• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.4
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• pp.581-586
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• 2018

A common characteristic of many patients whose illness is getting worse is that they miss the treatment red flag. When high subjective symptoms appear or there is no strong pain, this problem arises because it is reluctant to visit the hospital. Gingivitis causes bleeding from the gums in the early and mid-term, and shows mild symptoms of tooth collapse. When treatment is done at this point, it shows a very high effect. However, when you miss the timing of treatment you will have a situation where you can't eat food by causing serious problems in the health of the gums and oral cavity. In this paper, the patient's periodontal image is photographed with a smartphone and transmitted in real time. This is done by the doctor in charge. Then, we propose a design of a patient management system that provides information on the current situation to the patient so as not to miss the timing of treatment.

• Geomechanics and Engineering
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• v.18 no.3
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• pp.259-266
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• 2019

This paper presents a comparison between experimental measurements and numerical estimations of penetration length of a cement grout injected in discrete joints. In the experiment, a joint was generated by planar acryl plates with a certain separation distance (; aperture) and was designed in such a way to vary the separation distances. Since a cement grout was used, the grout viscosity can be varied by controlling water-cement (W/C) ratios. Throughout these experiments, the influence of joint aperture, cement grout viscosity, and injection rate on a penetration length in a discrete joint was investigated. During the experiments, we also measured the time-dependent variation of grout viscosity due to a hardening process. The time-dependent viscosity was included in our numerical simulations as a function of elapsed time to demonstrate its impact on the estimation of penetration length. In the numerical simulations, Bingham fluid model that has been known to be applicable to a viscous cement material, was employed. We showed that the estimations by the current numerical approach were well comparable to the experimental measurements only in limited conditions of lower injection rates and smaller joint apertures. The difference between two approaches resulted from the facts that material separation (; bleeding) of cement grout, which was noticeable in higher injection rate and there could be a significant surface friction between the grout and joint planes, which are not included in the numerical simulations. Our numerical simulation, meanwhile, could well demonstrate that penetration length can be significantly over-estimated without considering a time-dependency of viscosity in a cement grout.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.374-386
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• 2023

Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.6-19
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• 2023

A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181-269 minutes), 134 mL (95% CI, 85-184 mL), and 7 days (95% CI, 5-9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%-5%). It was 3% (95% CI, 1%-6%) for conversion to open surgery, 6% (95% CI, 0%-19%) for need for intra-abdominal drain, 1% (95% CI, 0%-3%) for postoperative mortality, 2% (95% CI, 0%-4%) for biliary leakage, 2% (95% CI, 0%-4%) for intra-abdominal abscess, 1% (95% CI, 0%-4%) for biliary stenosis, 1% (95% CI, 0%-3%) for postoperative bleeding, 1% (95% CI, 0%-4%) for pancreatic fistula, 2% (95% CI, 1%-5%) for pulmonary complications, 1% (95% CI, 0%-4%) for paralytic ileus, and 1% (95% CI, 0%-4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.835-845
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• 2023

Traumatic pelvic injuries usually include high-energy crush injuries and are associated with significant morbidity and mortality. Mortality rates range from 6% to 15% and increase to 36%-54% in cases of fractures that result in increased pelvic volume. Therefore, retroperitoneal hemorrhage can spiral and progress to hemorrhagic shock. Pelvic hemorrhage most commonly occurs secondary to disrupted pelvic veins or fractured bones, and 10%-20% of cases involve arterial injuries. Owing to extensive bleeding and limitations of surgery for pelvic hemorrhage, interventional treatment is at the forefront of pelvic hemorrhage management. CT is an accurate indicator of active hemorrhage in patients with pelvic trauma that affects the diagnosis and management, including interventions. Identification of the site of hemorrhage is necessary for focused interventional treatment. The current trend toward a more conservative approach for treatment of pelvic trauma and advances in interventional radiology in the field of pelvic trauma may favor widespread use of interventional treatment for patients with pelvic injuries. In this review, we discuss therapeutic modalities available to the interventional radiologist and common angiographic treatment strategies and techniques.

