[Analysis of the Environmental Factor of a Patient Falls in Department of Radiology-Proposal of Scientific Analysis Method in Patient Safety].

We analyzed 197 fall incidents in the questionnaire survey about the incident that occurred in Department of Radiology. In the past paper about the patient safety, there is no report that evaluated incident data directly. The purpose of this paper is to analyze the factor of the medical incidents using statistical technique scientifically. In this paper, we do not suggest concrete precaution. At first, we found the number of patients (each gender, modality, generation) in the five facilities of the coworker of one week. We found an incident rate from this patient total number, and we normalized data. As a result, we were able to do each risk evaluation because a risk ratio and relative risk degree was found. And, we were able to identify modality and the generation with the significant difference using the testing for differences in population rate. By our analyses, we revealed the chapter which must strengthen safety management.

[The Knowledge Gained from Questionnaire Survey of the Patients Fall in the Radiological Examinations -Focus on the Severity Due to Fall Accidents].

PURPOSE: The purpose of this study is to analyze the factors of patient's fall that causes serious injury in the radiological examinations. METHODS: We conducted a questionnaire survey on cases of medical accidents occurring in the radiological examination department in medical institutions. The number of responses to the questionnaire surveys was 372. Among them, 197 cases were related to fall. The incident influence classification divided into eight clusters (0, 0H, 1, 2, 3a, 3b, 4, 5) was divided into three clusters (tiny, moderate, serious injury) depending on severity. We analyzed the factors that cause serious injury. RESULTS: In the case of patient's fall, several factors have been found to cause serious injury. The factors were general radiography, standing position, outside working hours. CONCLUSION: All falls can cause serious injury. To reduce falls, it is important to analyze what kind of patient and in what situation tend to fall, and prevent falls in advance.

[The Actual Condition of Fall Accident and Suggestion of Improvement for Accident Prevention in the Department of Radiology].

We conducted a questionnaire survey (situation, patient factor, environmental factor, operator factor, degree of disability, countermeasure etc.) on cases that occurred up to the present to investigate the actual situation of the medical accidents that occur in the radiological examination department of medical institutions. There were 373 questionnaires collected. Among them, there were 197 cases of falls. In this study, we examined the age of patients who fell, the background of the accident, and factors. As for the accident, 11.7% of accidents with risk impact level 3b or higher occurred including the fatal accident. Of the accidents, 44.2% were foreseeable and 55.8% were unforeseeable. The most accident-prone age was elderly in their 60s to 80s. As the causative factor for the accident, the patient factor was the largest at 63.5%. We can prevent about 30% of the accident by improving the operator factor and the environmental factor which are parts other than patient factor. It is important for us to understand what kind of people tend to fall. Among foreseeable accidents, the causes of patient factors can be reduced.

[The Prevention of the Root Accident in the Department of Radiological Examination Room -Analysis of the Results of Questionnaire Survey about Medical Accident to Many Hospital].

PURPOSE: The purpose of this paper is to analyze the characteristics of incidents related to routes and drains that occur in the radiological examination room for the prevention of these incidents. METHODS: We conducted a questionnaire survey on incident cases that occurred in the radiological examination room. There were 373 responses, of which 76 responses were related to routes and drains. The question contents were the number of hospital beds, radiology department of occurrence, time of occurrence, patient's situation, method of visiting, years of experience of the radiological technologists, and countermeasures, and so on. Based on these answers to these questions, we analyzed which factors were involved in the occurrence of the incidents. RESULTS: Incidents related to routes and drains often occur when moving examination table or transferring the patients to the examination table using the slider. On the other hand, the years of experience of the radiological technologists hardly participated in the factor of these incidents. From these answers to questions, 75% of incidents might predictable, and these incidents could be prevented by improvement of human factors accounted for the majority rather than that of physical factors. CONCLUSION: The number of incidents related to routes and drains may reduce by that all staff involved in the radiological examination recognizing the characteristic of these incidents.

Discovery of new low-molecular-weight p53-Mdmx disruptors and their anti-cancer activities.

Although several p53-Mdm2-binding disruptors have been identified to date, few studies have been published on p53-Mdmx-interaction inhibitors. In the present study, we demonstrated that o-aminothiophenol derivatives with molecular weights of 200-300 selectively inhibited the p53-Mdmx interaction. S-2-Isobutyramidophenyl 2-methylpropanethioate (K-178) (1c) activated p53, up-regulated the expression of its downstream genes such as p21 and Mdm2, and preferentially inhibited the growth of cancer cells with wild-type p53 over those with mutant p53. Furthermore, we found that the S-isobutyryl-deprotected forms 1b and 3b of 1c and S-2-benzamidophenyl 2-methylpropanethioate (K-181) (3c) preferentially inhibited the p53-Mdmx interaction over the p53-Mdm2 interaction, respectively, by using a Flag-p53 and glutathione S-transferase (GST)-fused protein complex (Mdm2, Mdmx, DAPK1, or PPID). In addition, the interaction of p53 with Mdmx was lost by replacing a sulfur atom with an oxygen atom in 1b and 1c. These results suggest that sulfides such as 1b, 3b, 4b, and 5b interfere with the binding of p53-Mdmx, resulting in the dissociation of the two proteins. Furthermore, the results of oral administration experiments using xenografts in nude mice indicated that 1c reduced the volume of tumor masses to 49.0% and 36.6% that of the control at 100 mg/kg and 150 mg/kg, respectively, in 40 days.