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Imaging of Facial Nerve With 3D-DESS-WE-MRI Before Parotidectomy: Impact on Surgical Outcomes

  • Han-Sin Jeong;Yikyung Kim;Hyung-Jin Kim;Hak Jung, Kim;Eun-hye Kim;Sook-young Woo;Man Ki Chung;Young-Ik Son
    • 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.

A Study on the Spatial Configuration in the Metaverse - Focusing on Communication Game Virtual Worlds's 'Animal Crossing' - (메타버스에서의 공간 형태 구성에 관한 연구 - 커뮤니케이션 게임 가상세계 '모여봐요 동물의 숲'을 중심으로 -)

  • Yu, Yeon Seo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.52 no.1
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    • pp.1-16
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    • 2024
  • Alvin Toffler mentioned that it is important for future society to keep pace with synchronization and that time deviations can hinder social development. As we experience the new normal era of untact, we have experienced an increase in non-face-to-face contact and accelerated digital transformation. Amid these rapid changes, we can maintain the need for synchronization or change in space. Therefore, we would like to study what kind of settlements people create and choose. We looked at the metaverse as an object that could indirectly find out about this, and used the content called "Animal Crossing" to collect data related to the spatial form of the metaverse. Sampling utilized a judgment sampling method during non-probability sampling to alleviate differences due to the progress of the game. The collected data was classified according to floor plan and location type and briefly organized through descriptive statistics. After matching each facility by use, data was constructed by setting coordinates for each cluster and listing them. This data was interpreted graphically on the coordinate plane for each cluster, and Euclidean analysis was performed to analyze the relationships between clusters and residential choice using a Euclidean matrix. As a result of the analysis, it could be interpreted that efficiency was pursued by arranging similar functions in close proximity. Nevertheless, when choosing a residence, it was interpreted that the intention was to create a community through arrangement adjacent to residents rather than efficiency or convenience. Due to the differences between the metaverse and the real world, it is expected that there will be limitations in equating it with reality. However, through the space expressed in the virtual world by people who are far away from the constraints of reality, we can indirectly know the wishes that we have not been able to express due to our lack of awareness.

Medical Costs between Dietary Supplement Users and Non-users Using the Korea Health Panel Data (한국의료패널 자료를 활용한 건강기능식품 섭취에 따른 의료비 지출 비교분석)

  • Hye-Young Kwon;Soohyun Oh
    • Health Policy and Management
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    • v.34 no.1
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    • pp.87-93
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    • 2024
  • Background: In recent years, studies have shown conflicting results regarding the benefits of dietary supplements in reducing healthcare expenditures. This study aimed to address this inconsistency by examining the association between supplement consumption and health expenditures using nationally representative data from the Korea Health Panel Survey (2019-2020). Methods: A 1:1 matched case-control dataset was established using propensity score matching technique based on supplement consumption. Then, total annual healthcare expenditures were compared between the two groups. In addition, a multivariate regression analysis (Proc Surveyreg) was performed to determine the association between the supplement consumption and medical costs. Results: The supplement user group spent about 1.72 million Korean won, while the non-user group spent about 1.43 million Korean won on medical services (p=0.0186). The results of multivariate regression showed that the costs were approximately 26.15% higher in the user group than in the non-user group (p=0.0004). Conclusion: Contrary to the previous studies that have shown the benefits of supplement use in reducing healthcare costs, this study showed that those who consistently consumed supplements spent more on medical services. This can be interpreted in the same context as previous studies suggesting that dietary supplement intake is a healthy behavior for managing one's health. However, we caution against drawing firm conclusions due to data limitations. Further analysis using patient-level epidemiologic data is needed.

Effect of Automatic Exposure Control Marker with Chest Radiography in Radiation Reduction (자동노출제어를 사용한 X선 흉부촬영에서 AEC 표지자 사용에 따른 환자 피폭선량 감소 효과)

  • Jung, Ji-Sang;Choi, Byoung-Wook;Kim, Sung-Ho;Kim, Young-Mo;Shim, Ji-Na;Ahn, Ho-Sik;Jin, Duk-Eun;Lim, Jae-Sik;Kang, Sung-Ho
    • Journal of radiological science and technology
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    • v.37 no.3
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    • pp.177-185
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    • 2014
  • This study focused on effects of patient exposure dose reduction with AEC (Auto Exposure Control) marker that is designed for showing location of AEC in X-ray Chest radiography. It included 880 adults who have to use Chest X-ray Digital Radiography system (DRS, LISTEM, Korea). AEC (Ion chambers are posited in top of both sides) are used to every adult and set X-ray system as Field size $17{\times}17inch$, 120kVp, FFD 180cm. 440 people of control group are posited on detector to include both sides of lung field and the other 440 people of experimental group are set to contact their lung directly to Ion chamber (making marker to shows location). Then, measured every DAP and, estimated patient effective dose by using PCXMC 2.0. The average age of control group (M:F=245:195) is 53.9 and the average BMI is 23.4. BMI ranges from under weight: 35, normal range: 279, over weight: 106 to obese: 20 and average DAP is 223.56mGycm2, Mean effective dose is 0.045mSv. The average age of experimental group (M:F=197:243) is 53.7 and the average BMI is 22.7. BMI ranges from under weight: 34, normal range: 315, over weight: 85 to obese: 6 and average DAP is 207.36mGycm2, Mean effective dose is 0.041mSv. Experimental group shows less Mean effective dose as 0.004mSv (9.7%) than control group. Also, patient numbers who got over exposure more than 0.056mSv (limit point to know efficiency of AEC marker) is 65 in control group (14.7%), 19 in experimental group (4.3%) and take statistics with t-Test. The statistical difference between two groups is 0.006. In order to use proper amount of X-ray in auto exposure controlled chest X-ray system, matching location between ion chamber and body part is needed, and using AEC marker (designed for showing location of ion chamber) is a way to reduce unnecessary patient exposure dose.