• Title/Summary/Keyword: Pre-diagnosis

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A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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The Effect of Group Sensory Integration Therapy on Motor Skill and Social Function of Children With Developmental Disorder (그룹 감각통합치료가 발달장애 아동의 운동기능 및 사회성 증진에 미치는 영향)

  • Han, Mi-Yea;Chang, Ki-Yeon;Kim, Ji-Youn;Han, Su-Yeon
    • The Journal of Korean Academy of Sensory Integration
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    • v.7 no.2
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    • pp.23-35
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    • 2009
  • Objective : The purpose of this study is to understand whether group Sensory Integration(SI) therapy has the effect on improvement of motor skill and social function for children with developmental disorder. Method : The subjects were recruited among children received sensory integration therapy at a Children's Development Institute in Dae-Jeon, experimental group is total 5 participating in group sensory integration therapy and control group is also 5 participating in individual sensory integration therapy. The program was constructed for 90 minutes and all children either in the experimental or in the control group went through intervention for 20 weeks. Bruininks-Oseretsky test of Motor Proficiency II, Korean-Scales of Independent Behavior-Revised and Social Maturity Scale were used in order to evaluate the degree of improvement in motor skill and social function. Results : Most children in the experimental group showed improvement in overall aspects of motor skill and the social function comparing pre-intervention with post-intervention, but they did not show any statistically significant differences. However, comparing experimental group with control group, children in the experimental group showed improvement in motor skill and social function. Furthermore, there is statistically significant improvement especially in manual coordination, manual dexterity, and social age and social quotient in Behavior-Revised and Social Maturity Scale. Conclusions : It is found that a group Sensory Integration therapy program has effect on motor skill and social function for children with developmental disorder in this study. In the future study, group SI therapy should be applied for children with diverse diagnosis in order to generalize the effectiveness of therapy.

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The Research about the Classification System Improvement and Cord Development of Korean Classification of Disease on Oriental Internal Medicine (한국표준질병사인분류중 한방내과영역의 분류체계 개선 및 진단명 구성에 관한 연구)

  • Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.31 no.1
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    • pp.1-10
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    • 2010
  • Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.

Radiation Exposure Dose Reduction on Upper Gastrointestinal Series (위장조영검사에서 피폭선량 저감)

  • Lim, Byung-Hak;Chon, Kwon Su
    • Journal of the Korean Society of Radiology
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    • v.11 no.2
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    • pp.109-116
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    • 2017
  • Upper gastrointestinal series is non-invasive examination, and it is useful for patients or elderly patients who have difficulty in endoscopic examination because of absence of any side effects other than temporary constipation or abdominal pain. The entire image of the gastrointestinal tract can be seen and have been widely used in the diagnosis of upper gastrointestinal diseases. However, there is a possibility that radiation dose increases due to improper movement and breath control, when examination is carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. In upper gastrointestinal series to increase understanding of examination, to induce appropriate cooperation during examination, to reduce the number of retakes and shorten examination time, and to reduce dose of the subject, the procedure and precautions of the gastrointestinal test were made as a movie. We investigated the effectiveness of pre-education using the movie to reduce the inspection time, the number of re-shoots, and the reduction of exposure dose by watching the movie during the waiting time before examination. 120 patients that were selected each 20 patients aged from 30s to 80s were evaluated were evaluated for exposure dose, examination time, and the number of retakes before and after the movie training. The radiation dose, the examination time, and the number of retakes were respectively $3171.83{\mu}Gy{\cdot}m^2$ and $2931.73{\mu}Gy{\cdot}m^2$, 8.05 min, and 6.75 min, and 1.68 times and 1.22 times before and after movie training. It can be concluded that the movie training on the gastrointestinal examination influences the reduction of the examination time, the number of retakes and the reduction of the radiation dose.

Left Ventricular Systolic Function Improvement after Surgical Revascularization in Postinfarction Angina (급성 심근 경색 후 협심증 환자에서의 관상동맥 우회술 후 좌심실 수축 기능의 호전)

  • Yi Gi-Jong;Park Seong-Yong;Hong You-Sun;Yoo Kyung-Jong;Chang Byung-Chul;Lim Sang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.674-680
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    • 2006
  • Background: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who under-went surgical revascularization under diagnosis of acute MI. Material and Method: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. Result: WMSI decreased from $1.54{\pm}4.30\;to\;1.43{\pm}0.40$ (p<0.001) and LVEF increased from $48.1{\pm}12.2%\;to\;49.7{\pm}12.3%$ after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p=0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). Conclusion: Coronary artery by-pass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.

