• 대한의용생체공학회:의공학회지
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• 제45권2호
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• pp.66-74
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• 2024

This study analyzed the occurrence of abnormal muscle coactivations based on the assistance of upper limb weight during reaching task in stroke patients. Nine chronic stroke survivors with hemiplegia performed reaching tasks using a programmable haptic robot. Electromyography (EMG) coactivation levels in the upper limb muscles were analyzed using a linear model describing the activation levels of two muscles when the patient's upper limb weight was assisted at 0%, 25%, and 50%. As the upper limb weight assistance of the haptic robot decreased, the magnitude of the EMG signal in both the deltoid and biceps muscles increased simultaneously on both the paretic and non-paretic sides. However, no difference was found between the paretic and non-paretic sides when comparing the slope of the linear model describing the activation relationship between the deltoid and biceps. The aforementioned results suggest that in some stroke survivors, the deltoids, triceps, and biceps on the paretic side may not be abnormally coupled when supporting the upper limbs against gravity. Furthermore, these results suggest that the combination of haptic robots and EMG analysis might be utilized for evaluating abnormal coactivations in stroke patients.

• Journal of Chest Surgery
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• 제41권4호
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• pp.423-429
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• 2008

배경: 최근 수술 로봇을 이용한 심장수술에 대한 관심이 증가하고 있으나, 이에 대한 임상연구는 제한적이다. 본 연구는 2007년 8월부터 저자들에 의해 시행된 다빈치 수술 로봇을 이용한 심장수술의 조기 임상 경험을 보고하고, 로봇 심장수술 실현성 및 안정성을 살펴보고자 하였다. 대상 및 방법: 2007년 8월부터 12월까지 총 20명의 환자에게 다빈치 수술로봇을 이용한 심장수술을 시행하였다. 승모판막 질환(n=11), 삼첨판막 질환(n=1), 심방중격결손증(n=1)의 수술시에는 우측 대퇴 동정맥 및 우측 내경정맥을 이용한 말초 삽관 후 체외 순환을 시행하였고, 전방성 심정지액 투입 및 흘곽의 늑간을 통한 대동맥 겸자를 시행한 후 개심술을 시행하였다. 7명의 환자에서 최소 침습적 관상동맥 우회술(MIDCAB)을 시행하기 위하여 다빈치 수술로봇을 이용하여 좌측 혹은 양측 내흉동맥을 박리하였다. 결과: 환자의 평균 나이는 $50.1{\pm}15.1$세($26{\sim}78$)였으며, 11예의 승모판막 성형술시 3예의 Maze 수술 및 1예의 삼첨판막 성형술이 동반되었다. 평균 체외순환시간은 $208.0{\pm}61.3$분, 평균대동맥 차단시간은 $158.8{\pm}40.6$분이었다. 승모판막 성형술 후 2도를 초과하는 잔존하는 승모판막 역류는 없었으며 수술 후 재원 기간의 중간값은 4일이었다. 다빈치 수술로봇을 이용한 내흉동맥의 박리는 6명의 환자에서 좌측 내흉동맥을 박리하였고, 1명의 환자에서 양측 내흉동맥을 박리하였으며 평균 내흉동맥 박리 시간은 $43.2{\pm}12.0$분이었다. 박리된 내흉동맥은 양호한 혈류를 보였으며, 좌전 개흉술 후 직접시하에서 문합을 시행하였다. MIDCAB으로 시행한 문합의 개통률은 100% (18/18)였다. 결론: 다빈치 수술로봇을 이용한 심장수술은 승모판막 성형술, 삼첨판막 성형술, 심방중격 결손의 교정 및 관상동맥 우회술을 위한 내흉동맥의 박리 등에서 다양하게 적용되었으며, 비교적 안전하고 만족할만한 조기성적을 보였다. 본 연구를 계기로 국내에서도 다빈치 수술로봇을 이용한 심장수술의 임상적용 및 임상연구가 활발하게 진행될 것을 기대한다.

