• 제목/요약/키워드: Clinical Usefulness

검색결과 1,053건 처리시간 0.033초

Glasgow coma scale의 임상적 유용성 평가 - 중환자 중증도 분류도구 - (Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU))

  • 김희정;김지희;노상균
    • 한국화재소방학회:학술대회논문집
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    • 한국화재소방학회 2012년도 춘계학술발표회 초록집
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    • pp.190-193
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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임상실습교육의 만족도와 관련요인 분석 - 한방재활의학을 중심으로 - (The Analysis of Satisfaction with Clinical Training and the Related Factors - Especially in Oriental Rehabilitation Medicine -)

  • 조현우;황의형;신병철;설재욱;홍진우;신상우;이현엽;허광호;신미숙
    • 대한예방한의학회지
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    • 제16권2호
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    • pp.1-15
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    • 2012
  • Objectives : The aim of this study is to analyze satisfaction with clinical training in the department of oriental rehabilitation medicine and the related factors. Methods : All the students in the graduating class of school of Korean Medicine, Pusan National University must be trained for 2 weeks in the department of oriental rehabilitation medicine according to clinical training guideline including Objective Structured Clinical Examination(OSCE) and Clinical Performance Examination (CPX). After completing clinical training, we distributed questionaries to them about a reflex of the object of study, usefulness, difficulty, satisfaction and preference. And then, we analyzed the related factors including descriptive statistics, frequency analysis and correlation analysis by SPSS 18.0. Results : In general, a reflex of the aim of study($7.88{\pm}1.31$), satisfaction with contents($8.17{\pm}1.20$) and difficulty($5.53{\pm}0.99$) were evaluated respectively. The better a reflex of the aim of study is, the higher satisfaction with contents is(P<0.01, r=0.836). Chuna was highly estimated, whereas pharmacopuncture was not. In OSCE, a reflex of the aim of study($8.07{\pm}1.07$) and usefulness($8.13{\pm}1.16$) were highly evaluated. The preference for physical examination of the lumbar spine was highly estimated, whereas applying splint was not. Facilities and equipment($7.88{\pm}1.11$), contents of clinical training($7.25{\pm}1.79$), the handout($7.00{\pm}1.59$) and time scheduling($5.48{\pm}1.71$) were evaluated respectively in general composition of clinical training. There is no difference related to specialty, sex and age among students. Conclusions : Clinical training program in the department of oriental rehabilitation medicine can be highly estimated from the viewpoint of difficulty and satisfaction.

안경광학과 재학생과 안경사의 안경광학과 교과과정 분야별 유용도 - 경기지역 3년제 교과과정을 중심으로 - (Study on the Usefulness of the Classification in Ophthalmic Optics' Curriculum for Students and Optometrist - Focusing on Three-year Educational System in Gyeonggi Province -)

  • 이옥진;박희경
    • 한국안광학회지
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    • 제18권4호
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    • pp.413-428
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    • 2013
  • 목적: 안경광학과 재학생과 안경사를 대상으로 안경광학과 교과과정 분야별 유용도를 조사하여 교과과정 개발에 기초자료로 활용하고자 하였다. 방법: 안경광학과 재학생 292명과 산업체 재직 안경사 123명을 대상으로 교과과정 유용도(5점 척도)에 관한 설문조사를 실시하고 통계분석을 하였다. 결과: 교과과정 유용도의 평균은 안경사(3.89)가 재학생(3.71)보다 높았다. 재학생의 교과과정 분야별 유용도는 검안학분야가 가장 높았고(4.55) 안경사는 임상실습분야가 가장 높았다(4.48). 재학생과 안경사의 분야별 교과목의 유용도는 안광학분야, 안과학분야, 안경학분야, 전공기초분야, 안경사관련분야, 외국어분야에서 유의한 차이(p<.05)가 있었으나 검안학분야와 콘택트렌즈분야는 유의한 차이 없이 공통적으로 유용도가 높았다. 재학생의 교과목 유용도는 성별, 학년, 연령, 희망진로에 따른 유의한 차이가 나타났으며 안경사의 교과목 유용도는 성별, 연령, 학력, 경력, 근무처, 직위에 따른 유의한 차이가 나타났다. 결론: 안경광학과 표준교과과정을 위한 연구가 지속되어야 하며 재학생과 안경사의 교과과정에 대한 유용도와 요구가 반영된 교과과정의 개발이 필요하다.

