• Title/Summary/Keyword: medical errors

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An Open-Label Study of the Improvements in Clinical Symptoms and Neurocognitive Functions in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder after Treatment with Metadate CD (국내 주의력결핍 과잉행동장애 아동 및 청소년에서 메타데이트CD의 임상증상 및 신경인지기능 개선 효과에 대한 개방 연구)

  • Yoo, Han-Ik K.;Kim, Bong-Seog;Joung, Yoo-Sook;Bahn, Geon-Ho;Song, Dong-Ho;Ahn, Dong-Hyun;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.4
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    • pp.253-261
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    • 2011
  • Objectives : This study aimed to investigate the efficacy and safety of Metadate CD (MCD) when given to Korean children and adolescents with attention-deficit hyperactivity disorder (ADHD). We also explored the effects of the drug on diverse neuro-cognitive functions. Methods : Ninety-one subjects with ADHD (mean age 8.6${\pm}$2.2 years) were recruited at 6 outpatient clinics in Seoul, Korea. We used the ADHD Rating Scale (ARS), Clinical Global Impression (CGI), and comprehensive attention test (CAT) to measure the drug's effects. Results : After 0.92${\pm}$0.32mg/kg/day of MCD were administered for 57.4${\pm}$7.6 days, there was a 48.5% reduction in the mean total ARS scores (p<.001). Fifty-seven subjects (64.8%) showed either much improved or very much improved outcomes on the CGI-Improvement scale. The CGI-Severity scale also decreased from an average of 4.7 to an average of 2.9 (p<.001). Errors and response time standard deviations of the CAT, sustained attention test-to-response tasks, the flanker test, and divided attention test scores decreased after treatment (p<.05). The forward memory span of the spatial working memory test scores increased (p<.05). Thirty-five patients (39.8%) experienced side effects, of which the most common were headache (14.8%), nausea (12.5%), and anorexia (9.1%). Conclusion : This open-label study suggests that MCD is effective and safe in improving the symptoms and neurocognitive functions of Korean children and adolescents with ADHD.

Data mining Algorithms for the Development of Sasang Type Diagnosis (사상체질 진단검사를 위한 데이터마이닝 알고리즘 연구)

  • Hong, Jin-Woo;Kim, Young-In;Park, So-Jung;Kim, Byoung-Chul;Eom, Il-Kyu;Hwang, Min-Woo;Shin, Sang-Woo;Kim, Byung-Joo;Kwon, Young-Kyu;Chae, Han
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1234-1240
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    • 2009
  • This study was to compare the effectiveness and validity of various data-mining algorithm for Sasang type diagnostic test. We compared the sensitivity and specificity index of nine attribute selection and eleven class classification algorithms with 31 data-set characterizing Sasang typology and 10-fold validation methods installed in Waikato Environment Knowledge Analysis (WEKA). The highest classification validity score can be acquired as follows; 69.9 as Percentage Correctly Predicted index with Naive Bayes Classifier, 80 as sensitivity index with LWL/Tae-Eum type, 93.5 as specificity index with Naive Bayes Classifier/So-Eum type. The classification algorithm with highest PCP index of 69.62 after attribute selection was Naive Bayes Classifier. In this study we can find that the best-fit algorithm for traditional medicine is case sensitive and that characteristics of clinical circumstances, and data-mining algorithms and study purpose should be considered to get the highest validity even with the well defined data sets. It is also confirmed that we can't find one-fits-all algorithm and there should be many studies with trials and errors. This study will serve as a pivotal foundation for the development of medical instruments for Pattern Identification and Sasang type diagnosis on the basis of traditional Korean Medicine.

Association between the Pattern of Prophylactic Antibiotic Use and Surgical Site Infection Rate for Major Surgeries in Korea (예방적 항생제 사용 양상과 수술부위감염률의 관련성)

