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

No abstract available.
Hepatitis B e Antigens* ; Hepatitis B Surface Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis*

OBJECTIVE: In the mobile computing environments, doctors or patients with mobile devices can access services at any time, any place. It makes chronic diseases, such as asthma care successively and in long-term. This paper presents a new multiagent system using data mining technique for the management of asthma in mobile computing environments. METHODS: In mobile computing environments, mobile communication is prone to disconnection. To use the services when disconnected, we locally store the recommendation information in mobile devices. Then, when user reconnects network, the new information is delivered in mobile devices. Because mobile devices have a limitation of resource, we store only patterns and recent data. We adopted data mining technique from the large pool of accumulated patients data can be utilized to summarize observed correlations and trends. RESULTS: We propose multiagent system composed of a Pattern Agent, a Selection Agent and a Recommendation Agent. They make asthmatic-caring system access effectively in mobile computing environments. We describe the underlying architecture and the process. Then we make a prototype with asthmatic patients data in the Severance Hospital in Korea. CONCLUSION: The results of our study can be contributed to aid management of asthma in mobile computing environments.
Asthma* ; Chronic Disease ; Data Mining* ; Humans ; Korea ; Telemedicine

No abstract available.

No abstract available.
Humans

INTRODUCTION: Protamine reversal of heparin anticoagulation often produces profound hypotension. However, the precise mechanisms of its hypotensive effect have not been fully elucidated. Using a canine model, we explored the effects of cyclo-oxygenase inhibitor, indomethacin (INDO), and nitric oxide synthetase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME) either alone or both on the cardiopulmonary responses to protamine. METHODS: Fifty-four mongrel dogs in five groups were studied during 1.5% halothane anesthesia. GroupI (n=17) received heparin (300 IU/kg iv) followed by protamine (3 mg/kg iv over 30 s) 5 min after the heparin. The same protocol were used in groups II (n=11), III (n=12), and IV (n=7), except that L-NAME (20 mg/kg), INDO (10 mg/kg), and INDO (10 mg/kg) plus L-NAME (10 mg/kg) were infused over 10 min beginning 30 min before the protamine injection, respectively. Animals in group V (n=7) were given protamine (3 mg/kg) alone. Mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), left ventricular end-diastolic pressure (LVEDP), LVdP/dt and cardiac output and left circumflex coronary flow (LCX flow) via Doppler flowmeter and heart rate were continuously recorded in baseline conditions and up to 15 min. Plasma NOx (NO2-, NO3-) levels were also measured before (baseline) and 3, 5, 10, and 15 min after protamine injection. RESULTS: In group I, protamine caused immediate but transient decreases of MAP (41%), cardiac index (CI, 58%), dP/dt (28%), and LVEDP (62%) and increases of MPAP (38%) and systemic and pulmonary vascular resistance indices (SVRI, 30%; PVRI, 316%). INDO significantly attenuated the hemodynamic responses to protamine, whereas L-NAME did not affect them at all. INDO plus L-NAME prevented protamine-induced hypotension, but CI (-24%) and LVEDP (-30%) showed similar changes as those in group II. Protamine increased MPAP but inconsistently, meanwhile no correlation was found between the magnitude of increase of MPAP and decrease of MAP at peak responses in groups I-IV. LCX flow increased significantly (124~188%) immediately after protamine infusion without any changes in plasma NOx levels in groups I-IV. Neither significant hemodynamic effects nor NOx release was found in animals given protamine alone. CONCLUSION: Protamine in the presence of heparin induces profound hypotension which may be mediated by a prostanoid and other potent vasodilators. In addition, increase of PAP and NO release may not play a significant role in the protamine-induced hypotension.
Anesthesia ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Flowmeters ; Halothane ; Heart Rate ; Hemodynamics ; Heparin ; Hypotension* ; Indomethacin ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase ; Plasma ; Prostaglandin-Endoperoxide Synthases ; Protamines* ; Vascular Resistance ; Vasodilator Agents

Bone cement augmentation procedures have been getting more position as a minimally invasive surgical option for osteoporotic spinal fractures. However, complications related to these procedures have been increasingly reported. We describe a case of bone cement dislodgement following cement augmentation procedure for osteoporotic spinal fracture by reviewing the patient's medical records, imaging results and related literatures. A 73-year-old woman suffering back and buttock pain following a fall from level ground was diagnosed as an osteoporotic fracture of the 11th thoracic spine. Percutaneous kyphoplasty was performed for this lesion. Six weeks later, the patient complained of a recurrence of back and buttock pain. Radiologic images revealed superior dislodgement of bone cement through the 11th thoracic superior endplate with destruction of the lower part of the 10th thoracic spine. Staged anterior and posterior fusion was performed. Two years postoperatively, the patient carries on with her daily living without any significant disability. Delayed bone cement dislodgement can occur as one of complications following bone cement augmentation procedure for osteoporotic spinal fracture. It might be related to the presence of intravertebral cleft, lack of interdigitation of bone cement with the surrounding trabeculae, and possible damage of endplate during ballooning procedure.
Aged ; Bone Cements ; Buttocks ; Female ; Fractures, Compression ; Humans ; Kyphoplasty ; Medical Records ; Osteoporotic Fractures ; Recurrence ; Spinal Fractures* ; Spine ; Vertebroplasty

