• Korean Journal of Radiology
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• v.24 no.9
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• pp.860-870
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• 2023

Objective: The intra-parotid facial nerve (FN) can be visualized using three-dimensional double-echo steady-state water-excitation sequence magnetic resonance imaging (3D-DESS-WE-MRI). However, the clinical impact of FN imaging using 3D-DESS-WE-MRI before parotidectomy has not yet been explored. We compared the clinical outcomes of parotidectomy in patients with and without preoperative 3D-DESS-WE-MRI. Materials and Methods: This prospective, non-randomized, single-institution study included 296 adult patients who underwent parotidectomy for parotid tumors, excluding superficial and mobile tumors. Preoperative evaluation with 3D-DESS-WE-MRI was performed in 122 patients, and not performed in 174 patients. FN visibility and tumor location relative to FN on 3D-DESS-WE-MRI were evaluated in 120 patients. Rates of FN palsy (FNP) and operation times were compared between patients with and without 3D-DESS-WE-MRI; propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for surgical and tumor factors. Results: The main trunk, temporofacial branch, and cervicofacial branch of the intra-parotid FN were identified using 3D-DESS-WE-MRI in approximately 97.5% (117/120), 44.2% (53/120), and 25.0% (30/120) of cases, respectively. The tumor location relative to FN, as assessed on magnetic resonance imaging, concurred with surgical findings in 90.8% (109/120) of cases. Rates of temporary and permanent FNP did not vary between patients with and without 3D-DESS-WE-MRI according to PSM (odds ratio, 2.29 [95% confidence interval {CI} 0.64-8.25] and 2.02 [95% CI: 0.32-12.90], respectively) and IPTW (odds ratio, 1.76 [95% CI: 0.19-16.75] and 1.94 [95% CI: 0.20-18.49], respectively). Conversely, operation time for surgical identification of FN was significantly shorter with 3D-DESS-WE-MRI (median, 25 vs. 35 min for PSM and 25 vs. 30 min for IPTW, P < 0.001). Conclusion: Preoperative FN imaging with 3D-DESS-WE-MRI facilitated anatomical identification of FN and its relationship to the tumor during parotidectomy. This modality reduced operation time for FN identification, but did not significantly affect postoperative FNP rates.

• Journal of the Korean Institute of Landscape Architecture
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• v.46 no.5
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• pp.44-58
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• 2018

Cities face new challenges not only in natural disasters by climate change but also in social and economic fluctuations. With the existing simple reconstruction method, it is difficult to solve the overall problems that a city or region may face. As a new approach to cope with various changes, the concept of resilience is emerging. Resilience is also one of the themes of recent major urban design projects. Design with the concept of resilience is a new strategy that can deal with various changes of urban space, rather than a temporary trend. The purpose of this paper is to explore the design method by analyzing cases where the concept of resilience is employed. We aim to examine what kind of design strategies are needed for the resilience design and how this design process differ in character, as compared to general design projects. Cases for this study include the "Rebuild by Design" competition held in 2013 and the "Resilient by Design/Bay Area Challenge" competition held in 2017. This paper consists of literature reviews and case studies. The latter is divided into two aspects: content analysis based on the theory of resilience and characteristics of the design process. Cases are analyzed through literature reviews and process characteristics of resilience design in response to the general design process. The main categories for urban resilience used as the framework for analysis include: Urban Infrastructure, Social Dynamics, Economic Dynamics, Health and Wellbeing, Governance Networks, and Planning and Institutions. As a result, the aspects of resilience concepts considered and design strategies undertaken by each team were identified. Each team tried to connect all 6 categories to their design strategies, placing special value on the role of governance, a system that enables collaborative design and project persistency. In terms of the design process, the following characteristics were found: planning the whole project process in the pre-project phase, analyzing predictable socioeconomic risk factors in addition to physical vulnerabilities, aiming for landscape-oriented integrated design, and sustainable implementation strategies with specific operations and budget plans. This paper is meaningful to connect the concept of resilience, which has been discussed in various articles, to design strategy, and to explore the possibility of constructing a practical methodology by deriving the characteristics of the resilience design process. It remains a future task to research design strategies that apply the concept of resilience to various types of urban spaces, in addition to areas that are vulnerable to disasters.

• Korean Journal of Social Welfare Studies
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• v.44 no.3
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• pp.421-450
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• 2013

One of the challenging tasks of the National Health Insurance Corporation(NHIC). the only public insurance institution administrating the Korea's compulsory national health insurance(NHI) system, is to make those NHI beneficiaries who fail to make a scheduled monthly premium payment to pay. For this purpose, the NHIC has been using a measure known as 'Benefit Limit Measure(BLM)' in which those who miss premium payment for six or more month's in total are classified as 'late payer' and are sent warnings and late payer status notices. If the late payers fail to make a full payment of missed premiums even after receiving the written notices, the NHIC can order a temporary seizure of the late payer's property until all missed premiums plus interest are paid. Recently, the BLM has been criticized by the public of its cruel nature, and its effectiveness has been questioned because no empirical evidence has been collected. In this study, the authors using the NHIC data set attempted to analyze the effectiveness of the BLM. Those late payers for whom the BLM was administered were compared to those not in terms of the likelihood of paying missed premium payments with a series of logistic regression analyses models. Data analyses results showed that the likelihood of paying one or more month's unpaid premium of the former group was 14 to 46 times higher than the latter. It, however, was also found that the BLM was only effective to make no more than 12% of the late payers to pay at all. Based on the study findings, the authors made a few recommendations regarding the BLM.