• Title/Summary/Keyword: Patient skin dose

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A Comparative Effect of Meperidine between Intravenous and Epidural Patient-Controlled Analgesia for the Postoperative Pain Relief after Cesarean Section (제왕절개 수술후 통증조절을 위해 PCA를 이용한 정맥과 경막외 Meperidine 투여효과의 비교)

  • Lee, Byung-Ho;Chea, Jun-Seuk;Chung, Mee-Young;Byun, Hyung-Jin
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.257-265
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    • 1995
  • Patient-Controlled Analgesia (PCA) has been widely used for postoperative pain relief. Meperidine is useful for PCA and has efficient analgesia, rapid onset, and low incidence of adverse effect. To compare the analgesic effect, total dose and hourly dose, side effect and neonatal status of breast feeding with meperidine via intravenous or epidural PCA for 48 hours after Cesarean Section, 40 parturient women undergoing elective Cesarean Section were randomly divided into two groups. Each respective group of 20 parturient women received meperidine via one of the intravenous PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after general anesthesia with enflurane (IVPCA group) and the epidural PCA after epidural block with 2% lidocaine 20ml combined with general anesthesia with only $N_2O$ and $O_2$ (EpiPCA group) when they first complained of pain in recovery room. Following the administration of analgesic initial dose, parturient women of IVPCA group were allowed intravenous meperidine 10 mg every 8 minutes when they felt pain. The EpiPCA group received additional bolus dose of meperidine 2 mg and bupivacaine 0.7 mg were administered every 8 minutes as requested the patients with hourly continuous infusion of meperidine 4 mg and bupivacaine 1.4 mg. Data was collected during the 48 hours observation period including visual analog scale (VAS) pain scores, total meperidine dose, hourly dose during 48 hours and each time interval, incidence of adverse effect, satisfaction, and neonatal status with breast feeding. VAS pain scores of analgesic effect in EpiPCA group was significantly lower than in IVPCA group at 2 hours after the initial pain after Cesarean Section. Total dose and hourly dose of meperidine significantly reduced in EpiPCA group. Hourly dose of meperidine at each time interval significantly reduced during first 6 hours and from 12 hours to 24 hours in EpiPCA group. The side effects in IVPCA group were mainly sedation, nausea, and local irritation of skin. And EpiPCA group experienced numbness and itching. The degree of satisfaction of parturient women was 88.2 % in IVPCA group and 85.7 % in EpiPCA group. We did not observe any sedation, abnormal behavior, or seizure like activity in any neonates of breast feeding. From the above results we conclude that epidural PCA was more efficiently analgesic, less sedative, and consumptional, and safer for neonate than intravenous PCA, and could be an alternative method to intravenous PCA.

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BEHCET DISEASE WITH SUPERIOR VENA CAVA THROMBUS IN A PATIENT PRESENTING DELAYED FACIAL WOUND HEALING : A CASE REPORT (단순안면열상환자에서 발생한 창상치유지연 및 상대정맥혈전증을 동반한 베체트병 : 증례보고)

  • Choi, Sun-Mi;Ha, Joo-Hyo;Kim, Sun-Ae;Choi, Mi-Ra;Jung, Su-Jin;Lee, Hyen-Soo;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.2
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    • pp.198-204
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    • 2008
  • Behcet Disease is a multisystem inflammatory disorder of unknown orign. It is characterized by recurrent oral ulcer, genital ulcer, skin lesions and ocular inflammation, and which may involve the joints, skin, central nervous system and gastrointestinal tract. Because Behcet Disease dose not have any specific symptoms and laboratory findings, the diagnosis is made on the basis of the criteria proposed by the the International Study Group for Behcet Disease. Behcet Disease is affecting both arteries and veins, and clinically manifest large vessel involvement occurs in between 7 and 49% of patients. Superior vena cava thrombosis is a rare but well-recognized manifestation of Behcet disease. We report a case of a Behcet Disease with superior vena cava thrombosis in a patient presenting delayed facial wound healing.

