• Title/Summary/Keyword: Clinical characteristic

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Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

  • Dong, Wen;Liu, Xiguang;Zhu, Shunfang;Lu, Di;Cai, Kaican;Cai, Ruijun;Li, Qing;Zeng, Jingjing;Li, Mei
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.20-24
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    • 2020
  • BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

Abnormal Eye Movements in Patients with Dementia (치매 환자에서 나타나는 비정상적인 안구운동)

  • Kim, Hyun;Lee, Kang-Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.73-80
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    • 2007
  • Anumber of prior studies have reported eye movement dysfunction in patients with dementia. The eye movement test which is non-invasive can evaluate the local brain function quantitatively. Therefore, it can be a useful method for characterizing regional brain abnormalities of patients with dementia. The aim of this paper is to review the literatures on eye movement abnormalities in dementia patients. Saccade system dysfunctions in Alzheimer disease include increased latency, reduced accuracy, and increased antisaccade error rates. Patients with frontotemporal dementia showed impaired reflexive saccade inhibition and increased latency and errors of antisaccade task. And delayed initiation of voluntary saccades, slow saccades, and increased errors and latency on antisaccade task were found in Huntington's disease. Patients with Parkinson’s disease dementia and dementia with Lewy bodies have characteristics of impaired in both reflexive saccade execution and complex saccade performance. However, there were few reports of abnormal eye movements in Creutzfeldt-Jakob disease; they could be found at the later stages after symptoms of dementia came to be evident, and secondary to cerebellar and vestibular involvement. Slowing of saccades and hypometric saccades might precede the supranuclear limitation of vertical gaze in PSP. Dysfunction of voluntary eyelid movements was a characteristic finding of PSP as well. In conclusion, patients with dementia can show various abnormal eye movements and they are related with cortial and subcortical brain dysfunctions. The research on localization of brain relevant to each symptom can promise more clinical implications of eye movement of dementia.

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Through analyzing the health insurance data provided by Health Insurance Review & Assessment Service (HIRA) of Korea, understanding the characteristic of patient who were diagnosed somatic dysfunction and analysis of the current local status of the usage of code M99 (건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석)

  • Shin, Jae-Kwon;Joo, Han-Soo;Lee, Seong-Yup;Shin, Ye-Sle;Ko, Won-Il;Park, Ki-Byung;Kim, Min-Kyu;Ha, In-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.53-64
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    • 2016
  • Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

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The Analysis of Research Trend about Management of Low Back Pain (요통관리에 관한 연구동향 분석)

  • Hyun, Kyung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.51-60
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    • 1998
  • The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

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Anthropometric Analysis of the Mouth in Koreans (한국인 입에 대한 생체계측학적 연구)

  • Kim, Soon Heum;Kim, Na Yeon;Lee, Soo Hyang;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Lee, Jeong Yong;Song, Wu Chul;Koh, Ki Seok
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.139-146
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    • 2008
  • Purpose: The objective of this study is anthropometric analysis of mouth and lower face of Korean. The relationship of soft-tissue to underlying bony structures determine the overall aesthetics of the face. The goal of aesthetic surgery of the face is to achieve the ideal normal and enhance the aging face. The purpose of present study was to determine the change of the morphology of the mouth and lower face based on soft-tissue landmarks according to age group to facilitate prediction during aesthetic surgery. Methods: The standardized photographs of 2,018 healthy volunteers(18 to 79 years of age; 1,070 males, 948 females) were investigated. Age groups were classified into young, middle-aged, and elderly groups. Five and seven items were measured on frontal and lateral view photographs, respectively. Individual dimensions were compared in the three age groups and between males and females. Results: The width of mouth is 4.5 times larger than that of philtrum. Most of measured data decreased with age. However, woman's lip width of the mouth somewhat increased from the young to elderly. The width of lower face is 2.5 times larger than mouth in young age group and increased slightly from the young to middle-aged and thereafter slightly decreased to elderly group. Upper lip was more higher than lower lip and male lip was more higher than female. But male and female lip height is similar at old age. Conclusion: Most of Koreans showed prominent lower face because of the development or protrusion of the mandible. And the descent of soft-tissue around the mouth was one of the significant characteristics of senile change. The posterior retrusion of the subnasal was an another characteristic. This study will help to elucidate the age-related dimensional differences of the human being and to provide useful information for clinical applications in oral and aesthetic surgery.

