• Title/Summary/Keyword: medical errors

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Estimation of Respiration Using Photoplethysmograph During Sleep (광용적맥파 신호를 이용한 수면 중 호흡 추정)

  • Park, Jong-Uk;Lee, Jeon;Lee, Hyo-Ki;Kim, Hojoong;Lee, Kyoung-Joung
    • Journal of Biomedical Engineering Research
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    • v.34 no.3
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    • pp.105-110
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    • 2013
  • Respiratory signal is one of the important physiological information indicating the status and function of the body. Recent studies have provided the possibility of being able to estimate the respiratory signal by using a change of PWV(pulse width variability), PRV(pulse rate variability) and PAV(pulse amplitude variability) in the PPG (photoplethysmography) signal during daily life. But, it is not clear whether the respiratory monitoring is possible even during sleep. Therefore, in this paper, we estimated the respiration from PWV, PRV and PAV of PPG signals during sleep. In addition, respiration rates of the estimated respiration signal were calculated through a time-frequency analysis, and errors between respiration rates calculated from each parameter and from reference signal were evaluated in terms of 1 sec, 10 sec and 1 min. As a result, it showed the errors in PWV(1s: $36.38{\pm}37.69$ mHz, 10s: $36.53{\pm}38.16$ mHz, 60s: $30.35{\pm}38.72$ mHz), in PRV(1s: $1.45{\pm}1.38$ mHz, 10s: $1.44{\pm}1.37$ mHz, 60s: $0.45{\pm}0.56$ mHz), and in PAV(1s: $1.05{\pm}0.81$ mHz, 10s: $1.05{\pm}0.79$ mHz, 60s: $0.56{\pm}0.93$ mHz). The errors in PRV and PAV are lower than that of PWV. Finally, we concluded that PRV and PAV are more effective than PWV in monitoring the respiration in daily life as well as during sleep.

Feasibility Study of Patient Specific Quality Assurance Using Transit Dosimetry Based on Measurement with an Electronic Portal Imaging Device

  • Baek, Tae Seong;Chung, Eun Ji;Son, Jaeman;Yoon, Myonggeun
    • Progress in Medical Physics
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    • v.28 no.2
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    • pp.54-60
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    • 2017
  • This study was designed to measure transit dose with an electronic portal imaging device (EPID) in eight patients treated with intensity modulated radiotherapy (IMRT), and to verify the accuracy of dose delivery to patients. The calculated dose map of the treatment planning system (TPS) was compared with the EPID based dose measured on the same plane with a gamma index method. The plan for each patient was verified prior to treatment with a diode array (MapCHECK) and portal dose image prediction (PDIP). To simulate possible patient positioning errors during treatment, outcomes were evaluated after an anthropomorphic phantom was displaced 5 and 10 mm in various directions. Based on 3%/3 mm criteria, the $mean{\pm}SD$ passing rates of MapCHECK, PDIP (pre-treatment QA) for 47 IMRT were $99.8{\pm}0.1%$, $99.0{\pm}0.7%$, and, respectively. Besides, passing rates using transit dosimetry was $90.0{\pm}1.5%$ for the same condition. Setup errors of 5 and 10 mm reduced the mean passing rates by 1.3% and 3.0% (inferior to superior), 2.2% and 4.3% (superior to inferior), 5.9% and 10.9% (left to right), and 8.9% and 16.3% (right to left), respectively. These findings suggest that the transit dose-based IMRT verification method using EPID, in which the transit dose from patients is compared with the dose map calculated from the TPS, may be useful in verifying various errors including setup and/or patient positioning error, inhomogeneity and target motions.

Comparison of Nasalance Score Between Glottal and Oral Articulation in Children with Velopharyngeal Insufficiency (연인두 폐쇄부전 아동의 보상조음과 정조음에서의 비음치 비교)

  • Lee, Eun-Kyung;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.129-133
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    • 2007
  • Background and Objectives: Nasometry is an easy, noninvasive method to obtain objective data regarding the function of velopharynx. However, because articulation errors may affect the results of nasometry, the examiner should interpret the nasalance score based on appropriate speech stimuli. The purpose of this study is to examine the difference of nasalance score between glottal and oral articulations in patients with velopharyngeal insufficiency (VPI). Materials and Method: Nineteen children between 3.4 and 12.1 years of age (mean age 5.7 years) with a confirmed VPl showing hypernasality and articulation errors (glottal stops) were included. Nasalance scores were obtained for two speech patterns of glottal and oral stops. In addition, the velopharyngeal functions were analyzed in four subjects using video nasopharyngoscopy. Results: The $mean{\pm}S.D$ nasalance scores of the glottal stops and oral stops were $42.54{\pm}16.26%$ and $25.47{\pm}16.51%$ respectively (p=.000). Six of 19 patients achieved normal nasalance scores when glottal stops changed to oral stops by the trial speech therapy. Video nasopharyngoscope confirmed that large velopharyngeal gaps can be decreased into tiny gaps or complete closure when compensatory articulations were corrected for some cases. Conclusion: Compensatory articulation errors must be corrected for the reliable interpretation of the nasalance scores that are obtained in children with velopharyngeal insufficiency, which would facilitate to make a better decision for further management of these patients.

