• 대한족부족관절학회지
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• 제17권4호
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• pp.257-263
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• 2013

Open reduction and internal fixation is currently considered as a gold standard of treatment in most of the intra-articular calcaneal fractures. Among various different approaches, extensile lateral approach is the most popular since it provides good exposure to the subtalar joint. However, wide skin incision followed by extensive soft tissue dissection leading to increased risk of wound breakdown is the most serious drawback. Sinus tarsi approach, a minimal invasive technique to approach the subtalar joint and reduce the intra-articular calcaneal fractures, provides good clinical outcome and less wound complications compared to the extensile lateral approach. This article introduces the surgical technique and review of the literature regarding the sinus tarsi approach.

• Journal of Chest Surgery
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• 제49권5호
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• pp.356-360
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• 2016

Background: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. Methods: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy. Results: No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence. Conclusion: The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period.

• Journal of Electrical Engineering and Technology
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• 제10권6호
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• pp.2384-2392
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• 2015

The technical development and practical applications of big-data for health is one hot topic under the banner of big-data. Big-data medical image fusion is one of key problems. A new fusion approach with coding based on Spherical Coordinate Domain (SCD) in Wireless Sensor Network (WSN) for big-data medical image is proposed in this paper. In this approach, the three high-frequency coefficients in wavelet domain of medical image are pre-processed. This pre-processing strategy can reduce the redundant ratio of big-data medical image. Firstly, the high-frequency coefficients are transformed to the spherical coordinate domain to reduce the correlation in the same scale. Then, a multi-scale model product (MSMP) is used to control the shrinkage function so as to make the small wavelet coefficients and some noise removed. The high-frequency parts in spherical coordinate domain are coded by improved SPIHT algorithm. Finally, based on the multi-scale edge of medical image, it can be fused and reconstructed. Experimental results indicate the novel approach is effective and very useful for transmission of big-data medical image(especially, in the wireless environment).

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2009년도 춘계학술발표대회
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• pp.50-52
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• 2009

Ontology maintenance is a time consuming and costly process which requires special skill and knowledge. It requires joint effort of both ontology engineer and domain specialist to properly maintain ontology and update knowledge in it. This is specially true for medical domain which is highly specialized domain. This paper proposes a novel approach for maintenance and update of existing ontologies in a medical domain. The proposed approach is based on modified Ontology Maturing Process which was originally developed for web domain. The proposed approach provides way to populate medical ontology with new knowledge obtained from medical documents. This is achieved through use of natural language processing techniques and highly specialized medical knowledge bases such as Unified Medical Language System.

• 대한상한금궤의학회지
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• 제4권1호
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• pp.13-28
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• 2012

Objective : The purpose of this study is to suggest medical approach to musculoskeletal system disorders using the decoction of Sanghan-Geumgwe. We studied cases of Ling-Gui-Gan-Zao-Tang prescribed patients to evaluate the clinical efficacy in musculoskeletal system disorders Method : We devised medical approach of Sanghan-Geumgwe in musculoskeletal disorders as follows. First, we chose ryeon-je(攣劑) and soo-je(水劑) herb medicine, commonly used in musculoskeletal disorders. In the selected herb group, we designated ryeon-je(攣劑) to be first key herbs, Soo-Je(水劑) as the second key herb, and other herb groups as third key herb. In this sequential selection and exclusion process, herbs were chosen based upon yak-neung-hyo-seon (藥能效選). Combination of those selected herbs drew pre-prescription group, finally prescription were made by the prescription criteria. Results : Based on the medical approach of decoctions of Sanghan-Geumgwe, we chose Ling-Gui-Gan-Zao-Tang to treat many kinds of musculoskeletal system disorders. And we achieved higher results on treatment for musculoskeletal system disorders. Conclusions : The medical approch using the decoctions of Sanghan-Geumgwe is very useful in choosing accurate prescriptions for patients with musculoskeletal system disorders in clinic.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.631-635
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• 2007

Purpose: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. Material and methods: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 patients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. Result: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. Conclusion: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.

• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.538-541
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• 2011

Objective : We evaluated a modified trans-middle temporal gyrus (MTG) approach with good postoperative visual preservation for patients with trigonal tumors. Methods : Three patients with a trigonal tumor were treated via the modified trans-MTG approach guided by a neuro-navigator. Modified trans-MTG approach involve the incision at the MTG within 5 mm to the superior temporal sulcus. This approach makes a proper trajectory to the trigone but also reduces the retraction injury of MTG as little as possible to prevent postoperative visual field defect. Preoperative and postoperative visual field examination using perimetry was performed to evaluate the visual field. Results : Three patients underwent surgery for lymphoma in the right trigone, meningioma in the left trigone, and focal enhancing nodule in the right paratrigonal area, respectively. In case of lymphoma, preoperative examination showed a left homonymous hemianopsia : one week later after surgery, a visual field examination was performed and revealed improvement of the visual field defect. In case of the meningioma, the preoperative examination showed no visual field defect : one month later, the visual field had no defect. In case of the enhancing nodule, preoperative visual field testing revealed a partial left homonymous hemianopsia. Visual examination within one month after surgery showed no visual field defect. All three patients treated with the modified trans-MTG approach showed no visual deterioration after surgery. Conclusion : The modified trans-MTG approach provides a safe and useful technique for trigonal tumors without postoperative visual field deterioration and affords adequate exposure of the trigonal tumor with a short trajectory.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.23-27
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• 2017

Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

• 보건교육건강증진학회지
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• 제7권1호
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• pp.1-9
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• 1990

This paper discusses a new perspective in health approach and the effect of health life on health status, and suggests some points to be improved in the establishment of health policies hereafter. Today's health problems changed from the acute epidemic diseases caused by simple factor to the multifactorial chronic diseases. Therefore, the health approach tries the holistic health approach, that is, the integrative approach by the interdisciplinary cooperation. With the advent of holistic health and holistic medicine in 1970's, the behavioral medicine was born in 1977, which is the interdisciplinary field concerned with the development and integration of behavioral and biomedical science knowledge and techniques relevent to prevention, diagnosis and treatment. As a means to the reducement of the unnecessary medical utilization and medical expense, the medical self care and self-help movement is well under way in the countries of America, England, and Canada, in which lay persons are encouraged to actively function for themselves to prevent, detect and treat common illnesses and to promote positive health habits through the health activation programs such as The Course for Activated Patients and The Health Activated Person. This study shows that the individual health life gives great positive effect to his health status with the reducement of medical expense. These above facts suggest that the preventive health programs such as health education should be developed and strengthened instead of medical care-oriented health policy.

• 의학교육논단
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• 제24권3호
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• pp.193-204
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• 2022

One of the important roles of medical schools is to support medical students in deciding upon their future career path or choosing their specialty. The purpose of this study is to suggest a career advising model and strategies for medical students through a systematic approach. This study consists of three parts. The first part introduces some main career theories: super's career development theory, career decision-making theory, social cognitive career theory, and ecosystem theory. The second part proposes a systematic career advising model using the results acquired from previous studies and theories. This model considers a medical school as a social system that consists of two domains (internal and external). This social system is considered as a complex where various factors interact with each other: students' individual characteristics, institutional policies and culture, curriculum and learning experience, students' perceived specialty characteristics, and aspects of the external environment such as healthcare systems. The third part suggests some career advising strategies based on a systematic approach that medical schools can apply. These research results can be used for designing career advising courses for medical students, integrating various career advising programs and resources of medical schools, and evaluating the outcomes of career advising programs at an institutional level.