Development of a Home Care Nursing Network System for Low Income and Vulnerable Health People by Utilizing Wire-Wireless Network and Mobile Computing / 대한의료정보학회지

This study was to develop the home care nursing network system for low income and vulnerable health people by utilizing wire- wireless network and mobile computing in order to record and send patients' data in real time, and connect the headquarter office and four local community health centers. The methods were the Method/1 and Prototyping were adopted to develop the main network system. Results were: 1) home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis, dementia/mental disorder, and chronic arthritis were added in 12 domains of nursing problem field with nursing assessment/intervention algorithms. 2) upgrading PDA system by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX - 1X base construction in order to reduce a transmission hour and the transmission failure.

Evaluation of Web-Based Real-Time Telemedicine Application Using ActiveX ontrols for Medical Moving Picture Analysis / 대한의료정보학회지

Telemedicine is described as combination of topics from the fields of telecommunication, medicine, and information and literally telemedicine means medicine at a distance. In this study, we present a web based real-time telemedicine application(WEBRETA) that was designed for patients who needs diagnosis on the Internet. The WEBRETA system is supporting transmitting of MPEG-4 video format(640*480)that was appropriate for Internet and designed with ActiveX controls technology that is also suitable for telecommunication link such as ADSL, VDSL and Cable modem which are very popular communication link in Korea. To improve the reliability and the usefulness of this prototype we involved the PSNR method and subjective score measuring from doctors. Futhermore, we will evaluate the WEBRETA with various communication network environment to improve how this system can contribute the diagnosis of patients and to analysis.

An Ecological Study of Food and Nutrition in Elementary School Children in Korea / 대한지역사회영양학회지

The current socioeconomic climate has meant more children spend more time alone at home even for dining. This study was performed to characterize modem Korean childrens' food ecology based on mealtime atmosphere. A total of 705 elementary school students, 347 girls and 358 boys took part in the study. They were chosen evenly from the Seoul metropolitan areas, provincial cities, or rural areas, and were asked to fill out a questionnaire. The questionnaire was categorized to determine various factors related to food ecology, life styles, and health related symptoms. The average age of the study subjects was 11.5 years. The average height, weight, body mass index, and Rohrer index were 143.2 cm, 37.6 kg, 18.2 and 127.2 respectively. A significant number of children(39.2%) answered their bed time was between 11 and 12 pm. Only 28.3% answered that the whole family has breakfast together, and 47.7% have dinner together. A considerable number of children, 17.8% for breakfast and 6.9% for dinner, answered they eat alone. Most of the children answered they like to have dinner with the whole family. Half of the children answered they do not feel hungry before having breakfast. Proportions of children for their favorite meal time were 66.8%, and 25.4% and 7.8% for dinner, school lunch, and breakfast respectively. The largest proportions of children, 53.3% and 68.7%, have breakfast and dinner at home. Most of the children(75.2%) never purchase their dinner. Forty two% of the children answered they like school lunch, however, 60% of children answered they leave portions of lunch uneaten occasionally or always. Only 38.0% and 46.2% of the children have nutritionally adequate diet for breakfast and dinner. Children having more meals with the whole family possessed a more positive attitude towards breakfast compared to the children who eat with the whole family less frequently. In conclusion, Korea children are exposed to different health threatening food ecology problems related to changing environments, and consistent concern and support from community nutritionists are required.