OBJECTIVE: We report a case with a long-standing history of the ankylosing spondylitis(AS) who showed multiple cerebellar infarctions with bulbar symptom owing to vertebral artery obstruction, due to anterior and vertical subluxation of atlanto-axial and atlanto-occipital joint. CLINICAL PRESENTARION: An 51-year-old male patient with swallowing difficulty, tongue deviation to the left side and severe nuchal pain and rigidity is presented. INTERVENTION: After removal of posterior portion of foramen magnum, posterior portion of left transverse foramen of axis was decompressed. CONCLUSIONS: Spontaneous anterior atlanto-axial subluxation occurs in patients with AS about 2% of presents with or without signs of spinal cord compression. Vertical subluxation occurs in 3-8% of patient with rheumatoid arthritis but it is an exceedingly rare complication of AS. Close observation and follow-up are needed in patients with AS and if subluxation occurs, good prognosis is anticipated using an early operative treatment.
Arthritis, Rheumatoid ; Atlanto-Occipital Joint* ; Axis, Cervical Vertebra ; Deglutition ; Follow-Up Studies ; Foramen Magnum ; Humans ; Infarction ; Male ; Middle Aged ; Prognosis ; Spinal Cord Compression ; Spondylitis, Ankylosing* ; Tongue ; Vertebral Artery*

Since the concept of osseointegration has been introduced, a lot of researches were performed to achieve stronger fixation of the implant. In this study, we tried to find the different pattern of bone ingrowth after implanting pure titanium implant and Hydroxyapatite coated titanium implant in dogs. Four typed of cylindrical titanium implants (diameter 6 mm, length 1 mm) were inserted in the distal femur of adult dogs. The histological examination was done at postoperative 2, 4, 8, and 12 weeks. There was no foreign body reaction at contact site and all implants kept direct contact with bone tissue. In the light microscopic finding, after 2 weeks, the cases with Hydroxyapatite-coated Implant (HAP) showed greater formation of immature woven bone in comparison to Titanium implant. After 4 weeks, Hydroxyapatite-coated Implant (HAP) showed more mature lamellar bone. After 8 and 12 weeks, most of the woven bone was transformed into mature lamellar bone. The fluorescence microscopic finding, after 2 weeks, revealed calcein green fluorescence around implants in all cases and it was more prominent in the cases with Hydroxyapatite-coated Implant (HAP). After 4 weeks, the center of trabecula gave out green fluorescent light, the corner of them showed red fluorescent light, and they were more prominent in the cases with Hydroxyapatite-coated Implant (HAP). After 8 and 12 weeks, green fluorescence disappeared gradually, red fluorescence appeared for the most part, and there was no difference in each cases, especially in 12 weeks. As a result, we support the concept that Hydroxyapatite-coated Implant (HAP) induces faster bone ingrowth in 4 weeks than Titanium implant, and that it may be more profitable for early bone ingrowth and implant stability.
Adult ; Animals ; Bone and Bones ; Dogs* ; Durapatite ; Femur ; Fluorescence ; Foreign-Body Reaction ; Humans ; Osseointegration ; Titanium*

Using a high bandwidth cellular communication network is appropriate to implement a high-quality mobile emergency telemedicine system. In Korea, the commercial service of CDMA2000 1X-EVDO has been providing since 2002. In this paper, we designed the system that transfers the biological signal and the video information of a patient simultaneously based on this CDMA2000 1X-EVDO network environment. In CDMA2000 1X-EVDO, the maximum speed of its reverse link can be observed within 153.6Kbps. Before the system design, several field tests had been performed using commercial CDMA2000 1X-EVDO reverse link with the UDP data segments. The test had been taken under several velocity and tunnel areas of Seoul. With the test result we implemented an efficient emergency telemedicine system fitted to the features of CDMA2000 1X-EVDO reverse link using UDP packets. Additional header information is added to the UDP packet data. With the header information the emergency system can transmits the ECG signal prior to the video data and controls the transmission error. The designed system has the ability to transmit both the biological signals and MPEG4 video of 640x480 spatial resolution at the same time. We set up the ambulance with this system and test it on the road.
Ambulances ; Electrocardiography ; Emergencies* ; Humans ; Korea ; Seoul ; Telemedicine* ; Uridine Diphosphate