• Title/Summary/Keyword: Remote medicine

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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Health Status of Primary School Children in a Part of Remote Rural Area (일부(一部) 벽지농촌(僻地農村) 학동(學童)들의 건강실태(健康實態))

  • Park, Won-Kihl
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.211-222
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    • 1974
  • The survey was carried out on 1,031 primary school children for about 1 month, from June 1, to June 30, 1974, for the purose of understanding indirectly scio-medical status of a remote rural area, reflecting health status of primary school children. The summarized results were as follows: 1) The average age of surveyed children according to school year by sex was older in girls than in boys. The entrance in school at suitable age was peaked as 80.9% in boys of 5th school year and 72.4% in girls of 3rd school year, and also sunk 68.8% in boys of 2nd school year and 58.7% in girls of 1st school year. 2) Prevalence rate according to W.H.O. diseases classification during last a month and a year. a) During last month: The diseases of respiratory system remarked the highest 101.1 in boys and 116.6 in girls. The next were diseases of digestive system (24.2 in boys and 32.1 in girls), The girls were higher than boys in prevalence rate. b) During last year: The diseases of diegestive system ranked the highest 133.0 in boys and next, the diseases of respiratory system (108.6 in boys). c) Present illness: Number of code III ranked the highest 129.2 and next XII(127.3) in boys but inverted in girls such as XII(144.9) and III(116.7) and also, Number of code XVII was prevalenced twice in boys than in girls. d) Chief complaints by sex: Abdominal pain ranked the highest 71.2 per 1,000 population and next headache (34.7) in boys but headache ranked the heighest 88.5 and next abdominal pain (63.3) in girls. e) Water drinking habit: Number of code IX was higher in habit of raw water drinker than in habit of boiled water drinker and healthy children were higher in boiled water habit group than in raw water habit group. The diseases of respiratory system were the highest 124.74 in girls and next, the diseases of digestive system (52.3 in girls). According to school year, healthy children were increased to higher grades. 3) Average sick day per total surveyed children and patient during last month and last year. a) Per surveyed 1,031 children was 0.28 days during last month and 0.98 days during last year. And also per patient was 1.78 days during last month and 3.22 days during last year. b) Average sick day was higher in girls than in boys during last month, but inverted during last year. 4) Average absented day per total surveyed children and patient during last month and last year. a) Per surveyed 1,031 children were 0.43 days during last month and 3.81 days during last year (omitted 1st school year). b) Per absented children were 2.0 days during last month and 7.10 days during last year. c) Per absented children were 8.16 days in boys and 3.17 days in girls. 5) Utilization of medical facilities: The drug-store was consulted 91.2% of the total utilized boys and girls. The strengthening of medical facilities and medical care activities in health subcenter is urgently required 6) Medical Expenses by period and sex: a) Average medical expenses per surveyed 1,031 children were 35.95 won, per patient were 298.04 won during last month. b) Average medical expenses per survey children (omitted 1st school year) were 80.56 won, per patient were 243.98 won and per treated patient were 318.87 won during last year. c) Medical expenses were higher in boys than in girls. 7) Rohrer index by sex, present illness and school year. a) Average Rohrer index was 129.8 in boys and 126.2 in girls. b) Average Rohrer index was increased for 1st school year to 2nd school year and thereafter falling down step by step by school year. c) Under 151-160 Rohrer index number of code III was the highest and above 151-160 Rohrer index of code XII was peaked.

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Diagnosis of Diabetes Using Voltage Analysis Based on EIS (Electro Interstitial Scan) (EIS 기반 전압신호 분석을 통한 당뇨병 진단 가능성 평가)

  • Bae, Jang-Han;Kim, Soochan;Kaewkannate, Kanitthika;Jun, Min-Ho;Kim, Jaeuk U.
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.11
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    • pp.114-122
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    • 2016
  • EIS (Electro interstitial scan) is a non-invasive and simple method to find the physio-pathological information inferred by electric current response with respect to low direct current applied between remote sites of the body. Although a few EIS-based devices for diagnosing diabetes were commercialized, they were not successful in offering clinical validity nor in confirming diagnostic principle. In this study, we measured the voltage responses of diabetic patients and normal subjects with a commercialized EIS device to test the usefulness of EIS in screening diabetes. For this purpose, voltage was measured between pairs of electrodes contacted at both palm, both soles of the feet and left and right forehead above both eyes. After feature extraction of voltage signals, the AUC (area under the curve) between the two groups was calculated and we found that seven variables were appropriately shown above 60% of accuracy. In addition, we applied the k-NN (k-nearest neighbors) method and found that the accuracy of classification between the two groups reached the accuracy of 76.2%. This result implies that the voltage response analysis based on EIS has potential as a diabetics screening method.

