• Title/Summary/Keyword: medical cost

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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.

The Relationship between MRO E-Commerce System and Purchase Effects

  • Kwon, Soon-Won;Kim, Young-Ei;Youn, Myoung-Kil;Jeon, Ta-Sik
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.5-15
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    • 2010
  • Business corporations have become specialized and on the basis of various interests try to strengthen their competitiveness through a cooperative system of purchase, distribution, service and IT technology. And an advanced Internet-based electronic commerce has witnessed explosive growth and a business-to-business (B2B) electronic commerce. Through E-marketplace. business corporations achieve such diverse utilities as expenditure curtailment, process reduction and prime cost reduction. And with business depression worldwide and soaring prices of materials, many business corporations consider the introduction of comprehensive purchase of MRO (maintenance, repair and operation) materials. The Purpose of this study was to examine the definition of B2B E-marketplace and the utilities of MRO commerce correctly focusing on an empirical analysis of cases of MRO supply and purchase business corporations. The indications acquired from this research results are as follows. Firstly, as for MRO integrated purchase under the characteristics of the market environment, it had to use the supplier obligatorily through the integrated purchase on the level of CEO's decision-making or the group rather than the voluntary will of the purchasing department or the procurement department. Secondly, as for the present B2B E-marketplace MRO purchase, the purchasing agency business has formed the mainstream, but it is aiming at the diversification of the benefit by supplementing/correcting the business model such as category type, mediation business type, MRO-type advancing in the store inclusive of the purchasing agency business, keeping pace with the potential market of MRO. Thirdly, as for analysis of the products, the purchaser wants more various products and assortment of goods than those of the present time, and also to be provided with the precise product information. Especially, as the importance of the product sourcing becomes high, the whole energy has been bestowed on acquirement of the excellent suppliers. Fourth, as for use of B2B E-marketplace MRO integrated purchasing system, there are the purchasing companies complaining the inconvenience even until now, and there is the demerit spending the long time during the image move and the process treatment. It shall try to shorten the searching time and the process treatment time as the system is centered on the purchaser. In order to enhance the efficiency of MRO E-marketplace purchase, followings must be considered: First, because the importance of product sources ever increases, an excellent supplier must be secured earnestly. Second, the time of process must be reduced focusing on purchasers. B2B E-marketplace will increase and diversify electronic commerce continuously. Through MRO E-marketplace, business corporations will reduce expenditure, achieve a transparent and speedy trade, and purchase products of fine quality, thus establishing a most effective market. In addition, in this study the investigator brings focus into MRO which has not been clearly discussed in the academic and business world so far and intensively highlights an indirect material-oriented expenditure curtailment effect. By taking all the aspects of supplier, purchaser and practical economical value into account, the investigator presents a strategic direction for the successful comprehensive purchase of B2B MRO.

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Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

  • Keyhani, Elahe;Muhammadnejad, Ahad;Behjati, Farkhondeh;Sirati, Fereidoon;Khodadadi, Faranak;Karimlou, Masoud;Moghaddam, Fatemeh A.;Pazhoomand, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7651-7656
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    • 2013
  • Background: Breast cancer is the most common malignancy among women in both developed and developing countries. The burden is increasing in low-income and middle-income countries (LMCs) and threatens the public health of such societies. Introduction of expensive monoclonal antibodies to cancer treatment regimens poses a real challenge in the health systems of LMCs. Despite controversy of cost-effectiveness of bevacizumab in breast cancer, some studies indicate gain of patients from this drug. The present study aimed to propose a priority setting model for administration of anti-angiogenic agents in breast cancer via assessment of tumor angiogenesis by the microvessel density (MVD) method and associations with clinicopathological characteristics (including simultaneous mutations of TP53 and HER-2 genes). Materials and Methods: Age, axillary lymph nodes status, tumor size, stage and grade, estrogen and progesterone receptors status, HER-2/neu status (by immunohistochemistry and FISH test), TP53 mutation, Ki-67 (for proliferation assay) and CD34 (for angiogenesis assay) were assessed in 111 breast cancer patients. The molecular subtype of each tumor was also determined and correlations of simultaneous mutations of HER-2 and p53 genes with angiogenesis and other clinicopathological characteristics were evaluated. Results: There were significant associations between simultaneous mutations of HER-2 and p53 genes and all other parameters except tumor size. The degree of angiogenesis in the ERBB2 subtype was greater than the others. Younger patients showed a higher angiogenesis rate rather those older than 50 years. Conclusions: Our results demonstrated that patients with simultaneous mutations of HER-2 and p53 genes, those with ERBB2 molecular subtype and also younger women (often triple negative) seem more eligible for obtaining anti-angiogenic agents. These results suggest a model for priority setting of patients with breast cancer for treatment with anti-angiogenic drugs in LMCs.

