• The Korean Journal of Pain
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• 제35권4호
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• pp.403-412
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• 2022

Background: Most pain management techniques for challenging procedures are still performed under the guidance of the C-arm fluoroscope although it is sometimes difficult for even experienced clinicians to understand the modified three-dimensional anatomy as a two-dimensional X-ray image. To overcome these difficulties, the development of a virtual simulator may be helpful. Therefore, in this study, the authors developed a virtual simulator and presented its clinical application cases. Methods: We developed a computer program to simulate the actual environment of the procedure. Computed tomography (CT) Digital Imaging and Communications in Medicine (DICOM) data were used for the simulations. Virtual needle placement was simulated at the most appropriate position for a successful block. Using a virtual C-arm, the authors searched for the position of the C-arm at which the needle was visualized as a point. The positional relationships between the anatomy of the patient and the needle were identified. Results: For the simulations, the CT DICOM data of patients who visited the outpatient clinic was used. When the patients revisited the clinic, images similar to the simulated images were obtained by manipulating the C-arm. Transforaminal epidural injection, which was difficult to perform due to severe spinal deformity, and the challenging procedures of the superior hypogastric plexus block and Gasserian ganglion block, were successfully performed with the help of the simulation. Conclusions: We created a pre-procedural virtual simulation and demonstrated its successful application in patients who are expected to undergo challenging procedures.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2003년도 추계학술대회
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• pp.1373-1377
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• 2003

Current prostheses for amputees are generally extrinsic wearing socket type that the coupling between body stump and appliance wraps the soft tissue and this structure causes several problems :applying direct weight to soft tissue such as skin and muscle, skin trouble of contacting area and pain. In this study, osseointegration implant is a method to directly connect prosthesis to the residual stump skeletal tissue of arm, finger and leg through surgical operation. Technology presented in this paper essentially solves the problems of pain and abnormal weight transfer system indicated above and recovers the functions of the amputated arm and leg. In this paper, implant shape was designed for the first step for the development of osseointegration implant and then we studied the possibility to apply this osseointegration implant to human body by performing implant insertion operation to beagle tibia for the clinical animal test and normal beagle's gait analysis was executed in order to quantitatively verify the beagle's skeletal functions after the implant insertion.

• 한국경영과학회:학술대회논문집
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• 한국경영과학회/대한산업공학회 1999년도 춘계공동학술대회:정보화시대의 지식경영
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• pp.105-107
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• 1999

본 연구의 목적은 CT장비로부터 얻어지는 단면 영상을 이용하여 재구성한 3차원 Voxel 정보를 기반으로 의료 시술 중 위험도가 높으며 장기간의 수술 훈련이 필요한 수술인 척추경나사 삽입술에 대한 모의 시술기를 개발하는 것이다. 모의 시술기의 입력은 환자의 환부에 대한 CT와 모의 시술을 해보고자 하는 의사 (사용자)의 입력 (경나사의 진입 위치와 각도)이 되며 출력은 의사들이 시술장에서 받을 수 있는 유일한 방법인 Voxel데이터로부터 재생성된 X-Ray이미지, 혹은 C-Arm의 동영상이며, 최종 결과 출력은 나사못이 삽입된 재구성 CT 이미지들과 3차원 정보를 볼 수 있는 Image Based Rendering의 Image data set이 된다. 본 연구에서는 각 시각화 부분의 특성을 고려하여 direct volume projection, surface modeling, 그리고 최근 많은 관심을 받고 있는 Image Based Rendering 기법을 intergrate하여 사용하였으며 각 시각화 모듈의 초고속 정보 통신망에서의 정보 교환에 대한 방법론에 대해 다루고 있다.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.91-94
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• 2010

