• Title/Summary/Keyword: Upper abdomen

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Radiographic Status of the Visited Patients at University Hospital Emergency Room (한 대학병원 응급실 내원환자의 방사선촬영 실태)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.81-92
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    • 2011
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

Staging of Esophageal Cancer Using Positron Emission Tomography : Comparing to Computed Tomography (양전자방출단층촬영술(PET)을 이용한 식도암 환자의 병기 결정 -전산화단층촬영술(CT)과의 비교-)

  • 심영목;박승준;김병태;김성철
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.388-393
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    • 1999
  • Background: Correct preoperative staging of esophageal cancer is a prerequisite for adequate treatment. We prospectively compared the accuracy of positron emission tomography (PET) with [fluorine-18]FDG in the staging of esophageal cancer to that of computed tomography (CT). Material and Method: The findings of FDG PET and of chest CT including lower neck and the upper abdomen of 20 biopsy-proven squamous cell carcinoma patients (male, 19; female, 1; mean age, 61) were compared with the pathologic findings obtained from a curative esophagectomy with lymph node dissection. Result: The sensitivities of FDG PET and CT for diagnosis of primary tumor were the same, 90.0% (18/20). Both FDG PET and CT failed to show the primary tumor in 2 of 20 patients; one had a 1cm sized carcinoma in situ and the other had T1 stage cancer. By using the results of the pathologic examinations of 193 removed lymph node groups, we calculated the diagnostic sensitivities, specificities and accuracies of PET and CT (*$\chi$2 p < 0.005). Sensitivity** Specificity Accuracy* PET 55.6%(30/54) 97.1%(135/139) 85.5%(165/193) CT 13.0%(7/54) 98.6%(137/139) 74.6%(144/193) One of four patients with a false-positive for PEThad had active pulmonary tuberculosis. Among the 24 tumor involved lymph node groups, PET failed to show tumor metastasis in 5 lymph node groups abutting the tumor and in 14 lymph node groups located where the decay correction was not performed. Conclusion: Based on the above findings, it is suggested that [F-18]FDG-PET is superior to CT in the detection of nodal metastases and in the staging of patients with esophageal cancer.

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Shielding Effect of Radiation Protector for Interventional Procedure (중재적 방사선 분야 방호용구 차폐효과)

  • Ko, Shin-Kwan;Kang, Byung-Sam;Lim, Chung-Hwang
    • Journal of radiological science and technology
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    • v.30 no.3
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    • pp.213-219
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    • 2007
  • The purpose of this study is to evaluate shielding effect of radiation protector for interventional radiologists in procedures by measuring inside and outside of radiation protector. In this study, we measured the radiation dose of 4 interventional radiologists during TACE and PTBD procedure for 4 month(2005.05-2005.09). Absorbed dose were measured by TLD placed underneath and over radiation protector such as Goggle, Thyroid protector, Apron and placed on the 4th finger of Hand. In addition, we measured background radiation dose in the control room using TLD. During TACE procedure, using 0.07 mmPb Goggle decreased average 53.8% of radiation dose rate in continuous fluoroscopic mode and decreased average 77.6% of radiation dose rate in pulse fluoroscopic mode. Using 0.5 mmPb Thyroid protector decreased average 88.9% of radiation dose rate in continuous fluoroscopic mode and decreased average 92.8% in pulse fluoroscopic mode. During PTBD procedure, using 0.07 mmPb Goggle decreased radiation dose rate average 62.7%, 87.9% by 0.5 mmPb Thyroid protector, 90.5% by 0.5 mmPb Apron. The average fluoroscopic time of PTBD was 6.14 min. shorter than TACE procedure, but radiation exposure dose rate of PTBD was 3 times higher in total body dose, and 40 times higher in hand dose rate than TACE. Interventional radiologists must wear thicker protector recommended over 0.5 mmPb. Also, they must use lead Goggle during interventional procedure. Abdomen dose decreased average 38.4% by drawing a lead curtain under the patient's table, therefore, they must draw a lead curtain to shield scattering ray. Radiation exposure dose decreased average 59.0% by using pulse fluoroscopic mode. So radiologists would better use pulse fluoroscopic mode than continuous fluoroscopic mode to decrease exposure dose.

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A Study on etiological factors, symptoms of a disease, and treatments of obesity based on Dong-Yi Bo Gam (동의보감(東醫寶鑑)을 위주(爲主)로한 비만의 원인(原因), 증상(症狀), 치료법(治療法) 연구)

