• 제목/요약/키워드: medical exchange

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HL7(Healthy Level Seven) 프로토콜을 이용한 실시간 환자 모니터링 웹 뷰어시스템 개발 (The Web Viewer System Development of Real-Time Patient Monitering using HL7(Healthy Level Seven) Protocol)

  • 김광준;임세정
    • 한국정보통신학회논문지
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    • 제13권3호
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    • pp.546-555
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    • 2009
  • HL7은 병원정보 시스템에서 사용되는 정보와 관련된 표준화된 프로토콜이다. 생체 정보 웹 뷰어 시스템 또한 의료 영상 및 전송에 대해 표준화된 프로토콜이다. 본 논문에서는 ICU(Intensive Care Unit)에 설치된 Central Monitor에서 확인할 수 있는 환자의 생체 정보들을 웹상에서 실시간 확인할 수 있는 시스템 구성을 제안하기 위하여 생체정보 수신 모듈과 웹 뷰어 시스템을 구성하였다. 생체정보 수신 모듈은 Central Monitor로부터 수신할 수 있는 Raw Data 형태의 환자의 생체 정보를 생체 정보 웹 뷰어 시스템에서 사용가능 한 데이터로 분석할 수 있도록 설계가 이루어져 있다. 웹 뷰어 시스템은 환자 생체 정보에 대한 실시간성과 생체 정보에 대한 데이터의 연속성을 부여하여 베드 사이트의 환자에게서 발생된 모든 생체정보에 의해 환자 관리를 데이터 베이스를 이용하여 전산화함으로써 환자의 광범위한 자료 검색이 이루어지므로 획기적인 원격 진료로 활용이 가능하다. 또한 적절한 생체 정보데이터의 교환과 정보 관리의 수정을 통해 병원정보 시스템은 모든 병원 관계자의 보다나은 업무처리를 향상시킬 수 있다.

외부영상정보 입력 시 DICOM정보 충실성에 대한 평가 - DICOM Validation Tool 이용 - (The Evaluation about the Information Fidelity in the External Image Information Input - Using DICOM Validation Tool -)

  • 이송우;이호연;도지훈;장혜원
    • 대한디지털의료영상학회논문지
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    • 제13권1호
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    • pp.33-38
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    • 2011
  • Now a days, there's many change over for PACS among the most of hospital and it standard for DICOM 3.0. These kind of using of DICOM 3.0 improves increasing of medical imaging exchange and service for patient. However, there's some problems of compatibility caused during carry out CD and DVD from hospital. For this reason, this thesis analyzed patients image targeting those storages requested to hospitals in Seoul by using Validation Toolkit which is recommended from KFDA. The analyze type is like this. Make 100 data, total 500, each of MRI CT Plain x-ray Ultrasound PET-CT images and analyzed type of error occurred and loyalty of information. If express percentage of error occurred statistically, we can get a result as follows MRI 5%, Plain x-ray 11%, CT 18%, US 25%, PET-CT 30%. The reson why percentage of error occurred in PET-CT is because of imperfective support and we could notice that we weren't devoted to information. Even though, PET-CT showed highest percentage of error occurred, currently DICOM data improved a lot compare to past. Moreover, it should be devoted to rule of IHE TOOL or DICOM. In conclusion, we can help radiographer to analyze information of image by providing clues for solving primary problem and further more, each of PACS company or equipment company can enhance fidelity for following standard of image information through realizing the actual problem during transfer of image information.

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TMO를 이용한 실시간 생체정보 전송 모니터링 시스템 구현 (The Implementation of Real-Time Vital Sign Information Transmission Monitoring System using TMO)