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A Study on the Improvement of Compression Method Using Hilbert Curve Scanning for the Medical Images (Hilbert 곡선 Scan 방법을 이용한 의학 영상의 압축 방법에 관한 연구)

  • 지영준;박광석
    • Journal of Biomedical Engineering Research
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    • v.14 no.1
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    • pp.9-16
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    • 1993
  • For efficient storage and transmission of medical images, the requirement of image com pression is increasing. Because differences between reconstructed images and original images are related with errors In the diagnosis, lossless compression is generally preferred in mod- ical images. in Run Length Coding which is one of the lossless compression method, we have applied modified scanning direction based on the Hilbert curve, which is a kind of space fill ins curve. We have substituted the traditional raster scanning by Hilbert curve direction scanning. Using this method, we have studied enhancement of compression efficiency for medical images.

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Medical Students' Perceptions and Intentions Regarding Patient Safety (의과대학 학생들의 환자안전에 대한 인식)

  • Lee, Hoo-Yeon;Lee, Sang-Gyu
    • Quality Improvement in Health Care
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    • v.24 no.1
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    • pp.23-29
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    • 2018
  • Background: The purpose of this study was to examine undergraduate medical students' perceptions and intentions regarding patient safety during clinical clerkships. Methods: Cross-sectional and self-administered questionnaire survey was conducted on 34 students from one medical school using a modified version of the Medical Student Safety Attitudes and Professionalism Survey (MSSAPS). We assessed $4^{rd}-year$ medical students' perceptions of the cultures ('safety', 'teamwork', and 'error disclosure'), 'behavioural intentions' concerning patient safety issues and 'overall patient safety'. The overall response rate was 66.4%. Results: Among safety domains, "teamwork culture" was rated highest. "Error disclosure culture" received the lowest ratings. Regarding the error disclosure domain, only 10% of respondents reported that they have received education or training on how to disclose medical error to patients. Independent of survey domains, when students were asked "Overall, do you think your hospital is safe based on your clinical rotation?", 61.8% reported that the hospital was safe. Conclusions: Assessing students' perceptions of safety culture can provide clerkship directors and educators with information that enhances the educational environment and promotes patient safety. Discussions of medical errors, patient safety, and how best to incorporate an analysis of these issues into the existing curriculum are needed.

Study Focused on Task Process regarding Effective Information Transfer of Ancillary Tests in Diagnostic Pathology (병리추가조직검사 정보전달을 위한 업무프로세스 연구)

  • Ko, Jae-Nam;Park, Yun-Ik;Jung, Jin-Gyeong;Ahn, Sang-Ho;Kim, Jae-Ho;Shin, Hwa-Jeong;Hyun, Ji-Suk;Kim, Kyeong-Ho
    • Quality Improvement in Health Care
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    • v.22 no.2
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    • pp.95-108
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    • 2016
  • Purpose: Ancillary tests such as immunohistochemistry or molecular testing for pathologic diagnosis are performed using ready-made tissue blocks for a histological examination. Various methods and processes during ancillary testing cause some of issues, particularly in the time required and the results reporting scheme. Methods: To solve these issues, we constructed real-time management software. When a pathologist or a clinician had ancillary tests examined using this software by selecting the codes of the needed ancillary tests on site and the system assigned the tests to each laboratory. Then, pathology technologists checked the referred tests and performed the examination. In clinical departments, serial number of each ancillary test can be matched the original pathologic ID. In the department of pathology, numbers of tissue blocks that needed additional tests could be indicated and detected using one-click detection system when a clinician referred the test. Results: Using this system resulted in simplifying the referral procedures from nine-steps to three-steps in each clinical department and from seven-steps to two-steps in department of pathology. Errors that happened on the paper-based request system were also reduced. Furthermore, the time required was saved by seven hours in pathologic laboratory on average. Mean durations from requesting to reporting of the ancillary test was reduced by three days for specimens of health promotion center. Conclusion: Construction of an effective information transfer system may be helpful for shortening the time required, reducing errors, and checking processing information of the tests in real time.

