• Title/Summary/Keyword: weighted regional grading system

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A study of facial nerve grading system (구안와사(口眼喎斜)의 평가방법(評價方法)에 대한 고찰(考察))

  • Kim, Jong-In;Koh, Hyung-Kyun;Kim, Chang-Hwan
    • Journal of Acupuncture Research
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    • v.18 no.2
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    • pp.1-17
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    • 2001
  • Background and Objetive : Lack of uniformity in reporting facial nerve recovery in patients with facial nerve paralysis has been a major disadvantage in comparing treatment modalities. The objective evaluation of facial nerve function is a complex procedure. The House and Brackmann grading system, the Yanagihara grading system has been recommend as a universal standard for assessing the degree of facial nerve palsy. However, clinical studies for treatment of facial palsy have rarely used this universal standard in oriental medicine. That is the reason for analysing this facial nerve grading system. Material and Method : We choose 10 scales reported from 1955 till 1995. These facial nerve grading systems may be classified as Gross system, Regional system and Specific system. Result and Conculsion : The scales of Botmann and Jonkees, May, Peitersen, and House and Brackmann are the gross facial nerve grading systems with which we grossly assess the facial motor dysfunction and the secondary defect. Among these scales, H-B scale is the most widespred The scales of Yanagihara(若杉文吉), Smith, Adour and Swanson, Jassen, FEMA are the regional facial nerve grading system in which we weight, or unweight the facial motor dysfunction and the secondary defect. For example, the scales of Yanagihara(若杉文吉) and Smith are the unweighted regional scale, the scale of Adour and Swanson, Jassen, FEMA are the weighted regional grading system. The scale of Stennert is the Specific facial nerve grading system in which we respectively assess the grade of facial dysfunction at rest, in motion and the secondary defect. For the objective evaluation of the oriental medicine treatment for facial palsy, we must use the universal standard scale, i.e. the H-B scale, the Yanagihara scale.

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A Case Study of Oriental Medicine Treatment on Peripheral Facial Palsy (말초성 안면마비 환자의 한방치료 치험례)

  • Jung, You-jin;Choi, A-ryun;Han, Dong-kun;Kang, A-hyun;Seo, Hye-jin;Sung, Jae-yeon;Song, Woo-sub;Lee, Hyung-chul;Eom, Gook-hyun;Kim, Soo-yeon
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.769-777
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    • 2017
  • Objective: Facial nerve palsy is caused by damage to the 7th cranial nerve. It is the main symptom of facial muscle paralysis on the affected side. Usually, recovery from this disease begins 2-3 weeks after onset and most patients recover in 4-8 weeks. If the patients cannot receive proper treatment, severe permanent impairments, both physical and mental, may remain, so this disease should be treated appropriately. In this study, a patient with facial nerve palsy was admitted to the Korean medicine hospital for treatment. We report on the patient's progress and the effects of treatment. Methods: We cured the patient with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. We used a numerical rating scale, the House Brackmann grading system, and a weighted regional grading system to assess symptom changes. Result: The patient with facial nerve palsy was hospitalized for 23 days and recovered from symptoms without significant problems on the face or in motor function.

A Case of Traditional Korean Medical Treatment of a Patient with Facial Nerve Palsy Hospitalized at a Korean Medicine Hospital (한방병원에 입원한 말초성 안면신경마비 환자에 대한 한방 치료 1례)

  • Sung, Jae-yeon;Kang, Ah-hyun;Han, Dong-kun;Seo, Hye-jin;Oh, Ju-hyun;Lee, Yu-ra;Kang, Man-ho;Lee, Hyung-chul;Eom, Guk-hyeon;Song, Woo-sub
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.1075-1083
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    • 2018
  • Objective: Facial nerve palsy is caused by damage to the seventh cranial nerve. It is the main symptom of facial muscle paralysis on the affected side. If the patient cannot receive proper treatment, severe permanent impairments, both physical and mental, may result, so this disease must be treated appropriately. In this study, a patient with facial nerve palsy was admitted to a Korean medicine hospital for treatment. This case study reports on the patient's progress and the effects of the treatment. Methods: We treated the patient with herbal medicines, acupuncture, herbal acupuncture therapy, and physical therapy. The House-Brackmann Grading System and a weighted regional grading system were used to assess symptom changes. Results: The patient with facial nerve palsy was hospitalized for 50 days and recovered from symptoms without significant problems in the face or to motor function. Conclusion: This case report demonstrates the possibility of treating facial nerve palsy using Korean medicine.

