• Journal of Gastric Cancer
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• v.21 no.1
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• pp.74-83
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• 2021

Purpose: No consensus exists on whether to preserve or ligate an aberrant left hepatic artery (ALHA), which is the most commonly encountered hepatic arterial variation during gastric surgery. Therefore, we aimed to evaluate the clinical effects of ALHA ligation by analyzing the perioperative outcomes. Materials and Methods: We retrospectively reviewed the data of 5,310 patients who underwent subtotal/total gastrectomy for gastric cancer. Patients in whom the ALHA was ligated (n=486) were categorized into 2 groups according to peak aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels: moderate-to-severe (MS) elevation (≥5 times the upper limit of normal [ULN]; MS group, n=42) and no-to-mild (NM) elevation (<5 times the ULN; NM group, n=444). The groups were matched 1:3 using propensity score-matching analysis to minimize confounding factors that can affect the perioperative outcomes. Results: The mean operation time (P=0.646) and blood loss amount (P=0.937) were similar between the 2 groups. The length of hospital stay was longer in the MS group (13.0 vs. 7.8 days, P=0.022). No postoperative mortality occurred. The incidence of grade ≥ IIIa postoperative complications (19.0% vs. 5.1%, P=0.001), especially pulmonary complications (11.9% vs. 2.5%, P=0.003), was significantly higher in the MS group. This group also showed a higher Comprehensive Complication Index (29.0 vs. 13.9, P<0.001). Conclusions: Among patients with a ligated ALHA, those with peak AST/ALT ≥5 times the ULN showed worse perioperative outcomes in terms of hospital stay and severity of complications. More precise perioperative decision-making tools are needed to better determine whether to preserve or ligate an ALHA.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.203-210
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• 2020

By facing the era of the 4th industrial revolution, personalized medical services for patients are expanding with the development of information and communications technology. With these changes, digital medical devices have begun to be used to support diagnosis, patient monitoring, and decision-making of diseases, and recently software medical devices for the purpose of preventing, managing, or treating disorders or diseases have become popular. The aim of this article is to understand the current concept and status of Software as a Medical Device (SaMD), which are actively being carried out in the United States, and to find out what fields can be applied in the future. In addition, it intends to find out the Korean domestic policy trends related to smart healthcare and find out the application of digital software as a medical devices that can be used in dental clinic to keep pace with the upcoming changes in the medical field.

• Journal of Biomedical Engineering Research
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• v.44 no.1
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• pp.11-18
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• 2023

Currently, studies to predict the risk of rectal cancer surgery select MRI image slices based on the clinical experience of surgeons. The purpose of this study is to semi-automatically select and classify 2D MRI image slides to predict the risk of rectal cancer surgery using biomarkers. The data used were retrospectively collected MRI imaging data of 50 patients who underwent laparoscopic surgery for rectal cancer at Gachon University Gil Medical Center. Expert-selected MRI image slices and non-selected slices were screened and radiomics was used to extract a total of 102 features. A total of 16 approaches were used, combining 4 classifiers and 4 feature selection methods. The combination of Random Forest and Ridge performed with a sensitivity of 0.83, a specificity of 0.88, an accuracy of 0.85, and an AUC of 0.89±0.09. Differences between expert-selected MRI image slices and non-selected slices were analyzed by extracting the top five significant features. Selected quantitative features help expedite decision making and improve efficiency in studies to predict risk of rectal cancer surgery.

• The Journal of the Korea Contents Association
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• v.22 no.2
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• pp.762-769
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• 2022

Genetic testing in prenatal diagnosis is a precious tool providing valuable information in clinical management and parental decision-making. For the last year, cytogenetic testing methods, such as G-banding karyotype analysis, fluorescent in situ hybridization, chromosomal microarray, and gene panels have evolved to become part of routine laboratory testing. However, the limitations of each of these methods demonstrate the need for a revolutionary technology that can alleviate the need for multiple technologies. The recent introduction of new genomic technologies based on next-generation sequencing has changed the current practice of prenatal testing. The promise of these innovations lies in the fast and cost-effective generation of genome-scale sequence data with exquisite resolution and accuracy for prenatal diagnosis. Here, we review the current state of sequencing-based pediatric diagnostics, associated challenges, as well as future prospects.

• International Journal of Computer Science & Network Security
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• v.23 no.2
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• pp.1-12
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• 2023

The article examines the axiological psycho-philosophical understanding of the phenomenon of money and its value role in modern society. The traditional and virtual context of the representation of the money phenomenon is considered.Following the ideas of G. Simmel, the authors consider money not only as a purely economic, but also a psycho-philosophical, cultural and social phenomenon. Money appears as a result of cultural development of the world and gradually forms a monetary culture as a space of economic and social interaction of people. Under the influence of the monetary culture of one or another historical period, the character of a person's economic activity, values and life orientations are formed. Modern money culture is often called financial civilization. Peculiarities of modern monetary culture are studied, its main features and problems are determined in the article. The problem of the peculiarities of the constructive and destructive attitude of the individual towards money is identified; a psycho-philosophical and cultural-identification typology of people is described, which is based on clinical observations and interpreted through the prism of psychoanalytic theory. The concept of money is highlighted from the standpoint of a social-psychological approach. The theoretical foundations of money's influence on the decision-making process and human behavior are also revealed.

• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.156-161
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• 2023

Background: We analyzed association between viewing two-dimensional computed tomography (2D CT) images in addition to radiographs with radial head treatment recommendations after accounting for patient and surgeon factors in a survey-based experiment. Methods: One hundred and fifty-four surgeons reviewed 15 patient scenarios with terrible triad fracture dislocations of the elbow. Surgeons were randomized to view either radiographs only or radiographs and 2D CT images. The scenarios randomized patient age, hand dominance, and occupation. For each scenario, surgeons were asked if they would recommend fixation or arthroplasty of the radial head. Multi-level logistic regression analysis identified variables associated with radial head treatment recommendations. Results: Reviewing 2D CT images in addition to radiographs had no statistical association with treatment recommendations. A higher likelihood of recommending prosthetic arthroplasty was associated with older patient age, patient occupation not requiring manual labor, surgeon practice location in the United States, practicing for five years or less, and the subspecialties "trauma" and "shoulder and elbow." Conclusions: The results of this study suggest that in terrible triad injuries, the imaging appearance of radial head fractures has no measurable influence on treatment recommendations. Personal surgeon factors and patient demographic characteristics may have a larger role in surgical decision making. Level of evidence: Level III, therapeutic case-control study.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.17 no.10
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• pp.2627-2642
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• 2023

Parkinson's disease (PD) is a typical, chronic neurodegenerative disease involving the concentration of dopamine, which can disrupt motor activity and cause different degrees of gait disturbance relevant to PD severity in patients. As current clinical PD diagnosis is a complex, time-consuming, and challenging task that relays on physicians' subjective evaluation of visual observations, gait disturbance has been extensively explored to make automatic detection of PD diagnosis and severity rating and provides auxiliary information for physicians' decisions using gait data from various acquisition devices. Among them, wearable sensors have the advantage of flexibility since they do not limit the wearers' activity sphere in this application scenario. In this paper, an attention-based temporal network (ATN) is designed for the time series structure of gait data (vertical ground reaction force signals) from foot sensor systems, to learn the discriminative differences related to PD severity levels hidden in sequential data. The structure of the proposed method is illuminated by Transformer Network for its success in excavating temporal information, containing three modules: a preprocessing module to map intra-moment features, a feature extractor computing complicated gait characteristic of the whole signal sequence in the temporal dimension, and a classifier for the final decision-making about PD severity assessment. The experiment is conducted on the public dataset PDgait of VGRF signals to verify the proposed model's validity and show promising classification performance compared with several existing methods.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.95-105
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• 2024

PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.

• Hip & pelvis
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• v.34 no.4
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• pp.236-244
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• 2022

Purpose: The most recent diagnostic criteria for periprosthetic joint infection (PJI) include the use of the alpha-defensin (AD) lateral-flow (LF) test, but hip and knee arthroplasties were usually combined in previous studies. This prospective study was designed to examine the accuracy of the AD-LF test for diagnosis of PJI in chronic painful total hip arthroplasties (THA). Materials and Methods: Patients with chronic painful hip arthroplasties were prospectively enrolled between March 2018 and May 2020. Exclusion criteria included acute PJI or an insufficient amount of synovial fluid. The modified Musculoskeletal Infection Society (MSIS) criteria were primarily used for PJI diagnosis. Fifty-seven patients were included in the analysis group. Revision surgery was not performed in 38 patients, for different reasons (clinical group); these patients remain "Schrödinger's hips": in such cases PJI cannot be excluded nor confirmed until you "open the box". Results: The result of the AD-LF test was positive in nine patients and negative in 48 patients. Six patients were diagnosed with PJI. AD-LF sensitivity (MSIS criteria) was 83% (95% confidence interval [CI] 36-100%) and specificity was 92% (95% CI 81-98%). The positive and negative predictive value were 56% and 98%, respectively. Conclusion: The AD test is useful in addition to the existing arsenal of diagnostic tools, and can be helpful in the decision-making process. Not all patients with chronical painful THA will undergo revision surgery. Consequently, in order to determine the reliable diagnostic accuracy of this test, future PJI diagnostic studies should include a second arm of "Schrödinger's hips".

• Korean Circulation Journal
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• v.52 no.1
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• pp.1-33
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• 2022

In primary prevention for cardiovascular diseases, there are significant barriers to adherence including freedom from symptoms, long latency for therapeutic benefits, life-long duration of treatment, and need for combined lifestyle changes. However, to implement more systematic approaches, the focus on adherence improvement needs to be shifted away from patient factors to the effects of the treatment team and healthcare system. In addition to conventional educational approaches, more patient-oriented approaches such as patient-centered clinical communication skills, counseling using motivational strategies, decision-making by patient empowerment, and a multi-disciplinary team approach should be developed and implemented. Patients should be involved in a program of self-monitoring, self-management, and active counseling. Because most effective interventions on adherence improvement demand greater resources, the health care system and educational or training system of physicians and healthcare staff need to be supported for systematic improvement.