• Journal of the Korea Concrete Institute
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• v.22 no.3
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• pp.409-417
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• 2010

This paper discusses a series of experiments including material improvement in order to ensure quality of grouting for the post-tensioned structure. In prestressed concrete, grouting refers to the construction procedure of filling empty space of duct enclosing with strands using cementitious material, To date, adequate quality control of the grouting has not been established in Korea because the relationship between the grouting and durability of post-tensioned structure is not well-recognized. The Korean standard does not consider the important material characteristic, wick effect, which is caused by strands in the ducts and current standard testing method unlikely quantify reasonable material segregation. As a result, the grout material, which meets the current material standards, may exhibit excessive bleeding water or shrinkage during construction. In this study, international codes and standards related to grouting were surveyed. The ratio of constituents and novel admixtures were suggested to meet equivalently with these standards. Performance of this enhanced grout was compared to common domestic grout using the international standard testing method. A series of mock-up specimens considering geometry of PC beam was constructed and grout flow pattern was observed as the grout was injected. It was observed that the grouting performance was highly influenced by material properties and filling characteristic can be varied depending on geometry of ducts.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.638-642
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• 2000

Background: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery(RGEA)in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. Material and Method: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. Result: There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. Conclusion: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.

• Journal of Korean society of Dental Hygiene
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• v.5 no.2
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• pp.263-278
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• 2005

This study investigated the current oral health conditions of the elderly at home and welfare facilities in their age over 65 years around some rural areas in Gangwon province, which would expect the fewer medical benefits even with lower interest than urban areas, despite of relatively high ratio of elder populations, so that it could prepare a basic document necessary to determine certain planned quantification for the benefit of elder's oral healthcare. As of the end of December 2004 both 50 elders at home and 50 elders at welfare facilities were randomly sampled in their age over 65 years in Samcheok city. As a result of this study, it was found that the elders at welfare facilities scored 15 pts. in DMFT index level typical of oral health conditions, which was higher than the elders at home. In addition, the elders at welfare facilities scored 26.0% in the coexistence of immobile bridge and partial denture higher than the elders at home with regard to the presence of intraoral prosthetic appliance. The results of analyzing the difference in the one-year dental visiting experience of respondents hereof showed that the elders at home were relatively more in ratio(62.0%) than those at welfare facilities, while many of the former group(38.0%) had relatively more handicap in masticatory movement than the latter one with regard to the conditions of dental prosthesis in use. Besides, many of the elders at facilities(30% or more) felt subjective symptoms of periodontal disease including bleeding or swelling, which indicates higher ratio than the elders at home. Finally, the elders at home used to brush their teeth at more frequency on a daily basis than those at facilities, while the latter group suffered general body disease more than the former group. Summing up, it is concluded that a formulated oral healthcare system will become more needed in near future than now for the benefit of the elderly living in welfare facilities, while nationwide policy-level supports would be urgent for them in the aspect of national welfare.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.511-517
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• 2019

Background Cleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery. Methods This prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene. Results In this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ²=0.02; P<0.05). However, no relationship was found between perioperative complications related to anesthesia and the occurrence of postoperative complications (χ²=1.00; P>0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ²=0.031; P<0.05). Conclusions Further evaluation of these outcomes would help direct patient management toward decreasing the complication rate.

• Journal of Korean Neurosurgical Society
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• v.43 no.6
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• pp.265-269
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• 2008

Objective : Outcome of gamma knife radiosurgery (GKS) in the consecutive 100 cases with cerebral arteriovenous malformations (AVMs) was analyzed. Methods : Data from initial 100 patients treated with GKS in the authors' institute were reviewed retrospectively. Spetzler-Martin grade at diagnosis were I in 18 patients, II in 27, III in 36, IV in 11, and V in 8. Thirty-five patients had experienced previous bleeding, 27 patients presented with seizure, and 31 patients presented with headache. The mean volume of the lesion was $4.3\;cm^3\;(0.1-29.3\;cm^3)$. The median radiation dose delivered to the margin was 20.0Gy (13-32Gy). Mean follow-up period was 37.5 months (5-63 months). Results : Angiographic follow-up was performed in 48 patients at least 2 years after GKS. Sixteen patients were lost in follow up following 2 years from GKS. Twenty-eight of 48 patients (58%) showed complete obliteration and 20 patients (42%) showed partial obliteration. Seven patients presented with post-GKS hemorrhage. Adverse radiation effect (ARE) was observed at follow-up MRI in 25 of 76 patients, and it was symptomatic in 5 patients. Complete obliteration was confirmed in 24 of 31 (77%) patients with volume less than $4\;cm^3$, meanwhile only 4 of 17 (24%) patients with volume of $4\;cm^3$ or more showed complete obliteration. Complete obliteration rate was 67% with 20Gy or higher marginal dose, 63% with 15-20 Gy, and 17% with less than 15Gy. Conclusion : GKS can provide high rates of obliteration with acceptable risk of morbidity in a subgroup of small AVMs. However, overall outcome in whole spectrum of AVMs, in which large proportion of cases have unfavorable characteristics for radiosurgery, is much worse. More effective therapeutic strategy needs to be developed for large AVMs that are difficult to be managed with current available treatment modalities.