• Annals of Geriatric Medicine and Research
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• v.20 no.3
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• pp.125-130
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• 2016

Background: Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures. Methods: Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ${\geq}65years$ undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables. Results: Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group ($8.9{\pm}0.8days$) than in the usual care group ($14.2{\pm}3.7days$, p=0.006). Conclusion: This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1467-1470
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• 2008

An upper tibial opening wedge osteotomy is an operation to cure a malalignment and a degenerate arthritis. To prevent the postoperative malalignment caused by the upper tibial opening wedge osteotomy, the research to define the relationship between a Hinge Axis Angle and a Posterior Slope Angle is needed. The effect of the relationship between the hinge axis angle and the gap angle on the posterior slope angle is studied. After 3-D Compute Tomography (CT) scanning image is reconstructed, the virtual surgery is performed by the reconstructed 3-D tibia model. It was proved that the relationship between the hinge axis angle and the gap angle were constant and the simple mathematical model could be derived. To verify the suggested mathematical model, it compared with the measured data from the virtual surgery. In conclusion, while the deviation between the data from the virtual surgery and ones of the mathematical model under the gap angle<$10^{\circ}$ was less than 1%.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.484-490
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• 2018

Background: The use of three-dimensional multi-segment foot models (3D MFMs) is increasing since they have superior ability to illustrate the effect of foot and ankle pathologies on intersegmental motion of the foot compared to single-segment foot model gait analysis. However, validation of the repeatability of the 3D MFMs is important for their clinical use. Although many MFMs have been validated in normal adults, research on MFM repeatability in children is lacking. The purpose of this study is to validate the intrasession, intersession, and interrater repeatability of an MFM with a 15-marker set (DuPont foot model) in healthy children. Methods: The study included 20 feet of 20 healthy children (10 boys and 10 girls). We divided the participants into two groups of 10 each. One group was tested by the same operator in each test (intersession analysis), while the other group was tested by a different operator in each test (interrater analysis). The multiple correlation coefficient (CMC) and intraclass correlation coefficient (ICC) were calculated to assess repeatability. The difference between the two sessions of each group was assessed at each time point of gait cycle. Results: The intrasession CMC and ICC values of all parameters showed excellent or very good repeatability. The intersession CMC of many parameters showed good or better repeatability. Interrater CMC and ICC values were generally lower for all parameters than intrasession and intersession. The mean gaps of all parameters were generally similar to those of the previous study. Conclusions: We demonstrated that 3D MFM using a 15-marker set had high intrasession, intersession, and interrater repeatability in the assessment of foot motion in healthy children but recommend some caution in interpreting the hindfoot parameters.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.366-375
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• 2001

Bone shaving for surgical correction is general method in facial asymmetrical patient with fibrous dysplasia. Therefore, decision of bone shaving amount on the preoperative planning is very difficult for improvement of ideal occlusal relationship and harmonious face. Preoperative planning of facial asymmetry with fibrous dysplasia is generally confirmed by the simulation surgery based on evaluation of clinical examination, radiographic analysis and analysis of facial study model. However, the accurate postoperative results can not be predicted by this method. By using the computed tomography based RP(rapid prototyping) model, simulation of facial skeleton can be duplicated and 3-dimensional simmulation surgery can be perfomed. After fabrication of postoperative study model by preoperactive bone shaving, preoperative and postoperactive surgical index was made by omnivaccum and clear acrylic resin. Amount of bone shaving is confirmed by superimposition of surgical index at the operation. We performed the surgical correction of facial asymmetry patients with fibrous dysplasia using surgical index and prototyping model and obtained the favorable results.

• The Journal of Korea Robotics Society
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• v.3 no.1
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• pp.58-67
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• 2008

This study developed a novel augmented reality interface for minimally invasive surgery. The augmented reality technique can alleviate the sensory feedback problem inherent to laparoscopic surgery. An augmented reality system merges real laparoscope image and reconstructed 3D patient model based on diagnostic medical image such as CT, MRI data. By using reconstructed 3D patient model, AR interface could express structure of patient body that is invisible outside visual field of laparoscope. Therefore, an augmented reality system improved sight information of limited laparoscope. In our augmented reality system, the laparoscopic view is located at the center of a wide-angle concave screen and reconstructed 3D patient model is displayed outside the laparoscope. By using a joystick, the laparoscopic view and the reconstructed 3D patient model view are changed concurrently. With our augmented reality system, the surgeon can see the peritoneal cavity from a wide angle of view, without having to move the laparoscope. Since the concave screen serves immersive environments, the surgeon can feel as if she is in the patient body. For these reasons, a surgeon can recognize easily depth information about inner parts of patient and position information of surgical instruments without laparoscope motion. It is possible for surgeon to manipulate surgical instruments more exact and fast. Therefore immersive augmented reality interface for minimally invasive surgery will reduce bodily, environmental load of a surgeon and increase efficiency of MIS.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.633-638
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• 2010

