• Title/Summary/Keyword: clinical informatics

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Implementation of Service Model to Exchange of Biosignal Information based on HL7 Fast Health Interoperability Resources for the hypertensive management (고혈압 관리를 위한 헬스레벨 7 FHIR 기반 생체정보 교환 서비스 모델 구현)

  • Cho, Hune;Won, Ju Ok;Hong, Hae Sook;Kim, Hwa Sun
    • Journal of Internet Computing and Services
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    • v.15 no.3
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    • pp.21-30
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    • 2014
  • Hypertension is one of the major causes of death in the world as it is related with cardiovascular or cerebrovascular disease, so it is needed to provide continuos management for blood pressure. This study selected Health Level 7 Fast Health Interoperability Resources (HL7 FHIR) as a bio-signal data exchange service model that can provide constant blood pressure management in the rapidly growing mobile health care environment. The HL7 FHIR framework developed communicates with the IEEE 11073-10407 Personal Health Device (PHD) protocol through the bluetooth Health Device Profile (HDP) between the manager (smart phone) and the agent (hemomanometer) and acquires information about blood pressure. According to the test results, it performed its tasks successfully including hypertension patients' blood pressure monitoring, management on measured records, generation of document, or transmission of measured information. Because in the actual, clinical environment, it is possible to transmit measured information through the TCP/IP protocol, it will be needed to conduct constant research on it and vitalize it in the field of mobile health care afterwards.

Molecular Prognostic Profile of Egyptian HCC Cases Infected with Hepatitis C Virus

  • Zekri, Abdel-Rahman N.;Hassan, Zeinab K.;Bahnassy, Abeer A.;Sherif, Ghada M.;ELdahshan, Dina;Abouelhoda, Mohamed;Ali, Ahmed;Hafez, Mohamed M.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5433-5438
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    • 2012
  • Background: Hepatocellular carcinoma (HCC) is a common and aggressive malignancy. Despite of the improvements in its treatment, HCC prognosis remains poor due to its recurrence after resection. This study provides complete genetic profile for Egyptian HCC. Genome-wide analyses were performed to identify the predictive signatures. Patients and Methods: Liver tissue was collected from 31 patients with diagnosis of HCC and gene expression levels in the tumours and their adjacent non-neoplastic tissues samples were studied by analyzing changes by microarray then correlate these with the clinico-pathological parameters. Genes were validated in an independent set by qPCR. The genomic profile was associated with genetic disorders and cancer focused on gene expression, cell cycle and cell death. Molecular profile analysis revealed cell cycle progression and arrest at G2/M, but progression to mitosis; unregulated DNA damage check-points, and apoptosis. Result: Nine hundred fifty eight transcripts out of the 25,000 studied cDNAs were differentially expressed; 503 were up-regulated and 455 were down-regulated. A total of 19 pathways were up-regulated through 27 genes and 13 pathways were down-regulated through 19 genes. Thirty-seven genes showed significant differences in their expression between HCC cases with high and low Alpha Feto Protein ($AFP{\geq}600$ IU/ml). The validation for the microarray was done by real time PCR assay in which PPP3CA, ATG-5, BACE genes showed down-regulation and ABCG2, RXRA, ELOVL2, CXR3 genes showed up-regulation. cDNA microarrays showed that among the major upregulated genes in HCC are sets. Conclusion: The identified genes could provide a panel of new diagnostic and prognostic aids for HCC.

Construction of the Nursing Diagnosis Ontology in Obstetric and Gynecologic Nursing Unit using Nursing Process and SNOMED CT (산부인과 간호단위의 간호과정과 SNOMED CT를 이용한 간호진단 온톨로지의 구축)

  • Park, Jeong-Eun;Chung, Kwi-Ae;Cho, Hune;Kim, Hwa Sun
    • Women's Health Nursing
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    • v.19 no.1
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    • pp.1-12
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    • 2013
  • Purpose: This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice. Methods: The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010. Results: One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability. Conclusion: Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.

A Study on wind stroke, impediment disease, heart pain, side pain, headache, abdominal pain, lumbago in the "Byun Jeung Rok(辨證錄)" vol.II ("변증록(辨證錄)" 권지이(卷之二)의 중풍(中風), 비증(痹證), 심통(心痛), 협통(脇痛), 두통(頭痛), 복통(腹痛), 요통(腰痛)에 대(對)한 연구(硏究))

  • Lee, Gu-In;Park, Dong-Seok;Keum, Kyung-Soo
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.16 no.2
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    • pp.89-161
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    • 2010
  • "Byun Jeung Rok(辨證錄)" is composed of 14 volumes. In relation to the contents, it is organized into 126 gates(門) and 700 remaining syndromes(餘證) where internal medicine, external medicine, pediatrics, gynecology(內科 外科 小兒 婦人), etc. are divided into sub-sections of cold damage, cold stroke, wind stroke(傷寒 中寒 中風), etc. For every syndrome, the symptom, cause of disease, method of treatment, prescription, construction of prescription, instruction of medicine and prognosis.(症狀 病因 治法 處方 處方構成 服用法 預後) were explained thoroughly. This study, as an inquiry of the second volume, deals with wind stroke(中風), impediment disease(痹證), heart pain(心痛), side pain(脇痛), headache(頭痛), abdominal pain(腹痛), lumbago(腰痛) It was written very logically so it is easy to understand. The analysis of the symptoms are brief and appropriate. Also, in the usage of the medicine, the sovereign, minister, assistant and courier(君臣佐使) method was used as the basis for the prescriptions. Therefore, it is considered to have significant clinical value for future generations and is thus being applied by them.

