• 제목/요약/키워드: CM at Risk

검색결과 346건 처리시간 0.029초

Factors Associated with Echinococcosis-Induced Perioperative Anaphylactic Shock

  • Ye, Jianrong;Zhang, Qin;Xuan, Yan;Chen, Siyu;Ma, Long;Zhang, Yongqiang;Zheng, Hong
    • Parasites, Hosts and Diseases
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    • 제54권6호
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    • pp.769-775
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    • 2016
  • This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015-1.185; P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259-7.283, P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.

초음파 피로시험법을 이용한 엔지니어링 플라스틱 (Polyoxymethylen ; POM)의 내구성 평가 (Durability Assessment of Polyoxymethylen Using Ultrasonic Fatigue Testing)

  • 조인식;황정호;오주연;김현창;오세훈;이창순;박인규
    • 대한기계학회논문집A
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    • 제39권8호
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    • pp.781-785
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    • 2015
  • 엔지니어링 플라스틱(Engineering Plastic ; EP)에 대한 내구성 평가를 위해 현재 새롭게 국내에서 개발한 초음파 피로시험법을 이용하여 EP 중에서도 결정화 속도가 빠르고 결정화도가 높은 범용 POM(Polyoxymethylene) 소재에 대한 초음파 가속피로시험 거동을 평가하고자 하였다. 이에 본 연구에서 사용된 POM 소재의 밀도는 $1.37g/cm^3$, 동탄성계수는 3.49 GPa 로 측정되었으며, 초음파피로시험 20kHz, 응력비 R= -1 의 판상시편 두께 (4t, 7t, 10t)에 따른 피로수명평가 결과 전체 응력진폭 5.0~6.0MPa 부위에서 피로한도를 확인하였다. 피로시험 후 파단 면을 관찰한 결과 7t, 10t 두께 시편의 크랙 시작위치에서 미소 공동들이 서로 연결된 형태의 잔금(crazing) 균열현상으로 파단된 dimple 구조형상을 전자현미경을 통해 확인할 수 있었다.

조영제를 사용하는 환자의 부작용: 특성과 관리에 관한 연구 (Studies of the side effects on using the contrast media: It's characteristic and management)

  • 선종률;유세종
    • 대한안전경영과학회지
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    • 제16권4호
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    • pp.427-431
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    • 2014
  • The purpose of this study is to monitor the current adverse reactions in administering CT contrast agents at general hospitals and also to suggest the practical guidelines to minimize the risk and to show the successful patient management. At four Dajeon city general hospitals, the contrast agents were administered in 646,828 cases and the overall prevalence of adverse reactions was 4,110 cases from January 2010 to December 2013. However, we excluded the two hospitals' 3,658 cases because the patients' data was inadequate. Consequently, the case surveys on the rest of 452 cases have been studied and submitted. After comparing the patients with a control group, we evaluated that the key factors of the adverse reactions were the gender and age difference of the patients, the examination period, the examination method, the quantity and administrating speed of the contrast agents. Even though the four general hospitals have their own management systems on adverse reactions, but their systems were not satisfying. To improve the quality of the management systems and to investigate further cases, some hospital administration procedures on the subject should be systemized and general hospitals should follow the recommended procedures. Moreover, the existing three-year-term evaluation should not only judge the adverse reaction management but also conclude some details on the sub criteria of the evaluation. The details on the sub criteria include the contrast agent characters, the quantity and administrating speed of the drug, the incidents' occurred time, an anamnesis; a case history, the medical history of the patients and the reaction occurring body parts, and the examination title. The details of the medical examiners are also added to the sub criteria.

한 손 들기 작업과 내리기 작업의 요추부위(L5/S1) 부하에 대한 비교 연구 (Comparison of Biomechanical Stress on Low Back(L5/S1) for One-hand Lifting and Lowering Activity)

