• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.41.1-41.6
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• 2019

Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.655-664
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• 2002

The purpose of this study was to observe the degree of surface obliteration of dentinal tubule using Gluma(R) desensitizer and MS coat(R) with 15 specimens made out of 15 extracted lower incisors. They were divided into Root planning group(control), Gluma(R) desensitizer group(test I ) and MS coat(R) group(test II). Degree of Obliteration was examined under the scanning electron microscope(${\times}$2000). The following results were obtained: 1. In the root planning group(control), the complete open of dentinal tubule surface was accounted for 73.8%, the partial obliteration for 17.2% and the complete obliteration for 9.0%. 2. In the Gluma(R) desensitizer group (test I), the complete open of dentinal tubule surface was accounted for 23.6%, the partial obliteration for 42.8% and the complete obliteration for 33.6%. 3. In the MS coat(R) group (test II), the complete open of dentinal tubule surface was accounted for 19.2%, the partial obliteration for 45.6% and the complete obliteration for 35.2%. 4. The average number of open dentinal tubules in the control was significantly higher than in the test I and II (P<0.05), but there were no statistically significant differences between the test I and II. 5. The average number of the partially obliterated and the completely blocked dentinal tubules in the control was significantly lower than the test I and II(P<0.05), but there were no statistically significant differences between the test I and II. The results of this study suggest that Gluma(R) desensitizer and MS coat(R) is significantly effective on dentinal tubule obliteration, therefore they were effective on hypersensitivity caused by periodontal treatment

• Journal of The Korea Institute of Healthcare Architecture
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• v.13 no.2
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• pp.27-36
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• 2007

Recently, hospital patients experience anxiety, confusion, and stress about wayfinding as the spacial layout and treatment circulatory system of hospitals have become complicated due to their oversized and complex structure. As part of finding a solution to the problem, this study seeks to examine what are the essential elements of the wayfinding planning of O.P.D. in general hospitals, to develop the model of wayfinding, and to suggest the methods of improving the wayfinding system. The research methods of this study adopted were literature review in wayfinding cognition, plan analysis of ten general hospitals, space analysis of these hospitals through space syntax, analysis of the system of visual-perceptual information through a field study, and analysis of surveys and follow-up surveys conducted to support the results. Based on these results, the proposals for finding decision points, providing the information, and developing a model planning are listed as follows. 1) The comprehensive understanding of O.P.D. spacial layout and the visual-perceptual information system is necessary to find the essential elements of wayfinding. 2) The decision points are found through the full understanding of spacial functions, circulation systems, and facility configuration, considering the spacial layout, the bound of the visual-perceptual information system, and the circulatory system. Furthermore, the information decision points could be confined by space syntax. 3) The checklist and color compound & color codes, developed through the planning of signage system and color system could be applied to the methods of providing the information. 4) The planning of wayfinding system according to the whole process of practices for outpatients was mentioned above. The system of visual-perceptual information developed through the process of this study should be integrated in the spacial layout of the whole O.P.D.

• Korean Journal of Community Nutrition
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• v.8 no.1
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• pp.91-101
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• 2003

The purpose of this study was to investigate the compliance and need for diet therapy among diabetics and their caregivers. A total of 625 respondents participated in this survey. Appropriate management for long-term blood glucose control and difficult-to-manage cases appeared to be diet therapy, physical activity, medical treatment and folk remedies, in that order. The most important educational avenues for diet therapy were books, magazines and TV, Most respondents were educated in diet therapy within a year after diagnosis and had practiced diet therapy for over four years. The most common diet therapy Practices were food selection and Quantity control. Of the specific problems in practicing diet therapy, time and labor, taste, and meal planning appeared to be equally difficult factors. The prevailing diet therapy skills were controlling food amounts at breakfast and supper, and selecting food for lunch and refreshments. Respondents practicing both skills were about 20% of the participants; this shows the need to improve the current situation. The nutrients most frequently considered in diet therapy practice were simple sugars (sugar and sweet goods) , total fats and cholesterol. Since the perception of the role of dietary fiber among respondents was very low, nutrition education about the importance of dietary fiber and food sources of dietary fiber was needed. Diabetics seemed to be concerned about diabetic menus. Three difficult problems in planning diabetic menus were daily menu planning, patient's preferences, and the calculation of calories. As a means of nutrition counseling, they preferred interviews. The higher the educational status and the lower the age, the higher the preference was for internet or PC counseling. Therefore, it is necessary to develop nutrition educational programs so that diabetics can obtain practical knowledge of diet therapy. Furthermore, it is also necessary to develop additional means of informing diabetics about menu planning, while still considering Korean dietary behavior.

