• 대한치과보철학회지
• /
• 제60권4호
• /
• pp.354-361
• /
• 2022

디지털 기술의 발달은 치의학의 큰 변화를 일으키고 있고, 이러한 디지털 워크플로는 보철 치료 영역에서도 다양한 3D 데이터들을 하나로 중첩시켜, 진단과 보철물 제작에 활용되고 있다. 디지털 데이터를 종합하여 형성된 가상 환자에게서 계획된 진단과 보철물의 형성은 기존 통상적인 방법에 비해 보다 더 직관적으로 보철 치료의 결과를 시뮬레이션 할 수 있고, 이로 인해 심미적인 보철 치료의 예측성을 높일 수 있다. 본 증례에서는 디지털 워크플로를 통해 상악 전치부 선천성 결손 부위를 고정성 보철물로 제작하여 기능적, 심미적으로 만족할 만한 임상적 결과를 얻었으므로 이를 보고하는 바이다.

• Clinics in Shoulder and Elbow
• /
• 제24권3호
• /
• pp.156-165
• /
• 2021

Background: This study aimed to determine: the perspectives of the patient cohort that underwent telehealth consultation and shoulder rehabilitation during coronavirus disease 2019 (COVID-19) and the differences in the patients' perspectives with the two different telehealth video applications (apps) used in the study. Methods: This is a prospective study carried out during the COVID lockdown period of April to July 2020. Thirty consecutive patients from the orthopedics department of a tertiary institute in India underwent their first-ever session of a video app-based (Zoom or WhatsApp) telehealth consultation with shoulder rehabilitation exercises on a handheld mobile, tablet, or laptop device. After the virtual consultation, the patients were sent a validated telehealth usability questionnaire (TUQ) to evaluate their perspectives. Scores obtained from the TUQ were the primary outcome measure. Results: The study was completed by 30 patients (16 men and 14 women) with an average age of 56 years (range, 20-77 years). The patients who contacted us during the lockdown period with either a stiff shoulder or a conservatively treated shoulder fracture were included in the study. The average TUQ score was 13.6 (median, 14.5; range, 6-21) out of a maximum of 21 points. Eighty percent of the patients were satisfied and found the telehealth service useful. Use of the Zoom app scored significantly higher (median, 17; average, 15.6) than the WhatsApp app (median, 8.5; average, 9.6) (p=0.004). Conclusions: Patients who received telehealth consultation and shoulder rehabilitation were overall satisfied. Telehealth apps with advanced video calling features such as Zoom should be preferred for higher patient satisfaction.

• Journal of Korean Neurosurgical Society
• /
• 제66권6호
• /
• pp.632-641
• /
• 2023

Central nervous system tumors are identified as tumors of the brain and spinal cord. The associated morbidity and mortality of cerebrospinal tumors are disproportionately high compared to other malignancies. While minimally invasive techniques have initiated a revolution in neurosurgery, artificial intelligence (AI) is expediting it. Our study aims to analyze AI's role in the neurosurgical management of cerebrospinal tumors. We conducted a scoping review using the Arksey and O'Malley framework. Upon screening, data extraction and analysis were focused on exploring all potential implications of AI, classification of these implications in the management of cerebrospinal tumors. AI has enhanced the precision of diagnosis of these tumors, enables surgeons to excise the tumor margins completely, thereby reducing the risk of recurrence, and helps to make a more accurate prediction of the patient's prognosis than the conventional methods. AI also offers real-time training to neurosurgeons using virtual and 3D simulation, thereby increasing their confidence and skills during procedures. In addition, robotics is integrated into neurosurgery and identified to increase patient outcomes by making surgery less invasive. AI, including machine learning, is rigorously considered for its applications in the neurosurgical management of cerebrospinal tumors. This field requires further research focused on areas clinically essential in improving the outcome that is also economically feasible for clinical use. The authors suggest that data analysts and neurosurgeons collaborate to explore the full potential of AI.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권5호
• /
• pp.2051-2054
• /
• 2015

Background: Radiation therapy is a key part of the combined modality treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), which can achieve locoregional control of disease. The 3D-conformal radiation oncology can be extended-field (EFRT), involved-field (IFRT) and involved node (INRT). New techniques have resulted in a smaller radiation field and lower dose for critical organs such as lung heart and breast. Materials and Methods: In our research, we made a virtual simulation for one patient who was treated in four different radiotherapeutic techniques: mantle field (MFRT), EFRT, IFRT and INRT. After delineatiion we compared dose-volume histograms for each technique. The fusion of CT for planning radiotherapy with the initial PET/CT was made using Softver Xio 4.6 in the Focal program. The dose for all four techniques was 36Gy. Results: Our results support the use of PET/CT in radiation therapy planning. With IFRT and INRT, the burden on the organs at risk is less than with MFRT and EFRT. On the other hand, the dose distribution in the target volume is much better with the latter. Conclusions: The aim of modern radiotherapy of HL and NHL is to reduce the intensity of treatment and therefore PET/CT should be used to reduce and not increase the amount of tissue receiving radiation.