Analysis of Patient Exposure dose with Glass Dosimeter (Glass Dosimeter를 이용한 환자피폭선량에 관한 분석)

  • Kim, Jae-In;Choi, Won-Keun;Chang, Sung-Won;Oh, Chang-Seop;Lee, Kwan-Sup;Ha, Dong-Yoon
    • Korean Journal of Digital Imaging in Medicine
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    • v.11 no.1
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    • pp.15-20
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    • 2009
  • Far reducing medical radiation exposure and managing patient doses, Entrance surface doses(ESDs) were measured at Diagnostic Radiology Department in ASAN medical center, also we determined and compared with the Diagnostic Reference Level(DRL) of some other countries. ESDs were measured far the most common types of X-ray procedures, such as chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA. ESDs were measured by Glass dosimeter and Unfors Xi meter. Those were applied collimation center of phantom's entrance skin surface. The results of ESDs were compared Glass dosimeter with Unfors Xi meter. Those were measured within 5% statistical difference. It seemed well agreement at two devices. In most cases ESDs measured far the different types of X ray procedures were found to be lower than the DRL of IAEA, but ESDs on chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA were proximity ar excesses at DRL of advanced country. Through this study, we need an investigation and improvement at present diagnostic radiology exam system. Also, radiologists make an effort to reduce patient dose and having a technical skill.

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Treatment Result of Photochemotherapy for Systemic Psoriasis Patients (전신성 건선환자의 광선치료 후의 임상적 특성에 대한 고찰)

  • Cho, Eun-Jung;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.3 no.1
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    • pp.73-79
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    • 1996
  • Photochemotherapy(UVA with 8-methoxypsoralen) was given to 30 patients with systemic psoriasis. The results of clearing and long-term(6-month) interval maintenance were reported. Clearing requirements were in general similar to these reported by Melski and Burger. The skin of the 14 patients (46.6%) recovered good skin condition by a once weekly maintenance dose. This result was better than that reported by other authors. 1. During initial treatment period, average number of treatment was 27.3 and average duration treatment was 24.8 weeks. 2. The factors to quit treatment were motion decrease, moving to the remote area, complications, etc. 3. Number of patient who received maintenance treatment was 14. 4. The complications reported from the patients were hyperpigmentation, nausea, headache, pruritis, vomiting, gastritis.

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Radiation recall dermatitis triggered by sorafenib after radiation therapy for hepatocellular carcinoma

  • Kim, Gwi Eon;Song, Hee-Sung;Ahn, Ki Jung;Kim, Young Suk
    • Radiation Oncology Journal
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    • v.35 no.3
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    • pp.289-294
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    • 2017
  • Sorafenib is widely used for unresectable and metastatic hepatocellular carcinomas. Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin that occurs after the administration of certain drugs. RRD after sorafenib treatment is rare; five cases have been reported thus far. We describe a 44-year-old man irradiated for chest wall bone metastasis from hepatocellular carcinoma. Eight days after radiotherapy completion, systemic therapy for metastatic hepatocellular carcinoma was initiated with sorafenib treatment. Eleven days after starting sorafenib, the patient complained of erythematous rash with pruritus in the chest wall, in a location consistent with the previous radiation field. Sorafenib was continued at the same dose, despite the RRD. The skin reaction subsided over the next 2 weeks without any medical intervention.

Mitotane Therapy and Management of Naturally Occurring Pituitary Dependent Hyperadrenocorticism (PDH) in a Dog (개에서 자연발생한 뇌하수체 의존성 부신피질기능 항진증의 치료 및 관리)

  • Song, Jae-won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.233-236
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    • 2003
  • A 10 year old, intact female Yorkshire terrier was referred to the Veterinary Teaching Hospital of Konkuk University. Upon admission, the patient had severe necrotic skin disease on face and abdominal wall, and also showed polyuria, polydipsia (PUPD), and polyphagia. A tentatative diagnosis of hyperadrenocorticism was made on the basis of history takings, physical examination, and results of CBC and serum biochemistry. Hyperadrencorticism was confirmed by ACTH stimulation test and pituitary-dependent hyperadrenocorticism (PDH) was diagnosed according to the results of high dose dexamethasone suppression test (HDDST). After initiating mitotane therapy, severe skin problem and clinical signs including PUPD were improved. And we determined whether or not mitotane therapy well controlled serum cortisol level with ACTH stimulation test. This case was presented to show that the patient misdiagnosed and treated for more than 1 year as other dermatologic problem in 3 local animal clinics was treated and managed sucessfully with mitotane administration.

