Application of Dynamic Swallowing Simulation applying WKA-2

Appendix C
Application of Dynamic Swallowing
Simulation applying WKA-2
C.1 Purpose
Swallowing, known scientifically as deglutition, is the process in the human or animal
body that makes something pass from the mouth, to the pharynx, and into the esophagus,
while shutting the epiglottis, as shown in Fig. C.1. If this fails and the object goes through the
trachea, then choking or pulmonary aspiration can occur as shown in Fig. C.2. In the human
body it is controlled by the swallowing reflex [125]. Dysphagia (aspiration) is the medical
term for symptoms of difficulty in swallowing [126][127]. Some patients have limited
awareness of their own dysphagia, so lack of symptoms does not exclude an underlying
disease [128]. When dysphagia goes undiagnosed or untreated, patients are at a high risk of
aspiration and subsequent aspiration pneumonia secondary to food or liquids going the wrong
way into the lungs [129]. One of the most important causes of aspiration is the spillage of
food and liquid into the pharynx. It has been stated that normal subjects can hold food bolus
in the mouth without spillage in any head posture. Even if a slight spillage occurs, aspiration
following spillage will not occur because a swallowing reflex starts soon after spillage. As the
start of the reflex is delayed in patients with dysphagia, spillage becomes a risk factor of
aspiration [130]. For these reasons, a lot of researchers have tried to evaluate and diagnose the
causes of dysphagia in individual patients to determine appropriate therapies.
301
盧
博士論文
Video Fluorographic Swallowing Study (VFSS) is the gold standard for evaluating the
mechanism of swallowing. For this study, the patient is seated comfortably and given foods
mixed with barium to make them radiopaque [131][132]. The patient eats and drinks these
(a)
(b)
Figure C.1 Endoscopic image
(a) Before aspiration with food bolus
(b) Aspiration with food bolus
(a)
(b)
Figure C.2 Larynx and epiglottis
(a) Clinical image captured by fluoroscopic unit
(b) Anatomical position of epiglottic vallecula (arrow)
302
Application of Dynamic Swallowing Simulation Applying WKA-2m
Patient or Oralpharyngeal
model
Fluoros
copic
unit
model
Food bolus
(a)
(b)
Figure C.3 Video fluorographic swallowing study (VFSS)
(a) Fluoroscopic unit
(b) Image captured by Fluoroscopic
Pharyngeal wall
Back
Epiglottis
Tongue
Front
Tongue
Front
(a)
(b)
Figure C.4 in-vitro VFSS simulation system created by gypsum
(a) Integration of CT image
(b) 3D gypsum model
foods while radiographic images are observed on a video monitor and recorded on videotape.
Using the VFSS, the author can evaluate and diagnose the causes of dysphagia as shown in
Fig. C.3.
There are many therapies to reduce dysphagia, such as swallowing therapy, surgery,
and dietary modification [133]. In our study, the author focus on dietary modification, a
common treatment approach [134]. Normally, swallowing is affected by food bolus properties
303
博士論文
盧
Food
Bolus
Figure C.5 Image captured by Fluoroscopic unit using 3D gypsum model
such as hardness, stickiness and rheological characteristics. Dietary modifications can prevent
dysphagia in swallowing disorder patients, as well as promote good nutrition. Based on these
facts, our goal is to find food which prevents dysphagia, and develop food for swallowing
disorder patients accordingly. For dietary modification testing, the patient eats food boluses
(mixed with barium to make them radiopaque) which have different characteristics while
radiographic images are observed on a video monitor and recorded on videotape (Figure C.3).
Then, doctors evaluate and diagnose whether there is a risk of aspirating the food boluses or
not. However, performing these experiments with actual patients is too risky, and also
presents ethical problems. Therefore the author are proposing an in-vitro VFSS simulation
system.
