• Title/Summary/Keyword: clinical scales

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Hunt-Hess and Fisher Grades as Predicting Factors for Chronic Hydrocephalus in Surgically Treated Ruptured Aneurysm (수술적 치료를 받은 파열성 뇌동맥류환자에서의 예후와 뇌실-복강 단락술의 예측인자로써의 Hunt-Hess Grade와 Fisher Grade)

  • Hong, Chang Ki;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.60-65
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    • 2001
  • Objective : The popular grading systems in use, such as Hunt-Hess grade and Fisher scale score, are based primarily on the patient's clinical conditions or computerized tomography score after aneurysmal subarachnoid hemorrhage(SAH). The author investigated whether the need for ventriculoperitoneal(VP) shunt for chronic hydrocephalus and outcome can be predicted by Hunt-Hess grade and Fisher scale. Methods : A series of 146 patients admitted to our hospital from August 1991 to July 1999, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage which required shunting. Patients were evaluated based on following factors : Hunt-Hess grade, Fisher scale, age, sex, hypertension, aneurysm location, and intervals from aneurysm rupture to operation. Results : The overall mortality rate of the study group was 8.2%. Hunt-Hess grade(p=0.001) or Fisher scale (p=0.001) at all pretreatment times was significantly correlated with outcome. In addition, there was an increased risk of poor outcome in older age(65<). However, there were statistically no significant relationship between outcome and sex, location of aneurysm, hypertension, and interval from aneurysmal rupture to operation(p>0.05). Of 134 surviving patients, 16 patients(12%) underwent VP shunt placement secondary to chronic hydrocephalus. Hunt-Hess grade(p=0.001) is more predictive of chronic hydrocephalus than Fisher scale(p=0.146). Aneurysm location was significantly correlated with development of chronic hydrocephalus (p<0.05), without significant correlations in sex, age, hypertension. IVH, and ICH. Conclusion : This study suggests that there is a high clinical correlation between outcome and Hunt-Hess grades and Fisher scales on admission, but Hunt-Hess grade is more predictive for chronic hydrocephalus than Fisher scale. In addition, age(<65 yrs) is the significant factor for prediction of outcome. There was a trend of increasing risk for chronic hydrocephalus according to aneurymal location.

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Development of Yin-Deficiency Questionnaire and Examine the Reliability and Validity (음허증 측정도구의 개발 및 신뢰도 타당도 검정)

  • Lee Sang Jae;Park Jong Bae;Lee Song Shil;Kim Kwang Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.2
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    • pp.376-380
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    • 2004
  • The purpose of this study is the develop a questionnaire for measuring Yin-Deficiency and examine the reliability and validity for its' value as a barometer for evaluating Yin-Deficiency. Questionnaire was developed according to the symptoms of Yin-Deficiency suggested in the 'Standardization of diagnostic terms and requirements of Korean Medicine', With and as a reference, each symptom has been worked on to be put on the questionnaire. Visual analogue scales(VAS) was used as a barometer for measuring frequency of manifestation of symptoms. A study was performed to measure validity and reliability of the final questionnaire for analysis. reliability of YinDQ was measured by Cronbach's alpha coefficient and test-retest method. This study utilized factor analysis and clinical validity for evaluation of validity. For the purpose of decreasing the amount of data-the number of factors, and at the same time minimize the loss of information factor analysis was performed Component factors were extracted using Principal Component Analysis. This study evaluated the clinical validity for examination of difference between the normal group and the patient group. Evaluation on the's internal consistency showed strong internal consistency with value of 0.8615. reliability from test-rest with three-week interval, followed by comparisons of the correlation coefficient and mean values of each item between the two. The Spearman correlation coefficient was 0.54-0.79. By factor analyse two factors with Eigen value of greater than 2.2 were selected. Factor 1 consists of items of 'irritable fever on the five Hearts', 'flushing of the zygomatic region in the afternoon', 'tidal fever', 'night sweats', and 'dryness on the mouth or the throat'. Factor two consists of items of 'emaciation', 'dizziness', 'insomnia', 'decreased amount of urine with yellowish color', and 'constipation'. The comparison between the patient group and the normal group showed significant differences for every ten questions. The results implies that YinDQ is a barometer with sufficient reliability and validity. The questionnaire for Yin-Deficiency may not be enough to replace the specific differential diagnosis by a doctor of Oriental medicine. Nevertheless, it can be effectively utilized as an assisting method in consultation or a method of measuring the degree of Yin-Deficiency in a group.

