• Title/Summary/Keyword: clinical grading

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A1 Study on the Possibility of Surface Electromyography as a Clinical Assessment Scale for Facial Nerve Palsy

  • Tae Kyung Kim;Eun Ju Lee;Chang Min Shin;Jong Cheol Seo;Cheol Hong Kim;Yoo Min Choi;Hyun Min Yoon
    • Journal of Acupuncture Research
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    • v.41 no.1
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    • pp.53-62
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    • 2024
  • Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.

MALIGNANT HYPERTHERMIA (악교정 수술 중 발생한 지연성 악성 고열증의 치료)

  • Oh, Sung-Hwan;Min, Seung-Ki;Kwon, Kyung-Hwan;Jo, Pil-Kwy;Song, Yun-Kang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.381-387
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    • 2005
  • Malignant hyperthermia is a catastrophic, hypermetabolic syndrome that arises in susceptible individuals when they are exposed to certain inhalational anesthetics or muscle relaxants. It is characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. We experienced a 24 year old male Malignant hyperthermia presented for orthognathic surgery under $O_2-N_2O$-sevoflurane anesthesia without succinylcholine. Two half hours after induction, tachycardia developed and was followed by unstable blood pressure and hyperpyrexia. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated by the intravenous administration of dantrolene sodium. The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. So the malignant hyperthermia clinical grading scale is recommended for use as an aid to the objective definition of this disease. This clinical grading system provides a new and comprehensive clinical case definition for the malignant hyperthermia syndrome. We recently encountered a case of delayed malignant hyperthermia during sevoflurane anesthesia that was successfully treated by the intravenous administration of dantrolene sodium. In conclusion, exposure to sevoflurane should be avoided in patients thought to be susceprible to malignant hyperthermia.

Clinical Application of $^{18}F-FDG$ PET in Salivary Gland Cancer (타액선암(Salivary Gland Cancer)에서 $^{18}F-FDG$ PET의 임상 이용)

  • Yang, You-Jung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.14-16
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    • 2008
  • Salivary gland tumors are relatively rare, constituting 3% of all head and neck neoplasms. In patients with salivary gland malignancies, $^{18}F-FDG$ PET is clinically useful in initial staging, histologic grading, and monitoring after treatment. According to clinical research data hitherto, $^{18}F-FDG$ PET is expected to be an effective diagnostic tool in the management of salivary gland tumors.

Association of Serum and Salivary Tumor Necrosis Factor-α with Histological Grading in Oral Cancer and its Role in Differentiating Premalignant and Malignant Oral Disease

  • Krishnan, Rajkumar;Thayalan, Dinesh Kumar;Padmanaban, Rajashree;Ramadas, Ramya;Annasamy, Ramesh Kumar;Anandan, Nirmala
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7141-7148
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    • 2014
  • Background: Oral squamous cell carcinoma (OSCC) is an important malignancy throughout the world; early detection is an important criterion for achieving high cure rate. Out of the many reported markers for OSCC, this study validated the efficacy of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in differentially diagnosing premalignant oral lesions and OSCC. Also, the study aimed to correlate the levels of salivary and serum TNF-${\alpha}$ with clinicopathologic factors. Materials and Methods: A prospective experimental laboratory study was designed. Serum and salivary samples from 100 subjects in each group of healthy control, premalignant disease (PMD) and OSCC were collected for the study following appropriate exclusion and inclusion criteria. Serum and salivary level of TNF-${\alpha}$ was analysed by enzyme linked immunosorbent assay. The data obtained were subjected to appropriate statistical analysis. Results: Increased level of both serum and salivary TNF-${\alpha}$ was observed in OSCC subjects compared to healthy control and PMD group. Receiver operator characteristic curve analysis and area under curve values showed high specificity and sensitivity for salivary TNF-${\alpha}$ in differentiating OSCC from PMD and healthy controls. There was significant increase in TNF-${\alpha}$ level in moderately and poorly differentiated lesion compared to well differentiated lesion and in stage IV of clinical stage. A positive correlation was observed only with histological grading of OSCC and TNF-${\alpha}$. Conclusions: Salivary TNF-${\alpha}$ is proved to be superior for detecting OSCC. Increase in TNF-${\alpha}$ with histological grading and clinical staging suggests a role in prognosis.

