• 제목/요약/키워드: clinical indicator

검색결과 419건 처리시간 0.026초

Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.99-102
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    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

종양전문간호사의 성과지표 사용현황 및 성과평가에 대한 인식도 (Oncology Advanced Nurses' Use of Outcome Indicators and Perception of Outcome Evaluation)

  • 성영희;황문숙;이영희
    • 간호행정학회지
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    • 제18권2호
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    • pp.189-201
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    • 2012
  • Purpose: The purpose of this study was to explore the use of outcome indicators and perception of outcome evaluation of oncology advanced practice nurses (APNs). Method: A total of 111 oncology APNs from hospitals which have over 400 beds were surveyed. The participants' use of outcome indicators and perception of outcome evaluation were collected using a questionnaire including 84 outcome indicators for APNs developed by Sung et al. and 13 items on APNs' contribution to the hospitals developed by Kleinpell (2005). Data were analyzed using descriptive statistics, t-test, and $x^2$ test. Result: Twelve items out of 84 outcome indicators were used over 50% of the time and 57 items could be used in the future by the participants. Seven of the 10 top-ranking outcome indicators in use were education related and were also expected to be used frequently in the future. The score for participants' perception of outcome evaluation was average-high, 3.82 out of 5. Conclusions: The results of the study show that the main outcome indicator for oncology APNs is education related, and thus the use of education related outcome indicators is recommended to make oncology APNs' activities be more visible.

초기 당뇨병성 다발신경병증에서 비복/척골 감각신경활동전위 진폭 비의 진단적 유용성 (The Usefulness of Sural/Ulnar Amplitude Ratio in the Diagnosis of Early stage of Diabetic Polyneuropathy)

  • 장영희;노학재;안무영;문희수;배종석;김병준
    • Annals of Clinical Neurophysiology
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    • 제5권1호
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    • pp.34-38
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    • 2003
  • Backgrounds and Objectives: In the length-dependent axonal polyneuropathy like diabetic polyneuropathy (DPN), the distal part of the longer axons are affected earlier. In cases of minimal distal axonal changes, nerve conduction studies (NCS) are frequently normal. If sural nerve is affected in the early stage of DPN, supportive parameters to detect the early axonal degeneration may be helpful. We investigated whether the sural/ulnar SNAP amplitude ratio (SUAR) may be a more sensitive indicator than sural amplitude alone in the diagnosis of early diabetic polyneuropathy. Methods: We analyzed medical records and electrophysiological studies of 141 patients with DM and 30 healthy subjects. The patients with early stage of DPN were defined as those having symptoms of neuropathy and normal NCS findings among the patients with DM. We compared SUAR between 57 patients with early stage of DPN and 71 agematched control subjects. Results: Fifty seven patients had an average SUAR of 0.8, compared to that of 1.1 in the 71 normal controls. The SUAR of less than 0.9 was supplementary predictor of axonal polyneuropathy, with the best balance of sensitivity and specificity (70%). The SUAR did not vary significantly with age, height or duration of DM. Conclusions: We conclude that the SUAR is a useful electrodiagnostic indicator to detect early stage of DPN.

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3차병원에서의 TPN 사용의 적정성 점토 (Evaluation of Total Parenteral Nutrition in Tertiary Hospital)

  • 민경아;손기호;서옥경;최경업
    • 한국임상약학회지
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    • 제8권1호
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    • pp.35-46
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    • 1998
  • A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.

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Muscle Strength and Biochemical Markers as Predictors of Depression in Hemodialysis Patients: A Cross-Sectional Study

