• Title/Summary/Keyword: Medical safety

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A Study on the Dose Constraints for Occupational Exposure: Focusing on Expert Opinions by Field of Ridiation Industry (직무피폭의 선량제약치에 관한 연구: 분야별 전문가 의견 중심으로)

  • Il Park;Chan Hee Park;Kyu Hwan Jung;Chan Ho Park;Yong Geon Kim;Tae Jin Park
    • Journal of Radiation Industry
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    • v.17 no.1
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    • pp.61-67
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    • 2023
  • A Study on the Introduction of Dose Constraints for Occupational Exposures: Focusing on Experts' Opinions by Field of Radiation Industry. The International Commission on Radiological Protection suggests Justification, Optimization, and Dose Limits as the three principles of radiological protection, among which, as a means of protection optimization, ICRP 103 recommends to set dose constraints. In this study, opinions are collected from experts in each category of radiation industries for stakeholder participation to qualify dose constraints. A guidance and questionnaire for analyzing the dose constraints have been developed for their collection, and opinions were collected from radiation protection experts in selected categories. 20 out of 22 experts, consisted with 91%, have assessed the dose constraints setting is necessary, and 2 experts, consisted with 9%, assessed it is unnecessary. The average of dose constraint presented by experts for RI production institutions is to be the highest level of 15.3 mSv, and light-water reactors (14.6 mSv), non-destructive inspection (14.4 mSv), heavy-water reactor and medical institutes (13.9mSv) is to be above the overall average dose constraint. In case of public institutions, the average dose constraint is to be 8.6mSv, and research institutions (8.8mSv), educational institutions (9.6 mSv), waste disposal sites (9.7 mSv), and general industries (10.6 mSv) are resulted to below the overall average dose constraint. As for the means of setting dose constraints, 8 experts out of 22 suggested setting dose constraints for each specific industry or task. And, 5 experts especially suggest setting dose constraints for the specific groups with relatively high exposure, such as workers with above the record levels. As a countermeasure for workers who exceed the dose constraints, 15 experts out of 22 expressed that the cause analyses for them and preparation for a plan of reducing them are necessary.

Analysis of research trends on infants and school-age-child: Focusing on Journal of The Korean Society for School & Community Health Education from 2000 to 2023 (영·유아기 및 학령기 아동에 관한 연구동향 분석: 2000~2023년 한국학교·지역보건교육학회지 게재논문을 중심으로)

  • Hee-Jung Park;Minsung Sohn;Seok Hwan Kim
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.3
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    • pp.39-49
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    • 2024
  • Purpose: This study aims to analyze the current status of research related to infants and school-age-child published in the journal of Korean society for school & community health education from 2000 to 2023, with the goal of contributing to the future development and enhancement of the journal. Method: From 2000 to 2023, 52 papers were analyzed, comparing and classifying their journal topic, research types, data collection methods, and data analysis methods. Results: The results shows that the highest publication trend occurred between 2008 and 2012, with most studies focusing on school-age children. In terms of research topic, 'health behavior and health education' was the most frequent with 14 papers (26.9%), followed by oral health with 9 papers (17.3%), safety management with 7 papers (13.5%), and sexual awareness with 6 papers (11.5%). Quantitative research was the most common research type, with surveys being the primary data collection method. Descriptive statistics and t-test were the most frequently used data analysis methods. Conclusion: To enhance the quality of the journal of Korean society for school & community health education, there should be an expansion of evidence-based research focusing on infants and school-age children. Additionally, there is a need for greater diversity in research design, data collection, and analysis methods.

Prasugrel-based De-Escalation of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With STEMI

