• Journal of Radiation Protection and Research
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• v.38 no.4
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• pp.194-201
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• 2013

To investigate monitoring unit (MU) efficiency and plan quality of volumetric modulated arc therapy (VMAT) using flattening-filter free (FFF) photon beam in association with target size and location. A virtual patient was generated in Eclipse$^{TM}$ (ver. A10, Varian Medical Systems, Palo Alto, USA) treatment planning system. The length of major and minor axis in axial view was 50 cm and 30 cm, respectively. Cylindrical-shaped targets were generated inside that patient at the center (symmetric target) and in the periphery (asymmetric target, 7.5 cm away from the center of the patient to the right direction) of the virtual patient. The longitudinal length was 10 cm and the diameters were 2, 5, 10 and 15 cm. Total 8 targets were generated. RapidArc$^{TM}$ plans using TrueBeam STx$^{TM}$ were generated for each target. Two full arcs were used and the axis of rotation of the gantry was set to be at the center of the virtual patient. Total MU, homogeneity index (HI), target mean dose, the value of gradient measure and body mean dose were calculated. In the case of symmetric targets, averaged total MU of FFF plan was 23% and 19% higher than that of flattening filter (FF) plan when using 6 MV and 10 MV photons, respectively. The difference of HI, target mean dose, gradient measure and body mean dose between FF and FFF was less than 0.04, 2.6%, 0.1 cm and 2.2%, respectively. For the asymmetric targets, total MU of FFF plan was 21% and 32% was higher than that of FF when using 6 MV and 10 MV photons, respectively. The homogeneity of the target was always worse when using FFF than using FF. The maximum difference of HI was 0.22. The target mean dose of FFF was 3.2% and 4.1% higher than that of FF for the 6 MV and 10 MV, respectively. The difference of gradient measure was less than 0.1 cm. The body mean dose was higher when using FFF than FF about 4.2% and 2.8% for the 6 MV and 10 MV, respectively. No significant differences between VMAT plans of FFF beam and FF beam were observed in terms of quality of treatment plan. The HI was higher when using FFF 10 MV photons for the asymmetric targets. The MU was increased noticeably when using FFF photon beams.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.425-431
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• 2019

This clinical case report describes the digital workflow that combines a face scan, cone beam computed tomography and an intraoral scan to visualize the outcome of prosthodontic treatment in the anterior region. This approach improves communication between clinic, laboratory and patients. A patient with healthy general condition came for a restorative treatment to treat post-traumatic central incisors of maxilla. A virtual patient replica was made by incorporating a face scan, cone beam computed tomography and an intraoral scan. Design mockup of definitive restorations was shown to the patient and modified according to the patient's desire. This digital workflow facilitates the fabrication of optimal esthetic restorations, and enhances the predictability of outcome of restorations.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.21 no.7
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• pp.1379-1385
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• 2017

Virtual training is a kind of training that proceeds as if it were a real situation. In recent years, there has been a growing demand for experiencing a situation in which a virtual reality technology has not been experienced directly in the real world due to the rapid development of the technology. Especially, safety education is very necessary in Korea where safety accidents are caused by many disasters. Therefore, simulation of disaster response training using virtual reality is more urgent than ever. Although the automatic defibrillator is the medical device that is most needed to rescue patients with cardiac arrest, few people know how to use it. Therefore, there are very few cases where the use of automatic defibrillators has saved the patient's life in Korea. The proposed Automated External Defibrillator virtual training system enables immersive and experiential training in real situations and effective training at low cost.

• The Korean Journal of Pain
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• v.35 no.4
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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.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.178-181
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• 2020

In this report, we present a case in which good results were achieved by treatment using a free jejunal patch graft with virtual endoscopy (VE) assistance in a patient whose swallowing had failed to improve for 40 years after he mistakenly swallowed sulfuric acid, despite pectoralis major myocutaneous flap grafting and frequent balloon dilatation surgery. During the last 20 years, virtual computed tomography imaging has improved remarkably and continues to be used to address new challenges. For reconstructive surgeons, the greatest advantage of VE is that it is a noninvasive modality capable of visualizing areas inaccessible to a flexible endoscope. Using VE findings, we were able to visualize the 3-dimensional shape beyond the stenosis. VE can also help predict the area of the defect after contracture release.

