• 제목/요약/키워드: severity assessment

검색결과 714건 처리시간 0.025초

두드러기에 대한 임상 연구 및 평가 지침 (A Clinical Study of Urticaria and an Assessment Guideline)

  • 이길영;김혜정
    • 대한한의학회지
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    • 제26권2호
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    • pp.25-31
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    • 2005
  • Objectives: This study was designed to assess traditional Korean medical therapy for urticaria and establish a clinical assessment guideline. Methods: Duration of symptoms, personal and family history of allergic diseases, serum IgE level, suspected causes and Provocation factors were investigated in 56 patients. Frequency of wheals, duration of wheals, number of wheals, itch severity and antihistamine counts on a 6-point (0-5) scale were assessed in 34 patients. The change of total scores and each criterion between baseline and follow up were analyzed using paired t-test (p<0.05). Results: 1. Acute urticaria within 6 weeks was $26.8\%$ and chronic urticaria over 6 weeks was $73.2\%$. The mean duration of symptoms was $19.2\pm38.8$ months. 2. $57.1\%$ of patients had a personal history of allergic diseases and $50\%$had a family history. $29.1\%$ had over 200 IU/mL serum IgE level. 3. The suspected causes were none $(39.3\%)$, foods $(32.1\%)$, drugs $(12.5\%)$, contact $(5.4\%)$ and maternity$(5.4\%)$. 4. The suspected provocation factors were foods $(41.1\%)$, none $(26.8\%)$, fatigue $(12.5\%)$, heat and sweating $(12.5\%)$, pressure $(10,7\%)$ and stress $(7.1\%)$. 5. The total scores between baseline and follow up of 34 patients were lowered from $15.38^{\circ}\;{\ae}3.75\;to\;8.82^{\circ}\;{\ae}5.21$, which was significant statistically (p=0.000). 6. Itch severity, frequency of wheals and number of wheals were the most significantly lowered of all criteria. Conclusions: Traditional Korean medical therapy was proven to be effective for urticaria, while itch severity, frequency of wheals and number of wheals should be assessed clinically with greater priority.

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퇴행성 대동맥판 협착증의 중증도 평가: 증례보고 3례 (Assessment of the Severity of Degenerative Aortic Stenosis: Three Case Reports)

  • 김성희
    • 대한임상검사과학회지
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    • 제51권2호
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    • pp.270-275
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    • 2019
  • 노령 인구의 기대 수명이 증가함에 따라 퇴행성 판막 질환이 많아지고 있다. 류마티스성 판막 질환인 승모판 협착증과 대동맥판 역류가 점차적으로 감소하고 석회화된 퇴행성 대동맥판 협착증, 승모판 탈출증 및 허혈성 심장 질환으로 인한 승모판막 폐쇄 부전의 빈도가 증가하고 있다. 심장초음파는 심장판막질환의 진단은 물론, 치료방법 및 수술 시기와 더불어 예후 평가에서도 매우 중요한 도구이며, 판막질환을 평가할 때 모든 판막을 자세하게 관찰하는 이면성 심장초음파가 우선해야 한다. 흔히 접하는 퇴행성 판막질환에 대한 이해와 함께 임상적 특성을 파악하여 심장초음파를 정확하게 시행하는 것이 가장 중요하다. 아울러 대동맥판 협착증의 중증도 평가가 수술적 적응증을 판단하는 데 꼭 필요한 검사인만큼 정확한 판단 기준에 따라 평가하여 환자의 정확한 진단 및 치료가 이루어지도록 해야 한다. 퇴행성 대동맥판 협착증 환자 3례를 통해 심장초음파 검사의 중증도 평가를 쉽게 이해할 수 있기를 바라며 퇴행성 판막 질환의 심초음파 소견을 숙지하는 것이 심장초음파검사를 정확하게 수행하는 것에 수반되어야할 것으로 사료된다.

