• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.17-23
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• 2019

Background: The resection of head and neck cancer can result in postoperative defect. Many patients have difficulty swallowing and masticating, and some have difficulty speaking. Various types of flaps are used for palatal reconstruction, but flap selection remains controversial. Therefore, our study will suggest which flap to choose during palatal reconstruction. Methods: Thirteen patients who underwent palatal reconstruction from 30 January, 1989 to 4 October, 2016 at our institution. Size was classified as small when the width was < $4cm^2$, medium when it was $4-6cm^2$, and large when it was ${\geq}6cm^2$. Based on speech evaluation, the subjects were divided into a normal group and an easily understood group. After surgery, we assessed whether flap selection was appropriate through the evaluation of flap success, complications, and speech evaluation. Results: Defect size ranged from $1.5{\times}2.0cm$ to $5.0{\times}6.0cm$. In four cases, the defect was in the anterior third of the palate, in eight cases it was in the middle, and there was one case of whole palatal defect. There were three small defects, two medium-sized defects, and eight large defects. Latissimus dorsi free flaps were used in six of the eight large defects in the study. Conclusion: The key to successful reconstructive surgery is appropriate selection of the flap with reference to the characteristics of the defect. Depending on the size and location of the defect, the profiles of different flaps should be matched with the recipient from the outset.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.2
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• pp.63-69
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• 2011

Table strapis patient fixture for securing the patient movements and falls. if it designed to measure the abdominal circumference and used as an indicator of dose selection at CT scan. it will prevent the overexposure of dose without degradation of image quality and efficiently manage dose of each type of body to technician to deal with CT. First, in order to compare the dose used in CT image and qualitative characteristics. reference image is obtained by examining the abdominal phantom in same conditions with the hospital 120 kVp, 200 mAs, D-Dom (Dynamic Dose Of Modulation). SNR, PSNR, RMSE, MAE, CTDIvol of CT images are compared with reference image. for comparing with reference image, the image that Umbilicus level image of Abdomen CT is stored in the PACS were used. For comparison, the top 12 o'clock portion of the air drawn from the same ROI was measured. CTDIvol, mAs, etc. In order to analyze the characteristics of the image, by measuring the length of the umbilicus circumference, pattern of the dose was analyzed. by using the analyzed perimeter and dose information, To be identified visually, fixed band that scale marked were produced. Use them, If the length of circumference of less than 60 cm 100 mAs, Case of 61~80 cm 120 mAs, Case of 80~100 cm 150 mAs, more than 100 cm 200 mAs, dose selection based on the perimeter, the image was applied. by compare analyzed with the Reference Image, image quality was assessed. by compare with existing tests that equally 200 mAs applied, How much was confirmed that the dose reduction. 1. Depending on the Abdominal circumference, the average PSNR(dB) of the image that differently dose applied was 45.794. 2. Comparing with existing test. the dose of scan that adjusted the mAs depending on the circumference was decreased about 40%. SNR and PSNR of the image that obtained by adjusting the standard mAs based on dose modulation were not much different. Therefore, By choosing a low mAs. dose reduction can be obtained. and the dose selection method that measured Abdominal circumference using a fixed band can protect the overexposure and uniformly apply dose of each type of body to technician to deal with CT.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.11
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• pp.4354-4359
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• 2010

The study performed questionnaire to the patients receiving implant operation, who visited dental clinics and hospitals(2 hospitals and 5 clinics) from Jul. 1, 2009 to Sep. 12, 2009 in order to study the factors giving effects to patient's satisfaction in the selection of implant. 145 questionnaire papers collected from patients were analyzed with SPSS12.0 program. The result revealed that the satisfaction with implant operation was usually normal when implant was operated because of tooth extraction due to dental caries and periodontal disease and it was usually high when implant was operated because of wound(P<0.05). When considering each cause of tooth extraction, the satisfaction with pronunciation function was usually normal(P<0.001), the satisfaction with functional part including foreign body sense was very low when the cause of operation was periodontal disease(P<0.01). The satisfaction with hospital environment depending on the cause of hospital selection was usually high when hospital was selected because of doctor's fame. It was low when hospital was selected because it was close to home(P<0.001). The satisfaction with the number of hospital visits depending on the number of implanted teeth was usually low when many teeth were implanted(P<0.01). The analysis on the satisfaction with tooth shape and color showed that the satisfaction was high when '1~2' teeth and 'more than 6' teeth were implanted(P<0.05). In order to improve patient's satisfaction with implant, it is necessary to recognize individual's oral status and request correctly. It is determined that proposal of operation period, number of hospital visits, function and expected aesthetic satisfaction degree will contribute to the improvement of mutual reliance between doctor and patient and post-operation satisfaction degree.

