• Title/Summary/Keyword: clinical grading

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Clinical Study of Two Cases of Facial Diplegia with Continued Facial Palsy (편측 안면마비가 잇따라 발병한 양측 안면마비 환자 2례에 대한 임상적 고찰)

  • Yang, Gi-Young;Lee, Byung-Ryul;Kim, Young-Il
    • Journal of Acupuncture Research
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    • v.25 no.5
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    • pp.205-211
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    • 2008
  • Objectives : This study is designed in order to evaluate oriental medical treatment of facial diplegia with continued facial palsy. Methods : The authors observed patients by Yanagihara's unweighted grading system for operated acupuncture treatment, herbal medicine treatment and physiotherapy. Results & Conclusions : 1. Both facial grade had different scores in Yanagihara's unweighted grading system for 2 cases when the facial palsy occured. 2. Both cases were diagnosed in wind-cold(feng-han) type. 3. The left and right side of face took different amount of time to recover. 4. Facial diplegia was significantly improved.

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Clinical Case Study of Facial Nerve Paralysis with Sensorineural Hearing Loss and Tinnitus Caused by Traumatic Temporal Bone Fracture (난청과 이명을 동반한 외상성 안면신경마비 치험 1례)

  • Jang, Yeo Jin;Yang, Tae Joon;Shin, Jeong Cheol;Kim, Hye Hwa;Kim, Tae Gwang;Jeong, Mi Young;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • v.33 no.1
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    • pp.95-101
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    • 2016
  • Objectives : The aim of this report was to investigate the effects of Korean medical treatment on facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. Methods : We treated a patient with acupuncture, herbal medicine and physiotherapy. The effect of these treatments was evaluated by House-Brackmann facial grading scale, Yanagihara's unweighted grading system and by Digital Infrared Thermographic Image. Results : After 21 days of Korean medical treatment, House-Brackmann facial grading scale changed from III to II and Yanagihara's unweighted grading score increased from 14 to 27. Digital Infrared Thermographic Image also improved. Conclusions : These results suggest that Korean medical treatments were effective in treating facial nerve paralysis with sensorineural hearing loss and tinnitus caused by traumatic temporal bone fracture. We hope that a more efficient application of this treatment will be the result of clinical data accumulated in future studies.

Comparison studies on 20 cases of Bell's palsy patients by acupunture and Rainbow therapy & acupunture (특발성 안면신경 마비 환자 20례에 대한 체침과 체침및 Rainbow therapy병행치료의 비교연구)

  • Hwang, Yeong-Jin;Lee, Byun;Heo, Yoon-Kyoung;Song, Hyong-Gun;Ahn, Taek-Won;Hwang, Jae-Ok
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.87-95
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    • 2006
  • Objective : We suggested the clinical effect of Rainbow therapy on Bell's palsy. Methods : 20 Bell's palsy patients were divided into two groups. One group(A group) was treated by acupunture and the other group(B group) was treated by acupunture and Rainbow therapy. The effect of these treatments was evaluated by Yanagihara's unweighted grading system and House-Brackmann grading system. Results and Conclusions : In Yanagihara's unweighted grading system After 1 week and 2weeks treatment, group B marked more higher than group A in treatment outcome. We discovered that it is significant differences between two groups. After 3 weeks treatment, group B marked more higher than group A in treatment outcome but it is not significant differences between two groups. In House-Brackmann's facial nerve grading system, After 1 week treatment, group B marked more higher than group A in treatment outcome. We discovered that it is significant differences between two groups. After 2 weeks and 3 weeks treatment, group A marked more higher than group A in treatment outcome but it is not significant differences between two groups.

