• Title/Summary/Keyword: 환자격리

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Measurement of Effective Half-life Using Dual Time I-131 Whole Body Scan in Patients with Differentiated Thyroid Cancer Treated by High Dose Therapy (고용량 방사성옥소 치료를 받은 갑상선분화암 환자에서 Dual Time I-131 Whole Body Scan을 이용한 유효반감기의 측정)

  • Yoon, Jae Sik;Lee, Jae Gon;Lee, Ki Hyun;Lim, Kwang Seok;Choi, Hak Ki;Lee, Sang Mi
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.98-103
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    • 2014
  • Purpose: The effective half life of I-131 is useful to calculate radiation dose, period of hospitalization, and exposure dose of surrounding people from patient. However, it is difficult to measure. This study estimates the effective half life in whole body and thyroid in using of value of residual radioactivity obtained from the early and delay images of Dual time I-131 whole body scan. Also, the correlations between the effective half life and serum creatinine, GFR, and administration dose were investigated in this study. Materials and Methods: The targets were 50 patients administration high dose of I-131 from February to August in 2013, having normal range of serum creatinine and over $30{\mu}IU/mL$ of TSH levels. After administration radioactive I-131, the early scan in the 3rd day and the delay scan in the 5-6th days were performed. To measure the residual radioactivity in the whole body and thyroid, ROI was set and then background radioactivity was corrected to estimate. The effective half life was estimated by calculating the ratio of measured values between the early and delay images. To compare the effective half lives of the whole body and thyroid, it was analyzed by Independent t-test, and each correlation of the effective half life, GFR, serum creatinine, and the dose of administration were analyzed by calculating the pearson's correlation coefficient. All of the analysis were determined to be statistically significant when P<0.05. Results: The effective half life of the whole body was $17.06{\pm}5.50$ hours and of the thyroid was $17.22{\pm}5.41$ hours. The two effective half life did not show significant difference (P=0.887). As the value of GFR was increased, the effective half life of whole body (r=-0.407, P=0.003) and of thyroid (r=-0.473, P=0.001) were significantly decreased; as the value of serum creatinine was increased, the effective half life of whole body (r=0.309, P=0.029) and of thyroid (r=0.371, P=0.008) were significantly increased. In the administration dose, effective half life did not have correlations. Conclusion: The effective half life of I-131 of patients treated for their thyroids were estimated only by using the images of Dual time I-131 whole body scan. Also, the correlations with the effective life, GFR, and serum creatinine were examined. This study might be utilized for a study on optimization for the period of hospitalization of patients treated by high dose of I-131 and on evaluation for internal absorbed dose of MIRD schema in application of the effective half life.

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Perceived Anxiety and Uncertainty in Hematopoietic Stem Cell Transplantation Recipients to and from Isolation Unit (격리병동 입.퇴실시 조혈모세포 이식 환자가 지각하는 불안과 불확실성)

  • Kim, Hye-Jo;Choi, Dong-Won;Park, Ho-Ran;Sohng, Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.428-436
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    • 2006
  • Purpose: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. Results: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. Conclusion: Front the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.

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A Communicating Bronchopulmonary Foregut Malformation Associated with Absence of the Left Pericardium - A case report - (좌측 완전 심낭결손증을 동반한 Communicating Bronchopulmonary Foregut Malformation - 1예 보고 -)

  • Yoo, Dong-Gon;Park, Chong-Bin;Kang, Pil-Je;Lee, Jong-Hyeog;Kim, Chong-Wook
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.793-797
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    • 2007
  • A communicating bronchopulmonary foregut malformation (CBPFM) is a rare congenital anomaly that is characterized by a fistula between isolated respiratory tissue and the esophagus or stomach, The presence of accessory lung tissue arising from the primitive gastrointestinal tube is a common factor in the development of all forms of bronchopulmonary foregut malformations. Recurrent pneumonia associated with cystic radiographic structures is a characteristic of the condition. Further imaging studies using esophagogram, bronchography, computerized tomography, MRI, and arteriography can help in making a diagnostic evaluation. The treatment is a surgical resection of the involved lung tissue, and fistula closure with a good prognosis. We encountered a case of CBPFM, who presented with an extralobar pulmonary sequestration and bronchogenic cyst communicating with a tubular esophageal duplication that was associated with a complete left pericardial defect.

