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Effective Customer Risk Management at the Nuclear Medicine Department: Risk Managemont MOT Development Application and Producing Public Relations Film (핵의학과 내에서의 효과적인 고객위험관리: 위험관리 응대 MOT 개발적용 및 홍보동영상 제작)

  • Ham, Jong-Hum;Hwang, Jae-Bong;Kim, Joon-Ho;Lee, Gui-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.110-122
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    • 2009
  • Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.

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Bacteremia in pediatric cancer patients : A single center study (소아 암 환아에서 발생한 균혈증의 분석 : 단일기관 연구)

  • Park, Sun Mi;Choe, Byung Kyu;Kim, Chun Soo;Kim, Joon Sik;Kim, Heung Sik;Ryoo, Nam-Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.882-888
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    • 2006
  • Purpose : Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. Methods : We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. Results : There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), ${\alpha}$-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. Conclusion : Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.

Clinical efficacy and safety of lamotrigine monotherapy in newly diagnosed pediatric patients with epilepsy (간질 환아에서 Lamotrigine 초기 단독 요법의 효능 및 안정성에 대한 연구)

  • Han, Ji-Hye;Oh, Jung-Eun;Kim, Sun-Jun
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.565-570
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    • 2010
  • Purpose : To verify the efficacy and safety of lamotrigine (LTG) monotherapy in newly diagnosed children with epilepsy. Methods : We prospectively enrolled 148 children who had undergone LTG monotherapy at our institution between September 2002 and June 2009. Twenty-nine patients were excluded: 19 due to incomplete data and 10 were lost to follow up. The data of the remaining 119 patients was analyzed. Results : We enrolled 119 pediatric epilepsy patients (aged 2.8-19.3 years; 66 males and 53 females) in this study. Out of 119 patients, 29 (25.2%) had generalized epilepsy and 90 (74.8%) had partial epilepsy. The responses of seizure reduction were as follows: Seizure freedom (no seizure attack for at least 6 months) in 87/111 (78.4%, n=111) patients; partial response (reduced seizure frequency compared to baseline) in 13 (11.7%) patients; and persistent seizure in 11 (9.9%) patients. The seizure freedom rate was in 81.6% in patients with partial seizure (75.9% for complex partial seizure and 90.9% for benign rolandic epilepsy) and 44.8% in patients with generalized epilepsy (30.0% for absence seizure, 35.7% for juvenile myoclonic epilepsy patients, and 100.0% for idiopathic generalized epilepsy patients). Adverse reactions were reported in 17 (14.3%) patients, and 8 patients (6.7%) discontinued LTG because of rash and tic. No patient experienced severe adverse reaction such as Stevens-Johnson syndrome. Conclusion : LTG showed excellent therapeutic response and had few significant adverse effects. Our findings report may contribute in promoting the use of LTG monotherapy in epileptic children.

Coronary Artery Bypass Grafting with Cardiopulmonary Bypass Versus Without Cardiopulmonary Bypass (체외순환 및 비체외순환하에서의 관상동맥우회로술)

  • Park, Chan-Beom;Kwon, Jong-Bum;Park, Kuhn;Won, Yong-Soon
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.591-596
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    • 2001
  • Coronary artery bypass graft with cardiopulmonary bypass is a conventional method of operative revascularization of coronary artery disease. Because of many troubles of cardiopulmonary bypass such as systemic inflammatory reaction, mechanical trauma of blood components and coagulopathy, coronary artery bypass graft without cardiopulmonary bypass has been popularized. Material and Method: From March 1999 to September 2000, 35 patients under went CABG at our institution. Among them, 14 patients received CABG without the use of CPB and 21 patients under went CABG with the use of CPB. Mean operative time, mean postoperative tracheal intubation time, mean ICU stay, mean hospital stay, the amount of transfusion, postoperative use of inotropic agents, and postoperative changes of cardiac enzymes were compared in both groups. Result: There were differences between the CABG without CPB group and CABG with CPB group with regard to mean tracheal intubation time, the amount of transfusion and the elevation of postoperative cardiac enzymes(p<0.05). Conclusion: While CABG without CPB provided satisfactory results, more long term follow-up is required.