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A study of facial nerve grading system (안면신경기능의 평가방법에 대한 고찰;House-Brackmann scale이후의 New grade)

  • Kim, Mi-Bo;Kim, Ja-Hye;Shin, Sang-Ho;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.3
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    • pp.147-160
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    • 2007
  • Background and Objective : The facial nerve grading system proposed by House and Brackmann is most widely accepted for the clinical assessment of facial nerve injury. Because of the limitations and subjectivity of the House-Brackmann scale, several new scales of varying degrees of objectivity and ease of use have been introduced. To assess methods of evaluating the function of the facial nerve that have been introduced over the past 20 years, We compared with the House-Brackmann scale. Method : We referred to the information through Entrez Pubmed and Korean studies information(KSI) from 1985 to 2006 about methods of evaluating facial nerve function. We choose 7 scales that focused on objective and easy of use. Result and conclusion : Sunnybrook scale is a weighted, subjective scale with incorporation of secondary defects into a single composite score. Sunnybrook scale can be recommended over House-Brackmann scale.

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Clinical Observations of Complex Therapy, including Electroacupuncture and Magnetic-acupuncture, for Treating Peripheral Facial Nerve Palsy (전기와 자기장의 침 자극을 포함한 복합치료가 말초성 안면신경마비에 미치는 영향에 대한 관찰 연구)

  • Oh, Seo Young;Lee, Hyun;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.33 no.3
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    • pp.117-127
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    • 2016
  • Objectives : This study was performed to observe the effect of complex therapy, including electro-acupuncture and magnetic-acupuncture, on peripheral facial nerve palsy. Methods : Nine patients with peripheral facial nerve palsy were treated with acupuncture using electrical and magnetic stimulation. Acupoints in the face were stimulated with an electromagnetic field, as widely and as evenly as possible. To evaluate the effects before and after treatment we used Yanagihara's unweighted grading system, House-Brackmann scale, and Sunnybrook facial grading system and image once a week. Results : After treatment, the scores of Yanagihara's unweighted grading system, House-Brackmann scale and Sunnybrook facial grading system each improved (p-value < 0.05). Conclusion : Complex therapy using electro-acupuncture and magnetic-acupuncture might be an effective treatment to improve symptoms of peripheral facial nerve palsy. Further randomized-controlled trials are required to verify the efficacy and results of this study.

The clinical observation on Bell's palsy according to facial nerve grading system (안면신경평가기준에 따른 구안와사(口眼喎斜)의 임상관찰)

  • Kim, Jong-in;Seo, Jung-chul;Lee, Sang-hoon;Choi, Do-young;Kang, Sung-keel;Koh, Hyung-kyun
    • Journal of Acupuncture Research
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    • v.19 no.5
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    • pp.112-123
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    • 2002
  • Background and Objective : The evaluation of facial nerve function is a complex procedure. The House-Brackmann facial nerve grading system(H-B grade)and the Yanagihara grading system(Y-system) have been recommended as universal standards for assessing the degree of facial nerve palsy. The purpose of this study is to compare the effectiveness of Y-system and H-B system and to know the advantages of each system for each stage of incomplete recovery or sequelae of facial paralysis. Materials and Methods : A comparison between H-B grade and Y-system was studied with 137 evaluations of 61 cases of incomplete recovery or sequelae of peripheral facial paralysis. Each case was graded by using H-B system as a gross system and Y-system as a regional system before treatment, after 12 weeks and 6 months Results and Conclusions : The range of score in the Y-system 0-6, 8-16, 14-22, 24-34, 32-38, 38-40 were matched with grade VI, V, IV, III, II and I in the H-B system. The percentage of H-B grade III was the greatest among 137 evaluations and y-system showed the greatest score range. H-B system is easy to use but Y-system is more objective, quantitative and convenient to use in the incomplete recovery or sequelae state.

