• Title/Summary/Keyword: Standardized patients

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Association between Medial Temporal Atrophy, White Matter Hyperintensities, Neurocognitive Functions and Activities of Daily Living in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병 및 경도인지장애 환자에서 내측두엽 위축, 대뇌백질병변, 신경인지기능과 일상생활 수행능력과의 연관성)

  • An, Min hyuk;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.67-76
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    • 2021
  • Objectives : The aim of this study was to compare activities of daily living (ADLs) according to degenerative changes in brain [i.e., medial temporal lobe atrophy (MTA), white matter hyperintensities] and to examine the association between neurocognitive functions and ADLs in Korean patients with dementia due to Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 111 elderly subjects diagnosed with AD or MCI in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. ADLs was evaluated with the Korean version of Blessed Dementia Scale-Activity of daily living (BDS-ADL). Neurocognitive function was evaluated with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). Independent t-test was performed to compare ADLs with the degree of MTA. Pearson correlation and hierarchical multiple regression analyses were performed to analyze the relationship between ADLs and neurocognitive functions. Results : The group with high severity of the MTA showed significantly higher BDS-ADL scores (p<0.05). The BDS-ADL score showed the strongest correlation with the word list recognition test among sub-items of the CERAD-K test (r=-0.568). Findings from the hierarchical multiple regression analysis revealed that the scores of MMSE-K and word list recognition test were factors that predict ADLs (F=44.611, p<0.001). Conclusions : ADLs of AD and MCI patients had significant association with MTA. Our study, which identifies factors correlated with ADLs can provide useful information in clinical settings. Further evaluation is needed to confirm the association between certain brain structures and ADLs.

Developing a Diagnostic Bundle for Bronchiectasis in South Korea: A Modified Delphi Consensus Study

  • Choi, Hayoung;Lee, Hyun;Ra, Seung Won;Jang, Jong Geol;Lee, Ji-Ho;Jhun, Byung Woo;Park, Hye Yun;Jung, Ji Ye;Lee, Seung Jun;Jo, Kyung-Wook;Rhee, Chin Kook;Kim, Changwhan;Lee, Sei Won;Min, Kyung Hoon;Kwon, Yong-Soo;Kim, Deog Kyeom;Lee, Jin Hwa;Park, Yong Bum;Chung, Eun Hee;Kim, Yae-Jean;Yoo, Kwang Ha;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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    • pp.56-66
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    • 2022
  • Background: Because the etiologies of bronchiectasis and related diseases vary significantly among different regions and ethnicities, this study aimed to develop a diagnostic bundle for bronchiectasis in South Korea. Methods: A modified Delphi method was used to develop expert consensus statements on a diagnostic bundle for bronchiectasis in South Korea. Initial statements proposed by a core panel, based on international bronchiectasis guidelines, were discussed in an online meeting and two email surveys by a panel of experts (≥70% agreement). Results: The study involved 21 expert participants, and 30 statements regarding a diagnostic bundle for bronchiectasis were classified as recommended, conditional, or not recommended. The consensus statements of the expert panel were as follows: A standardized diagnostic bundle is useful in clinical practice; diagnostic tests for specific diseases, including immunodeficiency and allergic bronchopulmonary aspergillosis, are necessary when clinically suspected; initial diagnostic tests, including sputum microbiology and spirometry, are essential in all patients with bronchiectasis, and patients suspected with rare causes such as primary ciliary dyskinesia should be referred to specialized centers. Conclusion: Based on this Delphi survey, expert consensus statements were generated including specific diagnostic, laboratory, microbiological, and pulmonary function tests required to manage patients with bronchiectasis in South Korea.

Study of the Difference in Residual Amounts according to the Method of Securing Intravenous Injections and the Dose of Physiological Saline during 18F-FDG Administration (18F-FDG 투여 시 정맥주사 확보 방법 및 생리식염수 용량에 따른 잔류량의 차이에 관한 연구)

  • Ryu, Chan-Ju
    • Journal of the Korean Society of Radiology
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    • v.16 no.2
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    • pp.95-102
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    • 2022
  • This study compares the difference between the remaining amount in syringes according to injection method and the dose of physiological saline when the radiopharmaceutical 18F-FDG isotope is injected into patients who visited the hospital for PET examination. After performing a CT or MRI using a contrast medium when 18F-FDG was injected into 40 patients who came to the hospital for PET examination without removing the 3-way, the radioactivity remaining in the syringe and the 3-way was measured and the dose of radioactivity confirmed. At this time, 20 patients were divided into different dose groups of physiological saline. Another injection method was used to compare the remaining amount of the syringe and the difference in the remaining amount according to the amount of physiological saline when the injection was performed with an extension. After an injection of 18F-FDG, the actual administered dose was confirmed by measuring the radioactivity remaining in the syringe and the 3-way or extension with a calibrator. As a result of measuring the radioactivity of the syringe before administering the radiopharmaceutical and the radioactivity of the syringe and the 3-way or extension after administration, the 3-way injection method in 10 cc's of physiological saline had the lowest residual amount. The remaining amount increased in the order of the extension to 10 cc's of saline and the 3-way to 5 cc's of saline. Likewise, the 5 cc's saline solution and the extension injection method demonstrated the highest residual amounts. The residual difference with the lowest level of remaining injection method was found to be 0.053 mCi. It was found that in a PET examination, by considering the radioactivity remaining in the 3-way and extension and by adjusting the dose of physiological saline, if the intended dose to be administered to the actual patient is determined, it is possible to administer the radiopharmaceutical to the patient more accurately.