  • SaKong, Pil-Yong;Lee, Jin-Seok;Lee, Eun-Jung;Ko, Kwang-Pil;Kim, Cheol-Hwan;Kim, Yoon;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.1
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    • pp.12-20
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    • 2009
  • Objectives : The purpose of this study was to analyze the association between the pattern of prophylactic antibiotic use(PAU) and the surgical site infection(SSI) rate for major surgeries in Korea. Methods : We retrospectively reviewed the medical records of patients who underwent cardiac, colon and gastric surgery, hysterectomies and hip/knee replacements at 20 hospitals, and inclusive of over 500 beds. We randomly sampled 60 cases per surgery type for patients discharged between September and November, 2006. A total fo 2,924 cases were included in our analysis. Cox's proportional hazard analysis was conducted to evaluate the association between the pattern of PAU and SSI rate. Results : The proportion of patients who received their first prophylactic antibiotics(PA) 1 hour before incision was 65.5%, who received inappropriate PAs was 80.8%, and the proportion of patients whose PA was discontinued within 24 hours of surgery was 0.5%. The average duration of PAU after surgery was 9 days. The relative risk(RR) of SSI in patients who received their first PA more than 1 hour before incision was significantly higher than for those who received it within 1 hour prior to incision(RR=8.20, 95% CI=4.81-13.99). Inappropriate PA selection increased SSI rate, albeit with marginal significance(RR=1.97, 95% CI=0.96-4.03). Also, prolonged PAU following surgery had no effect on SSI rate. Conclusions : These results suggest that the pattern of PAU in the surgeries examined was not appropriate. Errors in the timing of PAU and of PA selection increase SSI rate. SSI rate remained unaltered following prolonged PAU after surgery.

A Study on Building the HD Map Prototype Based on Web GIS for the Generation of the Precise Road Maps (정밀도로지도 제작을 위한 Web GIS 기반 HD Map 프로토타입 구축 연구)

  • KWON, Yong-Ha;CHOUNG, Yun-Jae;CHO, Hyun-Ji;GU, Bon-Yup
    • Journal of the Korean Association of Geographic Information Studies
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    • v.24 no.2
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    • pp.102-116
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    • 2021
  • For the safe operation of autonomous vehicles, the representative technology of the 4th industrial revolution era, a combination of various technologies such as sensor technology, software technology and car technology is required. An autonomous vehicle is a vehicle that recognizes current location and situation by using the various sensors, and makes its own decisions without depending on the driver. Perfect recognition technology is required for fully autonomous driving. Since the precise road maps provide various road information including lanes, stop lines, traffic lights and crosswalks, it is possible to minimize the cognitive errors that occur in autonomous vehicles by using the precise road maps with location information of the road facilities. In this study, the definition, necessity and technical trends of the precise road map have been analyzed, and the HD(High Definition) map prototype based on the web GIS has been built in the autonomous driving-specialized areas of Daegu Metropolitan City(Suseong Medical District, about 24km), the Happy City of Sejong Special Self-Governing City(about 33km), and the FMTC(Future Mobility Technical Center) PG(Proving Ground) of Seoul National University Siheung Campus using the MMS(Mobile Mapping System) surveying results given by the National Geographic Information Institute. In future research, the built-in precise road map service will be installed in the autonomous vehicles and control systems to verify the real-time locations and its location correction algorithm.

Analysis of the Disposal Rate of Fresh Frozen Femoral Head in the Bone Bank of a Single Hospital (단일 병원 인체조직은행에서 채취한 신선 동결 대퇴골두의 폐기율 분석)

  • Lee, Jaeyoung;Lee, Donghun;Jeon, Jinhwa;Lee, Kee Haeng
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.305-309
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    • 2021
  • Purpose: This study analyzed the increase in disposal rate of femoral heads in the bone bank of a single hospital from medical disease and drug history, as assessed by the Korean health insurance review and assessment service. Materials and Methods: The disposal rate and cause of 340 femoral heads were analyzed according to the regulations of the bone bank based on the standard model of the Ministry of food and drug safety. Results: One hundred and seven (33%) of 323 femoral heads collected from 2009 to 2018, and 65 (46%) of 142 femoral heads collected from 2015 to 2018 were discarded. The most common causes were related to the history of dementia and the administration of radioisotope for nuclear medicine. Conclusion: The current methods and screening tools can lead to errors in disposing of the available tissues in a bone bank. Thus, improved standards and screening methods are needed.

