• Title/Summary/Keyword: 환자 안전 및 질

Search Result 95, Processing Time 0.05 seconds

Quantitative Assessment of the Radiation Exposure during Pathologic Process in the Sentinel Iymph Node Biopsy using Radioactive Colloid (방사성 콜로이드를 이용한 감시림프절 생검 병리처리과정에서 방사선 피폭의 정량적 평가)

  • Song, Yoo-Sung;Lee, Jeong-Won;Lee, Ho-Young;Kim, Seok-Ki;Kang, Keon-Wook;Kook, Myeong-Cherl;Park, Weon-Seo;Lee, Geon-Kook;Hong, Eun-Kyung;Lee, Eun-Sook
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.41 no.4
    • /
    • pp.309-316
    • /
    • 2007
  • 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)

Surgical Treatment of Arrhythmias Associated with Congenital Heart Disease (선천성 심장 기형에 동반된 부정맥에 대한 수술적 치료)

  • Hwang, Ui-Dong;Im, Yu-Mi;Park, Jeong-Jin;Seo, Dong-Man;Lee, Jae-Won;Yun, Tae-Jin
    • Journal of Chest Surgery
    • /
    • v.40 no.12
    • /
    • pp.811-816
    • /
    • 2007
  • Background: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. Material and Method: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. Result: The median age at surgery was 52 years ($4{\sim}75$ years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months ($1{\sim}95.2$ months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and $3{\sim}6$ months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). Conclusion: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.

Clinical Appilication of Endobornchial Cryoablation That's Performed through Flexible Bronchoscope for Treating Tracheobronchial Ostruction (기관 및 기관지 폐색환자에서 굴곡형 기관지내시경을 이용한 냉동수술의 임상적용)

  • Lee, Sung-Ho;Kim, Kwang-Taik;Chung, Jae-Ho;Chung, Won-Jae;Kang, Moon-Chul;Kang, Eun-Hae;Lee, Eun-Joo;In, Kwang-Ho
    • Journal of Chest Surgery
    • /
    • v.41 no.4
    • /
    • pp.457-462
    • /
    • 2008
  • Background: Emergency airway access is essential when a patient has dyspnea that's due to tracheal or bronchial obstruction. Such methods as laser therapy and PDT are now being used for the treatment of tracheal obstruction that's due to benign diseases or nonsurgical malignant diseases. Cryotherapy is a method that uses extreme hypothermia for freezing a tumor to cause necrosis. In this study, we have evaluated the clinical effectiveness of performing endobronchial cryoablation through a flexible bronchoscope. Material and Method: 10 patients with tracheal obstruction that was due to endotracheal tumors were evaluated between May 2005 and May 2007. Eight were male and the mean age of the 10 patients was $59.4{\pm}18.4$ years. Three cases of tracheal obstruction were due to benign tumors and 7 were due to malignant tumors. The obstruction sites were 3 at the trachea, 3 at the carina and 4 at the bronchus. A flexible bronchoscope was inserted and the tumor was eliminated using a flexible cryoprobe. Follow up bronchoscopy was performed at 1 week and 1 month after cryoablation, and then we evaluated the decrease of dyspnea, the improvement of the performance and the complications of the procedures. Result: Complete remission was achieved in 4 patients and partial remission was achieved in 6 patients. Complications such as hemoptysis (100%), and cough (50%) were noted. Hemoptysis was spontaneously resolved in 3 to 8 days (mean: 4.9 days). A decrease in dyspnea and improvement in the performance was noted in all patients. Conclusion: Endobronchial stenosis plays a detrimental role in the life quality of a terminal cancer patient. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryoablation is considered to be a safe method that is clinically applicable to a wide range of tumors, including the removal of large tumors. We concluded that endobronchial cryoablation through a flexible bronchoscope is a safe, effective method for treating tracheobroncheal obstructions.

Efficacy of Assisted Hatching by Laser in Human IVF-ET Program (체외수정 및 배아이식술에서 레이저를 이용한 보조부화술의 효용성에 대한 연구)

