• Title/Summary/Keyword: Patient isolation

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Investigation for the Infectious Diarrhea by Pathogenic Microorganism from Hospitals in ChungNam Province in 2004 (2004년 충남지역 의료기관의 설사환자 가검물에서 분리된 병원성미생물 감염실태에 관한 조사연구)

  • Kim, Woo-Sik;Song, Nak-Soo;Sung, Si-Yeoul;Cha, Yeun-Tae;Seo, Woo-Sung;Lee, Moo-Sik;Kim, Keon-Yeop;Na, Bak-Ju
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.137-149
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    • 2005
  • Objectives and Methods: This study was performed to investigate the etiologic bacterial, viral and protozoal organisms for the diarrhea from hospitals in Chungnam area from January to December in 2004. Total of 787 fecal samples were collected and examined. Results and Conclusions: In test for enteropathogenic bacteria, total of 79 cases out of 787 samples from hospitals showed positive isolation. Among 79 positive samples, 27 cases were confirmed as Salmonella spp.. 20 cases as pathogenic E. coli, 18 cases as Clostridium perfringens, 6 cases as Staphylococcus aureus, 4 cases as Shigella spp. and 4 cases as Vibrio parahaemolyticus. In test for enteropathogenic virus, 190 cases out of 787 samples from hospitals showed positive reaction. Among 190 samples, 115 cases were confirmed as rotavirus, 55 cases as norovirus, 5 case as astrovirus, 4 case as rotavirus & norovirus, 3 cases as adenovirus, 2 case as rotavirus & astrovirus. In test for enteropathogenic protozoa, 6 cases out of 787 samples from hospitals showed positive result. Among 6 samples, 5 cases were confirmed as Entamoeba histolytica and 1 cases as Giardia lamblia. When we classified the positive results by the age of the patients, the highest isolation rate was noted in a group of age under 10 and over 60 for bacterial, viral and protozoal pathogens. Especially, patient below age of 5 showed high positive rate. When we classified the positive results by the time, pageathogenic bacteria were isolated throughout the year, and the highest frequency was noted in August. On the other hand, pathogenic viruses were detected more frequently during the colder season from December to April. Antimicrobial susceptibility test for the isolated bacteria resulted as follows; Salmonella strains showed high drug resistance rates against ampicillin, chloramphenicol, tetracycline, nalidixic acid, ticarcillin. Shigella strains showed high drug resistance rates against ampicillin, trimethoprim/sulfamethoxazole, chloramphenicol, tetracycline, ampicillin/sulbactam, ticarcillin. Pathogenic E. coli strains showed high drug resistance rates against ampicillin, cephalothin, gentamicin, tetracycline, nalidixic acid, ampicillin/sulbactam, ticarcillin.

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Effective Half-life of I-131 in Patients with Differentiated Thyroid Cancer Treated by Radioactive I-131 (I-131 치료를 받은 분화갑상선암 환자에서 I-131의 유효반감기)

  • Park, Seok-Gun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.464-468
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    • 2008
  • Purpose: Effective half life of I-131 ($T_{eff}$) in patients with differentiated thyroid cancer treated by I-131 is must-know value for dose calculation and determination of release time from isolation room. There has been no report about $T_{eff}$ in Koreans. Thus, author tried to measure dose rate without radiation exposure to faculty members and calculated $T_{eff}$. Methods: Probe of radiation survey meter was fixed at the wall of isolation room, and body of survey meter was placed outside the room. With this simple arrangement, author could measure radiation frequently without radiation exposure to faculty members in 68 patient (F=55, M=13, age=$47{\pm}13.7$) treated by I-131 ($3.7{\sim}7.4\;GBq$) for differentiated thyroid cancer from Jan 2006 to Dec 2006. From this data, $T_{eff}$, 48 hr retention rate, and the time necessary to whole body retention of I-131 become less than 1.1 GBq were calculated. Serum creatinine levels were measured before and after thyroid hormone withdrawal. Results: $T_{eff}$ was $15.4{\pm}4.3\;hr$ ($9.4{\sim}32.5\;hr$). There was a loose correlation between $T_{eff}$ and serum creatinine concentration (r=0.45). 48hr retention was $4.9{\pm}4.2%$ ($1{\sim}23%$). Time necessary to whole body retention of I-131 become less than 1.1 GBq was calculated as $47.1{\pm}13.2\;hr$ for 9.25 GBq, $42.1{\pm}11.9\;hr$ for 7.4 GBq, $35.7{\pm}10.0\;hr$ for 5.55 GBq, and $26.7{\pm}7.5\;hr$ for 3.7 GBq dose of I-131. Conclusion: Author successfully measured radiation dose rates in isolated patients treated by high dose of I-131 without radiation exposure to the faculty members with simple arrangement of survey meter probe. Using those data, $T_{eff}$ and some other indices were calculated.

