• Title/Summary/Keyword: 환자격리

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방사성옥소 치료를 위한 표준 지침서 개발과 치료병실 환경 개선 연구

  • Kim, Bong-Soo;Pyo, Seong-Jae;Kim, Chang-Ho;Jo, Yong-Gwi;Sin, Chae-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.126-129
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    • 2008
  • 목적: 방사성옥소 치료 환자들은 주의 사항이나 식이요법 등을 지키는 것에 대한 어려움과 3~4일간의 격리 치료기간 동안의 막연한 불안감을 느끼는 등의 심리적, 신체적 부담감을 가지고 있다. 본 과에서는 방사성옥소 치료의 예약과 치료병실에 대한 표준지침서를 개발하여 환자들에게는 정확하고 쉬운 정보를 제공하여 막연한 불안감을 해소하고 치료 업무에 종사하는 종사자들에게는 통일된 정보를 제공하여 업무효율을 향상시키는 효과와 치료 병실의 환경개선을 통한 환자의 심리적 안정감을 찾는데 주력하고자 본 연구를 시작하였다. 대상 및 방법: 2006년 9월부터 2007년 2월까지 치료병실에 입원한 환자를 대상으로 치료환자의 치료 일정, 주의사항, 저옥소 식단과 치료병실의 표준 진료 지침서를 개발하고 치료 병동의 간호사와 협력하여 치료병실의 환경을 개선하여 환자에게 적용하였다. 결과: 방사성옥소 치료의 특성상 환자는 치료가 결정되는 순간부터 치료과정에 대한 이해도 부족과 치료병실 생활에 대한 불안감을 느끼게 되므로 치료 시 사용되는 일정 및 주의사항, 저옥소 식단의 표준지침서를 개발하여 환자 치료병실 개선과 치료병실에서의 표준지침서를 개발하고 사용하였다. 결론: 치료에 따른 진료지침서와 병실 환경을 개선 후 치료에 대한 환자의 이해도 및 치료병실에서의 생활이 예전과 비교해서 많이 향상 되었고 치료의 과정을 설명하는 예약 시에도 많은 도움이 되고 있다. 이러한 치료과정의 규격화 하는 작업들은 본원뿐 아니라 치료병실이 있는 병원의 치료환경을 개선하는데 도움이 될 것이라고 사료된다.

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Ethnography on Isolation Unit for Hematopoietic Stem Cell Transplantation: Focusing on Patients (조혈모세포이식 병동에 관한 문화기술지: 환자를 중심으로)

  • Kang, Young-Ah;Yi, Myung-Sun
    • Asian Oncology Nursing
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    • v.9 no.1
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    • pp.31-42
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    • 2009
  • Purpose: The purpose of the study was to understand how patients experience everyday life in an isolation unit for hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 25 patients with HSCT at the isolation unit from January to March in 2008 in one general hospital in Korea. The data were collected by participant observations and ethnographic interviews and were analyzed using ethnographic method. Results: Four themes regarding environmental area emerged: 'barrier pulling up the drawbridge', 'very strange world', 'small and restricted space tied by IV and other treatment lines', and 'loud noise in a silent space.' Three themes regarding patients emerged: 'facing fear and anxiety', 'continuation of loneliness and lethargy', and 'compromising with a very long, dull, and boring time'. These themes describe how patients with HSCT suffer from continuous physical and psychosocial problems in a confined space, while endeavoring to control these problems and to search for hope for a new life. Conclusion: The results of the study provide an in-depth understanding of the experience and culture of patients in an isolation unit for HSCT. They would be used in developing practical programs to decrease patient's culture shock including fear and anxiety at isolation unit for HSCT.

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A Case of Pulmonary Sequestration Treated with Arterial Embolization (동맥색전술로 시술한 폐격리증 1예)

  • Lee, Gun-Wha;Kim, Dong-Kyun;Na, Hyun-Sik;Bae, Jun-Yong;Choi, Jun-Ho;Kim, Yang-ki;Kim, Ki-up;Uh, Soo-taek;Kim, Dong-hoon;Hwang, Jung Hwa;Goo, Dong-Erk
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.68-73
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    • 2005
  • Pulmonary sequestration is a very rare congenital malformation in which a mass of pulmonary tissue is detached from the normal lung and receives its blood supply from a systemic artery. It may be clinically asymptomatic or it has a wide spectrum of various clinical manifestations. The clinical therapeutic approach is to resect the sequestered lobe to prevent frequent complication such as infection. The arterial embolization of feeding artery is a new technique and a less invasive treatment than conventional surgical removal. We have experienced a 17-year-old male with pulmonary sequestration whose complaints were pain in left lower chest. He was diagnosed by computed tomography and aortography and successfully treated with embolization of feeding artery. We report a case of pulmonary sequestration treated with arterial embolization instead of surgery.

