TaeBum Lee

Development of a radial pulse tonometric (RPT) sensor with a temperature compensation mechanism.

Several RPT sensors have been developed to acquire objective and quantitative pulse waves. These sensors offer improved performance with respect to pressure calibration, size and sensor deployment, but not temperature. Since most pressure sensors are sensitive to temperature, various temperature compensation techniques have been developed, but these techniques are largely inapplicable to RPT sensors due to the size restrictions of the sensor, and incompatibility between the compensation techniques and the RPT sensor. Consequently, in this paper a new RPT sensor comprising six piezoresistive pressure sensors and one thermistor has been developed through finite element analysis and then a suitable temperature compensation technique has been proposed. This technique compensates for temperature variations by using the thermistor and simple compensation equations. As verification of the proposed compensation technique, pulse waves of all types were successfully compensated for temperature changes.

Risk factors of radiation dose in patients undergoing peripherally-inserted central catheter procedure using conventional angiography equipment and flat panel detector-based mobile C-arm fluoroscopy

Background Although peripherally-inserted central catheter (PICC) insertion is commonly performed under fluoroscopic guidance, few reports have addressed performance and dosimetry when PICC is inserted under C-arm fluoroscopy. Purpose To evaluate the risk factors of radiation dose in performing PICC insertion using flat panel detector-based mobile C-arm fluoroscopy and a conventional angiography machine. Material and Methods Ninety-eight patients underwent the PICC procedure using conventional angiography equipment (n=49) or flat panel detector-based mobile C-arm fluoroscopy (n=49). Data were prospectively analyzed from July to November 2012. Dose-area product (DAP), tube voltage, tube current, fluoroscopy time, and image quality measured on a 5-point scale were estimated and compared using appropriate statistical tests. Results There were no significant differences in tube voltage, fluoroscopy time, and image quality between conventional angiography and mobile C-arm fluoroscopy. DAP, mean arm tube current, and tube current in chest fluoroscopy were significantly lower in mobile C-arm fluoroscopy than using the conventional angiography machine (P <0.05). Multivariate analysis identified tube current in chest fluoroscopy, arm tube current, and fluoroscopy equipment as significant risk factors for elevated radiation dose in PICC insertion. Conclusion PICC insertion can be performed using flat panel detector-based mobile C-arm fluoroscopy instead of a conventional angiography machine. Image quality and fluoroscopy time were not different between the two systems and the use of C-arm fluoroscopy significantly reduced radiation dose.

Community-Based Home Healthcare Project for Korean Older Adults

Objectives The aim of this study was to identify the effects of community-based home healthcare projects that influence service performances with regard to Korean national long-term care insurance services in older adults. Methods The projects applicants were 18 operational agencies in national long-term care institutions in Korea, and participants were care recipients (n = 2263) registered in long-term care institutions. We applied our healthcare system to the recruited participants for a 3-month period from October 2012 to December 2012. We measured the community-based home healthcare services such as long-term care, health and medical service, and welfare and leisure service prior to and after applying the community-based home healthcare system. Results After the implementation of community-based home healthcare project, all community-based home healthcare services showed an increase than prior to the project implementation. The nutrition management service was the most increased and its increase rate was 628.6%. A comparison between the long-term care insurance beneficiaries and nonbeneficiaries showed that health and medical services’ increase rate of nonbeneficiaries was significantly higher than beneficiaries (p < 0.001). Conclusion Our community-based home healthcare project might improve the service implementation for older adults and there was a difference in the increase rate of health and medical services between Korean national long-term care insurance beneficiaries and nonbeneficiaries.

A practical comparison of Copper Bromide Laser for the treatment of vascular lesions

The recent rapid growth in demand for aesthetic non-invasive laser treatments such as unwanted skin rejuvenation, removal of age-related vascular blemishes has led to a boom in the medical devices to treat these conditions. Among diverse laser for skin treatment, copper bromide laser is a very effective, safe, and well tolerated treatment for facial telangiectasia at various energy levels and the most important thing of the copper bromide laser device is that the stability of the energy. However there is no evidence about effective copper bromide lasers energy level for the treatment of vascular lesions. We compared energy stability and treatment performance between two energy levels in 2W and 8W which commonly use in laser treatment for the vascular lesions. 8W copper bromide laser was more stable compared than 2W copper bromide laser. Also, 8W copper bromide laser was effectively superior to 2W copper bromide laser in treatment of vascular legion. Consequently, 8W copper bromide laser treatment for vascular lesion might be more suitable than 2W copper bromide laser.

Comparison of Breast Cancer Screening Results in Korean Middle-Aged Women: A Hospital-based Prospective Cohort Study.

