• Title/Summary/Keyword: virtual patient

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Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

  • Jeong, Woo Shik;Choi, Jong Woo;Choi, Seung Ho
    • Archives of Plastic Surgery
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    • v.41 no.5
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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.

Effect of Virtual Reality Game on Old Patient's Depression, Relationship and Life Satisfaction (가상현실 게임이 노인 뇌졸중 환자의 우울, 대인관계, 삶의 만족도에 미치는 효과)

  • Shin, Kyung-Eun;Oh, Myung-Hwa;Chung, Hyun-Ae;Kim, Hee-Dong
    • 재활복지
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    • v.21 no.4
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    • pp.101-118
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    • 2017
  • This study was conducted to investigate the effect of virtual reality game on old stroke patient's depression, relationship and life satisfaction. The subjects of this study were 40 stroke patients of over 65 years old and each 20 patients were randomly assigned in two groups. The study was conducted for 12 weeks. Nintendo Wii Sports Resort program was applied to the virtual reality game for the experimental group. In order to investigate psychological social factor (depression, relationship) and life satisfaction of the objects, BDI, RCS, LSI-Z were checked three times. The results are as followings. First, the psychological social change (depression, relationship) after the training program showed that depression is significantly decreased (p<.001) along with the intervention period in both 2 groups. Second, change of life satisfaction after the training program showed that significant statistical improvement were found both in control group(p<.05), and experimental group(p<.001). Third, depression, relationship showed the significant statistically correlation with life satisfaction(p<.05). We can conclude from the above that virtual reality games which were played by 2 persons had the significant effect on old stroke patient's psychological social factor(depression, relationship) and life satisfaction.

Rational treatment planning for implant treatment of the edentulous patients (완전무치악환자의 전악 임플란트 치료 계획 수립을 위한 체계적인 접근법)

  • Jeong-In Bae
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.2
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    • pp.54-68
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    • 2023
  • Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

Clinical Implementation of 3D Printing in the Construction of Patient Specific Bolus for Photon Beam Radiotherapy for Mycosis Fungoides

  • Kim, Sung-woo;Kwak, Jungwon;Cho, Byungchul;Song, Si Yeol;Lee, Sang-wook;Jeong, Chiyoung
    • Progress in Medical Physics
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    • v.28 no.1
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    • pp.33-38
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    • 2017
  • Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.

Nursing Students and Clinical Nurses' Awareness of Virtual Reality(VR) Simulation and Educational Needs of VR-based Team Communication and Teamwork Skills for Patient Safety: A Mixed Method Study (간호대학생과 병원간호사의 가상현실기반 환자안전을 위한 팀 의사소통과 팀워크 기술에 대한 교육요구의 차이: 혼합연구설계)

  • Hur, Hea Kung;Jung, Ji Soo
    • The Journal of the Korea Contents Association
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    • v.22 no.1
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    • pp.629-645
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    • 2022
  • The purpose of this study is to investigate the educational needs of virtual reality(VR)-based communication and teamwork skills for patient safety intended for nursing students and nurses. For this study, mixed method design was used with surveyed data collected 60 nursing students and 123 nurses. And fourteen nurses was conducted focus group interview. SPSS/WIN 25.0 and inductive content analysis for focus group interviews were utilized for data analysis. The results indicated that the awareness of VR and educational needs of team communication, and teamwork skills were above average, and nursing students required higher educational needs than nurses. Teamwork knowledge was moderate, and there was no significant difference between the two groups. Regarding nurse's communication in hospital, 4 themes of contributing factors and 2 themes of result factors that cause communication difficulties among nurses were derived from the qualitative data. Therefore, it is necessary to develop a virtual reality-based simulation program reflecting the educational needs of nursing students and nurses in order to improve team communication and teamwork skills for patient safety required for nursing students and nurses.

