• 제목/요약/키워드: Patient circulation

검색결과 315건 처리시간 0.024초

근무형태 및 피폭선량에 따른 PET/CT실의 운영 효율성 평가 (Operation Efficiency Estimation of PET/CT Center by Work Form and Exposure Dose)

  • 권오진;정서희;백승찬;김경호
    • 핵의학기술
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    • 제13권1호
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    • pp.93-97
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    • 2009
  • 2006년~2008년 2사분기까지의 2.5년간의 환자 건수는 14,674건이었으며, $^{18}F$-FDG 평균 주사량은 461.5 MBq 였다. 2.5년간 순환근무는 3회 이루어졌고, 10명의 방사선사 중 PET과 Gamma 영역별 1인을 제외한 8명의 순환근무가 시행되었다. 추가로 2008년 3인의 신입인력이 야간에 투입되어 이에 대한 평가도 이루어졌다. 방사선사의 근무연한은 15년 이상이 2인, 10~15년이 3인, 5~10년이 1인, 5년 미만이 3인이었다. 이들의 개인별 피폭선량은 먼저 PET실에 근무를 하고 있을 때가 Gamma 영역에 근무하고 있을 때 보다 더 높게 나왔다. 가장 큰 원인으로는 일일 처리 건수 면에서 PET과 Gamma영역의 차이가 거의 없는 상태에서 $^{99m}Tc$보다는 상대적으로 에너지가 높은 $^{18}F$-FDG를 사용하는데 있다고 본다. 특히 개인별 피폭선량도 근무연한에 따른 분기별 평가에서 서로 다르게 나타났다. 또한 순환근무 초기 1개월째보다는 업무의 연속성을 익힌 3개월째에 더 낮은 피폭선량을 보여 주고 있다. 이는 PET 실의 근무연한이 길수록 업무의 숙달도가 증가하여 개인별 피폭선량은 감소하는 것으로 보인다. 예약실에 근무하는 간호사의 피폭선량은 $^{18}F$-FDG 주사 후 짧은 시간에 환자와의 접촉이 이루어지고 있어 그리 큰 문제점을 보이지는 않았다. 그러나 임신 가능성이 있는 간호사일 경우는 이를 재고해 보아야할 필요가 있다. 순환 근무를 통한 장시간 PET/CT실을 벗어난 상황이 될 경우 대부분의 근무자가 초기 1개월에서 업무의 연속성 결여 및 개인별 피폭선량 증가라는 위험성을 내포하였다. PET/CT 환자의 증가에 따른 PET/CT실 전체의 과도한 피폭을 분산하기 위한 순환 근무제의 도입이 또 다른 문제점을 갖고 있음을 알 수 있다.5,6) 이를 해결하기 위해서는 근무자의 업무재교육과 순환 및 고정 근무제의 적절한 병행을 시행할 필요가 있다고 본다. 또한 고정 근무자는 순환 근무 인력들의 이런 문제점을 해결하기 위해 업무영역에서 표준화된 업무지침서 등을 만들어야 한다.

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Deleterious Effects of Hyperoxemic Extracorporeal Circulation during Cardiovascular Surgery

  • Park, Seok-Cheol
    • 대한의생명과학회지
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    • 제7권1호
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    • pp.7-15
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    • 2001
  • Although extracorporeal circulation (ECC) has been routinely used for cardiovascular surgery, hyperoxemia during ECC may produce oxygen toxicity and cellular injury. This study was performed to investigate the clinical influences of hyperoxemic ECC during cardiovascular operation. 40 adult patients scheduled for elective cardiovascular surgery were classified into normoxemic (arterial oxygen tension: 115 mmHg, n=20) and hyperoxemic (arterial oxygen tension: 380 mmHg, n=20) ECC. At preoperative and postoperative period, total leukocyte and neutrophil counts, platelet counts, iron, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine in peripheral arterial blood, malondialdehyde (MDA) and troponin-T concentration (TnT) in coronary sinus blood, pulmonary vascular resistance (PVR), and postoperative blood loss volume (BLS) were measured and compared between groups. Hyperoxemic group had postoperatively higher total leukocyte and neutrophil counts, MDA, TnT, PVR total BLS, iron, glucose, AST, ALT, BUN, and creatinine than normoxemic group (p<0.05).0 conclusion, hyperoxemic ECC results in greater inflammatory response and oxidative damaging effects on the heart lung, liver and kidney, probably being adverse to postoperative patient recovery. For reducing these deleterious effects and improving postoperative outcomes, management lowering oxygen tension during ECC is recommended.

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성인 총폐정맥 환류이상 -1례 보고- (Total Anomalous Pulmonary Venous Connection in Adult -A Case Report-)

  • 김덕실
    • Journal of Chest Surgery
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    • 제28권12호
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    • pp.1174-1177
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    • 1995
  • We experienced one case of TAPVC patient who was 39 years old man with mild dyspnea on exertion and easy fatigability. He was the oldest patient among TAPVC which was reported in Korea. Preoperative echocardiogram, cardiac catheterization and angiogram revealed supracardiac type TAPVC drained through left innominate vein. An anastomosis between common pulmonary venous trunk and left atrium, pericardial patch closure of ASD and ligation of left vertical vein were performed with extracorporeal circulation. The postoperative course was uneventful and discharged with excellent general condition and has been well during 8 months follow-up.

