• Korean Journal of Radiology
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• 제20권5호
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• pp.695-708
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• 2019

Atrial fibrillation (AF) is the most common arrhythmia associated with the risk of morbidity and mortality in clinical patients. AF is considered as an arrhythmia type that develops and progresses through close connection with cardiac structural arrhythmogenic substrates. Since the introduction of catheter ablation-mediated electrical isolation of arrhythmogenic substrates, cardiac imaging indicates improved treatment outcome and prognosis with appropriate candidate selection, ablation catheter guidance, and post-ablation follow-up. Currently, cardiac computed tomography (CCT) and cardiovascular magnetic resonance (CMR) imaging are essential in the case management of AF at both pre-and post-procedural stages of catheter ablation. In this review, we discuss the roles and technical considerations of CCT and CMR imaging in the management of patients with AF undergoing catheter ablation.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.39-49
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• 2021

Purpose: The negative pressure isolation ward is a key facility in preparedness and response to infectious diseases. For the sustainable operation of the facility, appropriate facility improvement is required. The experience of medical staff responding to infectious diseases in the COVID-19 pandemic provides effective informations for facility planning. Methods: The post occupancy evaluation (POE) was conducted by interviewing medical staff who is working on Nationally designated negative pressure isolation ward in general hospital. Floor plan analysis was conducted before field surveys for identifying facility characteristic and spatial composition. After that, field surveys were conducted at 3 hospitals, and interviews and fieldwork were conducted together. Results: It is necessary to increase the standard size of ward area from 15m² to 20m². The size of the doffing room has to be planned for accommodation of two or more people. Equipment storage, clean storage and waste storage also should be properly planned. There were almost no problems with the circulation in the ward. There was not enough space for medical staff. Implications: For a sustainable and safe negative pressure isolation ward planning, it is necessary to exploit learning from the medical staffs who have many experiences of coping with infectious diseases.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.112-121
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• 2020

Background: Vancomycin-resistant Enterococcus (VRE) has become more common in nosocomial infections, especially in urine samples. However, until now, no treatment regimen has been proven to effectively eradicate urine VRE colonization. Therefore, to evaluate the efficacy of doxycycline in eradicating urine VRE and shortening VRE isolation period, we compared VRE colony detection period between doxycycline-treated and untreated patients. Methods: A retrospective cohort study of 83 patients with VRE colonization in urine cultures was conducted at a tertiary academic hospital from January 2011 to February 2018. Kaplan-Meier survival analysis was used to evaluate eradication rates in the treatment and non-treatment groups. Factors affecting urine VRE colonization persistence were analyzed by multiple logistic regression analysis. Results: The overall rate of VRE eradication during the entire hospital stay was higher in the doxycycline treatment group (90.5%) than in the non-treatment group (58.1%, p=0.014). Survival analysis showed that the 5-, 10-, and 20-day cumulative eradication rates were 78.3%, 100%, and 100% in the doxycycline treatment group, and 18.5%, 45.7%, and 67.8% in the non-treatment group, respectively, thereby indicating that eradication rates were higher in the doxycycline treatment group than in the non-treatment group (p<0.001). Only doxycycline treatment was shown to affect urine VRE colonization persistence in multivariate logistic regression analysis. Conclusion: Doxycycline treatment enhanced the eradication rate of urine VRE colonization and appeared to be useful in shortening VRE isolation period.

• 대한영상의학회지
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• 제84권4호
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• pp.891-899
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• 2023

목적 급성호흡기질환인 코로나바이러스감염증-19 (coronavirus disease 2019; 이하 COVID-19) 환자를 대상으로 한 음압격리들것(negative presurre isolation stretcher; 이하 NPIS)을 이용한 흉부 전산화단층촬영(이하 CT) 방식에 대해 전문의들의 경험과 의견을 확인하고자 하였다. 대상과 방법 격리입원 중인 COVID-19 환자에게 NPIS를 이용한 흉부 CT 검사를 시행했던 9개 의료기관 소속 27명의 전문의들을 대상으로 1) 조영증강 흉부 CT가 필요한 경우, 2) NPIS를 이용한 흉부 CT의 영상품질, 그리고 3) CT 조영제주사를 위한 NPIS 개방과 CT 검사실의 오염을 주제로 설문조사를 진행하였다 결과 조사대상인 9개의 의료기관들은 기관당 한 해 평균 116건의 COVID-19관련 흉부 CT 검사를 NPIS와 함께 진행했으며. 전체 검사 건수 중 평균 24건(21%)이 조영증강 흉부 CT였다. 설문에 참여한 호흡기내과 전문의 9명 중 5명(56%)은 환자의 혈중 D-dimer 이상이 확인되면 조영증강 CT가 필요하다고 의견을 밝혔다. 한편 영상의학과 전문의 9명 모두는 NPIS로 인한 흉부 CT 영상의 품질은 폐렴 또는 폐혈전 진단이 가능한 수준이라 답하였다. 또한 감염내과 전문의 9명 중 5명(56%)은 NPIS의 개방으로 인한 CT 검사실의 이차감염은 소독을 통해 예방할 수 있는 수준으로 생각하고 있었다. 결론 격리입원 중인 COVID-19 환자에서 NPIS와 함께 흉부 CT를 진행하더라도 CT의 품질은 진단이 가능한 수준이며 NPIS가 CT 검사실 내에서 잠시 개방되더라도 CT 검사실의 감염확산 위험은 높지 않은 것으로 전문의들은 인식하고 있었다.