Purpose: The purpose of this study is to describe the usefulness of intraoperative mobile CT scans in the reduction of zygomatic arch fracture. Method: Two patients with zygomatic arch fractures were selected who were indications of closed reduction by Gilles' approach. After the reduction was done in the operating room with zygomatic arch elevator, intraoperative CT scan was done to check the extent of reduction. Additional reduction was performed according to the obtained images from the intraoperative mobile CT scan. Examination of the preoperative CT, intraoperative CT after the reduction, and postoperative plain X-ray films were done for documentation and analysis. Results: Reduction was carried out successfully to the patients without any complications. Both patients were satisfied with the postoperative cosmetic and functional outcome. Revisional surgery was not necessary during the 6 months follow up. Conclusion: The advantage of this method is that it is easier to obtain three dimensional relationships of the fracture site. Furthermore, the operator is less exposed to radiation hazards compared to other methods that obtain intraoperative images such as the C-arm. In conclusion, intraoperative mobile CT scan can be a useful surgical aid in the reduction of zygomatic arch fractures.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1082-1089
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• 2005

목 적 : 복부 비만은 고혈압, 인슐린 저항, 고인슐린혈증, 당뇨, 고지혈증과 같은 많은 심혈관계 질환의 위험 요인으로 제시되고 있다. 복부 비만을 측정하는 지표로 허리/둔부 비와 허리둘레가 사용되고 있으나, 관상동맥 질환의 예측인자로 복부 비만의 측정학적 cut-off 수치가 소아에서는 아직 제시되지 못하고 있다. 복부 전산화 단층촬영과 초음파를 이용하여 복부 지방을 측정하고, 여러 비만 지표들과의 상관관계를 연구함으로써 복부 비만의 합병증으로 초래되는 심혈관계 질환의 위험인자 평가 방법을 알아 보고자 본 연구를 실시하였다. 방 법 : 비만한 청소년 27명과 나이와 성별이 대등한 정상 체중을 가진 청소년 22명을 대상으로 하여 체질량 지수와 비만 지수, 상완둘레 및 삼각근에서 피부 두께를 비교하였다. 또한, 12시간 공복 상태에서 혈중 지질 및 혈당, 인슐린, 4가지 사이토카인을 측정하고, 인슐린 저항 지수를 구하였으며, 생체 전기저항법을 이용하여 체지방량, 체지방률, 복부지방률을 측정하여 비교하였다. 비만군에서는 복부 초음파로 배꼽부위 피하지방 두께와 복강 내 지방 두께를 측정하고, 복부 전산화 단층 촬영으로 얻은 횡단면 스캔에서 전체 지방 면적을 구하였고, 이 중 피하지방의 면적을 감산하여 복강 내 지방 면적을 구하였다. 결 과 : 소아에서 복부 CT로 측정한 총 지방 면적과 생체 전기 저항법으로 측정한 총지방량과 상관성이 매우 높았다(r=0.954, P<0.05). 복부 CT에서 측정한 복강 내 지방 면적은 상완둘레, 복부비만율, 초음파로 측정한 복부 내 지방 깊이 및 피하 지방량, 체질량 지수, 중성지방 등과 상관성이 높았다. 결 론 : 복부 CT는 복강 내 지방을 측정하는 가장 정확한 방법이지만 임상적으로 유용하지 못하므로, CT와 상관성이 높은 복부 초음파로 대치할 수 있다. 외래나 학교 신체검사에서 사용할 수 있는 선별 검사로는 생체 전기 저항법에 의한 체지방 측정, 상완 둘레, 체질량 지수, 허리/둔부 비 등이 있다. 소아 성인병의 심혈관 위험 예측 지표로는 공복시 leptin, 중성지방, 인슐린 농도 등을 사용할 수 있다.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.458-460
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• 2010

Langerhans cell histiocytosis (LCH), a disorder of the phagocytic system, is a rare condition. Moreover, spinal involvement causing myelopathy is even rare and unusual. Here, we report a case of atypical LCH causing myelopathy, which was subsequently treated by corpectemy and fusion. A 5-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying right arm motor weakness. CT scans revealed destruction of C7 body and magnetic resonance imaging showed a tumoral process at C7 with cord compression. Interbody fusion using cervical mesh packed by autologus iliac bone was performed. Pathological examination confirmed the diagnosis of LCH. After the surgery, the boy recovered from radiating pain and motor weakness of right arm. Despite the rarity of the LCH in the cervical spine, it is necessary to maintain our awareness of this condition. When neurologic deficits are present, operative treatment should be considered.

