• Title/Summary/Keyword: 인자 중요도

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The Effect of Adequate Radiation Shield Production for Radiation Worker (방사선 차폐체 제작을 통한 작업종사자 피폭 감소 방안)

  • Kim, Ki;Hong, Gun-Chul;Kwak, In-Suk;Park, Sun-Myung;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.41-44
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    • 2010
  • Purpose: Along with recent advances in PET/CT instrumentation and imaging technology, the number of patients has also been steadily increasing. This resulted in the increased radiation exposure to radiation workers in PET/CT rooms. In this study, we installed a radiation shield and investigated whether it could reduce radiation exposure to the workers and thus enhance job satisfaction. Materials and Methods: A radiation shield is composed of 5 cm thick lead and has a structure in which a radiation worker sits and watches a patient through lead glass while injecting radiopharmaceutical to the patient. Quarterly absorbed dose of radiation workers was measured using thermoluminescence dosimeters (TLD) and the results were compared for six months each before and after installation of the radiation shield. Exposure dose was also measured using a pocket dosimeter placed at the same location in the front and the back of the radiation shield. In addition, frequency of use of the shield and job satisfaction of radiation workers were investigated using a survey. Results: Quarterly absorbed dose of radiation workers was 2.70 mSv on average before installation of new radiation shield, whereas that dropped to 2.13 mSv after installation of radiation shield, reducing radiation exposure dose by 21%. Exposure dose on the front side of the shield was 61.2 R, whereas that on the back side of shield was 2.8 R. According to the survey, 85% of workers used the shield and were satisfied with the outcome: each radiation worker made injections to patients average of 6.5 times/day and preferred sitting to standing while injecting radiopharmaceutical to patients. Conclusion: Use of radiation shield reduced the exposure dose of radiation workers, which is the ultimate goal of radiation protection to minimize radiation exposure and is an appropriate method for the improvement of hospital working environment. Furthermore, we found that use of radiation shield not only relieves physical and psychological burden of radiation workers but also enhances job satisfaction. This result indicates that use of radiation shield is important for improvement of the radiation workers' job environment in terms of radiation protection.

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MHC Class II Allele Association in Korean Children With IgA Nephropathy and its Role as a Prognostic Factor (한국인 IgA 신병증 환아에서 MHC Class II유전자형과 예후와의 관계 분석)

  • Kim Pyung Kil;Yook Jinwon;Kim Ji Hong;Jang Yoon Soo;Shin Jeon-Soo;Choi In-Hong
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.33-39
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    • 2000
  • Purpose: Our study was designed to investigate the association of MHC Class II (DR, DQ) allele with IgA nephropathy and its significance as a prognostic factor for progression to ESRD Material and Methods: 69 children with IgA nephropathy with normal renal function(serum creatinine $\leq$ 1.5mg/dL) was classified as group A and 70 patients who received renal transplantation due to IgA nephropathy were selected as group B. The HLA-DQB1 and HLA-DRB1 alleles were studied by polymerase chain reaction using sequence specific primers. We have compared the difference in alleles between these two groups and with normal control and also examined any possible effect of the MHC class II genes on the histopathological severity and prognosis of IgAN. Results: Mean age was $8.8{\pm}2.9$ years in group A and $35.0{\pm}15.5$ years in group B. Male to female ratio was 2.8:1 in group A and 2.5:1 in group B. There was a significantly higher frequency of HLA-$DQB1^*03\;and\;DQB1^*05$ in Group B. The frequency of HLA-$DQB1^*0302\;and\;^*05031$ allele had increasing tendency in Group B(P<0.05). HLA-$DRB1^*03\;and\;^*05$ were more common in Group B(P<0.05). HLA-$DRB1^*04$ allele was the most common DR alleles in both group, but there was no statistical significance. There were no significant correlation with MHC class 13 genes on the hjstopathological severity in Group A. Conclusion: In conclusion, $HLA-DQB1^*0302\;and\;HLA-DQB1^*05031 $ allele seemed to be more common in transplanted patients compared to group with normal renal function suggesting that this allele is associated with poor prognosis in IgAN. However larger studies and follow up are required to confirm this due to uncharacterized heterogeneity in etiopathogenesis of IgA nephropathy and possibly one or more than one gene may exert influence in determining susceptibility to the diseases.

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The Role of Initial Relative Renal Function in Unilateral Hydronephrosis (일측 폐색성 및 역류성 수신증에서 술전 상대적 신기능의 의미)

  • Han Sang-Won;Kang Seon-Jung;Kwon Min-Jung;Kim Dae-Joong;Choi Seung-Kang;Lee Tack
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.203-208
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    • 1999
  • Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.

