• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제20권1호
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• pp.7-14
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• 2014

Purpose: In this study, we performed ventilation simulations for a standard isolation ward including three intensive care rooms, one anteroom(buffer room), and its recommended ventilation equipments. The purpose of this study is to predict outflow of pathogenic bacteria from patient breath to verify the reliability and the safety of the isolation ward. Methods: We suppose three scenarios of the movement of medical staff. The leakage of patient's breath to out of the ward is predicted in these scenarios using CFD simulations. Results: The patient's breath leakage rate to out of the ward in scenario 1 according to room air changes per hour(ACH : 6 and 12) is predicted to be 0.000057% and 0.00002%, respectively. The patient's breath leakage rate to out of the ward in scenario 2 according to room air changes(ACH : 6 and 12) is predicted to be 0.00063% and 0.00019%, respectively. The patient's breath leakage rate to out of the ward in scenario 3, which is the worst case(6 room air changes) is predicted to be 0.1%. Implications: Through the ventilation simulation like that in this study, the reliability and the safety on isolation performance of various plan of isolation ward are predicted quantitatively.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권2호
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• pp.37-44
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• 2018

Purpose: This study investigates the influences of coughing direction and healthcare worker's location on the transport characteristics of coughed particles in airborne infection isolation room (AIIR), which is commonly called negative pressure isolation room, with a downward ventilation system. Methods: Computational Fluid Dynamics (CFD) was used to simulate the airflow and for tracing the behavior of particles. Results: The results show that the airflow pattern and coughing direction have a significant influence on the characteristics of particle dispersion and deposition. When healthcare workers are in the isolation room with the patient who is lying on the bed, it is recommended to be located far from the anteroom to reduce the exposures from infectious particles. And when the patient is lying, it is more effective in removing particles than when the patient is in Fowler's position. Although it is an isolation room that produces unidirectional flow, coughing particles can spread to the whole room and a large number of particles can be deposited onto patient, bed, side rails, healthcare worker, ceiling, floor, and sidewall. Implications: Following the patients' discharge or transfer, terminal cleaning of the vacated room, furniture, and all clinical equipment is essential. Also, it is necessary to establish detailed standard operating procedure (SOP) in order to reduce the risk of cross-contamination.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권4호
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• pp.67-75
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• 2017

Purpose: This study is for the facility eligibility and improvement evaluation analysis for the patient care environment of 7 facilities which has national inpatient isolation units. Methods: For the evaluation, first of all, the patient care environment of national inpatient isolation units are scrutinized by the checklist which is used on from 2014 with the 4 fields of criteria : architectural planning and layout, general requirement and condition for operating the negative pressured isolated patient room, HVAC system, and waste water discharging system. Finally, the evaluation results are compared with that of 2014. Results: The result shows that the average value of facility eligibility is 89.3 percent and which is 8.9 percent higher than the value before the MERS occurred. Implications: It is clear that facility remodeling of 7 institutions is being performed continuously, and the result of facility eligibility evaluation is reflected on design of a new 21 national inpatient isolation units those are going to be constructed from 2016. Therefore, it is expected that this study is used as a practical reference to establish the criteria of patient care environment management and safety management for both infectious disease outbreak and general service condition.

• 종양간호연구
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• 제9권1호
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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.

• Journal of Microbiology and Biotechnology
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• 제17권6호
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• pp.993-1001
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• 2007

The technique of serological analysis of antigens by recombinant cDNA expression library (SEREX) uses autologous patient sera as a screening probe to isolate tumor-associated antigens for various tumor types. Isolation of tumor-associated antigens that are specifically reactive with patient sera, but not with normal sera, is important to avoid false-positive and autoimmunogenic antigens for the cancer immunotherapy. Here, we describe a selection methodology to isolate patient sera-specific antigens from a yeast surface-expressed cDNA library constructed from 15 patient lung tissues with non-small cell lung cancer (NSCLC). Several rounds of positive selection using patient sera alone as a screening probe isolated clones exhibiting comparable reactivity with both patient and normal sera. However, the combination of negative selection with allogeneic normal sera to remove antigens reactive with normal sera and subsequent positive selection with patient sera efficiently enriched patient sera-specific antigens. Using the selection methodology described here, we isolated 3 known and 5 unknown proteins, which have not been isolated previously, but and potentially associated with NSCLC.

• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.43-47
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• 2023

Objective: To present a case study of a 69-year-old woman with COVID-19 who developed neurological complications due to Extracorporeal Membrane Oxygenation (ECMO) therapy and highlight the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU. Design: A case report Methods: The patient received ECMO therapy, followed by neurological monitoring and rehabilitation in an isolation ICU. Daily neurological examinations were conducted to monitor the patient's neurological symptoms. Computed tomography was performed to confirm the presence of a hematoma in the left hamstring, which was identified as the cause of the neurological complication. Ultrasound-guided aspiration was immediately performed, and sciatic neuropathy predominantly involving the peroneal division was identified after aspiration. Results: Successful recovery was made possible by the early detection of neurological complications and rehabilitation in an isolation ICU. Although electrodiagnostic tests were not performed due to limited access to the isolation ICU, the appropriate intervention time could be determined through daily neurological examinations and rehabilitation, thereby minimizing neurological sequelae. Conclusions: ECMO-related neurological complications are well known, and their recognition in the ICU can be challenging. The presented case highlights the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU, which can minimize neurological sequelae.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권2호
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• pp.63-72
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• 2017

