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Professor Kim Jung Kyung’s team, joint research on AIDS diagnostic technique

The Bio Dynamics Lab’s research team, under Professor Kim Jung Kyung, comprised of graduate school students from KMUs Mechanical Engineering Department and Advanced Fermentation Fusion Science and Technology Department, has developed a diagnostic system based on portable optics imaging. SmartScope is designed where optical components such as compact light sources, lenses and other tools are mounted on smartphones.

It’s a function that allows analyzing a cell image taken by a smartphone’s built-in camera directly through a self-developed app; a more innovate feature than similar type diagnostic devices being developed in the USA.

As a portable diagnostic platform, this system allows one to analyze special cell’s numbers, size, shape and samples through automatic image processing, The SmartScope can be expected not only to examine all sorts of infectious diseases much quicker and with a much lower cost than skilled experts can diagnose at typical hospitals with high-priced equipment, but also allows direct sharing of the results with medical experts at a distant location equipped with a cellular network.

The final process for professor Kim’s team of targeting the diagnosis of AIDS with SmartScope is in progress.

According to a statistical survey conducted in late 2010, around 34 million people worldwide are infected with HIV, the virus that causes AIDS, and among them, 68 percent are living in sub-Saharan Africa.

Also, 2.7 million people are newly infected every year and 70 percent of them are in the same area.

Consequently, a population decrease from AIDS is the reason for the vicious circle these people are facing; things like a shortage of labor, a decrease in agriculture, the livestock industry and its output. Thus innovative medical treatment dissemination, which is able to diagnose and treat early HIV infection, is required for economic development and improving the quality of life for this less favored area in Africa.

There are even close to 6 million people with HIV in South Africa, which is the most developed country on the African continent, so it has become the largest social issue. After the AIDS treatment called ART (Anti Retroviral Therapy) came out, South Africa conducted the world’s biggest ART program and 1.9 million people received this medical benefit through the middle of 2011. However it’s less than 50 percent of those infected, and around 300,000 South African have been dying from complications related to HIV every year.

Since ART has been introduced, the frequency of patients with HIV infection progressing into AIDS has decreased, however the standard testing being utilized to determine the timing of ART implementation relies on high priced large equipment. So, it takes from a minimum of 2 days to a maximum of 2 weeks to deliver examination results by mail including the delivery time of the infector’s blood being taken from remote areas.

Patients missed the perfect timing for ART treatment because of time delays from diagnosis to prescription. Therefore, if the inspection equipment which can be used on site is developed, the patient can know the result immediately and would able to get treatment at just the right time through a prompt prescription.

Through field testing equipment, patients can watch their treatment progress regularly and get check-ups for infection performed easily every 6 months after medical treatment is finished. Finally, the field testing equipment reduces the cost, which is the biggest problem of the ART program, by giving quick feedback to patients.

Meanwhile, Africa’s isolated areas which has limited health care infrastructure and residents cannot afford to go to hospitals due to financial conditions, definitely needs health care technology that allows community health workers to recognize whether residents are infected or not, then deliver results to a distant doctor and enable prompt prescriptions to be given.

These days Africa, which has a poor cable network infrastructure, the wireless network has been building actively and mobile products have been distributed and are being used at a rapid pace. The atmosphere has been created to enable the offering of a new concept of remote diagnose service technology combining field diagnose equipment for infectious diseases including HIV/AIDS using mobile phones.

Recently released smartphones offer not only current communication features but also high resolution cameras and an atmosphere to develop various apps. These can be utilized by taking pictures of patients’ samples (blood, saliva etc.) taken on the spot, treating them with a reacting reagent, and then judging infections automatically sending the images for analyzing at a remote site. 


 
Q. Can you tell me the purpose the teams have for this application program development?

The researchers aim to develop an innovative diagnosis platform combining field diagnosis equipment with the wireless SmartScope device and utilizing it in South Africa and nearby Swaziland, which both have a high ratio of HIV/AIDS, and they have been doing joint research with the Department of Family Medicine researchers (leader: Professor Jannie Hugo) of Pretoria University Medical College.

Unlike Korea, the role and importance of the family medicine unit in charge of primary medical care is quite large in South Africa’s isolated areas which have a big territory and a sizeable rich-poor gap. If the HIV/AIDS remote diagnosis platform goal of this research is developed, this could be a very useful instrument for local doctors and patients.

The medical college and hospital at Pretoria University are recognized as the best on the African continent with Cape Town University and have good infrastructure for research and an HIV/AIDS patients managing system.

KMU researchers will be in charge of the hardware and software improvement of diagnostic devices, considering the local environment and South African researchers will provide patients samples, conduct comparative verification with existing diagnostic methods, and be responsible for selecting the site for the field testing and operation of the new diagnostic devices.