The Clinical Study on the Visual Acuity and Cornea of ez-NANOsence II RGP Contact Lens (ez NANOsence II RGP 콘택트렌즈의 시력과 각막에 미치는 임상적 연구)

  • Kim, Douk-Hoon;Bae, Han-Young;Han, Mung-Gyo
    • Journal of Korean Ophthalmic Optics Society
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    • v.12 no.4
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    • pp.55-69
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    • 2007
  • The purpose of this study was to perform a clinical test using ez NANOsence II RGP contact lenses for the effects of visual acuity and cornea on subjects with abnormal refraction status. One hundred twenty one adults (twenty nine males, ninety two females, range = 17 to 43, mean = 22.86) were recorded. The subject's history including, the symptoms from previous lens wear, were studied. The subjects were observed, both pre and post lens wear, for any symptoms and signs of change of the eye. The Visual acuity and the binocular status were tested at the far distance using the contact lens. The refraction test was performed on the naked eye using the objective method (Topcon KR-8100, Japan). The Stereopsis test was performed at the near distance after contact lens wear by the Titmus fly (Stereo Optical Co., U.S.A) and TNO (TECH, The netherlands). The contrast sensitivity diagnosis was performed at 1m distance after contact lens wear by the contrast sensitivity chart (pelli-Robertson, USA). The corneal topography was analyzed on the naked eye after lens wear by ORB scan (Bausch Lomb, U.S.A.). The ultra structure of surface on the contact lens was observed using SEM (JMS-5800, Japan). The chemical component's of the contact lens was analyzed by EDS program. The results of this study were as follows: 1. The longer of contact lens wear period, The subjects have acquired the most improved visual function. 2. Subjects had experienced few side effects wearing the contact lenses. 3. The lenses were easy to use by the subjects. 4. The longer of contact lens wear period, the power of cornea had more decrease. but the base curve of cornea had more increase and corneal astigmatism was decrease (p<0.01). Also, the thickness of corneal center was few decrease. 5. Longer periods of using the contact lens showed stereopsis and contrast sensitivity at more normal values. 6 The corneal topographical after lens wear showed most subjects with similar morphology for different wear periods. 7. The surface ultrastructure of the new and used contact lens was the similar fine shape. 8. The chemical component's of in the new and used contact appeared to have similar results. In conclusion, this study showed that the surface ultrastructure and chemical component's of the new and used contact lens are similar. In addition, the subjects had improved the quality of vision and few experienced any side effects during long periods of contact lens wear. Also they have decrease of corneal astigmatism during the long period of lens wear. Our test has showed that the chemical composition and fine structure of contact lens have related to the visual function on contact lens wearer. In this paper, we suggested that ez NANOsence II RGP contact lenses had a moderate effect for correcting vision of abnormal refraction eye.

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Salmonellosis in Children in Daejeon, Korea, 1994~1999 (대전지역 살모넬라증 환아에 대한 임상적 연구(1994~1999년))

  • Chun, Jung-Soo;Lee, Kyung-Yil;Lee, Hyung-Shin;Kim, Sang-Yong;Han, Ji-Whan;Her, Jae-Kyun;Whang, Tyung-Tai
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.211-217
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    • 2000
  • Purpose : Salmonellosis including typhoid fever is still prevalent in Korea. Recently it has been reported that the incidence of salmonella gastroenteritis is increasing with a reduction of typhoid fever. We studied the clinical and laboratory features of salmonellosis. Methods : We evaluated the clinical records of 83 patients with salmonellosis who had been confirmed by stool culture from 1994 to 1999. Results : Annual incidence of salmonellosis showed an increasing tendency during recent 4 years. Seasonally, summer(45.8%) was the most prevalent, followed by fall(32.5%). Male to female ratio was 1.4 : 1. In age distribution, 64 cases(77.1%) were under 5 year-old, and 18 cases(21.7%) were younger than 1 year-old. Clinical features included diarrhea(96.4%), fever(91.6%), vomiting(49.4%), bloody stool(42.1%), abdominal pain(40.1%) and tenesmus(12.0%). In serogroups, there was no group A and group B, group C, group D(including 2 cases of S.typhi) and group E were in 41.0%(34 cases), 3.6%(3 csaes), 51.8%(43cases) and 3.6%(3 cases), respectively. In Widal test, 5 cases(13.5%) and 1 case(2.7%) of group B, C and E(total 37 cases) were observed the O titer above 1 : 80 and 1 : 320, respectively. However, in 36 cases of group D, 19 cases(52.7%) and 9 cases(25.0%) were above the O titer 1 : 80 and 1 : 320, respectively. Antibiotics resistant rates to ampicillin, trimethoprim/sulfamethoxazole and chloramphenicol were 23.2%, 10.1% and 51.4%, respectively. Conclusion : Salmonellosis has become a common cause of gastroenteritis in children, especially under the pre-school age. Isolation of salmonella is neccessary for accurate diagnosis of gastroenteritis and typhoid fever. A careful attention of the use of antibiotics is needed to reduce the muilti-drug resistant strains.

