• Title/Summary/Keyword: Patients' Evaluation

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A Study on Comparative Analysis of Mammography and Tc-99m MIBI Scintimammography for Dense Breast (치밀형 유방에서 유방특이감마영상검사의 유용성 평가)

  • Jeong, Eun-Mi;Kim, Ho-Seong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.76-79
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    • 2012
  • Purpose: This study was to evaluate usefulness of $^{99m}Tc$-MIBI scintimammography for dense breast by comparing concordance in test results between Tc-99m MIBI scintimammography and mammography whose effect was proved the most as an imaging tool depending on breast density and at the same time by examining limitation on evaluation depending on density of breast tissue. [Materials and Methods] In the period from December 2010 to July 2011, this study targeted 150 patients who took both of $^{99m}Tc$-MIBI scintimammography and mammography conducted by using breast gamma camera in this hospital. Breast density was classified to the four levels of pattern 1~4 based on the results of mammography. $^{99m}Tc$-MIBI scintimammography was conducted with the LCC, the RCC, the LMLO, and the RML one minute after intravenous injection of 99mTc-MIBI 7400 MBq (20 mCi) while analysis was made for concordance in test results of $^{99m}Tc$-MIBI scintimammography and mammography. [Results] Among the 150 patients, pattern 1 was found in 3 patients, pattern 2 in 44 patients, pattern 3 in 61 patients, and pattern 4 in 37 patients. There were 5 patients who showed the case where it was impossible to determine density of breast tissue due to foreign body inserted to breast. The concordance ratio of the results between $^{99m}Tc$-MIBI scintimammography and mammography was 95.5% for pattern 2, 95.1% for pattern 3 and 94.6% for pattern 4. This demonstrated that the concordance rate decreased according to the increase in breast density. [Conclusion] When there was limitation on evaluation of breast specific gamma imaging test results due to increased intake in breast tissue or surgical site, the concordance rate was 6.8% for pattern 2, 16.3% for pattern 3 and 18.9% for pattern 4. This demonstrated that the degree of limitation on evaluation of breast specific gamma imaging test results increased according to the increase in breast density.

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Effect of Frenulotomy in Tongue-Tie : Focused on Alveolar Sounds (설소대 단축증 아동의 설소대 절개술 전 후 치조음 발음 양상의 변화)

  • 안서지;양해동;김병철;신지철;고중화
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.5-11
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    • 2000
  • Background and Objectives : Tongue-tie, or partial ankyloglossia, is manifested by an abnormally short and thick lingual frenulum. Degree of tongue-tie varies from the mild to the rare, severe and its treatment of choice is frenulotomy. Theoretically tongue-tie can affect expression of alveolar sounds. The purpose of this study is to evaluate the degree of articulation problem and to evaluate the efficacy of frenulotomy itself on alveolar sounds in tongue-tie patients. Materials and Methods : Prospectively, the authors performed preoperative and postoperative speech evaluation using picture consonants test for tongue-tie patients. Percentage of consonants correct(PCC), mean value of each alveolar phoneme depends on articulation site were evaluated. for exclusion of other articulatory improving factors except of frenulotomy itself, postoperative picture consonants test was performed 1 month after surgery. Results : Preoperative speech evaluation was performed to 37(male 21, female 16) patients and postoperative speech evaluation was performed to 17(male 9, female 8) patients, the other 20 patients were follow-up loss. Low PCC was observed in tongue-tie patients and PCC of female was higher an at of male in 2-4 years old patients. Overall PCC was improved after frenulotomy. Preoperative mean value of liquids and fricatives was lower than the other alveolar phonemes(p<0.05) and it was improved postoperatively(p<0.05). Conclusion : Frenulotomy itself can improve the articulation of liquids and fricatives on short follow-up. Speech therapy would be needful for improvement of the other alveolar phonemes.

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Clinical evaluation of temporomandibular joint disorder after orthognathic surgery in skeletal class II malocclusion patients

  • Jang, Jin-Hyun;Choi, Sung-Keun;Park, Sung-Ho;Kim, Jin-Woo;Kim, Sun-Jong;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.139-144
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    • 2012
  • This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. Materials and Methods: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. Results: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from $34.5{\pm}2.1$ mm to $37.2{\pm}3.5$ mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. Conclusion: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

THE LITERACTURE REVIEW AND CLINICAL EVALUATION OF INTRAORAL APPROACH FOR SUBCONDYLAR FRACTURE (하악 과두하 골절시 구강내 접근의 문헌 고찰과 임상 연구)

  • Seo, Hyun-Soo;Hong, Soon-Min;Yoo, Seung-Eun;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.6
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    • pp.644-648
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    • 2008
  • Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach. Material and Method: Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up. Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm. Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.