  • You-Jeong Ki;Bong Ki Lee;Kyung Woo Park;Jang-Whan Bae;Doyeon Hwang;Jeehoon Kang;Jung-Kyu Han;Han-Mo Yang;Hyun-Jae Kang;Bon-Kwon Koo;Dong-Bin Kim;In-Ho Chae;Keon-Woong Moon;Hyun Woong Park;Ki-Bum Won;Dong Woon Jeon;Kyoo-Rok Han;Si Wan Choi;Jae Kean Ryu;Myung Ho Jeong;Kwang Soo Cha;Hyo-Soo Kim;HOST-RP-ACS investigators
    • Korean Circulation Journal
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    • v.52 no.4
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    • pp.304-319
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    • 2022
  • Background and Objectives: De-escalation of dual-antiplatelet therapy through dose reduction of prasugrel improved net adverse clinical events (NACEs) after acute coronary syndrome (ACS), mainly through the reduction of bleeding without an increase in ischemic outcomes. Whether the benefits of de-escalation are sustained in highly thrombotic conditions such as ST-elevation myocardial infarction (STEMI) is unknown. We aimed to assess the efficacy and safety of de-escalation therapy in patients with STEMI or non-ST-segment elevation ACS (NSTE-ACS). Methods: This is a pre-specified subgroup analysis of the HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomized to prasugrel de-escalation (5 mg daily) or conventional dose (10 mg daily) at 1-month post-percutaneous coronary intervention. The primary endpoint was a NACE, defined as a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, clinically driven revascularization, stroke, and bleeding events of grade ≥2 Bleeding Academic Research Consortium (BARC) criteria at 1 year. Results: Among 2,338 patients included in the randomization, 326 patients were diagnosed with STEMI. In patients with NSTE-ACS, the risk of the primary endpoint was significantly reduced with de-escalation (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.48-0.89; p=0.006 for de-escalation vs. conventional), mainly driven by a reduced bleeding. However, in those with STEMI, there was no difference in the occurrence of the primary outcome (HR, 1.04; 95% CI, 0.48-2.26; p=0.915; p for interaction=0.271). Conclusions: Prasugrel dose de-escalation reduced the rate of NACE and bleeding, without increasing the rate of ischemic events in NSTE-ACS patients but not in STEMI patients.

Modified application of SAMe-TT2R2 scoring system in Asian patients with atrial fibrillation for the selection of oral anticoagulants

  • Seong Won Jeon;Nuri Lee;Ki Hong Lee;Minjeong Ha;Changhyun Kim;Yoo Ri Kim;Nam Sik Yoon;Hyung Wook Park
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.458-468
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    • 2024
  • Background/Aims: The SAMe-TT2R2 score is used for assessing anticoagulation control (AC) quality with warfarin. However, it is hard to apply SAMe-TT2R2 score in Asian patients with atrial fibrillation (AF), because it has not been proven in those populations. This study aimed to validate the SAMe-TT2R2 score in Asian patients with AF and suggest a modified SAMe-TT2R2 score for this population. Methods: We analyzed 710 Korean patients with AF who were using warfarin. The AC quality was assessed as the mean time in therapeutic range (TTR). Each component of SAMe-TT2R2 score was evaluated for the relationship with AC. Further clinical factors that predict AC were analyzed. Identified factors were re-assorted and constructed as SA2Me-TTR scoring system. Results: Of the components of the SAMe-TT2R2 score, female, age, and rhythm control were associated with AC. Heart failure and renal insufficiency were newly identified factors associated with AC. The modified SA2Me-TTR score was reconstructed with the relevant risk factors (S, female gender, 1 point; A, age < 60 yr, 2 points; Me, medical history of heart failure, 1 point; T, treatment for rhythm control, 1 point; T, history of stroke or transient ischemic attack, 1 point; R, renal insufficiency, 1 point). The modified SA2Me-TTR score demonstrated an excellent relationship with the grading of AC. The modified SA2Me-TTR score ≤ 1 identified patients with good AC (hazard ratio 2.46, 95% CI 1.75-3.47). Conclusions: The modified SA2Me-TTR score was useful for guiding oral anticoagulants selection in Asian patients with AF.

