• Title/Summary/Keyword: Standardized patients

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Electroencephalographic Characteristics of Alcohol Dependent Patients : 3-Dimensional Source Localization (알코올 의존 환자군의 뇌파 특성 : 3차원적 신호원 국소화)

  • Seo, Sangchul;Im, Sungjin;Lee, Sang-Gu;Shin, Chul-Jin
    • Korean Journal of Biological Psychiatry
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    • v.22 no.2
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    • pp.87-94
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    • 2015
  • Objectives The power spectral analysis of electroencephalogram has been widely used to reveal the pathophysiology of the alcoholic brain. However, the results were not consistent and the three dimensional study can be hardly found. The purpose of this study was to investigate characteristics of the three dimensional electroencephalographic (EEG) activity of alcohol dependent patients using standardized low resolution electromagnetic tomography (sLORETA). Methods The participants consisted of 30 alcohol dependent patients and 30 normal healthy controls. All the participants were males who had refrained from alcohol at least one month and were not taking any medications. Thirty two channel EEG data was collected in the resting state with eyes-closed condition during 30 seconds. The three dimensional data was compared between two groups using sLORETA for delta, theta, alpha, beta1, beta2, and beta3 frequency bands. Results sLORETA revealed significantly increased brain cortical activity in alpha, beta1, beta2, and beta3 bands each in alcohol dependent patients compared to normal controls. The voxels showing the maximum significance were in the left transverse temporal gyrus, left superior temporal gyrus, left anterior cingulate, and left fusiform gyrus in alpha, beta1, beta2, and beta3 bands respectively. Conclusions These results suggest that chronic alcohol intake may cause neurophysiological changes in cerebral activity. Therefore, the measuring of EEG can be helpful in understanding the pathophysiology of cognitive impairements in alcohol dependence.

Bluetooth based Portable Healthcare Gateway Development for Hypertention Patients (고혈압 환자를 위한 블루투스 기반의 포터블 헬스케어 게이트웨이 개발)

  • Kim, Jong-Tak;Soh, Jae-Young;Kim, Jong-Hun;Kang, Un-Gu
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.339-344
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    • 2013
  • With the increasing number of chronic disease patients, the importance of everyday health care has grown more significant. The study researchers expected it would help for patients' health improvement and healthcare service expansion if users check their vital signs in their daily lives and send the results to a medical center's servers through a specific device automatically. This thesis, in line with this idea, seeks to develop a portable healthcare gateway. The gateway is designed in a USB type and can transmit standardized data, operating regardless of a user's location and Personal Healthcare Devices (PHDs). The developed portable healthcare gateway provides effective services in ubiquitous environments to customers, which will improve the health of chronic patients.

Could Clinical Pathways Improve the Quality of Care in Patients with Gastrointestinal Cancer? A Meta-analysis

  • Song, Xu-Ping;Tian, Jin-Hui;Cui, Qi;Zhang, Ting-Ting;Yang, Ke-Hu;Ding, Guo-Wu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8361-8366
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    • 2014
  • This meta-analysis was performed to assess the implementation effects of clinical pathways in patients with gastrointestinal cancer. A comprehensive search was conducted in the Cochrane Library, PubMed, EMBASE, Web of Science and Chinese Biomedical Literature Database (from inception to May 2014). Selection of studies, assessing risk of bias and extracting data were performed by two reviewers independently. Outcomes were analyzed by fixed-effects and random-effects model meta-analysis and reported as mean difference (MD), standardized mean difference (SMD) and odds ratio (OR) with 95% confidence intervals (CI). The Jadad methodological approach was used to assess the quality of included studies and the meta-analysis was conducted with RevMan 5.1 software. Nine citations (eight trials) involving 642 patients were included. The aggregate results showed that a shorter average length of stay [MD = -4.0; 95% CI (-5.1, -2.8); P < 0.00001] was observed with the clinical pathways as compared with the usual care. A reduction in inpatient expenditure [SMD = -1.5; 95% CI (-2.3, -0.7); P = 0.0001] was also associated with clinical pathways, along with higher patient satisfaction [OR = 4.9; 95% CI (2.2, 10.6); P < 0.0001]. Clinical pathways could improve the quality of care in patients with gastrointestinal cancer, as evidenced by a significant reduction in average length of stay, a decrease in inpatient expenditure and an improvement in patient satisfaction. Therefore, indicators and mechanisms within clinical pathways should be a focus in the future.

