Purpose: Sentinel lymph node biopsy became the standard procedure in early breast cancer surgery. Faculty members might be exposed to a trace amount of radiation. The aim of this study is to quantify the radiation exposure and verify the safety of the procedure and the facilities, especially during pathologic process. Materials and Methods: Sentinel lymph node biopsies with Tc-99m human serum albumin were performed as routine clinical work. Exposed radiation doses were measured in pathologic technologist, nuclear medicine technologist, and nuclear medicine physician using a thermoluminescence dosimeter (TLD) during one month. We also measured the residual radioactivities or absorbed dose rates, the exposure distance and time during procedure, the radiation dose of the waste and the ambient equivalent dose of the pathology laboratory. Results: Actual exposed doses were 0.21 and 0.85 (uSv/study) for the whole body and hand of pathology technologist after 47 sentinel node pathologic preparations were performed. Whole body exposed doses of nuclear medicine physician and technologist were 0.2 and 2.3 (uSv/study). According to this data and the exposure threshold of the general population (1 mSv), at least 1100 studies were allowed in pathology technologist. The calculated exposed dose rates (${\mu}$ Sv/study) from residual radioactivities data were 2.47/ 22.4 ${\mu}$ Sv (whole body/hand) for the surgeon; 0.22/ 0 ${\mu}$ Sv for operation nurse. The ambient equivalent dose of the pathology laboratory was 0.02-0.03 mR/hr. The radiation dose of the waste was less than 100 Bq/g and nearly was not detected. Conclusion: Pathologic procedure relating sentinel lymph node biopsy using radioactive colloid is safe in terms of the radiation safety.(Nucl Med Mol Imaging 2007;41(4);309-316)
Purpose: The object evaluation method about medical institutes of these days increases credibility of consumers about medical services by conducting a certification system about medical institutes. In addition, as nuclear medicine test rooms and diagnosis test medicine room adopt many kinds of international certification systems, the matters regarding safety management of test rooms are being regarded as important. Since the blood test rooms of nuclear medicine are exposed to many harmful factors such as infection from clinical specimen and radioactive isotope reagent, there is a need to pay lots of attention to the safety management of staff and patients. Therefore, this study discusses safety management activities of staff and patients, which are conducted in the blood test rooms of the nuclear medicine department in Asan Medical Center. Materials and Methods: In the blood test rooms of the nuclear medicine department in Asan Medical Center, the matters regarding comprehensive safety management by the person in charge of safety management are offered and all staff members of the test rooms apply them into work. Safety management education is regularly conducted according to established regulations, and infection is prevented through implementation of wearing personal protectors and hand sanitation during test work. In addition, technical safety guides and accident guides for interruption of electric power are provided against emergencies. Through infection management guides, infection prevention and preparation methods for infection are learned and radioactive isotope management, safety management about reagent use and safety guides about harmful chemical substances are being applied to work. Results: The blood test rooms of the nuclear medicine department apply safety management regulations to work. Under the situation where hand sanitation should be conducted, hands are washed to prevent infection between staff and patients, and for preventing infection from clinical specimen, personal protectors are worn. The reagent, which is classified as harmful substance, is separately stored to be easily recognized, radioactive wastes and general medical wastes are also safely managed. Through these lots of safety management activities, safety management awareness of staff members is enhanced, and patients are protected from many dangers. Conclusion: Staff members of the blood test rooms of the nuclear medicine department should be fully aware of safety management regulations and apply them to work. When better safety management suggestions are made, they need to be examined and applied for increasing quality of safety management for staff and patients.
Kim, Byeong-Hak;Myeong, Hwa-Ryeon;Lee, Jeong-Gyu;Park, Su-Hui;Lee, Jae-Hyeok
Journal of Korea Association of Health Promotion
/
v.4
no.1
/
pp.115-124
/
2006
Basically, diagnosis is a comprehensive judgement of the biochemical data which were collected from the patient directly. Therefore, no matter what kinds of well-managed data control are there, if data sample itself is not perfectly appropriate for any reason. we can not rule out high possibility of misunderstanding or wrong diagnosis. Among many possible reasons inadequate sample were collected maybe three situation and circumstances could be assumed as follows. 1. Client did not know what they are supposed to do for sampling 2. Technicians are to qualified or less-experienced on the job 3. Wrong managing or careless treat of the biochemical data sample If it is true, we could manage these problems to be solved through the information sharing and education. In order to verify this hypothesis, actually 5,800 cases were studied from January to August this year. Owing to the thorough education the rate of unappropriated samples reduced to 0.4% from 1.2%. This outcome strongly support the hypothesis of the mutual relation between the proper sample and well-designed education in advance. The importance of information sharing on right process of sample collection should be emphasized.
In Korea association of health promotion(KHAP) there are fourteen laboratories in branch offices and one laboratory in headquarter office. To standardize the reference ranges of all laboratories of KAHP, they have been newly calculated from the laboratory data perfomed during the previous yearsby statistical metod annually for the period of 2000 through2003 so far. The referance ranges of total 56 test items were assigned. Among these there were eight test items that needed referance ranges by age groups and nine test items that needed reference rages by gender. The age grouping was into six groups : baby (0-3y), children(4-12y), adolescent(13-18y), adult(19-64y), younger elderly(19-64y), older elderly(over 80y) with references of statics in Medical Informatics and WHO classification. All the data collected were statistically analyzed with SAS 6.04 for Gaussian distribution that had been repeated two or three times after trimming out the the tests showed Gaussian distribution. Subsequently, Thereference ranges were defined in the rage from the point of lower 2.5% to the point of higher 97.5%. And in case the lower range could be "0", the reference ranges were defined in the range of 0 to 95%.
