• 한국멀티미디어학회논문지
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• 제15권5호
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• pp.664-671
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• 2012

가상 의료 시뮬레이션을 통한 실습 교육은 학습 효과를 높이는 장점이 있기 때문에 최근 실제 의료 환경에 도입이 확대되고 있다. 특히 최소 침습적 수술 분야에서 가상 수술 의료 시뮬레이션의 필요성이 증가하고 있다. 하지만, 가상 수술 의료 시뮬레이션 환경에서 자주 발생하는 출혈 특수 효과를 현실감이 있게 표현하기 위한 출혈 애니메이션 기술은 아직까지 제안되지 않고 있다. 본 논문에서는 사실적인 실시간 출혈 애니메이션 기법을 제안한다. 제안 기법은 출혈 시뮬레이션을 위해서 주 출혈 방향 벡터 방향을 기준으로 주 출혈 영역과 유효 출혈 영역을 계산하여 자연스러운 출혈 효과의 표현이 가능하다. 또한, 출혈 렌더링을 위해서 정점들의 불투명도 값을 시그모이드 함수를 이용한 가중치 부여로 부드러운 불투명도 변화를 통하여 사실적이고, 자연스러운 출혈 애니메이션이 가능하다. 본 논문에서 제안한 기법은 가상 수술 의료 시뮬레이션의 현실감, 몰입감을 증진시켜 이러한 시뮬레이션을 사용하는 의사 혹은 의대생들에 대한 교육의 효과를 증진시킬 수 있다.

• 한국멀티미디어학회논문지
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• 제14권9호
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• pp.1175-1181
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• 2011

최근 의료 환경에 도입되고 있는 가상 의료 시뮬레이션을 통한 실습 교육은 학습 효과를 최대화한다. 특히 최소 침습적 수술 분야에서 가상 수술 의료 시뮬레이션의 필요성이 매우 증가하고 있다. 최소 침습적 수술 환경에서 많이 발생하는 소작 효과는 단순 출혈 효과로 표현되고 있어 아직까지 현실감이 있는 소작 효과 애니메이션 기술은 제안되지 않고 있다. 본 논문에서는 사실적인 실시간 소작 애니메이션 기법을 제안한 다. 제안 기법은 메쉬의 정점에 대한 칼라 값을 구성하는 각 요소 색상을 개별적으로 변화시키고, sigmoid 함수를 이용한 가중치 부여로 유효 영역 메쉬 내부의 부드러운 색상 변화를 통하여 사실적이고, 자연스러운 소작 효과의 애니메이션이 가능하였다. 또한, 소작 칼라 버퍼를 제안하여 중첩된 소작 효과 애니메이션도 자연스럽게 표현하였다. 본 논문에서 제안한 기법은 가상 수술 의료 시뮬레이션의 현실감, 몰입감을 크게 증진시켜 이러한 시뮬레이션을 사용하는 의사 혹은 의대생들에 대한 교육의 효과를 극대화시킬 수 있다.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

• Journal of International Society for Simulation Surgery
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• 제4권1호
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• pp.9-12
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• 2017

Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.

• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.52-57
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• 2015

Virtual Reality makes a virtual environment more realistic and, furthermore, it provides a variety of experiences which we cannot have in reality. A drastic growth of GPU performance and increase of computing capability make virtual environment more realistic than ever. One important element of constructing virtual environment is to animate 3D characters. Many researchers have been studying 3D characters animating and a myriad of methods have been proposed to make them more realistic. In this paper, we discuss the technologies and characteristics of 3D character animation. We believe that realistic characters in Virtual Reality will be applied to various fields: education, film and game industry, business and, particularly, medical area such as telemedicine, virtual surgery, etc.

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

• Archives of Plastic Surgery
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• 제45권5호
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• pp.395-402
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• 2018

Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors' opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established.

• Journal of International Society for Simulation Surgery
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• 제4권1호
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• pp.17-20
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• 2017

Purpose Interactive 3D visualization system through remote data transmission over heterogeneous network is growing due to the improvement of internet based real time streaming technology. Materials and Methods The current internet's IP layer has several weaknesses against IP spoofing or IP sniffing type of network attacks since it was developed for reliable packet exchange. In order to compensate the security issues with normal IP layer, we designed a remote medical visualization system, based on Virtual Private Network. Results Particularly in hospital, if there are many surgeons that need to receive the streaming information, too much load on the gateway can results in deficit of processing power and cause the delay. Conclusion End to end security through the network method would be required.

• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.90-93
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• 2015

The fibula free flap has now become the most reliable and frequently used option for mandible reconstruction. Recently, three dimensional images and printing technologies are applied to mandibular reconstruction. We introduce our recent experience of mandibular reconstruction using three dimensionally planned fibula free flap in a patient with gunshot injury. The defect was virtually reconstructed with three-dimensional image. Because bone fragments are dislocated from original position, relocation was necessary. Fragments are virtually relocated to original position using mirror image of unaffected right side of the mandible. A medical rapid prototyping (MRP) model and cutting guide was made with 3D printer. Titanium reconstruction plate was adapted to the MRP model manually. 7 cm-sized fibula bone flap was designed on left lower leg. After dissection, proximal and distal margin of fibula flap was osteotomized by using three dimensional cutting guide. Segmentation was also done as planned. The fibula bone flap was attached to the inner side of the prebent reconstruction plate and fixed with screws. Postoperative evaluation was done by comparison between preoperative planning and surgical outcome. Although dislocated condyle is still not in ideal position, we can see that reconstruction was done as planned.

• 한국정밀공학회지
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• 제27권2호
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• pp.137-144
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• 2010

In general, spinal fusion surgery takes pressure off the pain induced nerves, by restoring the alignment of the spine. Therefore spinal fixation system is used to maintain the alignment of spine. In this study, a biomechanical study was performed comparing the SROM(Spinal Range Of Motion) of three types of system such as Rigid, Dynesys, and Fused system to analyze the behavior of spinal fixation system inserted in vertebra. Dynesys system, a flexible posterior stabilization system that provides an alternative to fusion, is designed to preserve inter-segmental kinematics and alleviate loading at the facet joints. In this study, SROM of inter-vertebra with spinal fixation system installed in the virtual vertebra from L4 to S1 is estimated. To compare with spinal fixation system, a simulation was performed by BRG. LifeMOD 2005.5.0 was used to create the human virtual model of spinal fixation system. Through this, each SROM of flexion, extension, lateral bending, and axial rotation of human virtual model was measured. The result demonstrates that the movement of Dynesys system was similar to normal condition through allowing the movement of lumbar.