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Highly Accelerated SSFP Imaging with Controlled Aliasing in Parallel Imaging and integrated-SSFP (CAIPI-iSSFP)

  • Martin, Thomas;Wang, Yi;Rashid, Shams;Shao, Xingfeng;Moeller, Steen;Hu, Peng;Sung, Kyunghyun;Wang, Danny JJ
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.4
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    • pp.210-222
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    • 2017
  • Purpose: To develop a novel combination of controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) with integrated SSFP (CAIPI-iSSFP) for accelerated SSFP imaging without banding artifacts at 3T. Materials and Methods: CAIPI-iSSFP was developed by adding a dephasing gradient to the balanced SSFP (bSSFP) pulse sequence with a gradient area that results in $2{\pi}$ dephasing across a single pixel. Extended phase graph (EPG) simulations were performed to show the signal behaviors of iSSFP, bSSFP, and RF-spoiled gradient echo (SPGR) sequences. In vivo experiments were performed for brain and abdominal imaging at 3T with simultaneous multi-slice (SMS) acceleration factors of 2, 3 and 4 with CAIPI-iSSFP and CAIPI-bSSFP. The image quality was evaluated by measuring the relative contrast-to-noise ratio (CNR) and by qualitatively assessing banding artifact removal in the brain. Results: Banding artifacts were removed using CAIPI-iSSFP compared to CAIPI-bSSFP up to an SMS factor of 4 and 3 on brain and liver imaging, respectively. The relative CNRs between gray and white matter were on average 18% lower in CAIPI-iSSFP compared to that of CAIPI-bSSFP. Conclusion: This study demonstrated that CAIPI-iSSFP provides up to a factor of four acceleration, while minimizing the banding artifacts with up to a 20% decrease in the relative CNR.

Taichi for Arthritis : systematic review - focused on Korean studies (국내에 보고된 관절염 태극권 연구에 대한 체계적 고찰)

  • Hwang, Eui-Hyoung;Kim, Jong-Hoe;Kim, Sang-Un;Yang, Chang-Sop
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.14 no.2
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    • pp.79-93
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    • 2008
  • Objectives : Taichi for arthritis was developed in 1997 by Paul Lam, M.D. of family medicine in Australia. It is an exercise treatment program and a good approaching method of the oriental medicine for arthritis. However, clinical and academical researches were rare. The purpose of this study is to investigate the effectiveness of the Taichi for arthritis. Methods : We used the medical literature search system, MEDLIS and the database of academic journal, DBpia to search medical studies published in korea. Keywords were "Taichi", "Tai Chi Chuan" and "Arthritis". We classified literatures with two criteria, year of publishment and study design. Then we classified as placebo design and summarized whole material. We determined its effectiveness by positive-negative results of Taichi for arthritis. Results : Taichi for arthritis could release pain of the rheumatoid or degenerative arthritis. Also it is thought to increase muscular power and enhance physical flexibility, balance. Conclusions : There were limits to ensure effectiveness because of small number of studies comparing Taichi with other exercise program for arthritis. However the Taichi for arthritis could have positive effect to treat the rheumatoid and degenerative arthritis. We hope further studies to be followed in oriental medical field.

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The Clinical Observation of Oriental Medicine Treatment and Hominis placenta Pharmacopuncture in 4 Cases of Supraspinatus Tendinosis and Subdeltoid Bursitis (한방 치료와 자하거약침을 병행하여 치료한 극상근건염 및 삼각근하 점액낭염 환자 4례 증례보고)

  • Kim, Min-Yeong;Choi, Young-Il;Choi, Hee-Seung;Jung, Yoon-Gyoo;Choo, Won-Jung;Lee, Cha-Ro;Nam, Hang-Woo
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.17 no.2
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    • pp.1-15
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    • 2011
  • Objectives : The purpose of this case series is to investigate and report the effectiveness of oriental medicine treatment and Hominis placenta pharmacopuncture treatment for supraspinatus tendinosis and subdeltoid bursitis. Methods : 4 patients are admitted at Dept. of Oriental Rehabilitation Medicine, Bu-Cheon Jaseng Oriental Medicine Hospital, diagnosed as supraspinatus tendinosis and subdeltoid bursitis and treated with oriental medicine treatment and Hominis placenta pharmacopuncture. Each case is measured and assessed daily by NRS(Numeric Rating Scale) score and shoulder physical exam. Results : After treatment, patients' shoulder pain are decreased and they showed nearly full ROM(range of movement). In patients with supraspinatus tendinosis and subdeltoid bursitis, oriental medicine treatment and Hominis placenta is good method for pain relief and better movement. Conclusions : As seen in these 4 cases of supraspinatus tendinosis and subdeltoid bursitis, oriental medicine treatment and Hominis placenta pharmacopuncture appears to be effective.

