• Title/Summary/Keyword: Physiologic monitoring

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Study for the Liquid Metals Enabled Stretchable Electronics (액체금속을 활용한 신축성 전자소재 개발 동향)

  • Joo Hyung Lee;Yoon Su Lee;Jin Yoo;Seoyeon Won;Taehwan Lim
    • Journal of Industrial Technology
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    • v.43 no.1
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    • pp.25-31
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    • 2023
  • Stretchable and flexible electronics that comply with dynamic movements and micromotion of the human tissues can enable real-time monitoring of physiologic signals onto the human skin and in the brain, respectively. Especially, gallium based liquid metal stretchable electronics can offer human-interactive biosensors to monitor various physiologic parameters. However, the liquid-like nature, surface oxidation and contamination by organic materials, and low biostability of the liquid metals have still limited the long-term use as bioelectronics. Here we introduced electrochemical deposition without oxidation pathways to overcome these practical challenges in liquid metal bioelectronics. CNT/PDDA composite with reduction way and PEDOT:BF4 with oxidation way under organic solvent are suggested as rationally designed material engineering approaches. We confirmed that the structures with the soft, flexible, and stretchable liquid metal platform can successfully detect dopamine with a high sensitivity and selectivity, record neural signals including action potentials without scar formation, and monitor physiologic signals such as EMG and ECG.

The Significance of 24-Hour Esophageal pH Monitoring in Children with Recurrent Vomiting or Regurgitation (반복성 구토 또는 역류증 환아에서 24시간식도 산도 측정의 의의)

  • Lee, So-Hyun;Lee, Chang-Han;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.139-146
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    • 1999
  • Purpose: The aim of this study was to evaluate the clinical significance of 24 hour pH monitoring in the pediatric patients with recurrent vomiting or regurgitation. Methods: We performed 24 hour pH monitoring on 87 pediatric patients with recurrent vomiting or regurgitation using GastrograpH with glass electrode. The pathologic GER was determined by the reflux index (RI). RIs>10% were considered positive in patients <1 year of age, whereas RIs of >5% were positive in other age groups. We evaluated the mean and standard deviation of the reflux parameters between physiologic and pathologic GER groups, and also compared the reflux indices of each group with respect to time zones of the day. Results: Pathologic GER was found in 32 of 87 patients (36.8%), and the age incidence included 32.5% in infants <6 months old, 13.3% in infants aged 6 months-1 year old, 61.5% in children aged 1~2 years old, 14.3% in children aged 2~3 years old and 66.7% in children >3 years old. In physiologic GER patients, the RI was $3.7{\pm}2.9%$ for the patients <1 year old (group A), and $1.8{\pm}1.5%$ for those ${\geq}1$ year old (group B) which was statistically significant between the 2 age groups (p=0.02). The number of long refluxes more than 5 minutes was significantly increased (p=0.03) in group A ($1.7{\pm}1.9$) than in group B ($0.8{\pm}1.0$). The duration of the longest reflux was significantly longer (p=0.007) in group A ($604{\pm}551$ sec) than in group B ($275{\pm}296$ sec). In pathologic GER patients, the RI was $17.7{\pm}11.6%$ for the patients <1 year old and $7.8{\pm}2.9$ for those ${\geq}1$ year old. The number of long refluxes of more than 5 minutes were $8.9{\pm}4.6$ and $3.2{\pm}1.8$, and the duration of the longest reflux were $1955{\pm}2190$ sec and $1093{\pm}706$ sec for each age group. In both physiologic and pathologic GER patients, there was no significant difference of RI among the time zones of the day. Conclusion: Pathologic GER was found in 36.8% of patients. There was significant difference of RI between those <1 year old and those ${\geq}1$ year old in physiologic GER patients. There was no significant difference of RI among the time zones of the day in both pathologic and physiologic groups. In our study, the frequency of pathplogic GER was too much higher in age group of 1~2 years old (61.5%) than in group of 6 months-1 year old (13.3%), which means that further study is needed to determine the pathologic criteria of RI (Vandenplas criteria is >5%) in the age group of 1~2 years old.

