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COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD (주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구)

  • Hwang, Jun-Wan;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.160-167
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    • 2004
  • Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

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Studies on effect and Safety of various Aqua-acupunctures from Scutellariae Radix (다양(多樣)한 황금약침제제(黃芩藥鍼製劑)의 안전성(安定性) 및 효능(效能)에 관한 연구(硏究))

  • Kim, Ho-Kyoung;Ma, Jin-Yeul;Cheon, Won-Kyung;Yun, Su-Young;Kang, Eun-Jung;Joo, Hye-Jeong;Ko, Byoung-Seob
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.183-197
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    • 1997
  • In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri (足三里) of rat, repeatedly. We compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days(p<0.05) and after 7 days(p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight : In Palkang aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of Hwanggum aqua-aqupuncture$({\times}10\;group)$ was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture$({\times}100\;group)$, D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound(CPA group) and HG, there were significant value iii statistically. The diluted solution was more significant decrease than Hwanggum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupunture tended to decrease level of TG, regardless of its concentration. In acupunture guoup, we gained some interesting result In meaningful decrease in 7G. 5. Haematological examination showed significant increment of granulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

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The Obligation of Return Unjust Enrichment or Compensation for the Use of Flight Safety Zone -Seoul High Court Judgment 2018Na2034474, decided on 2018. 10. 11.- (비행안전구역의 사용에 대한 부당이득반환·손실 보상 의무의 존부 -서울고등법원 2018. 10. 11. 선고 2018나2034474 판결-)

  • Kwon, Chang-Young;Park, Soo-Jin
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.1
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    • pp.63-101
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    • 2020
  • 'Flight safety zone' means a zone that the Minister of National Defense designates under Articles 4 and 6 of the Protection of Military Bases and Installations Act (hereinafter 'PMBIA') for the safety of flight during takeoff and landing of military aircrafts. The purpose of flight safety zone is to contribute to the national security by providing necessary measures for the protection of military bases and installations and smooth conduct of military operations. In this case, when the state set and used the flight safety zone, the landowner claimed restitution of unjust enrichment against the country. This article is an analysis based on the existing legal theory regarding the legitimacy of plaintiff's claim, and the summary of the discussion is as follows. A person who without any legal ground derives a benefit from the property or services of another and thereby causes loss to the latter shall be bound to return such benefit (Article 741 of the Civil Act). Since the subject matter is an infringing profit, the defendant must prove that he has a legitimate right to retain the profit. The State reserves the right to use over the land designated as a flight safety zone in accordance with legitimate procedures established by the PMBIA for the safe takeoff and landing of military aircrafts. Therefore, it cannot be said that the State gained an unjust enrichment equivalent to the rent over the land without legal cause. Expropriation, use or restriction of private property from public necessity and compensation therefor shall be governed by Act: provided, that in such a case, just compensation shall be paid (Article 23 (1) of the Constitution of The Republic of KOREA). Since there is not any provision in the PMBIA for loss compensation for the case where a flight safety zone is set over land as in this case, next question would be whether or not it is unconstitutional. Even if it is designated as a flight safety zone and the use and profits of the land are limited, the justification of the purpose of the flight safety zone system, the appropriateness of the means, the minimization of infringement, and the balance of legal interests are still recognized; thus just not having any loss compensation clause does not make the act unconstitutional. In conclusion, plaintiff's claim for loss compensation based on the 'Act on Acquisition of and Compensation for land, etc. for Public Works Projects', which has no provision for loss compensation due to public limits, is unjust.

Community Ecological Study on the Quercus acuta Forests in Bogildo-Island (보길도(甫吉島) 붉가시나무림(林)의 군락생태학적(群落生態學的) 연구(硏究))

