyzed. Patient's were classified as nomentensive (blood pressure <120/90 mmHg, n=700), prehypertensive (blood pressure < $140-120{\leq}mmHg$, n=1297) hypertensive (blood pressure ${\geq}140/90mmHg$, n=214) according to the office blood pressure measurements. The comparison of sleep parameters showed that OSA groups had a significantly higher stage N1 (control group vs. moderate OSA, severe OSA; $66.4{\pm}30.7$ vs. $85.5{\pm}36.6$, $128.4{\pm}57.3$, p<0.001) and total arousal number (control vs. moderate OSA, severe OSA; $110.7{\pm}47.7$ vs. $150.8{\pm}56.6$, $236.6{\pm}95.8$, p<0.001) compared to control group. The comparison of sleep parameters showed that OSA groups had a significantly lower stage N2 (control group vs. moderate OSA, severe OSA; $172.6{\pm}47.2$ vs. $150.7{\pm}50.5$, $120.3{\pm}57.4$, p<0.001), stage N3 (control group vs. moderate OSA, severe OSA; $38.4{\pm}33.4$ vs. $27.4{\pm}26.0$, $56.1{\pm}27.5$, p<0.001), REM (control group vs. moderate OSA, severe OSA; $64.3{\pm}25.5$ vs. $56.1{\pm}27.5$, $47.3{\pm}25.9$, p<0.001) and mean SaO2% (control group vs. moderate OSA, severe OSA; $90.0{\pm}3.5$ vs. $82.5{\pm}5.5$, $70.0{\pm}8.8$, p<0.001) compared to control group. The Apnea-hypopnea index was significantly higher in OSA groups, increased systolic and diastolic blood pressure than in the nomentensive group (bed time systolic pressure vs. AHI; <120 vs. 120-139, 140-159, >159; $17.5{\pm}18.6$ vs. $24.9{\pm}21.0$, $31.0{\pm}25.7$, $42.3{\pm}31.7$, p<0.001), (bed time diastolic pressure vs. AHI; 60-79 vs. 80-89, 90-99, >99; $19.3{\pm}19.7$ vs. $22.4{\pm}20.3$, $29.8{\pm}23.3$, $38.8{\pm}28.5$, p<0.001). AHI was positively correlated with morning systolic pressure, diastolic pressure, bed time systolic pressure and diastolic pressure (r=0.314, 0.279, 0.233 and 0.200, respectively, p<0.001). We conclude that BMI, Age, neck circumference and AHI increase with the blood pressure.

특발성 안면신경 마비(Bell's Palsy)의 한방치료와 한양방 협진치료의 효과에 대한 임상적 비교 연구 (Comparative Clinical Study between Oriental Medical and Oriental-Western Medical Treatment on Bell's Palsy)

  • 권나현;신예지;김찬영;고필성;이원일;조병진;우현수;백용현;박동석
    • Journal of Acupuncture Research
    • /
    • 제25권3호
    • /
    • pp.19-28
    • /
    • 2008
  • Objectives : The purpose of this study is to investigate the therapeutic effects of oriental medical treatment and oriental-western medical treatment on Bell's palsy. Methods : From 1st June, 2006 to 31th August, 2007, 30 Bell's palsy patients who visited the Facial palsy center at East-West Neo Medical Center within 7days of onset and treated for more than 4weeks were randomly divided into two groups. Group A was treated with oriental medical therapy(Acupuncture, Herb, Physical therapy) and Group B with both oriental and western medical therapy(Acupuncture, Herb, Physical therapy, Administration of prednisone). We evaluated the treatment effect of each group with the House-Brackmann Gross Grading System before treatment, after 1week, 2weeks, 3weeks and 4weeks of treatment. Results : After 1week of treatment, Group A showed better performance compared with Group B. After 3weeks and 4 weeks of treatment, Group B showed better performance than Group A. Conclusions : These results proved that combination treatment of oriental and western medicine was more effective than just oriental medical treatment in long term treatment of Bell's palsy. But we discovered that there were no significant differences between the two groups.

