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The Design and Implementation of Telemedicine System for Emergency Patients in a Ship (해상응급환자를 위한 원격진료 시스템의 설계 및 구현)

  • Lee, Dong-Hoon;Kwon, Jang-Woo;Kim, Gyu-Dong;Hong, Jun-Eui;Lee, Sang-Min
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.13 no.3
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    • pp.537-545
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    • 2009
  • Though there were many research and development about telemedicine on land recently, not yet applied to that on the shore. In this paper, when emergency clinic situation were generated in a ship on shore, the telemedicine system was designed and implemented for transfer and clinic service to doctors on the land by measuring basic body signals of patients. Presently, wireless communication and inmarsat telephone are usually used by simple questions and clinic consults to remote doctors when emergency situation were happened in the ship. In this paper, the telemedicine system on the shore were developed for improving this problems by measuring patient's fundamental conditions such as the blood pressure, pulse, the respiratory condition, electrocardiogram, body temperature, patient image and sending these information to remote doctors on land for more accurate prescription. The developed system can supply the high level clinic service to emergency patients on the shore and cope with the emergency situation in ship.

A Prospective Clinical Study of Crystalloid and Colloid Solutions as Priming Additive Fluids for Cardiopulmonary bypass of the Small Children (소아에서 인공심폐기 충전액의 첨가용액으로서 사용한 crystalloid와 colloid 용액에 관한 임상연구)

  • Han, Jae-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.469-479
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    • 1992
  • Searching for the clinical effects of colloid solutions that used to increasing the oncotic pressure of priming solutions at the cardiopulmonary bypass, 29 patients [who were diagnosised as simple VSD around 10kg of body weight and scheduled to be operated from June 1990 to December 1990 at Sejong General Hospital] were divided randomly and prospectively to the two groups: A group [15] was received 4gm% albumin as addition to the priming solutions and B Group [14] the same amount of Ringer`s lactated solution. 34 clinical parameters [Body weight, sex, age, body surface area, Qp/Qs, pulmonary arterial pressure, cardiopulmonary bypass time, anesthetic time, intraoperatively infused crystalloid and colloid amount, hemoglobin, hematocrit, serum sodium concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum protein, serum albumin concentration, urine output, central venous pressure, postoperatively infused colloid amount, immedediate post-operative peak inspiratory pressure, cardiac index, blood pressure and pump flow during cardiopulmonary bypass, inotro-pic assist, diuretics, extubation period, total drain amount, duration of ICU] were measured and compaired between the two groups. There were no differences of preoperative and operative clinical parameters. And postoper-atively, practically there were no nearly differences at the clinical outcomes between the two groups, but some parameters [cardiac index, PIP, BP and pumpflow during CPB, etc] contributed to being preferable to the Group A at certain times [P<0.05]. Conclusively, it might be thought that the priming solution of cardiopulmonary bypass added by colloid solution had some beneficial effects on the patients, especially younger and associated with complex anomaly to be expected taken longer time of cardiopulmonary bypass, and more studies about the neonatal and complex anomaly cases were needed in that points.

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Compliance and Need Assessment for Diet Therapy among Diabetics and Their Caregivers (당뇨환자와 보호자의 당뇨식사요법 실천과 요구도 조사)

  • 박광순;이선영
    • Korean Journal of Community Nutrition
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    • v.8 no.1
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    • pp.91-101
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    • 2003
  • The purpose of this study was to investigate the compliance and need for diet therapy among diabetics and their caregivers. A total of 625 respondents participated in this survey. Appropriate management for long-term blood glucose control and difficult-to-manage cases appeared to be diet therapy, physical activity, medical treatment and folk remedies, in that order. The most important educational avenues for diet therapy were books, magazines and TV, Most respondents were educated in diet therapy within a year after diagnosis and had practiced diet therapy for over four years. The most common diet therapy Practices were food selection and Quantity control. Of the specific problems in practicing diet therapy, time and labor, taste, and meal planning appeared to be equally difficult factors. The prevailing diet therapy skills were controlling food amounts at breakfast and supper, and selecting food for lunch and refreshments. Respondents practicing both skills were about 20% of the participants; this shows the need to improve the current situation. The nutrients most frequently considered in diet therapy practice were simple sugars (sugar and sweet goods) , total fats and cholesterol. Since the perception of the role of dietary fiber among respondents was very low, nutrition education about the importance of dietary fiber and food sources of dietary fiber was needed. Diabetics seemed to be concerned about diabetic menus. Three difficult problems in planning diabetic menus were daily menu planning, patient's preferences, and the calculation of calories. As a means of nutrition counseling, they preferred interviews. The higher the educational status and the lower the age, the higher the preference was for internet or PC counseling. Therefore, it is necessary to develop nutrition educational programs so that diabetics can obtain practical knowledge of diet therapy. Furthermore, it is also necessary to develop additional means of informing diabetics about menu planning, while still considering Korean dietary behavior.

