• Journal of Biomedical Engineering Research
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• v.35 no.5
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• pp.119-124
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• 2014

A Ventricular assist device (VAD) is one of the most efficient treatments to raise the survivability of the end stage heart failure patient. However, some of LVAD patients have died for the failures and improper control of LVAD. To detect critical dangers in LVAD, the monitoring methods of LVAD outflow have been requested, because it can be affected by patient's hemodynamic states and abnormal conditions of LVAD. In the case of an external pulsatile LVAD, the air movement through the air line can be used to estimate LVAD outflow. In this study, the air movement in the air-line of the extracorporeal pulsatile LVAD was measured with a differential pressure sensor between different points. The precise estimation of air movement could be achieved by additional measurement of air pressure. In a series of in-vitro experiments, the LVAD outflow were changed according to the afterload of LVAD and the differential pressure of LVAD didn't have close correlation with the LVAD outflow that were measured with an ultrasonic flowmeter at the same time. However, new precise estimation with the data from differential pressure and one point pressure in the air-line showed higher correlations with LVAD outflow.

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.471-474
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• 2006

Objective : Neuroimaging data are of paramount importance in making correct diagnosis. We herein evaluate the clinical usefulness of image transfer using cellular phones to facilitate neurological diagnosis and decision-making. Methods : Selected images from CT, MRI scans, and plain films obtained from 50 neurosurgical patients were transferred by cellular phones. A cellular phone with a built-in 1,300,000-pixel digital camera was used to capture and send the images. A cellular phone with a 262,000 color thin-film transistor liquid crystal display was used to receive the images. Communication between both cellular phones was operated by the same wireless protocol and the same wireless internet service. We compared the concordance of diagnoses and treatment plans between a house staff who could review full-scale original films and a consultant who could only review transferred images. These finding were later analyzed by a third observer. Results : The mean time of complete transfer was $2{\sim}3\;minutes$. The quality of all images received was good enough to make precise diagnosis and to select treatment options. Transferred images were helpful in making correct diagnosis and decision making in 49/50 [98%] cases. Discordant result was caused in one patient by improper selection of images by the house staff. Conclusion : The cellular phone system was useful for image transfer and delivery patient's information, leading to earlier diagnosis and initiation of treatment. This usefulness was due to sufficient resolution of the built-in camera and the TFT-LCD, the user-friendly features of the devices, and their low cost.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.11-16
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• 2015

Background: Source material used to fill calvarial defects includes autologous bones and synthetic alternatives. While autologous bone is preferable to synthetic material, autologous reconstruction is not always feasible due to defect size, unacceptable donor-site morbidity, and other issues. Today, advanced three-dimensional (3D) printing techniques allow for fabrication of titanium implants customized to the exact need of individual patients with calvarial defects. In this report, we present three cases of calvarial reconstructions using 3D-printed porous titanium implants. Methods: From 2013 through 2014, three calvarial defects were repaired using custom-made 3D porous titanium implants. The defects were due either to traumatic subdural hematoma or to meningioma and were located in parieto-occipital, fronto-temporo-parietal, and parieto-temporal areas. The implants were prepared using individual 3D computed tomography (CT) data, Mimics software, and an electron beam melting machine. For each patient, several designs of the implant were evaluated against 3D-printed skull models. All three cases had a custom-made 3D porous titanium implant laid on the defect and rigid fixation was done with 8 mm screws. Results: The custom-made 3D implants fit each patient's skull defect precisely without any dead space. The operative site healed without any specific complications. Postoperative CTs revealed the implants to be in correct position. Conclusion: An autologous graft is not a feasible option in the reconstruction of large calvarial defects. Ideally, synthetic materials for calvarial reconstruction should be easily applicable, durable, and strong. In these aspects, a 3D titanium implant can be an optimal source material in calvarial reconstruction.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.295.1-295.7
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• 2018

Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.462-467
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• 2018

Background: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. Methods: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. Results: The average VSA of the lateral column was $22^{\circ}{\pm}6^{\circ}$, and that of the intermediate column was $29^{\circ}{\pm}8^{\circ}$ in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was $30{\pm}3mm$ at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. Conclusions: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.

