• Title/Summary/Keyword: Medical Cost

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Insect Pest Resistance to Insecticides and Future Researches (해충의 살충제저항성과 금후대책)

  • Choi Seung Yoon
    • Korean journal of applied entomology
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    • v.22 no.2 s.55
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    • pp.98-105
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    • 1983
  • The rapid increase in cases of insect resistance to insecticides indicates that the contribution of present chemical control practices inevitably leads to exhaustion of available insecticide resources against key insect species. Now the problem of insecticide resistance exists worldwide among insects and mites affecting field crops and animals including human beings, ranging from minimal or absent in some developing countries, where use of insecticides has been low, to extremely severe in many developed countries. Since the occurrence of insect resistance to insecticides was firstly recognized in 1908, the increase in recent decades has been almost linear and now the number of species of insects and acarines in which resistant strains have evolved have been increased to a total of 432. Of these, $261(60\%)$ are agricultural importance and $171(40\%)$ of medical/veterinary importance. The phenomenon of insecticide resistance is asserting itself as the greatest challenge to effective chemical control of many important insect pests. Resistance of insects to insecticides has a history of nearly 80 years, but its greatest increase and its strongest impact have occurred during the last 40 years following the discovery and extensive use of synthetic organic insecticides and acaricides. The impact of resistance should be considered not only in terms of greater cost of pest control due to increased dosages and number of applications but also in terms of the ecological disruption of pest-beneficial species density relationships, the loss of investment in the development of the insecticides concerned, and socio-economic disruption in agricultural communities. Despite its grave economic consequences, the phenomenon of insecticide resistance has received surprisingly little attention in Korea. Since the study of insecticides started firstly in 1963, many entomologists have been concerned with this study. According to their results, some of the rice pests and some of the mites on orchard trees, for example, have developed worrisome level of resistance in several areas of this peninsula. With many arthropods, considerable advances in the developed countries have been made in the study of the biochemical and physiological mechanisms of resistance. Progress involves the biochemical characteristics of specific defense mechanisms, their genetics, interactions, and their quantitative and qualitative contribution to resistance. But their studies arc still inadequately known and relatively little have been contributed in terms of unique schemes of population management in achieving satisfactory pest control. It is apparent that there is no easy solution to resistance as a general phenomenon. For future challenging to effective control of insect pests which are resistant to the insecticides concerned, new insecticide groups with distinctly novel mode of action are urgently needed. It is clear, however, that a great understanding of the factors which govern the intensity of selection of field population for resistance could lead to far more permanently successive use of chemicals within the framework of integrated pest management than heretofore practiced.

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Evaluation of Nutritional Improvement by Total Parenteral Nutrition Guideline in Early Malnourished Inpatients (입원초기 영양불량 환자의 TPN 지침에 따른 영양개선 평가)

  • Cha, Yun Young;Kim, Jung Tae;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.365-372
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    • 2013
  • Background: Malnutrition of inpatients has been associated with higher morbidity, mortality, cost, and longer hospital stay. Total parenteral nutrition (TPN) therapy plays an important role in decreasing morbidity and mortality among critical inpatients in hospitals, and has been commonly used to improve clinical outcomes. However, only a few studies were conducted regarding patients' nutritional improvement by TPN. Method: This study therefore evaluated the changes in nutritional parameters by TPN therapy for early malnourished inpatients. Data from early malnourished inpatients who were treated with TPN therapy between January 2012 and June 2013 at the ${\bigcirc}{\bigcirc}$ university Hospital were studied retrospectively. Information regarding sex, age, underlying diseases, division, TPN (peripheral and central), and changes in nutritional parameters were collected by reviewing electronic medical records. The criteria for evaluation of the changes in nutritional parameters were included physical marker, body mass index (BMI), and biochemical markers, including albumin (Alb), total lymphocyte count (TLC), and cholesterol. Nutritional parameters were collected three times: pre-TPN, mid-TPN and end-TPN. A total of 149 patients (peripheral, 97; central, 52) was evaluated. Results: In all patients, the malnutrition number was significantly decreased following the complete TPN therapy (peripheral patients, pre-TPN: $3.33{\pm}0.12$, mid-TPN : $3.06{\pm}0.17$, and end-TPN: $2.85{\pm}0.21$ (p < 0.05); central patients, pre-TPN: $3.38{\pm}0.11$, mid-TPN: $3.06{\pm}0.13$, and end-TPN: $2.75{\pm}0.21$ (p < 0.05). The malnutrition number means number of nutrition parameters below normal range of malnutrition. In addition, all of the four nutritional parameters (BMI, Alb, TLC and cholesterol) were increased with duration of TPN periods for all patients, and the changes in the early stage were larger than in the late stage (p < 0.05). The nutritional parameters of non-cancer patients were increased to a greater extent compared to cancer patients with longer TPN therapy, but it was not significant. The nutritional parameters of younger patients (50-60 years) were also increased more than of older patients (70-80 years), but it was not significant. Conclusion: In conclusion, the TPN therapy decreases malnutritional status and improves nutritional parameters in malnourished patients, thereby decreasing morbidity and mortality. The combined evaluation of all four nutritional parameters is more accurate for nutritional assessment than a single one.