Tc-99m-MIBI 심근 SPECT 극성지도 분석에 의한 심근 기능의 정량적 평가 (A Quantitative Method for the Assessment of Myocardial Function using the Polar Analysis of Tc-99m-MIBI Myocardial SPECT)

  • 곽철은;이동수;여정석;이경한;정준기;이명철;서정돈;고창순
    • 대한핵의학회지
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    • 제28권2호
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    • pp.172-176
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    • 1994
  • 심근 SPECT에 의한 심근질환의 심도 및 허혈부위를 평가하는 방법으로 정상인의 극성지도와의 비교에 의한 결손지도 평가방법이 상용화되었으나 본 연구에서는 결손부위의 범위만을 산출할 수 있었던 종래의 방법을 개선할 수 있는 관류회복정도 및 심도성적 산출 방법을 시도하여 보았다. 허혈 및 심도성적의 산출에서 부하 및 휴식기 극성지도의 차이를 3등급으로 분할하여 각 등급에 해당되는 화소의 수를 가중하므로서 관류결손부위의 면적이 반영된 허혈 및 심도성적 산출방법을 제안하고자 하였으며, 등급 및 가중치의 할당은 정상인의 잔상동맥영역별 관류분포를 반영하여 고른 등급 할당방법보다 상관도가 개선된 결과를 얻을 수 있었다.

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Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score

  • Kang, Min Woo;Ko, Seo Young;Song, Sung Wook;Kim, Woo Jeong;Kang, Young Joon;Kang, Kyeong Won;Park, Hyun Soo;Park, Chang Bae;Kang, Jeong Ho;Bu, Ji Hwan;Lee, Sung Kgun
    • Journal of Trauma and Injury
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    • 제34권1호
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    • pp.3-12
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    • 2021
  • Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

소아의 영양 평가 - 소아 신체계측과 생화학적 지표의 특성을 중심으로 (The Nutritional Assessment in Children - Understanding of Anthropometric Assessment and Biochemical Indexes in Children)

  • 박기영
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권sup1호
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    • pp.6-11
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    • 2009
  • Nutritional assessment is based on anthropometric, clinical, dietary and biochemical data. There is a lack of studies about the propriety of biochemical indexes for the nutritional assessment in children despite biochemical data in pediatric population are different from them in adult's in many respects. Serum albumin is useful index to evaluate the severity of malnutrition. Hemoglobin and hematocrit tend to decrease in malnutrition on account of defect of iron metabolism and to increase in metabolic syndrome on account of enhancement of erythropoiesis. But, unlike adult, total lymphocyte count is not so useful biochemical indexes in children. We should consider pediatric characteristic when interpret biochemical indexes for nutritional assessment in children, and nutritional status in children should be assessed comprehensively with anthropometric, clinical, dietary and biochemical data.

A Modified Length-Based Grading Method for Assessing Coronary Artery Calcium Severity on Non-Electrocardiogram-Gated Chest Computed Tomography: A Multiple-Observer Study