• Journal of Chest Surgery
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• 제38권5호
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• pp.366-370
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• 2005

배경: 일반적으로 심장수술은 정중흉골절개를 통해 행해져 오고 있으며, 과거 십 년간 내시경 장비와 수술 수기의 향상은 작은 절개를 이용한 최소 침습적 심장수술의 발전을 이끌었다. 술자의 음성 명령을 인식하여 내시경을 움직이는 로봇 팔(AESOP 3000, Automated Endoscope System for Optimal Positioning)의 등장으로 심장수술은 로봇 시대에 진입하였다. 대상 및 방법: 2004년 4월부터 12월까지 총 78명의 환자들에게 수술로봇을 이용한 심장수술을 시행하였고 그 중 64명의 환자들에게는 음성명령으로 조절되는 로봇 팔과 대퇴 동정맥관 삽관, 경피적 내경정맥관 삽관, 흉곽을 통한 대동맥 겸자를 사용하여 5cm 우외측 최소개흉으로 로봇을 이용한 최소 침습적 심장수술을 시행하였다. 다른 14명의 환자들에게는 AESOP을 이용한 내흉동맥 박리를 통해 최소 침습적 관상동맥 우회술(MIDCAB)을 시행하였다. 결과: 로봇을 이용한 심장수술은 승모판막 성형술이 37예, 승모판막 치환술이 10예, 대동맥판막 치환술이 1예, MIDCAB이 14예, 심방중격결손증 수술이 9예, Maze 수술만 시행한 경우가 1예였다. 승모판 수술의 경우 평균 체외순환시간은 $165.3\pm43.1$분이었고 평균대동맥 차단 시간은 $110.4\pm48.2$분이였다. 재원일수의 중간값은 승모판 수술인 경우 6일($3\~30$일), MIDCAB은 4일($2\~7$일), 심방중격결손증 수술은 4일($2\~6$일)이였다. 합병증으로는 술 후 출혈로 재수술한 경우가 3예이였고 사망환자는 없었다. 결론: 수술로봇을 이용한 심장수술을 시행한 우리의 경험으로 볼 때 많은 심장외과 의사들이 로봇을 이용하여 작은 창상을 통해 최소 침습적 심장수술이 가능하리라 본다. 수술로봇을 이용한 심장수술의 이점을 분석하기 위해서는 잘 계획된 연구와 긴밀한 장기간의 관찰이 필요할 것으로 판단된다.

• Korean Journal of Radiology
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• 제24권8호
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• pp.807-820
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• 2023

Objective: To assess whether computed tomography (CT) conversion across different scan parameters and manufacturers using a routable generative adversarial network (RouteGAN) can improve the accuracy and variability in quantifying interstitial lung disease (ILD) using a deep learning-based automated software. Materials and Methods: This study included patients with ILD who underwent thin-section CT. Unmatched CT images obtained using scanners from four manufacturers (vendors A-D), standard- or low-radiation doses, and sharp or medium kernels were classified into groups 1-7 according to acquisition conditions. CT images in groups 2-7 were converted into the target CT style (Group 1: vendor A, standard dose, and sharp kernel) using a RouteGAN. ILD was quantified on original and converted CT images using a deep learning-based software (Aview, Coreline Soft). The accuracy of quantification was analyzed using the dice similarity coefficient (DSC) and pixel-wise overlap accuracy metrics against manual quantification by a radiologist. Five radiologists evaluated quantification accuracy using a 10-point visual scoring system. Results: Three hundred and fifty CT slices from 150 patients (mean age: 67.6 ± 10.7 years; 56 females) were included. The overlap accuracies for quantifying total abnormalities in groups 2-7 improved after CT conversion (original vs. converted: 0.63 vs. 0.68 for DSC, 0.66 vs. 0.70 for pixel-wise recall, and 0.68 vs. 0.73 for pixel-wise precision; P < 0.002 for all). The DSCs of fibrosis score, honeycombing, and reticulation significantly increased after CT conversion (0.32 vs. 0.64, 0.19 vs. 0.47, and 0.23 vs. 0.54, P < 0.002 for all), whereas those of ground-glass opacity, consolidation, and emphysema did not change significantly or decreased slightly. The radiologists' scores were significantly higher (P < 0.001) and less variable on converted CT. Conclusion: CT conversion using a RouteGAN can improve the accuracy and variability of CT images obtained using different scan parameters and manufacturers in deep learning-based quantification of ILD.