  • 김홍기
    • 산업경영시스템학회지
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    • 제37권4호
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    • pp.72-81
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    • 2014
  • Even though two-hands lifting/lowering activity of manual materials handling tasks are prevalent at the industrial site, many manual materials handling tasks which require the worker to perform one-hand lifting/lowering are also very common at the industrial site, forestry, farming, and daily life. The objective of this study was to compare one-hand lowering activity to lifting activity in terms of biomechanical stress for the range of lowering heights from knuckle height to 10cm above floor level with two workload 7.5kg and 15.0kg. Eight male subjects with LMM were asked to perform lifting/lowering tasks using both a one-handed (left-hand and right-hand) as well as a two-handed technique. Spinal loading was estimated through an EMG-assisted free-dynamic biomechanical model. The biomechanical stress of one-hand lowering activity was shown to be 43% lower than that of one-hand lifting activity. It was claimed that the biomechanical stress for one-hand lifting/lowering activity is almost twice (194%) of the one for two-hands lifting/lowering activity. It was also found that biomechanical stress by one-hand lowering/lifting activity with the half workload of two-hands lowering/lifting activity was greater than that of the two-hands lowering/lifting activity. Therefore, it might be a risk to consider the RWL of one-hand lowering/lifting activity to simply be a half of the RWL of two-hands lowering/lifting activity recommended by NIOSH.

휴대용 손 선풍기의 극저주파 자기장 발생 수준 평가와 쟁점 고찰 (Discussion of Exposure Evaluation Associated with Extremely Low Frequency-magnetic Field in the Case of Portable Hand-held Fans)

  • 박동욱;이성진;김소연;배서연;최상준;김원;민승현;박지훈;안종주
    • 한국환경보건학회지
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    • 제44권5호
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    • pp.480-490
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    • 2018
  • Objective: This study aimed to report the level of extremely low frequency-magnetic field (ELF-MF) emitted by portable hand-held fans (HHF) and to discuss the methodologies for determining the health risk of ELF-MF for HHF products. Method: ELF-MF was monitored at eight locations by distances in the vicinity of HHFs. A total of 13 HHF brands on the market were randomly selected. A portable ELF-MF monitor MDEX II was used to measure the ELF-MF level in the range of 40-800 Hz with a resolution of $0.01{\mu}T$. This study also examined the frequency results of a total of 45 HHF products investigated by the Korean Ministry of Science and ICT (KMSICT). Results: ELF-MF higher than $0.3{\mu}T$ was found to be emitted at a distance of less than 20 cm from 12 HHF. ELF-MF emitted from four products was found to exceed the reference level ($83.3{\mu}T$ based on 60 Hz) recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). KMSIT reported that the principle frequency emitted from the HHFs ranged from 54 Hz to 284 kHz, without the level of LEF-MF. Unscientifically, the KMSICT used the reference level by ICNIRP as the chronic level and concluded that all HHFs are safe with a basis of 1.2-36.0% less than the reference level. Conclusion: The HHF emitted much higher levels of ELF-MF than $0.3-0.4{\mu}T$, which is regarded as the reference level for childhood leukemia. The risk of HHF should be examined in terms of whether they can be used by the general public, including children and pregnant woman.

악성 빈혈환자에서 발병한 위암 1예 보고 (Gastric Adenocarcinoma in Patient with Pernicious Anemia: A Case Report)

  • 김병수;김종원;이인규;김동출;김우호;이혁준;양한광
    • Journal of Gastric Cancer
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    • 제7권1호
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    • pp.38-41
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    • 2007
  • 악성빈혈을 동반한 자가면역성 만성 위축성 위염은 위암의 전구 병변으로 알려져 있다. 저자들은 악성빈혈에 동반된 위암 1예를 경험하였기에 보고한다. 40세 여자환자가 어지럼증과 공복 시 속쓰림으로 시행한 혈액검사상 혈색소 4.2 g/dl으로 측정되었다. 상부위장관 내시경상에서는 위 고위 체부의 편평 융기성 병변이 관찰되었고 조직검사상 위선암으로 보고되었다. 위전절제술을 시행하였고 병리조직 검사상 병변은 고위 체부 전벽에 점막하층(SM2)까지 침범한 조기위암이었으며, 검사된 림프절 44개 중에 전이된 림프절은 없었다. 악성빈혈 환자에서 위축성 위염이 동반된 경우 위암의 호발연령이 되면 위암의 발생 가능성이 있으므로 상부위장관 내시경의 주기적인 시행이 중요하리라 생각된다.

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Treatment outcomes of curative radiotherapy in patients with vulvar cancer: results of the retrospective KROG 1203 study

  • Kim, Youngkyong;Kim, Joo-Young;Kim, Ja Young;Lee, Nam Kwon;Kim, Jin Hee;Kim, Yong Bae;Kim, Young Seok;Kim, Juree;Kim, Yeon-Sil;Yang, Dae Sik;Kim, Yeon-Joo
    • Radiation Oncology Journal
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    • 제33권3호
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    • pp.198-206
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    • 2015
  • Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.

