• Title/Summary/Keyword: 파티마

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Merkel Cell Carcinoma of the Trunk: Two Case Reports and Imaging Review (몸통에 생긴 메르켈 세포암종: 2예 증례 보고 및 영상 소견 고찰)

  • Ha Yun Oh;Donghan Kim;Yun Sun Choi;EunKyung Kim;Tae Eun Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1134-1139
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    • 2023
  • Merkel cell carcinoma (MCC) is a rare malignant cutaneous tumor primarily located in the head and neck. We report the imaging features of pathologically confirmed MCC in the trunk. On US, MCC showed heterogeneous echogenicity with perpendicular hypoechoic linear bands that resembled "columns of smoke" in the skin and subcutaneous layers as well as prominent vascularity. On MRI, the tumor showed hypointensity on T1-weighted images and hyperintensity on proton density and T2-weighted images with linear low-signal bands in the skin and subcutaneous layers as well as intense enhancement on T1-enhanced images. Although MCC has nonspecific imaging features, these characteristics may be helpful for the early diagnosis of this disease.

Activity to reduce the record missing for nursing care charge (간호수가 누락률 감소활동)

  • Kim, Nan Ja;Lee, Yong Kyo;Kim, Hye Jin;Cheung, Ok Ju;Song, Nam Gyoung;Jun, Mi Sun
    • Quality Improvement in Health Care
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    • v.15 no.1
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    • pp.73-78
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    • 2009
  • 문제: 오늘날 간호사는 과거와 달리 현대적 보건의료 요구를 해결할 수 있는 체계적인 이론과 기술을 습득하도록 훈련된 고급 전문 인력이고, 간호행위를 생산하기 위해서는 서비스의 생산원가 뿐만 아니라 전문 인력으로서의 훈련 및 유지비용 등도 투입되어야만 가능하게 함으로서 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실 내에서 이루어지고 있는 많은 간호행위 중 수가를 받을 수 있는 부분이 생기게 되었고 간호행위의 중요성과 더불어 간호를 시행 후 받을 수 있는 수가에 대한 간호사들의 입력에 대한 의무도 늘어나게 되었다. 이에 빈번히 누락되고 있는 간호수가 관리를 통한 경제적 손실을 방지해야 할 필요성을 느껴 개선활동을 하고자 한다. 목적: 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실내에서 이루어지고 있는 간호 행위의 중요성을 인식하고 구체적인 문제 분석과 간호 현장에서의 개선안을 도출함으로써 경제적 손실을 방지할 수 있는 간호수가 누락률을 감소시키고자 함이다. 의료기관: 대구파티마병원 내과 중환자실. 질 향상 활동: 업무개선의 방법으로 환자 개인별 간호수가 입력 누락 방지 체크 리스트 사용 및 처방 전달 시스템의 간호수가 재입력 화면을 이용하여 입력의 용이성 도모하였고 입력된 간호수가를 처방 전달 시스템 간호수가 조회 프로그램을 이용해 익일 누락여부를 매일 모니터링 하였다. 교육 및 홍보활동으로는 간호수가 입력누락 방지를 위한 간호수가 입력 지침을 제작하여 전체간호사는 년 2회, 신규간호사는 개별 교육을 실시하였으며, 월별 간호수가 누락통계를 실명 공고 하여 간호수가 다 빈도 누락 간호사는 추가 개별교육을 실시하였다. 개선효과: 간호수가 입력 프로세스 개선을 통해 간호수가 평균 누락률이 개선 전 6.5%, 개선 후 1.2%로 5.3%의 누락 감소율을 보였으며 역치 5%를 달성하였고 간호수가 누락금액은 개선 전 2,992,752원, 개선 후 590,787원으로 2,401,965원의 누락 효과 비용을 구할 수 있었다. 본 QA활동으로 중환자실 간호수가 전산입력에 대한 체계적인 교육부재와 신규간호사들의 잦은 전산누락이 있어왔으나 표준화 된 체크리스트 지침과 입력확인 작업으로 전산입력 누락률이 감소하는 효과를 가져왔다. 추후 심평원 청구 작업을 하는 부서와 연계되어 실제 청구 누락률에 대한 비교와 간호사 근무연수와 간호수가 입력 누락률에 대한 상관관계 조사를 제언 해 본다.

