• Journal of Internet Computing and Services
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• v.16 no.1
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• pp.47-55
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• 2015

Recently, the environment of a hospital information system is a trend to combine various SMART technologies. Accordingly, various smart devices, such as a smart phone, Tablet PC is utilized in the medical information system. Also, these environments consist of various applications executing on heterogeneous sensors, devices, systems and networks. In these hospital information system environment, applying a security service by traditional access control method cause a problems. Most of the existing security system uses the access control list structure. It is only permitted access defined by an access control matrix such as client name, service object method name. The major problem with the static approach cannot quickly adapt to changed situations. Hence, we needs to new security mechanisms which provides more flexible and can be easily adapted to various environments with very different security requirements. In addition, for addressing the changing of service medical treatment of the patient, the researching is needed. In this paper, we suggest a dynamic approach to medical information systems in smart mobile environments. We focus on how to access medical information systems according to dynamic access control methods based on the existence of the hospital's information system environments. The physical environments consist of a mobile x-ray imaging devices, dedicated mobile/general smart devices, PACS, EMR server and authorization server. The software environment was developed based on the .Net Framework for synchronization and monitoring services based on mobile X-ray imaging equipment Windows7 OS. And dedicated a smart device application, we implemented a dynamic access services through JSP and Java SDK is based on the Android OS. PACS and mobile X-ray image devices in hospital, medical information between the dedicated smart devices are based on the DICOM medical image standard information. In addition, EMR information is based on H7. In order to providing dynamic access control service, we classify the context of the patients according to conditions of bio-information such as oxygen saturation, heart rate, BP and body temperature etc. It shows event trace diagrams which divided into two parts like general situation, emergency situation. And, we designed the dynamic approach of the medical care information by authentication method. The authentication Information are contained ID/PWD, the roles, position and working hours, emergency certification codes for emergency patients. General situations of dynamic access control method may have access to medical information by the value of the authentication information. In the case of an emergency, was to have access to medical information by an emergency code, without the authentication information. And, we constructed the medical information integration database scheme that is consist medical information, patient, medical staff and medical image information according to medical information standards.y Finally, we show the usefulness of the dynamic access application service based on the smart devices for execution results of the proposed system according to patient contexts such as general and emergency situation. Especially, the proposed systems are providing effective medical information services with smart devices in emergency situation by dynamic access control methods. As results, we expect the proposed systems to be useful for u-hospital information systems and services.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.16-22
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• 2009

Purpose: To update the epidemiologic information of hepatobiliary diseases in pediatric inpatients using cross-sectional survey data throughout the Republic of Korea. Methods: Nationwide cross-sectional survey was obtained from the 85 residency training hospitals in Korea to gather the final diagnosis on discharge. The surveyed periods were from 2004 to 2006. All the reports regarding the diagnosis were based on ICD-10 system. In this study, we focused on hepatobiliary diseases. Results: A total of 826,896 cases with discharge data were collected, of which 4,151 (5.0%) hepatobiliary cases were identified; 2,385 cases (57.4%) of hepatobiliary disease were hepatitis, which was the most common hepatobiliary disease. Other diseases included congenital hepatobiliary diseases (524 cases [12.6%]) and biliary diseases (315 cases [7.6%]). The prevalence of hepatobiliary disease according to age differed. Biliary atresia was the most common hepatobiliary disease in the neonatal period, whereas the prevalence of hepatitis increased in adolescents. The total number of hepatobiliary operations was 416 cases. With the comparison of annual data, there was no definite difference in the total number of hepatobiliary cases. The average duration of hospital stay appeared to decrease gradually. Conclusion: In this study, we have summarized the recent epidemiology of hepatobiliary disorders in Korean children based on discharge data. Hepatobiliary disorders in pediatric inpatient units consisted of diverse disorders with a low prevalence, so multi-center approaches should be considered to enhance the clinical and public health outcomes. To improve this nationwide survey, a new data collecting system should be developed.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.701-705
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• 2005

Purpose : Parents' genetic information plays an important role in their children's genetic expression. Human chromosome has 23-paternal chromosomes and 23-maternal chromosomes. Parental chromosomal translocation can induce clinical problems in their children because of imbalance in genetic information. We intent to analyze the cytogenentic and clinical features about children with maternal balanced translocation between chromosome 15 and 18. Methods : We detected by one family's FISH study of chromosome 15. We have evaluated children born to clinically normal parents about peripheral bood analysis, endocrine, metabolic, radiologic study, electroencephalogram and social & intelligence scale. and We analysis their clinical manifestation by hospital records. Results : Patient's father and elder sister are normal clinically and genetically. Her mother's chromosome show balanced translocation, 46, XX, t(15;18)(p11.2;p11.3). One child has 46, XX, der(18) t(15;18)(p11.2;p11.3), mental retardation, growth retardation, speech & social developmental delay, recurrent infection and mild mitochondria dysfunction. Her young brother has 46, XY, der(15) t(15;18) (p11.2;p11.3), mental retardation, aggressive behavior, obesity and speech developmental delay. Conclusion : In this study we observed the children with developmental delay, dysmorphic facial features, mental retardation, growth retardation associated with growth hormone deficiency and aggressive behavior due to unbalanced translocation between chromosome 15 and 18.