Effects of EGFR, CK19, CK20 and Survinin Gene Expression on Radiotherapy Results in Patients with Locally Advanced Head and Neck Cancer

  • Kekilli, Kezban Esra;Abakay, Candan Demioz;Tezcan, Gulcin;Tunca, Berrin;Egeli, Unal;Saraydaroglu, Ozlem;Esbah, Onur;Ekinci, Ahmet Siyar;Arslan, Sonay;Uslu, Nuri;Ozkan, Lutfi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.3023-3027
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    • 2015
  • Purpose: To investigate the effects of epidermal growth factor receptor (EGFR), cytokeratin 19 (CK19), cytokeratin 20 (CK20) and survinin gene expression on local control (LC) and overall survival (OS) in patients with locally advanced head and neck cancer (LAHNC) who were administered radiotherapy (RT). Materials and Methods: Twenty-six patients who were admitted to Uludag University Medical Faculty Department of Radiation Oncology with a diagnosis of LAHNC (GIII-GIV) were included in this study. Gene expression was evaluated in tumor tissues and peripheral blood. RNA isolation was performed on paraffinized tumor tissues and peripheral blood samples obtained before RT (BR). The densities of the obtained RNAs were analyzed at 260/280 nm. cDNA samples obtained from total RNA,EGFR, CK19, CK20 and survinin gene expression levels were assessed via the Sybr Green method and data were analyzed with the ${\Delta}{\Delta}Ct$ method. The same process was repeated for peripheral blood samples taken after RT (AR). Results: The female/male ratio was 3:23 and the mean age was 56.5 years (38-75years). After radiotherapy, CK19 and CK20 levels in the peripheral blood were found to be correlated according to Pearson correlation analysis(p=0.049). This result indicates a possibility of remaining positive for CK19 and CK20 in the peripheral blood even after RT in patients with CK19, CK20, and EGFR positive tumors before RT. There was a statistically significant correlation between survinin levels measured BR and AR (p=0.028). Conclusions: In this study, we found that patients with any EGFR, CK19, CK20 or survinin positivity in their peripheral blood obtain less benefit from radiotherapy. A wider patient population and advanced protein analyses are necessary in order to increase the reliability of our findings.

Early Results of Mitral Valve Reconstruction in Mitral Regurgitation (승모판막 폐쇄부전에 있어 승모판막 성형술의 단기성적)

  • Kim, Kyung-Hwan;Won, Tae-hee;Kim, Ki-Bong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.32-37
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    • 2000
  • Background: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. Material and Method: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9$\pm$14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. Result: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. Conclusion: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.

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Terminal Protein-specific scFv Production by Phage Display (Phage Display 방법을 이용한 B형 간염 바이러스의 Terminal Protein 특이 scFv 항체 생산)

  • Lee, Myung-Shin;Kwon, Myung-Hee;Park, Sun;Shin, Ho-Joon;Kim, Hyung-Il
    • IMMUNE NETWORK
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    • v.3 no.2
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    • pp.126-135
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    • 2003
  • Background: One of the important factors in the prognosis of chronic hepatitis B patient is the degree of replication of hepatitis B virus (HBV). It has been known that HBV DNA polymerase plays the essential role in the replication of HBV. HBV DNA polymerase is composed of four domains, TP (Terminal protein), spacer, RT (Reverse transcriptase) and RNaseH. Among these domains, tyrosine, the $65^{th}$ residue of TP is an important residue in protein-priming reaction that initiates reverse transcription. If monoclonal antibody that recognizes around tyrosine residue were selected, it could be applied to further study of HBV replication. Methods: To produce TP-specific scFv (single-chain Fv) by phage display, mice were immunized using synthetic TP-peptide contains $57{\sim}80^{th}$ amino acid residues of TP domain. After isolation of mRNA of heavy-variable region ($V_H$) and light-chain variable region ($V_L$) from the spleen of the immunized mouse, DNA of $V_H$ and $V_L$ were obtained by RT-PCR and joined by a DNA linker encoding peptide (Gly4Ser)3 as a scFv DNA fragments. ScFv DNA fragments were cloned into a phagemid vector. scFv was expressed in E.coli TG1 as a fusion protein with E tag and phage gIII. To select the scFv that has specific affinity to TP-peptide from the phage-antibody library, we used two cycles of panning and colony lift assay. Results: The TP-peptide-specific scFv was isolated by selection process using TP-peptide as an antigen. Selected scFv had 30 kDa of protein size and its nucleotide sequences were analyzed. Indirect- and competitive-ELISA revealed that the selected scFv specifically recognized both TP-peptide and the HBV DNA polymerase. Conclusion: The scFv that recognizes the TP domain of the HBV DNA polymerase was isolated by phage display.