The Association of Blood Concentrations of Healvy Metals and Blood Pressure in Residents Living Near Janghang Copper Smelter in Korea (제련소 주변 지역 주민들의 혈중 중금속 농도와 혈압과의 관련성)

  • Eom, Sang-Yong;Yim, Dong-Hyuk;Moon, Sun-In;Ochirpurev, Bolormaa;Choi, Young-Sook;Park, Choong-Hee;Kim, Guen-Bae;Yu, Seung-Do;Choi, Byung-Sun;Park, Jung-Duck;Kim, Yong-Dae;Kim, Heon
    • Journal of agricultural medicine and community health
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    • v.42 no.1
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    • pp.13-23
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    • 2017
  • Objectives: This study was conducted to evaluate a relationship between the blood concentrations of toxic metals and the blood pressure in people living near the copper smelter. Methods: The study included 570 adults living within 4km of the smelter. We compared systolic and diastolic blood pressure between tertiary groups for blood cadmium, mercury and lead levels, respectively. Multiple regression analysis was performed to identify risk factors affecting systolic and diastolic blood pressures. Results: In male subjects, there is a significant difference in the mean of systolic and diastolic blood pressure between tertiary groups of blood cadmium and mercury levels, but in women, there was no significant difference in the mean systolic and diastolic blood pressures in all tertiary groups of heavy metals. The results of multiple regression analysis showed that age, BMI, and cadmium concentration in men were risk factors for blood pressure. In women, age and BMI, drinking and smoking, and blood mercury were significantly influenced to blood pressure. Conclusions: Residents living near the Janghang smelter showed high concentrations of blood lead and cadmium, suggesting that they were exposed to high concentrations of heavy metals released from the smelter in the past. Such exposure may have caused some blood pressure increase. Especially, the concentration of cadmium in the case of men and the concentration of mercury in blood in the case of women were found to be significantly related to the increase of blood pressure. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize cardiovascular disease, and to pay close attention to any health problems possibly related to toxic metal exposure.

Simultaneous Determination of Non-steroidal Anti-inflammatory Drugs and Corticosteroids Added to Foods as Adulterants using LC-ESI-tandem Mass Spectrometry (LC/ESI-MS/MS를 이용한 식품 중 불법적으로 첨가된 비스테로이드성 소염진통제 및 스테로이드 의약품 동시분석)

  • Lee, Yongcheol;Park, Ju-Sung;Kim, Sung-Dan;Yang, Hye-Ran;Kim, Eun-Hee;Yi, Yun-Jung;Cho, Sung-Ja;Jo, Han-Bin;Kim, Jung-Hun;Chae, Young-Zoo
    • Journal of Food Hygiene and Safety
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    • v.28 no.3
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    • pp.247-251
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    • 2013
  • The objective of present study was to develop a simultaneous determination method of 5 medical compounds, including beclomethasone, dexamethasone, prednisolone, ketoprofen, phenylbutazone in foods, using LC-MS/MS. To optimize MS analytical condition of 5 compounds, each parameter was established by MRM mode. The chromatographic separation was achieved on a C18 column successfully, with a mobile phase made up of A (0.1% formic acid) and B (0.1% formic acid in acetonitrile), at a flow rate of 0.3 mL/min for 17 min with a gradient elution. LOD and LOQ of 5 compounds were in the range of 0.40~4.60 ng/mL and 0.81~11.46 ng/mL, respectively. As a result of analyzing the three concentrations of the standard mixture added to blank samples, the results showed that the mean recovery rate of 5 compounds was in the range of 81.52~103.83%, and RSD (%) of Intra- and Inter-day assay were 0.52-10.45. Since relatively fine selectivity, accuracy and reproducibility were shown in this qualified experimental method, it could be utilized efficiently to investigating those 5 compounds to see if it is added to food products illegally.

Clinical and Bacteriologic Efficacy of Cefprozil on Pharyngitis and Pharyngotonsilitis caused by Group A Beta Hemolytic Streptococci in Children (Group A-beta Hemolytic Streptococci에 의한 소아 인두편도염에 있어서 Cefprozil의 항균력과 임상적 및 세균학적 효과에 관한 연구)