A Study of the Nutritional Status and its Related Factors in the Elderly Hemodialysis Patients (노인 혈액투석 환자의 영양상태와 이에 관련된 요인에 관한 연구)

  • Park Kyung-Ae;Sim Yu-Mi;Kim Soon-Bae;Choi S-mi
    • Journal of Nutrition and Health
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    • v.39 no.2
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    • pp.133-144
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    • 2006
  • The purpose of this study was to evaluate the nutritional status and to identify related factors in elderly hemodialysis patients. Sixty-four patients who were registered in Asan Medical Center, Seoul, Korea, participated in the study. The data was collected between September and December, 2003. General characteristics were obtained with the use of an interviewer-administered questionnaire. Anthropometric and biochemical data, 3-day dietary records and dietary habits were also obtained. The results of this study were analyzed with t-test or $X^2$-test using SPSS package program. The percentage of elderly hemodialysis patients who were undergoing mild to severe malnutrition (MN group) and were normal nutrition (NN group) by subjective global assessment (SGA) criteria were 46.9% and 53.1 %, respectively. Appetite (p < 0.05) and dietary cholesterol intakes (p < 0.05) were significantly lower in MN group than the NN group. Body mass index (BMI, p < 0.001), lean body mass (LBM, p < 0.05), triceps skinfold thickness (TSF, p < 0.01), mid ann circumference (MAC, p < 0.01) and mid ann muscle circumference (MAMC, p < 0.05) were also lower in the MN group than the NN group. There were also significant differences in blood urea nitrogen (BUN, p < 0.05), creatinine (p < 0.05), prealbumin (p < 0.001) and C-reactive protein (CRP, p < 0.05). SGA was negatively correlated with serum BUN, creatinine and pre albumin, dry weight, BMI, LBM, total body water, TSF, MAC and MAMC, and positively correlated with age. In stepwise multiple regression analysis, SGA was related to BMI, CRP, age and BUN. In conclusion, almost half of the subjects were in malnourished status and had lower values in anthropometric and biochemical data. Our results suggest that SGA is a simple and adequate method for assessing the nutritional status in elderly hemodialysis patients and adequate dietary guidelines based on individual nutritional status are needed in the patients.

Exercise Strategies for the Prevention and Treatment of Obesity in Children (아동 비만의 예방 및 치료를 위한 운동 전략)

  • Cho, Jin-Kyung;Han, Jin-Hee;Kang, Hyun-Sik;Yoon, Jin-Hwan
    • Journal of Obesity & Metabolic Syndrome
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    • v.23 no.3
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    • pp.156-161
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    • 2014
  • Childhood obesity has more than doubled in children and adolescents in the last decade. Obese youth are more likely to have risk factors for cardiovascular disease and type 2 diabetes such as high cholesterol, high blood pressure, insulin resistance, and metabolic syndrome. There is no single or simple solution to the childhood obesity epidemic, but to learn that obesity is closely related to lifestyle factors including poor fitness and physical inactivity as well as prolonged sitting time in conjunction with westernized dietary habits. In addition to a healthy and balanced diet, promotion of physical activity combined with carefully supervised resistance exercise training, and reduced screen time is a primary recommendation for the prevention and treatment of obesity in children and adolescents. This review provides evidence based data to support this multiple-step physical activity strategy as the most effective and preventive means against childhood obesity.

Macrophage Migration Inhibitory Factor (MIF) Concentration in the Serum of Patients with Ovarian Cysts for Differential Diagnosis of Endometrioma (자궁내막종의 감별진단을 위한 난소낭종 환자의 혈청 Macrophage Migration Inhibitory Factor (MIF) 농도의 진단적 유용성에 대한 연구)

  • Kim, Man Ki;Kim, Yu Re;Hong, Seong Hwa;Park, Yeon Jin;Ji, IL Woon;Jeong, Eun Hwan;Kim, Hak Soon
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.3
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    • pp.287-293
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    • 2005
  • Objective: To evaluate the usefulness of serum concentrations of macrophage migration inhibitory factor (MIF) of patients with ovarian cysts for differential diagnosis of endometrioama. Method: From Jan. 2003 to Dec. 2004, preoperative serum MIF levels were assessed in 28 women with endometrioma, 32 with benign epithelial tumor, 23 with functional and simple cysts, 22 with benign mature cystic teratoma, and 25 women without ovarian tumor as control. MIF levels were determined using an ELISA (Quantikine Human MIF immunoassay, R&D Systems, Inc., USA). Results: Mean MIF levels were higher in all groups with benign tumors than control (all p<0.01), but there was no significant difference between benign tumor groups (p=0.95). There was no significant correlation between MIF levels and tumor volume, body mass index (BMI) (p=0.635, 0.674 respectively) Serum MIF level had significant correlation with count of WBC and neutrophils (p=0.008, 0.024 respectively), but had no correlation with count of lymhocytes and monocytes (p=0.688, 0.294 respectively). Conclusions: This study showed a marked increase in MIF concentrations in the peripheral blood of patients with endometrioma, but there was no significant difference with other benign tumors. Serum MIF level had significant correlation with count of WBC and neutrophils. These suggest serum MIF level has no usefulness for differential diagnosis of endometrioma from other benign ovarian cysts.