Dose Distribution of Rectum and Bladder in Intracavitary Irradiation (자궁경부암 강내 방사선 조사장치에 의한 직장 및 방광의 피폭선량 평가)

  • Chu S. S.;Oh W. Y.;Suh C. O.;Kim G. E.
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.261-270
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    • 1984
  • The intrauterine irradiation is essential to achieve adequate tumor dose to central tumor mass of uterine malignancy in radiotherapy. The complications of pelvic organ are known to be directly related to radiation dose and physical parameters. The simulation radiation and medical records of 203 patients who were treated with intrauterine irradiation from Feb. 1983 to Oct. 1983, were critically analized. The physical parameters to include distances between lateral walls of vaginal fornices, longitudinal and lateral angles of tandem applicator to the body axis, the distance from the external os of uterine cervix to the central axis of ovoids were measured for low dose rate irradiation system and high dose rate remote control afterloading system. The radiation doses and dose distributions within cervical area including interesting points and bladder, rectum, according to sources arrangement and location of applicator, were estimated with personal computer. Followings were summary of study results ; 1. In distances between lateral walls of vaginal fornices, the low dose rate system showed as $4\~7cm$ width and high dose rate system showed as $5\~6cm$. 2. In horizontal angulation of tandem to body axis, the low dose rate system revealed mid position$64.6\%$, left deviation $19.2\%$and right deviation $16.2\%$. 3. In longitudinal angulation of tandem to body axis, the mid position was $11.8\%$ and anterior angulation $88.2\%$ in low dose rate system but in high dose rate system, anterior angulation was $98.5\%$. 4. Down ward displacement of ovoids below external os was only $3\%$ in low dose rate system and $66.7\%$ in high dose rate system. 5. In radiation source arrangement, the most activities of tandem and ovoid were 35 by 30 in low dose rate system but 50 by 40 in high dose rate system. 6. In low and high dose rate system, the total doses an4 TDF were 50, 70 Gy and 141, 123, including 40 Gy external irradiation. 7. The doses and TDF in interesting points Co, B, were 93, 47 Gy and 230, 73 in high dose rate system but in low doss rate system, 123, 52 Gy and 262, 75 respectively. 8. Doses and TDF in bladder and rectum were 70, 68 Gy and 124, 120 in low dose rate system, but in high dose rate system, 58, 64 Gy 98, 110 respectively, and then grades of injuries in bladder and rectum were 25, $30\%$ and 18, $23\%$ respectively.

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Study on the Life of Jusuk(朱橚) and His Writings. (주숙(朱橚)의 생애(生涯)와 저서(著書)에 관한 연구(硏究))

  • Ji, Myoung-Soon;Ahn, Sang-Woo;Yoon, Chang-Yeol
    • Journal of Korean Medical classics
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    • v.23 no.3
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    • pp.1-11
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    • 2010
  • King of Jujeong(周定王) named Jusuk(朱橚) was thought to be an exemplary character as a scholar and a politician, who was not an Oriental medical doctor but a compiler publishing a set of three medical books and a set of volumes on famine relief to save people in the areas of natural disasters or spring poverty. He was born on July 1, 1361 as the fifth son of Juwonjang(朱元璋), the first Emperor (1368-1398) of the Myeong-dynasty (1368-1644) of China. It was not clearly known about his mother other than assuming, but hard to ascertain, that she was from Goryeo, the ancient country in the Korean Peninsula, and became a loyal concubine of Juwonjang(朱元璋). He was the brother of Yeongrakje(永樂帝), the third Emperor(1402-1424) of the Myeong-dynasty. As a focal figure in the political forces at that time in the Myeong-dynasty, he had a life full of vicissitudes such as being removed from office, being exiled to a remote place, being scattered far and wide between family members, being implicated in the rebellion and so on. It seemed that he brushed up on his study, taking a class on an emir until the year of 1380 at the age of twenty. And he published "Bosaeng-yeorok(保生餘錄)" and "Bojebang(普濟方)" for eight years from 1381 to 1389 (at age 21-29), "Sujinbang(袖珍方)" in 1391 (at 31), and "Guhwangboncho(救荒本草)" in 1406 (at 46), republishing "Sujinbang(袖珍方)" in 1415 (at 65). Endowed with a brilliant talent from early days, Yeong-rakje(永樂帝) wrote the poem(the poem paying a high tribute to a King) well and composed one hundred pieces of poetry on the story of the Won Dynasty (1271-1368) of China. He leaded a quiet life in his later years and died a natural death at Gaebong(開封, a city in China) at 65 in 1425. He had 15 sons including king of Juheon(朱憲王) Yudon(有敦) and 11 daughters. His books contributed absolutely to the growth of Oriental medical field, and also to the increase in population, having influence on bringing about compilation of the books on Oriental medicine and famine relief of the Joseon Dynasty (the old Korean kingdom from AD 1392 to 1910).