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여성전문병원 병동부의 거주성 향상을 위한 건축 계획적 연구 (A Study on the Architectural Planning for the Habitability of Women's Hospital ward)

  • 박승환;홍성우;최무혁
    • 한국주거학회논문집
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    • 제18권2호
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    • pp.29-38
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    • 2007
  • The purpose of this study was to provide the basic data for architectural planning through survey about the ward of women's hospital. This study considered the concept of women's hospital through theoretical consideration and analysed a blueprint of 30 cases about typical plan type, the size and layout of patient-room, space allocation and circulation. And then a survey of patients has to identify their needs. Because the rate of composition of an upper grade patient-room in women's hospital is higher than that of general hospital to improve habitability in ward needs not only the importance of the planing of patient-room itself, but also providing a small courtyard, day-room between the patient-rooms or outdoor terrace. When patient moves it was provided visual comfort and strengthen social exchange. Also, physical environment has to reflect mother's psychological needs and diversity by individuality in unit is essential to planning.

당뇨병성(糖尿病性) 족부(足部) 궤양(潰瘍) 환자(患者)에 대한 임상례(臨床例) (A Clinical Case Report of Diabetic patient with Foot ulcers)

  • 김정호;송정모;김혜원
    • 사상체질의학회지
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    • 제14권2호
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    • pp.132-137
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    • 2002
  • Diabetes is a controllable disease, not a curable disease. If Diabetic patients do not regularly monitor themselves, they run risk of diabetic complications that cannot be reversed or treated. Especially, if the patients have high blood suger level, a cardiovascular disease, or poor blood circulation, there immune system will not function, and thus making the patient more susceptible to infection. Eventually, the patient will have to undergo amputation. The case is a report about a Diabetic patient with foot ulcers. The patient was treated by Taeumin Bopyewontang and the foot ulcers were improved.

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노인요양병원 진료부의 경로인지 효율성 평가에 관한 연구 (A Study on the Evaluation of the Cognition of the Circulation Efficiency in Geriatric Hospital)

  • 배선미;김석태
    • 한국실내디자인학회논문집
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    • 제25권6호
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    • pp.40-51
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    • 2016
  • The aim of this study is to quantitatively deduce the circulation efficiency and space arrangements of the outpatient department in geriatric hospitals in terms of spatial structure and to find a methodology that could promote the improvement of accessibility and spatial cognition while using the facilities. All space units of the selected twelve geriatric hospitals were located on the first floor. The study adopted the psychological distance concept of space syntax to the unitized spaces, and presented a set of indices, such as TD, PN, RF, PNT and TRF. These indices were calculated according to the standard clinical use procedures. The study evaluated the effectiveness of circulation. The analysis of circulation was based on the four major geriatric illnesses that were selected in this study. The study established the standard clinical use procedure with consideration of the medical treatment, examinations and space units of outpatient departments. The results are as follows: 1) Based on the statistical data, four major geriatric illnesses are examined, and space requirement and standard procedures are established. Development indicators are applied in order to quantitatively deduce the efficiency of spatial cognition. 2) The percentage of the risk of cognitive decline(TRF) has an inversely proportional correlation to the circulation efficiency(PNT) at a certain point. TRF is more influenced by the clinical use procedure than the scale. 3) The arrangement of the waiting space and types of corridor greatly affect the percentage of the risk of cognitive decline. 4) Vulnerable facilities are selected on the basis of the evaluation, and two alternatives that could promote the circulation efficiency are presented. The result of the reanalysis showed that cognitive efficiency had much improved compared to the existing facilities.

119구급대에 의해 소생한 병원 전 심장정지 환자 1례 (Out-of-Hospital Resuscitation of Cardiac Arrest by 119 Emergency Medical Service System)

  • 윤형완;이재민;정지연
    • 한국화재소방학회논문지
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    • 제24권5호
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    • pp.142-149
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    • 2010
  • 심폐소생술이란 인공호흡과 순환보조를 통하여 조직으로의 산소 공급을 유지하여 임상적 사망에서 생물학적 사망으로 진행을 막고, 심장박동과 순환을 회복시켜 환자를 소생시켜주는 술기이다. 심폐소생술이 시행되더라도 모든 심장정지 환자가 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존률이 결정된다. 현장에서 심장정지가 목격되지 않은 환자는 병원이송 전 현장에서 2분간 5주기 심폐소생술을 수행하고 자동제세동기를 사용하도록 하였고, 목격된 환자에게는 즉시 자동제세동기를 사용할 것을 권장하고 있으며 이후 전문적인 심장구조술이 필요하다. 병원 전 단계에서 119 구급대가 이송한 환자 중 자발순환회복(return of spontaneous circulation, ROSC)되어 이송하는 경우와 전문심장구조술을 시행 하는 경우는 매우 드물다. 현장에서 심장정지가 목격되었으나 심폐소생술이 시행되지 않았고 구급대원이 도착한 후 심폐소생술 시행 및 전문심장구조술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

교통사고 환자의 피부저항변이도에 관한 Pilot Study - Factor AA 중심으로 - (A Pilot Study on Skin Resistance Variability (SRV) of Traffic Accident Patients - Focus on Factor AA -)

  • 허성규;차윤엽
    • 한방재활의학과학회지
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    • 제18권2호
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    • pp.119-130
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    • 2008
  • Objectives : The purpose of this study was to compare mean values of Factor AA on Skin Resistance Variability(SRV) of traffic accident patient group with those of non-traffic accident patient group(control group) by using 7-Zone-Diagnostic System. Methods : Two groups were selected from those who took the CP-6000A test in College of Oriental Medical Hospital of Sang-Ji University from March 2007 to November 2007. Two groups were control group(n=61) and traffic accident patient group(n=62). Mean values of Factor AA on Skin Resistance Variability(SRV) of two groups were compared. Results and Conclusions : The results suggest that traffic accident patient group and non-traffic accident patient group had problems in circulation but non-traffic accident patient group had more problems than traffic accident patient group, and that after oriental medical therapy, non-traffic accident patient group was more improved than traffic accident patient group. So, further studies will be needed.