  • Soudabeh Zare;Motahareh Hasani;M. Dulce Estevao;Rahim Tahmasebi;Leila Azadbakht;Farzad Shidfar;Javad Heshmati;Somayeh Ziaei
    • Clinical Nutrition Research
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    • 제12권4호
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    • pp.293-303
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    • 2023
  • Patients with chronic renal failure, many of which treated with hemodialysis, present a high prevalence of impaired muscle strength which suggest that muscle mass parameters may be used as markers for changes in muscle in these patients. Measurement of handgrip strength (HGS) is a common, simple, and quick measure of muscle function an indicator of overall muscle strength which has been associated with physical activity and several anthropometric traits. Intercellular adhesion molecule-1 (ICAM-1) and insulin-like growth factor-1 (IGF-1) are biochemical markers associated with inflammatory processes which are a common consequence of dialysis. Additionally, hemodialysis patients frequently present signs of malnutrition and depression. This cross-sectional study aimed to evaluate if muscle and biochemical markers could be used to predict the risk of depression in hemodialysis patients. Several anthropometric parameters, nutrient intake, depression state and the serum levels of ICAM-1 and IGF-1 were determined and Pearson's correlation coefficient and/or Spearman's correlation coefficient were used to test the correlation between them. Our results do not show a correlation between HGF, IGF-1 and ICAM-1 with the depression status of the patients, but mid-arm muscle circumference (MAMC) was statistically and positively correlated with depression. Additionally, ICAM-1 levels were negatively correlated with HGS, MAMC, and IGF-1. Overall, the results of the present study suggest that HGS may be used as an indicator of cardiovascular diseases and MAMC may be a good predictor of the level of depression in hemodialysis patients, although further studies are required.

Correlation of Overexpression of Nestin with Expression of Epithelial-Mesenchymal Transition-Related Proteins in Gastric Adenocarcinoma

  • Liu, Jin-Kai;Chen, Wan-Cheng;Ji, Xiao-Zhen;Zheng, Wen-Hong;Han, Wei;An, Jing
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2777-2783
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    • 2015
  • Background: Nestin is associated with neoplastic transformation. However, the mechanisms by which nestin contributes regarding invasion and malignancy of gastric adenocarcinoma (GAC) remain unknown. Recent studies have shown that the epithelial-mesenchymal transition (EMT) is important in invasion and migration of cancer cells. In the present study, we aimed to investigate the expression of nestin and its correlation with EMT-related proteins in GAC. Materials and Methods: The expression of nestin and EMT-related proteins was examined in GAC specimens and cell lines by immunohistochemistry and Western blotting. Clinicopathological features and survival outcomes were retrospectively analyzed. Results: Positive nestin immunostaining was most obviously detected in the cytoplasm, nucleus or both cytoplasm and nucleus of tumor cells in 19.2% (24/125) of GAC tissues, which was significantly higher than that in normal gastric mucosa tissues (1.7%, 1/60) (p=0.001). Nestin expression was closely related to several clinicopathological factors and EMT-related proteins (E-cadherin, vimentin and Snail) and displayed a poor prognosis. Interestingly, simultaneous cytoplasmic and nuclear nestin expression correlated with EMT-related proteins (E-cadherin, vimentin and Snail) (p<0.05) and lymph node metastasis (p=0.041) and a shorter survival time (p<0.05), but this was not the case with cytoplasmic or nuclear nestin expression. Conclusions: Nestin, particularly expression in both cytoplasm and nucleus, might be involved in regulating EMT and malignant progression in GAC, with potential as an unfavorable indicator in tumor diagnosis and a target for clinical therapy.

수직피개의 결정요인과 수직피개 심도지수(ODI)의 상호관계 (The determinants of vertical overbite and overbite depth indicator(ODI))

  • 양상덕
    • 대한치과교정학회지
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    • 제29권3호
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    • pp.349-360
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    • 1999
  • 전치부 수직피개 (overbite)는 하악평면, 구개평면 또한 AB 평면의 경사도에 의해 결정된다는 사실이 구명되었으며, ODI (overbite depth indicator)는 overbite의 세 결정요인이라 할 수 있는 FMA, PPA FABA의 합으로 구성되는 것으로 분석되었다. 따라서 ODI와 세 결정요인들과의 상호관계를 기하학적으로 분석하여 그 관계계수를 산출하였다. ODI 정상수치를 나타내는 관계식에 산출된 관계계수를 대압하여 정리하면, ODI norm=$85^{\circ}-0.5PMA-( 1.08 - 0.01FMA)( FABA-81^{\circ})$라는 식이 도출된다. 이는 ODI 정상수치는 절대적 개념이 아니라 개개인의 골격형태에 의해 결정되는 상대적 개념으로 파악해야 함을 의미하는 것이다. 이렇게 산출한 ODI정상수치 (Individualized ODI norm)개념의 임상적 적용과 진단학적 의미에 대하여 구체적으로 논의하였다.