• Transactions on Control, Automation and Systems Engineering
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• 제4권2호
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• pp.124-129
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• 2002

This paper demonstrates that the largest Lyapunov exponent λ of recurrent neural networks can be controlled efficiently by a stochastic gradient method. An essential core of the proposed method is a novel stochastic approximate formulation of the Lyapunov exponent λ as a function of the network parameters such as connection weights and thresholds of neural activation functions. By a gradient method, a direct calculation to minimize a square error (λ - λ$\^$obj/)$^2$, where λ$\^$obj/ is a desired exponent value, needs gradients collection through time which are given by a recursive calculation from past to present values. The collection is computationally expensive and causes unstable control of the exponent for networks with chaotic dynamics because of chaotic instability. The stochastic formulation derived in this paper gives us an approximation of the gradients collection in a fashion without the recursive calculation. This approximation can realize not only a faster calculation of the gradient, but also stable control for chaotic dynamics. Due to the non-recursive calculation. without respect to the time evolutions, the running times of this approximation grow only about as N$^2$ compared to as N$\^$5/T that is of the direct calculation method. It is also shown by simulation studies that the approximation is a robust formulation for the network size and that proposed method can control the chaos dynamics in recurrent neural networks efficiently.

• International Journal of Control, Automation, and Systems
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• 제5권6호
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• pp.643-651
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• 2007

The various blood pressure simulators have been proposed to evaluate and improve the performance of the automatic sphygmomanometer. These have some problems such as the deviation of the actual blood pressure waveform, limitation in the blood pressure condition of the simulator, or difficulty in displaying the blood flow. An improved simulator using disturbance observer is proposed to supplement the current problems of the blood pressure simulator. The proposed simulator has an artificial arm model capable of feeding appropriate fluids that can generate the blood pressure waveform to evaluate the automatic sphygmomanometer. A controller was designed and thereafter, simulation was performed to control the output signal with respect to the reference input in the fluid dynamic model using the proposed proportional control valve. To minimize the external fluctuation of pressure applied to the artificial arm, a disturbance observer was designed on the plant. A hybrid controller combined with a proportional controller and feed-forward controller was fabricated after applying a disturbance observer to the control plant. Comparison of the simulations between the conventional proportional controller and the proposed hybrid controller indicated that even though the former showed good control performance without disturbance, it was affected by the disturbance signal induced by the cuff. The latter exhibited an excellent performance under both situations.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 1991년도 한국자동제어학술회의논문집(국제학술편); KOEX, Seoul; 22-24 Oct. 1991
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• pp.1796-1800
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• 1991

Picture Archiving and Communication Systems(PACS) provide an integration of digital imaging information in a hospital, which encompasses various imaging equipment, viewing workstations, database archive systems, and a high speed fiber optic network. One of the most important requirements for integration is the standardization of communication protocols to connect devices from different vendors. Since 1985, the ACR-NEMA standard provides a hardware interface, a set of software commands, and a consistent set of data formats for point-to-point interconnection of medical equipment. However, it has been shown to be inadequate for PACS networking environments, because of its point-to-point nature and its inflexibility to allow other services and protocols in the future. Based on previous experience of PACS developments in The University of Arizona, a new communication protocol for PACS networks has been suggested to the ACR-NEMA Working Group VI. The defined PACS protocol is intended to facilitate the development of PACS's capable of interfacing with other hospital information systems. Also, it is intended to allow the creation of diagnostic information data bases which can be interrogated by a variety of distributed devices. A particularly important goal is to support communications in a multivendor environment. The new protocol specifications are defined primarily as a combination of the International Organization for Standardization / Open Systems Interconnection (ISO/OSI) protocols and the data format portion of ACR-NEMA standard. This paper addresses the specification and implementation of the proposed PACS protocol into network node. The protocol specification, which covers Presentation, Session, Transport, and Network layers, is summarized briefly. The implementation has natural extentions to Global PACS environments. The protocol implementation is discussed based on our implementation efforts in the UNIX Operating System Environment. At the same time, results of performance evaluation are presented to demonstrate the implementation of defined protocol. The testing of performance analysis is performed on the PACS prototype node.