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Incidence and Risk Factors for Extended-Spectrum ${\beta}-Lactamase-Producing$ Escherichia coli in Community-acquired Childhood Urinary Tract Infection (지역사회 획득 소아 요로 감염에서 Extended-Spectrum ${\beta}-Lactamase$ 생성)

  • Lee Jung-Won;Shin Jee-Sun;Seo Jeong-Wan;Lee Mi-Ae;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.214-222
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    • 2004
  • Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.

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Factors Affecting Clinical Course of BCG Lymphadenitis (BCG 림파선염의 경과에 영향을 미치는 인자들에 대한 연구)

  • Na, Kyong Hee;Rim, Sung Soo;Kim, Eun Yong;Kim, Kyoung Sim;Kim, Yong Wook
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.181-190
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    • 2001
  • Purpose : Lymphadenitis is the most common complication of BCG vaccination and has various clinical course and prognosis, but there are no accurate guidelines for management of BCG lymphadenitis. We performed this study to reveal the clinical course of BCG lymphadenitis and provide guidelines for its management. Methods : From January, 1997, to May, 2000, 73 patients in the 3~24 months were enrolled. We investigated retrospectively the size, site, and number of lymphadenitis, tuberculin skin test induration, used BCG strains, vaccination age, injection site, treatment and clinical course. The effects of various variables on clinical course were evaluated. Results : 1) There were no statistically significant difference between lymphadenitis size and tuberculin test induration diameter, spontaneous resolution rate, and suppuration rate. 2) Later vaccination(${\geq}1$ mo) and supraclavicular lymphadenitis increased suppuration rate. Using domestic BCG product increased surgical treatment rate. 3) According to treatment(observation vs antituberculous medication), medication did not affect the prevention of suppuration and ironically increased the rate of suppuration and surgical treatment. 4) Suppurative lymphadenitis required more surgical treatment than non-supurative one. Conclusions : Clinical course of BCG lymphadenitis is affected by vaccination age, used BCG strains, site of lymphadenitis, antituberculous medication and suppuration, but not affected by size and number of lymphadenitis. For management of BCG lymphadenitis, systemic antituberculous medicaion is not recommended and regular follow up with observation should be the mainstay. But for suppuration, active surgical en bloc resection should be the treatment of choice.

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Estimate and Analysis of Planetary Boundary Layer Height (PBLH) using a Mobile Lidar Vehicle system (이동형 차량탑재 라이다 시스템을 활용한 경계층고도 산출 및 분석)

  • Nam, Hyoung-Gu;Choi, Won;Kim, Yoo-Jun;Shim, Jae-Kwan;Choi, Byoung-Choel;Kim, Byung-Gon
    • Korean Journal of Remote Sensing
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    • v.32 no.3
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    • pp.307-321
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    • 2016
  • Planetary Boundary Layer Height (PBLH) is a major input parameter for weather forecasting and atmosphere diffusion models. In order to estimate the sub-grid scale variability of PBLH, we need to monitor PBLH data with high spatio-temporal resolution. Accordingly, we introduce a LIdar observation VEhicle (LIVE), and analyze PBLH derived from the lidar loaded in LIVE. PBLH estimated from LIVE shows high correlations with those estimated from both WRF model ($R^2=0.68$) and radiosonde ($R^2=0.72$). However, PBLH from lidar tend to be overestimated in comparison with those from both WRF and radiosonde because lidar appears to detect height of Residual Layer (RL) as PBLH which is overall below near the overlap height (< 300 m). PBLH from lidar with 10 min time resolution shows typical diurnal variation since it grows up after sunrise and reaches the maximum after 2 hours of sun culmination. The average growth rate of PBLH during the analysis period (2014/06/26 ~ 30) is 1.79 (-2.9 ~ 5.7) m $min^{-1}$. In addition, the lidar signal measured from moving LIVE shows that there is very low noise in comparison with that from the stationary observation. The PBLH from LIVE is 1065 m, similar to the value (1150 m) derived from the radiosonde launched at Sokcho. This study suggests that LIVE can observe continuous and reliable PBLH with high resolution in both stationary and mobile systems.

