• Title/Summary/Keyword: pre-hospital

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Comparison of Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios for Predicting Malignant Potential of Suspicious Ovarian Masses in Gynecology Practice

  • Topcu, Hasan Onur;Guzel, Ali Irfan;Ozer, Irfan;Kokanali, Mahmut Kuntay;Gokturk, Umut;Muftuoglu, Kamil Hakan;Doganay, Melike
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6239-6241
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    • 2014
  • Purpose: To compare the diagnostic accuracy of the neutrophil/lymphocyte ratio (NLR) with the platelet/lymphocyte ratio (PLR) in predicting malignancy of pelvic masses which are pre-operatively malignant suspicious. Materials and Methods: In this retrospective study we evaluated the clinical features of patients with ovarian masses which had pre-operatively been considered suspicious for malignancy. The patients whose intraoperative frozen sections were malign were classified as the study group, while those who had benign masses were the control group. Data recorded were age of the patient, diameter of the mass, pre-operative serum Ca 125 levels, platelet count, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio. Results: There was statistically significantly difference between the groups in terms of age, diameter of the mass, serum Ca 125 levels, platelet number and platelet/lymphocyte ratio. Mean neutrophil/lymphocyte ratios showed no difference between the groups. ROC curve analysis showed that age, serum Ca 125 levels, platelet number and PLR were discriminative markers in predicting malignancy in adnexal masses. Conclusions: According to the current study, serum Ca 125 levels, pre-operative platelet number and PLR may be good prognostic factors, while NLR is an ineffective marker in predicting the malignant characteristics of a pelvic mass.

Analysis of pre-hospital records of patients with non-traumatic subarachnoid hemorrhage using prediction tools (예측 도구를 활용한 비외상성 거미막밑출혈 환자의 병원 전 기록 분석)

  • Kim, Yong-Joon;Sim, Kyoung-Yul;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.7-18
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    • 2022
  • Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

Pre- and Post-Angioplasty Perfusion CT with Acetazolamide Challenge in Patients with Unilateral Cerebrovascular Stenotic Disease

  • You, Seung-Hoon;Jo, Sung-Min;Kim, Young-June;Lee, Jong-Hyeog;Jo, Kwang-Deog;Park, Woong-Sub
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.280-288
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    • 2013
  • Objective : Perfusion computed tomography (PCT) has the ability to measure quantitative value and produce maps of mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV). We assessed cerebral hemodynamics by using these parameters and acetazolamide (ACZ) challenge for pre- and post-procedural evaluation in patients with unilateral cerebrovascular stenotic disease. Methods : Thirty patients underwent pre-procedural PCT with ACZ challenge, and 24 patients (80%) was conducted follow up PCT after angioplasty with same protocol. The mean MTT, CBF, and CBV were measured and compared in both middle cerebral arterial (MCA) territories before and after ACZ challenge. Hemispheric ratio and percent change after ACZ challenge were calculated before and after angioplasty. Results : The mean stenosis rate was 76.6%. Significant increases in MTT (32.6%, p=0.000) and significant decreases in CBF (-14.2%, p=0.000) were found in stenotic side MCA territories. After ACZ challenge, there were significant changes in MTT (37.4%, p=0.000), CBF (-13.1%, p=0.000), and CBV (-10.5%, p=0.001) in pre-procedural perfusion study. However, no significant increases were found in MTT, or decreases in CBF and CBV in post-procedural study. There were no significant changes after ACZ challenge also. In addition, the degrees of these changes (before and after ACZ challenge) were highly correlated with the stenotic degrees in pre-procedural perfusion study. Conclusion : PCT with ACZ challenge appears to be a useful tool to assess the cerebral perfusion status especially in patients with unilateral symptomatic stenotic disease.

Prediction of Local Tumor Progression after Radiofrequency Ablation (RFA) of Hepatocellular Carcinoma by Assessment of Ablative Margin Using Pre-RFA MRI and Post-RFA CT Registration

