• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.1-15
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• 2023

Purpose : This study investigates the effectiveness of digital therapy for stroke patients in Korea. Methods : A comprehensive database search was performed using KCI, Science on, e-article, RISS, KISS and Korea OpenMed databases for randomized controlled trials (RCTs) that studied the effects of digital therapy on patients who had a stroke. This study includes RCTs published from January 2000 to July 15, 2022, which fulfilled the inclusion and exclusion criteria. A total 697 studies were screened and 30 studies were included in the final analysis. Methodological quality was assessed with the Cochrane's RoB (risk of bias) tool. Meta-analysis was performed using CMA 4.0 software. Results : A total of 56 effect sizes were calculated from the 30 selected studies. As a result of the analysis, the overall effect size of digital therapy was .59 (95 % CI=.43-.74). When classified according to type of intervention, VR (virtual reality) (g=.58, 95 % CI=.40-.75), and CACR (computer assisted cognitive rehabilitation) (g=.62, 95 % CI=.30-.95) were statistically significant. VR showed medium to large effect sizes in cognitive function (g=.78, 95 % CI=.20-1.37), psychosocial function (g=.63, 95 % CI=.20-1.07), and physical function (g=.61, 95 % CI=.38-.83). In the CACR, there was a large effect size in cognitive function (g=.84, 95 % CI=.52-1.15), but there was no significant difference in psychosocial function. Also, there was no significant difference between the two interventions in activities of daily living and no significant difference in the effect size of both interventions according to the intervention session. Furthermore, medium to large effect sizes were found for subacute and chronic stroke patients according to the duration of disease. Conclusion : This study presents evidence that digital therapy has a positive effect on various functions of stroke patients in Korea. The researchers expect to actively accept the new paradigm of digital therapy and continue to apply digital therapy in clinical practice.

• Journal of radiological science and technology
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• v.29 no.2
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• pp.83-92
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• 2006

Based on the data of cervical cancer patients who were treated by the radiotherapy with concurrent chemotherapy at the radiation oncology department of National Cancer Center from January 2002 to February 2003, we have studied the method recommended by ICRU 38 to maximize the prescription dose to the planing target volume (PTV) with minimizing the dose to surrounding normal organs. Clinical stage of the patients are 1 patient for stage IB, 3 patients for IIA, 19 patients for IIB, 3 patients for IIIA, 3 patients for IIIB and 1 patient for IV. All patients took the MRI before treatment and the maximum size of the gross tumor volume were under 4cm for 17 patients and from 4 cm to 6 cm for 12 patients and above 6 cm for 1 patient. The results show that while the irradiated volume can be reduced with optimized dose distribution using PTV treatment planning (p<0.0001) when the remained tumor size is small, the surrounding normal organs will receive unnecessarily large dose when the irradiated tumor volume is relatively large. This is because there is some limitation in controling the intensity of radiation in Fletcher Williamson Applicator. To overcome the limit of applicator and to achieve the optimal dose distribution, we have virtually applied 4 needles with Fletcher Williamson Applicator for 10 patients who have relatively large tumor and studied the change in dose distribution before and after application. The results show that this new virtual treatment plan reduces the volume covered by 100 % isodose (p=0.0608, p=0.0607) and reduces the dose of normal organs (p=0.0162, p=0.008). This evidence suggest that this method is superior than the currently used method such as PTV treatment and ICRU treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3045-3050
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• 2013

Purpose: Hepatic resection is arguably the preferred treatment for huge hepatocellular carcinoma (H-HCC). Estimating the remnant liver volume is therefore essential. This study aimed to evaluate the feasibility of using computer-assisted volumetric analysis for this purpose. Methods: The study involved 40 patients with H-HCC. Laboratory examinations were conducted, and a contrast CT-scan revealed that 30 cases out of the participating 40 had single-lesion tumors. The remaining 10 had less than three satellite tumors. With the consensus of the team, two physicians conducted computer-assisted 3D segmentation of the liver, tumor, and vessels in each case. Volume was automatically computed from each segmented/labeled anatomical field. To estimate the resection volume, virtual lobectomy was applied to the main tumor. A margin greater than 1 cm was applied to the satellite tumors. Resectability was predicted by computing a ratio of functional liver resection (R) as (Vresected-Vtumor)/(Vtotal-Vtumor) x 100%, applying a threshold of 50% and 60% for cirrhotic and non-cirrhotic cases, respectively. This estimation was then compared with surgical findings. Results: Out of the 22 patients who had undergone hepatectomies, only one had an R that exceeded the threshold. Among the remaining 18 patients with non-resectable H-HCC, 12 had Rs that exceeded the specified ratio and the remaining 6 had Rs that were < 50%. Four of the patients who had Rs less than 50% underwent incomplete surgery due to operative findings of more extensive satellite tumors, vascular invasion, or metastasis. The other two cases did not undergo surgery because of the high risk involved in removing the tumor. Overall, the ratio of functional liver resection for estimating resectability correlated well with the other surgical findings. Conclusion: Efficient pre-operative resectability assessment of H-HCC using computer-assisted volumetric analysis is feasible.

