• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.136-144
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• 2012

Background: Fresh frozen plasma (FFP) transfusion is administered primarily for management of acquired bleeding disorders. However, in practice, FFP transfusion is increasing without a solid rationale. Methods: We conducted an audit to evaluate the appropriateness of the indications for FFP transfusion during the period from July 2010 through June 2011. Assessment of the appropriateness of the indications was based on the national transfusion guidelines and the transfusion criteria promulgated by the Severance Hospital. Results: In total, 17,733 units of plasma were transfused to 1,949 patients over 4,982 events. We found that administration of FFP was not in compliance with the recommended guidelines in 1,990 events. The number of total FFP transfusions was higher in medical departments (Gastroenterology) than in surgical departments (Thoracic and cardiovascular surgery, General surgery). However, the proportion of cases of inappropriate transfusion was higher in surgical departments than in medical departments. Both the total number of FFP transfusion and the proportion of inappropriate transfusion were high in patient with neoplasm, disease of the digestive system, and diseases of the circulatory system. Conclusion: Continuous monitoring on appropriateness for FFP transfusion and feedback to the physician are critical in securing the transfusion safety as well as maintaining the quality of FFP transfusion. New-found indication for FFP transfusion should be investigated and applied in timely manner.

• Progress in Medical Physics
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• v.35 no.1
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• pp.16-19
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• 2024

A new E_n score of the proficiency test (PT) is formulated; it is applicable when a correlation exists between the reference and participant's values. Based on the uncertainty propagation rule given in ISO/IEC Guide 98-3 (GUM:1995), the E_n score covering the correlation case is newly developed for the PT. The new E_n score will be applied in a future PT organized by the Korea Research Institute of Standards and Science (KRISS) dosimetry team. The new E_n score will enhance measurement traceability and contribute to improving the quality management system of participants in the KRISS PT by avoiding performance underestimation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.8
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• pp.5009-5022
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• 2014

The purpose of this study was to obtain the serum lipid levels according to the lifestyles, and examine the influence of lifestyles on the serum lipid levels among adults who examined the health checkup in an university hospital. The subjects for this study were 4,112 adults who underwent medical examinations at the health center of a university hospital in Daejeon city from Jan 2012 to Dec 2013. The lifestyles and serum lipid levels of study subjects were obtained from self-recorded questionnaires and medical examination charts of the hospital. As a result, the mean values of the serum lipid levels (TC, HDL-C. LDL-C and TG) and atherogenic index (AI) of the study subjects showed a significantly difference according to the lifestyle, such as age, alcohol consumption, smoking, regular exercise, overeating and meat consumption in both sexes. The TC, HDL-C. LDL-C, TG and AI showed a positive correlation with age, AUDIT score, but the HPI score showed a negative correlation in both sexes. In the age-adjusted odds ratio, the risk ratio of an abnormality of TC, HDL-C. LDL-C, TG and AI increased significantly because there was an increase in the group of everyday overeating and meat consumption, smoking group, no exercise group, and low HPI group than their respective counterparts in both sexes. The above results suggested that the serum lipid levels of the subjects was closely related to increasing age, and lifestyles, such as alcohol consumption, smoking, regular exercise, overeating, and meat consumption.

• Progress in Medical Physics
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• v.24 no.4
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• pp.315-322
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• 2013

The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.19-22
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• 2002

The importance of accurate dose delivery in radiotherapy is well documented. Studies have shown that a mere 5% deviation of the prescribed dose can produce an undesirable treatment outcome. Uncertainties in the dose delivery can arise at different stages of the radiotherapy process. Therefore, a good quality assurance programme will ensure the best possible results and consistency of the radiotherapeutic treatment. Quality assurance in any radiotherapy department involves the responsibility of a multi-disciplinary team of radiation oncologists, medical physicists and radiation technologists. This paper will focus on the physical and technical aspects of QA. The organizational structure and responsibility of the physics QA team is outlined and also included the types and frequencies of QA checks. For a QA program to be effective, action levels should be clearly defined and understood by all staff concerned. Data of the Singapore National Cancer Centre's participation over the last ten years with the IAEA / WHO Postal TLD Dose Inter-comparison programme is presented. The data obtained were within the international criteria. For a QA program to be successfully implemented, there must be a commitment by management to provide adequate staff, test equipment, machine time as well as continual training and education. This is in addition to the positive attitudes of all the staff. A quality audit is also necessary to serve as a check and balance to ensure that the QA is in order.