Fifteen laboratoried troughout Korea of KAHP currently have standarzed reference rages of the tests that they perform. This means the patient data and reference values an be exchangeable among laboratories of KHAP.Annual revise of such reference rages can eventually lead to the level of those representing a standard of the national reference ranges.
Ha, Mikyung;Kim, Hyeongsu;Kim, Yong Ho;Na, Min Sun;Yu, Mi Jung
Journal of agricultural medicine and community health
/
v.43
no.4
/
pp.258-269
/
2018
Objectives: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June $5^{th}$ but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. Methods: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June $2^{nd}$ to June $12^{th}$. Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. Results: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) Conclusions: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.
Purpose: Until now, the process was improved by the needs of experimenters personally. But recently, suggestion system in hospital has been activated in various ways. So the department of nuclear medicine laboratory is also aware of the need of operation improvement using suggestion system. It is intend to assist in the development by sharing excellent suggestion cases with other hospitals. Material & Method: A total of 124 suggestion cases from January 2007 to March 2010 were analyzed. Suggestion cases were divided into customer satisfaction, cost reduction, improved testing methods, equipment, environmental improvement, and computational system. Result: Suggestion cases of environmental improvement and computational system were accounted for 26.6% as 33 cases, respectively. Suggestion for customer satisfaction is 25.8% as 32 in a total of 124 cases. Conclusion: Activation of the awareness of operation improvement is induced by suggestion system. By securing system of operation improvement, employees' ideas can lead to the production and systematization. Furthermore, it enhances hospital competitiveness and promotes the development of the hospital.
Journal of the Korean Society of Food Science and Nutrition
/
v.38
no.10
/
pp.1457-1465
/
2009
This study was conducted to analyze the food safety management practices and to provide data that could be used to improve food safety management at kindergarten foodservice establishments in Daegu and Gyeongbuk province. Microbiological hazard analysis was conducted from May to July, 2008 at the four foodservice establishments. A total (20 items) of foodservice facilities, cooking utensils, and equipment were tested about total plate counts, coliforms, E. coli, Staphylococcus aureus, Salmonella spp., and Listeria monocytogenes. The microbiological detected levels were higher than the critical limits for prepreparing and cooking knives, chopping boards, working tables (both prepreparing and cooking), refrigerator (inside wall), bart, basket, and tray. E. coli, Salmonella spp., and Listeria monocytogens were not detected in any samples. However, Staphylococcus aureus were detected in rubber gloves for cooking and trench in the bottom at one foodservice establishment. In conclusion, these results suggest that a prerequisite programs guideline should be provided to improve the food safety levels at kindergarten foodservice establishments and the foodservice manager must maintain proper food safety technique for foodservice facilities, cooking utensils, and equipment at kindergarten foodservice establishments to prevent cross-contamination and spread of foodborne pathogens.
The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections.
Respiratory viruses (RVs) cause infections in hospital environments through direct contact with infected visitors. In infection control, it causes major problems of acquired infections in hospitals by respiratory viruses. The surveillance data derived from clinical laboratories are often used to properly allocate medical resources to hospitals and communities for treatment, consumables, and diagnostic product purchases in the institutions and public health sectors that provide health care. An early diagnosis is essential in infection with respiratory viruses, and methods that can be used in diagnostic methods using respiratory samples include virus culture, molecular diagnosis, and analysis. A microchip provides a new strategy for developing a more diverse and powerful technology called point-of-care testing. The importance of the respiratory system should be applied strictly to the infection control guidelines to ensure the occupational health and safety of health care workers. Evidence of clinical efficacy, including this study, is challenging the long-standing paradigm for infection propagation. Additional assistance will be needed for frequent tests to detect respiratory viruses in inpatients who have begun to show new respiratory symptoms indicating infections requiring efforts to control the infection.
Kim, Jiwoo;Ju, Hyo-Jin;Koo, Jehyun;Lee, Hyeyoung;Park, Hyeonhwan;Song, Kyungcheol;Kim, Jayoung
Korean Journal of Clinical Laboratory Science
/
v.53
no.3
/
pp.225-232
/
2021
This study sought to investigate the distribution, antimicrobial resistance rate, and bacterial co-infection frequency of non-tuberculous mycobacteria (NTM) in a single center in Incheon, South Korea. A total of 8,258 specimens submitted for tuberculosis (TB)/NTM real-time PCR tests during the years 2015 to 2020 were retrospectively reviewed. In total, 296 specimens (3.6%) were NTM positive, and the positivity increased from 2.5% (30/1,209) in 2015 to 3.8% (66/1,740) in 2020. Of 296 NTM specimens, 54.7% (162/296) were identified as the Mycobacterium avium complex (MAC) followed by the Mycobacterium abscessus complex (MABC) 20.9% (62/296), M. fortuitum 6.4% (19/296) and M. flavescens 3.4% (10/296). Of the NTM-positive specimens, 76.7% (227/296) were tested for drug resistance. The results showed multidrug-resistant NTM in 40.1% (91/227) and extensively drug-resistant NTM in 59.9% (136/227) of these specimens. Of the 145 isolates taken for bacterial culture, bacteria/fungi co-infection with NTM accounted for 43.4% (63/145), in which the most common bacterial species was Klebsiella pneumonia (23.8%, 15/63). This study is the first report on the distribution and antimicrobial resistance of NTM in Incheon. As the proportion of NTM infections increases, active treatment and thorough infection control are required for effective management.
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