So far the author have studied dietary modification possibilities using the in-vitro
VFSS simulation system. From each of the CT images, the author create 3D models, and
based on the 3D models, the author manufacture a plaster model as shown in Fig. C.4. As
experimental conditions, viscosity and head position were set. While radiographic images are
observed on a video monitor and recorded on videotape, foods mixed with barium to make
them radiopaque are passed down from the oral cavity to the epiglottis as shown in Fig. C.5.
The data from this simulation might facilitate estimation of the optimal food viscosity and
feeding position that would allow such patients to eat without aspiration [135].
However, the proposed VFSS simulation system is static and the simulation data can
not provide quantitative information because it can not realistically simulate the act of
swallowing. Swallowing requires not only dynamic motion of the tongue, but also
simultaneous motion of the mandible. Therefore, in order to realistically simulate the act of
304
Application of Dynamic Swallowing Simulation Applying WKA-2m
(a)
(b)
Figure C.6 Dynamic VFSS simulation system
(a) Lateral view
(b) Frontal view
swallowing, the author is proposing an in-vitro dynamic VFSS simulation system. It consists
of a head, mandible, neck, tongue, trachea, larynx, pharynx and 16 actuators with wire driving
mechanisms. This system can simulate swallowing by moving the tongue and mandible
simultaneously. Just as with the static VFSS simulation system, a set of experiments can be
carried out with different viscosities and different head positions while radiographic images
are observed on a video monitor and recorded on videotape.
305
盧
博士論文
Figure C.7 Detail of the wiring mechanism with their
corresponding human muscle.
In this paper, the author will present our design concept for an in-vitro VFSS dynamic
simulation system, and its hardware configuration. Finally, the author will present a set of
swallowing experiments carried out using the dynamic VFSS simulation system, four food
boluses with different viscosities, and movie clips captured using the Video Fluoroscopy (VF)
unit.
C.2 Method
The design concept of the dynamic VFSS simulation system assumes four
requirements: first, the proposed system should assume patients with severe swallowing
disorder. Second, the proposed system should reproduce the physiology and anatomy of the
organs involved in swallowing. The third principle is that the system should be capable of
simulating swallowing. Finally, an accurate positioning control should be implemented to
assure that the task conditions are precisely reproduced. As a result, the dynamic VFSS
simulation system contains six active degree of freedoms (DOFs). Such actuation systems
306
Application of Dynamic Swallowing Simulation Applying WKA-2m
(a)
(b)
(c)
Figure C.8 3 Tongue model extracted by CT image
(a) One layer of CT images
(b) Extraction of one layer of one layer of CT image
(c) Integration of each of the layers of extracted parts
(a)
(b)
Figure C.9 Manufacture of Tongue, larynx, and trachea
(a) Tongue manufactured by 3D printer for the prototype
(b) Tongue manufactured by silicon for the simulation system
have been designed to control the positioning of the 16 wire driving mechanisms that
reproduces the swallowing. In particular, the wire driving mechanisms were designed to
control the motion of the following muscles (Figure C.6-7): lateral pterygoid muscle, masseter
muscle, infrahyoid muscles, temporal muscle, and suprahyoid muscle. In order to reproduce
the swallowing motion, the author have designed simulated organs by considering the range
of motion of human organs. In particular, the author reproduced the motion range of the
307
盧
博士論文
(a)
(b)
Figure C.10 Range of mandible of human and dynamic simulation system
(a) Range of human mandible
(b) Range of the mandible of the dynamic simulation system
mandible and tongue as closely as possible. For this purpose, the author has collected
information from medical literature as well as from MRI images.
C.2.1 Configuration of Hardware
Each part of the Dynamic VFSS simulation system, such as the head, mandible and
tongue, is designed based on CT images, and has been redesigned with embedded actuation
systems (Figure C.8-11). In particular, the simulation system has been designed to reproduce
the motion of the tongue, and the mandible. The actuation system of the simulation system is
based on a wire driving system, so that it fits into a human-size model. The wire driving
system consists of sixteen Teflon-coated wires (which have a low friction coefficient), pulleys
and RC servo motors (placed on a base). The wire driving mechanisms are shown in detail in
Fig. C.6-7. The details of these mechanisms are as follows:
a) Mandible
Humans have a large DOF for chewing food. For the swallowing motion, 2-DOFs is
sufficient to simulate with rotational motion (Ө) and translational motion (L). As shown in Fig.
