• Title/Summary/Keyword: management methods

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Study for Diagnostic Efficacy of Minibronchoalveolar Lavage in the Detection of Etiologic Agents of Ventilator-associated Pneumonia in Patients Receiving Antibiotics (항생제를 사용하고 있었던 인공호흡기 연관 폐렴환자에서의 원인균 발견을 위한 소량 기관지폐포세척술의 진단적 효용성에 관한 연구)

  • Moon, Doo-Seop;Lim, Chae-Man;Pai, Chik-Hyun;Kim, Mi-Na;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.321-330
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    • 1999
  • Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

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The Prognostic Value of the First Day and Daily Updated Scores of the APACHE III System in Sepsis (패혈증환자에서 APACHE III Scoring System의 예후적 가치)

  • Lim, Chae-Man;Lee, Jae-Kyun;Lee, Sung-Soon;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Pyung-Hwan;Choi, Jong-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.871-877
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    • 1995
  • Background: The index which could predict the prognosis of critically ill patients is needed to find out high risk patients and to individualize their treatment. The APACHE III scoring system was established in 1991, but there has been only a few studies concerning its prognostic value. We wanted to know whether the APACHE III scores have prognostic value in discriminating survivors from nonsurvivors in sepsis. Methods: In 48 patients meeting the Bones criteria for sepsis, we retrospectively surveyed the day 1(D1), day 2(D2) and day 3(D3) scores of patients who were admitted to intensive care unit. The scores of the sepsis survivors and nonsurvivors were compared in respect to the D1 score, and also in respect to the changes of the updated D2 and D3 scores. Results: 1) Of the 48 sepsis patients, 21(43.5%) survived and 27(56.5%) died. The nonsurvivors were older($62.7{\pm}12.6$ vs $51.1{\pm}18.1$ yrs), presented with lower mean arterial pressure($56.9{\pm}26.2$ vs $67.7{\pm}14.2\;mmHg$) and showed greater number of multisystem organ failure($1.2{\pm}0.8$ vs $0.2{\pm}0.4$) than the survivors(p<0.05, respectively). There were no significant differences in sex and initial body temperature between the two groups. 2) The D1 score was lower in the survivors (n=21) than in the nonsurvivors ($44.1{\pm}14.6$, $78.5{\pm}18.6$, p=0.0001). The D2 and D3 scores significantly decreased in the survivors (D1 vs D2, $44.1{\pm}14.6$ : $37.9{\pm}15.0$, p=0.035; D2 vs D3, $37.9{\pm}15.0$ : $30.1{\pm}9.3$, p=0.0001) but showed a tendency to increase in the nonsurvivors (D1 vs D2 (n=21), $78.5{\pm}18.6$ : $81.3{\pm}23.0$, p=0.1337; D2 vs D3 (n=11), $68.2{\pm}19.3$ : $75.3{\pm}18.8$, p=0.0078). 3) The D1 scores of 12 survivors and 6 nonsurvivors were in the same range of 42~67 (mean D1 score, $53.8{\pm}10.0$ in the survivors, $55.3{\pm}10.3$ in the nonsurvivors). The age, sex, initial body temperature, and mean arterial pressure were not different between the two groups. In this group, however, D2 and D3 was significantly decreased in the survivors(D1 vs D2, $53.3{\pm}10.0$ : $43.6{\pm}16.4$, p=0.0278; D2 vs D3, $43.6{\pm}16.4$ : $31.2{\pm}10.3$, p=0.0005), but showed a tendency to increase in the nonsurvivors(D1 vs D2 (n=6), $55.3{\pm}10.3:66.7{\pm}13.9$, p=0.1562; D2 vs D3 (n=4), $64.0{\pm}16.4:74.3{\pm}18.6$, p=0.1250). Among the individual items of the first day APACHE III score, only the score of respiratory rate was capable of discriminating the nonsurvivors from the survivors ($5.5{\pm}2.9$ vs $1.9{\pm}3.7$, p=0.046) in this group. Conclusion: In sepsis, nonsurvivors had higher first day APACHE III score and their updated scores on the following days failed to decline but showed a tendency to increase. Survivors, on the other hand, had lower first day score and showed decline in the updated APACHE scores. These results suggest that the first day and daily updated APACHE III scores are useful in predicting the outcome and assessing the response to management in patients with sepsis.

