• Title/Summary/Keyword: 생명의료

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A low noise, wideband signal receiver for photoacoustic microscopy (광음향 현미경 영상을 위한 저잡음 광대역 수신 시스템)

  • Han, Wonkook;Moon, Ju-Young;Park, Sunghun;Chang, Jin Ho
    • The Journal of the Acoustical Society of Korea
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    • v.41 no.5
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    • pp.507-517
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    • 2022
  • The PhotoAcoustic Microscopy (PAM) has been proved to be a useful tool for biological and medical applications due to its high spatial and contrast resolution. PAM is based on transmission of laser pulses and reception of PA signals. Since the strength of PA signals is generally low, not only are high-performance optical and acoustic modules required, but high-performance electronics for imaging are also particularly needed for high-quality PAM imaging. Most PAM systems are implemented with a combination of several pieces of equipment commercially available to receive, amplify, enhance, and digitize PA signals. To this end, PAM systems are inevitably bulky and not optimal because general purpose equipment is used. This paper reports a PA signal receiving system recently developed to attain the capability of improved Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) of PAM images; the main module of this system is a low noise, wideband signal receiver that consists of two low-noise amplifiers, two variable gain amplifiers, analog filters, an Analog to Digital Converter (ADC), and control logic. From phantom imaging experiments, it was found that the developed system can improve SNR by 6.7 dB and CNR by 3 dB, compared to a combination of several pieces of commercially available equipment.

The Overview of the Public Opinion Survey and Emerging Ethical Challenges in the Healthcare Big Data Research (보건의료빅데이터 연구에 대한 대중의 인식도 조사 및 윤리적 고찰)

  • Cho, Su Jin;Choe, Byung In
    • The Journal of KAIRB
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    • v.4 no.1
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    • pp.16-22
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    • 2022
  • Purpose: The traditional ethical study only suggests a blurred insight on the research using medical big data, especially in this rapid-changing and demanding environment which is called "4th Industry Revolution." Current institutional/ethical issues in big data research need to approach with the thoughtful insight of past ethical study reflecting the understanding of present conditions of this study. This study aims to examine the ethical issues that are emerging in recent health care big data research. So, this study aims to survey the public perceptions on of health care big data as part of the process of public discourse and the acceptance of the utility and provision of big data research as a subject of health care information. In addition, the emerging ethical challenges and how to comply with ethical principles in accordance with principles of the Belmont report will be discussed. Methods: Survey was conducted from June 3th August to 6th September 2020. The online survey was conducted through voluntary participation through Internet users. A total of 319 people who completed the survey (±5.49%P [95% confidence level] were analyzed. Results: In the area of the public's perspective, the survey showed that the medical information is useful for new medical development, but it is also necessary to obtain consents from subjects in order to use that medical information for various research purposes. In addition, many people were more concerned about the possibility of re-identifying personal information in medical big data. Therefore, they mentioned the necessity of transparency and privacy protection in the use of medical information. Conclusion: Big data on medical care is a core resource for the development of medicine directly related to human life, and it is necessary to open up medical data in order to realize the public good. But the ethical principles should not be overlooked. The right to self-determination must be guaranteed by means of clear, diverse consent or withdrawal of subjects, and processed in a lawful, fair and transparent manner in the processing of personal information. In addition, scientific and ethical validity of medical big data research is indispensable. Such ethical healthcare data is the only key that will lead to innovation in the future.

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The Role of Perfusionists during the COVID-19 Pandemic and Clinical Laboratory Technologists: Comparison of Training Systems in Japan and the United States (코로나19를 통해서 바라본 체외순환사의 역할과 임상병리사: 일본과 미국의 양성체계를 비교)

  • Dong-Ok, Aum;Dae Jin, Kim;Dae Eun, Kim;Myong Soo, Kim;Bon-Kyeong, Koo
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.293-297
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    • 2022
  • In 2022, Korea reported a total of 224 perfusionists, employing nurses or clinical laboratory technologists (also known as medical technologists) to provide hospital self-education or reliable education. In 2021, the total number of perfusionists in Japan was 2,100, mainly supported by clinical engineering technologists. During the same period, the number of perfusionists reported in the United States was 4,212, who had received training in the master's program, post-bachelor certificate program, and bachelor's program. Most personnel in the USA were graduates of healthcare sciences or life sciences. Perfusionists must be knowledgeable in heart anatomy, physiology, pharmacology, pathology, hemodynamics, laboratory analysis, and quality assurance, as well as techniques to operate the cardiopulmonary bypass machine (heart-lung bypass machine). These are jobs similarly handled by clinical laboratory technologists. The importance of perfusionists became more prominent during two major crises: the MERS-CoV and COVID-19 pandemic. Currently, perfusionists play a significant role in the rapidly expanding field of extracorporeal membrane oxygenation (ECMO) and extracorporeal circulation during cardiac surgery. Results of the current study indicate that hospitals offering cardiac surgery and infectious disease hospitalization need to be institutionalized to secure a certain number of qualified perfusionists. In the future, we look forward to establishing a perfusion technology association under the Korean Society for Clinical Laboratory Physiology to provide academic exchanges.