C.10a, the range of motion of the mandible is equivalent with that of human [83]. In order to
control the motion of the mandible, the author has attached six wires to it. In addition, three
308
Application of Dynamic Swallowing Simulation Applying WKA-2m
Figure C.11 Simplified 6 links model and arrangement of 16 wires
common wires were connected with the mandible and tongue. For the kinetic axis, the author
attached two linear guides. On the linear guides, the author also attached rotational axis (see
Fig. C.6-7).
b) Tongue
In order to control the position of the tongue, the author considered three points: the
tongue bone (hyoid bone), the center point of the tongue, and tip of the tongue. The actuation
mechanism of the tongue has six wires attached to the tongue bone, three to the center point
of the tongue and one to the tip of the tongue (Figure C.7). As the author has previously
mentioned, three of those wires are common with the mandible, so the motion of the tongue is
connected to that of the mandible. As it is shown in Fig. 11a, the range of motion of the hyoid
bone is equivalent with that of a human [86]. In order to control the motion of tongue, the
author must control the position of the tongue bone. On the other hand, in order to modify the
shape of the tongue, the author must control the center point and tip. Of course, controlling
the position of the center point and the tip of the tongue is dependent on the position of the
309
盧
博士論文
Figure C.12 Measurement device for test food texture analysis
tongue bone. By using these controls to modify the shape of the tongue, the author may
reproduce an oral cavity space appropriate for the swallowing motion.
c) Epiglottis and Pharynx
The epiglottis and pharynx play an important role in swallowing. During this process,
the larynx rises, the pharynx is narrowed, and the epiglottis, which is composed of cartilage,
covers its opening and directs food and fluid into the esophagus simultaneously, blocking
entry into the trachea which would then lead to the lungs. However, the author assume that
patients have severe swallowing disorder which is called severe dysphagia. In such patients,
the epiglottis does not close as it should, the larynx does not rise so much, and the pharynx is
not narrowed at the same time. Finally, food or liquid may enter the windpipe and become
Table C.1 Characterisitics of test foots
Test food
Barium
Barium with food
thickener
Custard pudding
Rice porridge
Hardness (Pa)
90
Stickiness (J/m3)
7
300
30
900
1500
10
200
310
Application of Dynamic Swallowing Simulation Applying WKA-2m
Figure C.13 Video fluoroscopy unit and dynamic VFSS simulation system
maxilla
soft palate
mandible
pharyngeal
space
epiglottis
hyoid bone
trachea
esophagus
epiglottic vallecula
(residue of food bolus)
(a)
(b)
Figure C.14 Image captured by video fluoroscopy unit
(a) Lateral fluoroscopy view
(b) Frontal oblique view
trapped, causing choking. The author call this epiglottic dysfunction [136][137]. For these
reasons, the epiglottis and the pharynx of the simulation system has no actuation, and has no
wire driving mechanism, as shown in Fig. C.9. Epiglottis and pharynx play an important role
in the swallowing procedure. During swallowing, the larynx rises and the epiglottis, which is
composed of cartilage, covers its opening which then directs food and fluid into the
esophagus and preventing its entry into the trachea which would then lead to the lungs.