  • Kim, Min-Woo;Ahn, Young-Min;Jang, Seong-Hee;Ma, Sang-Hyuk;Ahn, Byung-Moon;Kim, Jong-Duk;Lee, Jong-Kook;Kim, Mi-Lan;Chang, Jin-Kun;Park, Jin-Young;Bae, Jong-Woo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.206-212
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    • 2001
  • Objective : To determine the clinical and bacteriologic efficacy and safety of Cefprozil in acute pharyngitis and pharyngotonsilitis caused by Group A beta hemolytic streptococci in pediatric patients. Methods : Any patient of 3 to 14 age who visited the hospitals enrolled in this study with the signs and symptoms of pharyngitis or pharyngotonsilitis since July, 2000 to March, 2001, was taken throat culture and given Cefprozil(15 mg/kg/day, in two divided doses) for 10 days. 138 patients of whom showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Any undesirable effect was reported to determine the safety of the drug. Follow up cultures were done at the end of the study and bacteriologic efficacy was determined. Results : 138 of 256 patients who visited the hospitals with the signs and symptoms of pharyngitis or pharyngotonsilitis showed positive growth on throat culture. Mean age of the patients was $6.1{\pm}2.5$ and males and females were equally numbered. 129 of them complained fever on the first visit and 112(86.6%) of them were improved at the end of the study. Cervical lymphadenitis was seen in 58 patients and 44(75.9%) of them improved at the end of the study. Exudative pharyngitis was seen in 96 patients and 81(84.3%) of them improved. The overall clinical effcacy based on this results showed that 110(79.7%) of the patients were cured and 17(12.3%) of them improved. On the cultures and bacteriologic efficacy, 24.6% of them showed documented eradication after treatment and 62.3% of them showed presumptive eradication. Sensitivity test was done by agar dilution method and Cefprozil showed 100% sensitivity. Erythromycin, Clarithromycin and azithromycin showed 87%, 85.6 %, 90.6% sensitivity, respectively. Conclusion : Cefprozil is proved to be effective in controlling group A streptococcal pharyngitis and pharyngotonsilitis in children and showed good sensitivity. Cefprozil can be used as an effective oral cephalosporin in the patients showing penicillin hypersensitivity or patients who other drugs have failed.

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Detection and Measurement of Nuclear Medicine Workers' Internal Radioactive Contamination (핵의학과 종사자의 방사성동위원소 체내오염 측정)

  • Jeong, Gyu-Hwan;Kim, Yong-Jae;Jang, Jeong-Chan;Lee, Jai-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.123-131
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    • 2009
  • Purpose: We tested a sample of nuclear medicine workers at Korean healthcare institutions for internal contamination with radioactive isotopes, measuring concentrations and evaluating doses of individual exposure. Materials and Methods: The detection and measurement was performed on urine samples collected from 25 nuclear medicine workers at three large hospitals located in Seoul. Urine samples were collected once a week, 100~200 mL samples were gathered up to 6~10 times weekly. A high-purity germanium detector was used to measure gamma radiations in urine samples for the presence of radioactive isotopes. Based on the detection results, we estimated the amounts of intake and committed effective doses using IMBA software. In cases where committed effective doses could not be adequately evaluated with IMBA software, we estimated individual committed effective doses for radionuclides with a very short half life such as $^{99m}Tc$ and $^{123}I$, using the methods recommended by International Atomic Energy Agency. Results: Radionuclides detected through the analysis of urine samples included $^{99m}Tc$, $^{123}I$, $^{131}I$ and $^{201}Tl$, as well as $^{18}F$, a nuclide used in Positron Emission Tomography examinations. The committed effective doses, calculated based on the radionuclide concentrations in urine samples, ranged from 0 to 5 mSv, but were, in the majority of cases, less than 1 mSv. The committed effective dose exceeded 1 mSv in three of the samples, and all three were workers directly handling radioactive sources. No nurses were found to have a committed effective dose in excess of 1 mSv. Conclusions: To improve the accuracy of results, it may be necessary to conduct a long-term study, performed over a time span wide enough to allow the clear determination of the influence of seasonal factors. A larger sample should also help increase the reliability of results. However, as most Korean nuclear medicine workers are currently not necessary to monitored routinely for internal contamination with radionuclides. Notwithstanding, a continuous effort is recommended to reduce any unnecessary exposure to radioactive substances, even if in inconsequential amounts, by regularly surveying workplace environments and frequently monitoring atmospheric concentrations of radionuclides.