Comparison between Subjective Scoring and Computer-Based Asymmetry Assessment in Facial Nerve Palsy

  • Lee, Doh Young;Kim, Hyun Seok;Kim, So Young;Park, Kwang Suk;Kim, Young Ho
    • Journal of Audiology & Otology
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    • v.23 no.1
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    • pp.53-58
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    • 2019
  • Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

Comparison between Subjective Scoring and Computer-Based Asymmetry Assessment in Facial Nerve Palsy

  • Lee, Doh Young;Kim, Hyun Seok;Kim, So Young;Park, Kwang Suk;Kim, Young Ho
    • Korean Journal of Audiology
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    • v.23 no.1
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    • pp.53-58
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    • 2019
  • Background and Objectives: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). Subjects and Methods: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. Results: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p<0.001). The PC-FAAP was significantly more consistent in group I and group III (p<0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). Conclusions: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

Drought risk assessment considering regional socio-economic factors and water supply system (지역의 사회·경제적 인자와 용수공급체계를 고려한 가뭄 위험도 평가)

  • Kim, Ji Eun;Kim, Min Ji;Choi, Sijung;Lee, Joo-Heon;Kim, Tae-Woong
    • Journal of Korea Water Resources Association
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    • v.55 no.8
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    • pp.589-601
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    • 2022
  • Although drought is a natural phenomenon, its damage occurs in combination with regional physical and social factors. Especially, related to the supply and demand of various waters, drought causes great socio-economic damage. Even meteorological droughts occur with similar severity, its impact varies depending on the regional characteristics and water supply system. Therefore, this study assessed regional drought risk considering regional socio-economic factors and water supply system. Drought hazard was assessed by grading the joint drought management index (JDMI) which represents water shortage. Drought vulnerability was assessed by weighted averaging 10 socio-economic factors using Entropy, Principal Component Analysis (PCA), and Gaussian Mixture Model (GMM). Drought response capacity that represents regional water supply factors was assessed by employing Bayesian networks. Drought risk was determined by multiplying a cubic root of the hazard, vulnerability, and response capacity. For the drought hazard meaning the possibility of failure to supply water, Goesan-gun was the highest at 0.81. For the drought vulnerability, Daejeon was most vulnerable at 0.61. Considering the regional water supply system, Sejong had the lowest drought response capacity. Finally, the drought risk was the highest in Cheongju-si. This study identified the regional drought risk and vulnerable causes of drought, which is useful in preparing drought mitigation policy considering the regional characteristics in the future.

Leukoaraiosis on Magnetic Resonance Imaging Is Related to Long-Term Poor Functional Outcome after Thrombolysis in Acute Ischemic Stroke

  • Choi, Jae-Hyung;Bae, Hyo-Jin;Cha, Jae-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.2
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    • pp.75-80
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    • 2011
  • Objective : Leukoaraiosis (LA) has been suggested to be related to the poor outcome or the occurrence of symptomatic intracerebral hemorrhage (sICH) after acute ischemic stroke. We retrospectively investigated the influences of LA on long-term outcome and the occurrence of sICH after thrombolysis in acute ischemic stroke (AIS). Methods : In this study, we recruited 164 patients with AIS and magnetic resonance image (MRI)-detected thrombolysis. The presence and extent of LA were assessed using the Fazekas grading system. The National Institutes of Health Stroke Scale score was used to assess the baseline measure of neurologic severity, and the modified Rankin Scale score assessment was used up to 1 year after thrombolysis. Results : Of 164 subjects, 56 (34.2%) showed LA on MRI. Compared to the 108 patients without LA, the patients with LA were of much older age (p<0.01), had a higher prevalence of hypertension (p<0.01), and had a much poorer outcome at 90 days (p=0.05) and 1 yr (p=0.01) after thrombolysis. There were no significant differences in sICH between patients with and without LA on MRI. In univariate analysis for the occurrence of poor outcome at 90 days after thrombolysis, the size of ischemic lesion on diffusion weighted images (DWI), [odds ratio (OR), 1.03; 95% confidence interval (95% CI), 1.01-1.04; p<0.01], recanalization (OR, 0.03; 95% CI, 0.01-0.10; p<0.01), sICH (OR, 12.2; 95% CI, 1.54-95.8), neurologic severity (OR, 1.17; 95% CI, 1.09-1.25; p<0.01), blood glucose level (OR, 1.01; 95% CI, 1.00-1.02; p=0.03), and the presence of LA on MRI (OR, 2.01; 95% CI, 1.04-3.01; p=0.04) were statistically significant. In multivariate analysis, neurologic severity (OR, 1.14; 95% CI, 1.04-1.24; p<0.01), recanalization (OR, 0.03; 95% CI, 0.01-0.11; p<0.01), lesion size on DWI (OR, 1.02; 95% CI, 1.01-1.03; p=0.02), serum glucose level (OR, 1.01; 95% CI; 1.01-1.02; p=0.03), and the presence of LA on MRI (OR, 3.2; 95% CI, 1.22-8.48; p<0.01) showed statistically significant differences. These trends persisted up to 1 yr after thrombolysis. Conclusion : In this study, we demonstrated that the presence of LA on MRI might be related to poor outcome after use of intravenous tissue plasminogen activator in AIS.