• Title/Summary/Keyword: severity scoring system

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Study on the Analysis and Evaluation of 'Observation and Recommendation Letter by Teacher' Which is Utilized in Mathematically Gifted Elementary Students Screening (초등수학영재 선발전형에 활용되는 교사 관찰 추천서의 분석 및 평가에 관한 연구)

  • Kim, Jong Jun;Ryu, Sung Rim
    • Education of Primary School Mathematics
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    • v.16 no.3
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    • pp.229-250
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    • 2013
  • The purpose of this study is analyzing 'observation and recommendation letter by teacher', which is being submitted to screen and enhance the utilization of gifted students in accordance with recently introduced gifted students observation, recommendation and screening system. For the purpose, this study will provide with objective securing plan of 'observation and recommendation letter by teacher' by developing an optimum evaluation model. The research findings were as follows: First, the result of analysis on the mathematically gifted students behavior characteristic as appeared in 'observation and recommendation letter by teacher' suggested that the recommending teachers have the tendency of giving superficial statement instead of giving concrete case description. When it was analyzed for frequency by the 'observation and recommendation letter by teacher' analysis framework devised by the author, the teachers showed the tendency of concentrating on specific questions. Meanwhile, there was a tendency that teachers concentrate on specific gifted behavior characteristic or area for which concrete case had been suggested. The reason is believed that such part is easy to observe and state while others are not, or, teachers did not judge the other part as the characteristic of gifted students. Second, the gifted students behavior characteristics as appeared in 'observation and recommendation letter by teacher' were made into scores by Rubric model. When the interrater reliability was analyzed based on these scores, the correlation coefficient of 1st scoring was .641. After a discussion session was taken and 2nd scoring was done 3 weeks later, the correlation coefficient of 2nd scoring increased to .732. The reason is believed that; i) the severity among scorers was adjusted by the discussion session after the 1st scoring, ii) the scorers established detail judgment standard on various situations which can appear because of the descriptive nature, and, (iii) they found a consensus on scoring for a new situation appeared. It implies that thorough understanding and application of scorers on evaluation model is as important as the development of optimum model for the differentiation of mathematically gifted elementary students.

Hemiarthroplasty for the Comminuted Fracture of the Proximal Humerus (상완골 근위부 분쇄 골절에서의 상완골 두 치환술)

  • Seo Joong-Bae;Won Choong-Hee;Kim Yong-Min;Choi Eui-Seong;Lee Ho-Seung;Hong Yoon-Chul
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.61-67
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    • 2000
  • Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

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The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

Effects of a Mineral-Salt Laxative in Lactation Diets for Primiparous Sows and Their Litters

  • Kim, I.H.;Hancock, J.D.;Kim, C.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.11 no.4
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    • pp.381-384
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    • 1998
  • Twenty-three crossbred (Yorkshire $\times$ Duroc $\times$ Hampshire $\times$ Chester White) primiparous sows were used to evaluate the effects of the mineral-salt laxative in lactation diets on sow and litter performance. The sows were fed a sorghum-extruded soybean-based diet with .85% lysine, .90% Ca, .80% P, and 3.2 Mcal ME/kg. Sow body weight (p > .54) and backfat loss (p > .61), average daily feed intake (p > .42), and litter weight gain (p > .74) were not affected by the mineral-salt laxative in the diet. However, survivability of piglets was greater (p < .06) for sows with the mineral-salt laxative in their diet and, thus, number of pigs weaned was increased. As expected, fecal moisture was increased (p < .09) in sows fed the mineral-salt laxative. Apparent digestibilities of DM, N, and GE were not affected by treatment (p > .26). After weaning, stomachs were collected and scored for ulcers and keratinization using a scoring system of 0 = normal to 3 = severe. Severity of ulceration and keratinization was not significantly affected by treatment (row mean scores differ test p > .25), but scores for sows fed the diet containing the mineral-salt laxative were numerically lower than sows fed the control diet. Thus, our data indicate that sows fed the mineral-salt laxative during lactation had improved piglet survivability, greater fecal moisture, and tended to have fewer lesions in the mucosa of the stomach.

Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

  • Hur, Hyuk;Lee, Jung-Kil;Lee, Jae-Hyun;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.189-194
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    • 2009
  • Objectives : Ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy. The aim of this study was to identify factors associated with the surgical outcome on the basis of preoperative clinical and radiological findings. Methods : Data obtained in 26 patients whot underwent posterior decompression for thoracic myelopathy, caused by thoracic OLF, were analyzed retrospectively. Patient age, duration of symptoms, OLF type, preoperative and postoperative neurological status using the Japanese Orthopedic Association (JOA) scoring system, surgical outcome, and other factors were reviewed. We compared the various factors and postoperative prognosis. All patients had undergone decompressive laminectomy and excision of the OLF. Results : Using the JOA score, the functional improvement was excellent in 8 patients, good in 14, fair in 2, and unchanged in 2. A mean preoperative JOA score of 6.65 improved to 8.17 after an average of 27.3 months. According to our analysis, age, gender, duration of symptoms, the involved spinal level, coexisting spinal disorders, associated trauma, intramedullary signal change, and dural adhesions were not related to the surgical outcome. However, the preoperative JOA score and type of OLF were the most important predictors of the surgical outcome. Conclusion : Early diagnosis and sufficient surgical decompression could improve the functional prognosis for thoracic OLF. The postoperative results were found to be significantly associated with the preoperative severity of myelopathy and type of OLF.

