• 제목/요약/키워드: critical organ

검색결과 177건 처리시간 0.024초

인터벤션 시술 시 환자의 선량감소를 위한 3D 프린팅 재료의 적용성 평가 (Feasibility of the 3D Printing Materials for Radiation Dose Reduction in Interventional Radiology)

  • 조용인
    • 대한방사선기술학회지:방사선기술과학
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    • 제43권3호
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    • pp.169-176
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    • 2020
  • Interventional radiology is performed under real-time fluoroscopy, and patients are exposed to a wide range of exposures for a long period of time depending on the examination and procedure. However, studies on radiation protection for patients during an intervention are insufficient. This study aims to evaluate the doses exposed during the intervention and the applicability of 3D printing materials. The organ dose for each intervention site was evaluated using a monte carlo simulatio. Also, the dose reduction effect of the critical organs was calculated when using a shielding device using 3D printing materials. As a result, the organ dose distribution for each intervention site showed a lower dose distribution for organs located far from the x-ray tube. It was analyzed that the influence of scattered rays was higher in the superficial organs of the back of the human body where x-rays were incident. The dose reduction effect on the critical organ using the 3D printing shield showed the highest testis among the gonads, and in the case of other organs, the dose reduction effect gradually decreased in the order of the eye, thyroid, breast, and ovary. Accordingly, it is judged that the 3D printed shield will be sufficiently usable as a shielding device for the radiation protection of critical organs.

임상간호사의 뇌사자 장기기증에 대한 지식과 태도에 영향을 미치는 요인 (Factors Affecting Nurse Clinicians' Knowledge and Attitude of Organs Procurement from Brain Dead Patients)

  • 이현아;허유진;이영규;송가람;이은지;신수진
    • 중환자간호학회지
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    • 제10권3호
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    • pp.19-30
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    • 2017
  • Purpose : This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians. Methods : A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, Pearson's correlation coefficient, and a multiple regression analysis were used. Results : The mean score for knowledge of organ procurement from brain dead patients was $12.41{\pm}2.16$ (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (${\beta}=.454$, p < .001), a recent family death (${\beta}=.187$, p = .014), experience recognizing potential brain dead patients (${\beta}=.182$, p = .033), and experience referring to potential brain dead patients (${\beta}=-.192$, p = .048). Conclusion : To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.

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유미복막증이 동반된 복부장기 손상 (Abdominal Organ Injuries with Chyloperitoneum after Blunt Tauma: A Case Report)

  • 김영환;정윤중;홍석경
    • Journal of Trauma and Injury
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    • 제25권3호
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    • pp.105-108
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    • 2012
  • Chyloperitoneum or chylous ascite after trauma is a rare condition. It can develop after direct injuries of lymphatic vessels or cisterna chyli. Though isolated chyle duct injury has sometimes been reported, chyloperitoneum is generally accompanied by various kinds of damage to other intraabdominal organs. There's still no established therapeutic protocol regarding the treatment of chyloperitoneum when it is accompanied by the serious injuries of intraabdominal organs. We describe a 66-year-old male with serious intraabdominal organ injuries after blunt trauma. In our case, chyloperitoneum developed due to the injuries to the mesenteric lymph vessels and compression of cisterna chyli by hematoma around aorta.

몬테카를로 방법을 이용한 중재방사선시술자에 대한 선량평가 (Assessment of Occupational Dose to the Staff of Interventional Radiology Using Monte Carlo Simulations)

  • 임영기
    • Journal of Radiation Protection and Research
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    • 제39권4호
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    • pp.213-217
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    • 2014
  • 중재방사선을 이용한 의료적 시술이나 진단은 꾸준히 증가하고 있다. 특히 환자에 근접하여 이루어지는 중재방사선시술의 특성상 시술자에 대한 직무피폭의 관리 및 감시가 중요하다. 개인선량계를 통해 측정되는 방사선 방호 실용량인 심부선량은 중재방사선시술의 경우 균질한 방사선장에 의해 전신에 고르게 노출되는 경우가 아니므로 유효선량을 항상 대표할 수는 없다. 따라서 본 연구에서는 C-arm을 이용한 대표적인 중재방사선시술에 대해 수학적 모의피폭체와 몬테카를로 방법을 이용한 계산과 개인선량계를 이용한 실측을 통해 개인선량당량과 장기별 선량을 평가하고자 하였다. 주요 장기별 선량평가 결과는 개인선량계로 측정된 선량 값보다 낮았으나, 갑상선과 같은 장기는 전신 연조직 선량보다 상당히 높은 것으로 평가되었다. 중재방사선시술자에 대한 적절한 방사선방호를 위해 납치마의 착용과 같은 전신 방호와 더불어 갑상선 방호와 같은 추가적인 방호조치가 고려되어야 할 것이다.

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver;Raman, Sainath;Suen, Jacky Y.;Cho, Hwa Jin;Fraser, John F.
    • Clinical and Experimental Pediatrics
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    • 제64권5호
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    • pp.188-195
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    • 2021
  • Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.

