• Title/Summary/Keyword: Patient outcome

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Reliability and Validity of the Korean Version of Patient-Rated Tennis Elbow Evaluation (한국어판 환자 평정 주관절 외측상과염 평가서의 신뢰도와 타당도)

  • Lee, Dong-Rour;Kim, Jong-Soon
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.1
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    • pp.25-33
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    • 2014
  • PURPOSE: The purpose of this was to translate Patient-Rated Tennis Elbow Evaluation(PRTEE) into Korean and identify the reliability and validity of a Korean version of PRTEE. METHODS: The subjects of this study were 32 patients diagnosed with lateral epicondylitis. The subjects were surveyed using a Korean version of PRTEE three times: at the first visit, one week after, and two weeks after. This questionnaire consisted of 15 questions including 5 questions about pain and 10 questions about functions. Intraclass correlation coefficients were used to measure reliability and Cronbach's alpha coefficients were used to assess internal consistency. In addition, the validity of the survey results was examined by correlating a visual analogue scale with the outcome of holding without pain. RESULTS: Test-retest reliability of Korea version PRTEE was good total ICC= .962 (CI=.922-,982). Cronbach's alpha value for PRTEE was found to be .955 and it was statistically significant (p<.05). The positive correlation between PRTEE and VAS was moderate to high (r=.753, P=.00) and statistically significant. There was also a low significant negative correlation between PRTEE and PFG (r=-.362, P=.042). CONCLUSION: The Korean version of PRTEE had reliability and validity. Therefore, it is a useful measure to evaluate the conditions of patients with lateral epicondylitis.

Early and late Complications after Arterial Switch Operation for Transposition of the Great Srteries -7 Year Experience- (대혈관 전위증에 동맥치환술 후의 합豆증)

  • 안재호
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.746-751
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    • 1994
  • We reviewed our entire experience of 44 consecutive patients undergoing the arterial switch operation [ASO] for transposition of the great arteries [TGA] since March 1985.There were 28 patients with simple TGA[group I] and 16 with associated ventricular septal defect[VSD] [Group II] There were five hospital deaths[11.4%, 5/44], two related to single right coronary artery anatomy. There have been no late deaths. For group I hospital mortality was 14.3%[4/28], and for group II this was 6.25%[1/16]. Mean follow-up was 3.3 years[range 1 month to 8 years] and was completed for all patients. Actuarial survival at 7 years for hospital survivors was 85 $\pm$ 3.2 % in group I and 94 $\pm$ 3.5% in groupII. One patient has mild asymptomatic left ventricular outflow tract obstruction, and five patients [12.8 %,5/ 39] have right ventricular outflow tract gradients[RVOTO] exceeding 25 mmHg; only one patient has required reoperation for RVOTO. Mild neoaortic regurgitation is present in one patient. All survivors are currently in NYHA class I without medicalion, and all are in sinus rhythm. The ASO is associated with low operative risk and excellent medium-term outcome in most subsets of patients undergoing this operation. With more experience, improved results can be expected also in those patients currently at higher risk.

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A case of traumatic pseudoaneurysm of the internal carotid artery accompanying massive epistaxis: treated with detachable Coil (비출혈을 동반한 외상성 내경동맥 가성동맥류 1례 : Detachable Coil에 의한 색전술)

  • Park, Dong-Jin;Lee, Jun-Ho;Kim, Sun-Gon
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.35-41
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    • 2006
  • Traumatic pseudoaneurysm of the intracavernous internal carotid artery(ICA) is extremely rare, but it is life threatening condition because of massive recurrent epistaxis. Unfortunately, the prompt diagnosis and treatment of this disease are frequently delayed due to its rarity and variable latent period, so this disease is regarded as a challenge to clinicians. Optimal therapy for this diseases demands rapid suspicion for it and is essential in order to give the best functional outcome with minimizing its morbidity and mortality. The authors present a case of male patient with traumatic pseudoaneurysm of intracavernous ICA accompanying severe epistaxis. This patient was a 37-year-old male with unilateral blindness and recurrent massive epistaxis after suffering trauma to head. Computed tomography, MRI and carotid artery angiogram showed pseudoaneurysm of intracavernous ICA with sphenoid bone fracture. The patient was effectively managed with occlusion of the pseudoaneurysmal circulation by endovascular interventional embolization technique utilizing mechanically detachable tungsten coils.