Anomalous Systemic Arterial Supply to Normal Basal Segments of Left Lower Lobe : A Report of Two Cases (폐격리 없이 좌하엽이 체순환 동맥으로부터 공급되는 기형적인 혈관 2예)

  • Lee, Ki-Man;Ahn, Jong-Joon;Kim, Byung-Chul;Jeong, In-Du;Shin, Je-Kyoun;Jung, Jong-Pil;Hwang, Jae-Cheol;Suh, Jae-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.710-717
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    • 2001
  • Two cases of an anomalous systemic arterial supply to the basal segments of the left lower lobe without pulmonary sequestration are presented. In the first case, a preoperative diagnosis was made by chest CT, and confirmed by angiography, in a 22-year old man who had a recurrent hemoptysis. There was systemic arterial supply that originated from the thoracic descending aorta and no pulmonary arterial supply to the basilar segments of the left lower lobe. However, the pulmonary parenchyma was normal without sequestration. Ligation of the abnormal artery and a left lower lobectomy were performed without complications. In the second case, there were characteristic features of this anomaly on chest CT and the angiogram in a 31-year-old man with symptoms of hemoptysis. The patient refused surgery.

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Outpatient Radioablation Therapy for Thyroid Cancer Patients with Minimal Radiation Exposure to the Family Members (갑상선암 환자의 방사선옥소 외래치료시 가족 구성원의 방사선량 측정)

  • Park, Hee-Myung;Jang, Jung-Woong;Yang, Hee-Chul;Kim, Young-Gook
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.218-225
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    • 2007
  • Purpose: Postoperative thyroid remnant radioablation therapy is necessary to reduce the recurrence and mortality rates as well as to prepare the patients for a proper long term surveillance of well-differentiated thyroid cancers. The radiation safety rules of the government require the patient to be isolated in a hospital if the expected radiation exposure to the family members would be greater than 5 mSv (500 mRem). The purpose was to measure the radiation received by the family members of patients who received large doses of NaI-131. Material and Methods: We have administered 12 therapy doses ranging from 3.70-5.55 GBq (100 to 150 mCi) to 11 patients, and released them immediately if they met the radiation safety criteria. Informed consent was obtained from the subjects prior to the therapy, and each of them agreed to follow written radiation safety instructions. TLD badges were used to measure the radiation dose received by the family members and the room adjacent to the patient's bed room during the first 72 hours. Results: The average dose received by the family members who spent the most time in the closest distance with the patients was 0.04 mSv with a range of 0.01-0.17 mSv. Even the highest dose was only about 3% of the limit set by the government. The average radiation dose to the outer wall of the patient's room was 0.15 mSv. Conclusion: It is concluded that I-131 ablation therapy can be administered to outpatients safely to thyroid cancer patients who meet the established radiation safety criteria and follow the instructions.

A Study on the Radiation Dose Managements in the Nuclear Medicine Department (핵의학과에서 방사선 피폭관리 실태에 대한 조사 연구)

  • Lim, Chang-Seon;Kim, Se-Heon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.7
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    • pp.1760-1765
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    • 2009
  • After administration of a radiopharmaceutical, the patient remains radioactive for hours or even days, representing a source of potential radiation exposure. Thus, including the personnel who are occupationally exposed to ionizing radiation, radiation exposure must be managed for members of the public, in particular for people accompanying patients. In this study we investigated radiation exposure dose management in the nuclear medicine departments at seven general hospitals. Two of them had no radiation safety considerations for patient transporters, sanitation workers and the like. And they all were careless of radioprotection for people accompanying patients. The average dose rate to people accompanying patients from radioactive patients just before a bone scan was 25.60 ${\mu}$Sv h-1. This is higher than 20 ${\mu}$Sv $h^{-1}$which is the annual public dose limit for temporary use. Therefore radiation dose measurement and risk assessment of patient transporters, sanitation workers and the like should be performed. And the nuclear medicine technologist should provide advices on the radiation safety to patient transporters, sanitation workers, people accompanying patients and so on. To ensure the radiation safety for people accompanying patients, it is required to restrict the patient's access to his relatives, friends and other patients or isolate patients.