• Journal of Chest Surgery
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• 제22권2호
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• pp.330-336
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• 1989

The patient was 47-year-old male who had suffered from aphasia and hemiplegia of the right side, but mental state was alert. On physical examination, BP was 130/80 mmHg in the right arm, but not checked in the left arm. The pulses of the left common carotid, brachial, and radial arteries were not palpable. The pulses of the right femoral, popliteal, and dorsalis pedis arteries were weakly palpable. Brain CT Scan revealed cerebral infarction of the left hemisphere. Aortogram showed occlusion of the left common carotid, and the right internal carotid and common iliac arteries. Subclavian steal phenomena were observed in the delayed aortogram. Double extra-anatomic bypasses; Axillo-Axillar bypass and Femora-Femoral bypass, were performed in the local anesthesia at two stages, because of risk of major operation under general anesthesia. Postoperatively, all pulses except for pulse of the left common carotid artery were equally palpable. On discharge, the hemiplegia of the right side was improved and able to walk with assistance.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8089-8093
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• 2014

Background: To assess the frequency and severity of gastrointestinal adverse effects in advanced colorectal carcinoma patients treated with four different schedules of FOLFOX. Materials and Methods: Patients (median age 61 years) who underwent surgery were included in the study. All had measureable disease at CT scan, ultrasonography or clinical examination. Toxicity was graded on a scale of 1-5 according to the general grade definition of CTC v2.0. The severity of adverse effects (Grade 3 and 4) assessed in each treatment arm was compared. Results: Differences between the incidence rates of 3 and 4 toxicity and all grades of toxicity for all parameters in GI toxicity were very highly significant (p<0.001). Severe gastrointestinal symptoms of toxicity were noted with FOLFOX7 (oxaliplatin $130mg/m^2$). Grade 3 diarrhea was reported in 25% patients and grade 4 diarrhea in 4% in the FOLFOX7 treatment arm. Grade 2 vomiting was very frequently reported in the FOLFOX4 treatment arm (oxaliplatin $85mg/m^2$). Grade 2 stomatitis was reported in 42% patients treated with mFOLFOX6 (oxaliplatin $100mg/m^2$). Differences in the incidence rate of nausea, diarrhea and stomatitis among all treatment arms of FOLFOX were significant (p<0.05). Conclusions: Severe diarrhea is associated with FOLFOX7 treatment. No grade 3 or 4 GI toxicity was reported in patients of the mFOLFOX6 arm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.382-387
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• 2021

Objectives: Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hardware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system. Materials and Methods: This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan. Results: The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduction stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required. Conclusion: Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate results and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.

• 전자공학회논문지
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• 제54권7호
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• pp.110-114
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• 2017

팔꿈치관절 CT 검사 시에 골절 등으로 인해 부득이하게 팔을 거상하지 못할 때에 주로 선 감약이 많이 되는 복부 장기 및 요추에 중복된 상태로 검사하여 영상의 질이 저하되는 경우가 많다. 그로 인해, 판독에 많은 어려움이 있으며 선량 증가로 인해 환자의 피폭이 많아지고 있다. 본 실험에서는 복부 장기와의 중복을 피하고 상대적으로 선 감약이 적은 폐야와 중복되어 광자량을 증가시켜 영상의 질 향상을 도모하고자 하였다. 실험 방법은 환자의 오른쪽 팔꿈치관절을 대상으로 하여 환자를 바로 누운 자세에서 팔꿈치관절을 L2-3 level에 위치시킨 방법과 바로 누운 자세에서 왼쪽으로 30도 정도 돌려서 폐야와 중첩하고 완전한 흡기 상태에서 비교하여 진행하였다. 16, 128채널 각각 5회씩 측정하여 나온 데이터를 Image J 프로그램을 이용하여 평균값 및 표준편차를 구한 뒤 신호 대 잡음 비(SNR), 대조도 대 잡음 비(CNR), 평균대 표준편차 비(MSR)를 각각 측정하여 평가를 시행하였다. SPSS 프로그램을 이용하여 CNR, MSR을 통계 분석하였고 각각의 인자가 향상된 결과를 얻을 수 있었다. 따라서 팔꿈치관절 CT 검사 시 환자의 자세와 흡기를 통하여 검사하는 방법은 피폭선량을 최소화하고, 영상의 질을 향상하는 방법으로서 의의가 있었다고 생각한다.