OBJECTIVE: Under ubiquitous-healthcare circumstances, interest of one's health condition has been increased. People were required the measurement of biosignal by the wearable computing technology. The purpose of this paper is to measure the portable ECG (Electro- cardiogram) with the application of wearable computing technology. Therefore, the normal ECG measurement can be measured with a chest belt either in direct contract state or loose contact state. METHODS: The belt type circuit for measuring ECG was developed. In order to remove noises in loosely contact condition, a shield circuit was assembled with the measuring electrodes. Both of High performance differential amplifiers and notch filters were incorporated into the main amplifier circuits. The ECG data was converted from analog to digital form by MCU (Micro Control Unit). The main memory was composed of a memory controller and a memory card. RESULTS: The ECG measurement having bad electrode contact to body would be usually done in daily life, so we measured the biosignal by using the loose contact potable belt for accurate ECG data. The belt can be used to measure ECG by loose contact method. CONCLUSION: In this study, we could measure ECG without any spatial-temporal restriction due to the portable belt. This device is suitable for the ubiquitous-healthcare environment.
Contracts ; Electrocardiography ; Electrodes ; Memory ; Noise ; Thorax

This study was undertaken for the clinical analysis and evaluation on 121 patients with incompetent internal os of the cervix, who were admitted and treated with McDonald operation or Shirodkar operation at the Soonchounhyang Medical Center from January 1991 to December 1995. The results of this study were as follows : 1. The incidence of this IIOC was 1.1% of 11,116 cases of total delivery. 2. The mean age of IIOC was 31.7 years old. 3. The average number of gravida was 3.2. 4. The most common contributary factor was previous history of artificial abortion (51.2 %), and midtrimester abortion (17.4 %), cervical laceration due to previous vaginal delivery (8.3 %) etc. was followed. 5. The success rate of operation was 76 %, and the highest success rate (85.7 %) was reveald with period from 15th weeks to 16th weeks of gestation. 6. When cervical dilatation was abscent or small, the success rate of operation was high. 7. The factors of failed operation were preterm labor (58.7 %), PROM (34.5 %), and PIH, bleeding. 8. The delivery method after operation was vaginal delivery in 83 cases (68.6%) and cesarean section in 38 cases (31.4 %).
Cervix Uteri* ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second

OBJECTIVE: According to development of web service technology and mobile device supply, mobile web service becomes an essential element of ubiquitous healthcare. But there are many constraints for offering mobile web services on mobile devices. Hence, this paper propose optimal system supplying web services about medical information in wired /wireless network according to resources of device. METHODS: Proposed system consists of web server, database, desktop subscriber, mobile device and mobile context server. When a mobile device requires the web service, a mobile context server rewrites and offers the equivalent contents provided from web server to suit the requiring device's resource. Our proposed system services the same medical information after its recomposition as the network and devices of user. RESULTS: The medical staff may require patient information in wired/wireless environment, web server and mobile context server supports their correct judgment and expeditious response by servicing optimized data of the patient according to the requiring device. CONCLUSION: Proposed system designed the wired/wireless integrated medical information system using web service and mobile web service as the bases of ubiquitous healthcare system. Not only for web service in wired network, to provide the optimal web service in wireless network, we should know the limited resource of mobile devices and appropriately divide the web contents of wired network to fit the mobile device's screen. The future research needs dynamic division of screen according to extension of medical information data.
Delivery of Health Care ; Humans ; Information Management* ; Information Systems ; Judgment ; Medical Staff

OBJECTIVE: The progress in computer and communication technologies is making the Internet increasingly heterogeneous in terms of network, hardware and software capacities. Moreover, this has made it possible for emergency telemedicine services to provide high quality medical services. However, resource availability on the Internet varies unexpectedly. Thus, providing an efficient access to emergency telemedicine services requires that medical multimedia streams be adapted according to the environment constraints. One approach to this issue is based on the use of intermediate nodes within the network to perform such adaptations (media transformations and data transcoding). For this purpose, we have designed and implemented a proxy server for Quality of Service adaptations of medical multimedia streams. METHODS: We have organized a new emergency telemedicine system by designing a proxy server to execute transcoding. The proxy server is located between a patient system and a doctor system over heterogeneous networks. Before a patient system can deliver medical video streams to a doctor system, the proxy server measures uplink bandwidth which is one of the Quality of Service factors, from the proxy server to the doctor system. At this moment, frame rates are determined according to the measured bandwidth, and the proxy server transmits medical video streams modified for new frame rates to the doctor system. We describe the implementation of this proxy server on top of the Microsoft DirectShow(R) environment and report on a performance evaluation which demonstrates the effectiveness of the approach. RESULTS: The quality of requested medical video streams can be predicted when they are adapted to the receiver. With this prediction, adapted medical video streams which meet the frame rates constraints of the receiver can be delivered without additional measurements of bandwidth. CONCLUSION: This study represents a proxy server of a hybrid multimedia telemedicine system over heterogeneous networks. We expect that the designed proxy server can provide not only dynamic Quality of Service monitoring functions along bandwidth measurement, but also medical video adaptations to the receiver in heterogeneous network environments.
Emergencies ; Humans ; Internet ; Multimedia ; Proxy* ; Rivers* ; Telemedicine

