• Title/Summary/Keyword: Severity Score

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The effect of Chiljehyangbuhwan on the abdominal temperature in the primary dysmenorrhea patients (칠제향부환(七製香附丸)이 원발성(原發性) 월경통(月經痛) 환자(患者)의 복부(腹部) 온도(溫度)에 미치는 영향(影響))

  • Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Yoon, Young-Jin
    • Journal of Oriental Medical Thermology
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    • v.4 no.1
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    • pp.29-38
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    • 2005
  • Purpose: We intended to observe the relations between Chiljehyangbuhwan and abdominal temperature according to primary dysmenorrhea severity. Methods: We selected the 100 primary dysmenorrhea patients by the screening tests (first screening test-inquiry, second screening test-clinical test, additionally WHR (Waist-to-Hip ratio) by Inbody 2.0). By the fixed blocked randomization and double blind method, Chiljehyangbuhwan or placebo was administered for 1 menstration period. Finally, 69 patients remainded. Before and after administration, we measured 4 points abdominal temperature (Chon-jung(CV17), Chung-wan(CV12), Kwan-won(CV4), Chung-guk(CV3)) by DITI (DOREX Inc., USA). And then we checked the difference of temperature $({\Delta}T)$ between CV17 and CV12 / CV17 and CV4 / CV17 and CV3 / CV12 and CV4 / CV12 and CV3. After that, we compared ${\Delta}T$ with primary dysmenorrhea severity evaluated by VRS (verbal rating scale) and MVRS (multidimensional verbal rating scale). In dysmenorrhea severity, we standardized scale score and 3-group-severity by score (mild, moderate, severe). For statistics, we used Pearson correlations and Spearman's rho correlations, SPSS 11.0 for windows. Results: In case of MVRS, Chiljehyangbuhwan was correlated to ${\Delta}T$ (CV12 and CV3 / CV12 and CV4). In case of VRS, Chiljehyangbuhwan was not correlated to ${\Delta}T$. Statistically they showed significant result (p<0.05). Conclusion: The primary dysmenorrhea patients showed that severity by MVRS was connected with ${\Delta}T$ (CV12 and CV3 / CV12 and CV4) after Chiljehyangbuhwan administration. So we can consider Chiljehyangbuhwan effects the abdominal temperature according primary dysmenorrhea severity.

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Performance Evaluation of Emergency Medical Center (응급의료센터 성과 평가 기준개발과 적용)

  • Kang, Chul-Hwan;Kim, Yoon;Lee, Pyung-Soo;Kwon, Young-Dae;Kim, Chang-Yup;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.884-892
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    • 1997
  • Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion (중증외상환자에서 알코올 섭취에 따른 중증도와 예후에 대한 연구)

  • Jung, Ho Hyung;Han, Sang Kyoon;Lee, Sung Wha;Park, Sung Wook;Park, Soon Chang;Yeom, Seok Ran;Min, Moon Gi;Kim, Yong In;Ryu, Ji Ho
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.108-114
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    • 2014
  • Purpose: Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion. Methods: This study was performed retrospectively with severe traumatic patients (Injury Severity $Score{\geq}16$) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013. Results: In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group ($BAC{\leq}30mg/dl$) is 56 (57.10% )patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups. Conclusion: In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.

Effects of Trunk Stability Exercise and Hip Exercise on Lumbar Range of Motion, VAS, Disability Chronic Low Back Pain Patients (체간 안정화 운동과 고관절 운동이 만성 요통 환자의 허리가동범위, 통증, 장애정도에 미치는 영향)

  • Park, Chan-ho;Yang, Yeong-sik;Jeong, Yong-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.2
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    • pp.45-55
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    • 2022
  • Background: This study compared the effects of trunk stabilization exercise and hip joint exercises on the range of motion of the lumbar spine, pain severity, and severity of disability in patients with chronic lower back pain. Methods: A total of 30 participants were enrolled and divided into group 1 (n=10), group 2 (n=10), and group 3 (n=10) were performed by each group thrice a week for a total of 8 weeks. Group 1 performed warm-up exercise (15 min), trunk stabilization exercise (25 min), finish-up exercise (15mins). Group 2 performed warm-up exercise (15 min), hip exercise (25 mins, finish-up exercise (15mins). Group 3 warm-up exercise (15 min), trunk stabilization and hip exercise (25 min), Finish-up exercise (15 min). Participants were assessed for the range of motion of the lumbar spine, pain severity (visual analog scale score; VAS), and severity of disability (Oswestry disability index score; ODI) before and after the interventions. Results: All three groups showed a significant increase in the range of motion of the lumbar spine, but there was no significant difference among the groups. Moreover, the severity of pain and ODI were significantly decreased in all groups; however, the intergroup differences were non-significant. Conclusion: The results from this study confirmed the effectiveness of trunk stabilization and hip joint exercise in improving the lumbar range of motion, pain severity, and chronic lower back pain in patients. Thus, trunk and pelvic stabilization exercises and hip joint exercise can be used as clinical practices to treat and prevent chronic lower back pain.