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Home Bioelectrical Impedance Analysis Management System in Patients With Heart Failure: Rationale and Study Design

  • Min Gyu Kong;Inki Moon;Hye-Sun Seo;Jon Suh;Jah Yeon Choi;Jin Oh Na;Eung Ju Kim
    • International Journal of Heart Failure
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    • v.6 no.1
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    • pp.22-27
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    • 2024
  • Body fluid monitoring and management are essential to control dyspnea and prevent re-hospitalization in patients with chronic heart failure (HF). There are several methods to estimate and monitor patient's volume status, such as symptoms, signs, body weight, and implantable devices. However, these methods might be difficult to use for reasons that are slow to reflect body water change, inaccurate in specific patients' condition, or invasive. Bioelectrical impedance analysis (BIA) is a novel method for body water monitoring in patients with HF, and the value in prognosis has been proven in previous studies. We aim to determine the efficacy and safety of home BIA body water monitoring-guided HF treatment in patients with chronic HF. This multi-center, open-label, randomized control trial will enroll patients with HF who are taking loop diuretics. The home BIA group patients will be monitored for body water using a home BIA device and receive messages regarding their edema status and direction of additional diuretics usage or behavioral changes through the linked application system once weekly. The control group patients will receive the usual HF management. The primary endpoint is the change in N-terminal prohormone of brain natriuretic peptide levels from baseline after 12 weeks. This trial will provide crucial evidence for patient management with a novel home BIA body water monitoring system in patients with HF.

Assessment of interhospital transport care for pediatric patients

  • Chaichotjinda, Krittiya;Chantra, Marut;Pandee, Uthen
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.184-188
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    • 2020
  • Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

Microbial Biosensors for Environmental and Food industrial Applications (환경오염과 식품공업 측정용 미생물 바이오센서)

  • 김의락
    • KSBB Journal
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    • v.17 no.3
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    • pp.213-227
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    • 2002
  • To date, the majority of biosensor technologies use binding components such as enzymes antibodies, nucleic acids and protein ligands. In contrast, the goal underlying the use of cells and tissues of animals and plants for a sensor system is to obtain systems capable of extracting information based on the biological activity, mechanisms of action and consequences of exposure to a chemical or biological agent of interest. These systems enable the interrogation of more complex biological response and offer the potential to gather higher information content from measuring physiologic and metabolic response. In these articles, same of the recent trends and applications of microbial biosensors in environmental monitoring and for use in food and fermentations have been reviewed. This endeavor presents many technological challenges to fabricate new microbial biosensors for other scientific field.

High Resolution Pitch Determination Algorithm for Fetal Heart Rate Extraction (태아심음주기의 검출을 위한 고해상 피치 검출 알고리즘)

  • 이응구;이두수
    • Journal of the Korean Institute of Telematics and Electronics B
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    • v.31B no.2
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    • pp.80-87
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    • 1994
  • Fetal monitoring is a routine procedure to obtain a record of physiologic functions during pregnancy and labor. It is required to determine fetal heart frequency accurately. There are various types of fetal heart rate(FHR) determination and the most frequently applied method is transabdominal Doppler ultrasound. However, in the case of weak or noise corrupted Doppler ultrasound signals, conventional peak detections and the autocorrelation function method have many difficulties to determine FHR precisely. Also the autocorrelation function is effected by threshold level and window size. To solve these problems, the high resolution pitch determination algorinthm is introduced to detect FHR from Doppler ultrasound signals. This scheme digitally processes Doppler ultrasound signal for digital rectification, envelope detection, decimation and correlation calculation of two interconnected segments and then FHR is determined by its maximal value. Even in the case of a greatly smeared noise signal, this algorithm is able to search FHR more accurately than autocorrelation function by means of compensating FHR with a constant correlation threshold. This algorithm is simulated by 386-MATLAB on PC 486/DX and verified that it is superior to the autocorrelation function method.

