• Journal of the Institute of Electronics and Information Engineers
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• v.53 no.12
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• pp.175-179
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• 2016

Recent advances in technology of medical image have made surgical simulation that is helpful to diagnosis, operation plan, or education. Improving and enhancing the medical imaging have led to the availability of high definition images and three-dimensional (3D) visualization, it allows a better understanding in the surgical and educational field. The Real human field of view is stereoscopic. Therefore, with just 2D images, stereoscopic reconstruction process through the surgeon's head, is necessary. To reduce these process, 3D images have been used. 3D images enhanced 3D visualization, it provides significantly shorter time for surgeon for judgment in complex situations. Based on 3D image data set, virtual medical simulations, such as virtual endoscopy, surgical planning, and real-time interaction, have become possible. This article describes principles and recent applications of newer imaging techniques and special attention is directed towards medical 3D reconstruction techniques. Recent advances in technology of CT, MR and other imaging modalities has resulted in exciting new solutions and possibilities of shoulder imaging. Especially, three-dimensional (3D) images derived from medical devices provides advanced information. This presentation describes the principles and potential applications of 3D imaging techniques, simulation and printing in shoulder and elbow practice.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.66-71
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• 1989

It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.

• Health Policy and Management
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• v.2 no.1
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• pp.42-65
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• 1992

To survey the specialties or sujects of practice displayed by the private practitioners the authors visited 691 clinics in Taegu from April 1 to May 18, 1991, At the same time, a mail questionnaire was administered to ask the number of displayed subjects of practice, and the reasons for displaying the subjects, reasons for not displaying in case of no specialty was displayed, composition of patients, and role as a specialist. The questionnaire was returned by 308(44.6%) practitioners. The distributions of private practitioners by specialty were 13.9% for internal medicine (IM), 11.7% for pediatrics(Ped), 13.0% for obstetrics '||'&'||' gynecology(OBGY), 11.1% for general surgery(GS), 10.0% for family practice(FP), and 5.3% for general practitioner(GP). Ninety percent of the specialists have displayed their specialty in their offices. Among all the private practitioners, 61.9% of them have displayed their subjects of practice and 23.7% have shown telephone number. Among private practitioners who displayed the subjects of practice, 80.6% have signs of 'subjects of practice'. Mean number of the displayed subjects of practice for the all private practitioners is 1.20, and 1.93 for the private practitioners who displayed subjects of practice. FP and GS have displayed their subjects of practice in 91.2% and 87.0% respectively and OBGY have displayed in 32.2%, the lowest percentage among all the soecuaktues. IM specialists displays pediatrics as a major subject of practice in 72.1% the pediatricians display IM in 88.9% the OBGYs display pediatrics in 77.8%, and the GSs display IM in 51.9%. Most commonly displayed subjects of practice are Ped and IM. Sixty-five percent of the private practitioners answered that they don't display their specialties because their clinics are "primary health care facility". The reasons for displaying the subjects of practice and its relevance with their own specialty(45.6%), and the difficulty in clinic management only with the patients for their own specialty(36.9%). The proportion of clinics whose patients of other specialty are than their own specialty accounted less than 10% was 52.8% and that accounted more than 51% was 16.0%. Specially, 51.4% of GS specialists cared more than 51% of patients of other specialty area than their own specialty. Most of the patients of IM, Ped, and OBGY specialists are the patients of their own specialty. However, 56.8% of GS care more of IM patients and only 24.3% of them care mostly GS patients, The respondents to the mail questionnaire who stated that they can not play the role of specialist well are 30.5% and especially 72.9% of the GS specialists state so. The proportion of respondents who do not suffort the private practice of specialists is 71.1%. Among the surgical specialists, 82.7% of them rarely perform operation. The reasons for not performing operation are insufficient insurance fee (76.9%), and risk of operation(58.0%), so as the OBGY specialists. Above finidngs suggest that most of the specialists, especially surgeons, in the private practice can not play their role as a specialist. It is necessary to develop a policy that facilitates the production of practice and the retention of the specialists in the hospitals.s.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.277-281
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• 2018

Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

• Journal of Korean Neurosurgical Society
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• v.63 no.3
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• pp.346-357
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• 2020

During the follow-up period after surgery for spinal dysraphism, a certain portion of patients show neurological deterioration and its secondary phenomena, such as motor, sensory or sphincter changes, foot and spinal deformities, pain, and spasticity. These clinical manifestations are caused by tethering effects on the neural structures at the site of previous operation. The widespread recognition of retethering drew the attention of medical professionals of various specialties because of its incidence, which is not low when surveillance is adequate, and its progressive nature. This article reviews the literature on the incidence and timing of deterioration, predisposing factors for retethering, clinical manifestations, diagnosis, surgical treatment and its complications, clinical outcomes, prognostic factors after retethering surgery and preventive measures of retethering. Current practice and opinions of Seoul National University Children's Hospital team were added in some parts. The literature shows a wide range of data regarding the incidence, rate and degree of surgical complications and long-term outcomes. The method of prevention is still one of the main topics of this entity. Although alternatives such as spinal column shortening were introduced, re-untethering by conventional surgical methods remains the current main management tool. Re-untethering surgery is a much more difficult task than primary untethering surgery. Updated publications include strong skepticism on re-untethering surgery in a certain group of patients, though it is from a minority of research groups. For all of the abovementioned reasons, new information and ideas on the early diagnosis, treatment and prevention of retethering are critically necessary in this era.