• Journal of the Korea Society of Computer and Information
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• v.25 no.3
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• pp.185-190
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• 2020

The purpose of this study was to investigate the effects of systemic chronic inflammatory state on dry eye syndrome as a local chronic inflammatory condition. From June 16, 2016 to December 31, 2016, 726 patients who visited the general health examination center were screened using the Schirmer's test and the metabolic syndrome screening test. A total of 214 patients who were studied for hs-CRP and HbA1c were simultaneously selected for the study as well. Dry eye syndrome significantly increased in higher age groups (p<0.001) and women (p=0.020); there was no significant relationship with fasting plasma glucose, hs-CRP. In addition, as HbA1c increased the risk for dry eye syndrome also increased (β=1.960, p=0.025). Therefore, dry eye syndrome may not caused by microvascular changes in the lacrimal gland due to chronic inflammatory conditions. In diabetic patients, long-term blood glucose control may be more important than short-term blood glucose control. The high prevalence of dry eye syndrome in diabetic patients is thought to be due to autonomic dysfunction rather than microvascular changes caused by chronic inflammation.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.42-49
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• 2019

Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.

• Tuberculosis and Respiratory Diseases
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• v.50 no.1
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• pp.29-41
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• 2001

Background : The appearance of multiple-drug-resistant Mycobacterium tuberculosis strains has been seriously compromising successful control of tuberculosis. Rifampin-resistance, caused by mutations in the rpoB gene, can be indicative of multiple-drug-resistance, and its detection is of great importance. The present study aimed to develop an oligonucleotide chip for accurate and convenient screening of drug-resistance. Methods : In order to detect point mutations in the rpoB gene, an oligonucleotide chip was prepared by immobilizing specific probe DNA to a microscopic slide glass by a chemical reaction. The probe DNA that was selected from the 81 bp core region of the rpoB gene was designed to have mutation sites at the center. A total of 17 mutant probes related to rifampin-resistance including 8 rifabutin-sensitive mutant probes were used in this study. For accurate determination, wild type probes were prepared for each mutation position with an equal length, which enabled a direct comparison of the hybridization intensities between the mutant and wild type. Results : Mycobacterial genomic DNA from clinical samples was tested with the oligonucleotide chip and the results were compared with those of the drug-susceptibility test in addition to sequencing and INNO-LiPA Rif. TB kit test in some cases. Out of 15 samples, the oligonucleotide chip results of 13 samples showed good agreement with the rifabutin-sensitivity results. The two samples with conflicting result also showed a discrepancy between the other tests, suggesting such possibilities as existence of mixed strains and difference in drug-sensitivity. Further verification of these samples in addition to more case studies are required before the final evaluation of the oligonucleotide chip can be made. Conlcusion : An oligonucleotide chip was developed for the detection of rpoB gene mutations related to drugsusceptibility. The results to date show the potential for using the oligonucleotide chip for accurate and convenient screening of drug-resistance to provide useful information in antituberculosis drug therapy.

• Journal of Preventive Medicine and Public Health
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• v.33 no.3
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• pp.299-305
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• 2000

Objectives : To investigate the difference in the occurrence of lung cancer between foundry workers and non-foundry workers by comparing the number of workers diagnosed with lung cancer through health insurance data. Methods : The study population was comprised of 28,884 workers who had undergone at least one general or special medical examination between January 1995 and December 1997 at the occupational health center. All of the subjects had health insurance during this period. We combined the medical examination data with the health insurance data to compare the number of foundry workers diagnosed with lung cancer and the number of non-foundry workers diagnosed with lung cancer. Results : Seven workers were diagnosed with lung cancer among the 1,591 foundry workers, compared to twelve workers among the 27,293 non-foundry workers (odds ratio: 10.04, 95% confidence interval: 3.95-25.55). The seven foundry workers diagnosed with lung cancer were all exposed to dust, and six out these seven workers were engaged in finishing or shake-out processes. Conclusions : Although the information for this study was obtained from health insurance data, which has limitations such as accuracy and completeness, the number of foundry workers diagnosed with lung cancer was significantly higher than that of non-foundry workers. Therefore, a well-designed cohort study should be followed to confirm the higher lung cancer rates in foundry workers.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.779-788
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• 2005