Clinical Outcomes and Risk Factors of Traumatic Pancreatic Injuries (외상성 췌장 손상의 임상 결과 및 예후인자)

  • Lee, Hong-Tae;Kim, Jae-Il;Choi, Pyong-Wha;Park, Je-Hoon;Heo, Tae-Gil;Lee, Myung-Soo;Kim, Chul-Nam;Chang, Surk-Hyo
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.1-6
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    • 2011
  • Purpose: Even though traumatic pancreatic injuries occur in only 0.2% to 4% of all abdominal injuries, the morbidity and the mortality rates associated with pancreatic injuries remain high. The aim of this study was to evaluate the clinical outcomes of traumatic pancreatic injuries and to identify predictors of mortality and morbidity. Methods: We retrospectively reviewed the medical records of 26 consecutive patients with a pancreatic injury who underwent a laparotomy from January 2000 to December 2010. The data collected included demographic data, the mechanism of injury, the initial vital signs, the grade of pancreatic injury, the injury severity score (ISS), the revised trauma score (RTS), the Glasgow Coma Scale (GCS), the number of abbreviated injury scales (AIS), the number of associated injuries, the initial laboratory findings, the amount of blood transfusion, the type of operation, the mortality, the morbidity, and others. Results: The overall mortality rate in our series was 23.0%, and the morbidity rate was 76.9%. Twenty patients (76.9%) had associated injuries to either intra-abdominal organs or extra-abdominal organs. Two patients (7.7%) underwent external drainage, and 18 patients (69.3%) underwent a distal pancreatectomy. Pancreaticoduodenectomies were performed in 6 patients (23.0%). Three patients underwent a re-laparotomy due to anastomosis leakage or postoperative bleeding, and all patients died. The univariate analysis revealed 11 factors (amount of transfusion, AAST grade, re-laparotomy, associated duodenal injury, base excess, APACHE 11 score, type of operation, operation time, RTS, associated colon injury, GCS) to be significantly associated with mortality (p<0.05). Conclusion: Whenever a surgeon manages a patient with traumatic pancreatic injury, the surgeon needs to consider the predictive risk factors. And, if possible, the patient should undergo a proper and meticulous, less invasive surgical procedure.

Antispastic Effect of Electroacupuncture on Upper Extremity in Stroke Patients by T-reflex Study : A Single-Blind, Randomized Controlled, Preliminary Study

  • Cho, Min Kyoung;Lee, In;Kwon, Jung Nam;Shin, Byung Cheul;Ko, Sung Hwa;Ko, Hyun Yoon;Shin, Yong Il;Hong, Jin Woo
    • The Journal of Korean Medicine
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    • v.36 no.4
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    • pp.8-18
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    • 2015
  • Objectives: There have been several studies evaluated effect of electroacupuncture (EA) on spasticity but most studies could not assess spasticity quantitatively because they used clinical rating scales for assessment spasticity. The objective of this study is to evaluate effect of EA on poststroke spasticity quantitatively using tendon reflex (T-reflex). Methods: 29 stroke patients with upper extremity spasticity were randomized to EA group and control group. The EA group received combined EA and rehabilitation therapy 5 times a week for 3 weeks. Acupuncture treatment was given at Jian Yu (LI 15), Qu Chi (LI 11), Shao Hai (HT 3), Wai Guan (TE 5), He Gu (LI 4), Lie Que (LU 7), Hou Xi (SI 3) of the affected side, 30 minutes of electrical stimulation with a frequency of 40/13 Hz was applied at Qu Chi (LI 11), He Gu (LI 4). The control group received only rehabilitation therapy. The efficacy of treatment was assessed using T-reflex latency and amplitude, modified Ashworth scale (MAS) of biceps brachii, brachioradialis and triceps brachii. Fugl-Meyer motor function assessment (FMA) and functional independence measure (FIM) were also measured to assess motor function and functional independence. All outcomes were measured before treatment, immediately after 3 weeks of treatment and 1 week after 3 weeks of treatment. Results: No statistically significant differences were found in outcomes including T-reflex between the study groups except for FIM values immediately after 3 weeks of treatment (p=0.037). Conclusions: These results suggest that 3 weeks of EA does not reduce poststroke upper extremity spasticity electrophysiologically and clinically. However, small sample sizes and contradictory tendency between results from T-reflex and those from MAS require cautious judgement on interpretation of the results. A larger, well-designed clinical trials for quantitative evaluation of effect of EA on poststroke spasticity will be needed.