The Indepth Analysis of Plate Waste for DM Diet Served in General Hospital (종합병원 환자 당뇨식의 찬반에 대한 심층적 분석)

  • 양일선;이해영;김정려;차지아
    • Journal of Nutrition and Health
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    • v.35 no.3
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    • pp.394-401
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    • 2002
  • The purpose of this study was to : (a) examine diabetic patients' sensory evaluation and food preferences, (b) analyze the portion sizes & plate wastes, (c) investigate the factors affecting plate wastes, and (d) determine the nutritional & mometary values of the plate wastes. A questionnaire for determining food preference and sensory evaluation was developed. Thirty-three diabetic patients who were hospitalized in Sanggye Paik hospital in Seoul were studied. Serving sizes and plate wastes were weighed by using an electric scale, and the CAN-Pro program was used to evaluate the nutritional value or the food consumed. The data were analyzed using the SAS package program for descriptive analysis, t-test, ANOVA, and the Pearson correlation. Using a five-point Likeu-type scale, the temperature s[ore ranged from 3.1 to 3.3 (1 : very poor, 5 : excellent), the preference store was 3.0-3.2 (1 : very dislike, 5:very like), the taste score was 2.9-3.2 (1 : very poor, 5 : excellent), and the amount of food served score was 2.8-3.0 (1 : too little, 5 : too much). Serving sizes were considered insufficient by patients because most of the DM diet was low in calories. Average plate waste for the DM diet was 26.2% of the total served, by weight, and was lower than that for patients consuming a normal diet, which was 30.3%, found in previous research. Those subjects who had been previously hospitalized and who wished to participate in a campaign for food waste reduction produced less plate waste than other groups (p<.05). Plate wastes of the DM diet were negatively correlated with taste, temperature, and preference, and were positively correlated with the amount served: however, these results were not statistically significant. It was found that diabetic patients consumed adequate levels of energy, protein, Ca, Fe, Vitamin B$_1$, Vitamin B$_2$, and niacin, but inadequate levels of Phosphorus, Vitamin A and Vitamin C. The plate wastes were calculated to be 26.2% of the total cost (₩ 3,489), which is ₩9l5. This represents a significant wastage of resources from the hospital. The results of this study could assist foodservice managers in both controlling food wastage, and improving the quality of hospital food services.

Development of an evaluation tool for the quality of nursing care in abdominal surgery patients (복부수술 환자간호의 질평가 도구 개발)

  • Lee, Byoung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.107-127
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    • 1998
  • The purpose of this study was to develop an evaluation tool for the quality of nursing care in abdominal surgery patient. The target subjects of the tool were adult patients having abdominal surgery under general anesthesia. Process-outcome framework was selected for the development of the tool in this study. The results were as follows. 1. Nine standards. 40 criteria and 88 indicators were developed. A standard was summary statement of the ideal level of excellencein a dimension of quality of nursing care. which could be evaluated by criteria. Several criteria indicated a specific standard and each criterion could be measured by observable and measurable indicators. 2. The standards were divided into two dimensions. One was process dimension which contained four standards(23 criteria), the other was outcome dimension which contatined five standards(17 criteria). 3. Average CVI was .985 at 9 standards. .947 at 40 criteria. and .987 at 88 indicators. 4. The evaluation tool for the quality of nursing care in abdminal surgery patients was a criterion-referenced tool. And data collection methods of the tool were investigation of patient's record and interview( or questionnaire) with the patients. 5. Interrater reliabilities of the tool were ; r= .7572 (agreement between two raters), and pI=.8487 (intraclass correlation between five raters who rated the 84 patients). 6. Internal consistency reliability ${\alpha}$ was .6194, which was obtained from 32 criteria. Eight criteria were missed in the analyzing process because of data omission. 7. Scores of the process and the outcome dimensions showed significant. but low correlation(r= .3759, p < .001). 8. There were significant differences in total scores between the hospitals and the departments of surgery(F = 15.233. p .0001). There was also significant interaction effect between hospitals and departments to total score(F = 8.396. p = .0001). Construct validity of the toool was verified by the known-group method. these kinds of difference were expected by the nursing experts participated in the study. From these results, more specific patient classification is suggested for the development of evaluation tool of the quallity of nursing care. And indicators to be used for objective measurement for the quality of nursing care must be developed.

