• 대한유전성대사질환학회지
• /
• 제16권1호
• /
• pp.52-56
• /
• 2016

프로피오닌산혈증은 propionyl-CoA carboxylase(PCC)의 결핍으로 인한 드문 상염색체 열성 유전 대사 질환이다. 이는 분지 아미노산 대사 장애로 혈장과 소변에서 프로피오닌산과 다른 대사 산물들의 축적되게 된다. 감염, 질병 혹은 스트레스 등 이화작용을 유발하는 스트레스적인 상황은 빈번하게 응급 혹은 입원 치료가 필요하며 심각한 경우에는 환자가 혼수나 사망에 이를 수도 있다. 하지만 이런 잦은 입원과 응급실 방문은 환자와 가족들에게 일상생활을 힘들게 하는 등 많은 스트레스가 된다. 이에 저자들은 프로피오닌산혈증 환자에게 중심정맥관을 유치하고 가정 간호를 통해 계획적으로 예방적인 수액 치료를 유지하여 급성 대사 위기로 인한 잦은 입원을 예방하였고 환자와 가족들의 부담을 줄이는데 기여할 수 있었다. 또한 이 환자에게서 확인된 돌연변이가 이전에 보고된 바 없는 새로운 돌연변이로 확인되어 이를 같이 보고하는 바다.

• Journal of Chest Surgery
• /
• 제22권4호
• /
• pp.698-704
• /
• 1989

We experienced the seven cases of penetrating and non-penetrating cardiac injuries combined with cardiac tamponade from June 1986 to June 1989 at Seoul and Chun-An Hospital of SOONCHUNHYANG medical college. The results were as follows. l. In sex distribution, 7 cases were male. In age distribution, The fourth decades occupied about 58 % of all cases. 2. In mode of injury, 4 cases were stab wounds, 1 case penetration by metallic fragment, 2 cases blunt chest trauma. 3. We routinely checked the CVP with subclavian vein catheterization in case of suspicious cardiac tamponade. Significant increments were showed in 4 cases. 4. Becks triad [low blood pressure, raised central venous pressure, distant heart sound] were recorded in 43 % of the cases with proven tamponades. 5. The sites of injury included RV in 4 cases, LV in 1 case, RA in 1 case and branch of RCA in 1 case. The RV injuries were the most common. 6. Coronary artery damage occurred in 2 cases. LADA was severed in 1 case combined with RV rupture and branch of RCA was torn 1 case. 7. Pericardiocentesis was performed 1 case at another hospital before referring to our hospital. We have never used the procedure because we think that it is potentially dangerous with no clear benefit. 8. Subxyphoid pericardial window was performed in 2 cases of severe cardiac tamponade. We have employed this method to stabilize the patients who had systolic hypotension. 9. Surgical approaches were performed with median sternotomy in 3 cases, thoracotomy in 4 cases. 10. We undertook the simple closure in 6 penetrating cardiac wounds. The removal of impacted metallic fragment was performed under the cardiopulmonary bypass. Simple ligation was performed in 2 cases of coronary artery severance 11. One patient with no sign of life was urgently intubated and undertaken an emergency room thoracotomy on the stretch car without antiseptic preparation. The cardiorrhaphy in 6 cases were performed in the operating theater 12. One patient undertaken emergency room thoracotomy did not survive due to refractory hypovolemic shock. But the remaining 6 patients recovered.

• 한국콘텐츠학회논문지
• /
• 제14권11호
• /
• pp.378-388
• /
• 2014

연구목적은 국소마취 환자의 수술시 불안과 통증을 경감시키기 위해 손잡아주기, 내관지압의 간호중재를 통해 그 효과를 검증하고자 시도되었다. 연구기간은 2013년 7월부터 10월까지이며 연구대상은 H대학교 병원에서 국소마취를 통해 외래수술을 시행한 총 78명을 대상으로 하였다. 연구 설계는 비동등성대조군 사전사후 시차설계로 이루어졌다. 실험군1, 실험군2, 대조군 각 26명이었으며 외래수술환자를 대상으로 실험군1은 손잡아주기, 실험군2는 내관지압 간호중재를 실시하였다. 연구결과 세 군 간의 사전 동질성은 검증되었으며 간호중재 후 불안, 간호중재 후 통증이 실험군1, 실험군2에서 대조군보다 유의미하게 차이가 있었다. 결과에 근거하여 수술시 불안과 통증감소의 효과를 나타낸 손잡아주기와 내관지압의 효과가 시간과 경제적 측면에서 수술실에서 쉽게 접근할 수 있는 간호중재로 활용하는 것이 필요하다.