Purpose : Echinacea, a traditional plant medicine has been used as immune-stimulant. Recent studies have revealed that extract of Echinacea has immunostimulatory effects on human blood mononuclear cells. This study was designed for the purpose of screening the genes associated with immunologic effects of Echinacea on monocytes and dendritic cells using a cDNA microarray chip. Methods : $CD14^+$ monocyte cells were cultured for one day with Echinacea extract(final concentration : $50{\mu}g/mL$) in experiment 1, but were cultured without Echinacea in experiment 2. The gene expression of these cultured monocytes was analyzed using the cDNA microarray chip. Dendritic cells produced from $CD14^+$ monocyte were cultured for five days with GM-CSF and IL-4, and then cultured for one day with Echinacea in experiment 3, but were done without Echinacea in experiment 4. Results : In experiments 1 and 2, there were 17 significantly expressed genes with average expression ratios above 2.5, including interferon gamma-inducible protein 30(IFI 30), CDC(cell-division-cylcle)-like kinase 2(CLK 2), syndecan binding protein(syntenin), superoxide dismutase 2, etc. In experiments 3 and 4, there were 24 gene, with significantly expressed genes were 24 genes, which were insulin-like growth factor 2(somatomedin A), methyl-CpG binding domain protein 3, IFI 30, small inducible cytokine subfamily A, member 22, etc. The genes encoding CD44, IFI 30, mannose receptor C type 1(MRC 1), chemokine receptor 7(CCR 7), CLK 2, syntenin and cytochrome C oxidase subunit VIII were significantly expressed in both monocytes and dendritic cells cultured with Echinacea. Conclusion : This study employed a cDNA microarray chip to elicit the immune-associated gene profile; the expression was enhanced by Echinacea in CD14+ monocytes and dendritic cells. Thus we laid the basis for the quantitative and functional analysis of genes induced by Echinacea in monocytes and monocyte-derived dendritic cells.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.251-259
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• 2002

Background : Reduced lung compliance and increased lung resistance are the primary lung mechanical abnormalities in acute respiratory distress syndrome (ARDS). Although there is little information regarding the mechanisms responsible for the increases in the respiratory resistance of ARDS, bronchodilators have been frequently administered in mechanically ventilated ARDS patients. To determine the effect of a bronchodilator on the respiratory mechanics depending on the level of applied positive end-expiratory pressure (PEEP), the changes in the respiratory mechanics by salbutamol inhalation was measured under the variable PEEP level in patients with ARDS. Materials and Methods : Fifteen mechanically ventilated paralyzed ARDS patients (14 of male, mean age 57 years) were enrolled in this study. The respiratory system compliance, and the maximum and minimum inspiratory resistance were obtained by the end-inspiratory occlusion method during constant flow inflation using the CP-100 pulmonary monitor (Bicore, Irvine, CA, USA). The measurements were performed at randomly applied 8, 10 and 12 cm $H_2O$ PEEP before and 30 mins after administrating salbutamol using a meter-dose-inhaler (100ug${\times}$6). Results : 1) The maximum inspiratory resistance of the lung was higher than the reported normal values due to an increase in the minimal inspiratory resistance & additional resistance. 2) The maximum inspiratory resistance and peak airway pressure were significantly higher at 12cm $H_2O$ of PEEP compared with those at 10cm $H_2O$ of PEEP. 3) Salbutamol induced a significant decrease in the maximum and the minimum inspiratory resistance but no significant change in the additional resistance only was observed at 12cm $H_2O$ of PEEP(from $15.66{\pm}1.99$ to $13.54{\pm}2.41$, from $10.24{\pm}2.98$ to $8.04{\pm}2.34$, and from $5.42{\pm}3.41$ to $5.50{\pm}3.58cm$ $H_2O$/L/sec, respectively). 4)The lung compliance did not change at the applied PEEP and salbutamol inhalation levels. Conclusion : The bronchodilator response would be different depending on the level of applied PEEP despite the increased respiratory resistance in patients with ARDS.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.87-100
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• 2009

Objectives: This study was conducted to suggest the way to improve the tobacco control program of public health centers in Korea. Methods: A survey with a self-administered questionnaire was conducted among 246 persons in charge of tobacco control work in public health centers nationwide in December, 2006. Frequency analysis was performed with a final sample of 212 respondents with SPSS 12.0 for Windows. Results: The duration of engagement in tobacco control work was less than 3 years among 86.7% of respondents, and 87.3% of respondents had other duties besides tobacco control. Almost all public health centers conducted a campaign with posters or leaflets, and smoking prevention education among adolescents. The actual priority for programs was based on the community diagnosis in only 33.5% of the cases. Only 1.9% of respondents complained lack of budget, on the other hand, 44.7% of respondents appealed insufficient number of personnel. The route of knowledge and skill was largely dependent on self-learning or information from colleague. Collaboration with other related department was done well in 39.5% of the cases. The majority of respondents was satisfied with the general support from central government. Conclusions: To improve the tobacco control program of public health centers, it is needed the reinforcement of capacity and specialty among personnel, priority setting and performance of programs based on the scientific evidence, induction of community participation, utilization of community human resources, development of education and training course for practical skill, effective networking among departments.