  • Suh Young Kim;Young Joo Suh;Na Young Kim;Suji Lee;Kyungsun Nam;Jeongyun Kim;Hwan Kim;Hyunji Lee;Kyunghwa Han;Hwan Seok Yong
    • Korean Journal of Radiology
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    • 제24권4호
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    • pp.284-293
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    • 2023
  • Objective: To validate a simplified ordinal scoring method, referred to as modified length-based grading, for assessing coronary artery calcium (CAC) severity on non-electrocardiogram (ECG)-gated chest computed tomography (CT). Materials and Methods: This retrospective study enrolled 120 patients (mean age ± standard deviation [SD], 63.1 ± 14.5 years; male, 64) who underwent both non-ECG-gated chest CT and ECG-gated cardiac CT between January 2011 and December 2021. Six radiologists independently assessed CAC severity on chest CT using two scoring methods (visual assessment and modified length-based grading) and categorized the results as none, mild, moderate, or severe. The CAC category on cardiac CT assessed using the Agatston score was used as the reference standard. Agreement among the six observers for CAC category classification was assessed using Fleiss kappa statistics. Agreement between CAC categories on chest CT obtained using either method and the Agatston score categories on cardiac CT was assessed using Cohen's kappa. The time taken to evaluate CAC grading was compared between the observers and two grading methods. Results: For differentiation of the four CAC categories, interobserver agreement was moderate for visual assessment (Fleiss kappa, 0.553 [95% confidence interval {CI}: 0.496-0.610]) and good for modified length-based grading (Fleiss kappa, 0.695 [95% CI: 0.636-0.754]). The modified length-based grading demonstrated better agreement with the reference standard categorization with cardiac CT than visual assessment (Cohen's kappa, 0.565 [95% CI: 0.511-0.619 for visual assessment vs. 0.695 [95% CI: 0.638-0.752] for modified length-based grading). The overall time for evaluating CAC grading was slightly shorter in visual assessment (mean ± SD, 41.8 ± 38.9 s) than in modified length-based grading (43.5 ± 33.2 s) (P < 0.001). Conclusion: The modified length-based grading worked well for evaluating CAC on non-ECG-gated chest CT with better interobserver agreement and agreement with cardiac CT than visual assessment.

유방암 수술 후 부정적 감각 개선을 위한 발반사마사지의 효과: 라벤더 족욕과의 비교 (Foot Reflexology for the Intervention of Sensations after Breast Cancer Surgery: A Single-blind Repeated Measured Pilot Study with Comparison Group of Lavender Foot Bath)

  • 김달숙;박인숙
    • 종양간호연구
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    • 제10권2호
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    • pp.180-190
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    • 2010
  • Purpose: The purpose of this study was to compare the improvement and maintenance effects of foot reflexology (FR) on sensations after breast cancer surgery with those of lavender foot bath (LFB). Methods: Using a single-blind design, both 18 women to receive 20-min FR by trained experts and 14 women to soak feet in $40^{\circ}C$ foot tub water with 5 drop lavender essential oil, 15-min were intervened every two days. Repeated measures were taken pre 1st-(baseline-4th op. day), pre 3rd-(2nd data), and pre 5th-intervention (3rd data) with following up at 1-week after 5th intervention (4th data). The reliable translated Korean version of Baron's Breast Sensation Assessment Scale was used to assess sensations after breast cancer surgery (SABCS) characterized by prevalence, frequency, severity, and distress. Results: A significant difference between baseline and the 3rd, and a decrease tendency from baseline to the 3rd were observed for the severity and distress in FR and for the prevalence and severity in LFB. A significant or important decrease tendency between the 3rd and the 4th were observed for the severity and distress in FR and for the severity in LFB. Conclusion: Iterative FR has the improvement and maintenance effects on the severity and distress while LFB has only those on the severity.

A Simple Metric for Assessing the Severity of Partial Discharge Activity Based on Time-Sequence-Analysis-Discharge Level Patterns

  • Stewart Brian G;Yang Lily;Judd Martin D;Reid Alistair;Fouracre Richard A
    • Transactions on Electrical and Electronic Materials
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    • 제7권6호
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    • pp.313-318
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    • 2006
  • This paper introduces a partial discharge (PD) severity metric, S, based on the evaluation of time-sequence PD data capture and resulting Time-Sequence-Analysis Discharge (TSAD) level distributions. Basically based on an IEC60270 measurement technique, each PD event is time stamped and the discharge level noted. By evaluating the time differences between a previous and subsequent discharge, a 3D plot of time-sequence activity and discharge levels can be produced. From these parameters a measurement of severity, which takes into account dynamic or instantaneous variations in both the time of occurrence and the level of discharge, rather than using standard repetition rate techniques, can be formulated. The idea is to provide a measure of the severity of PD activity for potentially measuring the state of insulation within an item of plant. This severity measure is evaluated for a simple point-plane geometry in $SF_{6}$ as a function of gap distance and applied high voltage. The results show that as the partial discharge activity increases, the severity measure also increases. The importance of future investigations, quantifications and evaluations of the robustness, sensitivity and importance of such a severity measurement, as well as comparing it with typical repetition rate assessment techniques, and other monitoring techniques, are also very briefly discussed.