  • PDF

거골 골절 및 탈구의 임상적 고찰 (Clinical Observation and Treatment of Fracture-Dislocation of Talus)

  • 이동철;김세동;정해훈
    • Journal of Yeungnam Medical Science
    • /
    • 제9권2호
    • /
    • pp.302-311
    • /
    • 1992
  • 1984년 부터 1991년까지 영남대학 병원에서 치료한 거골 골절 및 탈구 환자에서 최장 8년에서 최단 1년간 원격 추시하여 다음과 같은 결론을 얻었다. 1. 평균 30세 나이로 활동기 연령군이였으며, 전부 남자이었다. 2. 손상원인은 추락사고가 대부분이었으며, 교통사고, 스포츠손상 순이었다. 3. 거골 골절 및 탈구는 Marti-Weber 방법으로 분류하였으며, Type I 1례, Type II 1례, Type III 4례, Type IV 5례이였다. 4. 치료는 관혈적 정복술 및 내고정술을 6례에서 시행하였고, 나머지 5례는 도수정북솔로 치료하였다. 5. 치료 결과에 대한 평가는 Hawkins 등급 점수표를 이용하여 약 64%의 만족도를 얻을 수 있었으나, Type IV에서 결과가 좋지 않았다. 6. 합병증으로는 무혈성 괴사가 3례, 퇴행성 관절염이 8례, 불유합이 1례로 퇴행성 관절염의 빈도가 약 70%를 차지하였고, 거골하 관절에서 대부분 발생하였다. 7. 관절의 운동범위에서 건측에 비교하여, 족관절은 약 74%에서 유지되었으며, 거골하 관절은 건측에 비해 약 43%로 감소되었다. 이상에서 거골 골절 및 탈구시에는 빠른 관혈적 정복 및 내고정을 실시하고, 술후 적극적인 재활 치료를 하여 무혈성 괴사증이나, 퇴행성 관절염의 합병증을 줄이면 이차적인 수술을 하지 않을 수 있으며, 족관절의 기능도 가능한 유지할 수 있을 것으로 사료된다.

  • PDF

Relative Frequency of Oral Malignancies and Oral Precancer in the Biopsy Service of Jazan Province, 2009-2014

  • Idris, AM;Vani, NV;Saleh, Sanna;Tubaigy, Faisal;Alharbi, Fahd;Sharwani, Abubkr;Tadrus, Nabil;Warnakulasuriya, Saman
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권2호
    • /
    • pp.519-525
    • /
    • 2016
  • Background: The objective of this study was to report the types and relative frequency of oral malignancies and precancer in the Jazan region of Saudi Arabia during the period 2009-2014. Materials and Methods: Pathology reports were retrieved from the archives of Histopathology Department, King Fahd hospital in Jazan. Demographic data on tobacco habits, clinical presentation and histologic grading of oral precancer and cancer cases were transcribed from the files. Results: 303 (42.7%) oral pre-malignant and malignant cases were found out of 714 oral biopsy lesions. A pathology diagnosis of squamous cell carcinoma (85.1%) was most frequent, followed by premalignant lesions/epithelial dysplasia (8.6%), verrucous carcinoma (3.3%) and malignancy of other histological types (3%) such as ameloblastic carcinoma, salivary gland malignancy and sarcomas. Oral squamous cell carcinoma was predominant in females with a male to female ratio of 1:1.9. Patient age ranged from 22 to 100 years with a mean of $65{\pm}13.9$. Almost 44.6% of oral cancer had occurred after 65 years of age. Only 16.3% cases were reported in patients younger than 50 years, predominantly females. The majority of female patients had the habit of using shammah with a long duration of usage for more than 45 years. Buccoalveolar mucosa (52.3%) was the common site of involvement followed by tongue/floor of the mouth (47.7%) and clinically presented mostly as ulceration/swelling clinically. Moderately differentiated tumours (53.9%) were common followed by well differentiated (32.2%) and poorly differentiated tumours (5.8%). The prevalence of oral verrucous carcinoma (3.3%) was comparatively low with an equal distribution in both males and females. Both bucco-alveolar mucosa and tongue were predominantly affected. Oral precancer/epithelial dysplasia (8.6%) was common in females with a shammah habit. Bucco-alveolar mucosa was commonly involved and clinically presented mostly as white/red patches. Most cases were mild followed by moderate and severe dysplasia. Tumours of other histological types (3%) include 1 ameloblastic carcinoma, 3 malignant salivary gland tumours and 5 sarcomas. Conclusions: In this study, it was found that oral cancers reported in the pathology service to be a common occurrence. This study reconfirms previous reports of the high burden of oral cancer in this population This indicates that conventional preventive programs focused on oral cancer are in need of revision. In addition, further research into identifying new risk factors and molecular markers for oral cancer are needed for screening high risk individuals.

