Three Dimensional Measurement of Ideal Trajectory of Pedicle Screws of Subaxial Cervical Spine Using the Algorithm Could Be Applied for Robotic Screw Insertion

Huh, Jisoon,Hyun, Jae Hwan,Park, Hyeong Geon,Kwak, Ho-Young The Korean Neurosurgical Society 2019 Journal of Korean neurosurgical society Vol.62 No.4

Objective : To define optimal method that calculate the safe direction of cervical pedicle screw placement using computed tomography (CT) image based three dimensional (3D) cortical shell model of human cervical spine. Methods : Cortical shell model of cervical spine from C3 to C6 was made after segmentation of in vivo CT image data of 44 volunteers. Three dimensional Cartesian coordinate of all points constituting surface of whole vertebra, bilateral pedicle and posterior wall were acquired. The ideal trajectory of pedicle screw insertion was defined as viewing direction at which the inner area of pedicle become largest when we see through the biconcave tubular pedicle. The ideal trajectory of 352 pedicles (eight pedicles for each of 44 subjects) were calculated using custom made program and were changed from global coordinate to local coordinate according to the three dimensional position of posterior wall of each vertebral body. The transverse and sagittal angle of trajectory were defined as the angle between ideal trajectory line and perpendicular line of posterior wall in the horizontal and sagittal plane. The averages and standard deviations of all measurements were calculated. Results : The average transverse angles were $50.60^{\circ}{\pm}6.22^{\circ}$ at C3, $51.42^{\circ}{\pm}7.44^{\circ}$ at C4, $47.79^{\circ}{\pm}7.61^{\circ}$ at C5, and $41.24^{\circ}{\pm}7.76^{\circ}$ at C6. The transverse angle becomes more steep from C3 to C6. The mean sagittal angles were $9.72^{\circ}{\pm}6.73^{\circ}$ downward at C3, $5.09^{\circ}{\pm}6.39^{\circ}$ downward at C4, $0.08^{\circ}{\pm}6.06^{\circ}$ downward at C5, and $1.67^{\circ}{\pm}6.06^{\circ}$ upward at C6. The sagittal angle changes from caudad to cephalad from C3 to C6. Conclusion : The absolute values of transverse and sagittal angle in our study were not same but the trend of changes were similar to previous studies. Because we know 3D address of all points constituting cortical shell of cervical vertebrae. we can easily reconstruct 3D model and manage it freely using computer program. More creative measurement of morphological characteristics could be carried out than direct inspection of raw bone. Furthermore this concept of measurement could be used for the computing program of automated robotic screw insertion.

Barotrauma-Induced Pneumocephalus Experienced by a High Risk Patient after Commercial Air Travel

Huh, Jisoon The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.54 No.2

A 49-year-old female with a history of several neurosurgical and otolaryngologic procedures for occipital meningioma and cerebrospinal fluid leaks was diagnosed with pneumocephalus after a one hour flight on a domestic jet airliner. Despite multiple operations, the air appeared to enter the cranium through a weak portion of the skull base due to the low atmospheric pressure in the cabin. The intracranial air was absorbed with conservative management. The patient was recommended not to fly before a definite diagnostic work up and a sealing procedure for the cerebrospinal fluid leak site had been performed. Recent advances in aviation technology have enabled many people to travel by air, including individuals with medical conditions. Low cabin pressure is not dangerous to healthy individuals; however, practicing consultant neurosurgeons should understand the cabin environment and prepare high risk patients for safe air travel.

Burr Hole Drainage : Could Be Another Treatment Option for Cerebrospinal Fluid Leakage after Unidentified Dural Tear during Spinal Surgery?

Huh, Jisoon The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.53 No.1

Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.