  • Kim, Chong-Young;Lee, Jeong-Seok;Oh, Kwang-In;Jang, Seok-Ki;Park, Jin-Hong
    • Journal of Korean Society of Forest Science
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    • v.89 no.5
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    • pp.618-629
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    • 2000
  • This study was carried out to investigate ecological niche of Quercus acuta communities in Bogildo-island from July to October, 1998. This island is occupied by a subtropical evergreen broad-leaved forests. The study on community ecology of Q. acuta, mostly dominant species of subtropical forests, is very important for successful forest management. Sampling areas were selected in 16 quadrats, dominated by Q. acuta to examine the vegetation characteristics(plant identification, D.B.H.) and environmental elements (microtopography, altitude, slope degree, aspect, illumination and soil physicochemical properties). On the basis of data from field surveys, importance values were calculated for the dominance of Q. acuta and volume growth was analyzed by tree ring widths. The results obtained were as follows ; 1. The lists of vascular plants in the investigations were identified as 54 families, 91 genera, 113 species, 9 varieties, 1 formae. It appeared that 45 kinds were evergreen, 6 kinds(Camellia japonica, Ligustrum japonicum, Eurya japonica, Smilax china, Trachelospermum asiaticum var. intermedium, Carex lanceolata) were commonly observed in all plots and 5 species(Cinnamomum japonicum, Ardisia japonica, Cymbidium goeringii, Dryopteris bissetiana, Viburnum erosum) were most highly observed in all plots(over 80%). 2. The dominating species per strata were, Quercus acuta, Castanopsis cuspidata sp. Quercus salicina, Pinus thunbergii, Prunus sargentii in tree layer, Camellia Japonica, Ligustrum japonicum, Quercus acuta, Eurya japonica, Castanopsis cuspidata sp. in subtree layer, Camellia japonica, Ligustrum japonicum, Smilax china, Cinnamomum japonicum, Viburnum erosum in shrub layer and Trachelospermum asiaticum var. intermedium, Ardisia japonica, Carex lanceolata, Camellia japonica(seedlings), Quercus acuta(seedlings) in herb layer, all in descending orders. 3. Quercus acuta could be suggested as shade intolerant tree, considering the distribution in southern, western, nothern and eastern slopes in the descending orders. 4. Mean relative illumination in the forest is 0.89 % and it is relatively low in brightness. 5. Sustainment of Quercus acuta community couldn't be confirmed by judging from their reverse J curve in even-aged forest, as shown in D.B.H. distribution analysis. 6. The result of annual ring width analysis(mean ; 2.44 mm) showed three stages, such as a gentle increasing(1~12 year ; 2.04 mm), a relatively steep increasing(13~22 year ; 2.95 mm) and decreasing or stagnating(23 year after ; 2.41 mm).

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Effects of Pranlukast on Ovalbumin Induced Early-Phase Bronchoconstriction in Guinea Pigs (기니픽에서 Ovalbumin으로 유발된 즉시형 기관지 수축반응에 대한 Pranlukast의 효과)

  • Lee, Sin-Hyung;Shim, Jae-Jeong;Kim, Kyung-Kyu;Jeong, Hye-Cheol;Kwon, Young-Hwan;Kim, Je-Hyeong;Lee, Sung-Yong;Lee, So-Ra;Lee, Sang-Youb;Cho, Jae-Youn;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.697-708
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    • 1999
  • Background : Leukotriene (LT) $C_4$, $D_4$, and $E_4$, the main components of slow-reacting substance of anaphylaxis (SRS-A), have been suggested to play an important role in bronchial asthma such as antigen-induced bronchoconstriction, airway hyperreactivity, and pulmonary eosinophil accumulation. The purpose of this study was to evaluate the effects of treatment with the cysteinyl-LTs (cys-LTs) antagonist, pranlukast on allergen-induced guinea pig asthma model. Methods : Guinea pigs of treatment and placebo groups were sensitized by subcutaneous injection of ovalbumin(OVA) and challenged by inhalation of aerosolized OVA (1% weight/volume OVA). Normal control group did not sensitize with OVA. Oral ingestion of pranlukast and normal saline to the treatment and placebo groups was performed. In the treatment and placebo groups, airway resistance was measured before and after oral ingestion. Serum $LTC_4$ and eosinophilic infiltration of the bronchiolar and peribronchiolar tissues were measured after ingestion in the treatment and placebo groups. Results : Allergen-induced airway constriction developed in 20 (8 in treatment group, 12 in placebo group) among 35 guinea pigs. Airway resistance was significantly decreased at 3 and 6 minutes after OVA challenge in the pranlukast treatment group. In the placebo group, there was no difference of airway resistance between before and after saline ingestion. Serum $LTC_4$ levels showed 348.4 pg/ml in the treatment group, 373.9 pg/ml in the placebo group, and 364.4 pg/ml in the control group. There were no statistically significant difference between treatment and placebo group (p=0.232), and treatment and control group (p=0.501). Eosinophilic infiltrations in the peribronchiolar region per one-microscopic field ($\times$400 high power fields) demonstrated 7.06 in the treatment group, 19.2 in the placebo group, and 4.50 in the control group. There was significant decrement of eosinophilic infiltration in the treatment group which was compared with placebo group (p=0.001). Conclusion : These results demonstrate that pranlukast, a cys-LTs receptor antagonist, can attenuate allergen induced early-phase bronchoconstriction and eosinophilic infiltration in the bronchiolar tissues.

