• Title/Summary/Keyword: patient dose

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Comparison of Whole versus Split-Dose PEG Solution for Colonoscopy Preparation on Patient Compliance, Quality of Bowel Cleansing, and Endoscopist's Satisfaction (대장내시경 정결제 복용방법에 따른 대상자 순응도, 대장정결 효과, 및 시술자 만족도)

  • Park, Keum-Mi;Kim, Myung Hee;Hwang, Sun Kyung;Kim, Dong Hee;Kim, Ju Sung
    • Korean Journal of Adult Nursing
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    • v.19 no.2
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    • pp.237-247
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    • 2007
  • Purpose: This study was a randomized single-blind trial of whole versus split-dose PEG solutions for colonoscopy preparation to compare the patient compliance, quality of bowel cleansing, and endoscopist's satisfaction. Methods: The participants were recruited from outpatients who planned to receive colonoscopy of C hospital in Busan. Sixty participants were randomly assigned to receive either a spit-dose group(n=30) consuming $2{\ell}$ of PEG solution twice, or a whole-dose group(n=30), consuming $4{\ell}$ of PEG solution once. These participants completed the questionnaire to assess their compliance before colonoscopy. The quality of bowel cleansing was assessed using the Ottawa Scale with the endoscopist who was blinded to the type of preparation, and their satisfaction by using VAS. Results: The participants who did not completely consume $4{\ell}$ of PEG solution were less in split-dose than in whole-dose group (0% vs 13.3%). The split-dose group complained less about abdominal pain(t=2.644, p=0.009) and abdominal bloating(t=2.802, p=0.013) with a statistical significance. For the quality of bowel preparation, there were no significant differences in the bowel cleansing scores and the endoscopist's satisfaction between two groups. Conclusion: Colonic preparation with split-dose of PEG solution could be a more useful method for better patient compliance, with no significant impact on bowel cleansing quality.

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The Properties of Beam Intensity Scanner(BInS) in IMRT with Phantom for Three Dimensional Dose Verification

  • Young W. Vahc;Park, Kwangyl;Byung Y. Yi;Park, Kyung R.;Lee, Jong Y.;Ohyun Kwon;Park, Kwangyl;Kim, Keun M.
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.64-64
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    • 2003
  • Objectives: Patient dose verification is clinically the most important parts in the treatment delivery of radiation therapy. The three dimensional(3D) reconstruction of dose distribution delivered to target volume helps to verify patient dose and determine the physical characteristics of beams used in intensity modulated radiation therapy(IMRT). We present Beam Intensity Scanner(BInS) system for the pre treatment dosimetric verification of two dimensional photon intensity. The BInS is a radiation detector with a custom made software for relative dose conversion of fluorescence signals from scintillator. Methods: This scintillator is fabricated by phosphor Gadolinium Oxysulphide and is used to produce fluorescence from the irradiation of 6MV photons on a Varian Clinac 21EX. The digitized fluoroscopic signals obtained by digital video camera will be processed by our custom made software to reproduce 3D relative dose distribution. For the intensity modulated beam(IMB), the BInS calculates absorbed dose in absolute beam fluence, which are used for the patient dose distribution. Results: Using BInS, we performed various measurements related to IMRT and found the followings: (1) The 3D dose profiles of the IMBs measured by the BInS demonstrate good agreement with radiographic film, pin type ionization chamber and Monte Carlo simulation. (2) The delivered beam intensity is altered by the mechanical and dosimetric properties of the collimating of dynamic and/or static MLC system. This is mostly due to leaf transmission, leaf penumbra, scattered photons from the round edges of leaves, and geometry of leaf. (3) The delivered dose depends on the operational detail of how to make multileaf opening. Conclusions: These phenomena result in a fluence distribution that can be substantially different from the initial and calculative intensity modulation and therefore, should be taken into account by the treatment planing for accurate dose calculations delivered to the target volume in IMRT.

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Effects on Patient Exposure Dose and Image Quality by Increasing Focal Film Distance in Abdominal Radiography (복부 일반촬영시 초점-필름간거리 변화가 피폭선량 및 화질에 미치는 영향)

