• Title/Summary/Keyword: Standardized patients

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Prostate Cancer Epidemiology in a Rural Area of North Western Greece

  • Grivas, N.;Hastazeris, K.;Kafarakis, V.;Tsimaris, I.;Xousianitis, Z.;Makatsori, A.;Raptis, P.;Aspiotis, S.;Ioachim, E.;Ntemou, A.;Kitsiou, E.;Malamou-Mitsi, V.;Sofikitis, N.;Kordela, V.;Papandreou, C.;Agnantis, N.J.;Stavropoulos, N.E.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.999-1002
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    • 2012
  • Epirus is a rural area of North-Western Greece. We reviewed data from 4 hospitals for 4.975 patients who underwent prostate biopsy in Epirus in the twelve year period from 1999 to 2010. Two six -year periods were compared (1999-2004 and 2004-2010). All cases of prostate cancer confirmed by biopsy were recorded and age-standardized incidence rates per 100,000 males were calculated. We also recorded the clinical stage for patients diagnosed in our hospital and correlated this with PSA and Gleason scores. Percentage of positive prostate biopsies was also calculated. There were a total of 1714 new cases during 1999-2010 and the mean annual age-adjusted incidence was 34/100.000. The mean incidences during 1999-2004 and 2005-2010 were 26/100,000 and 42/100,000, respectively. The mean age at diagnosis was 74. The most common Gleason score was 6 and the prevalent clinical stage was T2. Median PSA at diagnosis was 10.8 ng/ml. There was a significant difference between stage cT4 and all other stages regarding PSA value (p=0.000). A positive correlation was found between Gleason score and PSA (p=0.013). These results are in accordance with the incidence rise recorded in neighboring countries of South-East Europe. However we should keep in mind the risk of overdiagnosis and the detection of low-risk cancers that would not have caused morbidity or death during a man's lifetime anyway.

Operative Treatment of Displaced Proximal Humerus Fractures with the Angular Stable Locking Compression Plate (각안정 잠김 압박 금속판을 이용한 전위된 근위 상완골 골절에 대한 수술적 치료)

  • Kim, Dong-Wook;Kim, Chong-Kwan;Jung, Sung-Won;Kim, Hyeon-Soo
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.27-34
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    • 2011
  • Purpose: We examined the clinical and radiological outcomes for displaced proximal humerus fractures that were treated with a PHILOS angular stable plate. Materials and Method: Forty four patients who underwent surgery between March 2007 and February 2010 were included in this study. All the cases were followed up for an average of 12 months. All the patients were examined and interviewed using the Visual Analog Scale (VAS) score, the Constant score and standardized X-rays to check the neck-shaft angle (NSA) and the presence of medial support. Results: The average Visual Analog Scale score was 2.8 points and the average Constant score was 70.5 points. The average neck shaft angle was $122.5^{\circ}$ and this was statistically significant between the good result group and the poor result group. There were 36 cases of the presence of medial support and 8 cases of the absence of medial support and the difference was statistically significant. Complications such as fixation failure happened in 12 cases. Conclusion: PHILOS angular stable plate fixation as an operative treatment for displaced proximal humerus fractures is a good and reliable treatment option.

Reverse Total Shoulder Arthroplasty: Where we are? "Principles" (견관절 역행성 인공관절 치환술의 원칙)

  • Noh, Kyu-Cheol;Suh, Il-Woo
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.105-110
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    • 2011
  • Purpose: The purpose of this article is to identify and understand the complications of RTSA and to review the current methods of preventing and treating this malady. Materials and Methods: Previous constrained prostheses (ball-and-socket or reverse ball-and-socket designs) have failed because their center of rotation remained lateral to the scapula, which has limited of the motion of the prostheses and produced excessive torque on the glenoid component, and this leads to early loosening. The Grammont reverse prosthesis imposes a new biomechanical environment for the deltoid muscle to act, thus allowing it to compensate for the deficient rotator cuff muscles. Results: The clinical experience does live up to the lofty biomechanical concept and expectations: the reverse prosthesis restores active elevation above $90^{\circ}$ in patients with a cuff-deficient shoulder. However, external rotation often remains limited and particularly in patients with an absent or fat-infiltrated teres minor. Internal rotation is also rarely restored after a reverse prosthesis. Failure to restore sufficient tension in the deltoid may result in prosthetic instability. Conclusion: Finally, surgeons must be aware that the results are less predictable and the complication/revision rates are higher in revision surgery than that in the first surgery. A standardized monitoring tool that has clear definitions and assessment instructions is surely needed to document and then prevent complications after revision surgery.