The evaluation of usefulness of the newly manufactured immobilization device (치료보조기구의 제작 및 유용성 평가)

  • Seo Seok Jin;Kim Chan Yoeng;Lee Je Hee;Park Heung Deuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.1
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    • pp.45-55
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    • 2005
  • Purpose : To evaluate the usefulness of the handmade patient immobilization device and to report the clinical results of it. Materials and methods : We made two fusion images and analyzed those images. One image is made with diagnostic MR image and CT image, the other with therapeutic planning MR image and CT image. With open head holder, we measured the skin dose and attenuation dose. Also, we made the planning CT couch plate with acrylic plate and styrofoam and compared artifact. Results : We could get more accurate fusion image when we use MR head holder(within 2mm error). The skin dose was reduced 2 times and the attenuation dose was reduced more than $20\%$ when open head holder used. The planning CT couch plate was more convenient than conventional board and reduced artifact remarkably. Conclusion : We could verify the localization point in the MR image which is taken with MR head holder. So we could fuse the image more accurately. The same method could be applied to PET and US image, if the alike immobilization device used. With open head holder, the skin dose and the attenuation dose was reduced. And those above devices could substitute for expensive foreign device, if those are manufactured adequately.

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Reduction of Exposure dose in Cheat Roentgenography (흉부X선검사(胸部X線檢査)에 있어서 피폭선량(被曝線量)의 경감(輕減)에 대한 검토(檢討))

  • Huh, Joon;Kim, Chang-Kyun;Kang, Hong-Seok
    • Journal of radiological science and technology
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    • v.2 no.1
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    • pp.15-22
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    • 1979
  • Author made a experiment on the exposure dose with various intensifying screens in taking chest roentgenogram and obtained the results as follows; 1. Special speed type was the most sensitive intensifying screen, the r(gamma) value of this screen was distributed from 2.6 to 2.9. 2. The resolution activity of intensifying screen was inversely proportional to its sensitivity. If, the sensitivity and detail of the fine detail speed type intensifying screen at 100 KV were 100, those of the special speed type were 549 and 54.44 respectively. 3. If the exposure dose of the fine detail type intensifying screen was 1.0 at 60 KV, that of the special speed type intensifying screen was 0.1 at 80KV, and the skin dose of patient was as follows; it was 64.8 mRad at 60KV in mid speed type, 8.1 mRad at 80KV in super high speed type, and 7.2 mRad at 80KV in special speed type intensifying screen respectively.

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Evaluation of Applicability of Customized Bolus According to 3D Printer Material Characteristics (3D 프린터 소재 특성에 따른 맞춤형 볼루스의 적용성 평가)

  • Kyung-Tae Kwon;Hui-Min Jang;Myeong-Seong Yoon
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1091-1097
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    • 2023
  • Bolus is used in radiation therapy to prescribe an even dose to the tumor when the skin surface is inclined or has irregularities. At this time, the dose to the skin surface increases. Due to the patient's unique body structure and irregular skin, voids may occur between the bolus and the skin, which may reduce the accuracy of treatment. Therefore, in this study, the existing bolus and the self-produced bolus through 3D printing were applied to the nasal area, and the difference between the surface dose after treatment plan and the dose directly measured with an Optically Stimulated luminescence(OSL) dosimeter was compared to the existing bolus. The bolus rate was 97%, PLA 100.33%, ePETELA 75A 100.53%, and ePETELA 85A 100.36%. It was confirmed that there was little error in the measurement values and treatment plan values for each material. In addition, compared to when applying a conventional bolus, a difference of -3% to +0.5% for a 3D printed bolus can be confirmed, so a customized bolus produced through 3D printing can complement the shortcomings of the existing bolus. It is believed that there will be.

Patient Radiation Dose Values During Interventional Cardiology Examinations in University Hospital, Korea (심장혈관 조영술과 심장혈관 인터벤션의 환자 선량 평가)

  • Kim, Jung-Su;Lee, Joun-Hyuk;Jung, Hae-Kyoung;Kim, Jung-Min;Cho, Byung Ryul
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.27-33
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    • 2016
  • The use of cardiac angiography (CA) and the interventional procedures is rapidly increasing due to the increase in modern adult diseases. Cardiovascular intervention (CI) is an examination method where radiation is applied to the same area for a long period, and thus may cause skin injury. In this study, we investigate the diagnostic reference level (DRL) of the cardiovascular intervention (CI) carried out by medical institutions and use it as a tool to reduce patient exposure dose. In this study, the DRL was set by acquiring information about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), radiography DAP, cumulative DAP, air kerma, number of video clips, and the total number of images from the cardiac angiography and interventional procedures performed on 147 patients. The DAPs corresponding to the DRL of cardiac angiography(CA) and that of the interventional procedures were shown to be $44.4Gy{\cdot}cm2$ and $298.6Gy{\cdot}cm2$, respectively; the corresponding DRLs of fluoroscopy time were shown to be 191.5s and 1935.3s, respectively. A DRL is not a strict upper bound for radiation exposure. However, the process of setting, enacting, and reviewing the DRLs for the dose by medical institutions will contribute to a reduction in the unnecessary exposure dose of patients.