• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.350-358
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• 2012

Objective : Life expectancy for humans has increased dramatically and with this there has been a considerable increase in the number of patients suffering from lumbar spine disease. Symptomatic lumbar spinal disease should be treated, even in the elderly, and surgical procedures such as fusion surgery are needed for moderate to severe lumbar spinal disease. However, various perioperative complications are associated with fusion surgery. The aim of this study was to examine perioperative complications and assess risk factors associated with lumbar spinal fusion, focusing on geriatric patients at least 70 years of age in the Republic of Korea. Methods : We retrospectively investigated 489 patients with various lumbar spinal diseases who underwent lumbar spinal fusion surgery between 2003 and 2007 at our institution. Three fusion procedures and the number of fused segments were analyzed in this study. Chronic diseases were also evaluated. Risk factors for complications and their association with age were analyzed. Results : In this study, 74 patients experienced complications (15%). The rate of perioperative complications was significantly higher in patients 70 years of age or older than in other age groups (univariate analysis, p=0.001; multivariate analysis, p=0.004). However, perioperative complications were not significantly associated with the other factors tested (sex, comorbidities, operation procedures, fusion segments involved). Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery whereas other factors were not significant. We recommend good clinical judgment and careful selection of geriatric patients undergoing lumbar spinal fusion surgery.

• 한국응급구조학회지
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• 제23권1호
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• pp.101-112
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• 2019

Purpose: The purpose of the study was to contribute to the prevention of musculoskeletal disorders (MSDs) in 119 emergency medical technicians (EMTs) by evaluating ergonomic risk factors of patient lifting work-postures. Methods: Four procedures were evaluated: using long back-board (LBB) on the sitting and standing main stretcher, using variable stretcher on the sitting and standing main stretcher. Wok-postures were assessed during training. Results: In using LBB on the sitting main stretcher, the OWAS-score was Mode:3 (Mean:2.30, Maximum:3), the REBA-score was Mode:9 (Mean:7.61, Maximum:11), requiring improvement soon. In using LBB on the standing main stretcher, the OWAS-score was Mode:3 (Mean:2.33, Maximum:3), requiring as soon as possible corrective action, the REBA-score was Mode:6 (Mean:5.44, Maximum:11), requiring improvement. In using variable stretcher on the sitting main stretcher, the OWAS-score was Mode:1 (Mean:1.85, Maximum:3), not requiring corrective action, the REBA-score was Mode:6 (Mean:6.78, Maximum:11), requiring improvement. In using variable stretcher on the standing main stretcher, the OWAS-score was Mode:3 (Mean:2.84, Maximum:3), requiring as soon as possible corrective action, the REBA-score was Mode:11 (Mean:9.38, Maximum:11), requiring immediate improvement. Conclusion: All four-procedures showed improvement in work-posture. Thereby, required attention and management in training, occupational health professionals should participate in change of lifting-method, and programs aimed at preventing MSDs should be developed and implemented in fire-academy and fire-station.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.55-65
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• 2021

Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.676-682
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• 2022

Background Virtual education is an evolving method for teaching medical learners. During the coronavirus disease 2019 pandemic, remote learning has provided a replacement for conferences, lectures, and meetings, but has not been described as a method for conducting a cadaver dissection. We aim to demonstrate how learners perceive a virtual cadaver dissection as an alternative to live dissection. Methods A virtual cadaver dissection was performed to demonstrate several upper extremity nerve procedures. These procedures were livestreamed as part of an educational event with multimedia and interactive audience questions. Participants were queried both during and after the session regarding their perceptions of this teaching modality. Results Attendance of a virtual dissection held for three plastic surgery training institutions began at 100 and finished with 70 participants. Intrasession response rates from the audience varied between 68 and 75%, of which 75% strongly agreed that they were satisfied with the virtual environment. The audience strongly agreed or agreed that the addition of multimedia captions (88%), magnified video loupe views (82%), and split-screen multicast view (64%) was beneficial. Postsession response rate was 27%, and generally reflected a positive perspective about the content of the session. Conclusions Virtual cadaver dissection is an effective modality for teaching surgical procedures and can be enhanced through technologies such as video loupes and multiple camera perspectives. The audience viewed the virtual cadaver dissection as a beneficial adjunct to surgical education. This format may also make in-person cadaver courses more effective by improving visualization and allowing for anatomic references to be displayed synchronously.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.19-26
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• 2020

Background and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS. Materials and Methods This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed. Results The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure. Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

• 보건행정학회지
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• 제15권4호
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• pp.46-64
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• 2005

This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.