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Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis

  • Jeong, Tae Seok;Ahn, Yong;Lee, Sang Gu;Kim, Woo Kyung;Son, Seong;Kwon, Jung Hwa
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.465-470
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    • 2017
  • Objective : Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. Methods : Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using ${\kappa}$ statistics. Results : The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows : Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (${\kappa}=0.511$) and good for asymptomatic neuroforamens (${\kappa}=0.696$). Intraobserver agreement by reader 1 for operated neuroforamens was good (${\kappa}=0.776$) and that for asymptomatic neuroforamens was very good (${\kappa}=0.831$). In terms of lumbar level, interobserver agreement for L5-S1 (${\kappa}=0.313$, fair) was relatively lower than the other level (${\kappa}=0.804$, very good). Conclusion : MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5-S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.

A Seven Cases of Treating Atrophic Acne Scar with Subcision, Microneedle Therapy System and Herbal Peeling Therapy (절개침과 미세피부침, 약초필링을 이용한 위축성 여드름 흉터 치료 7례 임상보고)

  • Hyun-Seong Kim;Kyeong-Won Park;Yun-Jo Lee;Sang-Ok Choi;Ju-Young Jeong;Hyun-Jun An;Chung-Hee Lee;Chul-Hee Hong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.3
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    • pp.140-149
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    • 2023
  • Objectives : The purpose of this study is to present the effect of subcision, microneedle therapy system and herbal peeling therapy which is treatment of Korean medicine to atrophic acne scar patients. Methods : We administered subcision, microneedle therapy system and herbal peeling therapy to atrophic acne scar patients and tested the results by Qualitative Global Acne Scarring Grading System and Korean Acne Grading System as well. Results : After the treatment, all of the patients showed improvements in Qualitative Global Acne Scarring Grading System and Korean Acne Grading System as well. Qualitative Global Acne Scarring Grading System of patients changed from grade 2.71±0.71 to grade 1.14±0.86 along with the change of Korean Acne Grading System from grade 1.57±0.57 to grade 1.00±0.00. Conclusions : Subcision, microneedle therapy system and herbal peeling therapy may be effective in the treatment of moderate to severe acne scars, and could be applied in clinical practice.

Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade

  • Lee, Hak-Jae;Sun, Hyun-Woo;Lee, Jae-Seok;Choi, Nak-Joon;Jung, Yoon-Joong;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.51-57
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    • 2018
  • Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

Evaluation of Lasater Clinical Judgment Rubric to Measure Nursing Student' Performance of Emergency Management Simulation of Hypoglycemia (간호대학생의 저혈당 응급관리 시뮬레이션 실습 수행 평가를 위한 임상판단 루브릭 적용)

  • Hur, Hea Kung;Park, So Mi;Kim, Ki Kyong;Jung, Ji Soo;Shin, Yoon Hee;Choi, Hyang Ok
    • Journal of Korean Critical Care Nursing
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    • v.5 no.2
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    • pp.15-27
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    • 2012
  • Purpose: To evaluate the applicability of Lasater Clinical Judgment Rubric (LCJR) as an evaluation tool for hypoglycemia simulation practicum on Korean nursing students. Methods: The methodological study was done to evaluate the reliability and validity of the LCJR. Based on Benner's 4 levels of nursing grading rubric, ten items of the LCJR was evaluated for interrater reliability and internal consistency. The content validity was tested by eight experts and concurrent validity was done by Clark (2006)'s clinical simulation grading rubric. Fifty five video-taped cases of senior nursing students in Y University were used for the reliability and concurrent validity of the LCJR. Results: The interrater reliability was r=.90 (p<.001); Kendall tau b=.87 (p <.001), and Cronbach's alpha was .90. A value of item content validity index of the LCJR was .97 and correlation coefficient between the LCJR and Clark's instrument was .90 (p<.001). The mean (${\pm}SD$) of the nursing students' clinical judgment was 2.04 (${\pm}50$). Conclusion: The LCJR is a useful tool to examine the simulation performance evaluation for improving competency among nursing students. The results indicated that the LCJR may provide valuable information regarding clinical judgment of nursing students and thus, suggested to use to develop a simulation-based education program.

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