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Comparison of WHO and RECIST Criteria for Evaluation of Clinical Response to Chemotherapy in Patients with Advanced Breast Cancer

  • Khokher, Samina;Qureshi, Muhammad Usman;Chaudhry, Naseer Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3213-3218
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    • 2012
  • When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.

Effectiveness of the ultrasonography in the evaluation following orbit wall reconstruction (안와벽 재건술 시행 후 평가방법으로서 초음파의 효용성)

  • Kim, Chang Yun;Yang, Jeong Yeol;Cheon, Ji Seon;Moon, Jae won
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.428-431
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    • 2009
  • Purpose: Blow out fracture resulting from facial trauma is of high frequency among facial bone fractures, and can cause severe complications. So, proper management and close observation after operation are needed. So far, Computed tomography has been the best choice in the evalution following orbit wall reconstruction. However, cost - effectiveness, accessibility to patients and hazard of radiation exposure of computed tomography require supplementary measure for the evaluation following orbit wall reconstruction. This study was performed to describe the effectiveness of ultrasonography in the evalution following orbit wall reconstruction. Methods: A retrospective study was performed on 40 patients who underwent orbit wall reconstruction from June, 2008 to July, 2008. The patients' ages ranged from 13 to 65 years (mean 27.5 years), and this group was compsoed of 27 male and 13 female patients. The follow up period ranged from 2 weeks to 28 weeks (mean 11weeks). Preoperatively, all fractures were diagnosed using computed tomography. Ultrasonography for all cases, and computed tomography for 2 cases were performed for evaluation following orbit wall reconstruction. Results: Reduction of herniated orbital soft tissue and orbit implant was identified by using ultrasonography in 38 cases out of 40 cases. In other cases which we could not identify the orbit implant, computed tomography was performed. Con clusion: Compared to computed tomography, ultrasonography is simple, inexpensive and convenient method. Ultrasonography can be used as supplementary measure to computed tomography in the evaluation following orbit wall reconstruction for elective patients.

Correlation of Cognitive Function, Activities of Daily Living and Driving Performance in Stroke Hemiplegic Patients

  • Kwak, Hosoung;Yoo, Chanuk
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.2
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    • pp.89-95
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    • 2020
  • Purpose : This study aims to evaluate the correlation of cognitive function, activities of daily living (ADL), and driving performance in stroke hemiplegic patients residing in Korea. Methods : Subjects of the study were 18 stroke hemiplegic patients admitted to hospitals situated in Seoul. A clock drawing test (CDT), a modified Barthel index (MBI), and a virtual reality driving simulator (Eca faros-driving simulator) were used to examine their cognitive function, their ADL ability, and their driving skills, respectively. Results : Driving skills of stroke hemiplegic patients were shown to be associated with the CDT evaluation tool (r=-.777) (p<.001), but they were found to have any correlation with MBI (r=-.022) (p>.05). Additionally, an individual's CDT showed that the driving simulator evaluation result (pass/fail) could be discriminated with a sensitivity of 100.0 %, a specificity of 40.0 %, and an accuracy of 66.7 %. The result confirmed that the CDT is a useful evaluation tool for screening driving ability in people with stroke. But the MBI did not show any significant results (sensitivity of 62.5 %, specificity of 40.0 %, and predicted the results of the simulator with 50.0 % of accuracy) (p>.05). Conclusion : This study shows that cognitive function influences the driving performance in people with stroke. Driving skills of stroke hemiplegic patients are seen to be highly related to CDT. In the field of driving rehabilitation, these findings could be useful for evaluating driving skills relating to CDT. Furthermore, the study results will set a guideline for domestic occupational therapists to use the evaluation tool for assessing driving abilities in people with stroke.

The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study

  • Myung Jin Jang;Woo Sung Choi;Jung Nam Lee;Won Bin Park
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.106-113
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    • 2024
  • Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.