• Title/Summary/Keyword: Clinical Simulator

검색결과 94건 처리시간 0.042초

초음파 치료의 효율성 향상을 위한 초음파 온열 시뮬레이터 개발 (The Development of Ultrasonic Hyperthermia Simulator to Improve the Efficiency of Ultrasonic Therapy)

  • 유우진;노시철;정동환;박재현;최민주;최흥호
    • 대한의용생체공학회:의공학회지
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    • 제30권5호
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    • pp.418-427
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    • 2009
  • As many people are westernizing their life style and food consumption habits, a number of patients who have malignant tumors which grow very rapidly and hazardously destroy the human body are increasing. Ultrasonic hyperthermia is not only one of the tumor treatment methods which employs the non-radioactive ultrasonic waves to increase the temperature at the tumor region up to $40\sim45^{\circ}C$ to destroy and suppress tumor cells but also has been proved by many studies. Due to the rapid development of High Intensity Focused Ultrasound(HIFU), the ultrasound hyperthemia extensively boosts its applications in clinical field. For those reasons, Computed simulation factor should be needed before inspection to patients. To prove efficiency of ultrasonic hyperthermia, precise acoustic field measurement considering tissue characteristics and a heating experiment with tissue mimicking material phantom were conducted for effectiveness of simulation program. Finally, in this study, the computer simulation program verified the anticipated temperature effects induced by ultrasound hyperthermia. In the near future, it is hoped that this simulation program could be utilized to improve the efficiency of ultrasound hyperthermia.

사용 편의성과 소형화 기반의 맥파 측정장치 개발 (Development of Pulse Analysis System Based on Convenience and Compactness)

  • 조정희;배장한;김영민;전민호;양태헌;전영주
    • 대한의용생체공학회:의공학회지
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    • 제38권4호
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    • pp.168-174
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    • 2017
  • To improve and downsize the KIOM-Pulse Analysis System(KIOM-PAS), which has been traditionally used in clinical trials, a miniaturized PAS(M-PAS) with a pneumatic pump has been developed. M-PAS is composed of a measurement module and an arm-mounting module, on which an arm can be placed. The measurement module is equipped with a pressing component and sensor, which is a wearable wristband. The arm-mounting module includes a pneumatic motor, data acquisition board and valves. In addition, the measurement module is divided into a fixing module of band type for attachment to a pulsation site and a sensing module, which includes a sensor and a tube. The fixing module and sensing module are constructed independently, and the detachable fastening method improves the posture convenience of the subject during measurement. M-PAS has been reduced to 1/6 the size of KIOM-PAS, and the measurement time is shortened by 22%. Using a simulator, the difference between the waveforms measured by the two devices exhibited a high degree of similarity of within 3.65%. M-PAS represents improvements in size and convenience compared with KIOM-PAS, and it is expected to be widely used in clinics in the future because it improves the attachment method of the fixing module.

두경부암 환자 치료시 3차원 보상체의 임상 적용에 대한 고찰 (Clinical Application of 3-D Compensator in Head and Neck Cancer)

  • 홍동기;이정우;이두현;박광호;김정만
    • 대한방사선치료학회지
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    • 제9권1호
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    • pp.64-70
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    • 1997
  • The goal of radiation treatment planning is to deliver the dose to the patient within $5\%$ of that prescribed. We have often encountered the situation that the area which have not only several irregular contours but also tissue heterogeneities should be treated. With conventional devices such as wedges, missing tissue compensator. there are some limitations to achieve the uniform dose distribution in treatment volume. The use of CT simulator, 3-D planning system, computer-controlled milling machine enables it to deliver the dose uniformally. This report includes the whole procedure which have patient data acquisition 3D planning, computer-controlled milling, performance verification of 3D compensator, and TLD evaluation. We applied it for the treatment of head and heck cancer only. In Spite of the irregular contour and different electron density of tessue, we have achieved the uniformity of the dose distribution within ${\pm}3\%$ relatively. Although there are some problems which are not only verification of performance but uncertainties of using the new treatment device, we believe that the improvement of dosimetry will eliminate the uncertainties of that application. so the other lesions besides head and neck can will be ale to use the 3D compensator to achieve the dose uniformity

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Influence of zirconia and lithium disilicate tooth- or implant-supported crowns on wear of antagonistic and adjacent teeth