  • Kim, You-Hyun;Kwon, Soo-Il
    • Journal of radiological science and technology
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    • v.21 no.1
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    • pp.52-58
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    • 1998
  • We can and must improve the diagnostic images using available knowledge and technology. At the same time we must strive to reduce the patient's integral and entrance radiation dose. Reducing the integral dose to the patient during the radiologic procedure is a primary concern of the patient, especially the pediatric patient, the radiologist and the technologist. A 100cm focal film distance generally is used for most over-table radiography. The early x-ray tubes and screen film combinations required long exposures, which often resulted in motion artifacts. But nowaday, we have the generators and x-ray tubes that can deliver the energy necessary in a very short time and the receptors that can record the information just as rapidly. And, we performed this studies to evaluate the patient exposure dose and the image quality by increasing focal film distance in diagnostic radiography. There are many factors which affected to exposure factor, but we studied to verify of FFD increase, only. Effect of increasing the focal film distance to a 140 cm distance was tested as follows; 1. The focal film distances were set at 100, 120, and 140cm. 2. A 18cm acryl(tissue equivalent) phantom was placed on the table top. 3. An Capintec 192 electrometer with PM 05 ion chamber was placed at the entrance surface of the phantom, and exposure were made at each focal film distances. 4. The procedure was repeated in the same manner as above except the ion chamber was placed beneath the phantom at the film plane. 5. Exit exposure were normalize to 8mR for each portions of the experiment. Based on the success of the empirical measurements, a detailed mathematical analysis of the dose reduction was performed using the percent depth dose data. The results of this study can be summerized as followings ; 1) Increasing FFD from 100 cm to 140 cm, we would create a situation that would have a significant effect on the overall quality of radiograph and achive the 17.42% reduction of entrance dose and the 18.95% reduction of integral dose that the patient receives. 2) Thickness of Al step wedge for equal film density increased with the long distance. 3) Increasing FFD, Magnification of image was lowered. 4) Resolution of image also increased with the FFD. As the results described above, we strongly recommend using the long FFD to provide better information for our patients and profession in abdomen radiographic studies.

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A Effectiveness of Butorphanol and Nalbuphine as Utilized with Ketorolac in Patient Controlled Analgesia after Total Abdominal Hysterectomy (복식 전자궁 절제술 후 통증자가조절을 통하여 Ketorolac과 함께 투여한 Butorphanol과 Nalbuphine의 효과)

  • Kim, Dong-Hee;Park, Choong-Hak
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.263-267
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    • 1998
  • Background: This study was designed to know the dose requirement, analgesic efficacy and side effects of butorphanol and nalbuphine when administered with ketorolac by patient controlled analgesia (PCA) after total abdominal hysterectomy. Methods: Forty women who underwent total abdominal hysterectomy received ketorolac (bolus dose 2.4 mg, lockout interval 10 min) with either butorphanol (bolus dose 0.1 mg) or nalbuphine (bolus dose 1 mg) using PCA pump postoperatively. Results: Total amounts of 48 hr consumption were 8.7 mg (butorphanol)and 61.5 mg (nalbuphine). There were no significant differences between two groups in total ketorolac infusion doses, VAS score and side effects. Conclusions: Both butorphanol and nalbuphine were useful for PCA for postoperative pain control. We may suggest that ketorolac 180 mg with butorphanol 9 mg or nalbuphine 70 mg would be useful for 48 hr postoperative pain control.

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Dose Estimation of Patient by X-ray Positioning in Particle Cancer Therapy

  • Hirai, Masaaki;Nishizawa, Kanae;Shibayama, Kouichi;Kanai, Tatsuaki
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.206-207
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    • 2002
  • The effective dose due to the X-Ray radiography in the patient positioning for the heavy ion radiotherapy was measured on three regions, chest, upper-abdomen and pelvis. All the radiographic systems and the conditions used in the measurements were same as the clinical trial being performed in National Institute of Radiological Sciences, Japan. The organ or tissue for measurements was selected by following ICRP60$^1$ and the effective dose was calculated from measured organ doses and the surface dose.

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A Study of the Patient Dose in Chest Radiography (흉부(胸部) X선검사시(線檢査時) 환자(患者)의 피폭선양(被曝線量)에 대(對)한 연구(硏究))

  • Kim, Chang-Kyun
    • Journal of radiological science and technology
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    • v.13 no.1
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    • pp.3-9
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    • 1990
  • A study was carried out to investigate the technical factors and the patient dose (entrance and absorbed dose) in chest P-A radiography based on the 86 hospitals in Seoul from July 1 to July 30, 1989. As a result of this study, main finding were as follow : 1. 51.2% of the surveyed hospitals made use of $60{\sim}69\;kVp$ as tube voltage in chest radiography 2. The majority of the surveyed(88.3%) have the use of $6{\sim}20\;mAs$ as tube current-time. 3. Percentage absorbed doses in patient were showed more than 90 percent in every tube voltage. 4. Object densities were all much the same in all tube voltages. 5. 48.8% of surveyed entrance doses ranged from $100\;{\mu}Sv$ to $190\;{mu}Sv$, and the mean dose was $158\;{\mu}Sv$.

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The Experience in Dose Measurement of IVR with Glass Dosimeter System

  • Nishizawa, Kanae;Moritake, Takashi;Iwai, Kazuo;Matsumaru, Yuji;Tsuboi, Koji;Maruyama, Takashi
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.269-271
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    • 2002
  • It is reported that exposure for the patient and the medical staff from IVR is large. Direct measurement of patient exposure is difficult, since the measurement disturbs reading of images. The fluorescence glass-dosimeter system consisting of small-size glass chips is developed in recent years. Owing to its small size and physical characteristics, direct monitoring of surface dose may be feasible. The dose measurement for patient and medical staff during head interventional radiology (IVR) examinations was tried by using the fluorescence glass-dosimeter system. A dose response of the glass dosimeter is almost linear in large dose range but its energy dependency is high. About 20% variation of sensitivity was observed in the effective energy of 45-60keV which was used in IVR. In spite of this shortcoming, the fluorescence glass-dosimeter system is a convenient means for a dose monitoring during IVR performance.