Evaluation on Safety of Two-bed Therapy Rooms (2인용 치료병실 안전성 평가)

  • Lee, Kyung-Jae;Cho, Hyun-Duck;Oh, Chang-Bum;Ko, Kil-Man;Park, Young-Jae;Lee, In-Won;Ahn, Hee-Yong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.75-80
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    • 2011
  • Purpose: Europe and U.S use multi-bed therapy rooms. Hereupon, this study aims to examine the safety when current one-bed therapy rooms in Seoul National University Hospital is changed into two-bed ones. Materials and Methods: This study evaluated external exposure by gamma radiation emitted from other patients and internal and external exposure caused by pollutions from other patients in case that Seoul National University Hospital installs a shielding wall between beds in existing therapy rooms. Results: When internal and external exposure was evaluated to evaluate safety of two-bed hospital rooms, 'isolation amount of patients' 5mSv exposure or below is received according to the Atomic Energy Act. Conclusion: With the increasing number of patients with thyoid cancer, patients using therapy rooms are on the rise. Therefore, improving one-person therapy rooms to two-person ones in line with international trend would increase cost reduction and management efficiency, and patients' alienation and isolation can be reduced to increase healing effects.

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Obturator Bypass Surgery in a Patient with an Infected Femoral Artery Rupture after Performed ECMO - A case report - (ECMO를 시행했던 환자에서 발생한 대퇴동맥 파열 및 감염의 치료에 있어 폐쇄공 우회술을 시행한 치험 - 1예 보고 -)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Cho, Gwang-Jo;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.312-315
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    • 2010
  • Infection of both native and prosthetic vessels in the groin is a very serious disease because of recurrent arterial rupture and sepsis, which can cause death. The successful treatment of groin infection, including infection of the femoral artery, requires extensive excision of the infected tissues and restoration of the circulation where the infected area is isolated. Here we describe a case of obturator bypass in a patient with infected femoral artery rupture that occurred after extracorporeal membrane oxygenation for myocarditis and severe heart failure.

Nurses' Experience with Caring for COVID-19 Patients in a Negative Pressure Room Amid the Pandemic Situation (팬데믹 상황에서 음압병실 근무 간호사의 COVID-19 환자 간호 경험)

  • Noh, Eun-Young;Chai, Young Jun;Kim, Hyun Jeong;Kim, Eunjin;Park, Yeon-Hwan
    • Journal of Korean Academy of Nursing
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    • v.51 no.5
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    • pp.585-596
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    • 2021
  • Purpose: The purpose of this study was to explore nurses' experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic. Methods: This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis. Results: Two main themes emerged from the analysis: 'Struggling in an isolated space' and 'Limitations of nursing infrastructure and system'. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system. Conclusion: The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.

Factors related to Resilience of Coronavirus Infectious Diseases-19 Patients (코로나바이러스감염증-19 환자의 극복력 관련 요인)

  • Lee, MinHee;Park, MinJeong
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.349-358
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    • 2022
  • This study was aim to understand the relationship between uncertainty, social isolation, social support and resilience of coronavirus infectious diseases-19 (COVID-19) patients and to identify factors related to resilience. Data were carried out from March 7 to May 5, 2021, and a total of 200 questionnaires were used for data analysis. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and multiple regression using SPSS WIN 24.0 program. As a result of the analysis, the lower the sense of social isolation, the higher the social support, the satisfaction with the explanation of isolation and the economic status of 'medium' were identified as related factors for resilience. Based on the above results, a systematic program should be developed and applied to improve the resilience of COVID-19 patients including strengthening social support through families and health care providers, reducing social isolation through non-face-to-face counseling, providing sufficient information about diseases, and providing economic support.