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JYMS : Journal of Yeungnam Medical Science

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Original article
Storing information of stroke rehabilitation patients using blockchain technology: a software study
Min Cheol Chang
J Yeungnam Med Sci. 2022;39(2):98-107.   Published online September 7, 2021
DOI: https://doi.org/10.12701/yujm.2021.01368
  • 5,016 View
  • 85 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Stroke patients usually experience damage to multiple functions and a long rehabilitation period. Hence, there is a large volume of patient clinical information. It thus takes a long time for clinicians to identify the patient’s information and essential pieces of information may be overlooked. To solve this, we stored the essential clinical information of stroke patients in a blockchain and implemented the blockchain technology using the Java programming language.
Methods
We created a mini blockchain to store the medical information of patients using the Java programming language.
Results
After generating a unique pair of public/private keys for identity verification, a patient’s identity is verified by applying the Elliptic Curve Digital Signature Algorithm based on the generated keys. When the identity verification is complete, new medical data are stored in the transaction list and the generated transaction is verified. When verification is completed normally, the block hash value is derived using the transaction value and the hash value of the previous block. The hash value of the previous block is then stored in the generated block to interconnect the blocks.
Conclusion
We demonstrated that blockchain can be used to store and deliver the patient information of stroke patients. It may be difficult to directly implement the code that we developed in the medical field, but it can serve as a starting point for the creation of a blockchain system to be used in the field.

Citations

Citations to this article as recorded by  
  • Prediction of motor outcome based on brain perfusion single photon emission computed tomography in corona radiata infarct
    Eunjung Kong, Donghwi Park, Min Cheol Chang
    International Journal of Neuroscience.2023; : 1.     CrossRef
  • Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study
    Min Cheol Chang, Donghwi Park, Yoo Jin Choo
    Journal of Pain Research.2022; Volume 15: 4065.     CrossRef
Case report
Safety and effectiveness of early cardiac rehabilitation in a stroke patient with heart failure and atrial fibrillation: a case report
Sang Cheol Lee, Eun Jae Ko, Ju Yeon Lee, Ae Lee Hong
Yeungnam Univ J Med. 2021;38(4):361-365.   Published online March 22, 2021
DOI: https://doi.org/10.12701/yujm.2020.00885
  • 7,087 View
  • 161 Download
AbstractAbstract PDF
Stroke patients have reduced aerobic capacity. Therefore, intensive structured exercise programs are needed. We report the case of a patient with stroke and cardiac disease who underwent early inpatient cardiac rehabilitation (CR). A 38-year-old male patient with atrial fibrillation, heart failure, and cerebral infarction underwent a symptom-limited exercise tolerance test (ETT) without any problems on day 45 after admission. He completed a 2-week inpatient program and an 8-week home-based CR program. Follow-up ETT showed increased exercise capacity. The present case might be the first to report a safely performed CR program in a patient with stroke and cardiac comorbidity in Korea. Systematic guidance is needed for post-stroke patients to receive safe and effective CR for the secondary prevention of stroke and cardiovascular risk.
Original article
Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city
Jung Ho Kim, Hyun Wook Ryoo, Sungbae Moon, Tae Chang Jang, Sang Chan Jin, You Ho Mun, Byung Soo Do, Sam Beom Lee, Jong-yeon Kim
Yeungnam Univ J Med. 2019;36(3):241-248.   Published online July 2, 2019
DOI: https://doi.org/10.12701/yujm.2019.00248
  • 6,767 View
  • 81 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS).
Methods
We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression.
Results
Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102–3.017). The most suitable cutoff point for MHI by Youden’s index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%).
Conclusion
Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.

Citations

Citations to this article as recorded by  
  • Ambient heat exposure and kidney function in patients with chronic kidney disease: a post-hoc analysis of the DAPA-CKD trial
    Zhiyan Zhang, Hiddo J L Heerspink, Glenn M Chertow, Ricardo Correa-Rotter, Antonio Gasparrini, Niels Jongs, Anna Maria Langkilde, John J V McMurray, Malcolm N Mistry, Peter Rossing, Robert D Toto, Priya Vart, Dorothea Nitsch, David C Wheeler, Ben Caplin
    The Lancet Planetary Health.2024; 8(4): e225.     CrossRef
Original Article
The usefulness of newly developed R2CHA2DS2-VASc score and comparison with CHADS2 and CHA2DS2-VASc scores in atrial fibrillation patients.
Jae Hoon Kwak, Se Hwan Yeo, Yeo Un Kim, Jin Suk Lee, Byong Kyu Kim, Jin Wook Chung, Jun Ho Bae, Deuk Young Nah, Kwan Lee
Yeungnam Univ J Med. 2016;33(1):8-12.   Published online June 30, 2016
DOI: https://doi.org/10.12701/yujm.2016.33.1.8
  • 2,335 View
  • 18 Download
AbstractAbstract PDF
BACKGROUND
The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. METHODS: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. RESULTS: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. CONCLUSION: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.
Case Report
Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava.
Tae Hun Kwon, Kang Un Choi, Byung Jun Kim, Jae Ho Cho, Jae Young Lee, Kyu Hwan Park, Sang Hee Lee, Jang Won Son
Yeungnam Univ J Med. 2015;32(2):118-121.   Published online December 31, 2015
DOI: https://doi.org/10.12701/yujm.2015.32.2.118
  • 1,836 View
  • 4 Download
AbstractAbstract PDF
Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.

JYMS : Journal of Yeungnam Medical Science