Development of an Online System to Access the Availability of Beds and Equipments in the Referral Centers for the Transport of Newborn Patients

PURPOSE: An online system concerning bed and equipment availability in the referral centers was developed to prevent any delay in the transport of newborn infants to a referral center with adequate equipments. METHODS: A program using web user interface was developed by Developer 2000 and Oracle database under UNIX system. The availability of equipments in the NICU, patient's medical information, user's information were included. The program was tested on the server of the Yeungnam University Medical Center with personal computers as clients. RESULTS: The program consisted of six menus : bed and equipment availability, updating the data, contact numbers, patients' informations, users informations, others. After login, availability of beds and equipments were shown according to the selected area which was chosen by the user. Phone numbers of physicians at the referral center appear on a window newly opened by clicking on the hospital name where newborn patient will be transferred. Medical information about patients can be transmitted to the referral center. The data can be updated by the webmaster of the individual hospital, and new hospital, delivery mode, treatment modality can be added by the system operator. It took 5.1+/-0.7 seconds from connection to execution of the program when it was connected through local area network in the medical center, and 10.2+/-0.2 seconds after 15+/-0.9 seconds' connection time if it was connected by 56K dial-up modem. Conclusion : This program will be very useful if connection time were shortened, and shortage of the neonatal intensive care beds nationwide were resolved.

On-line detection system of Escherichia coli O157:H7: A new support for Public Health / Sistema de detección en línea de Eschericha coli O157: H7: Un nuevo apoyo para la Salud Pública

Sistema de detección en línea de Escherichia coli O157: H7: Un nuevo apoyo para la Salud Pública.Introducción. Motivado por los casos innumerables de infecciones de diarrea que frecuentemente ocurren, en los países en vías de desarrollo, se calibró un biosensor a fibra optica con intensidad modulada usando como ejemplar Escherichia coli O157: H7. Material y métodos. La sensibilidad del dispositivo se ha calibrado para las unidades formadoras de colonia (CFU) de 10 a 800 rindiendo un error más pequeño que 11 por ciento.Resultados. Se obtuvo una correlación entre la respuesta óptica y el número instantáneo de bacterias. El signo del rendimiento óptico fue 0.016 (ñ 0.001) dB por hora por bacteria. En todo los casos la detección empezó después de 270 ñ 4 minutos, 5-10 veces más rápido que las técnicas bacteriológicas convencionales.Discusión. Los resultados obtenidos pueden contribuir al problema de monitoreo de patógenos que representen problemas en el campo de la salud pública.

A One-Click Paging System in the ED via the Internet

BACKGROUND: The time lag and the difficulty associated with calling clinicians of other departments are major concern in the emergency department(ED). We tried to design a new paging system which was faster, easier, and more accurate. METHOD: We made a web page comprised of paging numbers and then connected a personal computer in the ED to the internet through a dial-up modem, via a web-paging service, and could page persons wearing public pagers. RESULTS: We found that using the internet for paging was faster and more accurate than the hand-operated way. Calls were placed via the internet with only one click of the mouse. CONCLUSION: The One-click paging system is useful for hospital telecommunication. In this way, the internet can be applied to the entire emergency medical service system.

A Study on the Implementation of Medical Telemetry Systems Using Wireless Public Data Network Medical Telemetry System / 대한의료정보학회지

As information communication technology developed we could check our blood pressure, pulsation, electrocardiogram, saturation of arterial oxygen (Sa02) and serologic chemical tests easily at home. It is possible though interlocking the house medical instrument with the wireless public data network. Data from patients can be transmitted to the distant hospital and will be essentially applied through wireless public data network. In this study we measured electrocardiogram (ECG) for the telemetry. We put the EGG function into the movable device and add 900MHz band wireless public data interface, through which patients could record EGG and keep the data at home. We used wireless network modem and NCL (Native Gontrol Language) protocol to contact through wireless network, and 8CR (Standard Context Routing) protocol in the networkto connect to the wired host computer. The host computer checks the recorded individual EGG data and then sends the correspondant reply to the movable device. The study suggests the medical transmit system model utilized by the wireless public data network. The suggestion in the study of telemetry system provides movement and preservation. And it will exam the health condition in distance or at home.