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Effect of Frequency of Using Forest Environment on Workers' Stress: a Comparative Study on Workers in Medical and Counseling Service Institution (산림환경 이용 빈도가 근로자의 스트레스에 미치는 영향: 의료 및 상담서비스기관 종사자에 대한 비교 연구)

  • Jung, Won Hee;Woo, Jong-Min;Ryu, Jee Soo
    • Journal of Korean Society of Forest Science
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    • v.103 no.1
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    • pp.129-136
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    • 2014
  • This study aims to investigate the effect of frequency of using forest environment on workers' stress. Workers in medical and counseling industry, which is recently known to require heavy emotional burden and thus cause a lot of stress and burnout syndrome, participated in the study. We classified 370 subjects, who were working at medical and counseling service institutions in Seoul metropolitan area, into two groups according to frequency of using forest environment by conducting a screening survey. 69 subjects submitted written consent and were recruited for either forest therapy program or control-group test; the "high" group (n=27) at the high frequency of using forest environment and the "low" group (n=42) at the low level. We measured the level of stress by using psychosocial indicators such as Worker's Stress Response Inventory (WSRI), Recovery Experience Questionnaire (REQ), and Maslach Burnout Inventory-General Survey (MBI-GS) and biological ones such as heart rate variability (HRV), cortisol, and Natural Killer cell (NK cell). The results suggested that the level of stress differed by frequency. The "high" group showed significantly low scores in the depression and work sub-scale and the total score of WSRI, emotional exhaustion, professional efficacy and total score of MBI-GS, and high scores in the total score of REQ. Similar tendencies were observed in the most of other indicators of psychosocial measures. Regarding the biological indicators, the "high" group showed the highest SDNN, RMSSD and TP measures of HRV and NK Cell activity and the low cortisol, although the statistical power did not reach the significant level. Our results suggest that the subjects who use forest environment frequently show favorable stress level both psychologically and biologically.

Ginseng Research in Natural Products Research Institute (NPRI) and the Pharmaceutical Industry Complex in Gaesong (생약연구소의 인삼연구와 약도개성)