Feasibility of the AtriClip Pro Left Atrium Appendage Elimination Device via the Transverse Sinus in Minimally Invasive Mitral Valve Surgery

  • Shirasaka, Tomonori;Kunioka, Shingo;Narita, Masahiko;Ushioda, Ryohei;Shibagaki, Keisuke;Kikuchi, Yuta;Wakabayashi, Naohiro;Ishikawa, Natsuya;Kamiya, Hiroyuki
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.383-388
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    • 2021
  • Background: Achieving external access to and manual occlusion of the left atrial appendage (LAA) during minimally invasive mitral valve surgery (MIMVS) through a small right thoracotomy is difficult. Occlusion of the LAA using an epicardial closure device seems quite useful compared to other surgical techniques. Methods: Fourteen patients with atrial fibrillation underwent MIMVS with concomitant surgical occlusion of the LAA using double-layered endocardial closure stitches (n=6, endocardial suture group) or the AtriClip Pro closure device (n=8, AtriClip group) at our institution. The primary safety endpoint was any device-related adverse event, and the primary efficacy endpoint was successful complete occlusion of blood flow into the LAA as assessed by transthoracic echocardiography at hospital discharge. The primary efficacy endpoint for stroke reduction was the occurrence of ischemic or hemorrhagic neurologic events. Results: All patients underwent LAA occlusion as scheduled. The cardiopulmonary bypass and aortic cross-clamp times in the endocardial suture group and the AtriClip group were 202±39 and 128±41 minutes, and 213±53 and 136±44 minutes, respectively (p=0.68, p=0.73). No patients in either group experienced any device-related serious adverse events, incomplete LAA occlusion, early postoperative stroke, or neurologic complication. Conclusion: Epicardial LAA occlusion using the AtriClip Pro during MIMVS in patients with mitral valve disease and atrial fibrillation is a simple, safe, and effective adjunctive procedure.

Proximal ligation after the side-to-end anastomosis recovery technique for lymphaticovenous anastomosis

  • Suzuki, Yushi;Sakuma, Hisashi;Ihara, Jun;Shimizu, Yusuke
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.344-349
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    • 2019
  • Background Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. Methods Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. Results Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. Conclusions Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.

Compatibility Study between Physiologically Based Pharmacokinetic (PBPK) and Compartmental PK Model Using Lumping Method: Application to the Voriconazole Case (럼핑법을 이용한 생리학 기반 약물동태모델 및 구획화 약물동태모델 상호 호환 연구: 보리코나졸 적용 연구)

  • Ryu, Hyo-jeong;Kang, Won-ho;Chae, Jung-woo;Yun, Hwi-yeol
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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    • pp.125-135
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    • 2021
  • Background: Generally, pharmacokinetics (PK) models could be stratified into two models. The compartment PK model uses the concept of simple compartmentalization to describe complex bodies, and the physiologically based pharmacokinetic (PBPK) model describes the body using multi-compartment networking. Notwithstanding sharing a theoretical background in both models, there was still a lack of knowledge to enhance compatibility in both models. Objective: This study aimed to evaluate the compatibility among PBPK, lumping model and compartment PK model with voriconazole PK case study. Methods: The number of compartments and blood flow on each tissue in the PBPK model were modified using the lumping method, considering physiological similarities. The concentration-time profiles and area under the concentration-time curve (AUC) parameters were simulated at each model, assuming taken voriconazole oral 400 mg single dose. After that, those mentioned PK parameters were compared. Results: The PK profiles and parameters of voriconazole in the three models were similar that proves their compatibility. The AUC of central compartment in the PBPK and lumping model was within a 2-fold range compared to those in the 2- compartment model. The AUC of non-eliminating tissues compartment in the PBPK model was similar to those in the lumping model. Conclusion: Regarding the compatibility of the three PK models, the utilization of the lumping method was confirmed by suggesting its reliable PK parameters with PBPK and compartment PK models. Further case studies are recommended to confirm our findings.

Osteoporotic Vertebral Compression Fracture Associated with Pregnancy and Lactation in Young Women (젊은 여성에서 임신 및 수유와 연관된 골다공증성 척추 압박골절)

  • Shin, Woo-Jin;Suh, Seung-Pyo;Yeom, Ji-Ung;Kim, Yun-Seong
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.266-271
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    • 2021
  • Osteoporosis associated with pregnancy and lactation is a rare disease that can cause osteoporotic vertebral compression fracture (OVCF). Patients usually complain of severe back pain, which is easily mistaken for pain due to pregnancy, childbirth, and lactation, making a rapid diagnosis and treatment difficult. The authors diagnosed OVCF related to pregnancy and lactation through a physical examination, simple radiography, whole-body bone scan, magnetic resonance image, bone marrow density, and blood tests in a 29-year-old female patient and a 31-year-old female patient who presented with low back pain. This paper reports two cases of symptom improvement through a teriparatide injection, wearing thoracic lumbar sacral orthosis and taking calcium and vitamin D with a review of the literature.