  • Rosentritt, Martin;Schumann, Frederik;Krifka, Stephanie;Preis, Verena
    • The Journal of Advanced Prosthodontics
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    • 제12권1호
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    • pp.1-8
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    • 2020
  • PURPOSE. To investigate the influence of crown material (lithium-disilicate, 3Y-TZP zirconia) and abutment type (rigid implant, resin tooth with artificial periodontium) on wear performance of their antagonist teeth and adjacent teeth. MATERIALS AND METHODS. A mandibular left first molar (#36) with adjacent human teeth (mandibular left second premolar: #35, mandibular left second molar: #37) and antagonistic human teeth (maxillary left second premolar: #25, maxillary left first molar: #26, maxillary left second molar: #27) was prepared simulating a section of the jaw. Samples were made with extracted human molars (Reference), crowned implants (Implant), or crowned resin tooth analogues (Tooth). Crowns (tooth #36; n = 16/material) were milled from lithium-disilicate (Li, IPS e.max CAD) or 3Y-TZP zirconia (Zr, IPS e.max ZirCAD, both Ivoclar Vivadent). Thermal cycling and mechanical loading (TCML) in the chewing simulator were applied simulating 15 years of clinical service. Wear traces were analyzed (frequency [n], depth [㎛]) and evaluated using scanning electron pictures. Wear results were compared by one-way-ANOVA and post-hoc-Bonferroni (α = 0.05). RESULTS. After TCML, no visible wear traces were found on Zr. Li showed more wear traces (n = 30-31) than the reference (n = 21). Antagonistic teeth #26 showed more wear traces in contact to both ceramics (n = 27-29) than to the reference (n = 21). Strong wear traces (> 350 ㎛) on antagonists and their adjacent teeth were found only in crowned groups. Abutment type influenced number and depth of wear facets on the antagonistic and adjacent teeth. CONCLUSION. The clinically relevant model with human antagonistic and adjacent teeth allowed for a limited comparison of the wear situation. The total number of wear traces and strong wear on crowns, antagonistic and adjacent teeth were influenced by crown material.

인공발목관절의 표면 마모 특성 (Surface Tribology of Total Ankle Joint Replacement)

  • Jeong, Yong-Hoon;Jung, Tae-Gon;Yang, Jae-Woong;Park, Kwang-Min;Lee, Su-Won
    • 한국표면공학회:학술대회논문집
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    • 한국표면공학회 2016년도 추계학술대회 논문집
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    • pp.117-117
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    • 2016
  • Total ankle replacement (TAR) is a visible option in the surgical treatment of degenerative or inflammatory diseases of ankle joint. it is attributed to the current TAR which has improvements in surgical technique, uncemented implant fixation and minimally constrained articulation. In the clinical result, they can show promised surgical result when compared to earlier attempts in TAR. However, TAR is still not as successful as total knee replacement (TKR) or total hip replacement (THR), it needs to be note that there are limitations in concerning of long term performance of TAR, the high failure rate still associated with wear of the PE (polyethylene) component that has related with their material property and surface roughness. The aim of this study was to introduce the tribology characteristics of total ankle joint prosthesis with one of TDR model which was fabricated to try multi-axis wear test as a region of motion in ankle joint. The wear specimen of TDR was prepared with Ti-6Al-4V alloy and UHMWPE (ultra-high molecular weight polyethylene) for tibia-talus and bearing component, respectively. A wear test was carried out using a Force 5 (AMTI, Massachusetts, US) wear simulator which can be allowed to move in three axis to flexion-extension ($+3^{\circ}{\sim}-6^{\circ}$), internal-external axial rotation (${\pm}5^{\circ}$), as well as sinusoidal compressive load (1.6 kN, R=10). All tests were performed following standard ISO 14243, wear rate was calculated with weight loss of UHMWPE bearing while the specimen has tested at certain cycles. As based on the preliminary results, wear rate of UHMWPE bearing was $7.9{\times}10^{-6}mg/cycles$ ($R^2=0.86$), calculated loss weight until $10^7cycles$ was 79 mg, respectively.

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홈 헬스케어에 적용 가능한 하부요로계 폐색 모니터링 시스템 구현 및 평가 (Implementation and Estimation of the LUTS Diagnosis System for Home Health Care)

  • 정도운;정완영;전계록
    • 한국정보통신학회:학술대회논문집
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    • 한국해양정보통신학회 2006년도 춘계종합학술대회
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    • pp.697-700
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    • 2006
  • 본 연구에서는 가정이나 일반 사무실 등에서 편리하게 하부요로계의 폐색을 진단하기 위하여 요속과 동시에 배뇨 시 발생하는 요류음을 계측할 수 있는 센서 및 계측 시스템을 구현하였다. 구현된 시스템은 로드셀을 이용한 요속계측센서, 청진기형 요류음 계측센서, 센서신호의 검출을 위한 전처리부, 신호의 증폭 및 필터부, 시스템 제어부, PC 계측 프로그램 등으로 구성되었다. 구현된 시스템의 평가를 위하여 하부요로계를 모식화한 실험장치를 구현하였다. 구현된 실험장치를 이용하여 요속 및 요음을 계측하고 시간영역과 주파수영역에서의 분석을 통해 하부요로계의 폐색을 가장 잘 반영하는 특징파라미터를 추출하고자 하였다. 그리고 구현된 시스템의 임상적용 가능성을 평가하기 위하여 정상인 5병을 대상으로 요속 및 요류음을 계측하고 분석하였다. 그 결과 요류음 신호의 $253\sim282Hz$ 대역이 폐색의 정도를 가장 잘 반영하는 것으로 나타났다.