• 대한미생물학회지
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• 제9권1호
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• pp.13-18
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• 1974

Blood is one of the most important clinical specimens for the isolation of bacteria. A rapid isolation and a high isolation rate of bacteria are very important in blood culture because bacteremic patients are mostly in grave condition. Various blood culture media which support growth of most fastidious bacteria are available commercially. However, growth of bacteria are frequently delayed because of antibacterial activity of blood. Sodium polyanethol sulfonate(Liquoid) has been reported to inactivate the antibacterial substance and disrupt phagocytic cells. The beneficial effect of SPS is well recognized in the isolation of gram-positive bacteria. However, the effect does not seem to be prominent for gram-negative bacilli isolation mainly due to the rapidity of their growth. It has been experienced with Sal. typhi that the growth is much slower than that of other gram-negative bacilli. For the rapid growth of the organism, use of bile broth has been recommended. Although Sal. typhi is the most frequently isolated organism at present, about one half of total isolates are other organisms and, in case bile broth is used, other media which support growth of these organisms should be used together. Fluid thioglycollate medium(FTM) which is always used in blood culture to isolate anaerobes is inferior to brain heart infusion(BHI) for the isolation of aerobes. This study was done to determine the effect of SPS on the isolation of Sal. typhi from blood. During the Sep. 1973 to Sep. 1974 study period, 2460 blood cultures were made from the Severance hospital patients: BHI and FTM sets 1431 specimens, BHI with SPS(0.05%) and FTM sets 396 specimens, BHI and FTM with SPS sets 359 specimens, BHI and BHI with SPS sets 274 specimens. Mean incubation time required for the macroscopic detection of growth of Sal. typhi were 3.5 days on BHI and 2.7 days on BHI with SPS. The 0.8 day difference was statistically significant. On FTM the mean incubation time was 3.8 days while it was 2.9 days on FTM with SPS. The 0.9 day difference was statistically significant. The result on BHI with and without SPS sets showed faster growth on BRI with SPS in 7 specimens and slower growth in one specimen and the remaining 12 showed growth at the same time. These specimens had mean incubation time of 3.2 days on BHI and 2.3 days on BHI with SPS. The 0.9 day difference was statistically significant. This study indicates beneficial effect of SPS for the rapid isolation of Sal. typhi from clinical blood specimens.

• 핵의학기술
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• 제15권1호
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• pp.75-80
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• 2011

유럽 및 미국에서는 다인용 치료병실을 사용하고 있는 실정이다. 이에 서울대학교병원에서 현재 1인용 치료병실로 사용하고 있는 병실을 2인용 치료병실로 운영할 때 안전성에 대해 알아보고자 한다. 서울대학교병원 기존 치료병실에 침대와 침대 사이 차폐벽을 설치하여 2인용 치료병실로 운영할 경우, 상대방 환자로부터 방출되는 감마선의 산란에 의한 외부피폭과 상대방 환자에 의해 발생되는 오염으로 인한 외부 및 내부피폭을 평가하였다. 2인용 치료병실의 안전성 평가를 위해 외부 및 내부피폭을 평가하였을 때 원자력법에서 고시하는 '진료환자의 격리 수량, 5 mSv'이하의 피폭을 받게 됨을 알 수 있었다. 그리고 환자들의 피폭관리방안을 수립하여 교육 및 관리함으로써 환자 상호 간의 불필요한 피폭을 방지할 수 있다는 것을 알 수 있었다. 갑상선암 환자의 증가에 따라 치료병실 이용하는 환자가 적체되고 있는 추세이다. 이에 국제적 추세에 발맞춰 현행 1인용 치료병실을 2인용 치료병실로 개선함으로써 비용절감 및 관리의 효율성을 증대할 수 있으며 환자의 소외감과 고립감을 해소하여 치료효과를 높일 수 있다.