• Journal of Preventive Medicine and Public Health
• /
• 제5권1호
• /
• pp.9-15
• /
• 1972

Carbon monoxide poisoning is one of the most serious health problems in Korea, because we have been encountered with the highest incidence of CO poisoning in the world due to the unique heating system in home called 'ondal'. We opened Hyperbaric chamber unit in the Seoul National University Hospital last Jan, 1969. We have treated 848 patients as of Sept. 30., 1972, around 44 months period. We collected the informations on the environmental conditions of the place where CO intoxication actually occured by filling up the questionaire from 505 patients. The following findings were obtained. 1. Age distribution showed that the highest incidence was found in the younger age group between age of 10 to age of 29 in both sex. 2. Sex ratio of the patients was 1:1.14. 3. The socio-economic level of the patient was relatively low. 4. Housewife & housemaid were the major victims of the intoxication in the female patients & in the case of the male patient, occupational backgrounds were diverse. 5. Many patients from the middle class experienced the intoxication by sleeping at newly built room. 6. Many intoxication has been occured in the structure of houses where communicating doors are existing between living room & kitchen. 7. All findings obtained taught us again that CO poisoning is the serious by-product of the national fuel policy which put emphasis on the use of coal & socio-economic status is a very important parameter in this hazards.

• 한국항해항만학회지
• /
• 제28권3호
• /
• pp.239-245
• /
• 2004

심전도 측정기와 청진기를 통하여 획득된 심전도와 심음도는 비관혈적 방법으로 환자를 진단할 수 있는 생체신호이며, 의사들의 진단도구로 널리 이용되어져 왔다. 그러나 의사들이 심전도 측정기나 청진기를 이용하여 환자를 진단하는 장소는 병원 내 진료실과 응급실로 한정되어 있기 때문에, 병원에서 거리가 먼 원거리 지역이나 자동차, 비행기, 선박에서는 환자의 심음을 확인할 수 없다. 특히, 원양항해에 종사하는 선박 환자는 전문 의료진으로부터 진료를 받을 수 없는 경우가 있다. 본 논문에서는 환자의 심음 및 심전을 용이하게 측정함으로써 PC기반의 선박용 디지털 심전도 및 청진기를 개발하였으며, 해상 원격진료의 출현을 앞 당길 수 있으리라 본다.

• Journal of Radiation Protection and Research
• /
• 제40권3호
• /
• pp.147-154
• /
• 2015

The scatter photons and photoneutrons from high energy photon beams (more than 10 MV) will increase the undesired dose to the patient and the staff working in linear accelerator room. This undesired dose which is found at out-of-field area can increase the probability of secondary malignancy. The purpose of this study is to determine the equivalent dose of scatter photons and neutrons generated by 3 different treatment techniques: 3D-conformal, intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). The measurement was performed using two types of the optically stimulation luminescence detectors (OSL and OSLN) in the Alderson Rando phantom that was irradiated by 3 different treatment techniques following the actual prostate cancer treatment plans. The scatter photon and neutron equivalent dose were compared among the 3 treatments techniques at the surface in the out-of-field area and the critical organs. Maximum equivalent dose of scatter photons and neutrons was found when using the IMRT technique. The scatter neutrons showed average equivalent doses of 0.26, 0.63 and $0.31mSv{\cdot}Gy^{-1}$ at abdominal surface region which was 20 cm from isocenter for 3D, IMRT and VMAT, respectively. The scattered photons equivalent doses were 6.94, 10.17 and $6.56mSv{\cdot}Gy^{-1}$ for 3D, IMRT and VMAT, respectively. For the 5 organ dose measurements, the scattered neutron and photon equivalent doses in out of field from the IMRT plan were highest. The result revealed that the scatter equivalent doses for neutron and photon were higher for IMRT. So the suitable treatment techniques should be selected to benefit the patient and the treatment room staff.

• 한국콘텐츠학회논문지
• /
• 제12권7호
• /
• pp.255-260
• /
• 2012

흉부 X-선 촬영 시 피사체의 유무, 촬영실내 X선관과 수광계 (image receptor), 환자 보기창 앞, 환자대기실 출입문 외측, 출입문 개폐여부, 방사선 관계 종사자 출입문 외측, 방사선 관계 종사자 출입문 개폐여부 등으로 구분하여 공간산란선발생을 알아보기 위한 연구로 공간산란선발생에 대한 연구 결과 피사체가 있을 때 수광계 (image receptor) 위치; Chest PA: $663{\pm}3.4$ mR/h, Chest Lateral: $2,067{\pm}3.7$ mR/h, X선관 위치; Chest PA: $293{\pm}2.1$ mR/h, Chest Lateral: $927{\pm}1.9$ mR/h, 환자대기실 출입문 외측 열고; Chest PA: $17{\pm}1.6$ mR/h, Chest Lateral: $88{\pm}2.6$ mR/h, 방사선 관계 종사자 촐입문 외측 열고; Chest PA: $3{\pm}1.6$ mR/h, Chest Lateral: $19{\pm}1.6$ mR/h), 피사체의 두께가 두꺼울수록 각 각의 측정지점에서 산란선 발생이 많았고, 출입문을 닫고 측정한 경우 산란선이 더 적었다. 그러므로 방사선 관계종사자는 촬영실내 산란선 분포에 대한 정확한 정보를 인지하여 불필요한 방사선 피폭을 줄일 수 있도록 노력해야 한다.