Current Status and Clinical Analysis of Gynecological Pelviscopy in Korea / 대한산부인과학회잡지

OBJECTIVE: To evaluate the current status and new trends in gynelcological pelviscopy in Korea. METHODS: A survey was conducted and analyzed based on 20997 cases of operative pelviscopy hom May, 1985 to February, 1998 reported from twenty four university hospitals in Korea. RESULTS: The results obtained were ss followings; 1) 45.9 % of the total cases was 30 to 39 years old age group and it was the most dominant age group, 2) The previous operative history was found in 10.9% of the tota1 cases and included cesarean section(30.0%), ectopic pregnancy(20.3%), etc. 3) The operative indications were diagnostic(26.2%), myoma uteri(23.1%), ectopic pregnancy(21.4%), adnexal mass(18.4%), etc. In cases of diagnostic indication, the most common post-operative diagnosis of pelviscopic surgery was tubal pregnancy(30,6%). 4) The operative titles were salpingectomy(25.1%), hysterectomy(19.9%), salpinghorectomy(19.8%), etc. 5) The complications of operative pelviscopy were composed of subcutaneous emphysema(0.58%), preperitoneal bleeding(0.3%), bladder injury(0,3%), bowel injury(0.3%), etc. 6) lhe survey showed that 57.1% of the respondents desired more than 1 year of period for well peration between the operator and the assistant. 56.7% of respondents indicated that the surgical technique of the operator was the most important factor for a successful pelvisocopic surgery. 7) The most beneficial effect of the pelviscopy included the comfortableness of the patient(40.0%), cosmetic effect(22.8%), decrease of complications(14.2%), etc. CONCLUSION: The modem methods of operative pelviscopy have been successfully used in the treatment of gynecological disease. Today, pelviscopic surgery is being applied in almost all the cases of gynecological disease. Hence, the majority of pelviscopy techniques and pracedures being performed by surgeon must be taught in the controlled setting of a residency or a fellowship training program.

Development of Asymmetric Satellite Data Communication System and Evaluation Compared to Conventional terrestrial Network / 대한의료정보학회지

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.

Development of Asymmetric Satellite Data Communication System and Evaluation Compared to Conventional terrestrial Network / 대한의료정보학회지

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.

Aging and Gender Specific Quality of Life: Seventh crucial life

The role of doctors in ancient China was that of Prevention as opposed to curios, and illness was a just cause for execution. Much later, at the time of the French Revolution. Saint-Just evolved a new concept around the idea of happiness. As we can see in modem times, this idea is no longer a fad but a precious right that we humans can cherish and also means the quality and longevity of life. Of course this meaning cannot be the same for all people, and more so as humans are the most complex of all living nature. Even all this stage I feel it is so difficult to discuss the quality of life per so, as we all have different physical, emotional and material needs and modem science still cannot uncover the mystery of life. 4 concept of quality of life already been included in the WHO definition of has health where well-feeling is as necessary as well-being, both being of concern to medical doctors. I personally feel that the role of doctors is not simply to cure diseases but how we can help patients extend their span of life to live more actively and fulfillingly, the quality of life should not only deal with the prevention and cure of illnesses, but touch all aspects of aging. Aging in itself is quite mutual with any kind of disease and disability; the expansion and reduction of our lifespan depends so much on the exposure to disease and how aging affects both sexes diversely is one important factor when considering the quality of life. It could be said that our bodies are always in a state of homeostasis where biological destruction and development arise. This process is naturally called aging. However, passing through every seven year cycle we are dressing up our quality of life against various physical and mental experiences, while maintaining a steady state of homeostasis, and therefor face aging and different environmental changes. As a physician and being in a profession where we can influence ones quality of life. I feel it is imperative to study how aging is related to endocrinology and its disease, and the different outcomes of diseases and symptoms shown by males and females. In my study, I have generally classified our life span into seven crucial stages of aging and dealt with "Aging and gender how its physiology affects the quality of life".