  • Lee, Jung-Hyun;Han, Ji-Eun;Kim, You-Shin;Won, Hyung-Jae;Cho, Chung-Hyun;Kwak, In-Pyung;Eum, Jin-Hee;Park, Eun-A;Choi, Yoon-Jung;Lee, Dong-Ryul;Yoon, Tae-Ki
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.35 no.3
    • /
    • pp.193-202
    • /
    • 2008
  • Objective: To evaluate efficacy of assisted hatching by laser (AHL) and acidified Tyrode solution (AHA) in selected groups of IVF-ET patients who have a poor prognosis. Methods: From February 2006 to September 2006, total of 328 IVF-ET cycles with advanced female age (${\geq}38$ years), recurrent implantation failure (${\geq}3$ cycles), thick zona (${\geq}17{\mu}m$), and/or poor quality of embryo were randomly divided into assisted hatching by acidified Tyrode solution (AHA, n=180) and the assisted hatching using the ZILOS-tk laser (AHL, n=148) groups. Clinical outcomes were analyzed and compared between AHA and AHL group based on the patient characteristics. Results: In all AHL and AHA group, there were no significant differences in pregnancy (42.6%, 63/148 vs. 33.3%, 60/180) and implantation rates (17.4%, 82/470 vs. 16.0%, 89/556) However, in advanced female age group (Group 1), pregnancy (37.0%, 20/54 vs. 18.7%, 14/75) and implantation rates (14.4%, 23/160 vs. 7.1%, 15/210) in AHL group were significantly (p<0.05) higher than those of AHA, although there was no difference in patient parameters of both groups. And, the clinical outcome of groups with recurrent implantation failure (Group 2), thick zona pellucida (Group 3) and poor quality embryo (Group 4) were improved in AHL compared to those of AHA: 43.8% (21/48) and 31.6% (25/79) in Group 2, 43.8% (32/73) and 34.1% (28/82) in Group 3, 25.0% (7/28) and 14.6% (6/41) in Group 4, but no significance. Conclusion: The AHL improved the pregnancy and implantation rates in patients with advanced female age and recurrent implantation failure when compared to outcomes achieved from AHA. Therefore, this AHL technique may be a efficient and safe method for patients with poor prognosis.

The Regional Characteristics of 119 Ambulance Dispatch, the Distance and Response Time to the Scene (119 구급서비스 지역별 출동특성 및 출동거리와 현장도착시간과의 관계)

  • Lee, Kyoung-youl;Moon, Jun-dong;Choi, Eun-sook
    • The Journal of the Korea Contents Association
    • /
    • v.16 no.1
    • /
    • pp.482-492
    • /
    • 2016
  • Purpose This study is to investigate regional characteristics of 119 ambulance dispatch and the relationship between the distance and response time to the scene. Methods This study was retrospectively conducted 119 running sheets with 1,321 patients who had been transferred to the hospital by 119 ambulance during ambulance attendant training. The training was performed at two, five and three fire station in Seoul, Daejeon and Chungnam respectively, from June 24, 2013 to July 19, 2014. Results Almost the emergency medical services provided were no more than basic first aid in all regions. The patients transferred by 119 ambulance in Seoul were more than other region. The time of call to scene and scene to hospital were the slowest in Chungnam. The major reason of call 119 was due to disease in Seoul and Daejeon, however due to injury in Chungnam. Conclusion Our study suggests that learning from ambulance attendant training course could diverse from region to region. It is, therefore, needed that standardization of ambulance attendant training course, appropriate logistics and resource allocation for providing universal quality of emergency medical services.

Efficacy and safety of electrolytes-free polyethylene glycol (PEG) 4000 for disimpaction in children with chronic functional constipation (소아 만성 기능성변비 치료에서 전해질이 함유되지 않은 polyethylene glycol (PEG) 4000의 분변박힘 제거효과 및 안전성)

  • Lee, Jeong Hee;Lee, Ran;Bae, Sun Hwan
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.4
    • /
    • pp.391-395
    • /
    • 2008
  • Purpose : This study was performed evaluate optimal dose for disimpaction, efficacy and safety of PEG 4000 in children with chronic functional constipation. Methods : Eighty six children with chronic functional constipation were enrolled in this prospective study at Konkuk university hospital March, 2003 through August, 2006. Success in disimpaction with PEG 4000 was defined as meeting at least two out of three criteria; resolution of chief complaint, getting easiness of defecation with respect to frequency of bowel movement and hardness of stool based on defecation diary, and decrease in fecal impaction on simple abdominal X-ray test. Adverse effects of PEG 4000 were monitored clinically and biochemically. Results : Eighty three out of 86 children completed the study, and success rate of disimpaction was 99% (82/83). The mean dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max.: 30 g/day). Frequency of bowel movement increased ($5.02{\pm}2.71/wk$ vs. $11.25{\pm}5.43/wk$) in most children (79/83). Fecal impaction on simple abdominal X-ray test improved with statistical significance in 25 children (P=0.0007). Because of adverse effect of PEG 4000, 3 children did not complete the study; urticaria, severe diarrhea, diarrhea and abdominal pain. One 6-year-old girl who completed the study complained tingling sensation in the hand and foot without laboratory abnormality (4/86, 4.7%). Laboratory test revealed hyperosmolality without clinical symptom in 1 child, and eosinophilia in 6 children. Conclusion : The average safe and effective dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max : 30 g/day) in children with chronic functional constipation.