스키에 의한 슬관절 인대 손상 (Ligament Injuries of Knee in the Recreational Skiers)

  • 이동철;고진혁;김동한
    • 대한정형외과스포츠의학회지
    • /
    • 제2권1호
    • /
    • pp.37-43
    • /
    • 2003
  • 목적: 스키손상에서슬관절인대손상의형태와영향을줄수있는인자를분석하고, 수상전후의슬관절기능평가및스포츠활동도변화를알고자하였다. 대상및방법: 슬관절인대손상환자30명을대상으로설문및이학적검사, X선및MRI 촬영을통한평가를하였고, 기능평가는Lysholm Knee Scoring Scale, 스포츠활동도는Tegner activity score로평가하였다. 결과: 내측측부인대손상을동반한전방십자인대손상이11명으로가장많았고, 내측측부인대손상이9명으로그다음이었다. 수상기전은유령발현상(phantom foot phenomenon)과외전-외회전기전이각각13례와12례로83 $\%$를차지했다. 최종추시에서평균Lysholm score는93.4점으로매우양호하였으며, 활동도는수상전Tegner activity score 6.1점에서수상후4.2점으로감소되었다. 기능과활동도평가에서내측측부인대단독손상군이경과가가장양호하였으며, 내측측부인대손상을동반한전방십자인대손상군이경과가불량하였다. 스키손상에영향을미칠수있는요인으로는스키를지속적으로2시간이상탄경우, 바인딩이풀리지않는경우, 적절한스키강습프로그램을받지않은경우였다. 결론: 환자들의수상후Lysholm score는매우양호했지만, 수상후스포츠활동도에서는수상전과뚜렷한차이를보여적극적이고체계적인스포츠복귀프로그램이필요함을알수있었다.

  • PDF

Fractional Photothermolysis 치료 후 피부회복 촉진에 미치는 경구용 저분자 콜라겐 펩타이드의 효과 (The Efficacy of Oral Low Molecular Weight Collagen Peptide for Skin Recovery after Fractional Photothermolysis Laser Treatment)