Quality Control and Image Quality Comparison according to Ultrasonic Equipment (초음파 장비에 따른 정도관리와 화질 비교)

  • Dong-Hee, Hong
    • Journal of the Korean Society of Radiology
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    • v.16 no.7
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    • pp.935-942
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    • 2022
  • In doing interventional treatment under the guidance of ultrasonography, the medical team detects the legion site with ultrasonic equipment at first, and insert angio needle. In this situation, if the position of legion and the depth of inserted needle on the ultrasonographic screen are different from real position and depth, the needle is likely to damage a major blood vessel or tissue. Accordingly, we had wondered how much such differences between screen image and reality, and so decided to examine them. Using five ultrasonographic equipments manufactured from different companies in different years, this study tried to compare the lengths of the needle on the screen images and real lengths of it, and find out the factors affecting skewness of them. This study used hog meat chunk to mimic human flesh, and sausages as the target of needle. It compared penetrating depths of the needle as the images on the five equipments using single sample t test in the SPSS 22 statistical program. It was found that all the errors were statistically significant(<.05). So, this study decided that it was wrong to evaluate performances of the equipments by the makers and ages of them. It is necessary to do periodic quality controls of equipments and improve the skillfulness of sonographers to reduce error rates between real treatment areas and the images of them.

A Simple Design of an Imaging System for Accurate Spatial Mapping of Blood Oxygen Saturation Using a Single Element of Multi-wavelength LED (혈중 산소 포화도의 정확한 공간 매핑을 위한 다중 파장 LED 단일소자를 활용한 이미징 시스템 설계)

  • Jun Hwan Kim;Gi Yeon Yu;Ye Eun Song;Chan Yeong Yu;Yun Chae Jang;Riaz Muhammad;Kay Thwe Htun;Ahmed Ali;Seung Ho Choi
    • Journal of Biomedical Engineering Research
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    • v.44 no.6
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    • pp.450-464
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    • 2023
  • Pulse oximetry, a non-invasive technique for evaluating blood oxygen saturation, conventionally depends on isolated measurements, rendering it vulnerable to factors like illumination profile, spatial blood flow fluctuations, and skin pigmentation. Previous efforts to address these issues through imaging systems often employed red and near-infrared illuminations with distinct profiles, leading to inconsistent ratios of transmitted light and the potential for errors in calculating spatial oxygen saturation distributions. While an integrating sphere was recently utilized as an illumination source to achieve uniform red and near-infrared illumination profiles on the sample surface, its bulkiness presented practical challenges. In this work, we have enhanced the pulse oximetry imaging system by transitioning illumination from an integrating sphere to a multi-wavelength LED configuration. This adjustment ensures simultaneous emission of red and near-infrared light from the same position, creating a homogeneous illumination profile on the sample surface. This approach guarantees consistent patterns of red and near-infrared illuminations that are spatially uniform. The sustained ratio between transmitted red and near-infrared light across space enables precise calculation of the spatial distribution of oxygen saturation, making our pulse oximetry imaging system more compact and portable without compromising accuracy. Our work significantly contributes to obtaining spatial information on blood oxygen saturation, providing valuable insights into tissue oxygenation in peripheral regions.

Analysis of the Rate of Discrepancy between Preliminary Reports by Radiology Residents and Final Reports by Certified Radiologists for Emergency Radiology: Studies in a University Hospital (대학병원 응급 영상검사에서 영상의학과 전공의 가판독과 전문의 최종 판독 간의 불일치 발생률 분석)

  • Younbeom Jeong;Cheong-Il Shin;Hwan Jun Jae;Jung Hoon Kim;Jin Wook Chung
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1186-1195
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    • 2021
  • Purpose In the adult emergency department of a university hospital, we investigated the frequency of major discrepancies between the preliminary reports by radiology residents and the final reports by certified radiologists. Materials and Methods Based on CT and MRI scans obtained between December 2016 and November 2019, we selected cases with diagnoses or treatment plans that could be changed due to discrepancies between preliminary and final reports and classified them by the type of discrepancy. We also examined the distributions of the major discrepancies and stratified them by residents' working time zone, experience, and subspecialty. Results Based on the 72137 preliminary reports evaluated, 1348 tests (1.9%) showed major discrepancies. Most of the major discrepancies were false negatives (72.0%), followed by misdiagnosis (26.3%) and false positives (1.7%). Acute findings (87.2%) were more common than non-acute findings (12.8%). The major discrepancy rate increased toward the second half of the 24-hour shift, with the highest rate of 2.9% occurring between 2 am and 4 am. The major discrepancy rate did not vary with experience, and it varied from 0.6% to 4.5% for each subspecialty. Conclusion The major discrepancy rate was less than 2%, and it increased with longer working hours during a 24-hour shift.

