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A Study of Institutional Status of Risk Management for Radiotherapy in Foreign Country

  • Lee, Soon Sung;Shin, Dong Oh;Ji, Young Hoon;Kim, Dong Wook;An, Sohyoun;Park, Dong-Wook;Cho, Gyu Suk;Kim, Kum-Bae;Koo, Jihye;Oh, Yoon-Jin;Choi, Sang Hyoun
    • Progress in Medical Physics
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    • v.27 no.3
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    • pp.139-145
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    • 2016
  • With the development in field of industry and medicine, new machines and techniques are being launched. Moreover, the complexity of the techniques is associated to an increasing risk of incident. Especially, a small error in radiotherapy can lead to a serious patient-related incident, risk management is necessary in radiotherapy in order to reduce the risk of incident. However, in field of radiotherapy, there are no legally binding clauses for risk management and there is an absence of risk management systems at an institutional level. Therefore, we analyzed institutional status of risk management, reporting & classification systems, and risk assessment & analysis in 31 countries. For risk management and reporting systems, 65% of countries investigated had legislation or regulations; however, only 35% of countries used classification systems. It was found that 43% more countries had legislation for risk management in healthcare than those for radiotherapy; 19% more countries had reporting systems for healthcare than those for radiotherapy. For classification systems, 60% more countries had legislation, recommendation, and guidelines in the field of radiotherapy than those for healthcare. Recently, international institutes have published several reports for risk management and patient safety in radiotherapy, owing to which, countries adopting risk management for radiotherapy will gradually increase. Before adopting risk management in Korea, we should precisely understand the procedures and functions of risk management, in order to increase efficiency of risk management because classification & reporting system and risk assessment & analysis are connected organically, and institutional management is needed for high quality of risk management in Korea.

Analysis of Food Intake and Physical Activity in Randomized Controlled Trials on Herbal Medicine for Treatment of Human Obesity (비만 치료 한약 무작위 대조 임상시험에서의 음식 섭취량과 운동량 실태분석)

  • Kim, Doo-Hee;Shin, Woo-Suk;Park, Won-Hyung;Cha, Yun-Yeop;Song, Yun-Kyung;Ahn, Min-Youn;Ko, Seong-Gyu
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.2
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    • pp.58-65
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    • 2013
  • Objectives: The objective of this study was to analyse the methods being used to control food intake and physical activity in RCTs of human obesity. Methods: A total of 21 randomized controlled trials (RCTs) were investigated. Nine of which were domestic studies from "http://oasis.kiom.re.kr" and the other of which were foreign studies from systematic reviews of RCTs on herbal medicine for treatment of human obesity. Results: According to domestic studies, "low calorie diet" were recommended in five cases of the domestic studies, "maintain current dietary habit" were recommended in two and no information on diet was two. Considering the seven cases where the information on diet was available, patients' food intake were checked at every visit in six cases. Only two cases among the six had been dropped owing to the violation of dietary habit by patients. Exercises were prohibited in two cases, "maintain current level of phisical activity" were recommended in three cases and, from the rest, no information was available. The level of physical activity were not strictly controlled by any means hence no drop out. According to foreign studies, "low calorie diet" were recommended in two cases, "very low calorie diet (less than 700 kcal/day)" in one case, "maintain current dietary habit" in two cases, "do not eat fat" in two cases and no information was available in the rest five cases. Exercises which concerns spending about 300 kcal/day was recommended in one case, "moderate exercise" were recommended in three cases, "maintain current level of physical activity" were recommended in three cases and no information available in the rest five cases. Conclusions: In order to improve the accuracy of RCT, for the dietary side, researchers should record patient food intake at every visit by means of 24-hour dietary recall methods. This can be supplemented by multiple choice survey that are designed to help patients to diagnose themselves more accurately leading to less bias. For the exercise side, it is highly recommended to confine the exercises to walking only so as to quantify the amount of physical activity more easily by using pedometer.

Long-term Effects on the Cervical Spine after Anterior Locking Plate Fixation (경추 전방 잠금식 금속판이 장기적으로 경추에 미치는 영향)

  • Kim, Keun Su
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.493-500
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    • 2001
  • Objective : Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. Method : Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. Results : There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. Conclusion : The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.