Alternative Carcinogenicity Screening Assay Using Colon Cancer Stem Cells: A Quantitative PCR (qPCR)-Based Prediction System for Colon Carcinogenesis

  • Bak, Yesol;Jang, Hui-Joo;Shin, Jong-Woon;Kim, Soo-Jin;Chun, Hyun woo;Seo, Ji-Hye;No, Su-Hyun;Chae, Jung-il;Son, Dong Hee;Lee, Seung Yeoun;Hong, Jintae;Yoon, Do-Young
    • Journal of Microbiology and Biotechnology
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    • v.28 no.4
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    • pp.645-651
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    • 2018
  • The carcinogenicity of chemicals in the environment is a major concern. Recently, numerous studies have attempted to develop methods for predicting carcinogenicity, including rodent and cell-based approaches. However, rodent carcinogenicity tests for evaluating the carcinogenic potential of a chemical to humans are time-consuming and costly. This study focused on the development of an alternative method for predicting carcinogenicity using quantitative PCR (qPCR) and colon cancer stem cells. A toxicogenomic method, mRNA profiling, is useful for predicting carcinogenicity. Using microarray analysis, we optimized 16 predictive gene sets from five carcinogens (azoxymethane, 3,2'-dimethyl-4-aminobiphenyl, N-ethyl-n-nitrosourea, metronidazole, 4-(n-methyl-n-nitrosamino)-1-(3-pyridyl)-1-butanone) used to treat colon cancer stem cell samples. The 16 genes were evaluated by qPCR using 23 positive and negative carcinogens in colon cancer stem cells. Among them, six genes could differentiate between positive and negative carcinogens with a p-value of ${\leq}0.05$. Our qPCR-based prediction system for colon carcinogenesis using colon cancer stem cells is cost- and time-efficient. Thus, this qPCR-based prediction system is an alternative to in vivo carcinogenicity screening assays.

Development of MRI Simulator Early Diagnosis Program for Self Learning (자가 학습을 위한 MRI Simulator 초기 검사 프로그램 개발)

  • Jeong, Cheon-Soo;Kim, Chong-Yeal
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.403-410
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    • 2015
  • Since 1970, MRI has greatly been developing in terms of strength of magnetic field, the number of receipt channels, and short time of examination. With the development of digital systems and wireless network, hospitals have also acquired, saved, and managed digital images taken by various kinds of medical imaging equipment. However, domestic universities fail to provide practice training course independently thanks to expensive practice equipment and high maintenance cost, and rely on clinical training. Therefore, this study developed a MR patient diagnosis program based on Windows PC to help out students before their working in clinical filed. The designed Relational Database of MRI Simulator is made up of seven tables according to functions and data characteristics. Regarding the designed patient information, each stepwise function was classified by the patient registration method in clinical field. In addition, on the assumption of the basic information for diagnosis, each setting and content were classified. The menu by execution step was arrayed on the left side for easy view. For patient registration, a patient's name, gender, unique ID, birth date, weight, and other types of basic information were entered, and the patient's posture and diagnosis direction were set up. In addition, the body regions for diagnosis and Pulse Sequence were listed for selection. Also, Protocol name and other additional factors were allowed to be entered. The final window was designed to check diagnosis images, patient information, and diagnosis conditions. By learning how to enter patient information and change diagnosis conditions in this program, users will be able to understand more theories and terms learned in practice and thereby to shorten their learning time in actual clinical work.