However, in the patient who has swallowing disorder, the epiglottis does not close as it should
food or liquid may enter the windpipe, causing choking or trapping of food. The author calls
311
博士論文
盧
Table C.2 Result of experiments
Test
food
Time
distance
of slip
down
Barium
0.2
Barium with
food
thickener
Custard
pudding
Rice porridge
3.5
1.8
9.6
Weight
(% of
Residual
volume)
(SD)
11.7
(7.7)
Area of Residual
(mm2)
(SD)
Lateral Frontal
View
View
43.7
56.8
(8.6)
(19.9)
62.4
(20.2)
123.1
(13.1)
232.9
(59.1)
52.8
(10.1)
75.8
(9.6)
130.7
(34.9)
162.9
(20.1)
207.6
(20.4)
254.0
(77.0)
Density of Residual
(% of gray level)
Lateral
View
Frontal
View
23.8
22.5
27.5
22.1
26.4
26.2
31.7
25.1
this epiglottic dysfunction [136][137]. For these reasons, the epiglottis of the simulation
system has no actuation, and has no wire driving mechanism as shown in Fig. C.9.
d) Kinematic Model, Patterns Generation and Control of Dynamic VFSS Simulation
System
In order to simulate the swallowing motion using our simulation system, the author
should analyze the kinematic model of the simulation system for position control. In human
anatomy, the motion of the tongue and the vocal cord follows the motion of the mandible
because all of the tongue muscles are attached to the mandible. As a result, the author can
simplify their motions into 6 DOF Link model as shown in Fig C.12. In order to simulate the
swallowing motion, the author propose two coordinate systems, such as one absolute
coordinate system O’ and one relative coordinate system O”, shown in Fig. C.12. First, the
author adjust the position of the tongue Po’’(xo”, yo”), θ0, θ1 with respect to the relative
coordinate, and the position of the mandible θ2, d0 with respect to the absolute coordinate as
shown in Fig. C.12. Then, from the kinematic model of the simulation system, the author can
obtain the center points of each of the pulleys on the head, the center points of each of the
bearing units on the mandible, and the center points of each of the pulleys on the chest.
Moreover, the author can also obtain the three points (tongue bone, center point, and tip of the
312
Figure C.15 Result of VFSS simulation
(a) Custard pudding
(b) Thickened liquid
313
(b)
(a)
Application of Dynamic Swallowing Simulation Applying WKA-2m
盧
博士論文
tongue) on the tongue. Based on these obtained points, the author can calculate each of the
wire lengths, as shown in Fig. C.12. The swallowing motion especially a normal swallowing
reflex is so complicate and quick. In comparison with normal human, motion of our robot is
very slow. The author highlighted the motion pattern of mandible and hyoid bone in patients
with severe dysphagia.
C.3 Result and Discussion
As stated in the introduction, as the start of the reflex is delayed in patients with
dysphagia, spillage becomes a risk factor of aspiration. It is meaningful if the robot could
simulate the relationship between the abnormal motion patten of hyoid bone, texture of the
food and the occurrence of aspiration. For the purpose of this simulation, the author used the
Dynamic VFSS simulation system with four food boluses which have different properties
such as hardness, stickiness and rheological characteristics. From the result of the experiments,
the author are trying to find the food bolus which does not cause dysphagia and develop food
for swallowing disorder patients accordingly. In our experiments, the author used four test
foods: barium, barium with food thickener, custard pudding, and rice. While the simulation
system swallows the four test food boluses, the author observe movie clips captured by a VF
unit to analyze and evaluate the four test foods and determine which food boluses cause
dysphagia (aspiration).
C.3.1 Measurement of Food Texture and Video Fluoroscopy
Using a device to measure food texture (Figure C.13), the author obtained data about
the characteristics of the four test food boluses such as hardness and stickiness, as shown in
Table 1. In addition, the author uses a VF unit in order to analyze and evaluate the test food
boluses during swallowing, as shown in Fig. C.14. This VF unit captures the lateral
fluoroscopic view as well as the frontal oblique view, as shown in Fig. 15.
314
Application of Dynamic Swallowing Simulation Applying WKA-2m
C.3.2 Video Fluoroscopy Swallow Study (VFSS) Simulation
The author prepared four test foods. a) Barium contrast medium, b) Barium contrast
medium with food thickening agent, c) Barium custard pudding, and d) Iodic contrast medium
coated rice porridge. Before inserting the four test foods into the oral cavity, the author form
them into food boluses, round or oval-shaped masses of food which are usually formed in the
mouth after thorough chewing. Then, the author place one of the food boluses on the center of
tongue with artificial saliva (Saliveht®, Teijin Pharma Tokyo, Japan to simulate the condition
of oral mucosa), as shown in Fig. C.16. Then simulation of the swallowing motion begins.