Long-Term Results of Atrial Fibrillation Surgery with Mitral Valvular Disease (승모판막 질환에 동반된 심방세동 수술의 장기 결과)

  • 장병철;맹대현;강정한;조상호
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.881-885
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    • 2000
  • 배경: 승모판막 질환에 동반된 심방세동의 경우 그 기간이 길면 승모판막 질환을 수술하여도 동성 율동으로 전환될 가능성이 매우 적다. 본 연구는 승모판막 질환에 동반된 심방세동에 대한 변형 Maze 수술후 장기 결과와 심방세도의 재발에 미치는 요인을 조사 하고자 하였다. 대상 및 방법: 1990년부터 1996년까지 승모판막 질환과 동반된 심방세동으로 외과적 요법을 시행받은 35명의 환자를 대상으로 하였다. 심방세동의 평균 유병기간은 평균 7.7$\pm$4.5년이었고 수술은 승모판막 대치술 34례(재수술 3례)와 승모판막 성형술 1례를 시행하였고 승모판 질환 수술 외에 동반 수술로는 삼첨판륜 성형술 4례, 삼첨판막 대치술 3례 였다. 심 방세동에 대한 수술은 좌측 폐정맥 부위는 격리하지 않는 변형 Maze 수술을 시행하였다. 수술 후 동성 율동으로 회복여부, 심방세동의 재발에 미치는 요인과 장기 결과를 분석하였다. 결과: 수술 직후 2례를 제외한 33례(93.9%)에서 동성율동으로 돌아왔으나 수술 후 퇴원 전에 12례에서 심방세동이 재발되었다. 수술환자중 1례에서 수술 후 3일에 동성 정지에 따른 심정지가 발생하여 소생되었으나 뇌손상으로 수술 후 15일에 사망하였다. 심방세동이 재발된 경우 수술 후 약 2개월에서 6개월 사이에 항부정맥 약물(mquinidine)과 전기적 제세동으로 치료하여 12례중 10례에서 동성 율동으로 돌아온 환자는 항부정맥 약물을 모두 중단하 였으며, 수술 후 3년에서 9년(평균 71.1$\pm$17.5개월) 추적 관찰 중 9례에서 심방세동이 재발되어 장기간 동성 율동이 유지된 환자는 34명중 25명으로 73.5%이었다. 승모판 질환이 있던 환자에서 수술 후 심방세동의 재발에 미치는 요인들을 조사한 결과 수술전 심방세동의 기간(동성율동 유지군 : 재발군=6.3년 : 10.3년, P=0.008)과 수술 전 단순 흉부 X선상 심흉비율(0.58 : 0.72, p=0.009)은 통계학적으로 유의하게 나타났으나 심초음파 검사상 좌심방의 직경(57.2mm : 77.4mm, p=0.106)은 통계학적 유의성이 없었다. 결론: 심방세동이 있는 환자에서 동반 질환 수술시 병행하여 수술한다면 정상 동성 율동으로 회복될 기회를 증가시킬 수 있는 유용한 수술법으로 생각된다. 그러나 수술후 재발률을 감소시키기 위하여 적절한 술기의 변형에 대한 연구와 약물요법의 병행을 고려하여야 할 것으로 사료된다.

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Suggestion of A Practical Simple Calculation Method for Safe Transportation Time after Radioactive Iodine Treatment in Patients with Thyroid Cancer (갑상선암 환자에서 방사성옥소치료 후 안전하게 이동할 수 있는 시간을 계산하기 위한 실용적인 간편계산법 제안)

  • Park, Seok-Gun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.3919-3925
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    • 2015
  • When a patient with thyroid cancer is released from isolation after I-131 treatment and return to home using a vehicle, travel time should be controlled to reduce the amount of radiation to accompanying person. As the calculation of appropriate travel time is difficult, there is no patient-specific guideline until now. If we assume that there is no excretion and no physical decay during the relatively short travel time, calculation become quite simple; total radiation dose = dose rate ${\times}$ travel time. Results of this simple calculation and conventional calculation were compared using datum from 120 patients. Travel time calculated by simple method was 56% of conventional method in 0.3 m, 91% in 0.5 m and 96% in 1 m. Simple method was safe. It can be applied easily and also can be applied to the patients with hyperthyroidism treated by I-131.