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Clinical Indices Predicting Resorption of Pleural Effusion in Tuberculous Pleurisy (결핵성 늑막염에서 삼출액의 흡수에 영향을 미치는 임상적 지표)

  • Lee, Joe-Ho;Chung, Hee-Soon;Lee, Jeong-Sang;Cho, Sang-Rok;Yoon, Hae-Kyung;Song, Chee-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.660-668
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    • 1995
  • Background: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. Methods: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age, sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. Results: 1) Group 1 patients had lower glucose level{$63.3{\pm}30.8$(mg/dl)} than that of the group 2{$98.5{\pm}34.2$(mg/dl), p<0.05}, and higher LDH level{$776.3{\pm}266.0$(IU/L)} than the group 2 patients{$376.3{\pm}123.1$(IU/L), p<0.05}, and also longer duration of symptom before treatment{$2.0{\pm}1.7$(month)} than the group 2{$1.1{\pm}1.2$(month), p<0.05}, respectively. 2) In group 1, FVC changed from preoperative $2.55{\pm}0.80$(L) to postoperative $2.99{\pm}0.78$(L)(p<0.05), and FEV1 changed from preoperative $2.19{\pm}0.70$(L/sec) to postoperative $2.50{\pm}0.69$(L/sec)(p<0.05). 3) There was no difference in pleural fluid protein level($5.05{\pm}1.01$(gm/dL) and $5.15{\pm}0.77$(gm/dl), p>0.05) and WBC differential count between group 1 and group 2. Conclusion: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.

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Research Trend Analysis Using Bibliographic Information and Citations of Cloud Computing Articles: Application of Social Network Analysis (클라우드 컴퓨팅 관련 논문의 서지정보 및 인용정보를 활용한 연구 동향 분석: 사회 네트워크 분석의 활용)

  • Kim, Dongsung;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.20 no.1
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    • pp.195-211
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    • 2014
  • Cloud computing services provide IT resources as services on demand. This is considered a key concept, which will lead a shift from an ownership-based paradigm to a new pay-for-use paradigm, which can reduce the fixed cost for IT resources, and improve flexibility and scalability. As IT services, cloud services have evolved from early similar computing concepts such as network computing, utility computing, server-based computing, and grid computing. So research into cloud computing is highly related to and combined with various relevant computing research areas. To seek promising research issues and topics in cloud computing, it is necessary to understand the research trends in cloud computing more comprehensively. In this study, we collect bibliographic information and citation information for cloud computing related research papers published in major international journals from 1994 to 2012, and analyzes macroscopic trends and network changes to citation relationships among papers and the co-occurrence relationships of key words by utilizing social network analysis measures. Through the analysis, we can identify the relationships and connections among research topics in cloud computing related areas, and highlight new potential research topics. In addition, we visualize dynamic changes of research topics relating to cloud computing using a proposed cloud computing "research trend map." A research trend map visualizes positions of research topics in two-dimensional space. Frequencies of key words (X-axis) and the rates of increase in the degree centrality of key words (Y-axis) are used as the two dimensions of the research trend map. Based on the values of the two dimensions, the two dimensional space of a research map is divided into four areas: maturation, growth, promising, and decline. An area with high keyword frequency, but low rates of increase of degree centrality is defined as a mature technology area; the area where both keyword frequency and the increase rate of degree centrality are high is defined as a growth technology area; the area where the keyword frequency is low, but the rate of increase in the degree centrality is high is defined as a promising technology area; and the area where both keyword frequency and the rate of degree centrality are low is defined as a declining technology area. Based on this method, cloud computing research trend maps make it possible to easily grasp the main research trends in cloud computing, and to explain the evolution of research topics. According to the results of an analysis of citation relationships, research papers on security, distributed processing, and optical networking for cloud computing are on the top based on the page-rank measure. From the analysis of key words in research papers, cloud computing and grid computing showed high centrality in 2009, and key words dealing with main elemental technologies such as data outsourcing, error detection methods, and infrastructure construction showed high centrality in 2010~2011. In 2012, security, virtualization, and resource management showed high centrality. Moreover, it was found that the interest in the technical issues of cloud computing increases gradually. From annual cloud computing research trend maps, it was verified that security is located in the promising area, virtualization has moved from the promising area to the growth area, and grid computing and distributed system has moved to the declining area. The study results indicate that distributed systems and grid computing received a lot of attention as similar computing paradigms in the early stage of cloud computing research. The early stage of cloud computing was a period focused on understanding and investigating cloud computing as an emergent technology, linking to relevant established computing concepts. After the early stage, security and virtualization technologies became main issues in cloud computing, which is reflected in the movement of security and virtualization technologies from the promising area to the growth area in the cloud computing research trend maps. Moreover, this study revealed that current research in cloud computing has rapidly transferred from a focus on technical issues to for a focus on application issues, such as SLAs (Service Level Agreements).