Change of Life of the Older due to Social Admission in Long-Term Care Hospital (노인의 사회적 입원으로 인한 요양병원에서의 삶의 변화)

  • Kang, Gun Saeng;Kim, Jeong Sun
    • 한국노년학
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    • v.37 no.1
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    • pp.103-123
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    • 2017
  • The purpose of this study is to explore the phenomenon in-depth with its context that what are changes of life in the older patients with social admission by applying the phenomenological research method, and to understand the essential meanings and structure of change experiences of life in elderly patients with social admission. The participants were 15 patients with chronic disease over 65 ages who were selected by convenience sampling. Data were collected through individual in-depth interviews from April to July 2016, and were analyzed using Colaizzi (1978)'s phenomenological analysis method. The essential meanings and structure of change experiences of life in the older patients with social admission were derived into six clusters of themes as follows: 'A lot of concerns are solved', 'New relationship', 'Life as a ordinary person that it looks nothing like a patient', 'The body and mind are comfortable', 'Fear of discharge','Social isolation'. The results of this study contributed to promoting a deeper understanding of change of life in older patients with social admission, and provided for the basic data of strategic approach in solving the social admission problem in long-term hospital.

Evaluation of Shear Bond Strength of Various Orthodontic Bracket Bonding Agents (수종의 교정용 브라켓 접착 레진의 전단 강도 평가)

  • Youngjun, Ham;Miran, Han
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.3
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    • pp.264-273
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    • 2022
  • Due to the development of properties of adhesive materials currently used in dentistry, the bonding ability between the brackets and the tooth enamel has been greatly improved. In general, in situations where cooperation can be obtained, adhesion of the orthodontic bracket through the conventional three-step process can show excellent bonding strength. However, if it is difficult to expect patient cooperation, as in the pediatric dentistry area, or if moisture isolation is not properly performed, the binding strength that does not reach the expected effect. As a result, various products that simplify the process for adhesion are being developed. The aim of this study was to evaluate and compare the shear bonding strength between the conventional 3-step adhesion system, self-etching primer system and one-step adhesion system that reduces the priming process. A total of 60 human maxillary, mandibular premolars were prepared. Group I (control group) were followed conventional 3-step bonding process. Group II were conditioned with self-etching primer. Group III were etched with 37% phosphoric acid and brackets were bonded with self-priming adhesive. The resultant shear bond strength of each group was measured and an adhesive remnant index (ARI) was recorded. The mean shear bond strength of group I, II, III were 14.69 MPa, 11.21 MPa and 12.21 MPa respectively. Significant differences could only be found between group I, II and group I, III (p < 0.05). The ARI indicated no significant difference among all groups.