A Study on the Use of Contrast Agent and the Improvement of Body Part Classification Performance through Deep Learning-Based CT Scan Reconstruction (딥러닝 기반 CT 스캔 재구성을 통한 조영제 사용 및 신체 부위 분류 성능 향상 연구)

  • Seongwon Na;Yousun Ko;Kyung Won Kim
    • Journal of Broadcast Engineering
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    • v.28 no.3
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    • pp.293-301
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    • 2023
  • Unstandardized medical data collection and management are still being conducted manually, and studies are being conducted to classify CT data using deep learning to solve this problem. However, most studies are developing models based only on the axial plane, which is a basic CT slice. Because CT images depict only human structures unlike general images, reconstructing CT scans alone can provide richer physical features. This study seeks to find ways to achieve higher performance through various methods of converting CT scan to 2D as well as axial planes. The training used 1042 CT scans from five body parts and collected 179 test sets and 448 with external datasets for model evaluation. To develop a deep learning model, we used InceptionResNetV2 pre-trained with ImageNet as a backbone and re-trained the entire layer of the model. As a result of the experiment, the reconstruction data model achieved 99.33% in body part classification, 1.12% higher than the axial model, and the axial model was higher only in brain and neck in contrast classification. In conclusion, it was possible to achieve more accurate performance when learning with data that shows better anatomical features than when trained with axial slice alone.

An Ethical Consideration on the Standard Operating Procedure Operation Status and the Ethical Review of the Vulnerable Research Subjects of Institutional Review Board, a Medical Institution in Korea (우리나라 의료기관 Institutional Review Board의 취약한 연구 대상자 관련 표준운영지침서 운영 현황과 윤리적 고찰)

  • Eun Hwa Byun;Byung In Choe
    • The Journal of KAIRB
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    • v.5 no.1
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    • pp.21-32
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    • 2023
  • Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

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General Population's View on Euthanasia (안락사에 대한 일반인들의 인식도)

  • Kim, Sun-Hyun;Lee, Hye-Ree
    • Journal of Hospice and Palliative Care
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    • v.6 no.2
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    • pp.133-143
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    • 2003
  • Purpose : Amont the various issues concerning bio-ethics, the concern on euthanasia has increased along with the development of medical technology. Thus, the general public tends to have more liberal opinion. They have detail research data and real practices in US, Europe and Australia, but we lack such studies in our country. This study was undertaken to address the need of studies on the recognition of euthanasia among the public because the existing studies have been focused on the medical staff. Methods : Survey 413 people the age of 17 or more, from May to July 2000. Testify the data on the variation of demography and the recognition of euthanasia by using SAS 6.12, the statistic program. Results : 304 people (73.6%) think that euthanasia should be legislated, 156 people (37.8%) permit euthanasia to the rage of voluntary one, and 234 people (56.6%) permit passive euthanasia. When the subject of voluntary euthanasia was himself, more people whose age is 35 or more (P=0.001) responded that they will undertake euthanasia. And, on issues related to the passive euthanasia, one's educational background (P=0.046) and economic power (P=0.040) arrangement showed significant differences. When the subject of voluntary euthanasia is other people, more people whose age is 35 or more than 35 (P=0.001), whose sex is male (P=0.001), and married people (P=0.002) were for allowing the matter. For the subject of passive euthanasia, survey participant's occupation (P=0.016) created meaningful difference. More people whose age is 35 or more than 35 responded that they want voluntary euthanasia for themselves (P=0.001), and in the case when euthanasia is legislated, marital status (P=0.002) also shows meaningful difference. Passive euthanasia is permitted by the more people whose age is less than 35 for respondents other people (P=0.001), marital status show meaningful difference in case for respondent himself. In the case of legal euthanasia is more people whose age is 35 or more than 35 (P=0.001), sex is male (P=0.004) and more married people (P=0.001) responded that they want voluntary euthanasia for other people. And, age (P=0.002), sex (P=0.001), education (P=0.025) and economic power (P=0.001) show meaningful difference for case the subject of passive euthanasia. Conclusion : Most of general public responded that the legislation on euthanasia is required; and, age, education and economic power seem to have an influence on their decisions on euthanasia. Not only such a study of demographic and sociological correlation; but, various basic data on the legislation of euthanasia are needed.

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A Review on Constitutional Discordance Adjudication of the Constitutional Court to Total Ban on Abortion ('낙태죄' 헌법재판소 헌법불합치 결정의 취지와 법률개정 방향 - 헌법재판소 2019. 4. 11. 선고 2017헌바127 전원재판부 결정에 따라 -)