The experiments show us the ratio of residue, the time required for the test food to travel
down, the area of residual foods in the lateral and the frontal images, and the gray-value
density of the image as shown in Table C.2. The higher viscosity foods flowed slowly down
the base of the tongue, and caused more residues because they flowed as a mass. Liquids, on
the other hand, flowed rapidly and diffusely, leaving less residue. Barium with food thickener,
custard pudding and rice porridge slid down the throat as a bolus (Figure C.16a). On the other
hand, liquid barium flowed down quickly and made a splash, leaving little residue (Figure
C.16b). Regarding the relationship between the amount of residues and the area in the VFSS
images, the frontal oblique view showed a better correlation than the lateral view. No
apparent correlation was seen between the type of the test food and the image density of
residues.
C.4 Conclusion
The results from these experiments revealed that thickened boluses have a tendency to
leave residue in the epiglottic vallecula. As in case of the liquid, fewer residues occur, and the
risk of penetration to the larynx and aspiration is increased. This study shows that not only the
lateral image but also the frontal image is important for evaluating the food residues in the
oral- pharyngeal space. In the future, additional experiments will be carried out with a greater
variety of different foods to find out which ones cause aspiration, and the author would like to
propose a set of the experiments to see whether the orientation of the head andneck can affect
aspiration or not. Moreover, motion of tongue, epiglottis, soft palate, and pharyngeal wall will
take under consideration in future study. In our dynamic FDSS simulation system, the author
315
盧
博士論文
found several problems. Each of the wires slackened while applying position control. This
caused position errors in the mandible and tongue. In the future, such errors should be
evaluated and minimized. The author will propose wire tension controls on each of wire in
order to prevent slack, and include embedded tensions sensors to do so.
316
Reference
[1]
Amitai Ziv, Paul Root Wolpe, Stephen D. Small, and Shimon Glick, “SimulationBased Medical Education: An Ethical Imperative,” Academicmedcine, vol.78, no.8,
pp783-788, 2003.
[2]
Lynoe N, Sandlund M, Westberg K, Duchek M., “Informed consent in clinical
training: patient experiences and motives for participating,” Journal of Med Educ.,
vol. 32, no. 5, pp. 465–471, 1998.
[3]
Hayes GJ. “Issues of consent: the use of the recently deceased for endotracheal
intubation training,” Journal of Clin Ethics, vol. 5, no. 3, pp. 264–266, 1994.
[4]
Kaldjian LC, Wu BJ, Jekel JF, Kaldjian EP, Duffy TP., “Insertion of femoral vein
catheters for practice by medical house officers during cardiopulmonary
resuscitation,” New England Journal of Medicine, vol. 341, no. 27, pp. 2088–91,
1999.
[5]
Feinstein, AR. System, supervision, standards, and the epidemic of Dreyfus HL,
Dreyfus SE. Mind over Machine: The Power of Human Intuition and Expertise in the
Era of the Computer, New York: Gxford U Press, MacMillan, 1986.
[6]
OED Inc., [Online]. Available: http://dictionary.oed.com.
317
盧
博士論文
[7]
Tjomsland N, Baskett P., “Resuscitation greats: Asmund S Lærdal,” Journal of
Resuscitation, vol. 53, no. 2, pp115–119, 2002.
[8]
Abrahamson S, Denson JS, Wolf RM., “Effectiveness of a simulator in training
anaesthesiology residents,” Journal of Med Educ., vol. 44, no. 6, pp. 515–519, 1969.