소설과 말기 암환자를 통해 본 한국인의 죽음의 의미

  • Jeon, Hye-Won;Kim, Bun-Han
    • Korean Journal of Hospice Care
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    • v.3 no.2
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    • pp.34-54
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    • 2003
  • Every one experiences death one day, however no one can knows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning I.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. 1.The death investigated in the fiction, was found as a progress of negative emotion, acceptance and sublimation, life related subjects in the negative emotion were tenacity for life, anxiety, lingering attachment, responsibility, abandonment and death related subjects were shock, isolation, fear, scare and rejection. Acceptance related subjects were acceptance, destiny, secularism, preparation and arrangement, and sublimation related subjects were sublimation through Christian and Buddhism. 2.The death showed in the participants was negative emotion, acceptance and sublimation, life related subjects were repentance, anxiety, responsibility and hopelessness, and death related subjects were dejection, solitude, anger, fear and scare. The acceptance was a type of religious acceptance that admitted instantly by reaching an understanding with the God, and death was accepted as a progress of preparation, arrangement, acceptance and hope. Sublimation related subjects were Christian sublimation and relief or destiny incurred from self-reflective sublimation through communications and thoughts. 3.The death in view of fiction and participants were positively accepted both death and negative emotion, and the study disclosed the fact that death was sublimated dependent on religion. 4.The progress of negative emotion, acceptance and sublimation was disclosed more complicated and various in the real end stage cancer patients and acceptance only found in the patients on the form of religious acceptance, according to the results compared with fiction and real end stage cancer patients. The death showed in the fiction was standardized, gradated and similar progress with psychological status of Kubler-Ross. However, death in the participants was showed complex and various feelings simultaneously, and sometimes they accepted death positively. The sublimation through religion was found in Buddhism and Christian in the fiction and mostly Christian in the participants due to a number of Hospice patients. It was found that negative emotion various types of death was more found in the participants than fiction. It is therefore necessary to study on the response of death in various types. In the participants death was incurred more systematic and variously, we knew that nursing practice focused on experience of participants is required and reality on death is much profound than we analyzed and presented, lots of situations and reactions should be premised because we can not completely rule out the negligence possibility of care mediation of participants. In caring for the facing death patients, we discovered and confirmed again through this study that the spiritual care should be needed as a mediation method.

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Thoracoscopic T-3 Sympathicotomy for Palmar Hyperhidrosis (수부 다한증에서 흉부 3번 교감신경 차단 수술의 효과)

  • Kim, Kwang-Taek;Kim, Il-Hyun;Lee, Song-Am;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Seong
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.739-744
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    • 1999
  • Background: This study was designed to evaluate the effectiveness of T3 sympathicotomy in treatment of palmar hyperhidrosis. Material and Method: During the period of June to December 1998, 50 patients (24 females and 26 males) suffering from palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13) were operated. The mean age of the patients was 20 years. The bilateral sympathetic trunks were severed on the 3rd rib (2nd and 3rd ganglia) for the isolated palmar hyperhidrosis and on the 3rd and 4th ribs for the combined type using electrocoagulation scissors. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10:0 = anhidrosis: 10 = excessive sweating) as well as the patient's satisfaction with the surgery (ranged 0 to 10:0 = regret; 10 = completely satisfied). Result: All of the patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T3 sympathicotomy was $1.5\pm$0.8. Some degree of compensatory sweating had occurred in 39 patients (78%) with a mean score of 3.4$\pm$1.6. Gustatory sweating occurred in 2 patients (4%). The mean score of the patient's satisfaction after the surgery was 8.5$\pm$1.2. Conclusion: Palmar hyperhidrosis can be successfully relieved by the T3 sympathicotomy. When considering the advantages of T3 sympathicotomy with respects to a better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating. We recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.

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Clinical Analysis of Acute Respiratory Tract Infections by Influenza Virus in Children (인플루엔자 바이러스에 의한 소아 급성 호흡기 감염증의 유행 및 임상 양상)

  • Kwon, Min Kyoung;Kim, Mi Ran;Park, Eun Young;Lee, Kon Hee;Yoon, Hae Sun;Kim, Kwang Nam;Lee, Kyu Man
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1519-1527
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    • 2002
  • Purpose : Although influenza virus is one of the most important causes of acute respiratory tract infections(ARTIs) in children, virus isolation is not popular and there are only a few clinical studies on influenza in Korea. We evaluated the epidemiologic and clinical features of ARTIs by influenza virus in children. Methods : From February 1995 to August 2001, nasopharyngeal aspirations were obtained and cultured for the isolation of influenza virus in children admitted with ARTIs. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Respiratory viruses were isolated in 997(22.0%) out of 4,533 patients examined, and influenza virus was isolated in 164 cases(3.6%). Influenza virus was isolated year after year mainly from December to April of next year. The ratio of male and female was 1.9 : 1 with a median age of 15 months. The most common clinical diagnosis of influenza virus infection was pneumonia, and fever and cough developed in most patients. There was no difference between influenza A and B infection in clinical diagnoses and symptoms. All patients recovered without receiving antiviral treatment except for one patient diagnosed with pneumonia who had underlying disease of Down syndrome with ventricular septal defect. Conclusion : ARTIs caused by influenza virus developed every winter and spring during the period of study. Because fatal complication can develop in the high risk group, prevention, early diagnosis and proper management of influenza should be emphasized.