• Journal of Digital Convergence
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• v.16 no.8
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• pp.311-320
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• 2018

In this study, we conducted a survey on the 20 - to 30-year-olds woman and men in a total of 291 questionnaires to analyze the impact on the level of customer satisfaction and revisit the factors of service quality and hospital selection. Analysis result, found that there was a correlation between the quality of service, customer satisfaction, and factors of re-intervient inquiry when selecting hospitals. In particular, it was found that hospital expenses and hospital map were affected by customer satisfaction and re-investigation companies, and the quality of the service after treatment had the greatest impact on other variables. As such, these results are considered to be of overall concern to the physician's ability to perform the procedure as well as to the service of the staff. Various follow-up studies are needed depending on the region.

• Journal of Information Processing Systems
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• v.13 no.5
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• pp.1243-1258
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• 2017

A new medical materials scheduling system and its modeling method for the complex rescue are presented. Different from other similar system, first both the BeiDou Satellite Communication System (BSCS) and the Special Fiber-optic Communication Network (SFCN) are used to collect the rescue requirements and the location information of disaster areas. Then all these messages will be displayed in a special medical software terminal. After that the bipartite graph models are utilized to compute the optimal scheduling of medical materials. Finally, all these results will be transmitted back by the BSCS and the SFCN again to implement a fast guidance of medical rescue. The sole drug scheduling issue, the multiple drugs scheduling issue, and the backup-scheme selection issue are all utilized: the Kuhn-Munkres algorithm is used to realize the optimal matching of sole drug scheduling issue, the spectral clustering-based method is employed to calculate the optimal distribution of multiple drugs scheduling issue, and the similarity metric of neighboring matrix is utilized to realize the estimation of backup-scheme selection issue of medical materials. Many simulation analysis experiments and applications have proved the correctness of proposed technique and system.

• Archives of Plastic Surgery
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• v.49 no.4
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• pp.531-537
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• 2022

Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.683-688
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• 2022

Background Reconstruction of large soft tissue defects of the lower extremity often requires the use of free flaps. The main limiting factor and potential for complications lie in the selection of proper donor and recipient vessels for microvascular anastomosis. While the superficial veins of the lower leg are easier to dissect, they are thought to be more vulnerable to trauma and lead to a higher complication rate when using them instead of the deep accompanying veins as recipient vessels. No clear evidence exists that proves this concept. Methods We retrospectively studied the outcomes of 97 patients who underwent free flap plasty to reconstruct predominantly traumatic defects of the lower extremity at our institute. The most used flap was the gracilis muscle flap. We divided the population into three groups based on the recipient veins that were used for microvascular anastomosis and compared their outcomes. The primary outcome was the major complication rate. Results Overall flap survivability was 93.81%. The complication rates were not higher when using the great saphenous vein as a recipient vessel when comparing to utilizing the deep concomitant veins alone or the great saphenous vein in combination to the concomitant veins. Conclusions In free flap surgery of the lower extremity, the selection of the recipient veins should not be restricted to the deep accompanying veins of the main vessels. The superficial veins, especially the great saphenous vein, offer an underrated option when performing free flap reconstruction.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.559-581
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• 2022

Although renal angiomyolipoma (AML) is a benign tumor, treatment may be necessary occasionally because it can cause potentially life-threatening retroperitoneal hemorrhage. Transarterial embolization (TAE) is a safe and effective treatment option to prevent the hemorrhagic rupture of AMLs and relieve the symptoms caused by enlarged lesions or active bleeding. However, there is no clear consensus regarding the indications for prophylactic TAE in patients with sporadic renal AMLs. In urgent TAE for bleeding AMLs, there is a likelihood of incomplete embolization when the focus is on stabilizing the clinical symptoms. This pictorial essay discusses the patient selection and technical considerations to achieve optimal therapeutic effects as well as the follow-up findings after TAE.

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.35-43
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• 2003

Purpose : In order to receive a health medical examination undergoing an examination which it visits it analyzes The bone mineral density of the object people who enforce the selection bone mineral density test with the object which will cut and prevalenc

• Health Policy and Management
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• v.15 no.4
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• pp.65-80
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• 2005

This study examines the effects of supplemental insurance on health care utilization and expenditures among cancer patients, who were hospitalized in a general hospital in Korea 2003. We find that those who purchase the supplemental insurance in addition to the social health insurance use more health care services and pay more than those who do not, suggesting insurance effects. This paper, however, cannot distinguish the moral effects of the health insurance from the selection effects due to adverse selection.