A Survey on Health Status of Group Controlled Pulmonary Tuberculosis Patients -Application of Cornell Medical Index- (집단관리 결핵환자들의 건강실태조사 -코오넬 의학지수의 응용-)

  • Jung, K.J.
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.14-23
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    • 1978
  • This survey was conducted on a total 672 pulmonary tuberculosis patients who were registered at certain health center in Busan, during the period from July 15th to August 31st, 1977, based on Modified Cornell Medical Index(CMI) consisting of 70 questions. Number of 'Yes' response of an individual patients was collected by each large section of Modified CMI. The each number of 'Yes' response was standardized by mean of Z scoring. Z score was obtained by following formula. Z=50+10(Xi-m)/s M : means of 'Yes' response by each section for all subjects s : standard deviation of the mean Xi : number of 'Yes' response by each section in an individual patients The results of obtained were as follows: 1. The number of investigated cases were 672 (459 males and 213 females). The most prevalent group was 20-24 years old group as 18.4% by age, moderate advanced group as 50.8% by radiological diagnosis, INH+PAS+SM group as 34.7% by antituberculotics and unemployed group as 59.9% by occupation. By bacteriological examination of sputum, the rate of negative group was 60.5% and positive group was 39.5%. 2. Z score of complaints by sex was higher in female as 52.4 than in male as 48.9 in general. By radiological diagnosis, there was decreasing tendency with age in male but increasing tendency with age in female. 3. By age group, Z score of complaints was increasing tendency with age in male but there was non-significant differences in female. 4. By bacteriological examination of sputum, the Z score of complaints was increasing tendency with the more discharged bacteria in both sex generally. 5. By antituberculotics, INH group was revealed the highest Z score of complaints as 50.4 in male and INH+PAS group was the highest as 51.21 in female. 6. By occupation, agricultural and fisherman group was the highest as 53.5 and the next group was professional, technical and related workers, unemployed and sales workers in that order.

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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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FDG PET/CT Assessment of the Biological Behavior of Meningiomas

  • Park, Yong-Sook;Jeon, Byung-Chan;Oh, Hyung-Suk;Lee, Seok-Mo;Chun, Bong-Kwon;Chang, Hee-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.428-433
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    • 2006
  • Objective : We investigated the pattern of glucose uptake in meningiomas using $^{18}F$-fluoro-2-deoxy-D-glucose[FDG] PET/CT. It was hypothesized that the degree of glucose uptake in each tumor could predict the histologic grade. Methods : In 19 patients with meningiomas, the Ki-67 proliferative index, standardized uptake values[SUV] of FDG uptake, tumor to contralateral gray matter ratio[TGR] of SUV, tumor size, edema grade, vascular endothelial growth factor[VEGF] expression, histopathologic grade and the blood supply pattern were assessed. Results : Of the 19 meningiomas, 8 were meningothelial, 1 fibrous, 2 transitional, 1 psammomatous, 2 angiomatous, and 5 atypical. The tumor proliferative index of Ki-67, tumor size, and peritumoral edema were larger in the histopathologic grade-2 meninigiomas than in the grade-1 meningioma group. There were no significant differences in SUV and TGR between two groups. Tumor size and peritumoral edema were significantly larger in VEGF-positive tumors than in negative tumors. Conventional angiography was performed in 12 patients. Dural supply was noted predominantly in 2 patients. Four patients had mainly pial cortical supply patterns. In tumors with more pial supply, VEGF was more frequently positive. There was a significant relation between SUV and Ki-67 and between SUV and peritumoral edema. Conclusion : We found FOG uptake in meningiomas is associated with proliferative potential, however, no clear limits of SUV and TGR can be set to distinguish between grade-1 and grade-2 meningiomas, which makes the assessment of malignancy grade using PET scan metabolic imaging difficult in individual cases.

