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THE CURRENT STATUS OF BIOMEDICAL ENGINEERING IN THE USA

  • Webster, John G.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.27-47
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    • 1992
  • Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

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Development and Reliability of Intraoral Appliance for Diagnosis and Control of Bruxism (이갈이 진단 및 조절용 구내장치의 개발과 신뢰도 조사)

  • Kim, Seung-Won;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.69-77
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    • 2005
  • The purposes of this study were to develop and introduce a novel intraoral appliance for bruxism composed of power switch and biofeedback device and further to examine inter- and intra-reliability of the appliance prior to clinical tests. The newly-developed appliance consisted of detection sensors, a central processing unit (CPU), a reactor and a storage unit and a displayer. Compact-sized, waterproof switches were selected as bruxism detection sensor and any sensor activation by clenching or grinding event was processed at the CPU and transmitted, by radio wave, to the reactor and storage unit and triggered auditory or vibratory signal, subsequently producing biofeedback to the patient with bruxism. The data on bruxing event in the storage unit can be displayed on the computer, making it possible analyzing frequency, duration and nature of bruxism. Cast models were obtained from ten volunteers with normal occlusion to evaluate reliability of the appliances. For inter-operator reliability on the intraoral appliances, each operator of the two fabricated the appliance for the same subject and compared the minimal contact forces provoking auditory biofeedback reaction in vertical, lateral and central directions. Intra-operator reliability was also investigated on the appliances made by a single operator at two separate times with an interval of two days. Conclusively, the newly-developed appliance is compact and safe to use in oral circumstance and easy to make. Furthermore, it had to be proven reliability excellent enough to apply in clinical settings. Thus, it is assumed that this appliance with the processor and the storage of data and auditory or vibratory biofeedback function is available and useful to analyze and control bruxism.

A Study on the Method of Educational Ministry for the Religious Life of the Christian Elders during the Corona Period (코로나 시대 기독 노인의 신앙생활을 위한 교육목회 방안 연구)

  • Kim, Jung Hee;Park, Eunhye
    • Journal of Christian Education in Korea
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    • v.66
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    • pp.243-272
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    • 2021
  • Corona 19 brought about a major shift in the Korean church's pastoral style. Contact and non-contact ministry styles using the Internet and media devices are being held together. The elderly, who have been classified as digital vulnerable, need to see whether they are properly adapting to these changes and they have any difficulties in their religious lives. This study is to organize the current status of Corona 19 related to Korean churches, look at the current state of church programs for Christian elderly people, look at how important the religious life is to their lives, and to suggest educational pastoral methods for their religious lives based on the theory of Maria Harris' educational ministry. First, in terms of Koinonia, it was suggested that the heritage, beliefs, values and ways of life held by the Christian elderly be shared with people inside and outside the church in order to entertain and embrace everyone without alienation. Second, from the perspective of Leiturgia, educational ministry was proposed to expand prayer life from a personal area to a public area to become a life of practicing prayer and justice by providing public prayer content with media that can be used by the elderly to perform spirituality. Third, it was suggested that in terms of Didache, it should be required that the elderly should be educated to be familiar with the changing technologies, that teaching environment should be extended from church to online, and that the educational content of tradition and new forms should be dealt with extensively. Fourth, from the perspective of Kerigma, Christian elderly people who have suffered in various life environments, both personally and socially, should listen to the words again and gain the power to overcome the corona crisis through the God's words, so that they can be melted into the curriculum of koinonia, leiturgia, didache, and diakonia. Fifth, it was suggested that senior citizens should switch their consciousness to become subjects of service, not objects of service, and that digital literacy education should be provided individually at eye level to narrow the digital gap for Diakonia curriculum.