Q. How long did this device take to develop and can you predict how long it will be before it’s put into practice?  Also, what processes are still in progress?

SmartScope’s development first started in 2009. At that time, Park Min-A, who is working for the Hyosung company now, was a senior of KMU’s Automotive Engineering Department, helped in selecting the topic for the team project of Capstone Design which is the engineering design’s subject.

The next year, in 2010, student Cho Myeong ok (finished master degree in Mechanical Engineering in 2012, co-representative in the company PaSce) participated in the first research at Medical Laboratory Technology and student Park Chun Ho (stage 4 of Master course in Advanced Fermentation Fusion Science and Technology, co-representative at PaSce) proceeded with development in earnest as a team.

Those 2 students suggested the business item titled Mobile SmartScope to the Youth Venture Academy Business, the Small and Medium Business Administration and the Small and Medium Business Corporation, and have proceeded since 2011. Then they were selected as the Youth Venture CEOs in the 1st stage and received venture funding.

They established a company named PaSce and produced their first sample.

Meanwhile, the researchers received support from the Korea-Africa Internationalization Base Development Project from the Ministry of Educational Science and Technology from Oct, 2011 to Sep, 2012, then built up a cooperate network for international joint research with an African local research center while conducting SMART (Swaziland’s Medical Appropriate Rapid Technology) development project.

Professor Kim Jung Kyung participated as a member of Korea’s delegation at the 4th Korea-South Africa science technology joint committee held in Pretoria, South Africa in Dec, 2011 and suggested new joint cooperation regarding distributed diagnosis for South Africa’s infectious disease monitoring and home health care technology development.

 Then they got support from the University Research Manpower International Exchange Support Business of the National Research Foundation and have been carrying out visiting research at Pretoria University in South Africa, which is the joint research center for the researching period since the last half of 2012.

These days, he has been intensively carrying out international joint research for use with HIV infection diagnosis by adding additional features in SmartScope with the South African medical team’s support. Currently, the most commonly used examination method to recognize HIV infection, measures and tests a number of CD4 lymphocytes in the blood per unit measure, but the goal is to obtain a fluorescent CD4 lymphocyte image and build the remote diagnostic platform enable to deliver automatically calculated results to remote areas through apps.

The researcher, Lee Dong Hee (KMU Mechanical Engineering Department master’s graduate, current doctoral student at Nebraska State University) who is the first graduate of the Vital Dynamics Office contributed much to this study. If the research and development process continues as planned, next year he is going to receive feedback from co-researchers in South Africa, while progressing with clinical trials targeting local patients in Africa where there is a demand of field diagnostic devices, and then reflect the equipment improvement needed for business. 



Q. Let me know if there is something that led you to promote this application program development.

Before and after 2000,POCT (Point-of-Care Testing)’s research and development was performed actively through convergence such as semiconductor processing, micro-fluidics and surface treatment technology on the strength of Korea’s advanced BT/IT technology. POCT enables one to perform process from preprocessing to reaction, analysis and detection promptly, and this is only a tiny sample of what is needed as a main element of technology to realize home medical treatments or u-healthcare systems these days.

Also, wireless networks competing for world rankings 1 and 2 and technology utilizing all sorts of smart devices to remote medical service have been developing. However, except some islands or mountain areas, Korea has a dense population in limited land space and medical facilities and labor are oversupplied. So, the necessity of remote treatment utilizing POCT and wireless networks is not that big and hasn’t been used yet except as a trial by business led by the government. The current medical insurance system and Medical Appliances Act have an effect on limiting requirements.

Meanwhile, people living in Africa’s less favored area don’t receive medical benefits for prevention, diagnosis and treatment of diseases, even thought the vast majority of infections break out there because of low educational standards and terrible sanitary facilities. To solve these problems, the international society is offering them a lot of support these days.

Representatively, Bill Gates' foundation in the USA and the World Health Organization (WHO) based in Europe have been carrying forward business supporting innovative diagnostic technologies for global healthcare. Most of CD4 lymphocyte counters for HIV/AIDS diagnosis are not suitable for the African continent or developing countries having many AIDS patients, and if they were to buy high priced equipment, it would not be helpful because most of those areas have lack of trained manpower, laboratories and electric power.

I considered that Africa is the country where the SmartScope technology is desperately needed when I saw the African’s life and heard about the local healthcare environment from local officials. The remote diagnostics platform verified that the possibility of field application targeted at local users through international joint research will be expected to be a core technology fully available if the home-health care and u-healthcare service environment is set up in advanced countries.