• Korea Journal of Hospital Management
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• v.21 no.4
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• pp.45-54
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• 2016

The purpose of this study is to identify patient and hospital characteristics with pulmonary tuberculosis and to analyze factors which were influencing length of stay and treatment. The Korean National Hospital Discharge In-depth Injury Survey database from 2006 to 2012 was used for analysis. Study subjects were 4,704 patients and analyzed by using frequency, chi-square and logistic regression through using STATA 12.0. To avoid selection bias, we used propensity score matching. Analysis results show that the length of stay and treatment of pulmonary tuberculosis was different between insurance types. Patients characteristic(female, comorbidity, admission by outpatient department, medical insurance type) and hospital characteristic(500-999 beds, over 1000 beds) significantly influence length of stay. Admission by outpatient department and over 1000 beds are significantly influence treatment. Based on these findings, it is necessary to clarify between length of stay and treatment outcome by medical aids beneficiaries and audit hospitals follow discharge guidelines in pulmonary tuberculosis patients.

• Korean Circulation Journal
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• v.53 no.9
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3911-3916
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• 2016

Background: Triple negative (TN) and triple positive (TP) breast cancers both are aggressive types but TN generally has a shorter survival. Objectives: To compare the clinical characteristics and treatment outcomes for patients with TN versus TP breast cancer and to assess various prognostic factors affecting overall survival. Materials and Methods: A retrospective audit of 85 breast cancer patients was conducted in the Department of Radiation Oncology and Medical Oncology on patients from 2006 to 2013 for whom IHC for ER, PgR and Her-2 neu were available. The patients were stratified into: ER-, PR- and Her-2 neu- (Arm A, n=47) and ER+, PgR+ and Her-2 neu+ (Arm B, n=38). Results: TN subtype had higher numbers of premenopausal and advanced stage patients as compared to TP subtype. The locoregional recurrence (LRR) and distant metastatic rate was also higher in TN subtype but there was no definite pattern in both the arms. Among the prognostic factors, patients with premenopausal status and advanced stage in TN breast cancer had inferior survival (P=0.07) whereas for those with postmenopausal status and early stage there was no survival difference between the two arms. Conclusions: TN subtype tends to be more aggressive in terms of younger age and advanced stage at presentation, higher tumour grade, LRR and metastasis, suggesting need for future research efforts on providing aggressive treatment to these patients. We could attribute better outcome for TP subtype to receptor positivity enabling role of hormonal treatment and targeted therapy, although less number of patients received targeted therapy.

• Anxiety and mood
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• v.9 no.2
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• pp.121-127
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• 2013

Objective : Several studies have reported the association between posttraumatic stress disorder (PTSD) and hypertension (HTN). The aim of this study was to evaluate the impact of PTSD symptoms on blood pressure. Methods : Korean veterans of the Vietnam War with (n=62) or without PTSD (n=87) participated in this study. The clinician administered PTSD scale (CAPS) and alcohol use disorder identification test (AUDIT) were applied. Blood pressure, pulse rate, risk factors of HTN and demographic data of the subjects were collected. Effects of potential explanatory variables on HTN were analyzed with logistic regression. Results : Diastolic blood pressure was significantly higher in PTSD group (p=0.015). However, PTSD subjects showed significantly lower pulse rate than non-PTSD subjects (p=0.004). Logistic regression analysis showed that avoidance symptom might be a predictor for hypertension (OR=1.065, p=0.030). Conclusion : These results suggest that PTSD, especially avoidance symptom, might be a risk factor on HTN in the elderly with PTSD. Further studies are needed to evaluate the change of blood pressure according to the clinical improvement of PTSD.

• Journal of Preventive Medicine and Public Health
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• v.55 no.6
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.