• Progress in Medical Physics
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• v.30 no.1
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• pp.1-6
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• 2019

Purpose: This study conducts a comparative evaluation of the skin dose in CyberKnife (CK) and Helical Tomotherapy (HT) to predict the accurate dose of radiation and minimize skin burns in head-and-neck stereotactic body radiotherapy. Materials and Methods: Arbitrarily-defined planning target volume (PTV) close to the skin was drawn on the planning computed tomography acquired from a head-and-neck phantom with 19 optically stimulated luminescent dosimeters (OSLDs) attached to the surface (3 OSLDs were positioned at the skin close to PTV and 16 OSLDs were near sideburns and forehead, away from PTV). The calculation doses were obtained from the MultiPlan 5.1.2 treatment planning system using raytracing (RT), finite size pencil beam (FSPB), and Monte Carlo (MC) algorithms for CK. For HT, the skin dose was estimated via convolution superposition (CS) algorithm from the Tomotherapy planning station 5.0.2.5. The prescribed dose was 8 Gy for 95% coverage of the PTV. Results and Conclusions: The mean differences between calculation and measurement values were $-1.2{\pm}3.1%$, $2.5{\pm}7.9%$, $-2.8{\pm}3.8%$, $-6.6{\pm}8.8%$, and $-1.4{\pm}1.8%$ in CS, RT, RT with contour correction (CC), FSPB, and MC, respectively. FSPB showed a dose error comparable to RT. CS and RT with CC led to a small error as compared to FSPB and RT. Considering OSLDs close to PTV, MC minimized the uncertainty of skin dose as compared to other algorithms.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.15-32
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• 2024

Purpose: The number of severely ill patients requiring post-acute care has been increasing. Careful discharge planning minimizes unplanned emergency room visits and readmissions. This study aimed to survey the knowledge, experience, confidence, and obstacles faced by medical residents and fellows regarding the discharge process of severely ill patients. Methods: A survey consisting of 27 questions was sent electronically to residents and fellows who had experience in discharging severely ill patients from a tertiary hospital in Korea. The survey was conducted over a two-week period from September 29, 2022. Results: A total of 98 residents and fellows responded to the survey. Of these, 94% experienced difficulties related to the discharge process. The main obstacle was changes in the patient's condition during discharge planning (92.3%). Although 95% of the respondents acknowledged the need for providing discharge information, only 53.1% of the residents and fellows practiced this. Only 42.9% of the respondents and 20.4% of residents and fellows explained local community healthcare and welfare resources to patients because of a lack of relevant knowledge (69.7%) and feeling no responsibility to explain (40.4%). Conclusion: This study revealed that residents and fellows experienced difficulties in devising discharge plans and providing post-acute care related information, despite recognizing the importance of these. These gaps result from the lack of a discharge planning curriculum regarding critically ill patients and appropriate training in the discharge process. This suggests that an integrated discharge planning curriculum should be developed and adopted in residents' training programs for the differentiated treatment of critically ill patients.

• Journal of The Korea Institute of Healthcare Architecture
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• v.30 no.1
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• pp.37-44
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• 2024

Purpose: The planning of medical facilities involves formulating a comprehensive medical basic plan, translating it into spatial dimensions through a space program. Feasibility assessment often relies on empirical methods like floor area per bed. However, with the shift towards specialized medical concepts, proportional scaling to bed numbers is challenging. This study proposes scale planning improvements during the feasibility assessment stage for comprehensive hospitals, analyzing cases using area determination factors and standard areas based on medical resources. Methods: The Korean Development Institute's Public Investment Management Center (KDI) identified issues in the scale determination of medical facilities in the Preliminary Feasibility Study Guidelines and investigated alternative approaches for determining the scale of a case that passed the preliminary feasibility study in 2019. The study assessed the feasibility of applying individual factors to determine not only the number of beds but also the scale at the sector and department levels. Additionally, a statistical analysis was conducted to examine the correlation between the total number of beds and various area determination factors. Results: Results suggest a strong correlation between total beds and major equipment needs, but in hospitals with <500 beds, this correlation weakens. Ward section scale is better calculated per ward type, not just total beds. Outpatient department scale depends on specialists, influencing treatment room numbers. Medical personnel play a crucial role in determining the scale of sections like rehabilitation therapy rooms, operating rooms, dialysis rooms, and overall facility scale.

