• KSII Transactions on Internet and Information Systems (TIIS)
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• 제15권7호
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• pp.2455-2475
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• 2021

Patient Navigation Program (PNP) is considered as an important implementation of health care systems that can assist in patient's treatment. Due to the feasibility of PNP implementation, a systematic reuse is needed for a wide adoption of PNP computerized system. SPL is one of the promising systematic reuse approaches for creating a reusable architecture to enabled reuse in several similar applications of PNP systems which has its own variations with other applications. However, stakeholder decision making which result from the imprecise, uncertain, and subjective nature of architecture selection based on quality attributes (QA) further hinders the development of the product line architecture. Therefore, this study aims to propose a quality-driven approach using Multi-Criteria Decision Analysis (MCDA) techniques for Software Product Line Architecture (SPLA) to have an objective selection based on the QA of stakeholders in the domain of PNP. There are two steps proposed to this approach. First, a clear representation of quality is proposed by extending feature model (FM) with QA feature to determine the QA in the early phase of architecture selection. Second, MCDA techniques were applied for architecture selection based on objective preference for certain QA in the domain of PNP. The result of the proposed approach is the implementation of the PNP system with SPLA that had been selected using MCDA techniques. Evaluation for the approach is done by checking the approach's applicability in a case study and stakeholder validation. Evaluation on ease of use and usefulness of the approach with selected stakeholders have shown positive responses. The evaluation results proved that the proposed approach assisted in the implementation of PNP systems.

• 임상이비인후과
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• 제29권2호
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• pp.269-275
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• 2018

Nasal valve compromise (NVC) is a distinct cause of symptomatic nasal obstruction, yet there are several ambiguities surrounding the diagnosis and management of this disease. Understanding of nasal valve anatomy with critical assessment of the site of obstruction is essential to effective nasal valve management. Technique selection should be individualized to the type of valve dysfunction. This case report presents a 56 year old man with nasal valve dysfunction due to narrow middle vault, concave lower lateral cartilage and swollen septal body which was diagnosed by various techniques including navigation system and treated by spreader graft, alar batten graft and reduction of septal body.

• 전자공학회논문지
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• 제53권1호
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• pp.118-125
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• 2016

본 논문에서는 얼굴 영역 수술용 네비게이션을 위한 스테레오 비전과 CT 영상을 이용하여 환자-영상 간 정합(Image to patient registration) 알고리즘의 성능을 평가한다. 환자 영상 간 정합은 스테레오 비전 영상의 특징점 추출과 이를 통한 3차원 좌표 계산, 3차원 좌표와 3차원 CT 영상과의 정합 과정을 거친다. 스테레오 비전 영상에서 3가지 얼굴 특징점 추출 방법과 3가지 정합 방법을 사용하여 생성될 수 있는 5가지 조합 중 정합 정확도가 가장 높은 방법을 평가한다. 또한 머리의 회전에 따라 환자 영상 간 정합의 정확도를 비교한다. 실험을 통해 머리의 회전 각도가 약 20도의 범위 내에서 Active Appearance Model과 Pseudo Inverse Matching을 사용한 정합의 정확도가 가장 높았으며, 각도가 20도 이상일 경우 Speeded Up Robust Features와 Iterative Closest Point를 사용하였을 때 정합 정확도가 높았다. 이 결과를 통해 회전각도가 20도 범위 내에서는 Active Appearance Model과 Pseudo Inverse Matching 방법을 사용하고, 20도 이상의 경우 Speeded Up Robust Features와 Iterative Closest Point를 이용하는 것이 정합의 오차를 줄일 수 있다.

• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.154-156
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• 2005

We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.237-247
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• 2020

Objective : Fixation of the C1-2 segment is challenging because of the complex anatomy in the region and the need for a high degree of accuracy to avoid complications. Preoperative 3D-computed tomography (CT) scans can help reduce the risk of complications in the vertebral artery, spinal cord, and nerve roots. However, the patient may be susceptible to injury if the patient's anatomy does not match the preoperative CT scans. The intraoperative 3D image-based navigation systems have reduced complications in instrument-assisted techniques due to greater accuracy. This study aimed to compare the radiologic outcomes of C1-2 fusion surgery between intraoperative CT image-guided operation and fluoroscopy-guided operation. Methods : We retrospectively reviewed the radiologic images of 34 patients who underwent C1-2 fusion spine surgery from January 2009 to November 2018 at our hospital. We assessed 17 cases each of degenerative cervical disease and trauma in a study population of 18 males and 16 females. The mean age was 54.8 years. A total of 139 screws were used and the surgical procedures included 68 screws in the C1 lateral mass, 58 screws in C2 pedicle, nine screws in C2 lamina and C2 pars screws, four lateral mass screws in sub-axial level. Of the 34 patients, 19 patients underwent screw insertion using intraoperative mobile CT. Other patients underwent atlantoaxial fusion with a standard fluoroscopy-guided device. Results : A total of 139 screws were correctly positioned. We analyzed the positions of 135 screws except for the four screws that performed the lateral mass screws in C3 vertebra. Minor screw penetration was observed in seven cases (5.2%), and major pedicle screw penetration was observed in three cases (2.2%). In one case, the malposition of a C2 pedicle screw was confirmed, which was subsequently corrected. There were no complications regarding vertebral artery injury or onset of new neurologic deficits. The screw malposition rate was lower (5.3%) in patients who underwent intraoperative CT-based navigation than that for fluoroscopy-guided cases (10.2%). And we confirmed that the operation time can be significantly reduced by surgery using intraoperative O-arm device. Conclusion : Spinal navigation using intraoperative cone-beam CT scans is reliable for posterior fixation in unstable C1-2 pathologies and can be reduced the operative time.

• 대한두개안면성형외과학회지
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• 제25권4호
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• pp.161-170
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• 2024

Background: The eyes are the central aesthetic unit of the face. Maxillofacial trauma can alter facial proportions and affect visual function with varying degrees of severity. Conventional approaches to reconstruction have numerous limitations, making the process challenging. The primary objective of this study was to evaluate the application of three-dimensional (3D) navigation in complex unilateral orbital reconstruction. Methods: A prospective cohort study was conducted over 19 months (January 2020 to July 2021), with consecutive enrollment of 12 patients who met the inclusion criteria. Each patient was followed for a minimum period of 6 months. The principal investigator carried out a comparative analysis of several factors, including fracture morphology, orbital volume, globe projection, diplopia, facial morphic changes, lid retraction, and infraorbital nerve hypoesthesia. Results: Nine patients had impure orbital fractures, while the remainder had pure fractures. The median orbital volume on the normal side (30.12 cm³; interquartile range [IQR], 28.45-30.64) was comparable to that of the reconstructed orbit (29.67 cm³; IQR, 27.92-31.52). Diplopia improved significantly (T(10)= 2.667, p= 0.02), although there was no statistically significant improvement in globe projection. Gross symmetry of facial landmarks was achieved, with comparable facial width-to-height ratio and palpebral fissure lengths. Two patients reported infraorbital hypoesthesia at presentation, which persisted at the 6-month follow-up. Additionally, five patients developed lower lid retraction (1-2 mm), and one experienced implant impingement at the infraorbital border. Conclusion: Our study provides level II evidence supporting the use of 3D navigation to improve surgical outcomes in complex orbital reconstruction.

• Brain Tumor Research and Treatment
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• 제6권2호
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• pp.78-81
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• 2018

Gliosarcoma (GS), known as variant of glioblastoma multiforme, is aggressive and very rare primary central nervous system malignant neoplasm. They are usually located in the supratentorial area with possible direct dural invasion or only reactive dural thickening. However, in this case, GS was located in lateral side of left posterior cranial fossa. A 78-year-old man was admitted to our hospital with 3 month history of continuous dizziness and gait disturbance without past medical history. A gadolinium-enhanced MRI demonstrated $5.6{\times}4.8{\times}3.2cm$ sized mass lesion in left posterior cranial fossa, heterogeneously enhanced. The patient underwent left retrosigmoid craniotomy with navigation system. The tumor was combined with 2 components, whitish firm mass and gray colored soft & suckable mass. On pathologic report, the final diagnosis was GS of WHO grade IV. In spite of successful gross total resection of tumor, we were no longer able to treat because of the patient's rejection of adjuvant treatment. The patient survived for nine months without receiving any special treatment from the hospital.