  • 임세정;김광준
    • 한국정보전자통신기술학회논문지
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    • 제1권3호
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    • pp.33-40
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    • 2008
  • TMO 구조는 시간 구동 메소드와 메시지 구동 메소드의 두 가지 형태의 메소드로 이루어져 있으며, 일정한 시간이 지남에 따라 자동적으로 수행되는 시간 구동 메소드와 객체 노드 사이의 실행 결과를 주고받을 수 있는 서비스 메시지 구동 메소드로 명확하게 구분된다. 시간 구동 메소드의 실행은 설계 시간을 설정하는 과정에 결정된 특정한 값에 의해 실시간 통신 클럭의 도착에 따라 이루어지고 반면에 서비스 구동 메소드 실행은 클라이언트로부터 메시지를 요구하는 서비스에 의해서만 실행된다. 본 논문에서는 이러한 TMO 구조를 이용하여 실시간 통신 시뮬레이션 프로그래밍을 하기 위해 환자 모니터 원격진료 시스템 응용 환경에 적용하였다. Central Monitor로부터 전송되어진 환자의 생체정보 Raw Data가 HIS의 데이터 수신 모듈을 통해 사용가능한 데이터로 재구성될 수 있도록 설계가 이루어져 있다. 환자 생체정보에 대한 실시간성과 생체정보에 대한 생체정보 데이터의 연속성을 부여함으로서 베드 사이트의 환자에게서 발생된 모든 생체정보에 의해 환자 관리가 이루어진다.

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The Influence of Maximal Aerobic Capacity on the Two Years Cardiac Related Re-Hospitalization in Patients with Heart Failure with Reduced Ejection Fraction in Korean Society

  • Ryu, Ho Youl;Hong, Do Sun;Kim, Tack Hoon
    • The Journal of Korean Physical Therapy
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    • 제31권5호
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    • pp.322-327
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    • 2019
  • Purpose: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society. Methods: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%). Results: The relative peak $VO_2$ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio ($VCO_2/VO_2$, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO2 slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak $VO_2$ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by $VCO_2/VO_2$ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization. Conclusion: The maximal aerobic capacity, especially the relative peak $VO_2$, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.

건선의 동서의학적 연구 특징의 비교 (Comparison of Research Characteristics in Western, Chinese Traditional Medicine and Korean Medicine on Psoriasis)

  • 이선동;정세영;이승은
    • 대한한의학회지
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    • 제42권2호
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    • pp.72-81
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    • 2021
  • Objectives: We compared research characteristics of western medicine, Chinese medicine and Korean medicine on causes, mechanisms, types, treatments and prevention of psoriasis. Methods: For western medicine, "Psoriasis" was used as keyword on Pubmed, for Chinese medicine, "銀屑病" and "中医" on CNKI (China National Knowledge Infrastructure" and for Korean medicine, "건선" on OASIS. Keyword searches were done for papers and books published after 2010. For Chinese medicine, there were more in-depth searches done for "從血論 (血熱, 血瘀, 血燥)" and "陽虛症". Results: Western medicine puts an emphasis on the foci, and approaches it from molecular and genetic levels based on molecular biology; while it views psoriasis as a disease with multiple possible causes, it ultimately sees it as an inflammation that is immunity-mediated. Western medicine seeks to suppress cytokine in order to prevent and eliminate inflammation at each stage of treatment While they are effective short-term, psoriasis recurs shortly after. Chinese and Korean medicines categorize psoriasis as an internal comprehensive systemic diseases that encompasses the patient's physical and mental characteristics, and defines it as a disease that has many causes and mechanisms such as "血熱, 血瘀, 血燥" and "陽虛". They use herbal medicine, acupuncture, and lifestyle interventions to improve the overall health of the patient in addition to treating psoriasis. Treatments are effective, but it takes relatively longer to see results, and can recur. Conclusion: In order for more progress to happen on psoriasis treatment, each branch of medicine must exchange knowledge and information more frequently.

Role of Cel5H protein surface amino acids in binding with clay minerals and measurements of its forces

  • Renukaradhya K. Math;Nagakumar Bharatham;Palaksha K. Javaregowda;Han Dae Yun
    • Applied Microscopy
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    • 제51권
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    • pp.17.1-17.10
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    • 2021
  • Our previous study on the binding activity between Cel5H and clay minerals showed highest binding efficiency among other cellulase enzymes cloned. Here, based on previous studies, we hypothesized that the positive amino acids on the surface of Cel5H protein may play an important role in binding to clay surfaces. To examine this, protein sequences of Bacillus licheniformis Cel5H (BlCel5H) and Paenibacillus polymyxa Cel5A (PpCel5A) were analyzed and then selected amino acids were mutated. These mutated proteins were investigated for binding activity and force measurement via atomic force microscopy (AFM). A total of seven amino acids which are only present in BlCel5H but not in PpCel5A were selected for mutational studies and the positive residues which are present in both were omitted. Of the seven selected surface lysine residues, only three mutants K196A(M2), K54A(M3) and K157T(M4) showed 12%, 7% and 8% less clay mineral binding ability, respectively compared with wild-type. The probable reason why other mutants did not show altered binding efficiency might be due to relative location of amino acids on the protein surface. Meanwhile, measurement of adhesion forces on mica sheets showed a well-defined maximum at 69±19 pN for wild-type, 58±19 pN for M2, 53±19 pN for M3, and 49±19 pN for M4 proteins. Hence, our results demonstrated that relative location of surface amino acids of Cel5H protein especially positive charged amino acids are important in the process of clay mineral-protein binding interaction through electrostatic exchange of charges.