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Monitoring of Antimicrobial Resistant Bacteria from Animal Farm Environments in Korea (국내 축산 환경 중의 항생제 내성균 모니터링에 관한 연구)

  • Kwon, Young-Il;Kim, Tae-Woon;Kim, Hae-Yeong;Chang, Yun-Hee;Kwak, Hyo-Sun;Woo, Gun-Jo;Chung, Yun-Hee
    • Microbiology and Biotechnology Letters
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    • v.35 no.1
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    • pp.17-25
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    • 2007
  • The kinds and quantity of antimicrobial agents used for cattle (animal industry) may be considerable, suggesting the possibility that pathogenic bacteria which cannot be extirpated by the existing antimicrobial agents could appear. Ten cattle, pig and chicken farms, respectively, were randomly selected from 5 provinces in Korea and the samples were collected from excrement, manure, underground water, farmers' hands and the neishboring environment. h total of 299 samples were examined and 197 of Escherichia coli, 13 of Campylobacter jejun/coli, 223 of Enterococcus faecium/faecalis and 42 of Staphylococcus aureus isolates were collected. All isolates were screened for antimicrobial resistance: 69.4% of E. coli (137/197 strains), 78.6% of S. aureus (33/42 strains), and 82.1% of E. faecium/faecalis (183/223 strains) were resistant to one antimicrobial agent and all of C. jejuni/coli Isolates showed the resistance to one antimicrobial agent. Meanwhile, the multiple resistance ratio for more than 4 lines of antimicrobial agent was 19.2% of E. coli (38/197 strains), 11.9% of S. aureus (5/42 strains), 15.4% of C. jejuni/coli (2/13 strains) and 6.2% of E. faecium/faecalis (14/223 strains). The antimicrobial resistance ratio of bacteria isolated from the cattle farm showed lower than that of bacteria isolated from the pig or chicken farm, which might be related to the quantify of antimicrobial agents consumed. And one strain of vancomycin resistant E..faecium (VREF) were isolated from the excrement of chicken and stream, respectively. Generally, the ratio of VREF collected in animal farm environments is lower than that of VREF collected in medical environment.

The influence of wearing helmet and cervical spine injury in skiers and snowboarders (스키와 스노우 보드에서 헬멧의 착용이 경추부 손상에 미치는 영향)

  • Kim, Sung Hun;Kim, Tae Kyun;Chun, Keun Churl;Hwang, Jae Sun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.94-99
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    • 2011
  • Purpose: As the number of people enjoying skiing and snowboarding which are two popular winter sports has been increasing, wearing helmet during doing these sports has been needed for safety. The rates of head or face injury have decreased after using helmet. However the effect that wearing helmet has on cervical damage is not yet to be known. So through this research we intend to be helpful in developing effective program and safety equipment. Materials and Methods: During two seasons from December 2009 to march 2011, cased 658 cervical injuries within 14538 admittance in medical center of major resort due to skiing and snow-boarding injuries. For survey and research model, one year before the research year conducted a pilot study. Admittance were 432 male and 226 female, advanced 273 and 385 novice. We divided them into two groups depending on wearing helmet, measured cervical damage ratio and injury mechanism, and researched the severity of damage and diagnosed injury. Each group used SPSS 12.0 (SPSS Inc., Chicago, IL, USA) to process data statistically. Results: The number of patients was 312 in skier and 346 in snow boarder. Patients wearing helmet were 146 in skier and 127 in snow boarder. Classification of each injuries were confirmed as 292 cases of simple sprain, 359 bruising, 6 cervical fractures and 1 case of dislocation. Classification of injury mechanisms were 287 of human collision, 212 material collision, 108 of slip down by oneself, 39 of falling and 12 cases of etc. In cases wearing helmet ski 78/ snow board 70 were simple sprain, ski 64/ snowboard 68 were shown as bruising, ski 1/ snow board 2 had cervical fracture or dislocation. The ratio of cervical sprain increased in cases of wearing helmet compared to non-wearing cases and there was a statistical significance (p<0.001). The ratio of cervical contusion increased significantly in non-wearing helmet user (p<0.05). However, there was no significant increase in fracture and dislocation compared between helmet user and non-user (p> 0.05). Conclusion: In this study, wearing helmet had no relation to additional cervical injury occurrence or severity among skiers and snow boarders. The ratio of cervical sprain increased significantly in helmet user with person to person accident. However, the cervical contusion decreased. On this ground, further biomechanical studies are required and modified helmet will be necessary.

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