Clinical Case Report of Recurrent Bell's Palsy (재발성 벨마비 환자의 치험 1례)

  • Sun, Yung Chen;Moon, Byung Soon;Yun, Jong Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.5
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    • pp.788-792
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    • 2012
  • The purpose of this report was to show that the oriental medical treatment is effective on recurrent bell's palsy. We investigated 1 patient with recurrent bell's palsy who was a case of recurrent ipsilateral bell's palsy with four distinct episodes over the past 11 years. As a treatment, Ligigepung-san(Liqiqufeng-san), Acupuncture, and Moxa were tried upon the patient for 40 days in order to relieve the symptom of palsy. In terms of observing the changes of symptoms, the progress of patient's condition was evaluated periodically by using the House-Brackamnn's grading system. In accordance with the observation under House-Brackamann's grading system, the patient's facial nerve palsy had gradually improved throughout the treatment. Therefore, this report suggests that Ligigepung-san (Liqiqufeng-sa n), Acupuncture, and Moxa are probably effective in the treatment of recurrent Bell's palsy.

Clinical Grading System, Surgical Outcomes and Prognostic Analysis of Cranial Base Chordomas

  • Wang, Benlin;Tian, Fengxuan;Tong, Xiaoguang
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.469-478
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    • 2022
  • Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.

An Analysis of Actual States of the Nursing Grade of Medical Institutions

  • Park, Hyun-Suk
    • Journal of Korean Clinical Health Science
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    • v.2 no.3
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    • pp.158-166
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    • 2014
  • Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.

Clinical Study on a Case of Cervical Myelopathy (경추증성 척수증 환자 1례에 대한 임상적 고찰)

  • Lee, Ok-ja;Yoon, Min-young;Kim, Hong-hun;Cho, Nam-geun
    • Journal of Acupuncture Research
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    • v.20 no.4
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    • pp.220-229
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    • 2003
  • Objective : Cervical myelopathy is one of the most severe disease, as well as a common diesaes. However, its clinical study and report about efficiency of oriental treatment are absolutely insufficient. Therefore, we report the treatment about 1 case of Cervical myelopathy like followings. Methods : From November 27th, 2002 to January 11th, 2003, we observed patient hospitalized because of cervical myelopathy, and for its valuation, JOA score(Japanese Orthopedic Association score), Nutric grading, VAS(visual analog scale), and D.I.T.I(Digital Infrared Thermal Imaging)were used. Results : After being hospotalized for 50 days, the patients' JOA score, Nuric grading system, and VAS were improved each from 7 to 13, from grade IV to grade II, and from 8 to 2. Conclusions : We considered that oriental treatment has an useful effect on cervical myelopathy patients' treatment and recovery. But continuous studies, such as comparative studies accompanied by more treatment case.

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The relationship between nerve conduction studies and neuropathic pain in sciatic nerve injury due to intramuscular injection

  • Fidanci, Halit;Ozturk, Ilker
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.124-131
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    • 2021
  • Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.

A Pilot Test on the Effects of Improvement on Acne Skin - Using Functional Soap, Containing Medicinal Herbs (한약 성분 함유 기능성 비누의 여드름 피부 개선에 대한 pilot test)

  • Jeong, Jae-Cheol;Roh, Jin-Ju;Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.1
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    • pp.182-190
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    • 2009
  • Purpose: The pilot study was done for checking the efficacy of using functional soap, containing medicinal herbs on acne skin. Methods: 30 participants with acne skin was recruited. They used functional soap during 8 weeks. Before and after the study, we checked the KAGS(Korean Acne Grading System) grade, and compared those score. For examining the clinical effect, global evaluation was done by both investigator and participants. Results: KAGS grade decreased from 1.6316 to 1.4211(p value = 0.042). And the clinical global evaluation was improved. Conclusion: This pilot test showed that using functional soap, containing medicinal herbs would be one of treatment on acne skin.