OBJECTIVE: The advancement of computing capabilities and increase of available network bandwidths have resulted in an emergency telemedicine services which can provide high quality medical services. However, existing telemedicine systems mainly have offered a one to one communication configuration instead of a multi-connection configuration. Therefore, we suggested a hybrid multimedia telemedicine system to support the multi-patients services in wired and wireless (heterogeneous) network environments. METHODS: We designed the hybrid multimedia telemedicine system consisting of 4 sub-systems, a patient system, a doctor system, a emergency monitoring system, and a multi-control server system. The patient system could deliver multimedia data of a patient to the emergency monitoring system or to the doctor system according to link configuration. The link configuration was decided as 'Flowing', or 'By-passing' in accordance the connection type of patient systems or doctor systems. At this time, as the multi-control server system considers the hybrid network, it monitored the patient's multimedia data and the state of emergency telemedicine services. RESULTS: The hybrid multimedia telemedicine system including the multi-control server system performed the best communication configuration over heterogeneous networks. This system achieved high quality emergency telemedicine services through dynamic wired and wireless networks at real-time. CONCLUSION: This study represented a hybrid multimedia telemedicine system over heterogeneous networks in emergency cases. We expected that the designed system could provide not only the high quality services, tele-diagnosis and tele-consultation, but also the effective emergency telemedicine services to multi-patients in the heterogeneous network environments.
Emergencies ; Humans ; Multimedia* ; Telemedicine*

INTRODUCTIONThe aim of this study is to investigate the amount of water loss and percentage dehydration experienced during 1 hour of paddling on the kayak ergometer so as to help coaches and athletes tailor a suitable and adequate rehydration regime. Also, rehydration efficacy between water and a well established, commercially available sports drink (Gatorade, Quaker Oats company, USA) was investigated in this cross-over study.

MATERIALS AND METHODSTen national flatwater kayakers were monitored in a controlled setting while paddling the kayak ergometer for 1 hour at an intensity sustainable for long distance marathon. They rehydrated themselves ad libitum with provided beverage. Post-void towel-dried body mass was measured before and after the exercise with percentage dehydration calculated. Body core temperature (tympanic temperatures), ratings of perceived exertion and thirst index were monitored every 15 minutes. The amount of fluid consumed, urine output and urine specific gravity were obtained after exercise.

RESULTSThe results [mean +/- standard deviation (SD)] showed that kayakers underwent 1.10 +/- 0.52% dehydration while rehydrating with water as compared to 0.72 +/- 0.38% while rehydrating with Gatorade. Also, athletes on water rehydration had higher rating of perceived exertion (RPE) at the 30th and 60th minute mark of the exercise. Overall, athletes undergoing water rehydration lost significantly more body mass (0.70 +/- 0.39 kg) as compared to rehydrating with Gatorade (0.46 +/- 0.27).

CONCLUSIONAlthough the hydration efficacy of Gatorade proved superior to that of water, the athletes' hydration habits with either fluids did not provide adequate hydration. It is recommended that specific strategies be developed to address dehydration and rehydration issues of kayakers in Singapore.

Adult ; Beverages ; Competitive Behavior ; Cross-Over Studies ; Dehydration ; metabolism ; physiopathology ; Drinking ; Exercise ; physiology ; Female ; Fluid Therapy ; methods ; Humans ; Male ; Monitoring, Physiologic ; Physical Exertion ; physiology ; Ships ; Sports ; Water-Electrolyte Balance ; physiology