Basic Data Analysis of the Quality Control for Patient Safety in Department of Radiation Oncologyat Yeungnam University Hospital (영남대학교병원의 환자안전을 위한 정도관리의 기초자료 분석)

  • Oh, Se An;Kim, Sung Kyu;Yea, Ji Woon;Kang, Min Kyu;Lee, Joon Ha;Lee, Rena
    • Progress in Medical Physics
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    • v.26 no.2
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    • pp.112-117
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    • 2015
  • In order to establish the quality control on patient safety following the guideline presented by American Association of Physicists in Medicine (AAPM) TG-100 committee, we aim to analyze the modes based on errors occurred during treatment of patients at the radiation oncology department at Yeungnam University Hospital and establish a quality control guideline for patient safety when patient-centered radiation treatment is conducted. We aim to analyze the errors that can occur during radiation treatment at the radiation department, and assess the frequency of error, the severity of error affecting patients, and probability of proceeding without noticing error, with scores. The places where errors can take place were divided into CT simulation treatment room, treatment planning room, and treatment room for the analysis. In CT simulation treatment room, an error from using the immobilization device showed the highest Risk Priority Number (RPN) value of 60, and an error from simulation treatment information input showed the lowest of 6. In treatment planning room, an error from selecting the radiation dose calculation model showed the highest RPN value of 168, and an error of patient treatment start date showed the lowest of 36. In treatment room, a Table Bar error showed the highest RPN value of 252, a weight change error showed 190, and a Pillow error showed the lowest of 24.

The Relationship between Depression, Cognitive Failure, Mistakes, and Accidents of the Train Drivers: The Moderating Effect of Self-Efficacy (철도기관사의 우울증세, 인지실패, 실수와 사고 간의 관계: 자기효능감의 조절효과)

  • Ro, Choon-Ho;Shin, Tack-Hyun;Park, Min-Kyu;Ku, Seung-Hwan
    • Journal of the Korea Safety Management & Science
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    • v.15 no.4
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    • pp.81-88
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    • 2013
  • In Korean society, the theme of human errors in railway has been emerging as a critical issue. As far as human error studies are concerned, main trend has been inclined to be led by industrial engineering and systems science. Apart from those trends, this study empirically highlighted the relationship between depression, which has been a frequent research subject in the medical science and psychology, and accidents, with setting depression as an exogenous variable and cognitive failure and mistake as endogenous variables, respectively. Results of hypotheses test for the 204 respondents showed that driver's depression has a significant effect on accidents mediated by cognitive failure and mistake. This findings suggest the need for exploring the diverse latent factors causing human errors and for understanding the complex cognitive process as well as for establishing integrative countermeasures to mitigate human errors.

In vitro physical, chemical, and biological evaluation of commercially available metal orthodontic brackets

  • Kim, Joo Hyoung;Cha, Jung Yul;Hwang, Chung Ju
    • The korean journal of orthodontics
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    • v.42 no.6
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    • pp.297-306
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    • 2012
  • Objective: This in vitro study was undertaken to evaluate the physical, chemical, and biological properties of commercially available metal orthodontic brackets in South Korea, because national standards for these products are lacking. Methods: Four bracket brands were tested for dimensional accuracy, (manufacturing errors in angulation and torque), cytotoxicity, composition, elution, and corrosion: Archist (Daeseung Medical), Victory (3M Unitek), Kosaka (Tomy), and Confidence (Shinye Odontology Materials). Results: The tested rackets showed no significant differences in manufacturing errors in angulation, but Confidence brackets showed a significant difference in manufacturing errors in torque. None of the brackets were cytotoxic to mouse fibroblasts. The metal ion components did not show a regular increasing or decreasing trend of elution over time, but the volume of the total eluted metal ions increased: Archist brackets had the maximal Cr elution and Confidence brackets appeared to have the largest volume of total eluted metal ions because of excessive Ni elution. Confidence brackets showed the lowest corrosion resistance during potentiodynamic polarization. Conclusions: The results of this study could potentially be applied in establishing national standards for metal orthodontic brackets and in evaluating commercially available products.

The Influence of the Number of Electrodes, the Position and Direction of a Single Dipole on the Relation Between S/N ratio and EEG Dipole Source Estimation Errors (뇌전위의 단일 쌍극자 모델에서 전극의 개수, 쌍극자의 위치 및 방향이 S/N과 쌍극자 추정 오차사이의 관계에 미치는 영향에 관한 시뮬레이션 연구)

  • 김동우;배병훈
    • Journal of Biomedical Engineering Research
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    • v.15 no.1
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    • pp.71-76
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    • 1994
  • In the source localization using single dipole model, the influence of the number of electrodes, the position and direction of a single dipole on the relation between S/W ratio and dipole parameter estimation errors is important. Monte Carlo simulation was used to investigate this influence. The forward problem was calculated using three spherical shell model, and dipole parameters were optimized by means of simplex method. As the number of electrodes became large, as the dipole went from midbrain to cortex, and as the direction of dipole changed from radial to tangential, the average and standard deviation of estimation errors became small.

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