  • Lee, Seok-Bae
    • The Korean Society of Law and Medicine
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    • v.20 no.2
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    • pp.3-39
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    • 2019
  • Even after the Constitutional Court decided on August 23, 2012 that the provisions of abortion were constitutional, discussions on the abolition of abortion continued. The controversy about abortion is not only happening recently, but it has already existed since the time when the Penal Code was enacted, and it shares the history of modern legislation with the Republic of Korea. Legislators whom submitted amendment while insisting upon the eradication of abortion in the process of enacting criminal law at that time, presented social and economic adaptation reasons as the core reason. From then on, the abolition of abortion has been discussed during the development dictatorship, but this was not intended to guarantee women's human rights, but it was closely connected to the national policy projects of "Contraception" and "Family Planning" of the Park's dictatorship. Since then, the enactment of the Mother and Child Health Law, which restrictively allow artificial abortion, was held on February 8, 1973, in an emergency cabinet meeting that replaced the legislative power after the National Assembly was disbanded. It became effected May 10th. The reason behind the Mother and Child Health Law that included legalization of abortion in part was that the Revitalizing Reform at that time did not allow any opinion, so it seem to be it was difficult for the religious to express opposition. The "Maternal and Child Health Law" enacted in this way has been maintained through several amendments. It can be seen that the question of maintenance of abortion has been running on parallel lines without any significant difference from the time when the Penal Code was enacted. On August 23, 2012, the Constitutional Court decided that the Constitutional Opinion and the unonstitutional Opinion were 4: 4. However, it was decided by the Constitution without satisfying the quorum for unconstitutional decision of the Constitutional Court. This argument about abolition of abortion is settled for the the time being with the decision of the constitutional inconsistency of the Constitutional Court, and now, the National Assembly bears the issue of new legislation. In other words, the improved legislation must be executed until December 31, 2020, and if the previous improved legislation is not implemented, the crime of abortion (Article 269, Paragraph 1, Article 270 of the Criminal Code) Article 1 (1) will cease to be effective from 1 January 2021. Therefore, in the following, we will look into the reason of the Constitutional Court's constitutional discordance adjudication on criminal abortion(II), and how it structurally differs from the previous Constitutional Court and the Supreme Court. After considering key issues arised from the constitutional discordance adjudication(III), the legislative direction and within the scope of legislative discretion in accordance with the criteria presented by the Constitutional Court We reviewed the proposed revisions to the Penal Code and the Mather and Child Health Act of Korea(IV).

ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

주사용 요오드화 조영제 및 MRI용 가돌리늄 조영제 유해 반응에 대한 한국 임상진료지침: 개정된 임상적 합의 및 권고안(2022년 제3판)

  • Se Won Oh;So Young Park;Hwan Seok Yong;Young Hun Choi;Min Jae Cha;Tae Bum Kim;Ji Hyang Lee;Sae Hoon Kim;Jae Hyun Lee;Gyu Young Hur;Jae Yeon Hwang;Sejoong Kim;Hyo Sang Kim;Ji Young Ryu;Miyoung Choi;Chi-Hoon Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.254-264
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    • 2022
  • The Korean Society of Radiology and Medical Guidelines Committee amended the existing 2016 guidelines to publish the "Korean Clinical Practice Guidelines for Adverse Reactions to Iodide Contrast for Injection and Gadolinium Contrast for MRI: The Revised Clinical Consensus and Recommendations (2022 Third Edition)." Expert members recommended and approved by the Korean Society of Radiology, the Korean Academy of Asthma, Allergy and Clinical Immunology, and the Korean Nephrology Society participated together. According to the expert consensus or systematic literature review, the description of the autoinjector and connection line for the infection control while using contrast medium, the acute adverse reaction, and renal toxicity to iodized contrast medium were modified and added. We would like to introduce the revised contents.

Correlation between Peripheral Neuropathy and Cognitive Factors in Type 2 Diabetic Patients (제2형 당뇨병환자에서 말초신경병증과 인지기능항목의 상관관계)

  • Yang, Wonyul;Kim, Jong Kuk;Park, Kyung Won;Suh, Sunghwan;Lee, Hye-Jeong;Park, Mi-Kyoung
    • Journal of Life Science
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    • v.30 no.3
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    • pp.250-259
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    • 2020
  • Diabetes is a well-known risk factor for dementia and cognitive impairment. Diabetic polyneuropathy (DPN) is the most prevalent microvascular complication in type 2 diabetes mellitus (T2DM) patients. The purpose of this study was to evaluate the relation between diabetic peripheral polyneuropathy and cognitive factors in T2DM patients. Retrospective chart review of type 2 diabetic patients with results of a nerve conduction study (NCS) and a neurocognitive study. A total of 19 patients were included. DPN was defined using data from a nerve conduction study: a score of less than 24 in the Korean version of the Mini-Mental State Examination (K-MMSE) was considered as an indicator of cognitive impairment (CI). The mean age of the 19 patients was 71.6±5.0 years. The mean duration of diabetes was 8.4±9.1 years, and the mean HbA1c level was 8.1±1.8%. DPN was present in 7 of the 19 patients. Based on the K-MMSE score, CI was diagnosed in eight patients. The mean K-MMSE scores and the prevalence of CI was not different between the groups with and without DPN. There was no significant difference in DPN prevalence between the groups with and without CI. Education was significantly correlated with cognitive factors. Only the digit span-forward among the cognitive factors showed a significant negative correlation with nerve conduction velocity. In conclusion, the longer education period was associated with higher cognitive function and no significant correlation was observed between diabetic peripheral neuropathy and cognitive dysfunction in type 2 diabetic patients. Further prospective research is needed in the future.