International Microsurgery Club and World Society for Reconstructive Microsurgery Webinar: Career Building in Microsurgery

  • Joachim N. Meuli;Jung-Ju Huang;Susana Heredero;Wei F. Chen;Tommy NJ Chang
    • Archives of Plastic Surgery
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    • 제51권2호
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    • pp.258-261
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    • 2024
  • Career building can be challenging for young surgeons, especially when topics such as lifestyle, work-life balance and subspecialization arise. Suggestions and advice from senior colleagues is very valuable but many young surgeons do not have such opportunities or are limited to a few senior surgeons. The International Microsurgery Club (IMC), in collaboration with the World Society of Reconstructive Microsurgery, organized a combined webinar for this topic and invited world renownedmicrosurgery masters polled by the IMCmembers to join, including Prof. Peter Neligan (Emeritus from University of Washington, United States), Prof. Raja Sabapathy (Ganga Hospital, India), Dr. Gregory Buncke (The Buncke Clinic, United States), Prof. Isao Koshima (Hiroshima University Hospital, Japan), Prof. David Chwei-Chin Chuang (Chang Gung Memorial Hospital, Taiwan), and Prof. Eric Santamaria (Hospital General Dr. Manuel Gea Gonzalez, Mexico) on May 1, 2022. Prof. Joon-Pio Hong (Asan Medical Center, South Korea) and Prof. Fu-Chan Wei (Chang Gung Memorial Hospital, Taiwan) were also selected but unfortunately could not make it and were therefore invited to another event in April 2023, summarized in a recently published paper. There is ample literature reporting on different aspects of developing a microsurgical career but the goal of this session was to offer an opportunity for direct exchange with experienced mentors. Moreover, insights from experienced microsurgeons from different part of the world were more likely to offer different perspectives on aspects such as career building, failure management, and team culture. This webinar event was moderated by Dr. Jung-Ju Huang (Taiwan), Dr. Susana Heredero (Spain), and Dr. Wei F. Chen (United States).

기계환기중인 환자에서 기관지내시경 검사에 따른 생리적 변화 (Physiologic Changes During Bronchoscopy in Mechanically Ventilated Patients)

  • 편유장;서지영;고원중;유창민;전경만;전익수;함형석;강은해;정만표;김호중;권오정
    • Tuberculosis and Respiratory Diseases
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    • 제56권5호
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    • pp.523-531
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    • 2004
  • 연구배경 : 최근 기계환기 중 기관지내시경술의 필요성이 증가하고 있으나, 시술 중 생리학적 변화나 안전성에 대한 연구가 부족한 상황이다. 이에 연구자들은 PEEP을 시술전과 동일하게 유지하면서 기관지내시경술을 시행하여 생리학적 변화 및 안전성에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 2002년 6월부터 2002년 11월까지 삼성서울병원 내과계 중환자실에서 기계환기를 하면서 기관지내시경술을 시행했던 19명의 환자(남자 10명 여자 9명, 연령 중앙값 61.6세)를 대상으로 하였다. 기관지내시경술을 시행하기 전 100% 산소로 15분간 전산 소요법을 시켰으며 기관지내시경 시술 중 기계환기는 용적조절양식으로, 일회환기량 4 ml/kg, 호흡수 20회/분, 흡기 대 호기비 1:2로 환기하였으며 PEEP은 시술전과 동일하게 유지하였다. 시행 후 30분간 100% 산소를 유지하였다. 결 과 : 기관지내시경술 시행시간의 중앙값은 6분(범위 3-15분)이었다. 기관지내시경술을 시행하면서 호흡성 산증과 저환기, 최고기도압의 상승, 심박수의 증가, auto-PEEP의 발생을 보였다. 이들 변화는 기관지내시경 시술 후에 시술 이전의 상태로 되었다. 압력손상 및 혈압 감소 등의 심각한 합병증은 관찰되지 않았다 결 론 : 심각한 저산소증으로 높은 PEEP을 유지하고 있는 환자에게서 PEEP을 유지한 채로 기관지내시경술을 시행하여도 심각한 합병증은 관찰되지 않았다. 다만, 기관지내시경을 시행하는 동안 호흡성 산증 및 저환기를 보였고, 비록 가역적이지만 이러한 상태에서 환자의 노출을 최소화하기 위해서는 기관지내시경 시행시간을 최소화하여야 한다고 사료된다.