Clinical Usefulness of Fatigue Severity Scale for Patients with Fatigue, and Anxiety or Depression (피로와 우울.불안증 환자에서 Fatigue Severity Scale의 임상적 유용성)

  • Chung, Koo-In;Song, Chan-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.164-173
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    • 2001
  • Objectives : Fatigue is a common symptom in primary medical care and has nonspecific and highly subjective features. So it has been difficult to define and measure fatigue, especially those present without any organic diseases. This study was conducted to evaluate the validity of the Fatigue severity scale(FSS) in patients with persistent fatigue who were free of any organic diseases or psychiatric disorders of depression or anxiety. Methods : Subjects consisted of 45 controls, 44 fatigued patients and 43 psychiatric patients with depression or anxiety. They all completed the fatigue severity, modified Bepsi stress, and Hospital anxiety and depression scales. Chalder fatigue scale was administrated randomly in 30 of them. Data were analyzed for reliability and validity of the FSS. Results: Cronbach's a coeffient of FSS was 0.929, and the Pearson correlation coefficient for test-retest was 0.916(p<0.01). ANCOVA for discriminant validity revealed that there were significant differences in mean FSS values among the three groups. The fatigue group had significantly higher FSS value than the other two groups. The psychiatric group also had significantly higher FSS value than the control group. The Pearson correlation coefficient for convergent validity by comparing FSS with Chalder fatigue scale was 0.782(p<0.01). Using FSS index 3.22 as the cut-off point, sensitivity was 84.1% and specificity was 85.7% for the fatigue and control groups, respectively. Conclusion : Results suggested the clinical application of the FSS to be a useful measurement for distinguishing fatigue between patients with physiologic fatigue and psychiatric patients with depression or anxiety.

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A Descriptive Study on Job satisfaction and its Related Factors for Clinical Nurses in Goneral Hospital (일 대학병원 간호사의 직업만족도와 그에 관련된 요인 조사연구)

  • 김조자;박지원
    • Journal of Korean Academy of Nursing
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    • v.18 no.1
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    • pp.5-18
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    • 1988
  • Herzberg and his associates concluded from their findings that job satisfaction consisted on two independent dimension ; the first dimension was related to job satisfaction, the second to job dissatisfaction. According to the Herzberg theory, the satisfiers are related to the nature of the work itself and the rewards that flow directly from the performance of that work. The dissatisfaction factors are associated with the individual's relation to the context or environment in which he works. The purpose of this study was to investigate selected factors which result in job satisfaction / dissatisfaction of nurses employed in general hospital. In a study of this nature, it is important that the population be as homogenous as possible in order to reduce the effects of the different environments and backgrounds on job satisfaction. A job satisfaction questionnaire developed by Slabitt et als. was used for this study. It contains 45 statements and utilizes a Likert type scale of 5. Participants were asked to select response which were congruent with their perceptions of the item. It was decided to conduct the study in one general hospital in Seoul. A sample of 505 clinical nurses were selected to participate in this study. The results of this study were as follows ; 1. The overall mean score for the 45 five-point scales of job satisfaction items was 2.945, showing that the subjects of this study were neither satisfied nor dissatisfied. 2. To identify the specific job related factors that result in Job satisfaction / dissatisfaction, the 45 items of job satisfaction were divided into 6 areas and the mean scores and % of agreement were compared. The specific job related factor that resulted in job satisfaction was the job status and those that resulted in job dissatisfaction were salaries, task requirements and organization requirements. But the areas of autonomy and interaction did not belong to either side of the specific job related factors. 3. To identify the relationship between the job satisfaction and the subject's general characteristic, data was analyzed using the t-test and the Pearson correlation coefficient. It was found that the relationship between the job satisfaction and the request for rotation and intention to remain on the job were statistically significant at .05 level, but the relationship between the job satisfaction and age, work experience, and educational background were nor statistically significant at the .05 level.