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CBCT와 Simulation CT를 이용한 치료계획의 선량비교 (Comparison of using CBCT with CT Simulator for Radiation dose of Treatment Planning)

  • 김대영;최지원;조정근
    • 한국콘텐츠학회논문지
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    • 제9권12호
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    • pp.742-749
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    • 2009
  • 최근의 방사선치료용 선형가속기에 부착된 진단용 kV 에너지 영역의 X선 선원과 아모퍼스 실리콘(a-Si)의 검출기로 구성된 온보드영상장치(OBI)를 이용하여 콘빔 전산화단층촬영 영상(CBCT)획득이 가능하다. CBCT영상을 이용하여 치료계획을 세우게 되면 치료실에서 CT영상 촬영이 가능해짐으로써 고식적 치료환자들의 부담이 많이 감소될 수 있고 더 나아가 선량을 재계산하여 치료과정 중 치료계획 재수립도 가능하다. 본 연구에서는 CBCT를 이용한 치료계획과 기존의 모의치료용 CT를 이용한 치료계획을 비교 연구 함으로서 CBCT영상만으로 광자선 선량계산이 정확한지를 평가하고 임상에서 고식적방사선치료를 목적으로 하는 환자들을 대상으로 온라인 방사선치료계획의 가능성을 연구하였다. 선량계산에 필요한 CT수와 밀도간의 상호관계 확인을 위하여 Catphan 600 팬텀을 이용하여 교정곡선을 산출하였고 팬텀과 환자들의 모의 치료용 CT영상과 CBCT영상을 획득하여 치료계획 및 선량계산 된 결과를 비교하였다. CBCT 영상을 이용한 치료계획에서의 MU차이는 중심점에 100cGy 처방하였을 때 Phantom에서의 경우 3~4MU로 약 2.7%, 환자에서의 경우 1~3MU로 약 2.5% 이하로 차이가 났다. 팬텀과 환자에서의 Monitor unit(MU)차이는 2.7%, 2.5% 이내였으나, CBCT영상의 경우 검출기의 크기의 제약 및 환자의 불수의적인 움직임에 의하여 전자밀도가 큰 물질에서 산란선과 artifact의 발생이 크게 증가한다. 따라서 뇌 및 폐 영역의 치료계획시 선량의 오차가 더 커질 수 있어 이에 대한 주의가 요구된다. 치료시작 전 CBCT 영상을 획득하여 환자의 자세와 내부 장기의 위치를 보정하고 선량을 재계산하여 치료계획을 재수립하는 적응방사선치료(ART)를 시행하기 위해서는 산란선과 움직임에 의한 artifact의 감소방안이 마련되어야 할 것으로 사료된다.

CBCT와 Simulation CT를 이용한 치료계획의 선량비교 (Comparison of using CBCT with CT simulator for radiation dose of treatment planning)

  • 조정근;김대영;한태종
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2009년도 춘계 종합학술대회 논문집
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    • pp.1159-1166
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    • 2009
  • 최근의 방사선치료용 선형가속기에 부착된 진단용 kV 에너지 영역의 X선 선원과 아모퍼스 실리콘(a-Si)의 검출기로 구성된 온보드영상장치(OBI)를 이용하여 콘빔 전산화단층촬영 영상(CBCT)획득이 가능하다. CBCT영상을 이용하여 치료계획을 세우게 되면 치료실에서 CT영상 촬영이 가능해짐으로써 고식적 치료 환자들의 부담이 많이 감소 될 수 있고 더 나아가 선량을 재계산하여 치료과정 중 치료계획 재수립도 가능하다. 본 연구에서는 CBCT를 이용한 치료계획과 기존의 모의치료용 CT를 이용한 치료계획을 비교 연구 함으로서 CBCT영상만으로 광자선 선량계산이 정확한지를 평가하고 임상에서 고식적방사선치료를 목적으로 하는 환자들을 대상으로 온라인 방사선치료계획의 가능성을 연구하였다. 선량계산에 필요한 CT수와 밀도간의 상호관계 확인을 위하여 Catphan 600 팬텀을 이용하여 교정곡선을 산출하였고 팬텀과 환자들의 모의치료용 CT영상과 CBCT영상을 획득하여 치료계획 및 선량계산 된 결과를 비교하였다. CBCT 영상을 이용한 치료계획에서의 MU차이는 중심점에 100cGy 처방하였을 때 Phantom에서의 경우 3~4MU로 약 2.7%, 환자에서의 경우 1~3MU로 약 2.5% 이하로 차이가 났다. 팬텀과 환자에서의 Monitor unit(MU)차이는 2.7%, 2.5% 이내였으나, CBCT영상의 경우 검출기의 크기의 제약 및 환자의 불수의적인 움직임에 의하여 전자밀도가 큰 물질에서 산란선과 artifact의 발생이 크게 증가한다. 따라서 뇌 및 폐 영역의 치료계획시 선량의 오차가 더 커질 수 있어 이에 대한 주의가 요구된다. 치료시작 전 CBCT 영상을 획득하여 환자의 자세와 내부 장기의 위치를 보정하고 선량을 재계산하여 치료 계획을 재수립하는 적응방사선치료(ART)를 시행하기 위해서는 산란선과 움직임에 의한 artifact의 감소방안이 마련되어야 할 것으로 사료된다.