  • Park, Ju-young
    • Journal of Ginseng Culture
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    • v.3
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    • pp.54-73
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    • 2021
  • The Natural Products Research Institute (NPRI, 生藥硏究所), an institution affiliated with Keijo Imperial University (京城帝國大學), was the predecessor of the NPRI at Seoul National University and a comprehensive research institute that focused on ginseng research during the Japanese colonial era. It was established under the leadership of Noriyuki Sugihara (杉原德行), a professor of the second lecture in pharmacology at the College of Medicine in Keijo Imperial University. Prof. Sugihara concentrated on studying Korean ginseng and herbal medicine beginning in 1926 when the second lecture of pharmacology was established. In addition to Prof. Sugihara, who majored in medicine and pharmacology, Kaku Tenmin (加來天民), an assistant professor who majored in pharmacy; Tsutomu Ishidoya (石戶谷勉), a lecturer who majored in agriculture and forestry; and about 36 researchers actively worked in the laboratory before the establishment of the NPRI in 1939. Among these personnel, approximately 14 Korean researchers had basic medical knowledge, derived mostly from specialized schools, such as medical, dental, and pharmaceutical institutions. As part of the initiative to explore the medicinal herbs of Joseon, the number of Korean researchers increased beginning in 1930. This increase started with Min Byung-Ki (閔丙祺) and Kim Ha-sik (金夏植). The second lecture of pharmacology presented various research results in areas covering medicinal plants in Joseon as well as pharmacological actions and component analyses of herbal medicines. It also conducted joint research with variousinstitutions. Meanwhile, in Gaesong (開城), the largest ginseng-producing area in Korea, the plan for the Pharmaceutical Industry Complex was established in 1935. This was a large-scale project aimed at generating profits through research on and the mass production of drugs and the reformation of the ginseng industry under collaboration among the Gaesong Ministry, Kwandong (關東) military forces, Keijo Imperial University, and private organizations. In 1936 and 1938, the Gyeonggi Provincial Medicinal Plant Research Institute (京畿道立 藥用植物硏究所) and the Herb Garden of Keijo Imperial University (京城帝國大學 藥草園) and Pharmaceutical Factory were established, respectively. These institutions merged to become Keijo Imperial University's NPRI, which wasthen overseen by Prof. Sugihara as director. Aside from conducting pharmacological research on ginseng, the NPRI devoted efforts to the development and sale of ginseng-based drugs, such as Sunryosam (鮮麗蔘), and the cultivation of ginseng. In 1941, the Jeju Urban Test Center (濟州島試驗場) was established, and an insecticide called Pancy (パンシ) was produced using Jeju-do medicinal herbs. However, even before research results were published in earnest, Japanese researchers, including Prof. Sugihara, hurriedly returned to Japan in 1945 because of the surrender of Japanese forces and the liberation of Korea. The NPRI was handed over to Seoul National University and led by Prof. Oh Jin-Sup (吳鎭燮), a former medical student at Keijo Imperial University. Scholars such as Woo Lin-Keun (禹麟根) and Seok Joo-Myung (石宙明) worked diligently to deal with the Korean pharmaceutical industry.

Evaluation of Indoor Radon Levels in a Hospital Underground Space and Internal Exposure (의료기관 지하시설의 라돈가스 측정과 내부피폭 조사)

  • Song, Jea-Ho;Jin, Gye-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.5
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    • pp.231-235
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    • 2011
  • Radium is rock or soil of crust or uranium of building materials and thorium after radioactivity collapse process are created colorless and odorless inert gas that accrue well in sealed space like mine or basement. It inflow to lung circulate respiratory organ and caused lung cancer because of deposition of lung or bronchial tubes. Radium sheath of medical institution treat person's life is possible big danger to professional regarding radioactivity who has much amount exposed radioactivity and weaker immune patient. so we do this test. Using measuring instrument at test is real time radium measuring instrument, Professional Continuous Radon monitor, and measuring places are basement first floor and second floor of two hospitals and measure from 10 a.m to 3 p.m. Measurement result of Professional Continuous Radon monitor is minimum 14.8 Bq/$m^3$ to maximum 70.3 Bq/$m^3$ and show domestic baseline below 148 Bq/$m^3$, effective dose-rate is minimum 0.296 mSv to maximum 1.406 mSv that show 2.4 mSv, 10~58.3% level, exposed radiation amount from nature radiation one year.

The Effects of Time-use on the Elderly for Facilities in Activity of Daily Living (시설 노인들의 시간 사용이 일상생활 수행능력에 미치는 영향)

  • Hong, Deok-Gi;Kang, Hyo-Suk;Seo, Min-Ji;Yang, Seung-i;Jeon, Byoung-Jin
    • The Journal of Korean society of community based occupational therapy
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    • v.1 no.2
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    • pp.11-20
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    • 2011
  • Objective : The purpose of this study was to investigate the effects of the activities of daily living on time-use of the Elderly in facility. This study is also to provide basic data of the redesign time management and lifestyle as occupational therapy. Methods : The subjects were 20 elderly people (over 65 years) who live in S institution of Daejeun from August 11th, to August 22th in 2008. We used time table, interview and FIM which was to evaluate the ability to collect the general characteristics of these subjects(gender, age, moving period, education). Results : There was no significant different between the general characteristics of the subjects and activity of daily living. The more they spent time in Active BADL and IADL, the more they got higher scores in ADL performance ability(p<0.01). The more they spent time in the more they got higher score in ADL performance ability(p<0.05). Conclusion : We could know the amount of spending time of the elderly in Daejeun area facility and it related to activity of daily living. To improve the efficiency of time-use of the elderly, it is needed the role of occupational therapists. They should prepare a intervention to maintain active and positive life of the elderly.

