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Glomerular Filtration Rate Test Methods and Guidelines (Glomerular Filtration Rate 검사방법 및 가이드라인)

  • Park, Min-Ho;Lee, Ha-Young;Ryu, Hwa-Jin;Yoo, Tae-Min;Noh, Gyeong-Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.97-100
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    • 2018
  • Purpose The glomerular filtration rate (GFR) test is an important indicator of glomerular filtration and has been used to test renal function and the extent of its function. The GFR test is performed by intravenous injection of radioactive medicines made of $^{51}Cr$-EDTA, and blood concentration is measured by taking blood according to the elapsed time. also, PET-CT, bone scan, transfusion and so on will affect the outcome. Therefore, we will improve the quality of the test by providing guidelines for the GFR test for more accurate testing. Materials and Methods 5 mL of physiological saline solution and 2 mL of $^{51}Cr$-EDTA solution are used to make 5 mL of the radiopharmaceutical solution to be injected into the patient. First, the syringe weight is measured before the injection, and then the radioactive medicine is injected into the patient's vein and the syringe weight is measured after the injection. Blood sampling is performed twice in total. In adults, blood is collected 3 hours / 5 hours after injection and in children 2 hours / 5 hours after injection. The blood sample is centrifuged at 3300 rpm for 5 minutes. Standard solution is prepared by filling diluent water up to the scale indicated in the 200-mL volumetric flask, discarding $500{\mu}L$, injecting $500{\mu}L$ of GFR reagent and mixing well. $500{\mu}L$ each of the standard solution is dispensed into two test tubes, and $500{\mu}L$ of each of the plasma samples collected in time is dispensed into two test tubes and measured with a Cobra Counter. Results At present, the reference range applied in this study is $119.5{\pm}30.3ml/min/1.73m2$ for males and $125.2{\pm}28.2ml/min/1.73m^2$ for females. Conclusion The GFR test is conducted using radioactive medical products. GFR testing is performed as a scheduled test, but PET-CT, dialysis and transfusion, which may affect GFR testing, may be scheduled during GFR testing. Therefore, we could get accurate GFR test results by notifying the ward and department beforehand when booking.

Discrepancy and Correlation in the renal length between Kidney CT and 99mTc-DMSA Renal scan (신장 CT 검사와 99mTc-DMSA Renal Scan 검사에서 측정한 신장 길이의 차이 및 상관분석)

  • Jung, Woo-Young;Shim, Dong-Oh;Lee, Dong-Hun;Choi, Jae-Min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.15-20
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    • 2021
  • Purpose This article studies the relationship between the length of a kidney measured by two scanning methods: Kidney Computed Tomography (CT) and 99mTc-Dimercaptosuccinic acid (DMSA) renal scan. Kidney CT provides a better anatomic assessment, while 99mTc-DMSA renal scan is superior in the kidney function test. Materials and Methods From January to December of 2019, two hundred patients who had Kidney CT and Tc99m-DMSA renal scan were chosen for this study. SPSS17.0 was selected for statistical analysis. Results Due to the effect of the breathing and resolution of 99mTc-DMSA renal scan, it showed the kidney's relatively longer length than the length of Kidney CT. For the same kidney, the length comparison among different brands' Gamma cameras was negligible. The length difference within the same age group did not show a noticeable discrepancy. However, there was a length difference between the radio technologists. Kidney CT and 99mTc-DMSA renal scan indicated a strong positive correlation between the length of the left and right kidney. Conclusion It is necessary to establish a standardized measurement method for measuring kidney length using 99mTc-DMSA renal scan. The kidney's functional changes and length changes are indications of Kidney diseases. Especially, pediatric patients tend to use 99mTc-DMSA renal scan for assessing the kidney's shape and the function to avoid potential radiation exposure during the Kidney CT. Therefore, it is significant to provide not only the kidney's functional information but also an anatomic analysis, including the kidney's size, length, and location through the 99mTc-DMSA renal scan.

Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

Analysis of Central Line-associated Bloodstream Infection among Infants in the Neonatal Intensive Care Unit: A Single Center Study

  • Kim, Minhye;Choi, Sujin;Jung, Young Hwa;Choi, Chang Won;Shin, Myoung-jin;Kim, Eu Suk;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.28 no.3
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    • pp.133-143
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    • 2021
  • Purpose: This study aimed to determine the incidence of central line-associated bloodstream infection (CLABSI) in the neonatal intensive care unit (NICU), evaluate the patients' clinical characteristics, and identify the etiologic agents for guidance in prevention and treatment. Methods: A retrospective chart review study of infants classified as having CLABSI was conducted at the NICU of Seoul National University Bundang Hospital from January 2016 to December 2020. Results: Of the 45 infants, 53 had CLABSIs within a follow-up period of 18,622 catheter days. The incidence of CLABSIs was 2.85 per 1,000 catheter days. The most common catheter type was a peripherally inserted central catheter (n=47, 81%). A total of 57 pathogens were isolated, of which 57.9% (n=33) were Gram-positive bacteria, 36.8% (n=21) were Gram-negative bacteria, and 5.3% (n=3) were Candida spp. The most common pathogens were Staphylococcus aureus (n=12, 21%) and coagulase-negative staphylococci (n=12, 21%), followed by Klebsiella aerogenes (n=8, 14%). The median duration of bacteremia was 2 days, and 19 episodes showed bacteremia for 3 days or more. The mortality rate of infants within 14 days of CLABSI was 13.3% (n=6). Conclusions: This study analyzed the incidence of CLABSI and the distribution of pathogens in the NICU. Continuous monitoring of CLABSI based on active surveillance serves as guidance for empiric antibiotic use and also serves as a tool to assess the necessity for implementation of prevention strategies and their impact.

Analysis of the diet of obese elementary school students using various dietary intake survey methods (다양한 식사섭취 조사방법을 활용한 비만 초등학생의 식생활 실태 분석)

  • Hye Bin Yoon;Jin Seon Song;Youngshin Han;Kyung A Lee
    • Journal of Nutrition and Health
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    • v.56 no.1
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    • pp.97-111
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    • 2023
  • Purpose: Childhood obesity has become a social problem due to the social distancing necessitated by the coronavirus disease 2019 pandemic. This study aimed to identify the dietary problems of obese children through various dietary assessment methods and to confirm the usefulness of each method. Methods: The subjects were 88 students in the 4th to 6th grade of elementary school who participated in the nutrition camp organised by the Busan Metropolitan Office of Education, 2020. To evaluate dietary problems and assess diet quality, 24-hour meal records, monthly food intake frequency, and Dietary Screening Test (DST) data were analyzed. Results: Of the subjects, 15.7%, 30.3%, and 53.9% were normal weight, overweight, and obese, respectively. The average age was 11.77 ± 0.77 years and the average body mass index was 23.96 ± 3.01 kg/m2. It was observed from the 24-hour meal record method that the overweight and obese subject groups consumed fewer green vegetables (p < 0.001) and white vegetables (p < 0.01) than the normal weight group. In the monthly food intake frequency method, the consumption of ramen (p < 0.01), snacks (p < 0.05), and sausages (p < 0.05) were high in the obese group, and that of anchovies, broccoli, and sweet pumpkin was high in the normal group (p < 0.05). The comparative data from the DST revealed that the overweight and obese groups had less vegetable intake than the normal weight group (p < 0.01) and had higher intakes of dairy products, fast food, and sweet snacks (p < 0.05). Conclusion: The usefulness of each method in the dietary evaluation of obese children was confirmed. To address the problem of obesity, it is necessary to evaluate the dietary problem and approach it with a customized solution tailor-made for the individual subject.

Clinical Presentation and Prognosis of SARS-CoV-2 Infection in Infants Aged ≤90 Days: Insights for Management During Outbreaks