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Contributing Factors on Pharmacokinetic Variability in Critically Ill Neonates (신생아중환자의 약동학적 다양성에 영향을 미치는 요인)

  • An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.2
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    • pp.63-68
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    • 2017
  • Neonates have large inter-individual variability in pharmacokinetic parameters of many drugs due to developmental differences. The aim of this study was to investigate the factors affecting the pharmacokinetic parameters of drugs, which are commonly used in critically ill neonates. Factors that reflect physiologic maturation such as gestational age, postnatal age, postconceptional age, birth weight, and current body weight were correlated with pharmacokinetic parameters in neonates, especially preterm infants. Comorbidity characteristics affecting pharmacokinetics in critically ill neonates were perinatal asphyxia, hypoxic ischemic encephalopathy, patent ductus arteriosus (PDA), and renal dysfunction. Administration of indomethacin or ibuprofen in neonates with PDA was associated with the reduced clearance of renally excreted drugs such as vancomycin and amikacin. Therapeutic hypothermia and extracoporeal membrane oxygenation were influencing factors on pharmacokinetic parameters in critically ill neonates. Dosing adjustment and careful monitoring according to the factors affecting pharmacokinetic variability is required for safe and effective pharmacotherapy in neonatal intensive care unit.

Intraoperative Neurophysiological Monitoring and Neuromuscular Anesthesia Depth Monitoring (수술 중 신경계 추적 감시 검사와 근 이완 마취 심도의 측정)

  • Kim, Sang-Hun;Park, Soon-Bu;Kang, Hyo-Chan;Park, Sang-Ku
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.4
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    • pp.317-326
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    • 2020
  • Deep blocking of consciousness alone does not prevent a reaction to severe stimuli, and copious amounts of pain medication do not guarantee unconsciousness. Therefore, anesthesia must satisfy both: the loss of consciousness as well as muscle relaxation. Muscle relaxants improve the intra-bronchial intubation, surgical field of vision, and operating conditions, while simultaneously reducing the dose of inhalation or intravenous anesthesia. Muscle relaxants are also very important for breathing management during controlled mechanical ventilation during surgery. Excessive dosage of such muscle relaxants may therefore affect neurological examinations during surgery, but an insufficient dosage will result in movement of the patient during the procedure. Hence, muscle relaxation anesthesia depth and neurophysiological monitoring during surgery are closely related. Using excessive muscle relaxants is disadvantageous, since neurophysiological examinations during surgery could be hindered, and eliminating the effects of complete muscle relaxation after surgery is challenging. In the operation of neurophysiological monitoring during the operation, the anesthesiologist administers muscle relaxant based on what standard, it is hoped that the examination will be performed more smoothly by examining the trends in the world as well as domestic and global trends in maintaining muscle relaxant.

The role of the Neonatal Nurse Specialist in 21st Century (21세기 신생아 전문 간호사의 역할과 전망)

  • Lee, Ja-Hyung
    • Korean Parent-Child Health Journal
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    • v.3 no.2
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    • pp.81-93
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    • 2000
  • The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

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Newborn heating screening (신생아 청력장애의 선별검사와 의의)

  • Kim, Lee-Suk
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.7-13
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    • 2007
  • Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing loss in the birth hospital prior discharge (Universal Newborn Heaing Screening, UNHS). Objective physiologic measures must be used to detect newborns and very young infants with hearing loss. Recent technological developments have produced screening methods and both evoked otoacoustic emission (EOAE) and auditory brainstem response (ABR) have been successfully implemented for UNHS. Audiologic evaluation should be carried out before 3 months of age and infants with confirmed hearing loss should receive intervention before 6 months of age. All infants who pass newborn hearing screening but who have risk indicators for other auditory disorders and/or speech and language delay receive ongoing audiologic surveillance and monitoring for communication development. Infants with sensorineural hearing loss are managed with hearing aids and receive auditory and speech-language rehabilitation therapies. Cochlear implants can be an outstanding option for certain children aged 12 months and older with severe to profound hearing loss who show limited benefit from conventional amplifications.