Efficacy of minimal invasive cardiac output and ScVO2 monitoring during controlled hypotension for double-jaw surgery

  • Kim, Seokkon;Song, Jaegyok;Ji, Sungmi;Kwon, Min A;Nam, Dajeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.353-360
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    • 2019
  • Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO2) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO2 monitoring did not present with sufficient benefits over the risk and cost.

Disability Weights for the Korean Burden of Disease Study : Focused on Comparison with Disability Weights in the Australian Burden of Disease Study (한국인 질병의 장애가중치 측정에 관한 연구 : 호주 장애가중치와의 측정 결과 비교를 중심으로 -)

  • Yoon, Seok-Jun;Lee, Jung-Kyu;Kwon, Young-Hoon;Lee, Sang-Il;Kim, Chang-Yup;Park, Ki-Dong;Kim, Yong-Ik;Shin, Young-Soo;Do, Young-Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.1
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    • pp.59-71
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    • 2004
  • Objectives: This study aimed to measure the disability weights for the Korean Burden of Disease study, and to compare them with those adopted in the Australian study to examine the validity and describe the distinctive features. Methods : The standardized valuation protocol was developed from the Global Burden of Disease (GBD) study and the Dutch Disability Weights study. Disability weights were measured for 123 diseases of the Korean version of Disease Classification by three panels of 10 medical doctors each. Then, overall distribution, correlation coefficients, difference by each disease, and mean of differences by disease group were analyzed for comparison of disability weights between the Korean and Australian studies. Results : Korean disability weights ranged from 0.037 to 0.927. While the rank correlation coefficient was moderate to high ($r_s$=0.68), Korean disability weights were higher than the corresponding Australian ones in 79.7% of the 118 diseases. Of these, war, leprosy, and most injuries showed the biggest differences. On the contrary, many infectious and parasitic diseases comprised the greater part of diseases of which Korean disability weights were lower. The mean of the differ ences was the highest in injuries of GBD disease groups, and in cardiovascular disease, injuries, and malignant neoplasm of the Korean disease category. Conclusions : Korean disability weights were found to be valid on the basis of overall distribution pattern and correlation, and are expected to be used as basic data for broadening the scope of burden of disease study. However, some distinctive features still remain to be explored in following studies.

The Effect of Additives in the Cardioplegic Solution on the Recovery of Myocardium, Compariosn Among Albumin, Mannitol, and Glucose (심마비용액의 삼투압을 유지하기위한 첨가 물질들의 차이가 심근보호에 미치는 영향)