  • Hye Jeong Moon;Mi Seon Han;Kyung Min Kim;Kyung Jin Oh;Ju Young Chang;Seong Yong Lee;Ji Eun Choi
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.84-90
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    • 2023
  • Purpose: Infants aged ≤90 days with fever are susceptible to severe infections. This study aimed to analyze the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this particular age group. Methods: Infants aged ≤90 days who were diagnosed with coronavirus disease 2019 (COVID-19) and hospitalized between March 1, 2020, and May 1, 2022 were included. Medical records of patients were retrospectively reviewed. Results: A total of 105 infants with COVID-19 were included; 27 (25.7%) neonates aged <28 days, and 48 (45.7%) and 30 (28.6%) infants aged 28-59 days and 60-90 days, respectively. Five (4.7%) patients remained asymptomatic and 68 (62.8%) were febrile, with a median fever duration of 2 days. The most common symptoms were respiratory including cough (66.6%), nasal stuffiness (51.4%), and rhinorrhea (40.9%). Blood cultures were performed in 10 infants but no organisms were detected. Cultures of bag-collected urine specimens from 8 infants were grown, resulting in positive growth for 2 without pyuria. Nine (8.6%) infants were treated with empirical antibiotics for a median duration of 2.3 days (range, 1-7 days). All 105 infants showed improvement without any complications, and there were no fatal cases. Conclusions: In this study, most infants aged ≤90 days with COVID-19 presented with mild symptoms and none of those evaluated had documented bacterial co-infection. The favorable prognosis among young infants with SARS-CoV-2 may aid clinicians in tailoring their approach to evaluation and management during outbreaks.

Service Philosophy as Wisdom for Human Society Development (인류사회 발전 지혜로서의 서비스철학)

  • Hyunsoo Kim
    • Journal of Service Research and Studies
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    • v.12 no.4
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    • pp.1-18
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    • 2022
  • This study was conducted to prove that the service philosophy is the development principle of human society in the service age. From ancient times to the present, the service philosophy was tried to show the wisdom of the development of human society in all earth spaces including the East and the West. In addition, it tried to prove that the service philosophy was at the center of the development wisdom of many countries and individuals who flickered on all space on earth and all human time. The study showed that the differences between countries were in software rather than hardware. Furthermore, it was analyzed that countries with a service philosophy embedded in the center of software such as spirit and culture made a great contribution to human society. The cases of Greece and Rome, the Republic of Venice, the Republic of the Netherlands, followed by the United States and modern Korea prove this, and the Soviet Union can be seen to disprove it. The former was a society in which state-run software was strong, and the latter was a society in which hardware was strong. There is a big difference between the case of the state, which citizens have autonomously organized and operated, and the case of the upper-level state-led operation. Since the leadership of the upper classes is not based on the service philosophy, the accumulated software power is weak, so it can be said that the accumulation of wisdom in human society is weak. Therefore, while the essence of human society so far has been a society of self-centered animal ecosystems led by selfishness, the human society in the service age from now on can be said to be a society of plant ecosystems where mutual respect and self-centeredness coexist. Just as the society centered on the service philosophy in the past human society prospered and left a greater legacy to mankind, it is suggested that the human society in the future service era should be a human society of a plant ecosystem centered on the service philosophy. Further in-depth studies related to this are needed in the future.

Analysis of the perception degree on dental medical accident and dispute experience, psychological status and preventive education according to clinical career of dental hygienist (일부지역 치과위생사의 임상경력에 따른 치과 의료사고 및 분쟁 경험, 심리상태, 예방교육에 대한 인식정도 분석)

  • Yoon, Na-Na;Lee, Myung-Ju;Seong, Mi-Gyung
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.13-21
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    • 2017
  • Objective: To understand the experience of medical accidents and disputes according to clinical career of dental hygienists. Methods: A self-administrated questionnaire survey was conducted from May 2012 to June 2012 targeting 313 dental hygienists in Gyeongsangnam-do, Republic of Korea. Data were analyzed by descriptive analysis, χ2-test, and one-way analysis of variance (ANOVA). Collected data were analyzed using SPSS 18.0. Results: 1) The group who had more than 6 years of clinical experience experienced complaints from patients (70.3%) and dental hygienists duty (30.7%); 2) Complaints were related to diagnosis, dental treatment instruments and materials, scaling, impression preparation, and prosthodontics. Pediatric patients had significantly more complaints compared to other patients. Overall, there were more frequent cases in the group with over 6 years of clinical career; 3) For the psychological state after experiencing patients' complaints, 'the process is difficult, but I forget after thinking it could be happen' had 160 respondents. Among them, 38.1% had clinical experience of more than 6 years, 37.5% had less than 3 years, and 24.4% had clinical career of 3~6 years; 4) About 73.6% of those had 3~6 years of clinical career answered that 'sometimes it is doubtful' on the issue of medical accidents and conflicts on prevention education of dental hygienists that 'there is a doubt about the issue of medical treatment or the occurrence of disputes'. About 60.0% of those who had less than 3 years of clinical experience answered that it was highly 'necessary but not urgent' on the necessity of preventive education, while 87.1% of those who had more than 6 years of clinical career answered that it was highly 'necessary but not urgent' on the necessity of preventive education. The difference between the two was not statistically significant. Conclusions: It is necessary and urgent to provide education related to prevention and countermeasures against malpractice disputes for dental hygienists.