The Role of $^{18}F$-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess

  • Park, Seong-Hyun;Lee, Sang-Woo;Kang, Dong-Hun;Hwang, Jeong-Hyun;Sung, Joo-Kyung;Hwang, Sung-Kyoo
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.278-283
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    • 2011
  • Objective : The purpose of this study was to evaluate whether $^{18}F$-fluorodeoxyglucose positron emission tomography (FOG-PET) can be used to assess the therapeutic response of brain abscess. Methods : A study was conducted on 10 consecutive patients with brain abscess, Magnetic resonance imaging (MRI) with diffuse-weighted imaging (DWI) was performed at 3 and 6 weeks after surgical treatment and intravenous antibiotics therapy and FOG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FOG-PET standardized uptake values were analyzed and correlated with the response to therapy. Results : Aspiration or craniotomy with excision of the abscess followed by intravenous antibiotics for 6-8 weeks resulted in good recovery with no recurrence. In 10 patients, two had low signal intensity on the DWI; one had no uptake on FOG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FOG-PET imaging after 6 weeks antibiotics and underwent an additional 2 weeks of intravenous antibiotics. The remaining eight patients had high signals on the DWI. Four had no uptake on FOG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FOG was accumulated in a diffuse or local area corresponding to a high signal area within the DWI and 2 weeks of intravenous antibiotics was added. Conclusion : MRI plus FOG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.

Effects of Critical Pathway(CP) on the patients with Primary Total hip replacement(THR) (고관절 전치환술 환자의 Critical pathway적용효과)

  • Lee, Mi-Kyoung;Doh, Bok-Num
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.295-308
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    • 2002
  • Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

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Effects of a Cognitive Training Program on Cognitive Function and Activities of Daily Living in Patients with Acute Ischemic Stroke (인지훈련 프로그램이 급성 허혈성 뇌졸중 환자의 인지기능과 일상생활 수행능력에 미치는 효과)

  • Oh, Eun Young;Jung, Mi Sook
    • Journal of Korean Academy of Nursing
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    • v.47 no.1
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    • pp.1-13
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    • 2017
  • Purpose: The purpose of this study was to examine the effects of a cognitive training program on neurocognitive task performance and activities of daily living (ADL) in patients who had a stroke. Methods: The research design for this study was a nonequivalent control group non-synchronized design. Patients were assigned to the experimental (n=21) or control group (n=21). The experimental group received a 4-week cognitive training program and usual care (i.e., rehabilitation service), while the control was received usual care only. Cognitive function was measured with a standardized neurocognitive test battery and ADL was assessed at baseline and one and two months after completion of the intervention. Repeated measures ANOVA was used to determine changes in cognitive function and ADL over 2 months. Results: The interaction of group and time was significant indicating that the experimental group showed improvement in attention, visuospatial function, verbal memory, and executive function compared to the control group which had a sustained or gradual decrease in test performance. A significant group by time interaction in instrumental ADL was also found between the experimental group with gradual improvement and the control group showing no noticeable change. Conclusion: Findings show that the cognitive training program developed in this study is beneficial in restoring cognitive function and improving ADL in patients following a stroke. Further study is needed to investigate the long-term relationship between cognitive training participation and cognitive improvement and effective functioning in daily living.

The Effect of Individual Education for Hypertensives at Home on Knowledge of Hypertension, Attitude about Chronic Disease, Self-care Management And Blood Pressue. (개별접촉 교육이 고혈압 환자의 지식$\cdot$태도와 자기건강관리 이행 및 혈압 변화에 미치는 영향)

  • Kim Myung Soon;Yang Young Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.52-68
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    • 1995
  • This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

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