• 대한방사선기술학회지:방사선기술과학
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• 제46권2호
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• pp.123-129
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• 2023

Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm² and 37.47 Gy·cm² , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm² and 117.51 Gy·cm² respectively. In PCI 43 case, those values were 198.73 Gy·cm² and 120.13 Gy·cm² respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2014년도 춘계 종합학술대회 논문집
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• pp.287-288
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• 2014

• 한국의학물리학회지:의학물리
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• 제28권2호
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• pp.67-75
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• 2017

Prior to the introduction of a medical apparatus based on heavy-ion medical accelerator in Korea, a study is needed on quality control in clinical operation for the safe and appropriate usage of the instrument. Data relevant for the study were obtained via information sharing sessions and visits by the Particle Therapy Co-Operative Group (PTCOG) and other related academic associations. Furthermore, investigative analysis of the European and Japanese performance evaluation guidelines for heavy ion, as well as research on relevant literature, were conducted. In addition, instrumental standards were analyzed through an investigation of the current usage status of the heavy-ion medical accelerator, and further analysis was conducted on the evaluation methods for the performance, safety, and significance of the instrument. Based on these analyses, regular quality control procedures for heavy-ion medical accelerators in hospitals and other institutes were extrapolated. It is hoped that the results of this study will facilitate hospitals that have introduced heavy-ion medical accelerators, or are considering the implementation of the instrument, in their understanding of the fundamental standards and capabilities of the treatment system, as well as in establishing and carrying out quality control procedures for clinical operations such that it will contribute to the safety of patients and the efficiency of medical practitioners.

• Tuberculosis and Respiratory Diseases
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• 제68권5호
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• pp.267-272
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• 2010

Background: Pulmonary sarcoidosis often involves mediastinal or hilar lymph nodes in the lung parenchyma. Mediastinoscopy is the gold standard for diagnosis, but it is invasive and expensive. Transbronchial needle aspiration using conventional bronchoscope is less invasive than mediastinoscopy, but its diagnostic accuracy is in question due to the blind approach to targeting lymph nodes. Transbronchial needle aspiration (TBNA) via endobronchial ultrasound (EBUS) has high diagnostic value due to direct visualization of lymph nodes and to its relatively safeness. The purpose of this study was to assess the usefulness of EBUS-TBNA in the diagnosis of pulmonary sarcoidosis. Methods: Twenty-five patients with symptoms of sarcoidosis were enrolled into this study. Core tissue was obtained for a definitive diagnosis. Endobronchial biopsy, transbronchial lung biopsy, and bronchoalveolar lavage were performed to verify diagnosis. For patients without a confirmed diagnosis after the above procedures were performed, the additional procedures of mediastinoscopy or video-associated thoracoscopic surgery were performed to confirm a final diagnosis. Results: A total 25 EBUS procedures were done and 50 lymph nodes were aspirated. Thirty-three (37) out of 50 lymph nodes were consistent with non-caseating granuloma, confirming sarcoidosis as the final diagnosis. Sarcoidosis was the final diagnosis for all 25 patients, and 21 required EBUS-TBNA for a final diagnosis. There were no complications associated with the procedure. Conclusion: EBUS-TBNA is already a well-known procedure for diagnosing mediastinal or hilar lymphadenopathy. We used EBUS-TBNA for the diagnosis of pulmonary sarcoidosis and our results showed 84% diagnostic accuracy and no complications related to the procedure. EBUS-TBNA is a reliable and practical diagnostic modality in the diagnosis of pulmonary sarcoidosis.