Therapeutic Effect of Majoon Mundi and Qairooti Karnab in Dā al-Ṣadaf (Psoriasis): A Case Series

  • Siddiqui, Gulnaz Fatima;Siddiqui, Shahid Akhtar;Jabeen, Arzeena;Qamaruddin, Qamaruddin;Kazmi, Munawwar Husain
    • CELLMED
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    • v.9 no.4
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    • pp.8.1-8.5
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    • 2019
  • Introduction: Psoriasis is a major health concern around the world. Physicians of the Unani system of medicine have been treating psoriasis for centuries. Aim: The purpose of our study was to assess the effect of Majoon Mundi (a semisolid Unani medication intended for oral intake used as blood purifier) and Qairooti Karnab (a Unani medication in paste form intended for topical application used as emollient) in the treatment $na{\ddot{i}}ve$ psoriasis cases and to collect data to warrant further clinical trials. Material and Methods: Psoriasis cases were diagnosed clinically. Data were collected during treatment of five patients of psoriasis treated with the Majoon Mundi (oral intake of 5 gm twice daily with 200 ml of water for 12 weeks) and Qairooti Karnab (topical application on affected sites twice a day for 12 weeks). Patients were treated for 12 weeks. Treatment response was seen with clinical improvement in skin lesions and measurement of Psoriasis Area and Severity Index (PASI Scoring) before and after treatment. Results: Reduced PASI Score was observed in all five patients after 12 weeks of treatment [PASI before and after treatment was (mean${\pm}$SD) $20.7{\pm}4.6$ vs. $3.2{\pm}1.8$; p-value <0.05.]. Clinical improvement was noticed within an average of 4 weeks of treatment. Conclusion: Preliminary findings indicate the potential therapeutic role of Majoon Mundi and Qairooti Karnab in the treatment of psoriasis. Clinical trials based on this Unani pharmacopeial formulation should be conducted to explore the therapeutic potential of this formulation in psoriasis

Analysis of Risk Factors for Infection in Orthopedic Trauma Patients

  • Moon, Gi Ho;Cho, Jae-Woo;Kim, Beom Soo;Yeo, Do Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.40-46
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    • 2019
  • Purpose: We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery. Methods: We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS. Results: Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor. Conclusions: The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

The Correlation between the Severity of Hypoxic Ischemic Encephalopathy and the Development of Acute Renal Failure in Asphyxiated Neonates (신생아 질식 환아에서 저산소성 허혈 뇌증의 정도와 급성신부전 발생과의 연관성)

  • Park, Sung-Shin;Chung, Sung-Hoon;Song, Jun-Hyuk;Kim, Sun-Kyoung;Cho, Byoung-Soo;Kim, Sung-Do
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.32-40
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    • 2007
  • Purpose : We performed this study to determine the incidence of acute renal failure(ARF) in birth asphyxia and to correlate the severity of asphyxia and hypoxic-ischemic encephalopathy (HIE) and ARF in asphyxiated neonates. Methods : Data was retrospectively collected from the medical records of 33 patients with neonatal asphyxia and of 33 neonates with no asphyxia. On the basis the 5-minute Apgar score, the asphyxiated neonates were further grouped into mild(6 or 7), moderate(4 or 5), and severe asphyxia(3 or less). Asphyxiated neonates with HIE were staged by the Sarnat and Sarnat scoring system. We compared serum creatinine, blood urea nitrogen, electrolytes, and urine output on day 3 of life and the incidence and severity of intraventricular hemorrhage(IVH) between each group. Results : ARF occurred in 8(24.2%) asphyxiated neonates. Of these, 3(37.5%) were oliguric, while 1(10.0%) patient with mild asphyxia, 2(18.2%) of moderate asphyxia, and 5(41.7%) with of severe asphyxia had ARF(P>0.05). One(25%) patient with stage I HIE, 4(50%) with stage II HIE, and 3(75%) of HIE with stage III HIE developed ARF(P<0.01). There was no statistical correlation between the severity of asphyxia and HIE stage. One(7.7%) patient with grade 1 IVE, 0(0.0%) with grade 2 IVH, 2(66.7%) with grade 3 IVH, and 2(100.0%) with grade 4 IVH had ARF(P<0.01). Mortality was higher in asphyxiated neonates with ARF(P<0.05). There was no significant difference between the oliguric and non-oliguric renal failure. Conclusion : We found that the greater the degree of HIE, the higher was the incidence of ARF. Asphyxiated neonates with ARF had a poorer prognosis.

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Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease (관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성)

  • Lee, Duk-Young;Bae, Jin-Ho;Lee, Sang-Woo;Chun, Kyung-Ah;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Ha, Jeoung-Hee;Chae, Shung-Chull;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.473-480
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    • 2005
  • Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

Prognostic Factor, for Major Trauma Patients in the Emergency Medical Service System (응급의료전달체계의 각 요인이 중증외상환자의 예후에 미치는 영향 분석)

  • Lim, Du-Ko;Chung, Tae-Nyoung;Lee, Chang-Jae;Jin, Su-Guun;Kim, Eui-Chung;Choi, Sung-Wook;Kim, Ok-Jun
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.89-94
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    • 2011
  • Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.