Objectives The aim of this hospital-based prospective study was to evaluate the diagnostic ability of breast cancer screening in Korean middle-aged women using age, ultrasonography, mammography, and magnification mammography, which are commonly used in most hospitals. Methods A total of 21 patents were examined using ultrasonography, mammography, and magnification mammography, and their data were prospectively analyzed from August 2011 to March 2013. All patients were divided into benign and malignant groups and the screening results were classified using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS). The final pathology report was used as the reference standard and the sensitivity and specificity of ultrasonography, mammography, and magnification mammography were evaluated using receiver-operating characteristics (ROC) analysis. Results The analysis included 21 patients who underwent biopsy. Among them, three (14.3%) were positive and 18 (85.7%) negative for breast cancer. The average age was 50.5 years (range = 38–61 years). The sensitivity was the same for ultrasonography and magnification mammography and the specificity of magnification mammography was higher than that of ultrasonography. The highest area under the ROC curve (AUC) was observed in the combination of age and magnification mammography (1.000) and the decreasing order of AUC in others was magnification mammography (0.833), ultrasonography (0.787), mammography (0.667), and age (0.648). Conclusions In Korean women, the diagnostic accuracy of magnification mammography was better than that of ultrasonography and mammography. The combination of age and magnification mammography increased the sensitivity and diagnostic accuracy.

Long term care education program for caregivers to improve home healthcare service in Korean older adults.

To the Editor: Long term care facilities (LTCFs), especially those with high levels of acuity, often breed high levels of multidrug-resistant organisms (MDROs).1 Facilities should not assume that published rates of MDROs reflect the level of MDROs in their facility. Considerable variation between LTCFs exists.2 Unfortunately, it is our impression that many LTCFs are not tracking or aware of their burden of MDROs. Perhaps a good starting point and potential motivator for antibiotic stewardship is the construction of a facilityspecific antibiogram. Many LTCFs perform few cultures. There may, however, be an adequate number of unique isolates to construct a urine-specific antibiogram. Ideally, isolates obtained in the emergency department or hospital within 2 days of transfer from the LTCF should be included in the facilities’ antibiogram. These isolates are NOT considered to be hospital acquired. Only one isolate of a given type (species/sensitivity) should be included per resident.3 In some cases, the reference laboratory may have software to construct and maintain the database. This could be included in a contract. The antibiogram will assist in the selection of empiric therapy. The analysis may yield startling results. In 2008, 51% of Escherichia coli urinary isolates from 63 LTCFs in the northeastern United States were quinolone resistant.3 We recently reviewed urine-specific antibiograms from 2 LTCFs in the Milwaukee metropolitan area. Only 22% and 60% of gram-negative urinary isolates were sensitive to ciprofloxacin. The post antibiotic era may have arrived in some LTCFs. High rates of ciprofloxacin resistance strongly imply that using this antibiotic as a single agent in suspected septicemia is inappropriate. Special attention should be given to quinolone resistance and chronic indwelling catheters (a specific risk factor for MDRO)4. Serial analysis of an antibiogram and incidence of Clostridium difficile diarrhea could determine the efficacy of an antibiotic stewardship program.

The effects of assistive products in Korean long-term care insurance system for the beneficiary older adults

Objectives : The purpose of this study is to evaluate the effects of assistive products usage on activity of daily living for the beneficiary older adults people in Korean long-term care insurance system. The study subjects were divided to assistive products users and non-users among the beneficiary older adults based on Korean long-term care insurance system to compare function improvement of the activity of daily living. Methodes : In national wide 12 community elderly care center enrolled the National Health Insurance Corporation, The numbers of 281 beneficiary older adults(long-term care Grade I : 66, Grade II : 58, Grade III : 157) participated in this study. This survey assessment tool for activity of daily living was used the long-term care assessment instrument of the physical functions in the law of Korean long-term care insurance. The function items of Activity of daily living were included in clothing, washing, tooth brushing, bathing, eating, posture converting, stand sitting, move sitting, out of room, using toilet, controlling of stool, controlling of urine, washing hair. According to independence to complete dependence functioning level, remarks pointed 1 to 3 points. The data were analyzed by chi-square, two-way anova using SPSS V. 12.0. Results : The results appeared that the mean score of the functions in activity of daily living of assistive products users was a 27.60, and that of non-users was a 30.66. Assistive products were not effected in Grade I and II recipients, but that effected in Grade III recipients. Conculsion : Preparing for activation of assistive products based Korean long-term care insurance system, the result application as follows is possible. The usage of assistive products could improve the function of daily living activity in older adults. Related to Grade III beneficiary elderly people were improved function in activity of daily living by using assistive products, it is necessary to extend coverage the non-eligible elderly people in Korean long-term care insurance system.

Development of Performance Indicators in Public Health Center Based Home Healthcare

The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P