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The Survey Research on Pregnant Woman's recognition about GO-UN-MAM CARD of Childbirth Promotion Policy (출산장려정책 중 고운맘 카드에 대한 산모들의 인식 조사)

  • Kim, Han-Kyoul;Lim, Sung-Won;Lee, Ru-Ree;Park, Soo-Hyun;Go, Dun-Sol;Na, Ha-Neul;Lee, Kyung-Sook;Rhee, Hyun-Sill
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.241-250
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    • 2012
  • Low birth rate is a persisting national challenge that causes a decrease in productive population and an increase in encumbrances by ever rising insurance premiums, eventually threatening the existence of the country. This study investigated the effectiveness of the current government's undergoing economic support of the child-birth promotion policy, "go-un-mam card", and suggested improvement plans about the problems derived on the basis of the perceptions of the card users. Multi-response analysis was used to find out the preference of the policy, and chi-square test was conducted to discover the user satisfaction rate and intent of re-parturition. Also, descriptive analysis was performed to identify the degree of the policy recognition. The results illustrated that a significant association exists between the satisfaction rate and the intention of re-parturition. In addition, pregnant women gained information about the policy from governmental agencies and medical institution as well as by word of mouth; then, applied to the policy. Also, the card users only took an advantage of discounts in the hospitals within the supported monetary amounts. Moreover, the card users expressed their dissatisfaction at the monetary amounts. For instance, the users were dissatisfied with the limit on the amount to be used in a day and requested upgrade on the monetary amounts. Based on the result, the government will improve and develop the go-un-mam card for the ultimate purpose of policy, increasing birth-rate.

Clinical and Radiological Outcomes of Posterior Vertebral Column Resection for Severe Spinal Deformities

  • Lee, Byoung Hun;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Yongjung J.;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.251-257
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    • 2018
  • Objective : The aim of this study was to investigate clinical and radiological outcomes of patients who underwent posterior vertebral column resection (PVCR) by a single neurosurgeon in a single institution. Methods : Thirty-four consecutive patients with severe spinal deformities who underwent PVCR between 2010 and 2016 were enrolled. The radiographic measurements included a kyphotic angle of PVCR levels (VCR angle), sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis (LL), and spinopelvic parameters. The data of surgical time, estimated blood loss, duration of hospital stay, complications, intraoperative neurophysiologic monitoring, and the Scoliosis Research Society (SRS)-22 questionnaire were collected using a retrospective review of medical records. Results : The VCR angle, LL, and SVA values were significantly corrected after surgery. The VCR and LL angle were changed from the average of $38.4{\pm}32.1^{\circ}$ and $-22.1{\pm}39.1^{\circ}$ to $-1.7{\pm}29.4^{\circ}$ (p<0.001) and $-46.3{\pm}23.8^{\circ}$ (p=0.001), respectively. The SVA was significantly reduced from $103.6{\pm}88.5mm$ to $22.0{\pm}46.3mm$ (p=0.001). The clinical results using SRS-22 survey improved from $2.6{\pm}0.9$ to $3.4{\pm}0.8$ (p=0.033). There were no death and permanent neurological deficits after PVCR. However, complications occurred in 19 (55.9%) patients. Those patients experienced a total of 31 complications during- and after surgery. Sixteen reoperations were performed in twelve (35.3%) patients. The incidence of transient neurological deterioration was 5.9% (two out of 34 patients). Conclusion : Severe spinal deformities can be effectively corrected by PVCR. However, the PVCR technique should be utilized limitedly because surgery-related serious complications are relatively common.