  • 김인수;최선영;김병규;김정기;김은주;김범준;김명남
    • 대한화장품학회지
    • /
    • 제38권4호
    • /
    • pp.321-326
    • /
    • 2012
  • 최근에는 콜라겐 펩타이드가 항상화효과를 통해 피부의 재생을 촉진시키는 효과를 한다는 연구가 보고되고 있다. 본 구는 저분자 경구 콜라겐 펩타이드가 1550 nm fractional photothermolysis 레이저 치료 후 피부재생에 미치는 영향을 알아보고자 한다. 본 실험에 참여한 환자는 총 10명으로 실험군과 대조군 각 5명씩 무작위배정되었다. 대조군과 실험군 모두 동일하게 fractional photothermolysis 레이저를 시술받았다. 실험군에서는 경구 콜라겐 펩타이드를 하루에 1,000 mg씩 총 8주간 복용하였다. 치료 전후 모든 환자에서 피부의 탄성도, 경표피수분손실도, 홍반지수를 측정하였다. 피부탄성도는 실험군에서 대조군에 비해 통계적으로 유의하게 피부의 탄력성이 증가하였음을 확인하였다(p < 0.05). 경표피수분손실도는 두군간에 유의한 차이가 없었고, 홍반지수는 실험군에서 더 빨리 감소하는 결과를 보였다. 환자의 주관적 만족도평가에서 시술 4주 후 환자의 만족도는 실험군에서 평균 2.0점, 대조군에서 1.2점으로 나타났다. 저분자 콜라겐 펩타이드는 1550 nm fractional photothermolysis 레이저 치료 후 피부회복 촉진에 도움이 된다.

The Importance of Interface Irregularity between the Tumor and Brain Parenchyma in Differentiating between Typical and Atypical Meningiomas: Correlation with Pathology

  • Lee, Jeongmin;Lee, Yeon Soo;Ahn, Kook-Jin;Lee, Song;Jang, Jinhee;Choi, Hyun Seok;Jung, So-Lyung;Kim, Bum-soo;Jeun, Sinsoo;Hong, Yongkil
    • Investigative Magnetic Resonance Imaging
    • /
    • 제20권3호
    • /
    • pp.158-166
    • /
    • 2016
  • Purpose: To understand clinical significance of irregular interface between meningioma and adjacent brain parenchyma in predicting histological grading of tumor, focusing on brain parenchymal invasion. Materials and Methods: Pathologically confirmed 79 cases with meningiomas with pathological reports about the presence of parenchymal invasion were included. We defined the presence of interface irregularity as either spiculations or fuzzy margins between the tumor and brain parenchyma. We counted number of spiculations and measured ratio of fuzzy margin length to whole length of mass with consensus of two neuroradiologists. We classified the patients into Present group and Absent group, and the two groups were compared by using the Mann-Whitney U test. Statistical correlations between the presence of an interface irregularity and brain parenchymal invasion by the tumor as well as meningioma histological grade were tested with chi-square test. The optimal cutoff values of spiculation numbers and the ratio of fuzzy margins were determined. The sensitivity and specificity of number of spiculations, ratio of fuzzy margin and the presence of irregular interface as combined parameters for predicting the parenchymal invasion were calculated using ROC curve analysis. Results: Statistically significant differences were noted between the Present and Absent groups for number of spiculations and ratio of fuzzy margin (P = 0.038 and P = 0.028, respectively). The optimal cutoff value for number of spiculations (> 4.5 with 61.1% sensitivity and 68.9% specificity) and the ratio of fuzzy margin (> 0.24 with 66.7% sensitivity and 65.6% specificity) were determined. The sensitivity and specificity of interface irregularity as the combined parameters were 72% and 59%, respectively. The interface irregularity between tumor and brain parenchyma significantly correlated with not only brain parenchymal invasion (P = 0.001) and but also histological grade (P < 0.001). Conclusion: The interface irregularity between tumor and brain parenchyma in MRI can be a strong predictive factor for brain parenchymal invasion and high grade meningioma.

소아 신경모세포종의 치료 후 조직소견의 변화와 예후와의 관계 (Pathologic Change and Prognosis after Combination Therapy in Advanced Neuroblastoma)