Basal Cell Nevus Syndrome : A Case Report (기저세포 모반 증후군 : 증례보고)

  • Kim, Jeeyoun;Oh, Sohee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.166-173
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    • 2014
  • The basal cell nevus syndrome is also known as the Gorlin-Goltz syndrom. It is a dominant autosomal disorder which is characterized by keratocystic odontogenic tumors in the jaw, skeletal abnormalities, and multiple basal cell nevi carcinomas. This study reports an 11-year-old boy with multiple odontogenic keratocysts in the jaw, hypertelorism, and frontal bossing. When a young patient has cystic lesions with an impacted permanent teeth, it is important to preserve the teeth. For a growing patient with impacted permanent teeth, a more conservative method is suggested, which will enable the preservation the permanent teeth in Gorlin-Goltz syndrome.

Design of multi-array pulse diagnosis sensor with FDB process (FDB 방식을 채용한 멀티 어레이 맥진 센서 설계)

  • Jeon, Y.J.;Lee, J.;Lee, Y.J.;Woo, Y.J.;Ryu, H.H.;Kim, J.Y.
    • Proceedings of the KIEE Conference
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    • 2008.10b
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    • pp.367-368
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    • 2008
  • 한의학의 주요 방법 중 하나인 맥진은 한의사가 환자의 손목 부위를 손가락으로 진맥하여 환자의 맥동을 감지하는 행위이다. 하지만 이러한 맥진은 주관적이고 형이학적 이어서 맥진의 발전을 위해서는 맥진의 객관화와 정량화가 요구된다. 본 연구는 기존의 와이어 본딩(wire bonding)을 이용한 맥진 센서의 단점인 내성을 극복하기 위하여 FDB(Face Down Bonding) 방식을 이용하였으며, $3{\times}3$ 멀티 어레이 센서간의 crosstalk를 극복하고자 센서들을 격리시킬 수 있는 댐(dam)을 형성하였다. 또한, 댐을 감싸고 상단 및 하단에 들기를 형성하는 패드를 이용하여 피부에 접촉하도록 제작하였다. 센서의 특성을 평가하기 위하여 각 센서 출력 단자의 저항 값을 측정하였으며 센서 스펙에서 제공하는 값과 동일함을 확인하였고, 실제 요골동맥 부위에서 맥파를 측정하여 전형적인 요골동맥 맥과 파형이 측정됨을 확인하였다.

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Tracheal Compression by Esophageal Mucocele after Surgical Exclusion of the Esophagus - One case report- (식도격리수술 후 식도 점액류에 의한 기관압박 -1예 보고-)

  • Song In Hag;Lee Seung Jin;Park Hyung Joo;Lee Cheol Sae;Lee Kihl Rho;Lee Seock Yeol
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.80-83
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    • 2005
  • A 43-year-old male was admitted to our hospital complaining of dyspnea and wheezing sound at respiration. He had received esophageal exclusion and esophagogastrostomy due to spontanous esophageal rupture 1-year ago. Chest computed tomography revealed esophageal mucocele like that of mediastinal tumor. Trachea is compressed by esophageal mucocele. The operation was performed by resection of thoracic esophagus through right open thoracotomy. Herein we report a case of a tracheal compression by esophageal mucocele after surgical exclusion of the esophagus.

Corrective Surgery of Congenital Cardiac Anomalies in the Noonan syndrome - Report of two cases - (Noonan 증후군에 동반된 심기형의 수술적 교정 - 2례 보고 -)

  • 이선희;이주현;심성보;박재길;곽문섭;김세화;오용석;윤호중;정욱성
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.552-555
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    • 2001
  • Noonan syndrome is characterized by a Turner-like phenotype and a normal karyotype associated with congenital abnormalities, such as short stature, variable mental retardation, hypertelorism, webbed neck, low posterior hair line, skeletal malformation and congenital cardiovascular defect. Two third of Noonan syndrome have cardiac anormalies, half with pulmonary stenosis. We have experienced two cases of pulmonary stenosis associated with other cardiac anomalies in Noonan syndrome. The first 31-year-old male patient had characteristic appearance of Noonan syndrome with severe infundibular pulmonic stenosis and patent foramen ovate. The second 28-year-old male patient had valvular and subvalvular Pulmonary stenosis with typical Noonan\`s face and stature. Pulmonary valvotomy and hypertrophied muscle bundles in the right ventricular cavity were resected in both cases. Patent foramen ovate was closed directly in the first case. Postoperative follow-up examinations revealed no symptoms and successful outcome.

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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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