• Journal of The Korea Institute of Healthcare Architecture
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• v.30 no.3
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• pp.17-24
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• 2024

Purpose: The medical care for children in Korea is needed more than previous time as the situation changed. However, there is a few useful research for the planning of the children's specialized public medical center. This study has been started to provide basic information for the planning of Korean children's specialized public medical center. Methods: Research and architectural documentation with field surveys to 5 of 14 children's specialized public medical center, data have been analyzed for characteristics of children's medical care. Results: The result of this study can be summarized into three points. The first one is that children's medical care can be categorized independent and integrated type according to connection with main hospital. Independent type has vertical or horizontal form from spatial composition. The second one is that spatial composition are allocated by typical service, outpatient, central, and inpatient ward zones. The outpatient zone has horizontal/vertical type, central zone has concentrated/separated type by spatial and treatment situation of medical center. The third one is that children's hospital school is the specific program and healing environment for children. Implications: It is necessary to make typical model for national wide medical care for children in Korea.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.181-186
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• 2013

Purpose: This study executed therapy plans on prostate cancer (homogeneous density area) and lung cancer (non-homogeneous density area) using radiation treatment planning systems such as $Pinnacle^3$ (version 9.2, Philips Medical Systems, USA) and Eclipse (version 10.0, Varian Medical Systems, USA) in order to quantify the difference between dose calculation according to density in IMRT. Materials and Methods: The subjects were prostate cancer patients (n=5) and lung cancer patients (n=5) who had therapies in our hospital. Identical constraints and optimization process according to the Protocol were administered on the subjects. For the therapy plan of prostate cancer patients, 10 MV and 7Beam were used and 2.5 Gy was prescribed in 28 fx to make 70 Gy in total. For lung cancer patients, 6 MV and 6Beam were used and 2 Gy was prescribed in 33 fx to make 66 Gy in total. Through two therapy planning systems, maximum dose, average dose, and minimum dose of OAR (Organ at Risk) of CTV, PTV and around tumor were investigated. Results: In prostate cancer, both therapy planning systems showed within 2% change of dose of CTV and PTV and normal organs (Bladder, Both femur and Rectum out) near the tumor satisfied the dose constraints. In lung cancer, CTV and PTV showed less than 2% changes in dose and normal organs (Esophagus, Spinal cord and Both lungs) satisfied dose restrictions. However, the minimum dose of Eclipse therapy plan was 1.9% higher in CTV and 3.5% higher in PTV, and in case of both lungs there was 3.0% difference at V5 Gy. Conclusion: Each TPS according to the density satisfied dose limits of our hospital proving the clinical accuracy. It is considered more accurate and precise therapy plan can be made if studies on treatment planning for diverse parts and the application of such TPS are made.

• Progress in Medical Physics
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• v.17 no.3
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• pp.179-186
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• 2006

Purpose: Photon beam data of linear accelerators in Korea are collected, analyzed, and a simple method for checking and verifying the dose calculations in a TPS are suggested. Materials and Methods: Photon beam data such as output calibration condition, output factor, wedge factor, percent depth dose, beam profile, and beam quality were collected from 26 institutions in Korea. In order to verify the accuracy of dose calculation, ten sample planning tests were peformed. These Include square, elongated, and blocked fields, wedge fields, off-axis dose calculation, SSD variation. The planned data were compared to that of manual calculations. Results: The average and standard deviation of photon beam quality for 6, 10, and 15 MV were $0.576{\pm}0.005,\;0.632{\pm}0.004,\;and\;0.647{\pm}0.006$, respectively. The output factors of 6 MV photon beam measured at depth of dose maximum for $5{\times}5cm,\;15{\times}15cm,\;20{\times}20cm\;were\;0.944{\pm}0.006,\;1.031{\pm}0.006,\;and\;1.055{\pm}0.007$. For 10 MV photon beam, the values were $0.935{\pm}0.006,\;1.031{\pm}0.007,\;1.054{\pm}0.0005$. The collected data were not enough to calculate average, the output factors for 15MV photon beam with field size of $5{\times}5cm,\;15{\times}15cm,\;20{\times}20cm\;were\;0.941{\pm}0.008,\;1.032{\pm}0.004,\;1.049{\pm}0.014$. There was seven institutions $e{\times}ceeding$ tolerance when monitor unit values calculated from treatment planning system and manually were compared. The measured average MU values for the machines calibrated at SAD setup were 3 MU and 5 MU higher than the machines calibrated at SSD for 6 MV and 10 MV, respectively except the wedge case. When the wedges were inserted, the MU values to deliver 100 cGy to 5 cm depends on manufactures. When the same wedge angle was used, Siemens machine requires more MUs then Varian machine. Conclusion: In this study, photon beam data are collected and analyzed to provide a baseline value for chocking beam data and the accuracy of dose calculation for a treatment planning system.