  • 서연경;정유진;김준식;김흥식;박우현;최순옥;이병육;권건영
    • Clinical and Experimental Pediatrics
    • /
    • 제46권11호
    • /
    • pp.1107-1111
    • /
    • 2003
  • 목 적 : 진행된 신경모세포종 환아의 약물치료 후 수술한 예에서 조직변화를 관찰하여 예후와의 상관관계를 알아보고자 이 연구를 시행하였다. 방 법 : 1991년 1월부터 2000년 6월까지 계명대학교 동산병원 소아과에서 진단된 신경모세포종 환아 중 항암치료 후 종양절제를 시행한 6례를 대상으로 하였다. 진단 당시 침생검소견과 항암치료 후 조직소견에서 신경모세포의 분화정도와 핵 모양 및 간질조직의 기질화 양상과 석회와 유무 등을 비교하여 변형된 Shimada 분류에 따라 분류하였다 결 과 : 항암치료 전과 후에 조직소견의 변화를 관찰하였으며 변형된 Shimada 분류에 따라 2가지 예후군으로 분류하였으며, 좋은 예후군 3례 중 2명은 생존해 있으며, 1명은 추적되지 않고 사망한 것으로 추정하였으며, 나쁜 예후군의 3례는 각각 패혈증과 retinoic acid 복용 중 발생한 출혈성 췌장염으로 사망하였다. 결 론 : 항암치료 전과 후에 조직소견의 변화를 관찰하였으며 Shimada 분류에 따라 비교하고, 치료 후 종양세포의 성숙을 관찰하였으며, 좋은 예후군에서 생존수가 많은 것을 확인할 수 있었다.

악성 종양 관련 일측성 성대 마비 환자에서 고식적 Hyaluronic Acid 성대 주입 성형술의 유용성 (Benefits of Palliative Office-Based Hyaluronic Acid Injection Laryngoplasty in Cancer-Related Unilateral Vocal Cord Paralysis Patients)

  • 김고운;박영학;주영훈;김상연;심미란;황연신;선동일
    • 대한후두음성언어의학회지
    • /
    • 제29권1호
    • /
    • pp.30-36
    • /
    • 2018
  • Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

연부 조직 종양에서 PET의 유용성: 기존의 진단법과의 비교 연구 (Diagnostic Efficacy of PET in Soft Tissue Tumors: Comparative Study with Conventional Methods)

  • 서성욱;박상민;조환성
    • 대한골관절종양학회지
    • /
    • 제11권1호
    • /
    • pp.32-39
    • /
    • 2005
  • 목적: 최근에는 연부 종양의 진단에 FDG-PET을 이용하기 위한 연구가 다양하게 이루어지고 있다. 그러나, 그 임상적 유용성에 대해서는 알려져 있지 않다. 이 연구의 목적은 기존의 진단법과 비교하여 FDG-PET의 유용성을 평가하는 데 있다. 대상 및 방법: 연구 대상은 2001년 3월에서 2002년 3월 사이에 연부 조직 종양으로 진단받은 29명의 환자(남자 16명, 여자 13명, 평균 47세)를 대상으로 하였다. 모든 환자군에서 기존의 검사법과 FDG-PET을 시행하였다. 타당성 검증에서 국소 병변은 모든 경우 조직검사로 판단하였고, 전이 병변은 조직 검사와 6개월 간의 추시 결과로 판단하였다. 각각의 진단은 독립적으로 시행되었으며, 진단의 정확도와 누적 비용-정확도율을 측정하였다. 결과: 국소 병변의 진단에서 MRI와 FDG-PET의 민감도, 특이도, 정확도는 각각 91%, 57%, 83% 와 95%, 43%, 83%이었다. 원격 전이의 진단에서 기존의 검사법과 FDG-PET의 민감도, 특이도, 정확도는 각각 77%, 89%, 87% 와 92%, 94%, 93%이었다. 누적 비용-정확도율은 145,000원/% 이었다. 종양의 등급별 민감도 분석에서 고등급의 종양이 가장 비용-효용성이 높았다. 결론: 국소부위의 재발과 잔존 종양의 진단에서 FDG-PET의 정확도는 MRI와 차이가 없었다. 반면, 원격 전이의 진단은 FDG-PET이 기존의 검사 보다 정확하였다. 고등급 종양의 경우 저등급 종양보다 FDG-PET의 유용성이 큰 것을 알 수 있었다.

  • PDF