  • Yoon, Jeong Hee;Lee, Jeong Min;Klotz, Ernst;Woo, Hyunsik;Yu, Mi Hye;Joo, Ijin;Lee, Eun Sun;Han, Joon Koo
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1053-1065
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    • 2018
  • Objective: To evaluate the clinical impact of using registration software for ablative margin assessment on pre-radiofrequency ablation (RFA) magnetic resonance imaging (MRI) and post-RFA computed tomography (CT) compared with the conventional side-by-side MR-CT visual comparison. Materials and Methods: In this Institutional Review Board-approved prospective study, 68 patients with 88 hepatocellulcar carcinomas (HCCs) who had undergone pre-RFA MRI were enrolled. Informed consent was obtained from all patients. Pre-RFA MRI and post-RFA CT images were analyzed to evaluate the presence of a sufficient safety margin (${\geq}3mm$) in two separate sessions using either side-by-side visual comparison or non-rigid registration software. Patients with an insufficient ablative margin on either one or both methods underwent additional treatment depending on the technical feasibility and patient's condition. Then, ablative margins were re-assessed using both methods. Local tumor progression (LTP) rates were compared between the sufficient and insufficient margin groups in each method. Results: The two methods showed 14.8% (13/88) discordance in estimating sufficient ablative margins. On registration software-assisted inspection, patients with insufficient ablative margins showed a significantly higher 5-year LTP rate than those with sufficient ablative margins (66.7% vs. 27.0%, p = 0.004). However, classification by visual inspection alone did not reveal a significant difference in 5-year LTP between the two groups (28.6% vs. 30.5%, p = 0.79). Conclusion: Registration software provided better ablative margin assessment than did visual inspection in patients with HCCs who had undergone pre-RFA MRI and post-RFA CT for prediction of LTP after RFA and may provide more precise risk stratification of those who are treated with RFA.

Clinical Characteristics of Acute Appendicitis in Children and Elderly Patients (소아와 고령자에서 급성 충수염의 임상적 특성)

  • Lee, Mi-Kyong;Lee, Sang-Hee;Kim, Jae-Man
    • Advances in pediatric surgery
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    • v.17 no.2
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    • pp.145-153
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    • 2011
  • Acute appendicitis is one of the most common diseases of young people that requires emergency operation. This is especially true for those age 10 years old and older. However, the numbers of cases of appendicitis are increasing in both the young and the elderly. The main purpose of this study is to understand the clinical features of acute appendicitis in children and elderly patients. We retrospectively compared clinical characteristics in 4 groups of patients who underwent appendectomy in our hospital. There were 16 patients in the pre-school age group, 9 were males and 7 females. The total number of patients in the juvenile group were 287, 156 were males and 131 females. The total numbers of patients in the adult group were 794, 436 were males and 358 females. The numbers of elderly patients were 189, 91 were males and 98 females. Complicated appendicitis was found in 15 patients (93.7 %) in the pre-school age group, 79 patients (27.5 %) in the juvenile group, 332 patients (41.8 %) in the adult group, and 96 patients (50.7 %) in the elderly group. Four patients (40 %) had generalized panperitonitis in the pre-school group. The occurrence of perforated appendicitis was the highest in the pre-school age group and the lowest in the juvenile group. Since generalized panperitonitis has a higher incidence in the pre-school age group, prudent and careful diagnosis and treatment are required for the pre-school age group.

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Effectiveness of Intravenous Immunoglobulin Therapy in Women with Recurrent Spontaneous Abortions and Elevated Pre-conceptional Peripheral Blood CD56+ Natural Killer Cell Percentage (말초 혈액 CD56+Natural Killer Cell 증가에 기인한 습관성 유산 환자에서 정맥 내 면역글로블린 치료의 효과에 관한 연구)

  • Cha, Sun Hwa;Park, Chan Woo;Kim, Hae Suk;Cho, Dong Hee;Kim, Jin Young;Kang, Inn Soo;Koong, Mi Kyoung;Yang, Kwang Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.2
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    • pp.165-170
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    • 2005
  • Objective: The aim of present study was to evaluate the effectiveness of low-dose intravenous immunoglobulin (IVIg) therapy in women with recurrent spontaneous abortions (RSA) and elevated pre-conceptional peripheral blood CD56+Natural Killer (NK) cell percentage. Study Design: Retrospective case control study. Materials and Methods: Thirty three women with RSA and elevated pre-conceptional peripheral blood CD56+NK cell percentage who had received low-dose IVIg therapy (400 mg/kg per day, every 4 week, until 20 gestational weeks) were included in this study. Controls were nine women with RSA and elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage who had not received IVIg therapy were included in this study. Medical records of study and control groups were retrospectively analyzed and we compared the successful pregnancy outcomes between two groups. Successful pregnancy outcome was defined as pregnancy ongoing beyond 25 gestational weeks. Results: Age, number of previous abortions, pre-conceptional CD56+NK cell percentage and type of RSA were not statistically different between two groups. Otherwise, twenty-five women who received IVIg therapy (25/33, 75.8%) but, only three women who had not received (3/9, 33.3%) had a successful pregnancy outcome and the rate difference between two groups was statistically significant. Conclusion: Based on our study, low-dose IVIg therapy have a effective role in treatment of RSA patients with elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage, but more larger scaled prospective study is needed for available of conclusive evidence.