Data-driven Adaptive Safety Monitoring Using Virtual Subjects in Medical Cyber-Physical Systems: A Glucose Control Case Study

  • Chen, Sanjian;Sokolsky, Oleg;Weimer, James;Lee, Insup
    • Journal of Computing Science and Engineering
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    • v.10 no.3
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    • pp.75-84
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    • 2016
  • Medical cyber-physical systems (MCPS) integrate sensors, actuators, and software to improve patient safety and quality of healthcare. These systems introduce major challenges to safety analysis because the patient's physiology is complex, nonlinear, unobservable, and uncertain. To cope with the challenge that unidentified physiological parameters may exhibit short-term variances in certain clinical scenarios, we propose a novel run-time predictive safety monitoring technique that leverages a maximal model coupled with online training of a computational virtual subject (CVS) set. The proposed monitor predicts safety-critical events at run-time using only clinically available measurements. We apply the technique to a surgical glucose control case study. Evaluation on retrospective real clinical data shows that the algorithm achieves 96% sensitivity with a low average false alarm rate of 0.5 false alarm per surgery.

Application of CAD-CAM technology to surgery-first orthognathic approach (디지털 기술을 이용한 선수술 악교정치료)

  • Kim, Yoon-Ji;Gil, Byung-Gyu;Ryu, Jae-Jun
    • The Journal of the Korean dental association
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    • v.56 no.11
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    • pp.622-630
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    • 2018
  • For successful surgery-first approach, accurate prediction of skeletal and dental changes following orthognathic surgery is essential. With recent development of digital technology using computer-aided design/computer-aided manufacturing (CAD/CAM) technology, attempts to provide more predictable orthodontic/orthognathic treatment have been made through 3D virtual surgery and digital tooth setup. A clinical protocol for the surgery-first orthognathic approach using virtual surgery is proposed. A case of skeletal Class III patient with facial asymmetry treated by the surgery-first approach using digital setup and virtual surgery is presented. Advantages and limitations of applying CAD/CAM technology to orthognathic surgery are discussed.

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Development of 360° virtual reality videos and common videos for cardiac arrest recognition : A sequential mixed methods study (심장정지 인지를 위한 360° 가상현실과 일반 동영상 개발 : 순차적 혼합 연구)

  • Jung, Eun-Kyung;Shin, Jun Ho
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.2
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    • pp.55-69
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    • 2021
  • Purpose: This study aimed to develop 360° virtual reality videos and common videos for cardiac arrest recognition. Methods: A sequential mixed methods study was conducted, using qualitative interviews (with a total of seven experts) and a quantitative survey. Results: First, the cardiac arrest situation should be developed within 2-3 minutes after witnessing the patient collapse, for each of the four cardiac arrest videos about apnea, gasping, seizure, gasping, and seizure. Second, the education program should be designed so that the education on cardiac arrest recognition can proceed before CPR practice begins. Conclusion: 360° virtual reality videos and common videos for cardiac arrest recognition can play an important role in the education of the general public about cardiac arrest experience.

A Study on the Effectiveness of Rehabilitation by Virtual Reality Program: Systematic Review (가상현실 프로그램을 사용한 재활치료의 효과성 연구: 체계적 고찰)

  • Park, Da-Sol;Shin, Ga-In;Woo, Ye-Shin;Park, Hae Yean
    • 재활복지
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    • v.22 no.3
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    • pp.209-224
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    • 2018
  • The purpose of this study is to provide a basic data about the virtual reality rehabilitation therapy to the occupational therapist in the domestic clinical field by systematically analyzing the types and effects of the rehabilitation therapy using the virtual reality program. Research articles were retrieved from January 2007 to December 2017 using the Research Information Sharing Service (RISS), Google Scholar, and Pubmed database. The main search terms were 'Virtual Reality AND Rehabilitation' and 'Virtual reality AND Effect'. Finally, 10 foreign studies were selected as the subjects of this study. Selected studies were organized using PICO (Patient, Intervention, Comparison, Outcome) format. The results were as follows: The subjects were divided into 4 types, stroke, brain tumor, Parkinson 's disease, and kidney disease. The tools used for arbitration were three IREX (30 %), two X-box Kinect (20 %), two Nintendo Wii (20 %), one [Existing tool + VR] (10 %), one [Mobile application + VR] (10 %). As a result of the intervention, improvement of function was observed in all 10 studies from overseas, and physical function was 24 times (66 %), mental function 6 times (17 %), cognitive function 5 times (14 %), Activity of daily living 1 time (10 %). this study could be used as a basic resource to enhance the professionalism and quality of rehabilitation services and expand the scope by organizing virtual reality-based rehabilitation and its effects.