Role of PET in Evaluating Indeterminate Solitary Pulmonary Nodule with CT (CT상 악성여부가 불명확한 단일 폐결절에서의 양전자방출단층촬영술의 유용성)

  • Yoon, Seok-Boo;Choi, Joon-Young;Kim, Sun-Jung;Choi, Yong;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Sang-Eun;Kwon, O-Jung;Lee, Kyung-Soo;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.83-89
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    • 1997
  • About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We peformed FDG-PET studies in patients who had radiologically indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC), Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch-ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.

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A Study of Diabetic Control for Diabetic Patient in $^{18}F$-FDG PET ($^{18}F$-FDG PET 검사를 위한 당뇨 환자의 혈당 조절에 관한 연구)

  • Cha, Min-Kyeong;Nam, Ki-Pyo;Lee, Young-Hee;Choi, Jae-Min;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.57-61
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    • 2008
  • Purpose: $^{18}F$-FDG PET is to evaluate the tumor using glucose metabolism. Blood Glucose Level (BGL) is important factor that affects on a result of examination. But it often appears the distort result on diabetic patient due to a failure of BGL control. The aim of this study is to make a effective guideline for diabetic patient prescribed $^{18}F$-FDG PET and improve accuracy and reliability of examination. Materials and methods: A subject of study is 69 diabetic patients and divided them into 3 groups; 1) BGL is less than 120 mg/dl & performed PET, 2) BGL is over than 120 mg/dl & performed PET, 3) BGL is over than 120 mg/dl & not performed PET. And we investigated the type of diabetic medications and the time of dosage, whether they have meal or not. And we analyzed SUV of liver and mediastinum to recognize the effect of BGL on PET images. Results: As a methods to diabetic control, Amalyl showed high percentage of 27.5% in oral medication and Humulin R showed 14.5% in insulin. Their peak time was 2-3 hrs, 2-4 hrs and duration time was 24 hrs, 5-7 hrs. The number of that had a breakfast was 16, 7 mens (43.8%) couldn't perform PET as over 120 mg/dl and 5 mens (31.3%) performed PET as less than 120 mg/dl after they took a medication. When we set the SUV of normal for 1.5-2.0, 1.0-1.5 on liver and mediastinum, the percentage out of the range was 31.8%, 52.9%, 62.5% in 120-139 mg/dl, 140-159 mg/dl, 160-200 mg/dl respectively. Conclusions: We completed standardized guideline for diabetic patients. As a result of this study, improved customer satisfaction and increased economic benefits. It is expect to be a effective model in other PET centers.

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A Qualitative Study on Traditional Korean Medicine Treatment for Child Patients with Night Crying - With a Focus on Descriptions by Main Fosterers - (야제 환아의 한의치료에 대한 질적 연구 - 주양육자의 서술을 중심으로 -)

  • Kim, Hyejin;Jeon, Chaeheun;Kim, Eunji;Kim, Hyunho;Leem, Jungtae;Ryu, Suhyang
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.1
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    • pp.44-53
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    • 2018
  • Objectives This study sets out to examine treatment experiences of child patients with night crying based on the traditional Korean medicine. Also, the study traces the process in which clients chose traditional Korean medicine treatment, and proposes a possible future direction of Korean medicine treatment. Methods The investigator conducted a semi-standardized open-ended question interview with two main fosterers of a child who received traditional Korean medicine treatment for night crying, and examined two fosterers' experiences of a child with the traditional Korean medicine treatment. Their interviews were recorded with their facial expressions and acts for analysis. Collected data was analyzed based on the Grounded theory. Results The participants felt a sense of responsibility, worry, and fear for their children with night crying. They had easy access to traditional Korean medicine doctors who were in the community and had positive experiences with traditional Korean medicine treatment. They reported that some people had been forced to use traditional Korean medicine, had misunderstandings about traditional Korean medicine, and had prejudice that night crying is not a disease. They felt there was a room for improvement in terms of the high medical expenses and the absence of a cooperative system between Oriental and Western medicine. Conclusions As the first qualitative study on night crying based on the traditional Korean medicine treatment, this study proposed a future direction for traditional Korean medicine treatment for night crying in the shoes of fosterers. The findings showed that the fosterers chose traditional Korean medicine treatment for night crying child based on their feelings, accessibility and experiences with traditional Korean medicine. Fosterers felt a need for improvement of the general public's perceptions about Korean medicine treatment on night crying, and a cooperative system between Oriental and Western medicine.