Evaluation of Efficacy and Risk of Intradermal Skin Testing for Antibiotic Pharmacotherapy in Hospital of Korea (한국 병원의 항생제 치료를 위한 항생제피부반응시험에 대한 유효성 및 위험성 평가)

  • Kim, Kyeong Ha;Lee, Yun Jeong;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.4
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    • pp.229-244
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    • 2014
  • Background: Antibiotic skin test(AST) is very useful for the diagnosis of drug allergies to prevent immediate allergic reactions. Although it is a safe and widespread method, it is performed very diversely by doctors and nurses without consistency and it also differs from countries and hospitals. This study aims to evaluate the current practice of AST by nurses in Korea and to compare it to the general guidelines. Methods: During January 1, 2013 to May 20, 2013, the study was conducted as questionnaires and case-based survey. The questionnaires were given to the nurses who were randomly selected in various University Hospitals (University Hospitals N=276, and Medical center N=19). The case-based surveys were given to the nurses who were conducting AST at various wards of a University Hospital (N=130). The analysis and evaluations of the responses were carried out. Results: The response rate for the questionnaires was 97.6% and 130 cases of the actual case-based surveys were collected. There were clear differences between the survey results and the general guidelines, such as the method of skin test (skin prick test was not conducted), the method of patient selection for AST, test drugs, concentration, volume and interpretation of AST. AST conducted by nurses was highly variable and inconsistent, even among nurses who worked in the same wards and hospitals. Manufactured standard concentration antibiotic solution of AST showed consistency of concentration to a certain degree. Conclusion: Although the general guidelines have been published by several countries including Korea, these are not a great help to nurses as they lack details for conducting AST, practical consideration for nurses in the clinical setting, propagation and education. Standardized guideline for nurses should be published and it should be a safe, clear, comfortable and easily accessible protocol. Futhermore, additional antibiotic solutions to standardize skin test should be developed and manufactured. Lastly, it would be the pharmacists role to compare their hospitals antibiotic skin test methods with the standard guidelines and develop a protocol within the hospital for patients' safety, and to strive to consistently implement it.

System Analysis of Disease Classification of Oriental Medicine Diagnosis and Study for Improvement Method (한방진단명의 질병분류체계 분석과 개선방안 연구)

  • Lee, Hyun Ju;Park, Su Bock;Kim, Su Jin;Ko, Seung Yeon
    • Quality Improvement in Health Care
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    • v.12 no.2
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    • pp.84-92
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    • 2006
  • Background : To examine the difference between ICD-10 and The Korean standard classification of disease(oriental medicine), and to aim at improve the practical use as statistical data. It is one of the reason of disease classification. On that account we convert the many to many correspondence presenting classification of oriental medicine into many to one correspondence. Method : The study tracked out 155 patients discharged from the university hospital which is located in Gyeonggi Province and managing hospital and oriental medicine hospital from July to October this year. The period of this study was from August 1 to November 18. We compared correspondence between the two services' diagnosis(hospital services and oriental medicine hospital services) at the same time and attempted many to one correspondence classification. That is for production of statistical data. Result : We investigated the group which have had medical treatment experience of two kinds of services at the same time. The result of this investigation was that the same oriental medicine diagnosis used differently in western medicine diagnosis. 44.5% was accorded with western medicine diagnosis. Correspondence of the western medicine diagnose with the top of the Korean standard classification of disease(oriental medicine) list's western medicine diagnosis was 13.5%. For many to one correspondence classification for statistics, one western medicine diagnosis was selected for one oriental medicine diagnosis. In case of the main diagnosis(I sign) was not enough to explain oriental medicine diagnosis' characteristic, we chose multiple other diagnosis, so other diagnosis(II sign) about patient's cause of disease could be selected for supplement after we examined the patient's records. The statistics was possible with this many to one correspondence. Conclusion : The result of this study about correspondence between western medicine diagnoses and those of oriental medicine confirms that The Korean standard classification of disease(oriental medicine) is hard to be standardized with western medicine diagnosis. Therefore, according to this study, we use new many to one correspondence classification, multiple oriental medicine diagnoses with one ICD-10, which can be used by statistical data.