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A PRELIMINARY STUDY FOR THE DEVELOPMENT OF THE ASSESSMENT SCALE FOR ADHD IN ADOLESCENTS:RELIABILITY AND VALIDITY FOR CASS(S) (청소년 ADHD 평가 도구 개발을 위한 예비연구-CASS(S)의 신뢰도 및 타당도 연구)

  • Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.218-224
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    • 2001
  • Although Attention Deficit Hyperactivity Disorder(ADHD) has been considered as the disorder occurring during childhood, the prevalence is increasing among adolescents and adults. The prevalence rate varies from 2.0 to 14.3% due to the difference of diagnostic criteria, different assessment methods, or subjects' age difference. Therefore, it needs to make age specific(i.e., for children, for adolescents, and for adults) assessment tools. Authors translated Conners-Wells Adolescents Self-Report Scales(short form)[CASS(S)] in to Korean to get validity and reliability as a way of development of assessment tool for adolescent with ADHD in Korea. CASS(S) was translated and corrtected by three psychiatrists and one clinical psychologist. To examine the concurrent validity and test-retest validity, CASS(S) was applied with K-YSR on one class of each grade in a middle school in Seoul with two week interval(total 115:male 58, female 57). To test validity, authors analysed and got Cronbach's as internal consistency. Construct validity was done by principal axis factor analysis on 4,354 students. As a result, Cronbach's alpha for internal consistency was .88, Pearson coefficient for test-retest reliability .83, and coefficient for concurrent validity .65. And in the factor analysis to examine construct validity, three factors were revealed as cognition, hyperactivity, and conduct. These results shows that CASS(S) may be useful tool for adolescents with ADHD, although there was a limit not to be done the comparison with clinical groups.

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Interim Report about The Effect of Sihogayonggolmoryeo-tang on the Anxiety of Hwa-byung (화병의 불안 증상에 대한 시호가용골모려탕의 효능 임상연구 중간보고)

  • Choi, Woo-Chang;Park, Dae-Myung;Kang, Wee-Chang;Lee, Sang-Ryong;Jung, In-Chul
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.4
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    • pp.133-152
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    • 2012
  • Objectives : The purpose of this study is to investigate the effect of Sihogayonggolmoryeo-tang on the anxiety of Hwa-byung. Methods : In this randomized, double blinded, placebo-controlled study, we planned to give Sihogayonggolmoryeo-tang or controlled medication for anxiety of Hwa-byung. Hamilton Anxiety Scale (HAM-A) was measured as the 1st evaluative instrument, and Korean State-Trait Anxiety Inventory (STAI-K), Likert scale for major symptom of Hwa-byung, Hwa-Byung Scale Score, Korean Beck's Depression Inventory (BDI-K), Korean State-Trait Anger Expression Inventory (STAXI-K), Insomnia severity Index (ISI), Instrument of Oriental Medical Evaluation for Hwa-Byung, WHO Quality of Life Avvreviated (WHOQOL-BREF), genral self-Efficacy Scale (GSES), Rosenberg Self-Esteem Inventory (SRE) and Heart Rate Variability (HRV) were also measured as the 2nd evaluative instrument before treatment. Results : Clinical characteristics-vital signs and demographic characteristics showed no significant difference between both groups. The characteristics of disease-chief complaint, pattern Identification, period, etiological factor, and etc, also showed similarity of distribution in both groups. The results of Chest PA, EKG and clinicopathologic examination showed no significant difference between both groups. There were no significant difference between both groups in all valuation scales; HAM-A was measured as the first evaluative instrument, and STAI-K, Likert scale for major symptom of Hwa-byung, Hwa-Byung Scale Score, BDI-K, STAXI-K, ISI, Instrument of Oriental Medical Evaluation for Hwa-Byung, WHOQOL-BREF, GSES, SRE and HRV. Conclusions : We considered that establishment of the experimental group and controlled group was objective and worth conducting this research. In addition, this methodology is expected to be applied to the subsequent research. Further, we hope to make up for this study through various study and discussion.