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Clinical Usefulness of Titanium Mesh in Reconstruction of the Craniofacial Bone Defects (두개안면골 결손부 재건에 있어서 티타늄 그물판의 임상적 유용성)

  • Seo, Yeong Min;Jeong, Seung Moon
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.688-694
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    • 2006
  • Purpose: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load-bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. Methods: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from $1.0{\times}1.5cm$ to $12{\times}10cm$. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. Results: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. Conclusion: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.

A Literature Review of Management on Radiodermatitis (방사선 피부염 치료법에 대한 문헌고찰)

  • Kwon, Mi Hye;Yoon, Jee-Hyun;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.25 no.1
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    • pp.11-24
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    • 2020
  • Objective : Radiodermatitis is a common sequelae in 95% of patients receiving radiation therapy, which is important to be well managed as it can affect the patient's quality of life as well as the cancer treatment schedule. The aim of this study is to review and summarize the interventions available for the treatment of acute radiodermatitis, including traditional Korean medicine, and to propose treatment algorithms for clinicians. Methods : To collect studies about managements for radiodermatitis, domestic and foreign database were used such as Korean journal of traditional knowledge portal (KTKP), Korean studies information service system (KISS), national discovery or science leaders (NDSL), and oriental medicine advance searching integrated system (OASIS), Pubmed, Google scholar and Scopus. Results : Thirty-two studies were selected. There were nine studies on usual care and dressing, eleven studies on chemical agents, two studies on biological preparations, and ten studies on herbal medicines. Conclusion : Hygienic options and dressings have proved to be useful in the management of radiodermatitis. Chemical agents such as corticosteroid, statin, and topical antibiotic agent have proved to alleviate symptoms and severity, regenerate damaged skin, and prevent secondary infection. In biological preparations, EGF (epidermal growth factor) and GM-CSF (granulocyte-macrophage colony-stimulating factor) could be used to protect skin and prevent radiodermatitis. For herbal medicines, Calendula, catechin, β-sitosterol, and Jaungo (紫雲膏) may be effective for symptoms including pain, itching, and burning sensation induced by radiation therapy. Because of some research with conflicting results, further studies are needed to propose an algorithm for more optimal treatments.

Convergence Study of Nursing Simulation Training for Patient with Schizophrenia: A Systematic Review (조현병 환자 간호 시뮬레이션 교육에 관한 융합연구 : 체계적 문헌고찰)

  • Kim, Sun-Kyung;Eom, Mi-Ran;Kim, Oe-Nam
    • Journal of Industrial Convergence
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    • v.17 no.2
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    • pp.45-52
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    • 2019
  • A systematic review was conducted to identify components and convergent effects of simulation program using schizophrenia scenario in nursing education. Using 4 different databases, 226 articles were identified and 11 studies met the inclusion criteria. There were 5 qualitative studies, 5 quantitative studies and 1 study used mixed method design. The simulation incorporated various methods including standardized patients, role playing, simulator and virtual reality that majority studies(63.6%) used standardized patients. For the evaluation, studies examined diverse variables including knowledge, learning self competency, learning satisfaction and self directed learning. Considering complexity and difficulty of nursing for schizophrenia, future studies with well designed simulation program are required to prove its effectiveness.

The Effect of Group Treatment Based on Occupational Therapy for Children : A Systematic Review (아동 그룹 작업치료의 효과 : 체계적 고찰)

  • Lee, Ga-Young;Lee, Ji-Ho;Kim, Bo-Ram;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.14 no.2
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    • pp.33-45
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    • 2016
  • Objective : The purpose of this article is to study the effectiveness of a group occupational therapy for children via systematic review, and to provide clinical evidences. Methods : The systematic review initially included articles in Pubmed, Ovid, RISS, KISS, and DBpia, published until 2014. Total 14 articles have been chosen, using different keyword of each domestic/foreign studies. Selected articles were divided depending on the level of evidence, and eventually been organized into group PICO (Patient, Intervention, Comparison, Outcome). Results : The results indicated that there are more diagnosed children than normal in participants and especially children with sensory integration disorder (28.6%) appeared to be the most common. In intervention, group sensory integrative intervention had the largest frequency, and instruments measuring social skills were used most for analyzing the intervention results. The effectiveness of interventions showing statistically significant results were 40.7% of Total. Conclusion : Group occupational therapy for children should be provided to various diagnosis with widely better quality of interventions providing the enough support for the evidence level.

