• Title/Summary/Keyword: Disturbance score

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The Clinical Characteristics of Electrolyte Disturbance in Patients with Moderate and Severe Traumatic Brain Injury Who Underwent Craniotomy and Its Influence on Prognosis

  • Geng Huan Wang;Yu Yan;He Ping Shen;Zhengmin Chu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.332-339
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    • 2023
  • Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

Assessment of Cognitive Disorders in Alcoholics Using the 7 Minute Screening Battery (주정의존 환자에서 7분선별검사를 이용한 인지장애의 평가)

  • Cheon, Jin-Sook;Yoon, Han-Cheol;Lee, Kwang-Young;Oh, Byoung-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.258-265
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    • 2001
  • Objectives : Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function, learning and short-term memory, visuospatial performance function, perceptuo-motor skills, and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. Methods : The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=3 : as well as in age and education level matched healthy male controls(N=30). Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. Results : 1) The average scores of four individual test of the 7MS for the alcoholics were $2.77{\pm}4.38$ for the Benton Temporal Orientation Test, $13.90{\pm}2.02$ for the Memory Test(the Cued Recall $6.77{\pm}1.94$, the Uncued Recall $7.10{\pm}2.45$), $5.84{\pm}1.86$ for the Clock Drawing, and $12.58{\pm}3.29$ for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score <24 were 9.68%. The average(${\pm}S.D.$) score of the MMSE-K for the patient group($27.23{\pm}2.62$) was significantly(p<0.001) lower than that of the healthy controls($29.20{\pm}1.24$). There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score <24(N=3) and those of alcoholics with the MMSE-K score ${\geq}24$(N=28). 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking, blood magnesium concentration, liver function and thyroid function. Conclusion : Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.

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Factors Influencing Quality of Life during Chemotherapy for Colorectal Cancer Patients in South Korea (항암화학요법을 받고 있는 한국 대장암 환자의 삶의 질 영향 요인)

  • Baek, Yongae;Yi, Myungsun
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.604-612
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    • 2015
  • Purpose: The purpose of this study was to investigate the levels of physical symptoms, anxiety, depression, and quality of life (QOL) during chemotherapy for colorectal cancer patients in South Korea and to identify factors influencing their QOL. Methods: Data were collected from 144 colorectal cancer patients receiving chemotherapy during 2012 at one general hospital located in Seoul. Physical symptoms were measured by the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, and anxiety and depression were measured by the Hospital Anxiety Depression Scale. QOL was measured by the Functional Assessment of Cancer Therapy-Colorectal. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, $Scheff{\acute{e}}$ post hoc test, Pearson correlation and stepwise multiple regression. Results: Mean age of the participants was 56.6 and most of them were not employed. In terms of cancer stage, 38.2% were in stage 3, followed by stage 4 (34.7%). The most frequent symptom was lack of appetite, followed by sleep disturbance and fatigue. The mean score for anxiety was 5.40 with a prevalence of 23% and that of depression 8.85 with a prevalence of 64.6%. The mean score for quality of life was 81.93 out of 136 and 75.3% of the variance in QOL was explained by depression, symptoms, anxiety, treatment place, and occupational status. Depression was the strongest predictive factor. Conclusion: Oncology professionals need to pay special attention to relieving depression as well as physical symptoms to improve QOL during chemotherapy for colorectal cancer patients.

A Case Report of Chronic Cystitis Treated with Bojoongikkitang-gamibang -Evaluated by the International Prostate Symptom Score- (보중익기탕가미방(補中益氣湯加味方)으로 호전된 만성 방광염 환자 처험1례 -IPSS 변화를 중심으로-)

  • Park, Song-Kee;Song, Kwang-Kyu;Jeon, Kwi-Ok;Cho, Dong-Hee;Shin, Hyeon-Cheol;Kang, Seok-Bong;Kwon, Eun-Hee
    • The Journal of Internal Korean Medicine
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    • v.26 no.2
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    • pp.475-481
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    • 2005
  • Objectives: This study was designed to evaluate the effects of an oriental medicine therapy, namely Bojoongikkitang-gamibang, on a chronic cystitis patient. Methods: The clinical data was analyzed on a patient with chronic cystitis due to Bigiheoyak(脾氣虛弱) and Junggihaham(中氣下陷) whose main symptoms were urinary disturbances, such as urgency, weak stream, hesitancy and nocturia, etc. The patient visited twice at the internal medicine department of Dae-Gu Hanny University Dae-Gu Oriental Medicine Hospital on May 20, and on June 3, 2004 and was only treated with herbal medicine(Bojoongikkitang-gamibang). Results: After treatment, improvement was seen in the subsection of the International Prostate Symptom Score(IPSS). Conclusions: This study suggests that Bojoongikkitang-gamibang is significantly effective in treatment of a chronic cystitis.