한 내과계 중환자실에서 치료하였던 중증 알코올성 케톤산증 환자들의 임상적 특성 (The Clinical Manifestations of Patients with Severe Alcoholic Ketoacidosis Treated at a Medical Intensive Care Unit)

  • 이광하;이세환;오연목;심태선;임채만;이상도;고윤석;김우성;김동순;김원동;홍상범
    • Tuberculosis and Respiratory Diseases
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    • 제60권5호
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    • pp.548-553
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    • 2006
  • 연구배경 : 알코올성 케톤산증은 대부분 예후가 양호하나 여러 장기부전을 동반한 경우 중환자실 치 료가 필요하다. 이런 중증환자에 대한 보고가 부족하여 저자들은 중증 알코올성 케톤산증의 증례를 분석하였다. 방 법 : 2000년 1월 1일부터 2005년 6월 30일까지 서울아산병원 중환자실에서 입원하여 치료받았던 합병증을 가진 알코올성 케톤산증 10례를 선정하여 분석하였다. 결 과 : 모두 남자환자였고, 평균 나이는 $52.7{\pm}12.4$ 세, 평균 $20{\pm}13$년의 음주력이 있었다. 내원시 주증상은 복통,구토등의 소화기증상이 50%로 가장 많았다. 주요 검사실 소견상 Lactic acid (mmol/L) $57.89{\pm}55.35$, 동맥혈 pH $6.828{\pm}0.139$, Osmolar Gap (mOsm/L) $37.28{\pm}24.55$, Anion Gap (mOsm/L) $31.43{\pm}11.61$이었다. 동반된 주된 합병증으로 횡문근 융해증(80%), 패혈증(20%), 췌장염(10%) 순이었다. 70% 환자에서 투석이 80% 환자에서 기계환기가 실시되었다. 사망자 (60%) 들은 모두 3일이내에 쇼크로 인해서 사망하였다. 생존자들은 12시간안에 동맥혈 pH 7.15 이상으로 회복되었다. 결 론 : 중증 알코올성 케톤산증은 횡문근 융해증 및 급성 신부전이 주된 합병증으로 동반되며 사망률이 높다.

Updates on the Immune Cell Basis of Hepatic Ischemia-Reperfusion Injury

  • Mi Jeong Heo;Ji Ho Suh;Kyle L. Poulsen;Cynthia Ju;Kang Ho Kim
    • Molecules and Cells
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    • 제46권9호
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    • pp.527-534
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    • 2023
  • Liver ischemia-reperfusion injury (IRI) is the main cause of organ dysfunction and failure after liver surgeries including organ transplantation. The mechanism of liver IRI is complex and numerous signals are involved but cellular metabolic disturbances, oxidative stress, and inflammation are considered the major contributors to liver IRI. In addition, the activation of inflammatory signals exacerbates liver IRI by recruiting macrophages, dendritic cells, and neutrophils, and activating NK cells, NKT cells, and cytotoxic T cells. Technological advances enable us to understand the role of specific immune cells during liver IRI. Accordingly, therapeutic strategies to prevent or treat liver IRI have been proposed but no definitive and effective therapies exist yet. This review summarizes the current update on the immune cell functions and discusses therapeutic potentials in liver IRI. A better understanding of this complex and highly dynamic process may allow for the development of innovative therapeutic approaches and optimize patient outcomes.

골수세포에 대한 Bordetella bronchiseptica 항원의 자극 효과 및 면역기억반응 (Stimulatory effects of Bordetella bronchiseptica antigen on bone marrow cells and immune memory responses)

  • 임설화;주홍구
    • 대한수의학회지
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    • 제54권4호
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    • pp.203-208
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    • 2014
  • Bone marrow is a hematological and immunological organ that provides multiple immune cells, including B lymphocytes, and thus plays a critical role in the efficacy of vaccine. We previously demonstrated that Bordetella (B.) bronchiseptica antigen has high immunogenicity in spleen cells, a peripheral immune organ. In this study, we investigated the immunogenicity of B. bronchiseptica antigen in bone marrow cells, a central immune organ. B. bronchiseptica antigen increased the cellular activity of bone marrow cells and significantly enhanced the production of nitric oxide, IL-6, and TNF-${\alpha}$. Bone marrow cells primed with B. bronchiseptica antigen in vivo were harvested and stimulated with the same antigen in vitro. The stimulation of B. bronchiseptica antigen significantly increased the cellular activity and proliferation rate of the primed cells. B. bronchiseptica antigen also greatly induced the production of antigen-specific antibody in the primed cells. Taken together, the present study demonstrated that B. bronchiseptica antigen can stimulate bone marrow cells, a central immune organ, and recall the immune response of the primed bone marrow cells.

중환자를 위한 근거중심 영양지원 (Evidence-based Nutritional Support in the Intensive Care Unit)

  • 이영희;위미숙
    • 중환자간호학회지
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    • 제3권1호
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    • pp.79-88
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    • 2010
  • Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.

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