Epidemiological Characteristic and Risk Factor of COVID-19 Cluster Related to Educational Facilities in Gangwon-do, Korea (December 10, 2020-September 23, 2021) (강원도내 교육시설관련 코로나바이러스감염증19 집단발생의 역학적특성과 위험요인 (2020.12.10-2021.9.23))

  • Hyosug Choi;Mi Young Kim;Shinyoung Lee;Eunmi Kim;Yeo Jin Kim
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.102-112
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    • 2024
  • Purpose: To identify the epidemiological characteristics and risk factors of coronavirus disease 19 (COVID-19) outbreaks depending on the type of educational facility by analyzing the COVID-19 cluster associated with educational facilities. Methods: This study is based on epidemiological investigation of COVID-19 cluster in Gangwon-do, Korea from December 10, 2020 to September 23, 2021 reported to the Korea Disease Control and Prevention Agency's Integrated Disease and Health Management System. Four hundred seven patients in 19 facilities, classified as cluster related to educational facilities, were the study population. The result of preliminary epidemiology survey report, in-depth epidemiological survey by phone and the result of risk assessment derived from the field epidemiology investigation were retrospectively analyzed to evaluate infectivity and the characteristics of the risk factors. Results: There were total of 407 confirmed patients related to 19 educational facilities, with 204 students under the age of 19 (50.1%). One hundred fifty-five preceding spreaders were from families (38.1%) and 125 were the teachers (30.7%). The place exposed to confirmed patients was the highest with 139 people (34.2%) at home. Conclusions: It was confirmed that the cause of the occurrence of clusters related to educational facilities was higher due to family transmission than the risk of facilities in schools. Nevertheless, continuous efforts should be made to control infection in educational facilities, and that teachers' implementation of principles for prevention of COVID-19 personal hygiene in their daily lives should be strengthened.

COVID-19 Rapid Antigen Test Results in Preschool and School (March 2 to May 1, 2022) (유치원·학교 구성원의 코로나19 신속항원검사 결과(2022년 3월 2일부터 5월 1일까지))

  • Gowoon Yun;Young-Joon Park;Eun Jung Jang;Sangeun Lee;Ryu Kyung Kim;Heegwon Jeong;Jin Gwack
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.113-121
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    • 2024
  • Purpose: In response to the surge in coronavirus disease 2019 (COVID-19) omicron variant cases, we have implemented preemptive testing for preschool and school. The purpose is to quickly detect COVID-19 cases using a rapid antigen test (RAT) kit so that normal school activities can continue. Methods: The results entered in The Healthcare Self-Test App were merged with the information on the status of confirmed cases in the COVID-19 Information Management System by Korea Disease Control and Prevention Agency (KDCA) for preschool and school of students and staffs March 2 to May 1, 2022 to analyze the RAT positive rate and positive predictive value of RAT. Results: In preschool and school 19,458,575 people were tested, weekly RAT positive rate ranged from 1.10% to 5.90%, positive predictive value of RAT ranged from 86.42% to 93.18%. By status, RAT positive rate ranged from 1.13% to 6.16% for students, 0.99% to 3.93% for staffs, positive predictive value of RAT ranged from 87.19% to 94.03% for students, 77.55% to 83.10% for staffs. RAT positive rate by symptoms ranged from 76.32% to 88.02% for those with symptoms and 0.34% to 1.11% for those without symptoms. As a result of preschool and school RAT, 943,342 confirmed cases were preemptively detected, before infection spread in preschool and school. Conclusions: RAT was well utilized to detect confirmed cases at an early stage, reducing the risk of transmission to minimize the educational gap in preschool and school. To compensate for the limitations of RAT, further research should continue to reevaluate the performance of RAT as new strains of viruses continue to emerge. We will have to come up with various ways to utilize it, such as performing periodic and repeated RAT and parallel polymerase chain reaction.