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The Effects of GLS(Gleditsiae spina) Treatment on Hematological and Cytopathological Alterations in Non-Bacterial Prostatitis Rat Model (조각자가 만성 비세균성 전립선염 Rat 모델에서 혈액 및 세포조직의 변화에 미치는 영향)

  • Jung, Gi-Hun;Chang, Sun-Kyu;Choi, Jung-Sik;Cho, Chung-Sik;Kim, Chul-Jung
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.779-790
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    • 2007
  • Objective : Although chronic non-bacterial prostatitis is a common disease, it is very difficult to treat effectively. GLS (Gleditsiae Spina) has traditionally been used in treatment of urinary tract inflammation and voiding disturbance. In this study, we investigated the therapeutic effects and action mechanism of GLS in the rat model of non-bacterial prostatitis induced by castration and testosterone treatment. Method : We observed four experimental objects of normal group, control group, testosterone group, and GLS group. Rats were treated with 17$\beta$-estradiol after castration for induction of experimental non-bacteral prostatitis, which is similar to human chronic prostatitis in histophatological profiles. GLS and testosterone were administered as an experimental specimen and a positive control, respectively. The prostates were evaluated by histopahological parameters including the epithelial score and epithelio-stromal ratio for glandular damage. Also, the prostates were observed by hematological alterations of WBC, RBC, hemoglobin, hematocrit and platelet. Results : While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with GLS showed a diminished range of tissue damage. Epithelial score was improved in GLS over that of the control. The epithelial-stromal ratio was lower in GLS when compared to that of the control. Conclusion : These findings suggest that GLS may protect the glandular epithelial cells. We concluded that GLS could be a useful remedy agent for treating chronic non-bacterial prostatitis.

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Anlysis of Fatigue Perceived by the Hospitalized Children's Mother (입원 환아의 어머니가 자각하는 피로)

  • Park In-Sook;Kim Shin-Jeong;Kang Kyung-Ah;Kim Tae-Hee
    • Child Health Nursing Research
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    • v.10 no.1
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    • pp.80-88
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    • 2004
  • Purpose: The purpose of this study was to explore the fatigue of the mothers of the hospitalized children's mothers in descriptive study. Method: Two hundred eighty three mothers who take care of the hospitalized children in three University hospitals were enrolled from June, 1 to October, 30, 2003. Data were collected using a questionnaire titled 'Symptom Table on Fatigue Perception' designed by the Fatigue Research Committee of Japan, consisted of a total 30 items categorized into three sub-dimensions: the physical, the psychological and the neuro-sensory. SPSS was used for the analysis of data with 0.05 of significance. Result: 1) The mean average fatigue score of subjects was 1.94(SD:.48): the physical fatigue revealed the highest value with a mean of 2.19(SD:.57), followed by psychological fatigue with a mean score of 1.85(SD:.52), neuro-sensory fatigue with a mean of 1.79(SD:.51). 2) With the respect to the general characteristics of hospitalized children and mothers, there were statistically significant differences in the mothers' fatigue perception by the child sex(t=-2.697, p=.008), the character of child(F=9.032, p=.000), the child condition compared to pre-hospitalization(F=3.523, p=.031), with or without support in domestic households(t=-1.981, p=.049), the amount of sleeping time(t=2.704, p=.007), and with or without of night-time sleep disturbance because of the child hospitalization(t=2.082, p=.038). Conclusion: These results suggest that health care professional need to be aware of the persistent presence of the maternal fatigue related to the child hospitalization and the factors worsen the degree of the fatigue.