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18-FDG EXTERNAL RADIATION DOSE RATES IN DIFFERENT BODY REGIONS OF PET-MRI PATIENTS

  • Han, Eunok;Kim, Ssangtae
    • Journal of Radiation Protection and Research
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    • v.38 no.3
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    • pp.157-165
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    • 2013
  • To determine the factors affecting the external radiation dose rates of patients undergoing PET-MRI examinations and to assess the trends of these differences, we measured the changes in the dose rates of $^{18}F$-FDG during a set period of time for each body region. Consistent with theoretical predictions, the dose rate decreased over time in patients undergoing PET-MRI examinations. Furthermore, immediately after the $^{18}F$-FDG injection, the dose rate in the chest region was the highest, followed by the abdominal region, the head region, and the foot region. The dose rate decreased drastically as time passed, by 2.47-fold, from $339.23{\pm}74.70mSv\;h^{-1}$ ($6.73{\pm}5.79$ min) at the time point immediately after the $^{18}F$-FDG injection to $102.71{\pm}26.17mSv\;h^{-1}$ ($136.11{\pm}25.64$ min) after the examination. In the foot region, there were no significant changes over time, from $32.05{\pm}20.23mSv\;h^{-1}$ ($6.73{\pm}5.79$ min) at the time point immediately after the $^{18}F$-FDG injection, to $23.89{\pm}9.14mSv\;h^{-1}$ ($136.11{\pm}25.64$ min) after the examination. The dose rate is dependent on the individual characteristics of the patient, and differed depending on the body region and time point. However, the dose rates were higher in patients who had a lower body weight, shorter stature, fewer urinations, lower fluid intake, and history of diabetes mellitus. To decrease radiation exposure, it is difficult or impossible to change factors inherent to the patient, such as sex, age, height, body weight, obesity, and history of diabetes mellitus. However, factors which can be changed, such as the $^{18}F$-FDG dose, fasting time, fluid intake, number of urinations, and contrast agent dose can be controlled to minimize the external radiation exposure of the patient.

Patient Exposure Dose Reduction in Coronary Angiography & Intervention (심혈관조영술 및 중재술 시 환자 선량 감소방안)

  • Lim, Do-Hyung;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.45 no.1
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    • pp.69-76
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    • 2022
  • This study, the method of reducing the exposure dose by changing the geometrical requirements among the preceding studies and the method of directly wearing a protector on the patient were used to expose the patient. A comparative experiment was conducted on the method of reducing the dose and the most effective method for reducing the exposure dose was investigated. Using the phantom, the dose of the lens, thyroid gland, and gonad gland in the 5 views most used in coronary angiography and intervention accumulated 5 times for 10 seconds at 60~70 kV, 200~250 mA as an automatic controller of the angiography system, and measured by Optically Stimulated Luminescent Dosimeter(OSLD). SID 100 cm and Cine 15 f/s as a control group the experiment was conducted by dividing the experimental group into 3 groups: a group lowered to Cine 7.5 f/s, a phantom protector, and a group lowered to 95 cm SID. As a result of the experiment, showing decrease in exposure dose compared to the control group. Lowering the cine frame may be the simplest and most effective method to reduce the exposure dose, but there is a limit that it cannot be applied if the operator judges that the diagnostic value is small or feels uncomfortable with the procedure. Conclusion as fallow reducing the exposure dose by directly wearing protector is the next best solution, and it is hoped that the conclusions obtained through this study will help reduce the exposure dose to unnecessary organ.

Estimation of Absorbed Dose for Anterior and Posterior Organs with Body Mass Index in Standing Whole Spine Examination (Standing Whole Spine 검사 시 체질량지수 (BMI)에 따른 전방 및 후방장기의 흡수선량 평가)

  • Shim, Ji Na;Lee, Yong-Gu;Lee, Youngjin
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.147-151
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    • 2016
  • Automatic exposure control (AEC) is frequently used in many hospitals for Standing Whole Spine examination which is able to control radiation dose with respect to the body type such as body mass index (BMI) and we can measure dose area product (DAP) based on respective patient information. However, few studies have been conducted organ absorbed dose evaluation based on location of patient organ. The purpose of this study was to evaluate the relationships between BMI and organ absorbed dose along with location of patient organ. For that purpose, we calculated absorbed dose with selected 5 patient organ (thyroid, breast, heart, kidney, and pancreas) using a PCXMC simulation tool with measured DAP. According to the results, measured DAP increases with BMI and organ absorbed dose decreases with BMI in anterior organs such as thyroid, breast, and heart. On the other hand, there is no correlation between organ absorbed dose and BMI in posterior organs such as kidney and pancreas. In conclusion, our results demonstrated that the radiation effects are different with respect to BMI and location of patient organ in Standing Whole Spine examination.