Q. Please tell me if there are functions to applications to be added or expanded.

Smartphone based diagnostic devices have various applications because they are portable and relatively cheap. This especially allows for field inspection in areas with a lack of manpower and facilities. According to the rapid increase of mobile phone subscribers in Africa, site inspection equipment combined with the smartphone is clever technology able to deliver inspection results performed on site to distant experts through the wireless communication infrastructure.

First, SmartScope was developed for inspection of people’s infectious diseases such as AIDS or malaria. However, people found that it also has the potential to be used to inspect livestock’s diseases in less populated areas in Africa that have a lack of resources through discussion with South African researchers. 
Large scale stock farming is well developed in undeveloped areas which have not yet been modernized by operating collective farms, therefore works controlling tropical diseases of livestock, such as babesiosis by blood parameter parasites, anaplasmosis, African trypanosomiasis, etc. are important for raising output. Also this can prevent phenomenon where infectious vectors such as bacteria, viruses, parasites, etc. are transmitted to humans.

SmartScope could be able to contribute to effectively controlling and eradicating livestock diseases through accurate and timely infection diagnostics. South Africa is known as the only country on the African continent which has independent veterinary research capabilities. The medical and veterinary colleges at Pretoria University are actively pushing ahead with joint research on infectious diseases seen in humans, livestock and wildlife with the slogan of One Health.

We think here is the perfect atmosphere for development and assessment of the on-site inspection system this researching team aims for because an onsite testing bed studying interactions related with infectious disease between humans, livestock and wildlife is already built.

Q. Do you expect something that how program will be used and which result it brings out?

Mobile phone users in developed countries are around 76 percent and the mobile communication method is very important in an area with a lack of infrastructure. They are investing in wireless based facilities rather than a cable based Internet one. The ratio of cell phone users in Africa is 53% but the increase of user rate is the highest in the world. In 2011, there were 5 million cell phone users and among them, 150,000 people were using smartphones.

A 3% smartphone sales rate in 2011 will be expected to increase by 15% in 2015. South African cell phone users are the highest on the African continent. In 2009, users already passed 85% (Africa Mobile Fact Book, 2008) and among them, smartphone users accounted for 15%. The field inspection equipment based on smartphones will be expected to increase as well in the future as the smartphone market has been increasing.

Now, as the interest in global healthcare from the USA has been increasing, Korea’s well advanced BT/IT convergence technology can be used for medical service improvement in Africa and it could contribute to release the imbalance of global healthcare service benefits, which has been deepening.

We would draw an effective and sustainable Korean style official development assistance (ODA) model by using Korea’s BT/IT convergence technology aiming at developing countries in southern Africa while performing these studies. In addition, we can try to study ODA strategy targeting healthcare and environment improvement through infectious disease and environmental pollution diagnosis by developing proper technology user-centered living in developing countries in southern Africa.

To develop state of the art technology that South Africa, not only the central country in Southern Africa but one of the countries in BRICS needs, we can push forward with joint research between Korea and South Africa, then popularize it through a proper technology form accommodating to local circumstances in nearby developing countries' high quality of life, and ultimately, proceed with ODA based on new concepts of proper technology inducing economic development. 

In the future, we can imagine that model social companies interested in proper technology will take part by receiving funding from public utility foundations, enabling them to attract major companies that want to show their interest in social issues to also participate.

In addition, aiming at KMU students, we are thinking about helping them by developing an outreach program based on the African local network to experience other countries' cultures and customs, acquire a cosmopolitan outlook and grow as globalized human beings. Students belonging to this laboratory are receiving support from the Energy Human Resources Development Center (Chief of center : Han Hwa Taek, http://etec.kookmin.ac.kr) operated by the Mechanical Systems Engineering Department at KMU College of Engineering, and funded by the Ministry of Knowledge Economy.

Q. Please give us a final word.

I came to realize that many people began showing interest in Africa from the field of politics, economics and diplomacy as well as related healthcare fields while conducting this study now in South Africa. Also aid from advanced countries are very active and in various forms.

However, there are diplomatic policies aimed at their own benefit such as securing Africa’s oil and mine resources, creating a new market behind the scenes. We should see Africa a bit more purely. These days, I heard touching news that retired professors from universities started their jobs as a dean or volunteer in developing countries in Africa such as Ethiopia and Uganda. Local Korean missionaries and experts in all sorts of fields are cooperating with local government and establishing medical colleges and hospitals in Swaziland. I was really moved when a young black woman came to me and held my hands while I was praying in a local church as I recognized that she was an HIV positive person. I hope SmartScope is successfully developed and acts as a warming tool which helps the local people in Africa who are suffering from AIDS.