Radiculopathy caused by lumbar epidural varix

Shin Jiyong,Oh Nawon,Huh Jisoon,현창림,Kim Joong-Goo,강사윤,Oh Jung-Hwan 대한신경집중치료학회 2020 대한신경집중치료학회지 Vol.13 No.2

Background: Lumbar epidural varix (LEV) is a very rare condition caused by dilatation of the vertebral venous plexus. LEV can result in lumbosacral radiculopathy, which is often mistaken for lumbosacral herniated intervertebral disc (HIVD). Case Report: A 72-year-old man visited the emergency department (ED) with radiating pain of the right leg that had developed 3 weeks previously. Before the ED visit, he was diagnosed with lumbosacral radiculopathy due to HIVD based on lumbar X-rays at an outpatient clinic. Despite conservative treatment, his symptoms deteriorated. On magnetic resonance imaging at the ED, an epidural cystic mass in the right L5–S1 with multiple HIVDs was observed. The mass was surgically removed, and the histological findings showed a dilated vessel with a thrombus, which led to the final diagnosis of LEV. Conclusion: In lumbosacral radiculopathy, LEV should be considered as a possibility even if degenerative spine disease is observed on lumbar X-rays.

Implementation of Cervical Pedicle Surgical Guide for Safe Surgery

Ho-Young Kwak(곽호영),Jisoon Huh(허지순),Won-Joo Lee(이원주) 한국컴퓨터정보학회 2017 韓國컴퓨터情報學會論文誌 Vol.22 No.12

Screw insertion surgery is frequently required among surgical procedures. Especially, very careful attention should be paid to the insertion of screw in the operation of the cervical vertebra. Therefore, there is a need for a guide that allows the surgeon to reliably and promptly perform treatment by calculating the desired insertion angle and length for screw insertion. In this study, the center and direction of the pedicle were calculated through 3D modeling and 3D vector numerical analysis using the CT or MRI image of the patient for the safe operation of the guide, and based on this, After that, we will implement surgical guide based on this.

연속 촬영 이미지를 이용한 Mouse의 운동 능력 평가 시스템

곽호영(Ho-Young Kwak),허지순(Jisoon Huh),이원주(Won Joo Lee) 한국컴퓨터정보학회 2015 韓國컴퓨터情報學會論文誌 Vol.20 No.1

본 논문에서는 연속 촬영 이미지를 이용한 실험용 쥐의 운동 능력 평가 시스탬을 제안한다. 의학이나 수의학 분야에서는 인류의 양질의 삶을 위해 mouse를 이용한 동물실험을 실시하고 있다. 특히 실험용 쥐(mouse)를 이용한 실험 중에는 인위적인 부상(injury)을 만들고, 다양한 처치를 통하여 그 부상에서 회복되는 정도를 측정하는 실험을 많이 하고 있다. 이러한 실험에서 그 동안의 전통적인 운동량 측정 방법은 사람이 직접 관찰하는 방법으로 이루어지고 있었다. 제안한 시스템은 실험용 쥐에 대한 움직임을 정해진 단위 시간동안 연속 촬영을 실시하고, 이 연속 촬영된 이미지에서 mouse의 외곽선을 point cloud로 추출한다. 추출된 point cloud를 이용하여 mouse의 몸통에 대한 내부 외곽선(interior contour line)을 다시 추출한 후, 이를 이용하여 그 중심점을 구하고, 이들 중심점들을 연결하여 거리를 계산하여 누적함으로써 mouse가 단위 시간동안 이동한 총 거리를 자동 계산하도록 하는 시스템을 설계하고 구현한다. In this paper, we propose a locomotor evaluation System for mouse based on continuous shooting images. In the field of veterinary medicine and animal studies are subjected to using the mouse for the quality of human life. In particular, during the experiments using the artificially created mice injury, through a variety of scoring and a lot of experiments to measure the extent of recovery from the injury. The traditional method of measuring the quantity of exercise while in this experiment was made of a method for directly observing person. The proposed system performs the continuous shooting per unit of time specified by the movement of the mouse is extracted from a continuous image shooting with the outline of a mouse point cloud. And using the extracted point cloud to extract again the inner contour of the body of the mouse. So using the new point cloud obtained its center, Then, using the center point calculated by accumulating the distance between two points on locomotor evaluation system design and implement to obtain the total distance the mouse moves over a unit of time.