• Journal of Korean Medical classics
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• v.26 no.1
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• pp.27-38
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• 2013

Objective : This article shows that while Seishu Hanaoka(華岡靑洲) is known to have developed an effective anesthetic formula composed of traditional herbs and performed the world first partial mastectomy under a general anesthesia in 1804, anesthetic formulas very similar to those developed by him were widely recorded and deemed used in Japan and Northeast Asia before his invention. The origin of the formulas will be tracked down to compare with the several formulas broadly administered in the region. Methods : Historical literature analysis was adopted to achieve the objective. 1. Mayaku-ku (麻藥考): this book is the main medical classic by Nakagawa Syutei(中川修亭) that introduces Seishu Hanaoka, his anesthetic formulas and mastectomy. 2. Northeast medical classics: Seuideukhyobang (世醫得效方) in 1337, Uibangryuchui (醫方類聚), Uihui(宜彙) and so on. Result : Herbs such as aconitum and datura were applied as a anesthetic agent early on before the Chinese Yuan dynasty. In Korea as well, some old medical books documented such use of those herbs and relevant formulas. Conclusion : Formulas that counted as invented and employed by Seishu Hanaoka as anesthetics, in fact, had been widely known and used in the region before his era. We should pay due attention to his creativity that combined a western surgical intervention and traditional anesthetic agents and successfully performed a newly introduced surgical practice in Japan. The point is that Hanaoka took note of anesthetic herbs or formulas traditionally inherited in North-east Asian medicine and successfully applied them to the surgical procedures for breast cancer, or mastectomy and mammotomy. This history alerts us to neglected or forgotten potentials of traditional medicine in anesthetic treatment and more.

• Korea-Australia Rheology Journal
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• v.21 no.3
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• pp.155-160
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• 2009

Micropore filtration of dilute red blood cell (RBC) suspensions is a widely known method for determining red blood cell deformability. Use of this method for cells from various laboratory animal species does require considering the effects of the cell size to pore size ratio and of suspension hematocrit. In general, previous animal studies have utilized 5% hematocrit suspensions and five micron pores, and thus conditions similar to human clinical laboratory practice. However, when used for repeated sampling from small laboratory animals or for parallel multiple samples from different sites in large laboratory animals, the volume of blood sampled and hence the hematocrit of the test suspension may be limited. Our results indicate that hematocrit levels yielding stable values of RBC pore transit time are pore size and species specific: three micron pores = $2{\sim}5%$ for dog and $3{\sim}5%$ for rat; five micron pores $3{\sim}5%$ for dog and $1{\sim}5%$ for rat. An analytical approach using a common expression for calculating transit time is useful for determining the sensitivity of this time to hematocrit alterations and hence to indicate hematocrit levels that may be problematic.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.3
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• pp.361-372
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• 2002

Purpose : The purpose of study was to identify to analysis of core nursing interventions performed by Operating Room nurses. Method : The subjects of the study were arbitrarily selected nurses(n=104) working in Operating Room. The period for data collection was 15 days from July, 15, 2002 to July, 30. 2002. The instrument for study was 486 Nursing Interventions Classification developed by McClosky & Bulechek(2000) and was translated into Korean. In 486 nursing interventions, 57 nursing interventions were selected by more than half of 47 professional nurses group of Operating Room. 57 nursing interventions were used as a secondary questionnaire. In the secondary questionnaire, labels and definitions of all 57 interventions were listed. The collected data were self reported by Operating Room nurses. The data were analysed with SPSS program. Result : In 57 nursing interventions, the 'Behavior' domain was the most frequently used. Core interventions of Operating Room were performed several times a day by more than 50% of Operating Room nurses. Core interventions of Operating Room were 16 Core interventions, 7 classes, 5 domains. In the core interventions, the 'Physiological:Complex' domain was the most frequently used. Core interventions of Operating Room were Surgical Preperation, Infection Control:Intraoperative, Surgical Precautions, Fall Prevention, Documentation, Surgical Assistance, Environmental Management:Safety, Skin Surveillance, Physical Restraint, Pressure Ulcer Prevention, Environmental Management:Comfort, Infection Protection, Presence, Emotional Support, Specimen Management, Shift Report. Conclusion : Core interventions of Operating Room have implications for nursing care practice, nursing education, nursing research, and nursing information system in Operating Room.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.660-669
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• 2021

Background The demand for aesthetic procedures continues to grow globally, particularly in East Asian countries. The popularity of specific aesthetic procedures varies, however, depending on the particular East Asian geographical region being studied. This study aimed to evaluate the experiences of and attitudes toward aesthetic procedures in five East Asian countries/regions, including China, Japan, South Korea, Hong Kong, and Taiwan. Methods To recruit participants, an online questionnaire was designed and distributed on social media networks between May 2015 and March 2016. The statistical analysis was conducted using SPSS software, version 22.0. Results A total of 3,088 people responded (approximately 600 in each country/region). Of these, 940 participants (47.8%) responded that they had experienced at least one aesthetic procedure in the past. Taiwan had the highest number of participants who had experienced at least one procedure (264/940, 41%), with primarily non-surgical experiences. Only in South Korea did surgical cosmetic experiences exceed non-surgical cosmetic experiences (55.9% vs. 44.1%). The popularity of particular procedures and the motivation for undergoing aesthetic procedures varied by country. Conclusions The popularity of aesthetic procedures continues to evolve. Similar trends were observed across the East Asian regions; however, each country had its unique demands and preferences. The information provided by this study can help aesthetic plastic surgeons further understand the patients in their corresponding region, customize their practice, and develop the requisite skills.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.24-28
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• 2021

Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.