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The Effect of Metallic Dental Implant on Positron Emission Tomography Computed Tomography Image (금속성 치아충전물이 PET/CT영상이 미치는 영향)

  • Kim, Ki-Jin;Bae, Seok-Hwan;Han, Sang-Hyun;Yu, Se-Jong;Lee, Bo-Woo
    • Journal of Digital Convergence
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    • v.10 no.2
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    • pp.243-247
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    • 2012
  • Beam hardening artifact happens in the CT image. when a PET/CT is conducted while there is a metallic dental implant. The artifact appears in the CT image can affect the PET image. When the patient with head and neck cancer has a metallic dental implant, Beam hardening artifact which was taken in th CT image can change the PET image and SUV value. Therefore, by Quantitative measure of the SUV according to the change in HU by the metallic dental implant, the appropriacy in the clinical application was assessed. The records of 47 patients with PET/CT August 2011. For the analysis, 2 region of interest were defined in area where CT and PET image. As a result of the experiment, if there in an implant, the HU and the SUV increased and there existed a statistically significant difference(p<0.01). Although this level of increase was not large compared with that in the patient who have no metallic dental implant, when a person has head and neck cancer, it is even more likely to be overestimated when diagnosing the cancer. When conducting PET/CT for the patient who have head and neck cancer, the physical biological parts should be considered in order not to make an error in decoding.

Epidemiological Pattern of Breast Cancer in Iranian Women: Is there an Ethnic Disparity?

  • Taheri, Neger Sadat;Nosrat, Sepideh Bakhshandeh;Aarabi, Mohsen;Tabiei, Mohammad Naeimi;Kashani, Elham;Rajaei, Siamak;Besharat, Sima;Semnani, Shahryar;Roshandel, Gholamreza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4517-4520
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    • 2012
  • Introduction: Northeastern Iran is known as a high risk area of upper gastrointestinal cancers. Recent reports have suggested a declining trend for these cancers as well as an increase in the incidence of other malignancies including breast cancer. Our present aim was to describe the epidemiological pattern of breast cancer in this region during 2004-2009. Methods: All new cancer cases from public and private diagnostic and therapeutic centers of Golestan province were registered. A structured questionnaire was prepared and used based on the standerds of the International Association of Cancer Registries. The international classification of diseases for oncology was considered for coding. Age standardized incidence rates (ASR) of breast cancer were calculated. Results: A total of 11,038 new cancer cases were registered during 2004-2009, of which, 1,101 (10%) were females with breast cancer. The median age of the breast cancer patients was 46 years. The ASR for breast cancer was 28 per 100,000 person-years. We found an unusual rapid increase in breast cancer rate at the age of 25 years. The ASR of breast cancer was significantly lower in females from Turkmen ethnicity and those from rural areas(P value <0.01). Conclusion: Our study showed high rate of breast cancer in Golestan province of Iran. We found an unusual peak of breast cancer in young women. So, the age of starting screening programs may need to be revised in this area. The rate of breast cancer was significantly lower in women from Turkmen ethnicity. Further studies are warranted to clarify the role of important determinants, especially regarding the ethnic disparity, on breast cancer in this region.

A Systematic Review of the Dual-Task Training for Stroke With Hemiplegia (뇌졸중 환자에게 적용한 이중과제 훈련이 미치는 효과에 대한 체계적 고찰)

  • Lee, Yei-Jin;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.5 no.1
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    • pp.23-32
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    • 2016
  • Objective : To investigate the current international researches which identify the effect of stroke with hemiplegia after dual-task training Methods : We systematically examined journals published from 2007 to 2015, searching PubMed. Total 5 researches were selected for the analyses. Results : Selected studies were all in international journal and they used two group experimental design. In addition, all the paper got PEDro scores above 6. They conducted gait task for motor task, at the same time used various domain of cognitive task such as from sustain attention to working memory. The outcome measure tools used for evaluation by the standardized assessment tool and operational definition, further also included the assessment tool designed for the dual-task training such as a variety of tools make possible to assess various aspects of effect. Discussion : Dual-task training in this study was found to give a positive effect on the dual-task performance, as well as improving the motor and cognitive function in patients with stroke. However there were also limitation to the studies conducted so far. In order to apply the occupational therapy, this results can consider as the preliminary data which suggest supplement point and can be a evidence for effective treatment for stroke with hemiplegia.

Clinical Nutrition Services of a Long-term Care Hospital in Korea (전국 요양병원에서의 임상영양서비스 실태 조사)

  • Um, Mi Hyang;Lyu, Eun Soon;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Park, Yoo Kyoung
    • Korean Journal of Community Nutrition
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    • v.20 no.3
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    • pp.220-235
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    • 2015
  • Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

Prevalence of Dementia in the Elderly of an Urban Community in Korea (도시지역 노인들의 치매유병률에 관한 단면조사연구)

  • Na, Duk-L.;Yeon, Byeon-Gil;Kang, Yeon-Wook;Min, Kyung-Bok;Lee, Soo-Hyun;Lee, Sang-Suk;Lee, Mi-Ra;Pyo, Ok-Jung;Park, Chan-Byung;Kim, Sun-Mean;Bae, Sang-Soo;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.306-316
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    • 1999
  • Objectives: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. Methods: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase 1,356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and feinted Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. Results: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12,8%(age-adjusted rate: 13,0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.0-10.4%]), The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. Conclusions : These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.

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