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Age- and Gender- Specific Reference Levels for Hearing Thresholds of Normal Aging in Korean (한국인의 정상적인 노화에 의한 성별 연령별 순음청력에 의한 기준청력)

  • Kim Sung Hee;Shin Jong Heon;Yeo Chang Ki;Han Young Kyung;Lee Jung Ki;Jarng Soon Suck
    • The Journal of the Acoustical Society of Korea
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    • v.24 no.6
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    • pp.353-357
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    • 2005
  • Declining auditory performance with advanced age is a well known and common problem that is becoming more Prevalent due to the increasing number of elderly people in our society. We introduce a novel ARCISM (Audiogram Result Computer Input. Save & Management software) data management program which enables the assessment of the risk of past history of hearing impairment on the basis of known risk factors. This study investigates the reference levels of pure tone hearing threshold of normal aging in Korean and the difference between fenders. The subjects were carefully selected by questionnaire and absence of any history of otologic infection, noise exposure. and ototoxic drug among 1603 subjects. who visited Health Promotion Center in Daegu Fatima Hospital for one year. The results show (1) hearing sensitivity declines with age. (2) higher frequency shows steeper slope of hearing declines than lower frequency. and (3) there were more hearing loss at 4 and 8 kHz in men than in women. Due to the ARCISM program. it was possible to manage huge data of hearing results and to obtain the reference level of a9e-related hearing declines. Furthermore, we expect that the results of this study can be the fundamental data for hearing rehabilitation for the elderly and for developing suitable hearing aids for Korean.

Study of the risk factors for pulmonary interstitial emphysema related to mechanical ventilator care (인공호흡기 치료와 관련된 폐간질기종 발생의 위험인자에 대한 연구)

  • Kim, Sang Yeob;Lee, Pil Sang;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1179-1184
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    • 2008
  • Purpose : Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. Methods : PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories. Results : Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax. Conclusion : Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.

Clinical Availability of Rapid Strep Test in Children with Group A Streptococcal Pharyngotonsilitis (A군 연쇄구균 상기도 감염에 있어 신속검사의 유용성)

  • Kim, Yeon Ho;Bae, Young Min;Cha, Sung Ho;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.90-93
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    • 2001
  • Purpose : The accurate diagnosis and proper treatment of group A streptococal infection should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. Inadequate & improperance of antobiotics have resulted in increased number of antibiotic-resistant bacteria. We would like to know the clinical usefulness of rapid strep test compared with conventional throat culture in out-patients with acute pharyngotonsilitis. Methods : From Sep. 2000. to Jan. 2001, rapid strep test(LINK 2 Strep A, USA) & throat culture were taken from 87 patients with clinically suspect pharyngotonsilitis from Masan Fatima hospital & kyunghee university hospital. Results : Of 87 cases with pharyngitis, 39 cases proved to have group A streptococci by throat culture. The positive predictive value of rapid test was 92.3%(36 of 39 cases) and sensitivity test was 81.8%(36 of 44 cases). The specificity of rapid test was 93.0%(40 of 43 cases) and negative predictive value was 83.3%(40 of 48 cases). Conclusion : The positive predictive value & specificity of rapid strep test is high. And so, this test will give the pediatricians practical guidance of antibiotic use in patients with pharyngitis. But more efforts should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.