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Analysis and Examination of Trends in Research on Medical Learning Support Tools: Focus on Problem-based Learning (PBL) and Medical Simulations

  • Yea, Sang-Jun;Jang, Hyun-Chul;Kim, An-Na;Kim, Sang-Kyun;Song, Mi-Young;Han, Chang-Hyun;Kim, Chul
    • 대한한의학회지
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    • 제33권4호
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    • pp.60-68
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    • 2012
  • Objectives: By grasping trends in research, technology, and general characteristics of learning support tools, this study was conducted to present a model for research on Korean Medicine (KM) to make use of information technology to support teaching and learning. The purpose is to improve the future clinical competence of medical personnel, which is directly linked to national health. Methods: With papers and patents published up to 2011 as the objects, 438 papers were extracted from "Web of Science" and 313 patents were extracted from the WIPS database (DB). Descriptive analysis and network analysis were conducted on the annual developments, academic journals, and research fields of the papers, patents searched were subjected to quantitative analysis per application year, nation, and technology, and an activity index (AI) was calculated. Results: First, research on medical learning support tools has continued to increase and is active in the fields of computer engineering, education research, and surgery. Second, the largest number of patent applications on medical learning support tools were made in the United States, South Korea, and Japan in this order, and the securement of remediation technology-centered patents, rather than basic/essential patents, seemed possible. Third, when the results of the analysis of research trends were comprehensively analyzed, international research on e-PBL- and medical simulation-centered medical learning support tools was seen to expand continuously to improve the clinical competence of medical personnel, which is directly linked to national health. Conclusions: The KM learning support tool model proposed in the present study is expected to be applicable to computer-based tests at KM schools and to be able to replace certain functions of national KM doctor license examinations once its problem DB, e-PBL, and TKM simulator have been constructed. This learning support tool will undergo a standardization process in the future.

자율신경계의 활성도 측정을 위한 Data Acquisition System의 개발 및 임상응용 (Development of Data Acquisition System for Quantification of Autonomic Nervous System Activity and It's Clinical Use)

  • 신동구;박종선;김영조;심봉섭;이상학;이준하
    • Journal of Yeungnam Medical Science
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    • 제18권1호
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    • pp.39-50
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    • 2001
  • 본 연구는 여러 가지 질병의 원인을 규명하는데 있어서 자율신경계 역할의 중요성을 인식하여 심전도 및 호흡신호의 변이를 이용하여 자율신경계를 감시할 수 있는 시스템을 개발하였다. 본 연구에서 제작된 증폭기에서는 트랜스를 사용하여 교류전원으로부터 환자를 격리시키고, 30 KHz의 고주파를 이용하여 임피던스법에 의한 호흡신호를 심전도와 동시에 처리할 수 있도록 하였으며, 아울러 서로의 채널에 대한 혼신의 영향을 최소화하도록 회로를 설계하였다. 시뮬레이터에 의한 테스트 결과에서 입력 조건에 따라 증폭기의 출력에 나타나는 시간 간격이 일치하게 나타나는 것을 확인하였다. 또 실제 서로 다른 조건을 가진 세 부류의 임상 환자의 심전도에서 R-R interval 및 호흡신호를 측정하여 추출할 수 있었다. 기존에는 주로 생체 신호 파라미터를 각각 측정하여 그 결과를 추출하였으나 본 연구에서는 R-R interval과 respiration의 파라미터를 통합하여 데이터를 수집, 처리함으로써 환자로부터 얻은 데이터를 임상 응용에 보다 효과적으로 적용할 수 있게 되었다. 따라서 향후 개발된 시스템의 보완을 통해 환자에 직접 적용하여 자율신경계 장애 환자에 대한 감시장치로 활용하고자 한다.

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