The Results and Prognostic Factors of Chemo-radiation Therapy in the Management of Small Cell Lung Cancer (항암화학요법과 방사선 치료를 시행한 소세포폐암 환자의 치료 성적 -생존율과 예후인자, 실패양상-)

  • Kim Eun-Seog;Choi Doo-Ho;Won Jong-Ho;Uh Soo-Taek;Hong Dae-Sik;Park Choon-Sik;Park Hee-Sook;Youm Wook
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.433-440
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    • 1998
  • Purpose : Although small ceil lung cancer (SCLC) has high response rate to chemotherapy and radiotherapy (RT), the prognosis is dismal. The authors evaluated survival and failure patterns according to the prognostic factors in SCLC patients who had thoracic radiation therapy with chemotherapy. Materials and Methods : One hundred and twenty nine patients with SCLC had received thoracic radiation therapy from August 1985 to December 1990. Seventy-seven accessible patients were evaluated retrospectively among 87 patients who completed RT. Median follow-up period was 14 months (2-87months). Results : The two years survival rate was 13$\%$ with a median survival time of 14 months. The two year survival rates of limited disease and extensive disease were 20$\%$ and 8$\%$, respectively, with median survival time of 14 months and 9 months, respectively. Twenty two patients (88$\%$) of limited disease showed complete response (CR) and 3 patients (12$\%$) did partial response (PR). The two year survival rates on CR and PR groups were 24$\%$ and 0$\%$, with median survival times of 14 months and 5 months. respectively (p=0.005). No patients with serum sodium were lower than 135 mmol/L survived 2years and their median survival time was 7 months (p=0.002). Patients whose alkaline phophatase lower than 130 IU/L showed 26$\%$ of 2 year survival rate and showed median survival time of 14 months and those with alkaline phosphatase higher than 130 IU/L showed no 2 year survival and median survival time of 5 the months, respectively (p=0.019). No statistical differences were found according to the age, sex, and performance status. Among the patients with extensive disease, two rear survivals according to the metastatic sites were 14$\%$, 0$\%$, and 7$\%$ in brain, liver, and other metastatic sites, respectively, with median survival time of 9 months, 9 months, and 8 months, respectively (p>0.05). Two year survivals on CR group and PR group were 15$\%$ and 4$\%$, respectively, with a median survival time of 11 months and 7 months, respectively (p=0.01). Conclusion : For SCLC, complete response after chemoradiotherapy was the most significant prognostic tactor. To achieve this goal. there should be further investigation about hyperfractionation, dose escalation, and compatible chemo-radiation schedule such as concurrent chemo-radiation and early radiation therapy with chemotherapy.

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A Study of Guidelines for Genetic Counseling in Preimplantation Genetic Diagnosis (PGD) (착상전 유전진단을 위한 유전상담 현황과 지침개발을 위한 기초 연구)

  • Kim, Min-Jee;Lee, Hyoung-Song;Kang, Inn-Soo;Jeong, Seon-Yong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.125-132
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    • 2010
  • Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

An Empirical Study on Motivation Factors and Reward Structure for User's Createve Contents Generation: Focusing on the Mediating Effect of Commitment (창의적인 UCC 제작에 영향을 미치는 동기 및 보상 체계에 대한 연구: 몰입에 매개 효과를 중심으로)