The Design and Implementation of Mouse Activity Measurement System using Infrared Sensor

곽호영(Ho-Young Kwak),허지순(Jisoon Huh),이원주(Won Joo Lee) 한국컴퓨터정보학회 2016 韓國컴퓨터情報學會論文誌 Vol.21 No.12

In this paper, we design and implement a mouse movement measurement system using an infrared sensor called MAMS (Mouse Activity Measurement System). Unlike existing systems, MAMS can measure movements between IREDs. MAMS is removable allowing convenient portability and is also low cost. MAMS automatically measures mouse activity during a pre-set time interval. Since the measured data can be easily stored in a computer system, it is much simpler and more efficient than the Ugo 47420 model. Moreover, MAMS can be used in medical and veterinary field to eliminate manual observations.

CT/MRI 영상에서의 이미지 추출-분석 시스템

곽호영(Ho-Young Kwak),허지순(Jisoon Huh) 한국컴퓨터정보학회 2014 韓國컴퓨터情報學會論文誌 Vol.19 No.1

오늘날 사용하고 있는 의료용 영상의 대부분은 주로 병변을 확인하기 위한 수단으로 이용되고 있는데, 이러한 의료용 영상을 병변 확인뿐만 아니라 학술적 연구나 외과적 수술 처치를 위한 분석 및 참고 자료로 이용할 수 있다면 의학적 학술 연구에 도움을 줄 수 있으며, 외과적 수술 처치 및 치료에서 선행 시뮬레이션을 통하여 처치 오류를 줄일 수 있다. 따라서 본 논문에서는 의료용 이미지 영상에 대해 해당 영상에서 필요한 부분을 벡터 형식의 점(point cloud)들로 추출하고, 이들 벡터 정보를 이용하여 연구나 진료 및 수술에서 필요한 정보로 가공하여 시뮬레이션이 가능하도록 하는 시스템을 설계하고 구현함으로써 학술적 연구나 환자에 대한 진단 처치에 보다 효율적으로 접근할 수 있는 방법을 제공하고자 하였다. TMost of the medical images that are being used today are to confirm the existence of lesions. These kind of medical images can not only be used to confirm lesions but if we could use it for academic studies or for analysis and reference materials for surgical operations, it could offer great help in medical studies. Furthermore, we could reduce the number of errors in treatment through simulations in the surgical operations and treatments. In this paper, the necessary parts regarding the medical image visuals were extracted through the point cloud and by using the information obtained through it, it manufactures the necessary information for academic studies, diagnoses or operations. By designing and realizing the system which makes simulation possible with the manufactured information, the paper attempts to provide a more effective way to approach academic studies or giving appropriate diagnoses in the treatment of patients.

로봇 수술을 위한 경추 척추경에 대한 이상적 궤적의 측정

곽호영(Ho-Young Kwak),허지순(Jisoon Huh),이원주(Won Joo Lee) 한국컴퓨터정보학회 2017 한국컴퓨터정보학회 학술발표논문집 Vol.25 No.2

무선 통신과 GPS 기술을 결합한 반려견 분실 방지 장치의 설계 및 구현

곽호영(Ho-Young Kwak),장진욱(Jin-Wook Chang),허지순(Jisoon Huh) 한국컴퓨터정보학회 2019 韓國컴퓨터情報學會論文誌 Vol.24 No.2

Recently, as the number of families raising dogs has increased, cases of lost dogs have frequently occurred. According to US statistics, 5% of the total dogs are reported to be alive, with only 18% reporting to their owners. Therefore, a device for preventing the loss of dogs is needed, and the demand for the market is rapidly growing. Therefore, it is necessary to develop a lost device for dogs. In this paper, we developed a loss prevention device that combines low-power broadband wireless communication technology, LoRa communication method, and GPS positioning technology. The result of this study is expected to prevent the loss of dogs. It is also expected that social problems will reduce the problem of lost dogs.