Apoptosis and Proliferative Activity of Non-Hodgkin's Lymphoma : Correlation with Bcl-2 and P53 Protein Expression (비호지킨림프종에서 아포프토시스 및 세포증식 : Bcl-2, P53 단백발현과의 관계)

  • Oh, Yoon-Kyeong;Lee, Mi-Ja;Jeon, Ho-Jong
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.73-80
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    • 2002
  • Purpose : Tumor growth in a given neoplasm is the net result of cell proliferation and cell loss, and apoptosis is the most significant component of continuous cell loss in most tumors. In this study, we examined non-Hodgkin's lymphoma (NHL, n=67) immunohistochemically for the presence of Bcl-2 oncoprotein and P53 protein and compared apoptotic indices (Als) and Ki-67 proliferative indices (percentages of Ki-67 positive cells). Materials and Methods : 67 patients with NHL were evaluated : 3 low-grade and 64 intermediate-grade. The phenotype was determined in 65 cases : 47 $(70\%)$ were B cell type and 18 $(27\%)$ were T ceil type. Als and Ki-67 proliferative indices were determined immunohistochemically and the overexpression of P53 and Bcl-2 protein were also evalutated. Results : The overexpressions of Bcl-2 protein and P53 protein were found in $40\%$ (26/65) and $31\%$ (20/65). The Al ranged from $0\%\;to\;15\%$ (mean 2.16, median 1.2). Cellular Bcl-2, which counteracts apoptosis, was significantly (p=0.005) associated with Als. Ki-67 proliferative indices ranged from $1\%\;to\;91\%$ (mean 55.4), and P53 was significantly (p=0.000) associated with Ki-67 proliferative indices. A positive correlation between Als and Ki-67 proliferative indices was revealed (p=0.012) in Bcl-2 positive patients. Conclusion : In NHL, we observed a correlation between Als and Bcl-2 expression, between Ki-67 proliferative indices and P53 expression, and between Als and Ki-67 proliferative indices in Bcl-2 positive patients. Our results suggest that cell apoptosis may be inseparable from cell proliferation during tumor growth.

The Effects of the Warm Ischemic Time, the Preserving Temperature and the Cryopreservation Solution on the Viability of Tracheas (온혈허혈시간과 냉동보존온도와 보존액 조성에 따른 기관의 생육성 비교)

  • Sa, Young-Jo;Park, Jae-Kil;Sim, Sung-Bo;Jin, Ung;Moon, Young-Kyu;Lee, Sun-Hee;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.283-291
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    • 2009
  • Background: Tracheal reconstruction after extended tracheal resection still remains as a major surgical challenge because good clinical outcomes are usually correlated with limited tracheal resection. Recent investigations with a using cryopreserved trachea for the reconstruction of a trachea have been carried out to overcome this problem. In this study, we analyzed viability of tracheas, which is an important determining factor for the success of transplanting a cryopreserved trachea and the development of post-transplantation tracheal stenosis, according to three different experimental factors: 1) the warm-ischemic time, 2) the cryopreservation solution and 3) the preserving temperature, to determine a better cryopreservation protocol and a better composition of the cryopreservation solution. Material and Method: Rats tracheas were harvested for different warm-ischemic times (0 hr, 12 hrs, 24 hrs). The tracheas were treated with recombinant insulin growth factor-1 (IGF) and they were stored at three different temperatures $(4^{\circ}C,\;-80^{\circ}C,\;-196^{\circ}C)$ for two weeks. After two weeks, we thawed the stored trachea and isolated the cells of the tracheas with using type II collagenase. We cultured the cells for seven days and then we compared the cellular viability by the MTT reduction assay. Result: Though cryopreservation is required to preserve a trachea for a longer time period, the viability of the tracheas stored at $-80^{\circ}C$ and $-196^{\circ}C$ was significantly reduced compared to that of the tracheas stored at $4^{\circ}C$. The viability of the tracheas with warm-ischemic times of 12 hrs and 24 hrs was also reduced in comparison to the tracheas with a warm-ischemic time of 0 hrs. Our data showed that the warm ischemic time and the parameters of crypreservation negatively affect on trachea viability. However, a cryopresrvation solution containing IGF-1 improved the cellular viability better than the existing cryopreservation solution. For the warm ischemic time group of a 0 hr, the addition of IGF-1 improved the viability of trachea at all the preserving temperatures. Conclusion: These experiments demonstrate that the viability of cryopreserved trachea can improved by modifying the components of the crypreservation solution with the addition of IGF-1 and reducing the warm-ischemic time.

Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

Efficacy of mechanical pleurodesis for the treatment of spontaneous pneumothorax with VATS - A comparison of short-term recurrence according to the intensities of pleural abrasion - (비디오 흉강경을 이용한 자연기흉 수술에서 기계적 흉막유착술의 효과 -기계적 흉막유착술의 강도에 따른 단기 재발율의 비교-)

  • 허진필;이정철;정태은;이동협;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1070-1075
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    • 1998
  • Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

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