• KSII Transactions on Internet and Information Systems (TIIS)
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• v.7 no.5
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• pp.967-979
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• 2013

Now a day, Wireless Sensor Networks (WSNs) are being widely used in different areas one of which is healthcare services. A wireless medical sensor network senses patient's vital physiological signs through medical sensor-nodes deployed on patient's body area; and transmits these signals to devices of registered medical professionals. These sensor-nodes have low computational power and limited storage capacity. Moreover, the wireless nature of technology attracts malicious minds. Thus, proper user authentication is a prime concern before granting access to patient's sensitive and private data. Recently, P. Kumar et al. claimed to propose a strong authentication protocol for healthcare using Wireless Medical Sensor Networks (WMSN). However, we find that P. Kumar et al.'s scheme is flawed with a number of security pitfalls. Information stored inside smart card, if extracted, is enough to deceive a valid user. Adversary can not only access patient's physiological data on behalf of a valid user without knowing actual password, can also send fake/irrelevant information about patient by playing role of medical sensor-node. Besides, adversary can guess a user's password and is able to compute the session key shared between user and medical sensor-nodes. Thus, the scheme looses message confidentiality. Additionally, the scheme fails to resist insider attack and lacks user anonymity.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.178-181
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• 1990

We experienced a rare case of a recanalization and aneurysmal formation of the previously ligated PDA on 18 year-old-girl. Continuous murmur was noted 3 months after operation and this recanalization was confirmed by angiography and cardiac catheterization. It was impossible to mobilize aneurysmal PDA with safety, so we closed the defect using left heart bypass to prevent spinal card injury. Postoperative course was uneventful and the patient was discharged in good condition.

• Journal of Korea Multimedia Society
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• v.11 no.9
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• pp.1267-1276
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• 2008

The time taken for an ischemic heart disease patient to have a percutaneous coronary intervention because of acute myocardial infarction after arriving at the hospitals (door-to-balloon time) affects the patient's mortality significantly. To improve the emergency service system that has been previously used in the hospitals, this study focused on reducing door-data time and data-to-decision time among three time stages. The newly established e-emergency service system has set up the database of patients that had an emergency operation for acute myocardial infarction in the emergency service system of the hospital and has issued health cards for the patients that regularly visit the Busan National University Hospital. In addition, it has stored prior operation permits in the form of a certified electronic document. The new electronic system will reduce the complex treatment and operation procedures innovatively. Therefore, it is expected that this will make the life save (or the emergency patients easier and reduce the mortality. Moreover, it will also settle down the hospital staff's and patients' predicaments caused by the complex procedure of the legacy system.

• Quality Improvement in Health Care
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• v.23 no.1
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• pp.69-90
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• 2017

Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.11 no.2
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• pp.924-944
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• 2017

Telecare Medical Information System (TMIS) helps the patients to gain the health monitoring information at home and access medical services over the mobile Internet. In 2015, Das et al proposed a secure and robust user AKA scheme for hierarchical multi-medical server environment in TMIS, referred to as DAKA protocol, and claimed that their protocol is against all possible attacks. In this paper, we first analyze and show DAKA protocol is vulnerable to internal attacks, impersonation attacks and stolen smart card attack. Furthermore, DAKA protocol also cannot provide confidentiality. We then propose a lightweight pseudonym AKA protocol for multi-medical server architecture in TMIS (short for PAKA). Our PAKA protocol not only keeps good security features declared by DAKA protocol, but also truly provides patient's anonymity by using pseudonym to protect sensitive information from illegal interception. Besides, our PAKA protocol can realize authentication and key agreement with energy-saving, extremely low computation cost, communication cost and fewer storage resources in smart card, medical servers and physical servers. What's more, the PAKA protocol is proved secure against known possible attacks by using Burrows-Abadi-Needham (BAN) logic. As a result, these features make PAKA protocol is very suitable for computation-limited mobile device.

• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.239-243
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• 2009

Delftia acidovorans is a gram-negative motile rod found ubiquitously in soil and in water. Confirmed isolation from clinical infections is rare, and has been documented mostly in immunocompromised patients or those with indwelling catheters. A 53-year-old man was referred for the evaluation of a huge mass-like lesion found incidentally by chest X-ray. The lesion occupied more than half of the right lung and was diagnosed as a large loculated pleural effusion by CT scan. Bloody pus was drained through a percutaneous catheter, and D. acidovorans, identified by the Vitek GN card and confirmed by amplification of 16S ribosomal RNA and sequencing analysis, was isolated repeatedly from the drained pus. The patient was treated with imipenem/cilastatin to which the organism was sensitive. This is a rare report of chronic empyema associated with D. acidovorans in the respiratory system of an immunocompetent patient.