• Journal of the Korean Society of Radiology
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• v.15 no.5
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• pp.691-696
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• 2021

In order to prevent and treat a patient's disease, the anatomical structure of the lesion through medical imaging is one of the important processes. However, there is a limit to the image displayed on the screen, so many studies are underway to overcome this by using 3D printing technology. To this end, this study implemented a three-dimensional cardiovascular model using actual patient image data, printed it out using a 3D printer, and conducted a usefulness test on current medical professionals. As a result of the usefulness evaluation, when the questionnaire conducted by a total of 5 people was converted to the Likert scale, the average value of all items showed a high result of 4.83 points, and the result of the cross-analysis was (P) = 10.000 (0.265), which was equally positive among all the questionnaires survey results were presented. Based on the results, it is expected that 3D printing technology will help advance medical technology.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.177-182
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• 2021

Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

• Genomics & Informatics
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• v.18 no.4
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• pp.44.1-44.7
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• 2020

The severity of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), greatly varies from patient to patient. In the present study, we explored and compared mutation profiles of SARS-CoV-2 isolated from mildly affected and severely affected COVID-19 patients in order to explore any relationship between mutation profile and disease severity. Genomic sequences of SARS-CoV-2 were downloaded from Global Initiative on Sharing Avian Influenza Data (GISAID) database. With the help of Genome Detective Coronavirus Typing Tool, genomic sequences were aligned with the Wuhan seafood market pneumonia virus reference sequence and all the mutations were identified. Distribution of mutant variants was then compared between mildly and severely affected groups. Among the numerous mutations detected, 14408C>T and 23403A>G mutations resulting in RNA-dependent RNA polymerase (RdRp) P323L and spike protein D614G mutations, respectively, were found predominantly in severely affected group (>82%) compared with mildly affected group (<46%, p < 0.001). The 241C>T mutation in the non-coding region of the genome was also found predominantly in severely affected group (p < 0.001). The 3037C>T, a silent mutation, also appeared in relatively high frequency in severely affected group compared with mildly affected group, but the difference was not statistically significant (p = 0.06). We concluded that spike protein D614G and RdRp P323L mutations in SARS-CoV-2 are associated with severity of COVID-19. Further studies will be required to explore whether these mutations have any impact on the severity of disease.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.1
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• pp.1-11
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• 2019

Purpose: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. Methods: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. Results: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p<.001), and healthcare costs of 17,052,784 Won (p<.001). Conclusion: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.61-69
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• 2019

Purpose: The study aims to provide basic data to enhance the health of paramedics responsible for patient transport and treatment by analyzing the exposure level of paramedics to electromagnetic waves generated by electric devices used in ambulances. Methods: The study measured electromagnetic waves in ambulances in N region from July to December 2018. ME3030B produced by German Gigahertz Solutions was used to measure these waves and the maximum value was selected by moving it slowly in various directions. Each measurement part was selected and the mean value was calculated by repeatedly measuring at 10-minute intervals three times in total: $1^{st}$, $2^{nd}$, and $3^{rd}$ phase. Results: Among the electrical devices installed in the patient room of the ambulance measured at distances of 1 cm or 30 cm, results showed a high level of electric waves at the inverter ($26.25{\pm}39V/m$) and high level of electromagnetic waves ($564.00{\pm}31.75nT$) at the ozone sterilizer. According to measurements toward the front near the driver's seat, results indicated high levels of electric waves ($3.67{\pm}1.15V/m$) and electromagnetic waves ($450.00{\pm}19.52nT$) at the black box hard drive. Conclusion: Electromagnetic waves within the ambulance were stable and not beyond the range that might impact human health. However, in the case of the black box hard drive ($3.67{\pm}1.15V/m$, $450.00{\pm}19.52nT$) located under the passenger seat, it may have a direct effect on the human body and, thus it is necessary to move it to a storage area further away from the paramedics to minimized the impact.