의료기기 일괄허가 및 기술문서 심사를 위한 품목별 길라잡이 개발 (Preparation of guidance documents item by item for one-step evaluation and approval for Medical Devices)

  • 김용우;신채민;방지영;이정연;오현주;배우진;최진만;임경미;오헌진;김미영;허찬회;김형범;최민용;곽지영;김수연;황상연;윤해석;홍혜경; 안소영;이창형;정진백;구자중;강세구;정재훈;임경택;임창근;김민수;이성희;이재근;박기정
    • 대한의용생체공학회:의공학회지
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    • 제31권4호
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    • pp.280-284
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    • 2010
  • Approvals of medical device increase every year as industry of medical device grows. Therefore KFDA keeps trying to improve approval systems. However, the firms of medical device are in trouble due to regulation amendment, a firm of small size, exchange of the person in charge. The staffs of KFDA increase their work load because applicants of approval of medical device aren't used to writing of document. Therefore the firm of medical device in business have a long term. KFDA develops eight guidance document item by item for one-step evaluation and approval for Medical Devices because applicants of approval of medical device write documents easily. KFDA reviewer can carry on quick reviewing in use of this eight guidances. This guidance are improved on satisfaction of applicants of approval of medical device.

초자화 동결에 의한 생쥐 1-세포기배의 체외 발달과 SCE 빈도 (Sister Chromatid Exchange (SCE) Frequency and In Vitro Development of Mouse Zygote Cryopreserved by Vitrification)

  • 김묘경;백청순;엄상준;김은영;윤산현;박세필;정길생;임진호
    • Clinical and Experimental Reproductive Medicine
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    • 제23권3호
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    • pp.379-384
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    • 1996
  • 본 연구는 생쥐 1-세포기 수정란의 초자화 동결과 동결액 노출에 따른 수정란의 배발달율과 SCE 빈도를 조사하고자 실시하였다. 체외수정된 생쥐 1-세포기 수정란의 동결은 EFS40 (40% ethylene glycol, 30% Ficoll, 0.3 M sucrose)의 초자화동결법을 이용하였으며, $25^{\circ}C$에서 30 초동안 EFS40에 노출시킨 다음, 곧바로 액체질소에 침투시키거나, 동결액의 독성 검사를 위해 동결없이 배양하여 다음과 같은 결과를 보였다. 융해후, 2-세포기 까지 생존율은 EFS40에 노출 혹은 초자화동결시 각각 95.2, 98.5% 로서 대조군의 100%와 비교했을때 큰 차이가 없었다. 그러나 배반포와 탈출배반포까지의 배발달율에 있어서 초자화 동결된 군 66.7, 50.0%는 동결액에 노출만된 군 94.0 78.8%와 대조군 93.9, 81.8%에 비해 낮았다 (p<0.05). 동결액에 노출 혹은 초자화동결된 생쥐 1-세포기의 체외 발달에 따른 SCE 빈도를 조사한 결과, 동결액 노출 ($20.2{\pm}2.1$) 혹은 초자화동결시 ($21.4{\pm}3.2$) SCE 빈도가 대조군 ($16.8{\pm}1.5$)에 비해 증가하였다. 이러한 결과를 종합하여 고찰할 때, 초자화동결된 1-세포기 수정란의 배반포 또는 탈출 배반포까지의 낮은 배발달율은 동결액의 영향을 받지 않았으나, SCE 빈도는 동결액에 노출 혹은 초자화 동결시 증가 된다는 것을 알수 있다.

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