The Trend of Overseas Studies on the Intervention of Multisensory Environment: Systemic Review (다감각환경중재에 관한 국외 연구의 경향: 체계적 고찰)

  • Cho, Eun-Hee;Song, Hyun-Eun;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.54-64
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    • 2019
  • Objective : The purpose of this study is to study the effects of multisensory environment interventions, to provide information about clinical applications, and to aid South Korean research on the multisensory environment. Methods : PubMed, Cochrane, and Google Scholar were used to search for papers published from 2008 to 2018. The main search terms were "multisensory environment" and "snoezelen", a total of 10 foreign research articles were selected. And they were summarized according to Patient, Intervention, Comparison, Outcome (PICO). Results : Among the 10 papers, 6 included participants with dementia. The other studies examined patients with intellectual disabilities, patients with schizophrenia, and pregnant women. The study periods ranged from 3 weeks to 10 months. Most of the interventions included 2 or 3 sessions per week. The duration of each intervention session was 30 to 60 minutes. The dependent variables were psychological factors (such as anxiety and depression), social factors (such as quality of life), and cognitive and physical domains. The multisensory environment used for the interventions in the studies consisted of visual, auditory, and tactile senses, as well as additional olfactory and taste sensations, and vestibular sensations. Conclusion : In the future, the research should be applied to various target groups, especially children, who are interested in multisensory environmental intervention in South Korea.

The study of Sports Injuries treatment with Korean Medicine : A survey of World Martial Arts Masterships' athletes and officials

  • Lee, Jaesung;Park, Jonghan;Park, Jangmi;Lee, Chamkyul;Jeong, Suhyeon;Kong, Kyunghwan;Lee, Eunyong
    • The Journal of Korean Medicine
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    • v.40 no.4
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    • pp.41-48
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    • 2019
  • Objectives: The objective of this study was to report the general characteristics, satisfaction, and changes before and after treatment to foreign athletes and officials who were received Korean Medicine at the 2019 Chungju World Martial Arts Masterships Korean Medical Clinic. Methods: We investigated age, gender, nationality, type of sports, and, onset through medical records. Besides, we developed the patient satisfaction survey to determine how satisfied the patients were with the treatment they received. The survey included type of injury, location of the injury, cause of injury, Numeric Rating Scale (NRS) before and after treatment, and treatment satisfaction. Result: This study showed that knee and lower leg injuries (S80-S89) were the most frequent injuries in the Korean Medicine(KM) clinic of the 2019 Chungju World Martial Arts Masterships. We provided KM treatments including acupuncture, cupping therapy, Chuna manual therapy, herbal medicine, dressing, and taping. Acupuncture was the most frequently performed and the most satisfactory treatment. The average NRS after treatment significantly decreased, suggesting that KM is effective in controlling pain in sports injuries. The overall satisfaction was also high with KM treatments.

Usefulness of Gold Thread Implantation for Crow's Feet

  • Shin, Kee-Cheol;Bae, Tae-Hui;Kim, Woo-Seob;Kim, Han-Koo
    • Archives of Plastic Surgery
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    • v.39 no.1
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    • pp.42-45
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    • 2012
  • Background : Conservative techniques designed to block or delay the aging process have been utilized in various ways for many years. However, their effects can be relatively minimal and short-term in most cases compared to surgery. The objective of this study was to evaluate the efficacy and safety of gold thread implantation for the treatment of periorbital wrinkles. Methods : A total of 78 consecutive patients who showed mild to severe periorbital wrinkles were deemed appropriate candidates, including 69 women and 9 men ranging from 31 to 59 years (mean, 47 years). Six gold threads about 4 cm in length were inserted subdermally in each patient at intervals of about 0.5 cm. Follow-up assessments were performed 1, 4, and 12 weeks after the procedure. The efficacy was rated by the physician using the Wrinkle Severity Rating Scale and patients who made global assessments of changes in periorbital wrinkles using the Visual Analog Scale. Adverse events were monitored throughout the course of the study. Results : The patients showed significant improvements after the procedure. There were minor complications such as foreign body sensation in the eye (2.63%) and eye pain (1.32%) that improved spontaneously without any specific treatments. Conclusions : Subdermal implantation of gold thread improves the appearance of periorbital wrinkles and does not appear to have serious side effects. Insertion of gold thread may be an effective and safe method for facial rejuvenation.