• 정보교육학회논문지
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• 제19권1호
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• pp.139-148
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• 2015

융합 이미지 생성의 목적은 여러 입력 이미지에 나타난 주요 시각적인 정보를 결합시켜 하나의 보다 정보적이고 완성적인 출력 이미지를 얻는 데 있다. 현재 이러한 이미지 융합 기술은 영상 의료, 원격 감지, 로봇공학 등의 분야에서 활발하게 연구되고 있다. 본 논문에서는 최대 엔트로피에 의한 임계값 추정과 이를 바탕으로 하는 특징 벡터 추출 및 상호 정보량에 의한 특징 벡터들의 밀접한 관계를 추정하는 방식으로 융합 이미지를 생성하는 하나의 접근방식을 제안한다. 이러한 융합 이미지 생성 방식은 이미지의 전반적인 불확실성을 감소시킨다는 점에서 장점이 있고, 더 나아가서 융합되는 이미지들 가운데 블러링 이미지가 사용되는 경우에 이미지 정합이 다른 기법에 비해 보다 좋은 성능을 가진다는 점이다.

• Structural Engineering and Mechanics
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• 제74권4호
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• pp.567-576
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• 2020

Considerable controversy surrounds the choice of the best abutment type for implant prosthetics. The two most common structures are hex and non-hex abutments. The non-hex abutment typically furnishes a larger contact area between itself and the implant than that provided by a hex structure. However, when a hex abutment is loaded, the position of its contact area may be deeper than that of a non-hex abutment. Hence, the purpose of this study is to determine the different biomechanical behaviors of an internal bone-level implant based on the abutment type-hex or non-hex-and clinical crown length under static and cyclic loadings using finite element analysis (FEA). The hex structure was found to increase the implant and abutment stability more than the nonhex structure among several criteria. The use of the hex structure resulted in a smaller volume of bone tissues being at risk of hypertrophy and fatigue failure. It also reduced micromovement (separation) between the implant components, which is significantly related to the pumping effect and possible inflammation. Both static and fatigue analyses, used to examine short- and long-term stability, demonstrated the advantages of the hex abutment over the non-hex type for the stability of the implant components. Moreover, although its impact was not as significant as that of the abutment type, a large crown-implant ratio (CIR) increased bone strain and stress in the implant components, particularly under oblique loading.

• 한국항행학회논문지
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• 제15권1호
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• pp.83-90
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• 2011

위치인식 기술은 사물이나 사람의 위치를 측정하여 서로 정보를 교환하고 환경을 제어하는데 필요한 핵심기술이다. 현재도 위치인식 기술은 다양한 방법들로 연구되고 있으며, 물류, 의학, 로봇 분야 등에 적용될 수 있다. 그러나 위치인식 기술을 적용하려면 많은 비용이 필요하다. 이에 본 논문에서는 적은 비용으로 구현 가능한 Zigbee기반 AoA 위치인식 시스템을 제안한다. 본 시스템은 흔히 이용하는 스텝 모터, 지향성 안테나, Zigbee 모듈을 사용하여 비컨에 지향성 안테나를 회전시켜 RSSI값을 측정하였다. RSSI값이 가장 큰 값을 가질 때 스텝 모터의 회전각을 계산하여 수신기가 위치한 각도를 판단하고 AoA 방식을 적용하여 수신기의 위치를 측정하였다. 수신기의 위치를 옮겨가며 측정한 결과 35~36cm 정도의 오차가 있었다.