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Clinical Comparison of Influenza A and B Virus Infection in Hospitalized Children (소아 입원환자에서의 A형 및 B형 인플루엔자 임상 비교)

  • Jung, Seungwon;Lee, Joon Hee;Kang, Jin Han;Lee, Hak Sung;Choi, Jae Won;Ma, Sang Hyuk;Lee, Jaywon
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.23-30
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    • 2017
  • Purpose: The objective of this study was to compare the clinical characteristics of influenza A and B infections and analyze the effect of oseltamivir in hospitalized children. Methods: We investigated children under the age of 15, who were diagnosed with influenza A/H1N1, A/H3N2, or B from January to April 2014. The subjects were admitted to the Changwon Fatima Hospital and diagnosed using a rapid antigen test from nasopharyngeal swabs. The medical records of the patients were retrospectively reviewed. Results: A total of 302 pediatric patients with influenza were enrolled. Influenza B infection was the most common type (n=187, 61.9%), followed by A/H3N2 (n=100, 33.1%) and A/H1N1 (n=15, 5.0%). Compared to patients diagnosed with influenza A, patients diagnosed with influenza B were older (P=0.005), and the duration of fever was significantly longer (P=0.001). A total of 161 patients (53.3%) had been vaccinated against influenza during the season, before admission. Among the patients infected with A/H3N2 and B, the duration of fever was shorter in oseltamivir recipients compared to oseltamivir non-recipients (P=0.026 and P=0.004, respectively). Conclusions: There were significant differences between influenza A and B groups in terms of age, demographics, and clinical course. Although the effectiveness of oseltamivir on influenza differs according to the type of influenza, our data provides evidence that oseltamivir is beneficial for both A and B infections.

Clinical Characteristics of Pertussis Epidemic in Changwon (창원에서 유행한 백일해의 임상적 특징)

  • Jang, Joon Weon;Kang, Jin Han;Choi, Jae Won;Lee, Hak Sung;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.37-43
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    • 2017
  • Purpose: Pertussis can be prevented with a vaccine. Despite this, there have been an increasing number of cases worldwide, and also in Korea. This study aimed to investigate the epidemiology and clinical characteristics of the recent outbreak in the Changwon area. Methods: Patients who visited Changwon Fatima Hospital from July 2015 to March 2016 with respiratory symptoms, including spasmodic cough, cough induced vomiting, inspiratory 'intake' sound (whooping), and a night-time cough for >1 week were included in this study. Respiratory specimens were collected from patients and a polymerase chain reaction (PCR) and detected anti-pertussis immunoglobulin G enzyme-linked immunosorbent assay kit test were performed. Patients with underlying diseases, or those who had received a DTaP or Tdap vaccination in recent 1 year were excluded. Results: Pertussis was diagnosed in 37 of 50 patients, two patients were positive according to the PCR, and 37 patients were positive according to serologic tests. The age distribution of the patients was 1 month to 15 years. After administering antibiotics, all patients recovered without complications. Conclusions: A pertussis outbreak occurred in Changwon in 2015 and 2016. This data can provide the basis for further study on the epidemiology of pertussis in Korea.

Clinical and Laboratory Finding of the 2009 Pandemic influenza A (H1N1) in Children (소아에서 2009 신종 인플루엔자 A (H1N1) 바이러스 감염의 임상적 특징)

  • Sohn, Yu Rak;Park, Su Hyun;Kim, Won Duck
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.173-181
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    • 2011
  • Purpose : 2009 Pandemic influenza A (H1N1) virus was identified in March 2009 and subsequently caused worldwide outbreaks. We described the clinical and epidemiological characteristics of H1N1 influenza infection. Methods : We used retrospective medical chart reviews to collect data on the visiting patients from a single institute. H1N1 infection was confirmed in specimens with the use of a RT-PCR (real time reverse transcriptase polymerase chain reaction assay). Result : 6,836 patients had H1N1 RT-PCR test, and 2,781 were confirmed with H1N1 virus infection. 158 patients (5.7%) had hospital treatment and inpatients were significantly younger (5.4${\pm}$3.3 years) than outpatients (7.5${\pm}$3.9 years) among H1N1 virus confirmed patients. Oxygen, steroid, immunoglobulin, ventilator treatment was provided in a substantial proportion among pneumonia patients accompanying wheezy respiration. In addition more intensive care was needed in patients accompanying segmental, lobar, interstitial, mixed pneumonia and lung effusion (27.2%) than patients with bronchopneumonia (7.3%) among H1N1 virus infection confirmed patients. Seventy-one infants had oseltamivir treatment out of 83 infants under 1 year, and no significant side effects and complications were identified. Conclusion : In 2009 pandemic influenza A (H1N1), hospital treatment was needed in younger patients. Early intensive care was needed in pneumonia patients accompanying wheezy respiration, and patients accompanying segmental, lobar, interstitial, mixed pneumonia and lung effusion.