• Therapeutic Science for Rehabilitation
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• v.7 no.2
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• pp.17-27
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• 2018

Objective : The purpose of this study was to investigate the effect of occupational therapy intervention using a fully immersive virtual reality device on the upper extremity function of patients with chronic stroke. Methods : This study used a single subject (ABA) design. The study subjects was a chronic stroke patient with left lateral deviation. Four baseline periods, 12 intervention periods, and 4 baseline regression periods were performed for a total of 20 sessions for 10 weeks. OT intervention with a fully immersive virtual reality device was used every 30 minutes. BBT and WMFT evaluations were performed at each session and the results were displayed in a line graph. Results : The patient's upper limb function has improved. During baseline recurrence, efficacy of treatment was confirmed after removal of intervention, but no significant changes were observed. Conclusion : It has been found that OT intervention with a fully immersive virtual reality device for upper limb function in chronic stroke patients is an effective intervention. However, the effectiveness of maintaining treatment is not important, so we need to develop an easy-to-use home intervention program.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2002.11a
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• pp.233-244
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• 2002

The purpose of this study is to assess the ability of balance control in moving surround using head mount device and force platform and to examine the clinical usefulness of COP parameters. Fifteen patients with stroke and healthy persons were participated. COP parameters were obtained as total path distance, frequency of anterior-posterior and medial-lateral component by FFT analysis, weight-spectrum analysis in the two different conditions; (1) in comfortable standing with opened or closed eyes, (2) in virtual moving surround delivered using HMD to four different moving pattern. In virtual moving surround setting, moving pattern was composed of close-far, superior-inferior tilting(pitch), right-left tilting(roll) and horizontal rotation(yaw) movement. In all parameters, the reliebility of COP analysis system was significantly high. Also, the construct validity compared between fifteen patients with stroke and normal persons was excellent in virtual moving surround condition(p

• The Journal of Korea Robotics Society
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• v.15 no.4
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• pp.323-329
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• 2020

This paper presents a control algorithm for a wearable walking aid robot for subjects with paraplegia after stroke. After a stroke, a slow, asymmetrical and unstable gait pattern is observed in a number of patients. In many cases, one leg can move in a relatively normal pattern, while the other leg is dysfunctional due to paralysis. We have adopted the so-called assist-as-needed control that encourages the patient to walk as much as possible while the robot assists as necessary to create the gait motion of the paralyzed leg. A virtual wall was implemented for the assist-as-needed control. A position based admittance controller was applied in the swing phase to follow human intentions for both the normal and paralyzed legs. A position controller was applied in the stance phase for both legs. A power controller was applied to obtain stable performance in that the output power of the system was delimited during the sample interval. In order to verify the proposed control algorithm, we performed a simulation with 1-DOF leg models. The preliminary results have shown that the control algorithm can follow human intentions during the swing phase by providing as much assistance as needed. In addition, the virtual wall effectively guided the paralyzed leg with stable force display.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.2.1-2.7
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• 2018

With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

• Korean Journal of Clinical Pharmacy
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• v.31 no.4
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• pp.285-292
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• 2021

Background: Recently, the Korean Association of Pharmacy Education has been focusing on competency-based education (CBE) and has established required areas of competencies to improve the graduation competency. However, competency-based assessment (CBA) tools for implementing CBE have not yet been developed for faculty members and students to successfully access the assessment tests. Moreover, the faculty members in charge in pharmacy schools have encountered various barriers in recruiting individuals with integrated clinical experience to act as virtual patients. Therefore, this study aimed to identify the advantages and limitations of applying CBA tool and faculty assessors in the development of CBE to ensure the reliability of this assessment. Methods: Utilizing CBA tool, the students' communication skills and styles were assessed. students and faculty assessors were surveyed to evaluate the advantages and limitations of the CBA tool. Results: 8 assessors and 96 students participated in this study. 100% (8/8) of the faculty assessors and 77.4% (65/84) of the students reported that CBA tool is valuable to assess and improve student's ability. 90.5% (76/84) of the students felt confident in applying knowledge to patient-centered care. CBA tool can be a valuable for the instructors in identifying the competency level of students but can also be associated with limitations in implementation to ensure the objectivity and reliability of the CBA. Conclusions: The CBA tool can be valuable in assessing the level of students' competency. Faculty assessors have the advantage of well-prepared themselves for patient roles, so that the time and cost required may be minimized.