[9]
Abrahamson S, Denson JS, Wolf RM., “Effectiveness of a simulator in training
anaesthesiology residents,” Journal of Qual Saf Health Care, vol. 13, no. 5, pp. 395–
397, 2004.
[10]
Gaba DM, DeAnda A., “A comprehensive anaesthesia simulation environment:
recreating the operating room for research and training,” Journal of Anaesthesiology,
vol. 69, no.3, pp. 387–394, 1988.
[11]
Good ML, Gravenstein JS., “Anaesthesia simulators and training devices,” Journal
of International Anesthesiology Clinics, vol. 27, no.3, pp. 161–166, 1989.
[12]
Gaba DM, Howard SK, Fish KJ, Smith BE, Sowb YA., “Simulation-based training
in anaesthesia crisis resource management (ACRM): a decade of experience,”
Journal of Simulation Gaming, vol. 32, no. 2, pp. 175–193, 2001.
[13]
General
Medical
Council,
Tomorrow’s
Doctors:
Recommendations
on
Undergraduate Medical Education, London, GMC, 1993.
[14]
Association of American Medical Colleges, “Learning objectives for medical student
education – guidelines for medical schools: Report 1 of the Medical School
Objectives Project,” Journal of Academic Medicine, vol. 74, no. 1, pp. 13–18, 1999.
[15]
Accreditation Committee, “Assessment and Accreditation of Medical Schools:
Standards and Procedures,” Canberra: Australian Medical Council 2002.
318
Referencem
[16]
World Federation for Medical Education., “Global Standards for Quality
Improvement. Copenhagen: WFME 2003. Bligh J. The clinical skills unit. Postgrad,”
Journal of Medicinal Chemistry, vol. 71, no. 842, pp. 730–732, 1995.
[17]
Bradley P, Bligh J., “One year’s experience with a clinical skills resource centre,”
Journal of Med Educ., vol. 33, no. 2, pp.114–120, 1999.
[18]
Dacre J, Nicol M, Holroyd D, Ingram D., “The development of a clinical skills
centre,” Journal of Coll Physicians Lond, vol. 30, no. 4, pp. 318–324, 1996;
[19]
Ziv A, Wolpe PR, Small SD, Glick S., “Simulation-based medical education: an
ethical imperative,” Journal of Academic Medicine., vol. 78, no. 8, pp.783-788, Aug.
2003.
[20]
Walls, R.M., Murphy, F., Luten, R.C., Schneider, E.C., Manual of Emergency
Airway Management, 2nd Edition, Philadelphia: LIPPINCOTT WILLIAMS and
WILKINS, 2004
[21]
Solis, J, “Robotic Control Systems for Learning and Teaching Human Skills,” Ph.D.
dissertation, Perceptual Robotics Laboratory, Scuola Superiore Sant’Anna, Pisa,
Italy, 2004.
[22]
Solis, J., Marcheshi, S., Frisoli, A., Avizzano, C.A., Bergamasco, M.,“Reactive
Robots System: An active human/robot interaction for transferring skills from robot
to unskilled persons,” Advanced Robotics Journal, vol. 21, no. 4, pp. 267-291, 2007.
[23]
Owen, H., Follows, V., Reynolds, K., Burgess, G., Plummer, J., “Learning to apply
effective cricoid pressure using a part task trainer,” Journal of Anaesthesia, vol. 57,
no. 11, pp. 1098-1101, 2002.
[24]
Laerdal Medical Inc., [Online].
Available: http://www.laerdal.com/simman/simman.htm.
319
盧
[25]
博士論文
N. D. Syroid, J. Agutter, F. A. Drews, D. R. Westenskow, R. W. Albert, J. C.
Bermudez, D. L. Strayer, H. Prenzel, R. G. Loeb, and M. B.Weinger, “Development
and evaluation of a graphical anesthesia drug display,” Journal of Anesthesiology,
vol. 96, no. 3, pp. 565-574, 2002.