Effects of Biodegradable Cephalexin Microspheres in Dry Cow Mastitis Therapy (젖소의 건유기 유방염 치료에 있어서 생분해 cephalexin microspheres의 효과)

  • Hwang, Cheol-Yang
    • Journal of Veterinary Clinics
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    • v.19 no.2
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    • pp.228-235
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    • 2002
  • Mastitis is the most costly disease results in lost milk production, decreased milk quality, milk discard, early culling of cows, drug costs and labor costs in dairy cow. Until now, a antibiotic administration at the end of lactation, dry cow therapy has been known the most effective and widely used mastitis control method. However, dry cow therapy do not control a new infection in the late dry and prepartum period because dry cow products have only persistent activity in the early dry period. Therefore, this study was conducted to evaluate clinical effect of sustained released biodegradable cephalexin microsphere using PLGA in bovine mastitis control during dry period. PLGA has been approved as controlled drug release system because of non-toxic, non-tissue reactive and bioerodible characteristics. This study revealed that cephalexin microsphere had a spherical shape with characteristic porous structure on the surface. Also, in vitro drug release studies are clearly observed that the release rate of cephalexin from PLGA microsphere decrease during the first 21 days after initial burst and then increase again between 3 and 4 weeks showing pulsatile releasing pattern. On the other hand, as tried in field the new infection rate, cure rate and mean SCC after parturition in cephalexin microsphere infused group were significantly differenced as compared to the control group. Accordingly, a sustained release of cephalexin from a biodegradable microsphere could make dry cow therapy more efficiently by preventing a new infection and decreasing the number of existing infection of mammary gland during dry period.

Spay-Related Urethral Sphincter Mechanism Incompetence Concurrent with Pituitary-Dependent Hyperadrenocorticism in a Bitch (암캐에서 부신피질기능 항진증 및 난소제거 이후 발생한 요도 괄약근 기능부전 증례)

  • Kang, Min-Hee;Kim, Ju-Won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.258-261
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    • 2011
  • An 8-year-old spayed female, Yorkshire terrier dog was presented with a urinary incontinence. Unaware urine dribbling during sleeping was observed eight months after spaying. Polyuria and polydipsia were also reported. Physical examination revealed obesity and hypertension. Characteristic laboratory findings in this dog were polycythemia, hyperlipidemia and elevated hepatic enzyme. Other causes of the urinary incontinence were ruled out through further diagnostic tests and spay-related urethral sphincter mechanism incompetence (USMI) was made as a presumptive diagnosis. In addition, the dog was also diagnosed with pituitary-dependent hyperadrenocorticism. Both conditions can cause urinary incontinence in dogs; therefore, definite diagnosis was made through a therapeutic approach. The synthetic estrogen, diethylstilbesterol, was initially administered and successfully managed the urinary incontinence in this dog. To the best of the author's knowledge, this is the first case report describing the clinical and laboratory features of spay-related USMI concurrent with hyperadrenocorticism and treatment outcomes in our country.

Statistical Study in 70 Cases for Dizziness Patients on the Effect of Jaeumgeonbi-tang Gamibang (자음건비탕가미방(滋陰健脾湯加味方)을 투여한 어지럼증 환자 70례에 대한 분석 및 고찰)