The comparison about lumbar extensor strength between pre op group and post op(after 6 weeks) group in HIVD patient (만성요통환자의 레이져 수술전과 수술6주후의 요부신전근력에 관한 비교)

  • Park, Sung-Kwang;Sok, Hye-Kyong;Kim, Myung-Joon
    • Journal of Korean Physical Therapy Science
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    • v.7 no.1
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    • pp.353-365
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    • 2000
  • The purpose of this study were to compare the lumbar extensor strength between pre op patients group and after 6 weeks post op patients group. To evaluate lumbar extensor strength of total 273 patients with HIVD. Lumbar extensor strength was measured in 151 male patients and 122 female patients(Lumbar extensor strength was measured in 91 PELD patients group and 182 OLM group patients) by Medx lumbar extension machine. Maximum voluntary lumbar extension strength was appear $149.36{\pm}61.92ft$-lbs in pre op of PELD group, $158.47{\pm}54.67ft$-lbs in post op of PELD group and $135.54{\pm}54.24ft$-lbs in pre op of OLM group. $147.19{\pm}52.42ft$-lbs in post op of OLM group in male. Maximum voluntary lumbar extension strength was appear $83.85{\pm}30.22ft$-lbs in pre op of PELD group. $92.99{\pm}28.66ft$-lbs in post op of PELD group and $75.16{\pm}24.98ft$-lbs in pre op of OLM group, $79.88{\pm}25.25ft$-lbs in post op of OLM group in female. Male and female lumbar extension strength was statistically significant difference(P<.05). Lumbar flexion/extension ratio of the two group was 2.14:1 pre op and 2.05:1 post op in lumbar flexion 72 and 0 degree. The ratio of post op group was lesser than pre op group.

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Comparison of the Indications and Treatment Results of Burr-Hole Drainage at the Maximal Thickness Area versus Twist-Drill Craniostomy at the Pre-Coronal Point for the Evacuation of Symptomatic Chronic Subdural Hematomas

  • Kim, Gi Hun;Kim, Bum-Tae;Im, Soo-Bin;Hwang, Sun-Chul;Jeong, Je Hoon;Shin, Dong-Seong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.243-247
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    • 2014
  • Objective : To analyze the clinical data and surgical results from symptomatic chronic subdural hematoma (CSDH) patients who underwent burr-hole drainage (BHD) at the maximal thickness area and twist-drill craniostomy (TDC) at the precoronal point. Methods : We analyzed data from 65 symptomatic CSDH patients who underwent TDC at the pre-coronal point or BHD at the maximal thickness area. For TDC, we defined the pre-coronal point to be 1 cm anterior to the coronal suture at the level of the superior temporal line. TDC was performed in patients with CSDH that extended beyond the coronal suture, as confirmed by preoperative CT scans. Medical records, radiological findings, and clinical performance were reviewed and analyzed. Results : Of the 65 CSDH patients, 13/17 (76.4%) with BHD and 42/48 (87.5%) with TDC showed improved clinical performance and radiological findings after surgery. Catheter failure was seen in 1/48 (2.4%) cases of TDC. Five patients (29.4%) in the BHD group and four patients (8.33%) in the TDC group underwent reoperations due to remaining hematomas, and they improved with a second operation, BHD or TDC. Conclusion : Both BHD at the maximal thickness area and TDC at the pre-coronal point are safe and effective drainage methods for symptomatic CSDHs with reasonable indications.

A Clinical Study for Pre- and Intraoperative Risk Factors of Hospital Mortality after Mitral Valve Replacement (승모판막 치환술후 조기사망의 술전 및 술중 위험인자에 대한 임상적 고찰)

  • 박승규
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.236-244
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    • 1990
  • To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

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A Survey of food procurement practices in hospital dietetics -Assessment of the level of processing for purchased foods- (병원급식의 구매관리 실태조사 -구매 식품의 가공정도 평가를 중심으로-)

  • 신익자;남순란;곽동경
    • Korean journal of food and cookery science
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    • v.4 no.1
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    • pp.65-73
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    • 1988
  • Food procurement practices were assessed in 31 general hospital's dietetics in terms of the level of processing for purchased food. The level of processing before purchase by the institution was noted by a numerical value. a Food Processing Index (FPI). Labor productivity measured in terms of labor minutes per meal served averaged 12.59 minutes. Responsible persons for procurement practices were mostly dietitians, but effective purchasing methods as well as inventory control techniques were not fully systematized. Dietetic directors anticipate the large increase in the use of convenience foods in the future mainly due to the improved labor productivity, and also a highly increasing demand for completely pre-prepared food items (FPI 3). The grand mean of FPI scores for purchased foods in surveyed hospitals was 3.34, which indicates partially pre-prepared to completely pre-prepared food items. Significant negative correlation was found between the grand mean of FPI scores and the number of beds in a hospital.

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