Violence Experiences of Community Mental Health Nurse (지역사회 정신보건간호사의 폭력경험)

  • Kim, Mi-Hye;Kim, Han-Na;Shin, Yoon-Mee;Oh, Hyun-Mi;Lee, Jeong-Seop
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.16 no.12
    • /
    • pp.8626-8636
    • /
    • 2015
  • This study is a qualitative study to disclose the meaning and reality of violence experiences of the mental health nurses by the phenomenological approach. This study is done with the participation of 9 community mental health nurses who have work experiences more than 3 years in the city of S, from Nov 7, 2014 till Dec 21, 2014. The result of the study revealed that the violence experiences of this study participants may be categorized into 4 categories, 'a small boat running into a storm', 'open sea', 'a small boat lost of the sign post', 'a captain controlling the rudder' and may be identified with 11 theme cluster and 32 theme.Therefore violence from patients who have experienced mental health nurse could be found to affect even the identity of the mental health nurse as well as threaten safety of professionals. This may threaten the quality of service provided to the patient, so we have to accept reality as a serious problem. Also it has been preceded by what the support program development of the nursing organization for the nurse who is violence victims with preparing for violence Prevention. As the result we suggest that you prepare a practical measures for the safety and quality nursing services performed by mental health nurses.

Integrative literature review of nursing performance in Korea (간호 퍼포먼스에 관한 국내 연구의 통합적 고찰)

  • Cho, Sumi;Lee, Eunjoo
    • Journal of the Korean Data and Information Science Society
    • /
    • v.26 no.2
    • /
    • pp.441-453
    • /
    • 2015
  • This paper review nursing performance in Korea to suggest the direction of future research. A literature review of research nursing performance journal articles was performed. Thirty-three articles were analyzed research design, measurement tools, definition, and variables which with nursing performance. Most of the on nursing performance in Korea descriptive correlation study. There considerable confusion about Korean term and definitions nursing performance. used the instrument developed by Park (1989) to measure nursing performance. The variables with nursing performance leadership and empowerment. No agreement on definitions or concepts of nursing performance evident in Korea. Research on nursing performance that addresses all domains of nursing is needed to analyze the impact of nursing performance on patient and healthcare outcomes.

The Effect of Breast Cancer Survivors' Participation in Line Dance: A Phenomenological Study (유방암 생존자의 라인댄스 참여효과에 대한 현상학적 연구)

  • Kang, Min Jae;Byeon, Ji Yong;Park, Ji Hye;Yu, Mi-seong;Hwang, Seo-Hyeon;Jeon, Justin Y.
    • 한국체육학회지인문사회과학편
    • /
    • v.56 no.6
    • /
    • pp.541-559
    • /
    • 2017
  • The purpose of this study was to understand breast cancer survivors' line dance program participation experience and their perceived effects. Nine participants were selected by the purposive sampling. In the current study, phenomenological research methods were used and qualitative data were collected through in-depth interviews and observation. The analyses indicated that participants's positive experiences were categorized into physical (physiological change, improved digestive system, sleep quality and cognitive function), psychological (pleasure, vigor, peace, self confidence, and satisfaction) and social (improved mood among family members, peer support and pleasure) benefit. Furthermore, participants enjoyed unique characteristics of line dance such as continuous music and nature of group exercise where they enjoy information sharing and peer support In summary, a line dance program was safe and beneficial for breast cancer survivors and should be recommended as one of exercise options for breast cancer survivors.

Discovering the Anti-cancer Effects of Ligusticum Chuanxiong through Network-based Pharmacology Analysis and Molecular Docking: An Inquiry into Natural Products (네트워크 기반 약리학 분석 및 분자 도킹을 통한 천궁의 항암 효과 예측: 천연물에 대한 탐구)

  • Do Kyung Han;Jee Won Shon;Eui Suk Sung;Youn Sook Kim;Won G. An
    • Journal of Life Science
    • /
    • v.33 no.11
    • /
    • pp.876-886
    • /
    • 2023
  • In some cases of head and neck cancers (HNC), surgical interventions may result in the loss of organs and/or changes to their functions, thereby significantly affecting the patient's quality of life. As a result, the surgical treatment of HNC patients is often limited to specific cases, and alternative treatment modalities, such as chemotherapy, are considered. However, serious adverse effects caused by chemotherapy, such as severe nausea and vomiting, necessitate the need for the development of adjunctive methods to minimize patient suffering. Chuanxiong, Ligusticum chuanxiong (L. chuanxiong), is a natural herb used in Eastern medicine to treat cerebrovascular disorders and headaches. This study aimed to predict the effect and potential of L. chuanxiong as an auxiliary anticancer drug through network-based pharmacology and molecular docking analysis. The study results showed that 40 out of 41 genes of L. chuanxiong shared common targets of HNC and their proteins could be used to target HNC cells to prevent cancer progression. The results of the functional enrichment analysis confirmed that L. chuanxiong is associated with the neuroactive-ligand metabolism and neurotransmitter pathways, indicating its potential medicinal value as an adjuvant in HNC treatment. Lastly, our findings demonstrated that the active ingredient of L. chuanxiong, (Z)-Ligustilide, has the ATP binding site of heat shock protein 90, a protein known to promote the activation of cancer cells. These results suggest that L. chuanxiong is a promising candidate for developing auxiliary anticancer drugs, and further research could potentially lead to the discovery of newer and safer anti-cancer agents.