• 한국항행학회논문지
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• 제13권5호
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• pp.787-792
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• 2009

최근 유망한 응용분야 중 U-Health와 건강 모니터링에 관심이 집중되고 있다. 이는 무선통신과 의료장비를 접목하여 원거리에서 환자의 상태를 관찰할 수 있기 때문이다. 만약 긴급 상황이 발생한다면, 빨리 대처하기 위한 것이다. 본 논문에서는 블루투스를 탑재한 의료정보 전송 시스템과 새로운 데이터 포맷을 제안한다. 이 시스템은 각기 독립적으로 존재하는 개인 의료측정 장비 중 혈압과 혈당 측정기를 통합하였고, 통합 혈압 혈당 단말기에 블루투스 모듈을 탑재하였다. 그리고 블루투스 통신에 의해 수집된 의료 정보는 유선망을 통하여 의료서버로 전송된다. 제작된 원격의료정보 전송시스템을 실험실 환경에서 테스트하여 그 성능을 평가하였고 우수한 성능을 확인하였다.

• 한국항행학회논문지
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• 제19권5호
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• pp.458-463
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• 2015

본 논문에서는 IEEE 802.15.4 기반 무선 센서 네트워크와 압력패드와 가드센서를 이용하여 병실 내 환자의 동작을 감지하는 시스템을 개발 하였다. 이 시스템은 주간에 환자의 일상적인 활동 뿐 만 아니라 특히 야간 취침 시에 발생하는 낙상 사고 감지를 위해 설계 되었다. 환자의 침대에 설치된 노드는 압력 패드 및 가드 센서에서 환자의 활동 및 낙상을 감지하여 게더로 송신하고 게더에 수신된 데이터는 TCP/IP 통신으로 업무 지원 센터의 모니터로 보내도록 하였다. 이때 압력 패드 및 가드 센서가 on, off 동작 시에 발생하는 스위치 채터링 현상을 방지하기 위해 타이머를 사용 하였다. 그리고 통신 모듈의 송신 파워를 조절하여 병실의 다양한 환경에서 적용이 가능 하도록 구성 하였으며 수집된 데이터를 바탕으로 간호사가 실시간으로 병상의 환자 상태를 확인하고 관리 할 수 있게 하였다.

• 한국항행학회논문지
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• 제15권6호
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• pp.1152-1162
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• 2011

본 논문에서는 등장성 수축(isotonic contraction)시 연령에 따른 변화의 추이 등을 알아보기 위해 일상생활에서 주로 사용하는 대퇴사두근의 근 활성도(muscle activity)와 근 피로도(muscle fatigue) 해석에 관한 연구를 하였다. 실험은 남자 20대와 50대 각 10명씩을 대상으로 무릎 확장운동으로 각 피 실험자가 할 수 있는 최대 부하(1RM)를 측정한 다음 그 부하의 20-90%부하를 차례로 증가 시키면서 대퇴사두근(Quadriceps Femoris :QF)은 내측광근(vastus medialis : VM), 대퇴직근(rectus femoris : RF), 외측광근(vastus lateralis : VL) 등을 각각 근전도 신호를 추출하고, 수축, 이완모드에서 각속도를 측정하였다. 20대와 50대의 속도를 비교분석한 결과 대퇴사두근의 20대 근육에서는 (p < 0.89)로 50대에서는 (p < 0.70)로 유의차가 없는 것으로 나타났다. 생체 동역학 연구와 체육 분야의 선수 훈련방법, 산업분야에서 상해방지와 근육부상방지, 재활의약분야의 부상치료 등에 응용할 수 있을 것으로 사료된다.