  • Kim, Eun-Gi;Lee, Jong-Guk;Lee, Sang-Heon
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1058-1067
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    • 1991
  • High potassium cardioplegia is a widely accepted procedure to enhance myocardial protection from ischemic injuries associated with open heart surgery. Maintaining optimum osmolarity of the cardioplegic solution is one of the required conditions for an ideal cardioplegic solution Albumin is an frequently added component for maintaining optimum osmolarity of clinically used cardioplegic solutions. But the source of albumin is human blood so that the supply is limited and the cost of manufacturing is relatively high. Recently there are moves to minimized the use of blood product for fear of blood-associated infections or immunological disorders. In this experiment, we substituted mannitol or glucose for albumin added to the cardioplegic solution which has been used at the Wonju Medical College, To determine whether addition of mannitol or glucose instead of albumin in the cardioplegic solution can produce satisfactory myocardial protection during ischemia, three different groups of isolated rat heart perfused by modified Langendorff technique were studied. Wonju Cardioplegic Solution was selected as a standard high potassium[18mEq/L of K+] cardioplegic solution. Three kinds of cardioplegic solution were made by modifying the composition maintaining the same osmolarity[339$\pm$1mOsm/Kg] Isolated rat heart were perfused initially with retrograde nonworking mode and then changed to working mode. After measuring the heart rate, systolic aortic pressure, aortic flow, coronary flow, ischemic arrest by aorta cross clamp and cardioplegia was made maintaining the temperature of water jacket at 10oC. The heart was rewarmed and reperfused after 60min of ischemic arrest with intermittent cardioplegia at the 30min interval. The time to return of heart beat and the time required to get. Regular heart beat were observed after reperfusion. The recovery rate of the functional variables-heart rate, systolic aortic pressure, aortic flow, coronary flow and cardiac output were calculated and compared among the three groups of different cardioplegia-albumin, mannitol, and glucose. The wet weight and dry weight was measured and the water content of the heart as figured out for comparison. The time to return of heart beat was fastest in the albumin group, The functional recovery rates were best in the albumin group also. In the above conditions, albumin was the best additive to the cardioplegic solution compared to the mannitol or glucose.

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New Paradigm for Patients with Pulmonary Nodule Expecting Thoracoscopic Resection (흉강경수술이 예상되는 폐결절 환자에서의 새로운 방침)

  • 조민섭;심성보;왕영필;조건현;서종희;곽문섭;이선희;김학희;문석환
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.748-753
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    • 2003
  • Background: The pulmonary nodules (PN), when indicated, need thoracoscopic resection, especially in cases of non-diagnostic or technically infeasible PCNA (percutaneous needle aspiration). In the difficult situations of small or deeply seated PN, several techniques facilitating thoracoscopy have been used for detecting them. Our new protocol for managing PN was developed and prospectively reviewed. Material and Method: In the procedure of PCNA, we firstly placed the tip of the needle in the center of, or just in contact with PN under CT guidance, and loaded one or two segments of platinum radiomarker inside the needle after removing the stylet. Then, we forced the radiomarker to move to the tip of the needle by pushing the stylet. Finally, if the tip of the needle was not within PN, it was reoriented to the their center to obtain the sample for PCNA. Result: Between May 1999 and May 2000, radiomarkers were successfully placed in 28 PN of 26 patients, with the exception of one. In 18 (85%) of 21 nodules needing throacoscopy, intraoperative fluoroscopy was used to detect them or guide stapling resection during thoracoscopy. Conclusion: The advantages of this technique are that there is that there is no need for further localization for thoracoscopy even in cases of unsuccessful PCNA, and it was more effective in respect to both cost and time. Therefore, this strategy for PN expecting thoracoscopy will be helpful to patients and medical staff alike.

Development of a Metamodel-Based Healthcare Service System using OSGi Component Platform (OSGi 컴포넌트 플랫폼을 이용한 메타모델 기반의 건강관리 서비스 시스템 개발)

  • Kim, Tae-Woong;Kim, Hee-Cheol
    • Journal of Korea Multimedia Society
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    • v.14 no.1
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    • pp.121-132
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    • 2011
  • A healthcare system is a type of medical information system that performs early detection and prevention in diseases by checking one's health condition periodically. Such a healthcare system is based on the signal obtained from the body. However, the developed existing system represents certain differences in the storage and description of vital signs according to medicare devices and the evaluation method of the system. It brings some disadvantages, such as lacks in the interoperability between systems, increases in the development cost of systems, and absence of a unified system. Thus, this study develops a healthcare system based on a meta model. For establishing this objective, this study describes and stores vital sign data based on the standard meta model of HL7 and applies OCL, which is a mathematical specification language, for defining wellness indexes and extracting data in order to evaluate health risk appraisals in health. In addition, this study implements components based on OSGi and assemble them in order to easily extend various devices and systems. By describing vital data based on the meta model, it represents some advantages that it makes possible to ensure the interoperability between systems and introduce the standardization of the evaluation method of health conditions through defining the wellness index using OCL. Also, it provides dear specifications.