Evaluation method for interoperability of weapon systems applying natural language processing techniques (자연어처리 기법을 적용한 무기체계의 상호운용성 평가방법)

  • Yong-Gyun Kim;Dong-Hyen Lee
    • Journal of The Korean Institute of Defense Technology
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    • v.5 no.3
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    • pp.8-17
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    • 2023
  • The current weapon system is operated as a complex weapon system with various standards and protocols applied, so there is a risk of failure in smooth information exchange during combined and joint operations on the battlefield. The interoperability of weapon systems to carry out precise strikes on key targets through rapid situational judgment between weapon systems is a key element in the conduct of war. Since the Korean military went into service, there has been a need to change the configuration and improve performance of a large number of software and hardware, but there is no verification system for the impact on interoperability, and there are no related test tools and facilities. In addition, during combined and joint training, errors frequently occur during use after arbitrarily changing the detailed operation method and software of the weapon/power support system. Therefore, periodic verification of interoperability between weapon systems is necessary. To solve this problem, rather than having people schedule an evaluation period and conduct the evaluation once, AI should continuously evaluate the interoperability between weapons and power support systems 24 hours a day to advance warfighting capabilities. To solve these problems, To this end, preliminary research was conducted to improve defense interoperability capabilities by applying natural language processing techniques (①Word2Vec model, ②FastText model, ③Swivel model) (using published algorithms and source code). Based on the results of this experiment, we would like to present a methodology (automated evaluation of interoperability requirements evaluation / level measurement through natural language processing model) to implement an automated defense interoperability evaluation tool without relying on humans.

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Compare to Evaluate the Imaging dose of MVCT and CBCT (Tomotherapy MVCT와 Linac CBCT의 Imaging dose 비교평가)

  • Yoon, Bo Reum;Hong, Mi Lan;Ahn, Jong Ho;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.83-89
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    • 2014
  • Purpose : In case of the intensity modulated radiation therapy (IMRT) using Tomotherapy and linear accelerator (Linac), it was to compare and to evaluate the imaging dose of MVCT and CBCT that were performed daily for the correct set up of the patient. Materials and Methods : The human body model Phantom (Anderson rando Phantom, USA) was divided into the three parts as Head, Thorax, pelvis, and after GafChromic EBT3 film cut to the size of $0.5{\times}0.5cm2$.in the center of the recording area were situated on the ant, post, left, and right surface of the phantom and 2cm in depth from the ant, post, left, right, and center surface of the phantom, the surface dose and inner dose were measured repeatedly three times, respectively, using the tomotherapy (Hi Art) and the OBI of NovalisTx. The measured film calculated the output value by RIP version6.0 and then the average value of the dose was calculated by the one-way analysis of variance. Results : Using the human body model phantom, the results of MVCT and CBCT performance were that measurements of MVCT inner dose were showed $15.43cGy{\pm}6.05$ in the head, $16.62cGy{\pm}3.08$ in the thorax, $16.81cGy{\pm}5.24$ in the pelvis, and measurements of CBCT inner dose were showed $13.28{\pm}3.68$ in the head, from $13.66{\pm}4.04$ in the thorax, $15.52{\pm}3.52$ in the pelvis. The measurements of surface dose were showed in case of MVCT performance, $11.64{\pm}4.05$ in the head, $12.16{\pm}4.38$ in the thorax, $12.05{\pm}2.71$ in the pelvis, and in case of CBCT performance, $14.59{\pm}3.51$ in the head, $15.82{\pm}2.89$ in the thorax, $17.48{\pm}2.80$ in the pelvis, respectively. Conclusion : In case of Inner dose, the MVCT using MV energy showed higher than the CBCT using kV energy at 1.16 times in the head, at 1.22 times in the thorax, at 1.08 times in the pelvis, and in case of surface dose, the CBCT was higher than MVCT, at 1.25 times in the head, at 1.30 times in the thorax, at 1.45 times in the pelvis. Imaging dose was a small amount compared to the therapeutic dose but it was thought to affect partially to normal tissue because it was done in daily schedule. However, IMRT treatment was necessarily parallel with the IGRT treatment through the image-guide to minimize errors between planned and actual treatment. Thus, to minimize imaging dose that the patients receive, when planning the treatment, it should be set up a treatment plan considering imaging dose, or it must be performed by minimizing the scan range when shooting MVCT.