  • Kim, Jin-Woo;Yang, Seung-Hwa;Lim, Seong-Taek;Lee, In-Seong
    • Asia pacific journal of information systems
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    • v.20 no.1
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    • pp.141-170
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    • 2010
  • User created content (UCC) is created and shared by common users on line. From the user's perspective, the increase of UCCs has led to an expansion of alternative means of communications, while from the business perspective UCCs have formed an environment in which an abundant amount of new contents can be produced. Despite outward quantitative growth, however, many aspects of UCCs do not meet the expectations of general users in terms of quality, and this can be observed through pirated contents and user-copied contents. The purpose of this research is to investigate effective methods for fostering production of creative user-generated content. This study proposes two core elements, namely, reward and motivation, which are believed to enhance content creativity as well as the mediating factor and users' committement, which will be effective for bridging the increasing motivation and content creativity. Based on this perspective, this research takes an in-depth look at issues related to constructing the dimensions of reward and motivation in UCC services for creative content product, which are identified in three phases. First, three dimensions of rewards have been proposed: task dimension, social dimension, and organizational dimention. The task dimension rewards are related to the inherent characteristics of a task such as writing blog articles and pasting photos. Four concrete ways of providing task-related rewards in UCC environments are suggested in this study, which include skill variety, task significance, task identity, and autonomy. The social dimensioni rewards are related to the connected relationships among users. The organizational dimension consists of monetary payoff and recognition from others. Second, the two types of motivations are suggested to be affected by the diverse rewards schemes: intrinsic motivation and extrinsic motivation. Intrinsic motivation occurs when people create new UCC contents for its' own sake, whereas extrinsic motivation occurs when people create new contents for other purposes such as fame and money. Third, commitments are suggested to work as important mediating variables between motivation and content creativity. We believe commitments are especially important in online environments because they have been found to exert stronger impacts on the Internet users than other relevant factors do. Two types of commitments are suggested in this study: emotional commitment and continuity commitment. Finally, content creativity is proposed as the final dependent variable in this study. We provide a systematic method to measure the creativity of UCC content based on the prior studies in creativity measurement. The method includes expert evaluation of blog pages posted by the Internet users. In order to test the theoretical model of our study, 133 active blog users were recruited to participate in a group discussion as well as a survey. They were asked to fill out a questionnaire on their commitment, motivation and rewards of creating UCC contents. At the same time, their creativity was measured by independent experts using Torrance Tests of Creative Thinking. Finally, two independent users visited the study participants' blog pages and evaluated their content creativity using the Creative Products Semantic Scale. All the data were compiled and analyzed through structural equation modeling. We first conducted a confirmatory factor analysis to validate the measurement model of our research. It was found that measures used in our study satisfied the requirement of reliability, convergent validity as well as discriminant validity. Given the fact that our measurement model is valid and reliable, we proceeded to conduct a structural model analysis. The results indicated that all the variables in our model had higher than necessary explanatory powers in terms of R-square values. The study results identified several important reward shemes. First of all, skill variety, task importance, task identity, and automony were all found to have significant influences on the intrinsic motivation of creating UCC contents. Also, the relationship with other users was found to have strong influences upon both intrinsic and extrinsic motivation. Finally, the opportunity to get recognition for their UCC work was found to have a significant impact on the extrinsic motivation of UCC users. However, different from our expectation, monetary compensation was found not to have a significant impact on the extrinsic motivation. It was also found that commitment was an important mediating factor in UCC environment between motivation and content creativity. A more fully mediating model was found to have the highest explanation power compared to no-mediation or partially mediated models. This paper ends with implications of the study results. First, from the theoretical perspective this study proposes and empirically validates the commitment as an important mediating factor between motivation and content creativity. This result reflects the characteristics of online environment in which the UCC creation activities occur voluntarily. Second, from the practical perspective this study proposes several concrete reward factors that are germane to the UCC environment, and their effectiveness to the content creativity is estimated. In addition to the quantitive results of relative importance of the reward factrs, this study also proposes concrete ways to provide the rewards in the UCC environment based on the FGI data that are collected after our participants finish asnwering survey questions. Finally, from the methodological perspective, this study suggests and implements a way to measure the UCC content creativity independently from the content generators' creativity, which can be used later by future research on UCC creativity. In sum, this study proposes and validates important reward features and their relations to the motivation, commitment, and the content creativity in UCC environment, which is believed to be one of the most important factors for the success of UCC and Web 2.0. As such, this study can provide significant theoretical as well as practical bases for fostering creativity in UCC contents.

Evaluation of Radiation Exposure to Nurse on Nuclear Medicine Examination by Use Radioisotope (방사성 동위원소를 이용한 핵의학과 검사에서 병동 간호사의 방사선 피폭선량 평가)