The Empirical Research on Relationship Between Traits of Medical and Non-Medical Staffs with Indexes of Computer Related Effectiveness / 대한의료정보학회지

In the complexity and diversity of modem society, there is an urgent need for an information system which can systematically collect, manage and analyze data. The purpose of this paper is to find the relationship between traits of medical and non-medical staffs with indicators of computer-related effectiveness. In order to fulfill this purpose, dependent and independent variables are extracted from previous findings, and hypotheses are formulated. To test these hypotheses we carried out field research. The sample size which we studied is 203 employees of a general hospital in Taegu. Some of the meaningful findings of this study are as follows: The educational level has a positive relationship with computer usage time. And the attitude about computers has a positive relationship with degrees of satisfaction. Nurses' group especially has the most positive relationship with degrees of satisfaction, and physicians' group, resident doctors' group, pharmacologists' group, non-medicals' group(administrative etc.) are ranked in order of satisfaction.

Computerization in Ward Nursing Information System Using Order-Communicating System / 대한의료정보학회지

In the complexity and diversity of modem society, there is an urgent need for an information system which can systematically collect, manage and analyze data. Especially in the discipline of Nursing, a nursing information system is necessary to maximize nursing resources and improve nursing care in the present system which is faced with increases in client needs and multiple changes in recent hospital environment. This research was done to provide a basis for the development of nursing information system, which was extracted from an analysis of the demand of nurses and other medicine staffs in the general wards excluding the special unit(ER, OR, CSR, etc.). The ward nursing information system was analysed through analysis of nursing practice related to recordings, such as the work book, work list, kardex, other nursing practice recording on 24 wards, and open questionnaire of 288 nurses. Through this process, only four subsystems of output material for nursing practice were described in this study; (1) order communication system in nursing, (2) ward management system in nursing, (3) census reporting system in nursing, (4) materials management system.

Reduction of patients Treatment Time Through Quality Assurance Program

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.

Comparison of Imposed Work of Breathing Between Pressure-Triggered and Flow-Triggered Ventilation During Mechanical Ventilation / 결핵

BACKGROUND: The level of imposed work of breathing (WOB) is important for patient-ventilator synchrony and during weaning from mechanical ventilation. Triggering methods and the sensitivity of demand system are important determining factors of the imposed WOB. Flow triggering method is available on several modem ventilator and is believed to impose less work to a patient-triggered breath than pressure triggering method. We intended to compare the level of imposed WOB on two different methods of triggering and also at different levels of sensitivities on each triggering method (0.7 L/min vs 2.0 L/min on flow triggering ; -1 cmH2O vs -2 cm H2O on pressure triggering). METHODS: The subjects were 12 patients (64.8α4.2 yrs) on mechanical ventilation and were stable in respiratory pattern on CPAP 3 cmH2O. Four different triggering sensitivities were applied at random order. For determination of imposed WOB, tracheal end pressure was measured through the monitoring lumen of Hi-Lo Jet tracheal tube (Mallincrodt, New York, USA) using pneumotachograph/pressure transducer (CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Other data of respiratory mechanics wert also obtained by CP-100 pulmonary monitor. RESULTS: The imposed WOB was decreased by 37.5% during 0.7 L/min on flow triggering compared to -2 cmH2O on pressure triggering and also decreased by 14% during -1 cmH2O compared to -2 cmH2O on pressure triggering (p<0.05 in each). The PTP(Pressure Time Product) was also decreased significantly during 0.7 L/min on flow triggering and -I cmH2O on pressure triggering compared to -2 cmH2O on pressure triggering(p<0.05 in each). The proportions of imposed WOB in total WOB were ranged from 37% to 85% and no significant changes among different methods and sensitivities. The physiologic WOB showed no significant changes among different triggering methods and sensitivities. CONCLUSION: To reduce the imposed WOB, flow triggering with sensitivity of 0.7 L/min would be better method than pressure triggering with sensitivity of -2 cm H2O.

Comparative Analysis of Trauma Outcomes

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.