Purpose: Orbital bone is one of the most complex bones in the human body. When the patient has a fracture of the orbital bone, it is difficult for the surgeon to restore the fractured orbital bone to normal anatomic curvature because the orbital bone has complex curvature. We developed a rapid prototyping model based on a mirror image of the patient's 3D-CT (3 dimensional computed tomography) for accurate reduction of the fractured orbital wall. Methods: A total of 7 cases of large orbital wall fracture recieved absorbable plate prefabrication using rapid prototyping model during surgery and had the manufactured plate inserted in the fracture site. Results: There was no significant postoperative complication. One patient had persistent diplopia, but it was resolved completely after 5 weeks. Enophthalmos was improved in all patients. Conclusion: With long term follow-up, this new method of orbital wall reduction proved to be accurate, efficient and cost-effective, and we recommend this method for difficult large orbital wall fracture operations.

• Korean Journal of Cleft Lip And Palate
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• v.14 no.1_2
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• pp.45-56
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• 2011

Face transplantation has been reported over the last six years, and it started in 2004 with the announcement of Cleveland Clinic granting the world's first IRB approval to proceed with human face transplantation. Composite tissue allografts (CTAs) in the facial region are considered to be more immunogenic than other solid organ transplants, so these kinds of animal experiments were also considered as challengeable activities to the facial reconstructive surgeons. For the better understanding of CTAs in the oral and maxillofacial fields, we reviewed several recent articles about facial composite transplantation animal model, and summarized some knowledges of composite midface allotransplantation model with sensory and motor reinnervation in this review article.

• Journal of the Korean Society of Visualization
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• v.19 no.3
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• pp.115-122
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• 2021

Oral cancer surgery typically consists of resection of lesion, neck dissection and reconstruction, and it has an impact on the position of hyoid bone. Therefore, morphological change of airway can occur since the geometric parameter of airway is correlated with the hyoid bone. Airflow is affected by geometry of the airway. In this study, flow characteristics were compared between pre- and post-surgery models by both particle image velocimetry (PIV) and numerical simulation. 3D model of upper airway was reconstructed based on CT data. Velocity is accelerated by the reduced channel area, and vortex and recirculation region are observed in pre- and post-surgery models. For the post-surgery model, high pressure distribution is developed by significantly decreased hydraulic diameter, and the longitudinal flow stream is also interrupted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.5
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• pp.555-561
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• 2008

Purpose: The goal of this study was to develop a technique for creating a computerized composite maxillofacial-dental model, based on point-based surface best fit algorithm and to test its accuracy. The computerized composite maxillofacial-dental model was made by the three dimensional combination of a 3-dimensional (3D) computed tomography (CT) bone model with digital dental model. Materials and Methods: This integration procedure mainly consists of following steps : 1) a reconstruction of a virtual skull and digital dental model from CT and laser scanned dental model ; 2) an incorporation of dental model into virtual maxillofacial-dental model by point-based surface best fit algorithm; 3) an assessment of the accuracy of incorporation. To test this system, CTs and dental models from 3 volunteers with cranio-maxillofacial deformities were obtained. And the registration accuracy was determined by the root mean squared distance between the corresponding reference points in a set of 2 images. Results and Conclusions: Fusion error for the maxillofacial 3D CT model with the digital dental model ranged between 0.1 and 0.3 mm with mean of 0.2 mm. The range of errors were similar to those reported elsewhere with the fiducial markers. So this study confirmed the feasibility and accuracy of combining digital dental model and 3D CT maxillofacial model. And this technique seemed to be easier for us that its clinical applicability can good in the field of digital cranio-maxillofacial surgery.

• Archives of Plastic Surgery
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• v.43 no.4
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• pp.379-381
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• 2016