• 대한의용생체공학회:의공학회지
• /
• 제20권2호
• /
• pp.155-164
• /
• 1999

본 논문에서는 화상 신호처리 및 컴퓨터 그래픽스 요소기술을 이용하여, 컴퓨터 상에서 인공고관절의 시술절차를 적용해 보기 위한 Simulated Implantation System (이하 SIS)을 소개한다 SIS는 일련의 자동화된 절차에 따라, 골반(pelvis)과의 접촉이 이루어지는 대퇴골의 상단부위인 고관절(femoral head)을 대체하는 과정을 3차원적으로 가상 수행할 수 있으며, 환자의 고관절과 인공고관절간의 정합정도를 수치적으로 해석할 수 있는 기능을 궁극적 목표로 하게 된다. 이를 위해 필수적으로 필요한 CT-Image를 이용한 고관절 영상의 3차원 재구성, 그리고 projection image글 이용한 인공고관절의 3차원 표현기법에 대해 논의하고, 각각에 대응되는 결과물들을 분석해봄으로써 현재 의공학 분야에서 절실히 요구되고 있는, 영상신호처리와 컴퓨터그래픽스를 이용한 SIS의 prototype에 대한 모습을 제시해 보고자 한다

• 대한의용생체공학회:의공학회지
• /
• 제41권4호
• /
• pp.154-164
• /
• 2020

Various simulator systems for surgery training have been developed and recently become more widely utilized with technology advancement and change in medical education adopting actively simulation-based training. The authors have developed tissue-instrument interaction modeling and graphical simulation algorithms for an arthroscopic surgery training simulator system. In this paper, we propose algorithms for basic surgical techniques, such as cutting, shaving, drilling, grasping, suturing and knot tying for rotator cuff surgery. The proposed method constructs a virtual 3-dimensional model from actual patient data and implements a real-time deformation of the surgical object model through interaction between ten types of arthroscopic surgical tools and a surgical object model. The implementation is based on the Simulation Open Framework Architecture (SOFA, Inria Foundation, France) and custom algorithms were implemented as pulg-in codes. Qualitative review of the developed results by physicians showed both feasibility and limitations of the system for actual use in surgery training.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제41권
• /
• pp.14.1-14.10
• /
• 2019

Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.

• 디지털콘텐츠학회 논문지
• /
• 제9권4호
• /
• pp.751-758
• /
• 2008

본 논문은 3D 그래픽 기술을 활용하여 사용자의 실제 모습과 같은 3D 얼굴 모델을 구현하고, 구현된 얼굴 모델을 활용하여 성형 시술 전과 후를 가상으로 비교함으로 성형수혜자의 만족도를 높이는 응용프로그램인 3D 가상 얼굴 성형 시스템에 대한 연구 및 구현이다. 사용자의 실물과 최대한 유사한 원형 3D 얼굴 모델링 제작을 위한 3D 모델링 기법과 피부를 표현하는 맵핑 기법, 그리고 데이터베이스 시스템을 사용한 얼굴 데이터의 저장 및 사용자 맞춤 가이드 시스템을 구현한다. 또한, 세부적인 미세 조정을 위한 변형 Controller를 구현하여 얼굴의 미세한 변화를 나타낼 수 있다. 본 논문에서 구현한 3D 얼굴 성형 시스템은 성형외과 등에서 사용되고 있는 이미지를 활용한 시스템에 비하여 정확성, 편리성, 만족도가 높은 결과를 보여주고 있다.

• Tuberculosis and Respiratory Diseases
• /
• 제70권1호
• /
• pp.10-20
• /
• 2011

Various diseases can diffusely involve central airways, including the trachea and main stem bronchi. Central airway abnormalities are frequently not apparent or are overlooked on chest radiographs, even though the patient may have significant symptoms. Recent advances in spiral and multi-detector computed tomography (CT) with multi-planar reconstruction and three-dimensional demonstration, including virtual bronchoscopy, allow for excellent display of central airway anatomy and abnormalities with visualization of accurate locations of lesions. Early detection and proper diagnosis of airway diseases based on various radiographic findings will help determine appropriate treatment, including surgical planning and evaluation of treatment response. Herein we describe and illustrate the imaging findings of a wide spectra of diffuse central airway diseases.

• 한국의학물리학회지:의학물리
• /
• 제32권2호
• /
• pp.50-58
• /
• 2021

Purpose: In this study, we investigated the relationship between the noise characteristics and the number of projected images in tomosynthesis using a digital phantom. Methods: The digital phantom consisted of a columnar phantom in the center of the image and a spherical phantom with a diameter of 80 pixels. A virtual scan was performed, and 128 projected images (Tomo_w/o) of the phantoms were obtained. The image noise according to the Poisson distribution was added to the projected images (Tomo_×1). Furthermore, another projected image with additional noise was prepared (Tomo_×1/2). For each dataset, we created datasets with 64 (half) and 32 (quarter) projections by removing the even-numbered images twice from the 128 (fully) projected images. Tomosynthesis images were reconstructed by filtered back projection (FBP). The modulation transfer function (MTF) was estimated using the sphere method, and the noise power spectrum (NPS) was estimated using the two-dimensional Fourier transform method. Results: The MTFs did not change between datasets, and the NPSs improved as the number of projected images increased. The noise characteristics of the Tomo_×1_half images were the same as those of the Tomo_×1/2_full. Conclusions: To achieve a reduction in the patient dose in tomosynthesis acquisition, we recommend reducing the number of projected images rather than reducing the dose per projection.