• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.18-23
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• 2023

BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

• The Korean Journal of Health Service Management
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• v.12 no.4
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• pp.127-138
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• 2018

Objectives: The purpose of this study was to identify the intrinsic strengths and weaknesses, as well as opportunities for success and threats of Korean health care industry when planning strategies to enter Chinese health care market. Methods: To suggest directions for planning the strategies, a SWOT(Strengths, Weaknesses, Opportunities, Threats) analysis was used in combination with an AHP(Analytic Hierarchy Process) in this study. A total of twenty SWOT factors and the relative weight of SWOT groups were examined through a survey on the respondents who have work experiences in the area of entering Chinese market. Results: "Geographical proximity between Korea and China" was recognized as a key strength. "Absence of success case in medical service industry" was selected as a critical weakness. "Increase in demand for advanced medical services in China" was identified as an important opportunity. "Difficulty in establishing Korea-China partnership" was considered as a major threat. The respondents prioritized weaknesses, followed by threats, opportunities, and strengths when conducting strategic planning to enter Chinese health care market. Conclusions: Improving local hospital management plan as well as specializing in certain health care services may be necessary.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.2
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• pp.17-29
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• 2022

Purpose: In terms of efficiency and safety, this study attempted to organize data on the operation methods and architectural planning of infectious diseases hospitals. Methods: The results obtained through on-site and interview surveys with hospital officials and medical staffs at four infectious diseases hospitals under construction were summarized based on those original business plans and facility guidelines. Results: First, the operational methods to secure safety and operational efficiency were summarized for each department which are major hospital functions of infectious disease hospitals. Second, as the architectural planning, the characteristics of space and circulation of each department are summarized. For safety of medical staff, negative pressure and non-negative pressure zone have to completely separated. In addition medical staff wears PPE and enters the negative pressure zone and returns in the order of admiral, shower, and gowning in the PPE undressing room after patient treatment. In case of operational efficiency, flexible operation is required in normal and crisis situations. For example, it is important for The Ward to gradually switch to negative pressure beds in times of crisis from normal situation and the outpatient department considers the composition of negative pressure and non-negative pressure outpatient spaces that can operate in parallel even in crisis situations. Implications: Infectious disease hospitals require flexible operation and appropriate facilities for normal and crisis situations.

• Journal of The Korea Institute of Healthcare Architecture
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• v.7 no.1
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• pp.57-68
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• 2001

this study is aiming to obtain an index and a standard assessment which will help in forecasting circulation (critical movement-line) & behavior of pediatric out-patients for each sickness for future children's hospitals construction planning. The study above was based on the analytical results of ordinary disease types of child patients and the circulation of pediatric out-patients by each sickness, along with the comparison study on relationship between these analytical results and hospital facilities.

• Journal of The Korea Institute of Healthcare Architecture
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• v.6 no.10
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• pp.67-76
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• 2000

Hospital architecture is in a transitional period and faces a great change. Furthermore, patients' demand on medical service has been changing. It is said that the importance of public space for people as well as that of private space for patients, doctors and nurses becomes more important than ever. For example, corridor space becomes pathway, waiting room and rest area of patients. Accordingly, the importance of corridor space of public space in general hospitals is increasing. This study aims to present standard data for hospital planning by analyzing space allocation and floor area of corridor space in general hospitals.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.74-79
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• 2018

The aim of this study was to present a case series of the orthognathic treatment of facial asymmetry due to temporomandibular joint (TMJ) ankylosis and to characterize the current treatment modalities through a literature review. Four patients who presented with facial asymmetry due to TMJ ankylosis between 2010 and 2014 were included in this study. TMJ ankylosis was surgically treated before bimaxillary surgery with advancement genioplasty in some of the cases. In 2 cases, 3-dimensional (3D) models were used for diagnosis and treatment planning, as 3D models are very important tools for planning surgical maneuvers. Aesthetically pleasant facial symmetry and a good facial profile were obtained in all the cases.

• Journal of Chest Surgery
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• v.54 no.4
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• pp.246-252
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• 2021

Although lobectomy remains the gold-standard surgical treatment for non-small-cell lung cancer, the frequency of thoracoscopic segmentectomy is increasing. Multiple factors must be considered in the choice of the procedure, ranging from adequate surgical planning or simulation, tumor localization, and identification of the intersegmental plane to severing the intersegmental plane to achieve an oncologically safe surgical margin with no or minimal manual palpation and different landmarks. In this article, we present an overview of methods for each procedural step of thoracoscopic segmentectomy, from preoperative planning to division of the intersegmental plane.

• The korean journal of orthodontics
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• v.51 no.5
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• pp.321-328
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• 2021

Objective: To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome. Methods: The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Real-time Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated. Results: The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases. Conclusions: This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.212-227
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• 2020

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

• Radiation Oncology Journal
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• v.36 no.1
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• pp.11-16
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• 2018

Purpose: To investigate interobserver variation in target volume delineations for prostate cancer salvage radiotherapy using planning computed tomography (CT) versus combined planning CT and magnetic resonance imaging (MRI). Materials and Methods: Ten radiation oncologists independently delineated a target volume on the planning CT scans of five cases with different pathological status after radical prostatectomy. Two weeks later, this was repeated with the addition of planning MRI. The volumes obtained with CT only and combined CT and MRI were compared, and the effect of the addition of planning MRI on interobserver variability was assessed. Results: There were large differences in clinical target volume (CTV) delineated by each observer, regardless of the addition of planning MRI ($9.44-139.27cm^3$ in CT only and $7.77-122.83cm^3$ in CT plus MRI) and no significant differences in the mean and standard deviation of CTV. However, there were decreases in mean volume and standard deviation as a result of using the planning MRI. Conclusion: This study showed substantial interobserver variation in target volume delineation for salvage radiotherapy. The combination of planning MRI with CT tended to decrease the target volume and the variation.