• Journal of Advanced Navigation Technology
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• v.25 no.1
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• pp.102-107
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• 2021

In the case of long-term hospitalization for young patients, 'Hospital Schools' are operated to pursue school classes and to develop social and emotional abilities for them. However, face-to-face classes at hospital schools have been completely prohibited, and the untact or limited contact environment has been strengthened even for young patients due to the COVID-19 in recent years. Augmented Reality(AR) technology enables the development of experiential content with virtual environments, objects and characters similar to real life. The developed contents should revitalize the imagination of young patients living only in hospitals and allow them to experience, not only acquiring knowledge, but also improving interpersonal skills and sociality. This study is intended to provide diverse adventures and in-depth choice experiences to young patients who are struggling in an environment of untact and limited contact by creating experiential fairy tale contents using AR technology. In addition, long-term hospitalized children will be able to cultivate the will to overcome illness with positive emotions through the augmented reality experience fairy tale content studied and implemented in this study.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.261-275
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• 2022

Purpose : According to the Korean Diabetes Association, the number of metabolic disease patients in Korea is approximately 14.97 million as of 2020;, the prevalence of diabetes among adults over 30 years old is 44.3 %, and the prevalence of diabetes in the elderly over 65 years old is 50.4%. These individuals exposed to the risk of complications. Therefore, the purpose of this study was to determine a distribution method for a customized fusion exercise marine healing program for metabolic disease patients. Methods : We have searched numerous papers concerning artificial intelligence (AI), virtual reality (VR), augmented reality (AR), and marine resources related to marine healing programs that can be introduced in marine healing centers for people with metabolic diseases Results : Through the production of various marine resources and evidence-based exercise programs, the provision of exercise programs using AI, and the development of exercise platforms using AR and VR, we were able to establish guidelines for how to operate marine healing programs at marine healing centers. Conclusion : Korea has much more diverse marine healing resources than other advanced countries in the marine healing industry. However, the development of these resources has only just begun. It is hoped that the studied marine healing program will be of great help to metabolic patients by creating contents that will be implemented in marine healing centers by using the cutting-edge technologies and various marine resources that Korea possesses.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1286-1297
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• 2022

Purpose To assess the usefulness of various metal artifact reduction (MAR) methods in patients with hip prostheses. Materials and Methods This retrospective study included 47 consecutive patients who underwent hip arthroplasty and dual-energy CT. Conventional polyenergetic image (CI), orthopedic-MAR (OMAR), and virtual monoenergetic image (VMI, 50-200 keV) were tested for MAR. Quantitative analysis was performed in seven regions around the prostheses. Qualitative assessments included evaluation of the degree of artifacts and the presence of secondary artifacts. Results The lowest amount of image noise was observed in the O-MAR, followed by the VMI. O-MAR also showed the lowest artifact index, followed by high-keV VMI in the range of 120-200 keV (soft tissue) or 200 keV (bone). O-MAR had the highest contrast-to-noise ratio (CNR) in regions with severe hypodense artifacts, while VMI had the highest CNR in other regions, including the periprosthetic bone. On assessment of the CI of pelvic soft tissues, VMI showed a higher structural similarity than O-MAR. Upon qualitative analysis, metal artifacts were significantly reduced in O-MAR, followed by that in VMI, while secondary artifacts were the most frequently found in the O-MAR (p < 0.001). Conclusion O-MAR is the best technique for severe MAR, but it can generate secondary artifacts. VMI at high keV can be advantageous for evaluating periprosthetic bone.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.10
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• pp.4564-4571
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• 2012

This study performed a virtual reality exercise program for self-back pain control of industrial workers with chronic back pain and analysed their physical function and health-related quality of life relating to industrial chronic back pain. The subjects of the study were thirty chronic back pain patients working for K company and were divided into Nintendo Wii Sports Group made of 15 subjects and Physical Therapy Group made of 15. As variables for physical functions, back strength, flexibility, balance and pain were measured and for the health-related quality of life, SF-36 of each group was measured before and after the exercise program. To compare differences before and after the program, a paired t-test was used and to compare differences between both groups, an independent samples t-test was used. As a result of the test, it was discovered that balance and pain of the both groups were improved statistically significantly. Physical functions of the Nintendo Wii Sports Group were improved statistically significantly in comparison with those of the Physical Therapy Group. The health-related quality of life was improved statistically significantly only for the Nintendo Wii Sports Group. In conclusion, it is suggested that as the virtual reality exercise program had a positive influence on chronic back pain of industrial workers, it should be considered as a home exercise program for back pain control.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.413-419
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• 2011

Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.37-47
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• 2024

Purpose: This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma. Methods: This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images. Results: When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm. Conclusions: Using the sternum length as a tube thoracostomy indicator might be feasible.

• Proceedings of the Korea Contents Association Conference
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• 2016.05a
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• pp.285-286
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• 2016

본 연구는 가상현실시스템을 이용한 훈련이 뇌졸중 환자의 균형과 낙상효능감에 미치는 영향을 알아보기 위해 실시하였다. 연구 대상자는 뇌졸중 환자 20명으로 실험군 10명 대조군 10명씩 각각 배정하였다. 실험군과 대조군 모두 일반적인 주 5회의 물리치료와 작업치료를 받았다. 실험군은 추가적으로 가상현실 프로그램을 이용하여 8주간 1일 20분 주 3회 시행하였다. 본 연구의 측정은 균형수행 능력검사, 낙상효능감 척도검사를 사용하였다. 두 군 간 훈련 후 측정 사이에 균형수행 능력검사와, 낙상효능감 검사에서 통계적으로 유의한 차이를 보였다(p<0.05). 또한 각 군 간 훈련 후 측정 사이에 균형수행 능력검사와, 낙상효능감 검사에서 통계적으로 유의한 차이를 보였다(p<0.05). 따라서 가상현실 프로그램 병행한 훈련이 뇌졸중 환자의 균형과 낙상효능감을 향상시키는데 긍적적인 도움을 주어 유용한 뇌졸중 환자의 치료 프로그램으로 사용될 수 있을 것으로 보여 진다.