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The Continuous Monitoring of Oxygen Saturation During Fiberoptic Bronchoscopy (기관지내시경 검사시 지속적인 동맥혈 산소포화도 감시의 필요성)

  • Kang, Hyun Jae;Kim, Yeon Jae;Chyun, Jae Hyun;Do, Yun Kyung;Lee, Byung Ki;Kim, Won Ho;Park, Jae Yong;Jung, Tae Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.385-394
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    • 2002
  • Background : Flexible fiberoptic bronchoscopy(FFB) has become a widely performed technique for diagnosing and managing pulmonary disease because of its low complication and mortality rate. Since the use of FFB can in patients with severely depressed cardiorespiratory function is increasing and hypoxemia during the FFB can induce significant cardiac arrhythmias, the early detection and adequate management of hypoxemia during FFB is clinically important. Method : To evaluate the necessity of the continuous monitoring of the oxygen saturation($SaO_2$) during the FFB, the $SaO_2$ was continuously monitored from the finger tip using pulse oximetry before, during and after the FFB in 379 patient. The patients were then divided into two groups, those with and without hypoxemia($SaO_2$<90%). The baseline pulmonary function data and the clinical characteristics of the two groups were compared. Results : The mean baseline $SaO_2$ was $96.9{\pm}2.85%$. An $SaO_2$ <90% was recorded at some point in 62(16.4%) out of 379 patients, with 12 out of 62 experiencing this prior to the FFB, in 37 out of 62 during the FFB, and in 13 out of 62 after the FFB. No differences were observed in the smoking and sex distribution between those with and without hypoxemia. The mean age was older in those with hypoxemia than in those without. Significant differences were observed in the mean baseline $SaO_2$ and the mean time for the procedure between the two groups. The $FEV_1$ was significantly lower in those with hypoxemia, and both the FVC and $FEV_1/FVC$ also tended to decrease in this group. Managing hypoxemia included deep breathing in 20 patients, a supplemental oxygen supply in 39 patients, and the abortion of the procedure in 3 patients. Conclusion : These results suggest that the continuous monitoring of the oxygen saturation is necessary during fiberoptic bronchoscopy, and it should be performed in patients with a depressed pulmonay function in order for the early detection and adequate management of hypoxemia.

A Clinical Study on Transpulmonary Leukostasis and Prophylactic Effects of Steroid in Cardiac Surgery (심장수술시 백혈구의 폐내정체와 스테로이드의 예방적 효과에 관한 연구)

  • 최석철
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.133-151
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    • 1996
  • After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.

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A Study on the Nonpoint Pollutant Loadings in Urban and Agricultural Areas (도시(都市)와 농촌(農村)에서의 비점원(非點源) 오염물(汚染物) 배출양상(排出樣相)에 관한 연구(硏究))

  • Lim, Bong Su;Lee, Byung Hyun;Choi, Eui So
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.4 no.2
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    • pp.45-53
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    • 1984
  • This study was conducted to investigate characteristics of nonpoint pollutant discharges and concentrations in runoff from the urban and agricultural areas in Korea. The analytical parameters used for this study were COD, BOD and SS. This study was conducted during the period from May to August 1981. Nonpoint pollutant mass loadings from the urban area were influenced by the rainfall intensity and the duration of rainfall, and etc. The concentrations of pollutants in the first flush was higher as the discharges increased. It was, however, found that the concentrations of pollutants in the heavy storm runoff were decreased due to the dilution effect. When other rainfall followed a peak rainfall, the concentrations of pollutants were lower than expected, because the first flush conveyed the most of pollutants deposited on the combined sewers. However the concentrations were increased in proportion to the increased flow when a rainfall of higher intensity than the first flush was continued. Yearly area yield rates in kg/ha were estimated to be 690.5(489.9~1,328) of COD, 319.7(226.8~614.8) of BOD, and 831.2(589.7~1,598) of SS. Pollutant sources in agricultural area were of the domestic waste water, manure composting stack, and agricultural solid wastes and etc. In the paddy field, yearly area yield rates in kg/ha were estimated to be 623.4(21.7~114) of COD, 18.65(9.53~34.5) of BOD, and 91.9(46.3~171.8) of SS. In the crop land, however, yearly rates in kg/ha were estimated to be 91.9(46.3~171.8) of COD, 23.09(11.7~42.5) of BOD, and 23.09(11.4~43.4) of SS. Pollutant sources in the feedlot area were originating from the feces of cattle, the cleaning water, the wastes spilled from manure composting stack during rain. Yearly area yield rate in kg/ha was estimated to be 3.804(2,489~6,658) of COD, 2.047(464~2,900) of BOD, and 1.149 (729~1,442) of SS. Pollutant discharges in the forest area were resulted from the organic layer like leaves and others deposited on the surface. Yearly area yield rate in kg/ha was estimated to be 9.86(5.45~18.56) of COD, 3.48(1.67~7.54) of BOD, and 4.64(9.74~10.35) of SS.

