• 한국임상수의학회지
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• 제34권3호
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• pp.200-203
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• 2017

The objective of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) method for treatment of tibial shaft fractures in dogs by comparing MIPO radiographic and fracture healing time results with those from the popular open reduction and internal fixation (ORIF) technique. In this clinical study at the Royal Animal Medical Center, five consecutive dogs with diagnoses of comminuted tibial shaft fractures were treated with the MIPO surgical approach. For comparison, an additional five breed-, age-, and weight-matched dogs with comminuted tibial shaft fractures were treated with the ORIF technique. Mean healing time was $75.6{\pm}12.5$ days in the MIPO group and $131.8{\pm}18.6$ days in the ORIF group (p < 0.01). The mean surgery time in the MIPO group ($36.4{\pm}3.5$ minutes) was significantly shorter (p < 0.01) than that for the ORIF group ($47.0{\pm}2.2$ minutes). Based on the short surgical and healing times, the MIPO approach is clinically superior to the ORIF approach and should be the preferred approach in tibial fracture cases.

• Journal of Chest Surgery
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• 제47권1호
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• pp.1-5
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• 2014

Background: Recently, a hybrid surgical-electrophysiological (EP) approach for confirming ablation lines in patients with atrial fibrillation (AF) was suggested. The aim of this approach was to overcome the limitations of current surgery- and catheter-based techniques to yield better outcomes. Methods: Ten consecutive patients with AF underwent total thoracoscopic ablation (TTA) following transvenous catheter EP ablation (residual gap and cavotricuspid isthmus [CTI] ablation). Holter monitoring was performed 6 months postoperatively. Results: Ten patients (90% with persistent AF) underwent successful hybrid procedures, and there was no in-hospital mortality. An EP study was performed in 8 patients and showed that successful antral ablation in all pulmonary veins was achieved in 7 of them. The median follow-up duration was 7.63 months (range, 6.7 to 11.6 months). Nine patients underwent Holter monitoring 6 months postoperatively, and the results indicated an underlying sinus rhythm without AF, atrial flutter, or atrial tachycardia lasting more than 30 seconds in all of the patients. There was no recurrence of AF during follow-up. Conclusion: A hybrid approach that consists of TTA followed by transvenous catheter EP ablation (residual gap and CTI ablation) yielded excellent outcomes in our patient population. A hybrid approach should be considered in patients with a high risk of AF recurrence.

• 센서학회지
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• 제26권4호
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• pp.266-273
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• 2017

In this research a medical palpation guidance system for minimally invasive surgery (MIS) is proposed. Palpation is a useful tool for identifying a size and location of a lump during a surgery. However, conventional manual palpation is only available in open surgery, so there has been several researches about palpation assistant or guidance system for MIS. The previously developed systems are based on a pressure based or stiffness based approach. These previous approaches have some limitations in increasing complexity of the systems and lack of geometric information about the lump which is more important information for the lump removal than the stiffness information. We propose a palpation guidance system using a novel approach using contact pressure distribution. Since our approach gives the geometry information of the lump as well as the existence information, the operator can easily notice the currently identified lump region and the optimal position for the next palpation. The experiment results show that our approach can offer the geometry information of the lump correctly.

• Educational Technology International
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• 제19권2호
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• pp.175-197
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• 2018

Flipped classroom (FC) has gained attention as an active learning approach. Designing effective out-of-class activities to help prepare students for in-class activities is fundamental for successful implementation of FC. This study investigated the effectiveness of Goal-Based Scenarios (GBS) for out-of-class learning in FC. Four out of twelve units in a medical humanities course for Year 2 medical students was redesigned into a FC format, where e-learning modules were designed using a GBS approach for out-of-class activities and classroom debates were implemented for in-class activities. The other eight units were delivered in a conventional classroom debate format, which included reading text materials as pre-class assignments. A formative evaluation study was conducted using questionnaires and interview methods and students' academic achievements were evaluated by comparing their pre- and post-test scores between FC and conventional units. Students had positive perceptions of the e-learning modules in GBS approach and preferred the structure of learning in the FC format. Students' pre-test scores were slightly higher in the FC units, yet their post-test scores were comparable with conventional units. This study illustrates students' perceptions that the learning was bettered structured in FC and that the out-of-class learning using the GBS approach helped them better prepared for in-class activities.

• Hip & pelvis
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• 제36권3호
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• pp.196-203
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• 2024

Purpose: The direct anterior approach (DAA) for conducting total hip arthroplasty (THA) is gaining popularity worldwide. However, careful selection of patients and surgeon experience are important. Although promising outcomes have been reported in international studies, research on DAA in Southern and Southeast Asia has been limited. Materials and Methods: This prospective study included 157 patients who underwent THA using the DAA between January 2019 and June 2022. The patients were divided into three groups for the comparison. Data on preoperative, intraoperative, and postoperative variables were acquired. Improvement of the surgeon's performance to use of a DAA approach was examined using the CUSUM (cumulative summation method). Results: The mean age of the patients was 43.9 years. Differences in intraoperative variables and complications were observed among the three groups, and improved outcomes were reported in later cases. Functional outcomes showed significant improvement, and no differences were observed between groups. The results of learning curve analysis indicated a shift towards consistent success after the 82nd case, reaching an acceptable rate of failure by the 118th case. Conclusion: The findings of this study suggest that DAA can offer benefits but there is a learning curve. Complications were initially high but began decreasing after approximately 80 cases. Careful selection of patients is critical, particularly in the effort to minimize being presented with a challenging case. This study provides insights that may be helpful to surgeons when considering DAA; however, further study is warranted.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.643-646
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• 2016

Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제2권7호
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• pp.487-494
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• 2013

의료 영상 워터마킹은 헬스케어 정보 시스템의 보안 서비스 분야에서 많은 주목을 받고 있다. 본 논문은 워터마킹을 삽입할 최적의 서버 블록 위치 선택을 위한 개선된 퍼지 클러스터링 기법, 이산 웨이블릿 변환 및 이산 코사인 변환을 분할된 회백질 의료 영상에 적용한 블라인드 의료 영상 워터마킹 기법을 제안한다. 모의실험결과, 제안한 워터마킹 기법은 기존의 기법들보다 PSNR과 M-SVD에서 우수한 성능을 보였다. 또한, 제안한 워터마킹 기법은 노이즈 첨가, 필터링, JPEG 압축, 블러링, 히스토그램 균일화, 크로핑과 같은 공격에서도 기존의 기법들보다 정규화된 연관성 값에서 보다 강인함을 보였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3483-3486
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• 2014

Background: To evaluate the overtreatment rate with the see and treat approach in the management of women with abnormal cervical cytology. Materials and Methods: A retrospective review of patients with abnormal cervical cytology who underwent S&T at MSMC between January 2008 and December 2012 was conducted. Loop electrosurgical excision procedure (LEEP), histological results, cytology and colposcopic impression were analyzed to evaluate overtreatment rate, cyto-histologic correlation and related factors. Results: Average age of S&T cases was 42 years. Ninety seven percents were referred from affiliated health care providers. The study revealed 83.2% patients had HSIL or higher from cervical cytology. Correlation between HSIL and final histology was relatively low at 75% compared to other studies. Overtreatment rate was 28%. Conclusions: S&T was done in 197 patients in a tertiary care health facility with patient satisfaction. Overtreatment occurred, but the rate can be reduced with appropriate recommendations. HSIL Pap smears should be reexamined before S&T while low grade and lesser colposcopic impression groups should obtain conventional colposcopic approach for patient future reproductive benefit.

• Journal of Information Processing Systems
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• 제13권6호
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• pp.1496-1515
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• 2017

One of the most visible developments in Decision Support Systems (DSS) was the emergence of rule-based expert systems. Hence, despite their success in many sectors, developers of Medical Rule-Based Systems have met several critical problems. Firstly, the rules are related to a clearly stated subject. Secondly, a rule-based system can only learn by updating of its rule-base, since it requires explicit knowledge of the used domain. Solutions to these problems have been sought through improved techniques and tools, improved development paradigms, knowledge modeling languages and ontology, as well as advanced reasoning techniques such as case-based reasoning (CBR) which is well suited to provide decision support in the healthcare setting. However, using CBR reveals some drawbacks, mainly in its interrelated tasks: the retrieval and the adaptation. For the retrieval task, a major drawback raises when several similar cases are found and consequently several solutions. Hence, a choice for the best solution must be done. To overcome these limitations, numerous useful works related to the retrieval task were conducted with simple and convenient procedures or by combining CBR with other techniques. Through this paper, we provide a combining approach using the multi-criteria analysis (MCA) to help, the traditional retrieval task of CBR, in choosing the best solution. Afterwards, we integrate this approach in a decision model to support medical decision. We present, also, some preliminary results and suggestions to extend our approach.

• 보건행정학회지
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• 제28권3호
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• pp.202-209
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• 2018

Health care has two different facets. One is commodity and another is a right of human being. Health care as a commodity is utilized by demand approach in market. Demand is determined by economic factors such as price and income. From the last third of the 19th century until the early 1920s, priority of sickness insurance was replacing the income that workers lost as a result of illness and injury. By the 1920s, the capacity of applied biological and medical science was remarkably developed. Development of medical science stimulated the cost of medical care, and the burden of increased medical care cost required new role of medical care security system. In 1942, Beveridge report was published in United Kingdom, and health care was considered as a right of human being. In 1948, United Nations declared heath care as a right in the Universal Declaration of Human Right. In most countries introduced new medical care security policy based on health care as a right. The viewing health care as a commodity must be shifted toward need based care as a right. Need were understood to rest on demographic, epidemiological, scientific, and medical knowledge factors. Bring needed care to the population could best be achieved institutionally by a hierarchy of provider organizations, guided by planning bodies, which would provide comprehensive benefits. In Korea, health care in social health insurance (SHI) is considered as a commodity not a right. However, health policies under SHI must be need approach based on health care as a right. Mismatch between health policies and ideology of SHI made big troubles. It is important to realize ideology of SHI for good health policies.