인공위성자료와 디지털 토양자료를 통해 분석한 미중부 대평원 지역 가뭄정도에 미친 물리적 토양특성의 영향 (Influences of Physical Soil Properties on Drought Severity in the Central Great Plains Based on Satellite Data and a Digital Soil Database)

  • Sunyurp Park
    • 대한지리학회지
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    • 제38권6호
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    • pp.935-948
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    • 2003
  • STATSGO 데이터베이스는 주단위의 토양 특성을 분석하는 데에 있어 효과적인 자료다. 본 연구에서는 GIS 기법을 이용하여 STATSGO로부터 8개 주요 토양 특성을 추출하였다: 함수력(available water capacity), 점토비율, 토양깊이, 사면경사. 지하수위까지의 깊이, 배수 특성, 토성, 투수도, 평균적인 NDVI로부터의 편차로 정의된 가뭄 정도(drought severity)에 대해 앞서 열거한 토양 특성이 미치는 영향을 캔자스 중서부 지역을 대상으로 분석하였다. 연구 결과에 따르면, 분석된 8개 변수 중 7개가 통계적으로 유의한 상관관계를 가진 것으로 나타났는데, 상관계수는 -0.89에서 0.85에 이르렀다. Moderate Resolution Imaging Spectroradiometer(MODIS)로부터 취득된 지표복사열(thermal emission) 자료는 평균 NDVI에 대한 편차로 표현되는 가뭄정도와 통계적으로 유의한 상관관계를 가졌으며, 식물생육기간에 걸친 가뭄지역의 공간적 변화를 잘 나타내었다. 토양수분의 결핍양이 많아질수록, 복사열 시그널 값도 높아지며, 공간적 분포로 볼 때. 상대적으로 건조한 캔자스 서부로부터 증가하여 시간에 따라 점차 그 분포도 변화하였다. 연구결과는 또한 가뭄의 진행단계에 따라 가뭄에 대한 각 토양 변수의 영향도 달라짐을 보여주었다.

아토피 피부염 심각도에 따른 빈혈 유병률 비교 분석 (Analysis of Prevalence of Anemia according to Severity of Atopic Dermatitis)

  • 윤다이;장지은;유기연
    • 한국임상약학회지
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    • 제30권4호
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    • pp.264-269
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    • 2020
  • Background: Inflammatory diseases can increase the prevalence of anemia. Recent studies confirmed that the prevalence of anemia is increased by atopic dermatitis (AD), a chronic inflammatory disease. Therefore, we aimed to elucidate the correlation between AD severity and prevalence of anemia. Methods: We used data of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2016). We included pediatric patients (<18 years) with AD diagnosis who were prescribed medications for AD. We applied a propensity score method with inverse probability of treatment weighting (IPTW) adjusting for differences in prevalence of confounders and performed IPTW logistic regression to evaluate associations between the anemia and severity of AD. Results: In total, 91,501 patients (mild AD: 47,054 patients; moderate-to-severe AD: 44,447 patients) <18 years who were prescribed drugs for AD were analyzed. Analysis of the probability of patients with mild AD and prevalence of anemia as a reference revealed an odds ratio (OR) of 1.159 (95% CI, 1.109-1.212; p<0.001) in moderate-to-severe AD patients, indicating a correlation between anemia prevalence and AD severity. Subgroup analysis according to gender, age group, and type of health insurance revealed there was an association between AD severity and anemia except in patients equal or older than 7 years. Conclusion: The prevalence of anemia increased with AD severity despite adjusting for confounding factors. Our results support the hypothesis that AD can cause anemia, and anemia prevalence could be increased in severe AD patients. Further studies are needed to establish a pathological basis.