Effect of MSE on Activity and Molecular Biology in Rat Induced Liver Injury (간 손상으로 유도된 랫드에서 MSE가 활성 변화와 분자생물학에 미치는 영향)

  • Yea, Chun-Jung;Lee, Tae-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.520-526
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    • 2019
  • The purpose of this experiment is to investigate the feasibility of extracts (sample extract, MSE) mixed with hot - water extracts as health functional nutritional foods for prevention and treatment of liver damage. The experimental method was to investigate the effects of carbon tetrachloride on liver damage in rats by 60% of liver cirrhosis level. The effect of mixed extracts (MSE) was investigated by measuring the physiological functions, biochemical functions, and molecular biologic TGF - ${\beta}$ and P53 levels in liver - injured rats. with MSE doses administered differently(0.50ml, 0.75ml). A total of 30 rats were used for normal group, control group, positive control group, experimental group 1, and experimental group 2. The rats were given 6 times a week for 6 weeks at a fixed time once a day. The results of the experiment were statistically significantly higher in the control group than in the normal group and the positive control group, and statistically significantly lower in the experimental group (1 and 2) than the control group. There were some significant differences in the comparison between the experimental groups (1 and 2), but no significant changes were found. In conclusion, the results of this study are expected to be useful as functional food, and the variation of physiological activity and the degree of liver molecular biotechnology will be used for the research of the same field.

Comparison of the Equivalent Dose of the Lens Part and the Effective Dose of the Chest in the PET/CT Radiation Workers in the Nuclear Medicine Department (핵의학과 PET/CT실 방사선작업종사자의 수정체 부위의 등가선량과 흉부의 유효선량의 측정 비교)

  • Son, Sang-Joon;Park, Jeong-Kyu;Jung, Dong-Kyung;Park, Myeong-Hwan
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.209-215
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    • 2019
  • Comparison of the effective dose of the chest and the equivalent dose of the lens site in the radiation workers working at four medical institutions with the PET / CT room located in one metropolitan city and province from April 1 to June 30, 2018 Respectively. Radioactive medicine were measured at the time of dispensing and at the time of injection. In this experiment, the average dispensing time per patient was 5.7 minutes and the average injection time was 3.1 minutes. The equivalent dose at the lens site was $0.78{\mu}Sv/h$ for 1 mCi, and the effective dose for chest was $0.18{\mu}Sv/h$ per 1 mCi. The equivalent dose at the lens site during injection was $0.88{\mu}Sv/h$ per mCi and the effective dose of chest was $0.20{\mu}Sv/h$ per mCi. The daily effective dose of the chest was $0.9{\pm}0.6{\mu}Sv$ and the equivalent dose of the lens site was $3.6{\pm}1.4{\mu}Sv$ during daily dosing for 20 days. The effective dose of the chest during the day was $0.6{\pm}0.5{\mu}Sv$ and the equivalent dose of the lens was $2.2{\pm}1.0{\mu}Sv$. At the time of dispensing, the equivalent dose of the lens was $0.187{\pm}0.035mSv$, the effective dose of the chest was $0.137{\pm}0.055mSv$, the equivalent dose of the lens was $0.247{\pm}0.057mSv$, and the effective dose of the monthly chest was $0.187{\pm}0.021mSv$. As a result of the corresponding sample test, the equivalent dose and the effective dose of the chest, the effective dose of the chest, the effective dose of the chest, the effective dose of the chest, The equivalent dose of the lens and the effective dose of the chest were statistically significant (p<0.05) with a significance of 0.000. However, there was no statistically significant difference (p>0.05) between the equivalent dose and the effective dose of the chest, the equivalent dose of the lens at the time of injection, and the effective dose of the chest at 0.138 and 0.230, respectively.