• 한국임상수의학회지
• /
• 제34권2호
• /
• pp.76-81
• /
• 2017

Studies on the concentration of airborne microorganisms in human medicine as a part of a study on the nosocomial infections have been conducted properly, but in veterinary medicine, there has been rarely performed in Korea to the best of study's knowledge. The purpose of this study was to evaluate the distribution of airborne microorganisms and to identify their species in different places in the animal hospital to alert the necessity of thorough cleanliness management. This study evaluated the concentrations of airborne bacteria and fungi in hospital areas, such as patient waiting room, internal medicine ward, surgical ward and radiological diagnostic ward. The concentration of bacteria and fungi was significantly lower (p < 0.05) in two operating rooms and higher in the patient waiting room. The dominant species of bacteria were Micrococcus spp., Staphylococcus spp., and fungi were Penicillium spp., Dermatophyte mold. Animal hospitals need to perform proper procedures for disinfection, sterilization, and environmental cleaning as well as appropriate employee training and monitoring in order to the maximum prevention of the risk of nosocomial and surgical infections.

• 대한방사선기술학회지:방사선기술과학
• /
• 제45권2호
• /
• pp.127-134
• /
• 2022

In order to overcome the image quality limitations of the conventional C-arm, a flat panel detector (FPD) is used to enhance spatial resolution, detective quantum efficiency, frame rate, and dynamic range. Three-dimensional (3D) visualized information can be obtained from C-arm computed tomography (CT) equipped with an FPD, which can reduce patient discomfort and provide various medical information to health care providers by conducting procedures in the interventional procedure room without moving the patient to the CT scan room. Unlike a conventional C-arm device, a C-arm CT requires different basic safety and essential performance evaluation criteria; therefore, in this study, basic safety and essential performance evaluation criteria to protect patients, medical staff, and radiologists were derived based on International Electrotechnical Commission (IEC) standards, the Ministry of Food and Drug Safety (MFDS) standards in Korea, and the rules on the installation and operation of special medical equipment in Korea. As a result of the study, six basic safety evaluation criteria related to electrical and mechanical radiation safety (leakage current, collision protection, emergency stopping device, overheating, recovery management, and ingress of water or particulate matter into medical electrical (ME) equipment and ME systems: footswitches) and 14 essential performance evaluation criteria (accuracy of tube voltage, accuracy of tube current, accuracy of loading time, accuracy of current time product, reproducibility of radiation output, linearity and consistency in radiography, half layer value in X-ray equipment, focal size and collimator, relationship between X-ray field and image reception area, consistency of light irradiation versus X-ray irradiation, performance of the mechanical device, focal spot to skin distance accuracy, image quality evaluation, and technical characteristic of cone-beam computed tomography) were selected for a total of 20 criteria.

• 대한방사선기술학회지:방사선기술과학
• /
• 제39권3호
• /
• pp.421-427
• /
• 2016

경상북도 소재 100병상 이상의 3개 종합병원 응급실에 설치된 일반촬영장비와 CT장비에 대한 세균 오염도 검사를 실시하여 감염관리에 대한 기초자료를 제공하고 관리방안을 제안하고자하였다. 2015년 12월 1일부터 12월 31일까지 이루어졌으며 경상북도 소재 응급실내의 일반촬영장비와 CT장비를 대상으로 하였다. 일반촬영장비는 업무종사자가 가장 많이 사용하는 control box 위, 노출 버튼 위, 환자의 피부 접촉 부위인 테이블 위 전체와 stand bucky의 grid 위 및 턱 올려놓은 곳 등 총 4곳을 수집하였다. CT장비는 촬영실 업무종사자가 가장 많이 사용하는 control box위와 X-선 노출 버튼, 환자의 피부 접촉 부위인 환자 테이블 위 전체, gantry inner 등 총 3곳을 수집하였다. 영상의학과 응급실내 일반촬영장비에서 검출된 표면 오염 균주는 Providencia stuartii(25%), Stenotrophomonas maltophilia(18%), Enterobacter cloacae(8%), Pseudomonas species(8%), Staphylococcus epidermidis(8%), Gram negative bacilli(8%), incubator에서 48시간 배양 후 자라지 않은 세균은 25%를 차지하였다. 또한 영상의학과 응급실 내 CT장비의 검출된 표면 오염 균주는 Stenotrophomonas maltophilia(11%), Enteococcus faecalis(11%), Escherichia coli(11%), incubator에서 48시간 배양 후 자라지 않은 세균은 67%로 대부분이었다. 영상의학과 일반촬영장치의 Stand bucky-grid와 Stand bucky 상연에서 대부분의 세균이 발견되었고, CT장비의 검체 수집 부분 중 Patient table에 집중되어 검출되었다. 이는 여러 질환을 갖고 있는 환자에 의해 오염된 것을 의미하며 균주 모두 면역력이 저하된 환자에게는 치명적인 질환을 일으킬 수 있다. 그러므로 검사 전후 70% 알코올 소독을 통해 감염예방을 하여야 한다.