In-Kwang Lee

Miliary tuberculosis: a comparison of CT findings in HIV-seropositive and HIV-seronegative patients

The aim of this study was to determine the differences in CT findings of miliary tuberculosis in patients with and without HIV infection. Two radiologists reviewed retrospectively the CT findings of 15 HIV-seropositive and 14 HIV-seronegative patients with miliary tuberculosis. The decisions on the findings were reached by consensus. Statistical analysis was performed using the chi2 test, Mann-Whitney U-test and Fishers exact test. All of the HIV-seropositive and -seronegative patients had small nodules and micronodules distributed randomly throughout both lungs. HIV-seropositive patients had a higher prevalence of interlobular septal thickening (p = 0.017), necrotic lymph nodes (p = 0.005) and extrathoracic involvement (p = 0.040). The seropositive patients had a lower prevalence of large nodules (p = 0.031). In conclusion, recognition of the differences in the radiological findings between HIV-seropositive and -seronegative patients may help in the establishment of an earlier diagnosis of immune status in patients with miliary tuberculosis.

Conductive rubber belt to monitor respiratory changes

Conductive rubber material was molded in a belt shape to incorporate with patients pants for continuous monitoring of breathing activity. Dimension changes of the abdomen resulted in corresponding resistance changes, which successfully monitored respiration. When the standard air flow rate was simultaneously measured by a pneumotachometer, mean relative error was approximately 15%, presumably due to lack of chest signal. Wireless Zigbee transmission also provided a great convenience for monitoring. The present device would be of advantages for wearable applications for its simplicity, low cost, and being washable.

Wearable wireless respiratory monitoring system

Respiration is induced by muscular contraction of the chest and abdomen, resulting in the abdominal volume change. Thus, continuous measurement of the abdominal dimension enables to monitor breathing activity. Conductive rubber cord has been previously introduced and tested to develop wearable application for respiratory measurements. The present study implemented wireless wearable respiratory monitoring system with the conductive rubber cord in the patient`s pants. Signal extraction circuitry was developed to obtain the abdominal circumference changes reflecting the lung volume variation caused by respiratory activity. Wireless transmission was followed based on the zigbee communication protocol in a size of 65mm105mm easily put in pocket. Successful wireless monitoring of respiration was performed in that breathing frequency was accurately estimated as well as different breathing patterns were easily recognized from the abdominal signal. inhalation experiment was additionally performed in purpose of quantitative estimation of tidal volume. Air mixed with was inhaled by 4 normal males and the respiratory air flow rate, abdominal dimension change, and end tidal concentration were simultaneously measured in steady state. inhalation increased the tidal volume in normal physiological state with a correlation coefficient of 0.90 between the tidal volume and the end tidal concentration. The tidal volume estimated from the abdominal signal linearly correlated with the accurate tidal volume measured by pneumotachometer with a correlation coefficient of 0.88 with mean relative error of approximately 8%. Therefore, the tidal volume was accurately estimated by measuring the abdominal dimension change.

Mathematical Model for In-Ward Nursing Staffing Optimization Based on Patient Classification System

이 논문은 2014년도 충북대학교 학술연구지원사업의 연구비 지원에 의하여 연구되었으며(This work was supported by the research grant of Chungbuk National University in 2014), 2015도 정부(미래창조과학부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임(NRF-2015R1A2A2A040042 51).

Efficacy and safety of a patient-positioning device (EZ-FIX) for endoscopic retrograde cholangiopancreatography

AIM To assess the efficacy and safety of a patient-positioning device (EZ-FIX) for endoscopic retrograde cholangiopancreatography (ERCP). METHODS A total of 105 patients were randomized to the EZ-FIX (n = 53) or non-EZ-FIX (n = 52) group in this prospective study. Midazolam and propofol, titrated to provide an adequate level of sedation during therapeutic ERCP, were administered by trained registered nurses under endoscopist supervision. Primary outcome measures were the total dose of propofol and sedative-related complications, including hypoxia and hypotension. Secondary outcome measures were recovery time and sedation satisfaction of the endoscopist, nurses, and patients. RESULTS There was no significant difference in the rate of hypoxia, but there was a statistical trend (EX-FIX group; n = 4, 7.55%, control group; n = 6, 11.53%, P = 0.06). The mean total dose of propofol was lower in the EZ-FIX group than in the non-EZ-FIX group (89.43 ± 49.8 mg vs 112.4 ± 53.8 mg, P = 0.025). In addition, the EZ-FIX group had a shorter mean recovery time (11.23 ± 4.61 mg vs 14.96 ± 5.12 mg, P < 0.001). Sedation satisfaction of the endoscopist and nurses was higher in the EX-FIX group than in the non-EZ-FIX group. Technical success rates of the procedure were 96.23% and 96.15%, respectively (P = 0.856). Procedure-related complications did not differ by group (11.32% vs 13.46%, respectively, P = 0.735). CONCLUSION Using EZ-FIX reduced the total dose of propofol and the recovery time, and increased the satisfaction of the endoscopist and nurses.