Application of artificial intelligence for diagnosis of early gastric cancer based on magnifying endoscopy with narrow-band imaging

  • Yusuke Horiuchi;Toshiaki Hirasawa;Junko Fujisaki
    • Clinical Endoscopy
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    • 제57권1호
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    • pp.11-17
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    • 2024
  • Although magnifying endoscopy with narrow-band imaging is the standard diagnostic test for gastric cancer, diagnosing gastric cancer using this technology requires considerable skill. Artificial intelligence has superior image recognition, and its usefulness in endoscopic image diagnosis has been reported in many cases. The diagnostic performance (accuracy, sensitivity, and specificity) of artificial intelligence using magnifying endoscopy with narrow band still images and videos for gastric cancer was higher than that of expert endoscopists, suggesting the usefulness of artificial intelligence in diagnosing gastric cancer. Histological diagnosis of gastric cancer using artificial intelligence is also promising. However, previous studies on the use of artificial intelligence to diagnose gastric cancer were small-scale; thus, large-scale studies are necessary to examine whether a high diagnostic performance can be achieved. In addition, the diagnosis of gastric cancer using artificial intelligence has not yet become widespread in clinical practice, and further research is necessary. Therefore, in the future, artificial intelligence must be further developed as an instrument, and its diagnostic performance is expected to improve with the accumulation of numerous cases nationwide.

Diagnostic Usefulness of High Resolution Cross Sectional MRI in Symptomatic Middle Cerabral Arterial Dissection

  • Lee, Hai-Ong;Kwak, Hyo-Sung;Chung, Gyung-Ho;Hwang, Seung-Bae
    • Journal of Korean Neurosurgical Society
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    • 제49권6호
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    • pp.370-372
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    • 2011
  • Dissection of the middle cerebral artery (MCA) is less frequent compared with dissection of the vertebrobasilar system or carotid artery. Recently, high-resolution cross sectional MR imaging (HRMRI) has emerged as a potential technique for atherosclerotic plaque imaging in MCA, We introduce the findings of HRMRI in a 56-year-old woman with traumatic MCA dissection, HRMRI showed an intimal flap and tapered pseudolumen with intra-luminal hemorrhage, We performed stent deployment about MCA dissection after failed medical treatment Three months later, there was no in-stent restenosis and no further neurological deficit were noted.

Clinical Assessment of Usefulness, Effectiveness and Safety of Kyejibokryung-hwan on Various Neuropathies

  • Park, Seong-Uk;Jung, Woo-Sang;Kim, Yun-Kyung;Moon, Sang-Kwan;Kim, Young-Suk;Bae, Hyung-Sup;Cho, Ki-Ho;Ko, Chang-Nam
    • 대한한의학회지
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    • 제27권4호
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    • pp.135-141
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    • 2006
  • We were to assess clinical effectiveness, safety and usefulness of Kyejibokryung-hwan (KBH), which has been used for Er-hyul similar with vascular or neurologic disorders causing sensory or motor abnormalities. This study is a retrospective single case series. Two hundred ninety five patients were treated with KBH for various neuropathies in our hospital. Of them, 120 cases were excluded because of insufficient medical records or failure to follow up; the remaining 175 were included in the analysis. There were 18 patients with sensory abnormalities and 28 with motor abnormalities after stroke. Of peripheral type, there were 14 with diabetic neuropathy, 12 with carpal tunnel syndrome, 41 with spinal radiculopathies, and 62 with idiopathic neuropathies, for which the effectiveness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 56.5%, respectively. Adverse effects including indigestion or diarrhea were seen in 3.4% of the total patients. Taking the effectiveness and the safety together into consideration, the usefulness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 54.8% for treating post-stroke sensory and motor abnormalities, diabetic neuropathy, carpal tunnel syndrome, spinal radiculopathies, and idiopathic neuropathies, respectively. In conclusion, we suggest that KBH is a useful herbal medicine for various neuropathies, especially of sensory type.