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Failure of Fecal Microbiota Transplantation in a Three-Year-Old Child with Severe Refractory Ulcerative Colitis

  • Kumagai, Hideki;Yokoyama, Koji;Imagawa, Tomoyuki;Inoue, Shun;Tulyeu, Janyerkye;Tanaka, Mamoru;Yamagata, Takanori
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.214-220
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    • 2016
  • Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (${\times}2$) and via a nasoduodenal tube (${\times}4$) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.

Preliminary Surgical Results of Open Sella Method with Intentionally Staged Transsphenoidal Approach for Patients with Giant Pituitary Adenomas

  • Kim, Young-Zoon;Song, Yeung-Jin;Kim, Hyung-Dong
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.16-19
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    • 2005
  • Objective: This study is designed to evaluate the clinical outcome, the safety and the effectiveness of the open sella methods(OSM) with intentionally staged transsphenoidal approach(TSA) for giant pituitary adenomas(GPA). Methods: Eight patients with GPA were managed by the OSM with intentionally staged TSA. There were 5 nonfunctioning adenomas, 2 prolactin-secreting adenomas, and 1 growth hormone-secreting adenoma. Among them, 6 patients underwent two times of TSA, one patient underwent three times of TSA, and the other patient underwent two times of TSA followed by radiation therapy. The mean time interval between staged operations was 3.9 months except for one case. Results: Seven out of the eight patients with GPA treated with the OSM with intentionally staged TSA showed that the tumors were completely removed on magnetic resonance imaging and that they were free from headache and visual problem suffered previously. Only one patient experienced severe complications including panhypo-pituitarism, cerebrospinal fluid rhinorrhea and permanent diabetes insipidus. Conclusion: With the surgical treatment for 8 cases of GPA, which extended to the suprasellar and parasellar area, we suggest that the OSM with intentionally staged TSA is a safe and effective method in management for GPA.

Collective Experience: A Database-Fuelled, Inter-Disciplinary Team-Led Learning System

  • Celi, Leo A.;Mark, Roger G.;Lee, Joon;Scott, Daniel J.;Panch, Trishan
    • Journal of Computing Science and Engineering
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    • v.6 no.1
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    • pp.51-59
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    • 2012
  • We describe the framework of a data-fuelled, interdisciplinary team-led learning system. The idea is to build models using patients from one's own institution whose features are similar to an index patient as regards an outcome of interest, in order to predict the utility of diagnostic tests and interventions, as well as inform prognosis. The Laboratory of Computational Physiology at the Massachusetts Institute of Technology developed and maintains MIMIC-II, a public deidentified high- resolution database of patients admitted to Beth Israel Deaconess Medical Center. It hosts teams of clinicians (nurses, doctors, pharmacists) and scientists (database engineers, modelers, epidemiologists) who translate the day-to-day questions during rounds that have no clear answers in the current medical literature into study designs, perform the modeling and the analysis and publish their findings. The studies fall into the following broad categories: identification and interrogation of practice variation, predictive modeling of clinical outcomes within patient subsets and comparative effectiveness research on diagnostic tests and therapeutic interventions. Clinical databases such as MIMIC-II, where recorded health care transactions - clinical decisions linked with patient outcomes - are constantly uploaded, become the centerpiece of a learning system.