• 대한족부족관절학회지
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• 제15권3호
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• pp.144-148
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• 2011

Purpose: To investigate the results of percutaneous repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: We retrospectively analyzed the outcomes of 73 patients with ruptured Achilles tendon from October 1995 to September 2009. 28 patients were excluded due to short follow up period. 34 patients were male and 11 patients were female. The mean patient age was 37.19 (10~62) years. The location of rupture site was 6.58 cm proximal to the tendon insertion into the calcaneus on average. Mean follow up period was 55 months and All patients were surgically repaired using percutaneous technique with sural nerve isolation. Results: Arner-lindholm score were excellent in 32 (71%), good in 12 (27%), poor in 1 (2%) case. 44 cases (98%) had the score more than good. Mean American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot function score was 92.93 (67~100). We had 1 case of superficial infection, 1 case of soft tissue irritation by suture knot. Conclusion: Percutaneous repair with sural nerve isolation in treating ruptured Achilles tendon showed low complication rate and reliable clinical outcome.

• 가정∙방문간호학회지
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• 제31권1호
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• pp.56-65
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• 2024

Purpose: This study aimed to explore the association between demographic characteristics, hospitalization-related characteristics, and the severity of long-term hospitalization in a high-level general hospital, and to analyze the factors influencing decisions of all patients. Methods: General and clinical characteristics of the participants were analyzed using frequency, percentage, mean, and standard deviation. Differences in these characteristics, contingent upon whether a power source was requested, were analyzed using independent t-Test and Chi-squared tests. Logistic regression analysis was used to identify the factors related to the presence or absence of power requests. Results: The factors impacting the decision to refer a dependent variable include medical treatment (neurosurgery) (B=2.118, SE=0.960, p-value=.027, OR=8.314, 95% CI=1.267-54.551), infection isolation (CRE) (B=1.336, SE=0.666, p-value=.045, OR=3.804, 95% CI=1.032-14.021), and the utilization of tertiary antibiotics (B=3.076, SE=1.362, p-value= .024, OR=21.663, 95% CI=1.502-312.530). Conclusion: This study found a significant association between medical treatment (neurosurgery), infection isolation (CRE), and the use of tertiary antibiotics as dependent variables. These findings indicate that continuous monitoring can contribute to a reduction in long-term financial burdens.

• Earthquakes and Structures
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• 제9권3호
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• pp.657-671
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• 2015

The level of ductility is determined by depending on the intended use of the building, the region's seismic characteristics and the type of structural system when buildings are planned by engineers. Major portion of seismic energy is intended to be consumed in the plastic zone in structural systems of high ductility, so the occurrence of damages in load bearing and non-load bearing structural elements is accepted in planning stage under severe earthquakes. However, these damages must be limited among specific values in order not to endanger buildings in terms of the bearing capacity. Isolators placed between the basement and upper structure make buildings behave elastically by reducing the effects of seismic loads and improving seismic performance of building significantly. Thus, damages can be limited among desired values. In this study, the effectiveness of seismic isolation is investigated on both fixed based and seismic isolated models of a hospital building with high ductility level with regard to lateral displacements, internal forces, structural periods and cost of the building. Layered rubber bearings are interposed between the base of the structure and foundation. Earthquake analysis of the building are performed using earthquake records in time domain (Kocaeli, Loma Prieta and Landers). Results obtained from three-dimensional finite element models are presented by graphs and tables in detail. That seismic isolation reduces significantly the destructive effects of earthquakes on structures is seen from the results obtained by seismic analysis.

• 임상간호연구
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• 제28권2호
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• pp.112-121
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• 2022

Purpose: This study aims to identify the effects of mobile web-based COVID-19 isolation hospitalization management training on patient's uncertainty, anxiety, and nursing education satisfaction. Methods: Patients hospitalized with COVID-19 isolation rooms from August to October 2021, in Medical Center B which is an infectious disease dedicated hospital located in metropolitan city B were included. The total number of subjects was 142, of which 71 were the experimental group and 71 the control group. As an experimental treatment, a total of 5 minutes and 35 seconds of mobile web-based education were provided to the experimental group three times, including the day of, the first day of, and the second day of hospitalization. Existing training conducted on the control group was provided by the nurses in charge of the ward through oral explanation using printed materials. The data were analysed using the IBM SPSS/WIN 26.0 program. Results: Significant differences were observed between the two groups in pre-and post-assessment of uncertainty scores (t=-22.92, p<.001), anxiety scores (t=-15.03, p<.001) and nursing education satisfaction score (t=11.61, p<.001). Conclusion: As a result of the above, mobile web-based education can be used as an effective educational medium in nursing practice to improve the work efficiency and quality of nursing care and contribute to improving the patient's educational satisfaction.