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Lung Uptake of $^{99m}Tc-sestamibi$ during Routine Gated Exercise SPECT Imaging : Comparison with Left Ventricular Ejection Fraction and Severity of Perfusion Defect (일상적인 운동 부하 게이트 심근 관류 SPECT에서 $^{99m}Tc-sestamibi$ 폐섭취 : 좌심실 구혈률과 관류 결손 정도와의 비교)

  • Jeong, Shin-Young;Lee, Jae-Tae;Bae, Jin-Ho;Ahn, Byeong-Cheol;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.83-93
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    • 2003
  • Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

In the Treatment I-131, the Significance of the Research that the Patient's Discharge Dose and Treatment Ward can Affect a Patient's Kidney Function on the Significance of Various Factors (I-131 치료시 환자의 신장기능과 다양한 요인으로 의한 퇴원선량 및 치료병실 오염도의 유의성에 관한 연구)

  • Im, Kwang Seok;Choi, Hak Gi;Lee, Gi Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.62-66
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    • 2013
  • Purpose: I-131 is a radioisotope widely used for thyroid gland treatments. The physical half life is 8.01 and characterized by emitting beta and gamma rays which is used in clinical practice for the purpose of acquiring treatment and images. In order to reduce the recurrence rate after surgery in high-risk thyroid cancer patients, the remaining thyroid tissue is either removed or the I-131 is used for treatment during relapse. In cases of using a high dosage of radioactive iodine requiring hospitalization, the patient is administered dosage in the hospital isolation ward over a certain period of time preventing I-131 exposure to others. By checking the radiation amount emitted from patients before discharge, the patients are discharged after checking whether they meet the legal standards (50 uSv/h). After patients are discharged from the hospital, the contamination level is checked in many parts of the ward before the next patients are hospitalized and when necessary, decontamination operations are performed. It is expected that there is exposure to radiation when measuring the ward contamination level and dose check emitted from patients at the time of discharge whereby the radiation exposure by health workers that come from the patients in this process is the main factor. This study analyzed the correlation between discharge dose of patients and ward contamination level through a variety of factors such as renal functions, gender, age, dosage, etc.). Materials and Method: The study was conducted on 151 patients who received high-dosage radioactive iodine treatment at Soon Chun Hyang University Hospital during the period between 8/1/2011~5/31/2012 (Male: Female: 31:120, $47.5{\pm}11.9$, average dosage of $138{\pm}22.4$ mCi). As various factors expected to influence the patient discharge dose & ward contamination such as the beds, floors, bathroom floors, and washbasins, the patient renal function (GFR), age, gender, dosage, and the correlation between the expected Tg & Tg-Tb expected to reflect the remaining tissue in patients were analyzed. Results: In terms of the discharge dose and GFR, a low correlation was shown in the patient discharge dose as the GFR was higher (p < 0.0001). When comparing the group with a dosage of over 150mCi and the group with a lower dosage, the lower dosage group showed a significantly lower discharge dose ($24{\pm}10.4uSv/h$ vs $28.7{\pm}11.8uSv/h$, p<0.05). Age, gender, Tg, Tg-Tb did not show a significant relationship with discharge dose (p> 0.05). The contamination level in each spot of the treatment ward showed no significant relationship with GFR, Tg, Tg-Tb, age, gender, and dosage (p>0.05 ). Conclusion: This study says that discharge of the dose in the patient's body is low in GFR higher and Dosage 150mCi under lower. There was no case of contamination of the treatment ward, depending on the dose and renal association. This suggests that patients' lifestyles or be affected by a variety of other factors.

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