  • Jeong, Jae Hoon;Lee, Chung Wun;You, Yeon Wook;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.44-49
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    • 2017
  • Purpose Radiation exposure management has been strictly regulated for the radiation workers, but there are only a few studies on potential risk of radiation exposure to non-radiation workers, especially nurses in a general ward. The present study aimed to estimate the exact total exposure of the nurse in a general ward by close contact with the patient undergoing nuclear medicine examinations. Materials and Methods Radiation exposure rate was determined by using thermoluminescent dosimeter (TLD) and optical simulated luminescence (OSL) in 14 nurses in a general ward from October 2015 to June 2016. External radiation rate was measured immediately after injection and examination at skin surface, and 50 cm and 1 m distance from 50 patients (PET/CT 20 pts; Bone scan 20 pts; Myocardial SPECT 10 pts). After measurement, effective half-life, and total radiation exposure expected in nurses were calculated. Then, expected total exposure was compared with total exposures actually measured in nurses by TLD and OSL. Results Mean and maximum amount of radiation exposure of 14 nurses in a general ward were 0.01 and 0.02 mSv, respectively in each measuring period. External radiation rate after injection at skin surface, 0.5 m and 1 m distance from patients was as following; $376.0{\pm}25.2$, $88.1{\pm}8.2$ and $29.0{\pm}5.8{\mu}Sv/hr$, respectively in PET/CT; $206.7{\pm}56.6$, $23.1{\pm}4.4$ and $10.1{\pm}1.4{\mu}Sv/hr$, respectively in bone scan; $22.5{\pm}2.6$, $2.4{\pm}0.7$ and $0.9{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. After examination, external radiation rate at skin surface, 0.5 m and 1 m distance from patients was decreased as following; $165.3{\pm}22.1$, $38.7{\pm}5.9$ and $12.4{\pm}2.5{\mu}Sv/hr$, respectively in PET/CT; $32.1{\pm}8.7$, $6.2{\pm}1.1$, $2.8{\pm}0.6$, respectively in bone scan; $14.0{\pm}1.2$, $2.1{\pm}0.3$, $0.8{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. Based upon the results, an effective half-life was calculated, and at 30 minutes after examination the time to reach normal dose limit in 'Nuclear Safety Act' was calculated conservatively without considering a half-life. In oder of distance (at skin surface, 0.5 m and 1 m distance from patients), it was 7.9, 34.1 and 106.8 hr, respectively in PET/CT; 40.4, 199.5 and 451.1 hr, respectively in bone scan, 62.5, 519.3 and 1313.6 hr, respectively in myocardial SPECT. Conclusion Radiation exposure rate may differ slightly depending on the work process and the environment in a general ward. Exposure rate was measured at step in the general examination procedure and it made our results more reliable. Our results clearly showed that total amount of radiation exposure caused by residual radioactive isotope in the patient body was neglectable, even comparing with the natural radiation exposure. In conclusion, nurses in a general ward were much less exposed than the normal dose limit, and the effects of exposure by contacting patients undergoing nuclear medicine examination was ignorable.

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Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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A comparison study of hygiene status in meals for poorly-fed children through microbiological analysis (결식아동이 이용하는 도시락의 미생물 검사를 통한 위생 상태 비교.분석)

  • Yu, Ok-Kyeong;Kim, Hyun-Suk;Byun, Moon-Sun;Kim, Mina;Cha, Youn-Soo
    • Journal of Nutrition and Health
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    • v.47 no.3
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    • pp.214-220
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    • 2014
  • Purpose: The purpose of this study was to assess hygiene status of meals for poorly-fed children through microbiological quality. Methods: Meals were provided by two social enterprises, one franchise, and one convenience store. There were a total of six meal samples; two samples (social enterprise meal 1; SEM 1, social enterprise meal 2; SEM 2) from two social enterprises, respectively, two samples (franchise meal 1; FM 1, franchise meal 2; FM 2) from one franchise, and two samples (convenience store meal 1; CSM 1, convenience store meal 2; CSM 2) from one convenience store. Microbiological analysis and assessment were performed by Korean food standards codex (KFSC). Results: General bacteria and E. coli in SEM 1 were detected, but the levels were not over KFSC, and Coliform less than $9.2{\times}10$ CFU/g was also detected in seasoned bean sprouts of SEM 1. General bacteria was detected at $1.6{\times}10^6$ CFU/g in cabbage kimchi of SEM 2. Coliform was detected in cabbage kimchi, squid cutlet, stir-fried pork, and fried chicken of FM1 and 2, but the levels were not over KFSC. In addition, S. aureus was detected in cabbage kimchi and seasoned dried white radish of FM 1 and 2 ($9.8{\times}10^2$ CFU/g, $9.4{\times}10^3$ CFU/g respectively), thus was over KFSC. B. cereus was detected in stir-fried pork and fried chicken ($1.2{\times}10^3$ CFU/g, $1.5{\times}10^3$ CFU/g respectively) of FM 1 and 2, thus was over KFSC. Finally, S. aureus was detected in stir-fried dried squid, seasoned spicy chicken, and stir-fried kimchi of CSM 1 and 2, and was over KFSC too ($9.5{\times}10^4$ CFU/g, $2.4{\times}10^2$ CFU/g, $1.3{\times}10^3$ CFU/g respectively). Conclusion: Results of this study suggest that systemic management of hygiene is necessary to safely providing meals to poorly-fed children.