• Journal of Biomedical Engineering Research
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• v.19 no.3
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• pp.251-260
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• 1998

The Holter monitoring system is a widely used noninvasive diagnostic tool for ambulatory patient who may be at risk from latent life-threatening cardiac abnormalities. In this paper, we design a high performance intelligent holter monitoring system which is characterized by the small-sized and the low-power consumption. The system hardware consists of one-chip microcontroller(68HC11E9), ECG preprocessing circuit, and flash memory card. ECG preprocessing circuit is made of ECG preamplifier with gain of 250, 500 and 1000, the bandpass filter with bandwidth of 0.05-100Hz, the auto-balancing circuit and the saturation-calibrating circuit to eliminate baseline wandering, ECG signal sampled at 240 samples/sec is converted to the digital signal. We use a linear recursive filter and preprocessing algorithm to detect the ECG parameters which are QRS complex, and Q-R-T points, ST-level, HR, QT interval. The long-term acquired ECG signals and diagnostic parameters are compressed by the MFan(Modified Fan) and the delta modulation method. To easily interface with the PC based analyzer program which is operated in DOS and Windows, the compressed data, that are compatible to FFS(flash file system) format, are stored at the flash memory card with SBF(symmetric block format).

• Journal of the Ergonomics Society of Korea
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• v.31 no.1
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• pp.109-116
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• 2012

Objective: The aim of this study is to present a solution to problems in the services provided by the general hospitals by creating a user-centric environment through analyzing the User Journey Map and the User Context. Background: The rapid growth in aging population and the monopolization of superior medical staffs by the general hospitals increased demand for the general hospitals in Korea. But, often services provided by the general hospitals are provider-centric and low quality. Method: This study examines problems in the services provided by the general hospitals by analyzing the User Journey Map through stakeholder interviews(contextual interviews) and on-site observation. Based on the contextual analysis of the user(i.e. the patient), this study proposes new and improved user-centric services to be provided by the general hospitals. Results: Ten new user-centric services proposed by this study are: (1) "Booklet on Success Story", (2) "FAQs by Doctor", (3) "Designated Nurse", (4) "Patient Interview Record Card", (5) "Close relationship between doctor & patient", (6) "Thank You Notice Board", (7) "Step by Step", (8) "Green Cap", (9) "Patient Kit", (10) "RFID Direction Display System". Conclusion: The service design for the general hospitals proposed by this study is an important case-study on improving the environment of the general hospitals from provider(medical staffs)-centric to user(patents and its family)-centric. Application: This study is expected to be used in various areas to improve existing system(products and/or services) to be more user-centric.

• Journal of Korean Physical Therapy Science
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• v.9 no.1
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• pp.81-88
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• 2002

This paper presents a design and a control of a New Reciprocating Gait Orthosis and dynamic walking simulation for this system. The New Reciprocating Gait Orthosis is distinguished from other one by which has a very light-weight and a new RGO type with servo motors. The gait of a New Reciprocating Gait Orthosis depends on the constrains of mechanical kinematics and initial posture. The stability of dynamic walking is investigated by ZMP(Zero Moment Point) of the New Reciprocating Gait Orthosis. It is designed according to a human wear type and is able to accomodate itself to human environments. The joints of each leg are adopted with a good kinematic characteristics. To test of the analysis of joint kinematic properties, we did the strain stress analysis of dynamic PLS and the study of FEM with a dynamic PLS. It will be expect that the spinal card injury patients are able to train effectively with a Reciprocating Gait Orthosis. The New Reciprocating Gait Orthosis was able to keep smooth walling by the orthotic servo motors and hybrid system, make a sequence of flexion and extension of the joint during the walking. Also, the New Reciprocating Gait Orthosis turned out to be a satisfactory orthosis for walling training, for the spinal cord injury patient.

• Journal of the Korea Society of Computer and Information
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• v.20 no.12
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• pp.53-59
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• 2015

In this paper, we developed a Hospital Information System in which the business process is formalized and a wire/wireless integrated solution is used. This system consists of the administration office program, the medical office program, the ward management program and the rounds management program. The administration office program can enroll and accept patients, issue and reissue the RFID card. The medical office program inputs a medical examination and treatment, outputs a diagnosis, requests a hospitalization, retrieves the record of a medical examination and treatment, assigns the corresponding examination room to the accepted patients, and updates the number of an waiting patient and a patient number according to the examination room on real time. The ward management program handles hospitalizations and leaving hospital, a nurse's note, and an isolation ward monitoring. The rounds management program handles a medical examination and treatment, and a leaving hospital using PDA. This developed system can be built at low cost and increase the quality of the medical services highly by making it automated the medical administration automation. Also the small number of the medical staffs can manage the inpatients efficiently by using the monitoring functions.