OBJECTIVE: For the ubiquity of medical service, when user who has proper authority want to access medical data, user accessability should be assured. And the security of the disclosed medical data is important. This paper presents single user access interface on multiple patient reservoirs and elaborate access control using the Role-Based Access Control(RBAC) system. METHODS: Proposed system consists of 4-tier architecture that is client application, Access Control Central(ACC) agent, Local Access Control(LAC) agent and Hospital Information Systems(HIS). User requests medical data with client application. ACC notarizes user identity and controls access of user request and selectively encrypts medical data. LAC charges data conversion for communication between ACC and HIS. HIS has repositories of medical datum. System provides security service with digital certificate, X.509v3, of user. RESULTS: User requests medical data of several HIS approaching single ACC not by each HIS. Through conversion process of LAC, data that is described XML and is used for communication inter system enables information exchange with single common data format that is independent to several HIS. CONCLUSION: In the proposed system, user accesses medical datum of several HIS regardless of location and has consistent access interface. And using independent format against each HIS makes easy information exchange between several HIS. Transferred data maintains security about significant datum by selective encryption and increases encryption efficiency. Unified access control about multiple patient reservoirs that are scattered in other places provides unified and precise diagnosis of patient information. And it functions the portal of collaborate treatment in inter-HIS.
Computer Security ; Delivery of Health Care, Integrated ; Diagnosis ; Health Services Accessibility ; Hospital Information Systems ; Humans

OBJECTIVESThe objectives of this study were to compare the prevalence of submandibular gland neoplasia in an Asian population with a Western population and to evaluate the accuracy of fi ne needle aspiration cytology (FNAC) and computed tomography (CT) scan in the study of submandibular gland pathologies.

MATERIALS AND METHODSWe conducted a 10-year retrospective review of 101 submandibular mass excisions. Data on the demographic profi le of patients, clinical features, correlation of fi ne needle aspiration cytology, CT scans and histology and morbidities related to surgery were collected.

RESULTSThe prevalence of submandibular gland neoplasia was 27.1%. Most (78.9%) of these were benign. FNAC and CT scans were accurate for benign neoplasia. However, the accuracy of FNAC and CT scans for sialadenitis without sialolithiasis was low.

CONCLUSIONThe prevalence of submandibular gland malignancy was lower in the Asian population. FNAC and CT scans were accurate for benign neoplasia of the submandibular gland.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Biopsy, Fine-Needle ; Child ; European Continental Ancestry Group ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prevalence ; Singapore ; epidemiology ; Submandibular Gland Diseases ; diagnostic imaging ; epidemiology ; pathology ; Submandibular Gland Neoplasms ; diagnostic imaging ; epidemiology ; pathology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVEAfter performed symptom-limited maximum cardiopulmonary exercise testing (CPET) before and after acute alkalized blood, we repeated CPET with pure oxygen.

METHODSFive volunteers, 3hr after alkalizing blood room air CPET, re-performed CPET inhaling from Douglas bag connected with pure oxygen tank. We compared with those of room air CPETs before and after alkalized blood.

RESULTSAfter alkalized blood oxygen CPET had a similar response pattern as those of CPETs before and after blood alkalization. During the CPET, all breath frequency, minute ventilation and tidal volume at each stage were similar to those of CPETs before and after alkalized blood (P > 0.05),except there was a lower peak tidal volume than those of both CPETs and a slightly higher resting minute ventilation only than CPET after alkalized blood (P > 0.05). After alkalized blood, oxygen CPET, all PaO2 and SaO2 and most Hb were lower than those of both CPETs (P < 0.05). The pHa and [HCO3-]a were higher than those of CPET before alkalized blood (P < 0.05); but were not CPET after alkalized blood (P > 0.05). PaCO2 was similar to that of CPET before alkalized blood (P > 0.05), but was lower than that of CPET after alkalized blood at resting and warm-up (P < 0.05); then was similar to both CPETs at anaerobic threshold (P > 0.05); but was higher at peak exercise higher than those of both CPETs (P < 0.01). Oxygen increased 2,3 volunteers' workload and time at AT and peak exercises.

CONCLUSIONRespiratory response pattern to oxygen CPET after alkalized blood is similar to those of both CPETs before and after alkalized blood. The CPET response is dominantly depended upon metabolic rate, but not levels of pHa, PaCO2 and PaO2.

Blood Gas Analysis ; Exercise Test ; Humans ; Oxygen ; Respiratory Physiological Phenomena

The ageing population is posing new challenges to Singapore's healthcare system. The rise of dual income and the decline of extended families, as well as an increase in age-related degenerative disorders due to increased longevity render it difficult for the family to remain the primary social safety net to care for our elderly in their own homes. Consequently, nursing homes may become increasingly relevant for resource and expertise-challenged families to cope with the burden of caring for a frail and dependent elderly. However, as the recent Nightingale Nursing Home elderly mistreatment incident attests, the standards of some have been found wanting. This paper will trace the history of nursing homes in Singapore and the evolution of government policies towards them, discuss the challenges and trade-offs of nursing home regulation, and provide suggestions for better care and governance.
Aged ; Forecasting ; Guidelines as Topic ; History, 20th Century ; History, 21st Century ; Humans ; Nursing Homes ; history ; legislation & jurisprudence ; standards ; trends ; Singapore