Is it Meaningful to Use the Serum Cholinesterase Level as a Predictive Value in Acute Organophosphate Poisoning? (혈청 콜린에스테라제 활성도를 이용하여 유기인계 농약 음독 환자의 증증도를 예측할 수 있는가?)

  • Lee, Sang-Jin;Jung, Jin-Hee;Jung, Koo-Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.72-76
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    • 2004
  • Purpose: Dealing patients with organophosphate poisoning, cholinesterase level has been used as a diagnostic and prognostic value. But there are some controversies that the cholinesterase level is significantly related to the severity or prognosis of acute organophosphate poisoning. We evaluated the correlation between initial serum level of cholinesterase and APACHE II score as an index for severity, and we assessed cholinesterase levels for predicting value of weaning from mechanical ventilation. Method: From August 1996 to March 2003, 23 patients with organophosphate poisoning who needed ventilatory care were enrolled. Retrospective review was done for the serum level of cholinesterase, APACHE II score, and the duration of ventilatory care. The percentage of measured serum cholinesterase to median normal value was used to standardize cholinesterase levels from different laboratories. Result: There were tendencies that the lower initial serum of cholinesterase, the higher the APACHE II score (r=0.297) and the longer the duration of mechanical ventilation (r=-0.204), but they were not significant (p=0.264 and p=0.351 respectively). In 9 patients whose serum cholinesterase level were checked at the time of weaning, mean of measured cholinesterase level was $10.3\pm7.60\%$ of normal value. Conclusion: There was no significant relationship between initial level of serum cholinesterase and severity or duration of mechanical ventilation. General health status of patient, amount of ingestion, toxicity of agent should be considered as important factors for severity of poisoning. And the decision of weaning should be based not solely on the cholinesterase level but on the consideration of general and respiratory state of individual patients.

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A Clinical Study on Atopic Dermatitis (아토피 피부염에 대한 임상적 연구)

  • 남봉수;조재훈;김윤범;채병윤
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.204-215
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    • 2000
  • Objectives: This study was conducted to establish the study form of atopic dermatitis in oriental medicine, to find out the effect of herbal medicine and to compare Bangpungtongsungsan group with symptom-complexes prescription group. Methods: We gave scores(1-3) to the 37 outpatients who visited the dept. of Ophthalmotolaryngology & Dermatosurgery of the Kyunghee Oriental Medical Center from June 1,2000 to September 30, 2000. According to transformed the G. Rajka, T. Langeland and Jon M. Hanifin standard. We checked the Eosinophil count, IgE and the scores (intensity: the degree of itching, course: the degree of itching during a year, extent: erythema, lichenification, scaling. dryness, erosion' oozing). After herbal treatment for 6 weeks, we checked the above factors again in the same way. In treatment, we divided the patients into Bangpungtongsungsan group and Symptom-complexes group for cross-comparison. Results: There were 19 patients we could check by score and 14 patients by laboratory. 1. In the 14 lab cases, the number of abnormal value of Eosinophil count and IgE was decreased but it was not significant. 2. In the 19 cases by score, clinical severity of the intensity of itching, lichenification, scaling' dryness was significantly decreased between the before- and after-herbal treatment periods (P<0.01, P<0.01, P<0.05). 3. In 19 cases, clinical severity of erythema, erosion. oozing was decreased after herbal treatment but it was not significant(p>0.05). 4. In point of total score, clinical severity of atopic dermatitis was significantly decreased after herbal treatment(p<0.01). 5. There was no significant difference between Bangpungtongsungsan group and Symptom-complexes group(P<0.05). Conclusions: Although more study is needed, these results indicate that herbal treatment is effective on atopic dermatitis.