Study on the Applicability of Thermography as Severity Measurement in the Patients with Osteoarthritis of the Knee (퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구)

  • Seo, Byung-Kwan;Ryu, Seong-Ryong;Kang, Jung-Won;An, Kyung-Eh;Lee, Jae-Dong;Choi, Do-Young;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Yun-Ho;Lee, Sang-Hoon
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.35-45
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    • 2005
  • Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index. Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, VAS were not correlated with the thermal differences of each region. Conclusion : Futher study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

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Nutritional Status of Recipients of Allogeneic Hemopoietic Stem Cell Transplantation by Types of Conditioning Regimen (동종 조혈모세포 이식환자의 이식 전 처치 형태에 따른 영양상태)

  • Kim Nam-Cho;Kim Hee-Seung;Choi So-Eun;Park Hyun-Jeong
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.191-202
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    • 2000
  • This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.

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The study on the abdominal temperature difference according to primary dysmenorrhea severity (원발성(原發性) 월경통(月經痛) 정도에 따른 하복부(下腹部) 온도차이(溫度差異) 연구(硏究))

  • Yoon, Young-Jin;Choi, Yun-Hui;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.3 no.1
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    • pp.6-14
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    • 2004
  • Purpose: We intended to research the relations between abdominal temperature and primary dysmenorrhea severity. Methods: We selected the 95 primary dysmenorrhea patients by means of screening test (first screening test-inquiry, second screening test-clinical test, additionally Waist-to-Hip ratio (WHR) by Inbody 2.0). 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 CV4 / CV17 and CV3 / CV12 and CV4 / CV12 and CV3. After that, we compared ${\Delta}T$ with primary dysmenorrhea severity evaluated by multidimensional scales (verbal rating scale modified from the one devised by Bibe roglu & Berhrman(VRS; B&B), multidimensional verbal rating scale by Andersch & Milsom(MVRS)). 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, MVRS score and 3-group-severity were not correlated to ${\Delta}T$. In case of VRS; B&B, VRS; B&B score was correlated to ${\Delta}T$ (CV12 and CV4 / CV12 and CV3) and 3-group-severity was correlated to ${\Delta}T$ (CV12 and CV3). Statistically they showed significant result (p<0.05). So we can consider that ${\Delta}T$ (CV12 and CV3) and the primary dysmenorrhea severity by VRS; B&B are most correlated. Conclusion: The primary dysmenorrhea patients showed that severity by VRS; B&B was connected with ${\Delta}T$ (CV12 and CV3). So we can consider DITI as primary dysmenorrhea evaluation instrument and must further research measurement points for the exact primary dysmenorrhea evaluation by DITI.

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Prediction of frontal soft tissue changes after mandibular surgery in facial asymmetry individuals (안면비대칭자의 하악골 악교정수술 후 정면 연조직 변화 예측을 위한 연구)

  • Hwang, Hyeon-Shik;Lee, Jessica J.;Hwang, Chung-Hyon;Choi, Hak-Hee;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.38 no.4
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    • pp.252-264
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    • 2008
  • Objective: To aid the development of a frontal image simulating program, we evaluated the soft tissue frontal changes in relationship to movement of hard tissue with orthognathic surgery of facial asymmetry patients. Methods: Preoperative and postoperative frontal cephalograms and frontal view photographs of 45 mandibular surgery patients with facial asymmetry were obtained in a standardized manner. Vertical and horizontal changes of hard tissue and soft tissue were measured from cephalograms and photographs, respectively. Soft tissue change in result to hard tissue change was then analyzed. Results: Both vertical and horizontal correlation analysis showed a weak relationship between the changes. Hard tissue points that were picked for 1 : 1 mean ratio with soft tissue points did not show any significant relevance. For each soft tissue change, regressive equation was formulated by stepwise multiple regression analysis, and the equation for soft tissue Menton was most reliable in predicting changes. Both vertical and horizontal hard tissue changes were used together in prediction of vertical or horizontal soft tissue change. Conclusions: The results suggest that computerized image simulation using regression analysis may be of help for prediction of soft tissue change, while 1:1 mean ratio method is not useful.