Design of a Teleradiology System / 대한의료정보학회지

In clinical surgery, there are frequent needs for communication between the house staff and the attending physician in an emergency situation. It's often insufficient for the house staff to make a decision through the information which is delivered in the form of only voice through the telephone line. To overcome the limitation of voice communication, we have designed an emergency teleradiology system which can be used for emergency surgical and medical decision making. The system can transmit the high quality images of CT, MRI, and other X-ray data using a PC attached to a modem through the conventional telephone line. Progressive transmission adopted in the system enables us to efficiently utilize the band-width of telephone line which is typically very low. The iterative residual coding/decoding algorithm compresses various medical images effectively, and thus fast-transmission of images date helps the house staff to perceive the status of emergent patient and make a fast and correct decision about the patient. The system also satisfies design requirements such as low-cost, ease of operation and interactive image communication including voice. 'Teleradiology system' proposed in this paper has been installed and operated in the emergency care unit of Severance Hospital, and as a result, it is effective in the emergency situations.

Assessment of Ovarian Malignancy by Positron Emission Tomography(PET) / 대한부인종양콜포스코피학회잡지

One of the moot important goals of modem gynexologic oncology is the adequate management of ocarian cancer. This includes early detection and differenciation of recurrence or residurd turnur. A promising method is availaible today with the use of mctabolic suubstrates used by tumor cells that are labeled with positron emittillg isotopes and a special instrument capable of detecting the radiations in vivo. Measuring tumor metabolic characteristics appear also to diffnencinte tumor recurrence or reeidual tumor from surgical or irradiation changes which is important since this wil1 not be defferentiaited by other modalities such ac CT or MRI. The goal of this study was to rletennine the potential utility uf whole-body PET using the giucose malogue 2-(18F)-fluoro-2-deoxy-D-glucoae(F-18-FDO for the detection of primey, metastatic, and recurrent ovarian cancer. Six patients had imaging studies prior to laparotomy for suspected ovarian cancer. PET(Positron Emission Tomogrnphy) scans were done with an ECAT 921(Emission Computed Axial Tomograpy 921, Sieinens/CTI. The result of this study show good correla- tion between PET nnd pathological findirs. The tumor detection rate of CT, MRI, CA-125, PET for ocarian cancer was 50%, 75%, 25%, 100% respectively. In summary, this work indicates that PET may be useful in the rnanagement of patients with ovwrian cancers by idengying occult foci of rnetabolically active tumor that do not appear on morphological studies.

Assessment of Ovarian Malignancy by Positron Emission Tomography(PET) / 대한부인종양콜포스코피학회잡지

One of the moot important goals of modem gynexologic oncology is the adequate management of ocarian cancer. This includes early detection and differenciation of recurrence or residurd turnur. A promising method is availaible today with the use of mctabolic suubstrates used by tumor cells that are labeled with positron emittillg isotopes and a special instrument capable of detecting the radiations in vivo. Measuring tumor metabolic characteristics appear also to diffnencinte tumor recurrence or reeidual tumor from surgical or irradiation changes which is important since this wil1 not be defferentiaited by other modalities such ac CT or MRI. The goal of this study was to rletennine the potential utility uf whole-body PET using the giucose malogue 2-(18F)-fluoro-2-deoxy-D-glucoae(F-18-FDO for the detection of primey, metastatic, and recurrent ovarian cancer. Six patients had imaging studies prior to laparotomy for suspected ovarian cancer. PET(Positron Emission Tomogrnphy) scans were done with an ECAT 921(Emission Computed Axial Tomograpy 921, Sieinens/CTI. The result of this study show good correla- tion between PET nnd pathological findirs. The tumor detection rate of CT, MRI, CA-125, PET for ocarian cancer was 50%, 75%, 25%, 100% respectively. In summary, this work indicates that PET may be useful in the rnanagement of patients with ovwrian cancers by idengying occult foci of rnetabolically active tumor that do not appear on morphological studies.