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A Study on comparison of menstrual pattern according to Mibyeong Index of Korean women in their thirties and forties (30-40대 여성의 미병상태에 따른 월경양상 비교연구)

  • Park, Minyoung;Oh, Hyunjoo;Hwang, Minwoo
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.1
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    • pp.61-72
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    • 2019
  • Introduction : The aim of this study was to investigate menstrual pattern according to Mibyeong Index(MBI) and compare Mibyeong symptom score according to severity of menstrual pain. Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms(fatigue, pain, low sleep quality, indigestion) and mental distress including anxiety, anger, depression. Method : We used the clinical data of Korean medicine Date Center(KDC) for subjects who participated in the study of 'Clinical research for collecting of clinical cases based on the personal type of Mibyeng' conducted in Seoul, from June 26, 2015 to June 26, 2017. A total of 566 fertile women aged 30 to 50 who completed the questionnaires were included in this study. In this study, we used items of Mibyeong Index and the menstrual pattern by self-report questionnaires. The date were analyzed through Kruskal Wallis test, Pearson's chi-square test, and one-way ANOVA using SPSS statistics 19.0. Results : Mibyeong status was significantly associated with severity of menstrual pain(p<0.001), worst day of menstrual pain(p<0.05), and type of menstrual pain(low back pain, nausea, depression, and none (respectively, p<0.05)). In addition, The 7-subtype score (fatigue (p<0.001), pain(p<0.001), low sleep quality(p<0.001), indigestion(p<0.001), anxiety(p<0.05), anger(p<0.05) and depression(p<0.05)) of Mibyeong index and total score of Mibyeong Index (p<0.001) showed significant difference for severity of menstrual pain. Conclusion : This result indicates that a close relationship between Mibyeong status and severity of menstrual pain. Further studies are needed but, we hope that this results will be used as the basic data to improve mibyeong status through health care to alleviate dysmenorrhea.

Severity Measurement Methods and Comparing Hospital Death Rates for Coronary Artery Bypass Graft Surgery (관상동맥우회술의 중증도 측정과 병원 사망률 비교에 관한 연구)

  • Ahn, Hyung-Sik;Shin, Young-Soo;Kwon, Young-Dae
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.3
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    • pp.244-252
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    • 2001
  • Objective : Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. Methods : The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHE III and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. Results : The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and $R^2$ than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. Conclusion : These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.

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Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital

  • Kim, Kyoung Hwan;Han, Sung Ho;Chon, Soon-Ho;Kim, Joongsuck;Kwon, Oh Sang;Lee, Min Koo;Lee, Hohyoung
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.1-7
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    • 2019
  • Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region. Methods: We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups. Results: No significant differences were found in the annual patients' average age ($54.1{\pm}20.0$ vs. $52.8{\pm}18.2$, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958). Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.

Systemic Inflammation Response Syndrome Score Predicts the Mortality in Multiple Trauma Patients

  • Baek, Jong Hyun;Kim, Myeong Su;Lee, Jung Cheul;Lee, Jang Hoon
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.523-528
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    • 2014
  • Background: Numerous statistical models have been developed to accurately predict outcomes in multiple trauma patients. However, such trauma scoring systems reflect the patient's physiological condition, which can only be determined to a limited extent, and are difficult to use when performing a rapid initial assessment. We studied the predictive ability of the systemic inflammatory response syndrome (SIRS) score compared to other scoring systems. Methods: We retrospectively reviewed 229 patients with multiple trauma combined with chest injury from January 2006 to June 2011. A SIRS score was calculated for patients based on their presentation to the emergency room. The patients were divided into two groups: those with an SIRS score of two points or above and those with an SIRS score of one or zero. Then, the outcomes between the two groups were compared. Furthermore, the ability of the SIRS score and other injury severity scoring systems to predict mortality was compared. Results: Hospital death occurred in 12 patients (5.2%). There were no significant differences in the general characteristics of patients, but the trauma severity scores were significantly different between the two groups. The SIRS scores, number of complications, and mortality rate were significantly higher in those with a SIRS score of two or above (p<0.001). In the multivariant analysis, the SIRS score was the only independent factor related to mortality. Conclusion: The SIRS score is easily calculated on admission and may accurately predict mortality in patients with multiple traumas.