Geant4 몬테칼로 시뮬레이션을 활용한 불균질 매질에서의 양성자의 이차입자 영향 분석 (Evaluation of the Secondary Particle Effect in Inhomogeneous Media for Proton Therapy Using Geant4 Based MC Simulation)

  • 박소현;정원균;라정은;박성용;서태석
    • 한국의학물리학회지:의학물리
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    • 제21권4호
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    • pp.311-322
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    • 2010
  • 양성자 치료 시, 이차 입자는 암 부위 이외의 영역에 선량을 전달하고 이차 암 발생 가능성을 내재하기 때문에 이에 대한 정확한 분석은 중요한 역할을 한다. 본 연구의 목적은 불균질 물질에 의해 양성자 빔으로부터 발생 된 이차입자의 플루언스와 에너지 분포가 받는 영향에 대해 Geant4 (Geometry And Tracking) 전산모사를 통해 분석 하는 것이다. 불균질 조건은 브래그 커브 내에 최대 선량의 30% (플라토)와 80% (브래그 피크) 선량 지점에 두께 2 cm의 지방, 뼈 그리고 폐 등가 물질을 삽입하여 구성하였다. 또한, 양성자의 에너지는 100, 130, 160 그리고 190 MeV로 변화시켰으며, 이차 입자에 대한 결과는 불균질 물질에서의 이차입자의 플루언스와 에너지 분포로 나타내었다. 이차입자의 플루언스는 불균질 물질의 밀도에 적은 영향을 받지만, 삽입위치, 양성자의 초기 에너지에 따라서는 영향을 받지 않는다. 이차입자의 에너지 분포는 불균질 물질의 삽입 위치에 따라 다르다. 플라토 영역 내에서 이차입자의 에너지 분포는 물질의 밀도에 영향을 받지만, 브래그 영역 내에서는 불균질 물질의 밀도와 양성자의 초기 에너지에 영향을 받는다. 본 연구는 더욱 복잡한 불균질 물질에서의 이차입자의 분포에 대한 예측 가능성을 내제한다.

Significantly Low Effective Dose from 18FDG PET/CT Scans Using Dose Reducing Strategies: "Lesser is Better"

  • uz Zaman, Maseeh;Fatima, Nosheen;Zaman, Areeba;Zaman, Unaiza;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3465-3468
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    • 2016
  • Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

방풍통성산이 비만인에 미치는 영향에 대한 임상적 연구 (Clinical study of Bangpoongtongsungsan on body weight change in subjects with obesity)

  • 신대희;조국현;이혁;문미경;강대길;윤용갑;박도심;정선관;이호섭
    • 대한한의학방제학회지
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    • 제16권2호
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    • pp.133-144
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    • 2008
  • Recently, people are becoming fatter in most parts of the world. Obesity is regarded as an important risk factor to adversely affect the health of humans, associated with hypertension, hyperlipidemia, diabetes, and cardiovascular diseases. In the present study, therefore, we tested the short time efficiency and safety of Bangpoongtongsungsan as a drug to decrease body weight in subjects with obesity. A total 48 volunteers (24 man, 24 woman) with body mass index (BMI : weight in kg divided by square of height in meters) of $23㎏/m^2$ participated in clinical study for 12 weeks, from 2008, March 01 to 2008, Jun 30. The subjects was received a dietary supplement of 12 pieces hard capsules per day (4 pieces in one, 3 times in a day) during the clinical study. At the end of clinical study, body weight of subjects was significantly decreased from $72.21{\pm}11.44\;kg$ to $70.53{\pm}11.67\;kg$ (p<0.05). Waist circumferences of subjects were reduced $91.58{\pm}6.43\;cm$ to $85.25{\pm}7.70\;cm$ (p<0.05). Also, a BMI of subjects was significantly decreased $26.07{\pm}2.35\;kg/m^2$ to $25.63{\pm}2.63\;kg/m^2$ (p<0.05). Particularly, a decrease in body weight, waist circumferences, and BMI was more significant in woman than man. But, other biochemical levels including lipid and glucose in plasma had no changes at the end of clinical study. In conclusion, administration of Bangpoongtongsungsan in subjects with high body weight fat could inhibit obesity associated with a decrease in body weight, waist circumferences, and BMI.

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