Microbiology and Epidemiology of Infectious Spinal Disease

  • Jeong, Se-Jin;Choi, Seung-Won;Youm, Jin-Young;Kim, Hyun-Woo;Ha, Ho-Gyun;Yi, Jin-Seok
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.21-27
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    • 2014
  • Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

PDA Transmission of Medical Images by CDMA (CDMA에 의한 의료영상의 PDA전송)

  • Lee, Myong-Ho;Lim, Jae-Dong;Ahn, Bung-Ju;Lee, Hwun-Jae;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.1 no.2
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    • pp.13-22
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    • 2007
  • The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.

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Statue of Intestinal Parasitic Infections in a Remote Island, Yondo, Jeonranarn-do (Province) (전라남도 여천군 남면 연도 주민의 장내 기생충 감염상황)

  • 구기수;민득영
    • Parasites, Hosts and Diseases
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    • v.26 no.4
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    • pp.275-284
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    • 1988
  • This study was performed to observe the present status of intestinal parasitic infections in a remote island, Yondo, located in southern part of Jeonranam-do (Province) , Korea. In February and May, 1988, total 1,011 individual stool samples were collected and examined for intestinal helminths and protozoa using formalin-ether centrifugal sedimentation technique. The results are summarized as follows: 1. Of 1,011 inhabitants examined, 398(39.4%) were positive for intestinal parasites. Helminth positives were 372(36.8%) , and protozoan cyst positives were 56(5.5%) . 2. Ten species of parasites were found. Trichuris trichiura revealed the highest infection rate of 27.5%, Ascaris lumbricoides 17.4%, Taenia sp. 5.8%, Entamoeba coli 3.3%, Ciardia Zamblia 1.5%, Endelimax nasa 0.8%, Hymenolepis nana 0.4%, Hookworm 0.2%, Trichostrongylus orientalis 0,2%, and Entamoeba histolytica 0.2%, respectively. 3. The female group showed higher positive rate(44.0%) than males (34.7%). Also, higher positive rates were observed among adults as compared with the group younger than 10 years old. 4. Average value of E.P.G. was 1,876(range 200∼17,800) in A. lumbricoides positives, and 327 (range 200∼1,600) in T. trichiura positive cases. 5. In helminth egg Positive cases, single in(traction was 63.4%, double infection 34.7%, and triple infection 1.9%, respectively. Among protozoan cyst positives, single infection was 94.6%, and double infection was 5.4%. The present study revealed that the prevalence of intestinal parasites among inhabitants in Yondo island is still so high that special control measures should be performed.

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Interoperability Framework between GRID and PACS based on Web Services (웹서비스 기반의 Grid-PACS 상호운용성 프레임워크)

  • Lee, Bong-Hwan;Cho, Hyun-Sug
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.8
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    • pp.1799-1808
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    • 2010
  • Recently the increasing collaborative research requires the remote medical and clinical data sharing and access of external institutions. In this paper, an interoperability framework between Grid and PACS using Web services is proposed and implemented in order to provide flexible and efficient medical data management. The Digital Imaging and Communications in Medicine(DICOM) standard defines medical image data exchange and transfer between PACSs and image databases. However, medical data exchange between hospitals is limited within the trusted and static environments. Moreover, DICOM does not provide medical data management and the Grid middleware does not include standard toolkit to access DICOM data. To address this issue, a Web services-based Grid Service Mediator (WGSM) which provides PACS integration and medical image data management is developed. The WGSM consists of several service mediators such as compress mediator, GridFTP mediator, RFT mediator, MyProxy mediator, MDS mediator, and RLS mediator and others. The proposed Web services-based framework provides user authentication and secure data access between PACSs in collaborative environments. In particular, the WGSM allows ordinary users to access remote PACS data in a simple and efficient manner without any the knowledge about underlying Grid middleware.

Parallel Network Model of Abnormal Respiratory Sound Classification with Stacking Ensemble

  • Nam, Myung-woo;Choi, Young-Jin;Choi, Hoe-Ryeon;Lee, Hong-Chul
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.11
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    • pp.21-31
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    • 2021
  • As the COVID-19 pandemic rapidly changes healthcare around the globe, the need for smart healthcare that allows for remote diagnosis is increasing. The current classification of respiratory diseases cost high and requires a face-to-face visit with a skilled medical professional, thus the pandemic significantly hinders monitoring and early diagnosis. Therefore, the ability to accurately classify and diagnose respiratory sound using deep learning-based AI models is essential to modern medicine as a remote alternative to the current stethoscope. In this study, we propose a deep learning-based respiratory sound classification model using data collected from medical experts. The sound data were preprocessed with BandPassFilter, and the relevant respiratory audio features were extracted with Log-Mel Spectrogram and Mel Frequency Cepstral Coefficient (MFCC). Subsequently, a Parallel CNN network model was trained on these two inputs using stacking ensemble techniques combined with various machine learning classifiers to efficiently classify and detect abnormal respiratory sounds with high accuracy. The model proposed in this paper classified abnormal respiratory sounds with an accuracy of 96.9%, which is approximately 6.1% higher than the classification accuracy of baseline model.