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Antineutrophil Cytoplasmic Antibody in Korean Children with Henoch-$Sch{\ddot{o}}nlein$ Purpura (소아 Henoch-$Sch{\ddot{o}}nlein$ 자반증에서의 항호중구 항체)

  • Choi, Ji-Na;Shin, Jae-Il;Lee, Jae-Seung;Kim, Hyon-Suk
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.164-169
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    • 2008
  • Purpose : There have been some reports on the prevalence of positive antineutrophil cytoplasmic antibody(ANCA) in Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the results were conflicting. We performed this study to evaluate the clinical significance of ANCA(c-ANCA and p-ANCA) in Korean children with HSP. Methods : The medical records of 30 patients(13 boys and 17 girls) aged 6.0$\pm$1.9(5-12) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2008, the sera from children with acute HSP were tested for antineutrophil cytoplasmic antibodies(ANCA). The target antigens of these autoantibodies are proteinase 3(c-ANCA) or myeloperoxidase(p-ANCA). Results : Palpable purpura was seen in all 30 patients(100%), abdominal pain in 20(67%), arthralgia in 17(57%), and renal involvement in 11(37%). Laboratory findings showed leukocytosis in 4 patients(13%), thrombocytosis 18 in(60%), and elevated erythrocyte sedimentation rate in 18(60%). Anti-streptolysin O titers were elevated in 7% of the patients and no patient showed elevation of serum IgA level. The sera from 29 patients were negative for c-ANCA and p-ANCA by indirect immunofluorescence, but only one patient had weakly positive results, which became negative at follow-up. Conclusions : We conclude that c-ANCA or p-ANCA is not an important serologic marker in children with HSP, because it was neither diagnostically nor immunologically specific in children with HSP. These results suggest that ANCA are not involved in the pathogenesis of HSP in children.

Trends in Rapid Detection Methods for Marine Organism-derived Toxins (해양 생물 유래 독소의 나노 기술 기반 신속 진단법 개발 동향)

  • Park, Chan Yeong;Kweon, So Yeon;Moon, Sunhee;Kim, Min Woo;Ha, Sang-Do;Park, Jong Pil;Park, Tae Jung
    • Journal of Food Hygiene and Safety
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    • v.35 no.4
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    • pp.291-303
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    • 2020
  • Marine organism-derived toxins have negative effects not only on human health but also in aquaculture, fisheries, and marine ecosystems. However, traditional analytical methods are insufficient in preventing this threat. In this paper, we reviewed new rapid methods of toxin detection, which have been improved by adopting diverse types of nanomaterials and technologies. Moreover, we herein describe the main strategies for toxin detection and their related sensing performance. Notably, to popularize and commercialize these newly developed technologies, simplifying the process of pre-treating real samples real samples is very important. As part of these efforts, numerous studies have reported pretreatment methods based on the antibody-immobilized magnetic nanoparticles, and some cases have applied nanoparticles to enhance the sensing performance by utilizing the intrinsic catalytic activity. Furthermore, some reports have introduced fluorescent nanoparticles, such as quantum dots, to represent the lower detection limits of conventional enzyme-based colorimetric methods and lateral flow assays. Some studies using electrochemical measurements based on aptamer-nanoparticle complexes have also been announced. In addition, as the response to new toxins generated by changes in the marine environment is still lacking, further research on diagnostic and detection is also greatly needed for these kinds of marine toxins and their derivatives.

A Study of Esthetic Facial Profile Preference In Korean (한국인의 연조직측모 선호경향에 대한 연구)

  • Choi, Jun-Gyu;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.32 no.5 s.94
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    • pp.327-342
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    • 2002
  • Soft tissue profile is a critical area of interest in the development of an orthodontic treatment and diagnosis. The purpose of this study was to determine the facial profile preference of diversified group and to investigate the relationship between most Preferred facial Profile and existing soft tissue reference lines. A survey instrument of constructed facial silhouettes was evaluated by 894 lay person. The silhouettes had varied nose, lips, chin and soft tissue subnasale point. Seven sets of facial type were computer-generated by an orthodontist to represent distinct facial types. The varied facial profiles were graded on the basis of most preferred to least preferred. Every facial profile were measured by soft tissue reference lines(Ricketts E-line, Burstone B-line) to observe the most preferred facial profile. The results as follows: 1. In reliability test, the childhood group showed lower value than other groups, which means that this group has no concern on facial profile preference. 2. It appears that sexual and age difference made no significant difference in selecting the profile 3. An agreement to least preferred facial profile was higher than an agreement to most preferred facial profile. 4. Coefficient of concordance (Kendall W) was higher in the twentieth group. It means that a profile preference of the twentieth is distinct. 5. A lip protrusion (to Ricketts E-line and Burstone B-line) of most preferred facial profile was similar to measurements of previous study that investigate skeletal and soft tissue of esthetic facial profile of young Korean. So these reference lines can be used valuably in clinics. 6. Profile of excessive lip protrusion or retrusion to E-line & B-line was least preferred. 7. Most preferred profile of all respondents group was straight profile. Profile that showing convex profile was not pre(erred and the least preferred profile was concave profile.