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고감도 범용성 콜리메이터를 이용한 소아 환자 99mTc-DMSA 신장 SPECT의 유용성 (Clinical Usefulness of 99mTc-DMSA Renal SPECT Using High Sensitivity-All Purpose Collimator for Pediatric Patients)

  • 김진의;김정수;한재복;최남길
    • 한국콘텐츠학회논문지
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    • 제16권3호
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    • pp.219-231
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    • 2016
  • 신장의 기능을 정량분석 할 수 있는 $^{99m}Tc$-DMSA 평면 영상은 단층영상에 비해 병소의 위치 정보에 한계가 있다. 따라서 광자 신호에 민감한 범용성 collimator로 교체하여 SPECT 방식으로 임상실험을 시행한 후, 진단의 정확도와 검사 소요시간을 분석하여 임상적용 가능성을 평가하였다. 10명의 실험대상에게 방사성의약품(1.0-1.2 MBq/kg)을 정맥주사하고, 이중 검출기 감마카메라를 이용하여 planar scan (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image)과 SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction)를 시행하였다. 획득한 데이터를 분석 프로그램을 이용하여 비교한 결과, 실험 방법에 따라서 total counts는 high sensitive-mode SPECT가 대략 1.8-5.6 배 정도 많았고, counts를 이용한 상대신장기능은 모든 실험에서 유의한 수준 범위에서 차이가 없었으며(p=0.96), 검사 소요시간은 39%정도 단축되었다. 그러므로 고감도 범용성 collimator를 이용한 $^{99m}Tc$-DMSA renal SPECT는 planar scan에 비하여 신장의 기능을 정량분석 할 수 있고, 병변의 위치에 대한 정보를 보다 정확하게 진단할 수 있으며, 동시에 검사 소요시간을 단축시킬 수 있으므로 임상적으로 유용하게 활용할 수 있을 것으로 사료된다.

Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach

  • Kim, Jung-Wook
    • Clinical Endoscopy
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    • 제51권6호
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    • pp.527-533
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    • 2018
  • There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is an innovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studies have demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared with conventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasion depth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopy with narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations with invasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imaging offers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitations of narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness in undifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use of endoscopic submucosal dissection for the treatment of gastric tumors.

경두개 자기자극과 확산텐서 신경섬유로 검사를 통한 대뇌 병변의 국소화: 증례보고 (Localization of Bilateral Hemisphere Lesion Using Combined Transcranial Magnetic Stimulation and Diffusion Tensor Imaging: Report of Two Cases)

  • 이형남;오영빈;김기욱;원유희;고명환;서정환;박성희
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.106-111
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    • 2018
  • Transcranial magnetic stimulation (TMS) has been a gold standard for investigating central motor pathways in humans. Diffusion tensor imaging with fiber tractography (DTI FT) is known for its usefulness in detecting white matter lesion in vivo. We investigated the clinical usefulness of elucidating the integrity and continuity of corticospinal tract (CST) by combined use of TMS and DTI FT in this study. We report two cases who have presented with left hemiparesis and evaluated by both TMS and DTI FT; 10-year-old boy with Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episode syndrome and 20-year-old woman with traumatic brain injury. Combined use of TMS and DTI FT successfully led to localize the brain lesion that might cause motor impairment in patients with abnormal signal intensities in MRI. The results of this study suggest that TMS and DTI FT might provide the detailed information between function and anatomy of the CST, complementarily.

의료기기에 대한 임상모니터링 기반의 지속적 품질개선: 치과용 임플란트의 사례 (Continuous Quality Improvement of Medical Equipments Based on Clinical Monitoring: A Case Study of Dental Implants)

  • 김명덕;엄태관;김영진
    • 품질경영학회지
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    • 제36권2호
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    • pp.59-66
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    • 2008
  • Dental implant has recently become one of the most viable treatment options for regaining the oral function and dental aesthetics compared with conventional fixed or removable dentures. Dental implants vary in material, dimensions, geometries, surface properties, and interface geometries. It has been reported that there has been a proliferation of manufacturers who produce implants using various materials and surface treatments, and the dentist needs to select from over 2,000 different dental implants and abutments in a specific treatment situation. Unfortunately, however, no metrics have been specifically identified for the purpose of quality assessment and selection of an appropriate dental implant. This study aims to provide practical guidelines for quality assessment of dental implant based on clinical data. Like other medical devices and materials, the superiority related to specific characteristics of the dental implant needs to be verified through extensive clinical studies. The procedures of clinical monitoring for dental implants have been proposed along with a case study to exemplify the usefulness of clinical monitoring for the purpose of continuous quality improvement in medical industry.