Patient Outcomes according to Blood Glucose Level in Neonates with Cardiovascular Surgery (심혈관 수술 신생아의 혈당수준에 따른 환아 결과)

  • Hwang, Jeong-Hye;Park, Hyoung-Sook
    • Child Health Nursing Research
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    • v.18 no.1
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    • pp.43-52
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    • 2012
  • Purpose: The purpose of this study was to provide basic data for suitable neonate blood glucose maintenance by investigating and analyzing the blood glucose level of post cardiovascular surgery neonates in the ICU for the effect of blood glucose levels on the following outcomes; ICU stay, hospital stay, mechanical ventilation time, morbidity, and mortality. Methods: The participants were 143 neonates in the ICU after having had cardiovascular surgery. The design for this study was an investigation of the blood glucose levels of the neonates and retrospective analysis of patient outcomes according to blood glucose level. Results: The results for the neonate groups showed that the factors of hospital stay, ICU stay, mechanical ventilation time and mortality, for the group with a blood glucose level over 140 mg/dL were longer and higher than for the group with blood glucose of less than 100 mg/dL or the group between 100-139 mg/dL. Conclusion: The results of this study indicate that when caring for neonates after cardiovascular surgery, it is important to recognize the influence of blood glucose levels on patient outcomes like hospital days, ICU stay, length of time on mechanical ventilation and mortality. Further, care guidelines for neonates' glucose level management need to be developed.

Avulsion Fracture of Navicular (주상골의 견열 골절)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Hwang, Seung-Keun
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.232-237
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    • 2003
  • The purpose of this article is to evaluate and analyze diagnosis and the clinical result of avulsion fracture of navicular. Eight patients operated from Jan. 1991 to June 2002 were evaluated retrospectively. Clinical tolerability, AOFAS score, patient's satisfaction were evaluated. Preoperative AOFAS score is $59.88{\pm}10.90$. Postoperative AOFAS score is $94.75{\pm}6.11$. All patient satisfied result of operation, and 5 patient return to training wihin 3 month. Navicula avulsion fracure is relatively rare. The small dorsal bone triangular fragment is best seen in lateral view radiographs and bone scan and/or computed tomography help corfirm diagnosis. Operative treatment is the method of choice because of shorter recovery time. Simple excision is enough to get a good clincal outcome.

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Combination of Korean Medicine Therapy to Treat Posttraumatic Knee Stiffness: A Case Report (외상 후 슬관절 강직에 대한 복합 한의치료의 경과: 증례보고)

  • Lee, Geon-Yeong;Seol, Jae-Uk;Jo, Hee-Geun;Kwon, Min-Gu;Jeong, Sin-Yeong;Kim, Jong-Hwan;Park, Eo-Jin
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.2
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    • pp.109-115
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    • 2017
  • The purpose of this study is to illustrate the potential for clinical improvement in treating a patient with a case of Posttraumatic Knee Stiffness with a combination of Korean medicine therapy. We treated the patient with acupuncture, electroacupuncture, CHUNA manual therapy and Interferential Current Therapy from $5^{th}$ December 2016 to $13^{th}$ January 2017 (total 29 times) by evaluating knee function with VAS score. After six weeks of treatment, this patient achieved effective outcome following the technique, showing that clinical symptom as able to walked and pain was relieved, VAS changed from 10 to 2 and the knee flexion ROM (active/passive) changed from 30/60 degrees to 120/140 degrees. This result shows that Korean Medicine therapy may be an effective option for Posttraumatic Knee Stiffness. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on Posttraumatic Knee Stiffness.

Korean Medicine Treatment for Developmental Dysplasia of the Hip in Adults: A Case Report (성인의 발달성 고관절 이형성증에 대한 한방치료: 증례보고)

  • Kim, Euibyeol;Kang, Kiwan;Kim, Minwoo;Jo, Dongchan;Ko, Younseok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.165-171
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    • 2020
  • The purpose of this study is to report the effect of korean medicine treatment for developmental dysplasia of the hip (DDH) in adults. A patient diagnosed with DDH had been treated with acupuncture, electroacupuncture, cupping therapy and chuna manual therapy for 8 weeks. The patient was evaluated by using range of motion (ROM) of hip joint, muscle strength of lower extremity, leg length, numeric rating scale (NRS) and Korean version of hip disability and osteoarthritis outcome score (K-HOOS). After the treatment, the patient had an improvement in the symptoms, pain, and activities of daily living of K-HOOS, especially the quality of life. In addition, NRS decreased from 7 to 4 points, and ROM and muscle strength also improved. The results of this study show that korean medicine treatment is effective and meaningful as one of the conservative treatment for DDH in adults.