Efficacy of Enrofloxacin and Silver Sulfadiaznine Topical Otic Suspension for the Treatment of Canine Otitis Externa (개 외이염에 대한 Enrofloxacin과 Silver Sulfadiazine 국소제제의 치료효과)

  • Bae, Seulgi;Kim, Byeongmok;Choi, Sungwon;Sin, Hui-Ju;Lee, Young-Ju;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.172-177
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    • 2013
  • The aim of this study was to evaluate the in vivo and in vitro efficacy of enrofloxacin-silver sulfadiazine (Baytril$^{(R)}$ otic, Bayer, USA) for the treatment of otitis externa in dogs. Twenty-four dogs with otitis externa were included in this double-blinded, randomized study. The experimental group was treated with the Baytril$^{(R)}$ otic and the distilled water was applied to the control group. Both groups were administered each solution twice daily for 7 days and next 7 days off treatment. On days 0, 7 and 14, clinical signs, bacteriological and fungal counts were graded using semi-quantitative scales, respectively. For the evaluation of in vitro efficacy of Baytril$^{(R)}$ otic, we also performed Minimal Inhibitory Concentration (MIC) test by agar dilution method against Staphylococcus pseudintermedius, Pseudomonas aeruginosa and Malassezia pachydermatis. In the experimental group, the sum of clinical scores was decreased 81.0% and microbial scores were significantly reduced 87.0% at days 14, compared with day 0. The results of MIC testing were showed the concentration of enrofloxacin and silver sulfadiazine in Baytril$^{(R)}$ otic is high enough to kill for 3 infectious agents. No adverse reactions were observed in any of the dogs during this study. These results suggest that Baytril$^{(R)}$ otic are efficient and safe treatment for canine otitis externa.

A Review of Acupuncture Treatment Methods for Lumbar Herniated Intervertebral Disc

  • Kim, Sung Jin;Jeong, Seong Mok;Lee, Chang Hee;Yoon, Jin-Young;Shim, Sung Eun;Kim, Jeong Hyon;Goo, Bon Hyuk;Park, Yeon Cheol;Baek, Yong-Hyun;Nam, Sang Soo;Seo, Byung-Kwan
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.158-168
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    • 2018
  • The purpose of this study was to review clinical studies of lumbar herniated intervertebral disc (LHIVD) treatment using acupuncture. Online database (PubMed, COCHRANE Library, EMBASE, CNKI, KISS, NDSL, KoreaMed, KMbase, OASIS, and KISTI) searches were conducted in May 2018. Studies that used acupuncture, electroacupuncture or warm needle acupuncture were included, along with participants who had lower back pain and radiating pain of their lower limbs consistent with radiological findings. Animal studies and nonclinical data were excluded. Data on treatment methods, site, time, frequency, period, and scales used were analyzed. There were 69 studies including 38 randomized controlled trials, 14 retrospective observational studies, and 17 clinical case studies. There were 51 acupoints selected for acupuncture treatment of LHIVD. The most frequently treated acupoints were BL23, BL25, BL24, and BL40. The mean treatment time, frequency, and duration were $26.06{\pm}6.70$ mins, $6.29{\pm}1.70$ times/week, and $20.57{\pm}11.04$ days, respectively, in randomized controlled trials (RCT), and $18.62{\pm}4.60$ mins, $11.58{\pm}3.99$ times/week, and $34.43{\pm}17.62$ days, respectively, in case/retrospective studies ($mean{\pm}SD$). This review collates information about acupuncture treatment methods for LHIVD.