A Practical standard Air Flow Generator System to Calibrate and Compare Performance of Two Different Respiratory Air Flow Measurement Modules

Abstract: A standard air flow generator system was developed to generate air flows of various levels simultaneouslyapplied to two different air flow transducer modules. Axes of two identical standard syringes for spirometer calibrationwere connected with each other and driven by a servo-motor. Linear displacement transducer was also connectedto the syringe axis to accurately acquire the volume change signal. The user can select either sinusoidal or squarewaveform of volume change and manually input any volume as well as maximal flow rate levels ranging 0~3l and0~15 l/s, respectively. Various volume and flow levels were input to operate the system, then the volume signal wasacquired followed by numerical differentiation to obtain the air flow signal. The measured volumes and maximal airflow rates were compared with the user input data. The relative errors between the user-input and the measuredstroke volumes were all within 0.5%, demonstrating very accurate driving of the system. In case of the maximal flowrate, relatively large error was observed when the syringe was driven very fast within a very short time duration.However, except for these few data, most measured flow rates revealed relative errors of approximately 2%. Whenthe measure and user-input stroke volume and maximal flow rate data were analyzed by linear regression analysis,respectively, the correlation coefficients were satisfactorily higher than 0.99 (p < 0.0001). These results demonstratethat the servo-motor controls the syringes with enough accuracy to generate standard air flows. Therefore, thepresent system would be very much practical for calibration process as well as performance evaluation and com-parison of two different air flow transducer modules.Key words: Standard air flow rate, Spirometer, Calibration technique

Development of Wireless Respiratory Air Flow and Urinary Flow Measurement System for Home Healthcare

Medical system for personal health management recently changes its paradigm from hospital service to self home care based on ubiquitous technology for healthcare anywhere at any time. The present study developed a wireless bio-signal measurement system for patients to self manage pulmonary disease and benign prostate hyperplasia(BPH), both of which are chronic diseases with increasing frequency in modern society. Velocity-type respiratory air flow transducer adapted to develop respiratory module for pulmonary disease management was simplified in structure to measure uni-directional flow since most important diagnostic parameters are evaluated on the expiratory flow signal only. Standard weight measurement technique was introduced to obtain urinary flow signal for BPH management. Three load cell signals were acquired for averaging to minimize noise, followed by accuracy evaluation. Transmission and receiver modules were also developed with user program for wireless communication. Averaged relative errors were 2.05 and 1.02% for respiratory volume and maximal flow rate, respectively, and the relative error was 2.17% for urinary volume, demonstrating that both modules enabled very accurate measurements. Wireless communication distance was verified within 15m, long enough for home care application. The present system allows the user to select a necessary measurement module on a particular health demand and to immediately provide the self-test results, thus better quality health care would be possible.

Mobile Phone based Asthma Management System

Asthma requires continuous long-term management with at least 5% outcome of general population as well as being the second cause of death and disability after cancer. The present study developed an efficient self management system based on the commercial mobile phone network. The spirometric test results are input to the mobile phone through the communication line connected to the portable spirometer. The doctor or the care-giver can search, identify, and review the data accumulated daily by the patient, and feedback to the patient necessary recommendations by short message and color mail services. Patient can also send an emergency call to the doctor and/or the care-giver. User interface was designed as convenient as possible for maximum efficiency of these operations. The present system provides a desired remote medical services, thus would enhance health management of chronic diseased patients.

Comparative analysis of blood glucose test results on the forearm, finger, and vein

Abstract Capillary blood sampling on the forearm reduces pain caused by skin puncture. The present study comparedthe blood glucose test results performed at different sampling sites of the forearm, finger, and vein to evaluate clinicalvalidity of this alternative site blood sampling technique. Subjects numbered 555 including 61 diabetic patients participated to measure the glucose concentration on the finger (G F ) and the forearm (G A ) with a portable glucometerunder overnight fasting state. Then, the venous glucose concentration (G V ) was measured in 514 subjects in less than1 hour. The test results were analyzed by simple linear regression, intraclass correlation, and Passing-Bablok regression techniques. G A was highly correlated with G F or G V showing the correlation coefficients (r) of approximately 0.97 (P<0.0001) in the normal group. The patient group also resulted similarly high correlation with only slightly lower r value. The mean differences in glucose concentration were less than ±10mg/dL regardless ofthe sampling sites. Intraclass correlation coefficients were slightly smaller than r but very much similar in value inboth groups. The 95% confidence intervals of the slope as well as the intercept in the Passing-Bablok regressionanalysis were <±20% and <±20mg/dL, respectively, which were within the clinically acceptable ranges. These threestatistical techniques introduced in the present study well demonstrated the consistency of G

Automation of urine dipstick test by simultaneous scanning : A pilot study

Urinalysis is an important clinical test to diagnose urinary diseases, and dipstick method with visual inspection is widely applied in practice. Automated optical devices recently developed have disadvantages of long measurement time, big size and heavy weight, accuracy degradation with time, etc. The present study proposed a new computer scanning technique, in which the test strip and the standard chart were simultaneously scanned to remove any environmental artifacts, followed by automated differentiation with the minimum distance algorithm, leading to significant enhancement of accuracy. Experiments demonstrated an accuracy of 100 % in that all test results were identical with the human visual inspection. The present technique only uses a personal computer with scanner and shortens the test time to a great degree. The results are also stored and accumulated for later use which can be transmitted to remote locations through a network, thus could be easily integrated to any ubiquitous health care systems.