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A Review of Neurofeedback Studies (뉴로피드백의 최신 연구 동향)

  • Lee, Hyuk-Jae;Park, Young-Bae;Park, Young-Jae;Oh, Hwan-Sup
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.11 no.2
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    • pp.13-26
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    • 2007
  • Background: Neurofeedback is an electroencephalographic biofeedback technique for training individuals to alter their brain activity via operant conditioning. Also neurofeedback is a form of behavioural training aimed at developing skills for brain activity. Within the past decade, several neurofeedback studies have been published that tend to overcome the methodological shortcomings of earlier studies. This research describes the methodical basis of neurofeedback and reviews the evidence base for its clinical efficacy and effectiveness in attention-deficit hyperactivity disorder (ADHD). Methods: In neurofeedback training, self-regulation of specific aspects of electrical brain activity is acquired by means of immediate feedback and positive reinforcement. In frequency training, activity in different EEG frequency bands has to be decreased or increased. Slow cortical potentials (SCPs) training is focused on the regulation of cortical excitability. Results: Neurofeedback studies revealed training-specific effects on, for example, attention and memory processes and performance improvements in real-life conditions, in healthy subjects as well as in patients. In several studies it was shown that ADHD symptomatology was reduced after frequency training or SCP(Slow cortical potentials) training. Moreover a decrease of impulsivity errors and an increase of the contingent negative variation. Conclusions: This research provides evidence for both positive behavioural and specific neurophysiological effects of neurofeedback training. Also there is growing evidence for neurofeedback as a valuable module in neuropsychiatric disorders. Further, controlled studies are warranted.

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The Clinical Observation on 1 Case of Patient with Central Cord Syndrome (중심성 척수 증후군 치험 1례)

  • Ryu, Do-Kyun;Lee, Ji-Hun;Oh, Kyung-Hwan;Park, Dong-Joon;Park, Soon-Il;Han, Chang-Ho;Chung, Sung-Hyun;Shin, Gil-Cho;Lee, Won-Chul;Hwang, Joo-Won
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.11 no.2
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    • pp.23-31
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    • 2005
  • Central cord syndrome (CCS) is the most common incomplete spinal cord injury (SCI) syndrome, occured by cervical hyperextension injury. It is characterized by disproportionately greater motor impairment in the upper extremities compared to the lower extremities, bladder dysfunction, and variable degrees of sensory loss below the level of injury. Recently 36 year-old male was admitted with upper motor neuron weakness, sensory loss in the upper extremities and stiff neck. We report the improvement of his symptoms through both western medical treatment and oriental medical treatment.

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Right Ventricular Strain Is Associated With Increased Length of Stay After Tetralogy of Fallot Repair

  • Ranjini Srinivasan;Jennifer A. Faerber;Grace DeCost;Xuemei Zhang;Michael DiLorenzo;Elizabeth Goldmuntz;Mark Fogel;Laura Mercer-Rosa
    • Journal of Cardiovascular Imaging
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    • v.30 no.1
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    • pp.50-58
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    • 2022
  • BACKGROUND: Little is known regarding right ventricular (RV) remodeling immediately after Tetralogy of Fallot (TOF) repair. We sought to describe myocardial deformation by cardiac magnetic resonance imaging (CMR) after TOF repair and investigate associations between these parameters and early post-operative outcomes. METHODS: Fifteen infants underwent CMR without sedation as part of a prospective pilot study after undergoing complete TOF repair, prior to hospital discharge. RV deformation (strain) was measured using tissue tracking, in addition to RV ejection fraction (EF), volumes, and pulmonary regurgitant fraction. Pearson correlation coefficients were used to determine associations between both strain and CMR measures/clinical outcomes. RESULTS: Most patients were male (11/15, 73%), with median age at TOF repair 53 days (interquartile range, 13,131). Most patients had pulmonary stenosis (vs. atresia) (11/15, 73%) and 7 (47%) received a transannular patch as part of their repair. RV function was overall preserved with mean RV EF of 62% (standard deviation [SD], 9.8). Peak radial and longitudinal strain were overall diminished (mean ± SD, 33.80 ± 18.30% and -15.50 ± 6.40%, respectively). Longer hospital length of stay after TOF repair was associated with worse RV peak radial ventricular strain (correlation coefficient (r), -0.54; p = 0.04). Greater pulmonary regurgitant fraction was associated with shorter time to peak radial RV strain (r = -0.55, p = 0.03). CONCLUSIONS: In this small study, our findings suggest presence of early decrease in RV strain after TOF repair and its association with hospital stay when changes in EF and RV size are not yet apparent.