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DIAGNOSTIC EFFICACY OF MENTAL NERVE SEP(SOMATOSENSORY EVOKED POTENTIALS) FOR THE INJURED INFERIOR ALVEOLAR NERVE (하치조신경 손상시 턱끝신경 체성감각유발전위검사의 진단적 유용성에 관한 연구)

  • Jeong, Hyeon-Ju;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.250-257
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    • 2001
  • Sensory dysfunction following the injury of the inferior alveolar nerve requires objective examination to get a reproducible data and to provide necessary treatment. This study was designed to evaluate if the SEP(somatosensory evoked potentials) of the mental nerve can be used as an objective method for the diagnosis of nerve injury and sensory disturbances. The subjects were nineteen patients ($37.4{\pm}11.3$ years old) who had been suffered from sensory disturbance of the unilateral lower lip and mental region for over 6 months after the inferior alveolar nerve injuries confirmed by the microsurgical explorations. The clinical neurosensory tests as SLTD(static light touch discrimination), MDD(moving direction discrimination), 2PD(two point discrimination), PPN(pin prick nociception) and accompanied pain were preceded to electro-physiologic examinations as SEP. The score of sensory dysfunction (sum score of all sensory tests) ranged from 0 to 8 were compared to the latency differences of the mental nerve SEPs. The correlation between clinical sensory scores and SEPs were tested by Spearman nonparametric rank correlation analysis, the differences in SEP latency by Kruskal-Wallis test and the latency differences according to PPN and accompanied pain by Mann-Whitney U test. This study resulted that the difference of the latencies between normal side and affected side was $2.22{\pm}2.46$ msec and correlated significantly with the neurosensory dysfunction scores (p=0.0001). Conclusively, the somatosensory evoked potentials of the mental nerve can be a useful diagnostic method to evaluate the inferior alveolar nerve injuries and the change of sensory dysfunction to be reproduced as an objective assessment.

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Transcultural Research for Mental Health between the Rural Population of Nepalese and Korean (농촌거주 네팔인과 한국인의 정신건강에 관한 횡문화적 연구)

  • Kim, Young-Uck;Cheung, Seung-Douk
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.142-158
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    • 1991
  • In order to make transcultural research mental health centered on anxiety and depression between two centuries of which psychosocial factors are different, the author studied 698 Nepalese in Dolka in January 1990 and 417 Korean of Chungdo and Kyungju in Korea from July to August 1990 by using the Combined Self-Rating Anxiety Depression Scale(CSADS). The author applied t-teat and ANOVA to compare these two groups. The results were as follows : The total scores of Nepalese scored $51.27{\pm}11.10$ while Korean Scored $44.29{\pm}11.79$. The anxiety-depresion scores relating to the items of restlessness, depressed affect, appehension, crying spells and fatigue were significantly high in Nepalese, while fatigue, sleep disturbance, dissatisfaction, dizziness, and anxiousness were significantly high in Korean. Both groups showed an increase of score with age. The item relating to education, the scores of the CSADS was significantly high in lower education level in Nepal but Korean showed no significant difference among education level. The score of the CSADS above 50 (clinically significant level) was seen in 361(51.7%) Nepalese and 116(27.9%) Korean, which shows the proportion of Nepalese are significantly higher than that of Korean..

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Surgical management of male genital lymphedema: A systematic review

  • Aulia, Indri;Yessica, Eva Chintia
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.3-8
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    • 2020
  • Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.

Breast Conserving Therapy and Quality of Life in Thai Females: a Mixed Methods Study

  • Peerawong, Thanarpan;Phenwan, Tharin;Supanitwatthana, Sojirat;Mahattanobon, Somrit;Kongkamol, Chanon
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2917-2921
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    • 2016
  • Background: To explore factors that influence quality of life (QOL) in patients receiving breast conserving therapy (BCT). Materials and Methods: In this sequential mixed methods study, 118 women from Songklanagarind Hospital were included. We used participants' characteristics, Body Image Scale (BIS), and Functional Assessment of Cancer Therapy with the Breast Cancer Subscale (FACT-B) for analysis. The BIS transformed into presence of body image disturbance (BID). Factors that influenced QOL were determined by stepwise multiple linear regression. Forty-one participants were selected for qualitative analysis. Our female researcher performed the semi-structured interviews with questions based on the symbolic interaction theory. Final codes were analysed using thematic analysis along with investigator triangulation methods. Results: Ninety percent had early stage breast cancer with post-completed BCT, for an average of 2.7 years. The median BIS score and FACT-B score were 2 (IQR=10) and 130 (IQR=39). In the regression analysis, an age of more than 50 years and BID were significant factors. As for the value of conserved breasts, two themes emerged: a conserved breast is an essential part of a participant's life and also the representation of her womanhood; the importance of a breast is related to age. Conclusions: Body image influenced QOL in post BCT participants. The conserved breasts also lead to positive and better impact on their body image as an essential part of their life.