  • Kim, Seok;Jin, Seng-Hee;Kim, Tae-Hee
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.125-136
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    • 1998
  • This study is on the etiological factors of the obesity, symptoms of a disease caused by the etiological factors and the method of medical treatment resulted from symptoms of a disease, it is based on Dong-Yi Bo Gam. The conclusion of this study is as follows. 1. The final metabolic of fat is depend on the defensive energy. The shape of fatty layer is changed by the point where the defensive energy is replenish or not. So 'Goin(暠人)' 'Bein(肥人)' and 'Yuckin(肉人)' is made a discriminated and there is defferent between 'Besudaeso(肥瘦大小)' and 'Herlqidaso(血氣多少)'. 2. Etiological factors of obesity is ; essential substance from cereals overcome the primodial energy, spleen and stomach are strong at once, spleen and stomach are weak at once, spleen is disturbed by evil energy, retention of phlegm and fluid, muscle is weak, blood is excess but energy (qi)is weak, hua-sid(華食) eating the sweat food very often, a rich fatty diet. 3. To investigate each syndrome as etiological factons, essential substance from cereals overcome primodial energy is divided into two case: one is the food increase itself because of the weakness of stomach energy (qi), the other is not to digest the food because liver overact spleen by seven emotion. The obesity because of strengthen of the spleen and stomach at once do not feel hungry very well and spleen and stomach do not damaged easily by overacting. The obesity because of weakness of spleen and stomach at once, and disturbace in spleen cause by evil energy, gain the weight even if they eat food a little. Also it is hard to move four limbs. Weakness of muscle is weakness of spleen and stomach. Weakness of muscle is caused by weakness of spleen and stomach. That is the case of faining the weight because of eating food with an empty stomach. The obsity caused by retention of fluid has intestine rumbling and gain the weight suddenly. 4. The method of medical treatment fallowing to the etiological factors: The food is inclined to increase itself caused by weakness of stomach energy, In case of the obseity caused by this phenomenon. We can use Decoction for Reinforcing Middle wanner and Replenishing Qi(補中益氣湯), five tastes il-going-san(左味異功散) and so on. The method of medical treatment on obsity caused by strengthen of spleen and stomach is not referred yet. But we must investigate about using peptic powder(平胃散), ji-chul-huan(枳朮丸) for strengthen of stomach qi (胃氣). If the obesity appear caused by weakness of spleen and stomach and disturbance in spleen as to evil energy, and in the same time stomach qi is weak, we can use li-gong san(異功散). If not only obesity but also indigestion, we can use Decoction for naurishing the stomach and promotion eating(養胃進食湯). If not only obesity but also weakness of spleen and stomach, we can use Decoction for Reinforcing Middle warmer and replenishing Qi(補中益氣湯). The energy being weak, we can use Decoction for six noble drugs(六君子湯). If the obesity appear because of retention of fluid, we can use sin-chul-huan(神朮丸). On the obesit, caused by excess of blood and weakness of qi(血管氣虛), there is not method of mectical treatment yet, but the method of medical treatment that we count of first important maybe to invigorate the spleen and the lung qi and to disperse and recitify the depressed liver energy(疏肝利氣). The method of medical treament about the obesity caused by a rich fatty diet is not mentioned yet, but it is important to improve the lifestyle of food and we think that invigorate the spleen, and the lung-qi(補疏肝氣) and disperse and recitify the depressed liver-energy (??肝利機) amy count of first important. 5.There is useful medicine for weight down for example Herb tea(茶), red bean, wax gourd, etc. 6.The etiological factors of the obesity that revive frequently is weakness of qi(氣虛), from 形成氣衰, deficiency of yang, hasty of qi, damp and so on. The symptoms and sign of a disease that revive frequently to the obesity is appoplexia(中風), leucorrhea, reddish and whitish turbid, feeling of fullness in the upper abdomen, diabetes and so on.

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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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A Study do parts of So-yin-In and So-yang-In (소음인(少陰人)·소양인편(少陽人篇)의 표병(表病)·이병(裏病)에 대한 고찰考察(표이음양승강(表裏陰陽升降)을 중심으로))

  • Lee, Eui-Ju;Song, Il-Byeong
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.43-56
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    • 1996
  • As considering a study of the So-um-In and So-yang-In desease, I know each of Extra-disease (表病) and Intra-disease (裏病). I takes serious view of the Extra-Intra-Um-Yang-Up-Down (表裏陰陽升降). I try to join costitutional disease to the parts of human body, which base on the theory on Sa-sang constituional Medicine. And I make some diagrams of them. They could be summerized as follows. 1.The Extra-qi (表氣) is four-viscera (四臟) and four back parts of hurman body (後四海). The Intra-qi (裏氣) is four-digestive organs (四腑) and four fore parts of human body (前四海). 2. It is important that Yang-qi (陽氣) go up at So-um-In Extra-disease (少陰人 表病) and Um-qi (陰氣) go down at So-yang-In Extra-disease (少陽人 表病). And It is important that Um-qi (陰氣) go down at So-um-In Intra-disease (少陰人 裏病) and Yang-qi of Large Intestine (大關局) go up at So-yang-In Intra-disese (少陽人 裏病). 3. Looking into the Extra-disease, ◈ Sin-Yang-Gon-Yiel (腎陽困熱) and Ha-Cho-Chuk-Hyel (下篇蓄血) of So-um-In disease are the disease that Yang-qi don't go up from the buttock. So-Yang-sang-Pung (少陽傷風) of So-yang-In disease is the disease that Um-qi don't go down from the upper back. ◈ Yui-Ga-Sil (胃家室) of So-um-In disease is the disease that Yang-qi don't go up from the lower abdomen Gyel-Hung (結胸) of So-yang-In disease is the disease that Um-qi don't go down from the thorax. ◈ Mang-Yang (亡陽) of So-um-In disease is the disease that Yang-qi don't go up from Intra-qi so it go out to the Extra-qi. Mang-Um (亡陰) of So-yang-In disease is the disease that Um-qi don't go down from the Extra-qi so it go into the Extra-qi. ◈ Dea-Jang-Pa-Han of So-um-In disease and Sim-Ha-Gyel-Hung (心下結胸) of So-yang-In desease are half of Extra-qi and Inrea-qi. 4. Looking into the Intra-disease, ◈ The Intra-disease of So-um-In is Tae-um symtom (太陰證) and So-um symtom (少陰證). The So-um symtom is more severe than Tae-um symtom because a cold wave of Large Intestine (大腸冷氣) involve a warm wave of Stomach (胃局). ◈ The Intra-disease of So-yang-In is not to go up Yang-qi of Large Intestine. Deficit of Yang-qi from Large Intestine which go up at Stomach is more sever than deficit of Yang-qi from Stomach which go up at extremes.

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