Purpose: The purpose of this study is to review the material handling system of the Airborne Infection Isolation Hospitals which is the one of the key elements of infection control and to improve the basic data for the planning and design of those facilities. Methods: Research was conducted by literature reviews and case studies for the material handling system of domestic and foreign Isolation hospitals. Results: The result of this study can be summarized into three points. First, a general isolation unit and a high level isolated unit need to be distinguished in terms of efficiency and safety. In particular, it is desirable that a high level isolated unit have to completely separate clean and soiled circulations, and soiled corridor should be installed by those means. By doing this, the medical staff can observe patient rooms and supply clean materials directly in the clean zone without wearing PPE, so that safety and work efficiency can be improved at the same time. Second, for the safe disposal of wastes, it is desirable to install a dedicated sterilizer per ward and sterilize it at least in the ward. In addition, It is desirable to install a central waste treatment room and a dedicated soiled corridor in consideration of the inadequate handling capacity and emergency situation. Third, the characteristics of material flow chart in the negative pressured isolation hospitals and the corresponding material handling system have been presented. Implications: Infection control is very important in safety, but it is necessary to respond to the symptoms of the patient.

• 한국화재소방학회논문지
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• 제32권3호
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• pp.116-122
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• 2018

본 연구의 목적은 개발 중인 화학, 생물학, 방사능 및 원자력 특수재난 대응 격리 이송 장비의 효율성과 사용 용이성을 평가하는 것이다. 상기 개발 장비는 자체 개발한 격리, 이송, 환자 감시 모듈을 통합하여 제작하였다. 응급구조사를 대상으로 한 마네킹을 이용한 무작위 교차 실험(또는 시뮬레이션)연구이며, 모든 연구대상자는 기존 장비와 특수재난 대응 격리 이송 장비의 시제품을 교대로 사용하였다. 생체신호 변화 검출 소요 시간과 치료 적용 소요 시간으로 효율성을 평가하였고 각 감시장치, 이송카트, 격리 장치 편의성에 대한 설문조사를 통해 사용 편의성으로 평가하였다. 총 12명의 응급구조사가 연구에 참여하였고 특수재난 대응 격리 이송 장비 군의 저산소증 검출 시간이 3.5초(2.5-3.9)로 기존 장비군의 4.9초(3.8-3.9)보다 유의하게 짧았다(p < 0.05). 심전도 변화 감지 소요 시간 및 안면 마스크 산소 공급 소요 시간의 감소 경향은 있었으나 통계적 유의성은 관찰되지 않았다. 특수재난 대응 격리 이송 장비 군의 환자 감시 장치의 전반적 만족도도 특수재난 대응 격리 이송 장비 군이 4점(3.5-5)으로 기존 장비군의 3점(3-3)에 비해 높았다(p < 0.05). 특수재난 대응 격리 이송 장비 사용군이 저산소증 검출 시간이 짧았으며 기존장비에 비해 환자 감시 장치의 전반적 만족도가 높은 것을 확인하였다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권4호
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• pp.29-35
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• 2023

Purpose: The 2015 Middle East Respiratory Syndrome (MERS) outbreak and the recent COVID-19 pandemic have highlighted the lack of negative pressure isolation rooms and the fragility of the healthcare system. The need for healthcare facility transformation for respiratory infectious diseases has become more prominent due to COVID-19, and the purpose of this study is to provide a foundation for the rapid, economical, and safe construction of negative pressure isolation wards. Methods: This study analyzes the current status of hospitals that have been converted to negative pressure isolation rooms, and provides architectural plans and examples to provide a reference for bedroom change. Research data of this study have been obtained by analyzing the drawings of negative pressure isolation wards of nationally designated inpatient treatment beds and urgent isolation beds. In addition, the relevant literature of urgent isolation beds has been analyzed to derive bedroom change type. Result: In this study, a total of 21 isolation bed conversion methods have been presented. Implications: In order to change efficiently from a general ward to an isolation ward, it is necessary to consider the actual hospital's infectious disease transmission patterns and facility conditions.

• 설비공학논문집
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• 제23권7호
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• pp.520-527
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• 2011

Recently, Influenza(AI, PI) patients have been increasing rapidly. But, there is a lack of isolation hospitals. In particular, according to increase the rate of patients with airborne infection, in order to prevent the spread of pathogens, design of layout plan and air conditioning system of isolation hospitals becomes more important to maintain patient's room as negative pressure. In this study, the spread of pathogens are analyzed as room differential pressure, moving time of medical staff and patients, and moving way in isolation hospitals by multizone simulation; CONTAM 2.4. Through the analysis, the ways to improve isolation hospital considered at the design step are reached to prevent the spread of pathogens effectively. Also, it verifies that HVAC system for isolation hospital is suitably designed as standard.