  • Lee, Jae-Hwi;Shin, Hyun-Su;Kim, Dong-Hyun;Jo, Chang-Hwan;Lim, Seung-Min;An, Joung-Jo;Jo, Hyun-Kyung;Kim, Yoon-Sik;Seol, In-Chan;Yoo, Ho-Rhyong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.1
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    • pp.171-176
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    • 2010
  • Jaeumgeonbi-tang Gamibang is noted as effective method to treat a dizziness in Korean Medicine. The main purpose of this research is analysis of the effects of Jaeumgeonbi-tang Gamibang on dizziness patients. In following research, 70 cases of dizziness patients who treated in Daejeon oriental medicine hospital from Oct, 2004 to Feb, 2009 were researched. The research is focused on clinical efficacy of Jaeumgeonbi-tang Gamibang. This research measured DHI and VAS before Jaeumgeonbi-tang Gamibang were prescribed. And Jaeumgeonbi-tang Gamibang were treated to all 70 patients. Finally DHI and VAS were measured again. Before this research, We had characterized and searched such as age, prevalence period, prescribed dosage, sex, vertigo type, pathological history in 70 patients. And DHI and VAS score were compared each other. The compared characteristic data shows that every cases were effective, in the DHI and VAS comparison, between pre-treatment and post-treatment group, vertigo and dizziness group, man and woman group. but In the age case, some age group were not effective. Conclusion: Most cases, we gained effective results. These result suggest that Jaeumgeonbi-tang might be effective in treatment of dizziness patients although man or woman, vertigo or dizziness.

Genotoxicity and Anti-Oxidative Effectiveness Study of Functional Food Additive Containing Astaxanthin (Astaxanthin 함유 기능성 식품소재의 유전독성 및 항산화능 검사)

  • Kim, Jun-Sung;Park, Jin-Hong;Jin, Hua;Cho, Hyun-Sun;Hwang, Soon-Kyung;Nah, Woon-Seong;Kang, Hwan-Goo;An, Gil-Hwan;Cho, Myung-Haing
    • Toxicological Research
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    • v.22 no.4
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    • pp.381-390
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    • 2006
  • Astaxanthine is a pigment that belongs to the family of the xanthophylls, the oxygenated derivatives of carotenoids whose synthesis in plants derives from lycopene. Astaxanthine is also a carotenoid widely used in salmonid and crustacean aquaculture to provide the pink color characteristic of that. Recent study reported that astaxanthine has the role as a detoxicant against the free radicals. On our study, we estimated the genotoxicity in ICR mice and possibility as antioxidant reagents of mutant Phaffia rhodozyma strain over expressing the astaxanthine by gamma-lay and carophyll pink including astaxanthine in apoE knock out mice, respectively. In our study, we administered Phaffia rhodozyma (2 mg and 3 mg) and carophyll pink for 4 and 8 week. The clinical sign and mortality were not detected compared with control groups. In the mutant frequency of hprt gene and chromosome aberration in splenic cells, there was not detected abnormality. There was not critical change in hematological and serum biochemical test compared to control. In expression level of repair enzyme, increase of catalase were detected and increase of expression level of Nrf-2 was detected in Phaffia rhodozyma (3 mg) and carophyll pink in 8 week treated group. In GSH level, the group of treated with Phaffia rhodozyma (3 mg) showed the increase of the GSH. In conclusion, mutant Phaffia rhodozyma and caphyll pink may be applied to the effective food additives to reduce the free radical.

An Evaluation Method of X-ray Imaging System Resolution for Non-Engineers (비공학도를 위한 X-ray 영상촬영 시스템 해상력 평가 방법)

  • Woo, Jung-Eun;Lee, Yong-Geum;Bae, Seok-Hwan;Kim, Yong-Gwon
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.309-314
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    • 2012
  • Nowadays, digital Radiography (DR) systems are widely used in clinical sites and substitute the analog-film x-ray imaging systems. The resolution of DR images depends on several factors such as characteristic contrast and motion of the object, the focal spot size and the quality of x-ray beam, x-ray scattering, the performance of the DR detector (x-ray conversion efficiency, the intrinsic resolution). The DR detector is composed of an x-ray capturing element, a coupling element and a collecting element, which systematically affect the system resolution. Generally speaking, the resolution of a medical imaging system is the discrimination ability of anatomical structures. Modulation transfer function (MTF) is widely used for the quantification of the resolution performance for an imaging system. MTF is defined as the frequency response of the imaging system to the input of a point spread function and can be obtained by doing Fourier transform of a line spread function, which is extracted from a test image. In clinic, radiologic technologists, who are in charge of system maintenance and quality control, have to evaluate or make routine check on their imaging system. However, it is not an easy task for the radiologic technologists to measure MTF accurately due to lack of their engineering and mathematical backgrounds. The objective of this study is to develop and provide for radiologic technologists a medical system imaging evaluation tool, so that they can measure and quantify system performance easily.