Implementation of a portable pulse oximeter for SpO2 using Compact Flash Interface (컴팩트 플래쉬 방식의 휴대용 산소포화도 측정 시스템 구현)

  • Lee, Han;Kim, Young-Kil
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2003.05a
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    • pp.678-681
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    • 2003
  • In this paper, we aims to develop a microcontroll er-based portable pulse oximeter using Compact Flash Interface. First, portable pulse oxineter system is designed to record 2 channel of biosignals simultaneously, including 1 channel of SpO$_2$ and 1 channel of pulse rate. It is very small and portable. Besides, the system makes it possible to measure a patients condition without an additional medical equipment. We tried to solve the problems generated by a patient's motion. That is, we added an analog circuit to a traditional pulse oximeter in order to eliminate the change of the base line. And we used 2D sector algorithm. As present, SpO$_2$ modules are completed. But there are still many further development needed in order to enhance the function. Especially, compact flash interface remains the most to complete. Second, ECG monitoring system uses almost same as present 3-lead ECG system. But we focus on the analog part, especially in filter. The proposed filter is composed of two parts. One is a filter to remove the power-line interface. The other is a filter to remove the baseline drift. A filter to remove the power-line and the baseline drift is necessarily used in the ECG system. The implemented filter have three features; minimizing the distortion in DC component, removing the harmonic component of power-line frequency. Using compact flash interface, we can easily transfer a patient's personal information and the measured signal data to a network based server environment. That means, it is possible to implement a patient's monitoring system with low cost.

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Design and fabrication of paper microfluidic channel (종이기반 미세유체 채널의 설계 및 제작기술)

  • Lee, Jung-Hyun;Hwang, Yoo-Sun;Jung, Hyo-Il
    • Science of Emotion and Sensibility
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    • v.14 no.4
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    • pp.525-530
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    • 2011
  • Emotion is composed of various feelings such as pleasure, sorrow, comfortability, and so on. The complicated process of the measurement has long been recognized as a major hindrance for the studies of emotion. Previously, individuals' emotion has mainly been measured by means of self-report, interview, EEG (electroencephalogram), ECG (electrocardiogram), EOG (electroculography), and body temperature. With thanks to nano/micro technologies, the possibility in the development of emotion-on-a-chip (EOC) has begun to be proposed. EOC will make it possible to analyze one's psychological status by taking a drop of blood. Discovery of emotional biomarkers in body fluids, understanding of the correlation between those biomarkers and the results from brain science are prerequisites to validate the EOC technology. In this paper, paper microfluidics are introduced as a good candidate for the EOC. As paper microfluidics is cost-effective and easy to use it is expected to be a useful device for the emotion measurement. We present the design and fabrication process for the simple paper-based microfluidic device and discuss the possible application in the field of measuring the human emotion.

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The analysis of Complex Type and the Facility Status of Community Mixed-support Facility (공동체복합지원시설의 시설현황 및 복합유형 분석)

  • Kim, Sumi;Kim, Suk-Young
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.507-517
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    • 2013
  • Welfare desire has been diversified according to the increase of economic level and rapid social change. The desire for comprehensive service on culture, medical, mental and information level has appeared. Accordingly, it is necessary to establish an integrated community mixed-support facility, a space of accepting administration, welfare, leisure, culture and informatization request in a small local community in the future. The community mixed-support facility is a meeting place of local resident for information change, various basic service and ultimately for activation of community in order to contribute to regeneration and activation of existing urban core. Thus, this study figured out general status of community mixed-support facility and physical mixed type and analyzed spatial characteristics. Current community mixed-support facility has insufficient program and space to participate in by local residents and to accommodate mixed function. The future planned community mixed-support facility must secure multiple opportunities for various types of life by returning time and cost to user through the introduction of creative mixed concept. While reflecting unique local characteristics, and considering diversity of users, it needs to make mixed facility to cope with social changes. This study is limited in that the study reached a conclusion by survey and analysis only. However, it is expected that the result can be used as basic research data for the planning of community mixed-support facility to cope with living conditions of local residents or realistic requirements.