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Serum Pleiotrophin Could Be an Early Indicator for Diagnosis and Prognosis of Non-Small Cell Lung Cancer

  • Du, Zi-Yan;Shi, Min-Hua;Ji, Cheng-Hong;Yu, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1421-1425
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    • 2015
  • Aims: Pleiotrophin (PTN), an angiogenic factor, is associated with various types of cancer, including lung cancer. Our aim was to investigate the possibility of using serum PTN as an early indicator regarding disease diagnosis, classification and prognosis, for patients with non-small cell lung cancer (NSCLC). Methods: Significant differences among PTN levels in patients with small cell lung cancer (SCLC, n=40), NSCLC (n=136), and control subjects with benign pulmonary lesions (n=21), as well as patients with different pathological subtypes of NSCLC were observed. Results: A serum level of PTN of 300.1 ng/ml, was determined as the cutoff value differentiating lung cancer patients and controls, with a sensitivity and specificity of 78.4% and 66.7%, respectively. Negative correlations between serum PTN level and pathological differentiation level, stage, and survival time were observed in our cohort of patients with NSCLC. In addition, specific elevation of PTN levels in pulmonary tissue in and around NSCLC lesions in comparison to normal pulmonary tissue obtained from the same subjects was also observed (n=2). Conclusion: This study suggests that the serum PTN level of patients with NSCLC could be an early indicator for diagnosis and prognosis. This conclusion should be further assessed in randomized clinical trials.

한방진단시스템을 이용한 여성불임(女性不姙)의 한의학적 인자(因子) 연구 (A Study on Association of DSOM Symptom Scores for Women infertility in Oriental Medicine)

  • 조혜숙;엄윤경;유주희;강종근;김규곤;이인선
    • 대한한방부인과학회지
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    • 제20권1호
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    • pp.214-238
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    • 2007
  • Purpose : We have carried out this study to investigate association of DSOM scores and women infertility in oriental medicine for systematization diagnosis and treatment of women infertility. Methods : We analyzed the results of medical records for 151 patients who were diagnosed as women infertility. We investigated the possession of symptom index of women infertility, recognition association of DSOM. Results : 1. In comparison with 151 clinical trial's data. deficiency of Yin(陰虛), coldness(寒), spleen(脾) are associated positively and deficiency of Yang(陽虛), phlegm(痰) are associated negatively. 2. In pathogenesis(病機) indicator of average, cold inside the body is associated positively and diarrhea, kidney are associated negatively. 3. In pathogenesis five score-point of value, Heat(熱), kidney(腎) are associated negatively. 4. In pathogenesis(病機) indicator. constipation(便秘) is associated positively and hardness of lower abdomen, tingly weakness of lower back and knee question are associated negatively. 5. In 140 questions, nine questions are associated positively and ten question are associated negatively.

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혈액투석환자를 위한 동영상 식사교육 프로그램의 적용 효과 (The Effect of a Video Dietary Instruction Program for Hemodialysis Patients)

  • 김소연;김진동;박애경;구자선
    • 임상간호연구
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    • 제20권1호
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    • pp.134-145
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    • 2014
  • Purpose: The purpose of this study was to develop and apply a video dietary instruction program for hemodialysis patients to understand dietary compliance as well as the effect on the physiological indicator. Methods: This is a quasi-experimental study of a nonequivalent control group pre-post test design. Data were collected from August 6, 2012 to January 10, 2013. Twenty patients were assigned to an experimental group and twenty-one patients were assigned to a control group. A video dietary instruction program was developed and applied only to the experimental group once a week for a total of 8 weeks. Dietary compliance and physiological indicators were subsequently measured. Results: Dietary compliance was improved in both groups over time. There was no significant change in the physiological indicator value in both groups, indicating that there was no correlation between the treatment type and time. Conclusion: The video dietary instruction program could not make a statistically significant change on the physiological indicator value of the experimental group; however, this change was maintained within the allowable limits. Therefore, the video dietary instruction program can be utilized continuously as a standardized nursing intervention program in order to maintain the dietary compliance of hemodialysis patients.