No abstract available.
Publications

PURPOSE: This study identifies accident sequences from the past accidents in order to help the risk analysis application to the external radiotherapy. MATERIALS AND METHODS: This study reviews 59 accidental cases in two retrospective safety analyses that have collected the incidents in the external radiotherapy extensively. Two accident analysis reports that accumulated past incidents are investigated to identify accident sequences including initiating events, failure of safety measures, and consequences. This study classifies the accidents by the treatments stages and sources of errors for initiating events, types of failures in the safety measures, and types of undesirable consequences and the number of affected patients. Then, the accident sequences are grouped into several categories on the basis of similarity of progression. As a result, these cases can be categorized into 14 groups of accident sequence. RESULTS: The result indicates that risk analysis needs to pay attention to not only the planning stage, but also the calibration stage that is committed prior to the main treatment process. It also shows that human error is the largest contributor to initiating events as well as to the failure of safety measures. This study also illustrates an event tree analysis for an accident sequence initiated in the calibration. CONCLUSION: This study is expected to provide sights into the accident sequences for the prospective risk analysis through the review of experiences.
Calibration ; Humans ; Retrospective Studies ; Risk Assessment

As a result of heightened awareness that ophthalmologic examinations are essential for diagnosis and management of certain systemic diseases, the number of patients referred to the department of ophthalmology by other specialists have increased. This paper presents a statistical analysis of the in-patients referred from other departments for ophthalmologic evaluations at the Yonsei University Severance Hospital. Among the total 9.350 in-patients of Severance Hospital excluding the admissions to the department of ophthalmology during the six month period from November of 1970 to April of 1971, 200 patients (2.1%) were send for ophthalmologic consultations. They consisted of 127 (63.5%) males and 73(36.5%) females, and the incidence was high at the fifth decade (40 patients, 20%) followed by in order of frequency forth, sixth, third, and second decades. The patients were referred most frequently by internists (91 patients, 45.5%) followed by psychiatrists, obstetrician, and neurologists, etc. in that order. The underlying diseases necessitated the ophthalmologic consultations were diseases of cardiovascular system (43 patients, 21.5%), and of nervous system, trauma, and toxemias of pregnancies, etc. Seventy-nine patients demonstrated no specific findings in the eyes, and 59 of the remaining 121 patients had retinal changes. Diseases of the lids, conjunctivae, refraction, and the lens followed. There were 51 patients with hypertensive retinopathy among the 59 patients with retinal changes.
Cardiovascular System ; Conjunctiva ; Diagnosis ; Female ; Humans ; Hypertensive Retinopathy ; Incidence ; Male ; Nervous System ; Ophthalmology ; Pregnancy ; Psychiatry ; Referral and Consultation ; Retinaldehyde ; Specialization ; Toxemia

No abstract available.

No abstract available.
Lymphoma, B-Cell, Marginal Zone*

No abstract available.
Breast Neoplasms* ; Breast* ; Diagnosis*

No abstract available.
Telemedicine*

BACKGROUND: Medical emergency teams (METs) have shown their merit in preventing unexpected cardiac arrest. However, it might be impractical for small- or medium-sized hospitals to operate an MET due to limited manpower and resources. In this study, we sought to evaluate the feasibility of a medical alert system (MAS) that alerts all doctors involved in patient care of patient deterioration via text message using smart-phones. METHODS: The MAS was test-operated from July 2015 to September 2015, in five general wards with a high incidence of cardiac arrest. The number of cardiac arrests was compared to that of 2014. The indication for activation of MAS was decided by the intensive care unit committee of the institution, which examined previous reports on MET. RESULTS: During the three-month study period, 2,322 patients were admitted to the participating wards. In all, MAS activation occurred in 9 patients (0.39%). After activation, 7 patients were admitted to the intensive care unit. Two patients (0.09%) experienced cardiac arrest. Of 13,129 patients admitted to the ward in 2014, there were 50 cases (0.38%) of cardiac arrest (p = 0.009). CONCLUSIONS: It is feasible to use MAS to prevent unexpected cardiac arrest in a general ward.
Emergencies ; Heart Arrest ; Hospital Rapid Response Team ; Humans ; Incidence ; Intensive Care Units ; Mortality ; Patient Care ; Patients' Rooms ; Pilot Projects* ; Text Messaging

In order to investigate a hemodynamic complication associated with the resection of a large arteriovenous malformation, we planed the following experiment. We divided the left common caroted artery and the internal jugular vein for microsurgical anastomsis between the rostral carotid and caudal jugular vessel ends : the 2 remaining wessel stumps were ligated. This created an arteriovenous shunt with afferent flow from the contralateral caroted and the basilar artery and retrograde down to the carotid-jugular anastomosis. And then, we occluded the shunt vessels at the each stage of the first and fourth week after anteriovenous shunt. Forty adult cats weighing from 2.2 to 2.4kg were used in this study The animals were devided into 4 groups : group 1(acute occlusion-1 week after shunt, n=10), group 2(staged occlusion-1 week after shunt, n=10), group 3(acute occlusion-4 week after shunt, n=10), group 4(staged occlusion-4 week after shunt, n=10) respectively. The regional cerebral blood flow(rCBF), cardiopulmonary function were measured in each animal group and also observed the response of the cerebral blood flow on induced changes of the blood pressure and the arterial bicarbonate. The arteriovenous shunt patency was evaluated by serial angiography. The results were as follows ; 1) Considerable increases in the mean arterial blood pressure(mABP) as well as bradycardia were observed in acute occlusion groups(group 1, 3). After induced hyercarbia, the increments of mABP in acute occlusion groups were less than staged occlusion groups, considerbly. 2) Significant decreases in the mean pulse rate were observed in acute occlusion groups. the mean pulse rate were the highest decrease in group 3. 3) The values of rCBF of left frontal cortex in acute occlusion groups were more greater increase than those of staged occlusion groups considerably. 4) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and increases of the rCBF were lowest in group 3 compared with the other groups. After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and reductions of the rCBF were lowest in group 3 compared with the other groups. 5) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups. The rCBFs were the highest increase in group3 and lowest increase in group 2 compared with the other groups. After induced hypotension, considerable reductions of the rCBF were demonstrated in all groups. The rCBFs were the highest reduction in group 3 and lowest reduction in group 2 compared with the other groups. It might be infered from these results that patients with large arteriovenous malformations, particulary those with cerebral steal symptoms, are at risk to develp neurologic defictis related to perfusion breakthrough if their malformed vessels are abruptly removed, and staged or gradual occlusion of feeding arteries may prevent this potentially devastating complication.
Adult ; Angiography ; Animals ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Blood Pressure ; Bradycardia ; Cats ; Heart Rate ; Hemodynamics ; Homeostasis* ; Humans ; Hypotension ; Jugular Veins ; Perfusion

No abstract available.
Delivery of Health Care ; Informatics