[26]
D. M. Gaba, S. K. Howard, B. Flanagan, B. E. Smith, K. J. Fish, and R. Botney,
“Assessment of clinical performance during simulated crises using both technical
and behavioral ratings,” Journal of Anesthesiology, vol. 89, no. 22, pp. 8-18, 1998.
[27]
F. A. Drews, N. Syroid, J. Agutter, D. L. Strayer, and D. R.Westenskow, “Drug
delivery as control task: Improving performance in a common anesthetic task,”
Journal of Human Factors, vol. 48, no. 45, pp. 85-94, 2006.
[28]
S. B. Wachter, K. Johnson, R. Albert, N. Syroid, F. Drews, and D.Westenskow, “The
evaluation of a pulmonary display to detect adverse respiratory events using high
resolution human simulator,” Journal of the American Medical Informatics
Association, vol. 13, no. 6, pp. 635-642, 2006.
[29]
N. Segall, J. M. Taekman, J. B. Mark, G. Hobbs, and M. C. Wright, “Coding,
visualizing, and analyzing eye tracking data in simulated anesthesia care,”
Proceedings of the 51st Annual Meeting of the Human Factors and Ergonomics
Society, pp. 670-675, 2003.
[30]
M. C. Wright, J. M. Taekman, and M. R. Endsley, “Objective measures of situation
awareness in a simulated medical environment,” Journal of Quality and Safety in
Health Care, vol. 13, no. 7, pp. 165-171, 2004.
[31]
Martin, J.L, Bucx, M.J.L., van de Vegt, M.H, Snijders C.J., Stijnen, T., Wesselink, P.
“Transverse forces exerted on the maxillary incisors during laryngoscopy,”
Canadian Journal of Anaesthesia, vol. 43, no. 7, pp. 665-671, 1996
320
Referencem
[32]
Mayrose J., Kesavadas T., Chugh K., Dhananjay J., Ellis D.G.,“Utilization of
Virtual Reality for Endotracheal Intubation Training,” Journal of Resuscitation, vol.
59, no. 1, pp. 133-138, 2003.
[33]
Burt, D. “Virtual reality in anaesthesia,” British Journal of Anesthesia, vol. 75, no. 4,
pp. 472-480, 1995.
[34]
Aizuddin, M., Oshima, N., Midorikawa, R., Takanishi, A. “Development of Sensor
System for Effective Evaluation of Surgical Skills,” Proceedings of the International
Conference on Biomedical Robotics and Biomechatronics, ID 287, 2006.
[35]
Nobuki Oshima, Muhamad Aizuddin, Ryo Midorikawa, Jorge Solis, Yu Ogura,
Atsuo Takanishi, “Development of a Suture Training Simulator with Quantitative
Evaluation Function,” Proceedings of 5th International Special Topic Conference
on Information Technology Applications in Biomedicine, IO 104, 2006.
[36]
Nobuki Oshima, Muhamad Aizuddin, Ryu Midorikawa, Jorge Solis, Yu Ogura,
Atsuo Takanishi, “Development of a Ligature/Suture Training System which
provides quantitative information of the learning process of trainees,” Proceedings of
the International Conference on Robotics and Automation, pp. 2056-2061, 2007.
[37]
Nobuki Oshima, Jorge Solis, Hiroyuki Ishii, Kazuyuki Hatake, Atsuo Takanishi,
“Acquisition of Quantitative Data for the Detailed Analysis of the Suture/Ligature
Tasks with the WKS-2R,” Proceedings of the International Special Topic
Conference on Information Technology in Biomedicine, pp. 210-213, 2007.
[38]
Nobuki Oshima, Jorge Solis, Hiroyuki Ishii, Noriyuki Matsuoka, Kazuyuki Hatake,
Atsuo Takanishi: Integration of an evaluation function into the suture/ligature
training system WKS-2R,” Proceedings of the International Conference on Robotics
and Automation, pp. 1045-1050, 2008.
321
盧
[39]
博士論文
Solis, J., Oshima, N., Ishii, H., Matsuoka, N., Hatake, K., Takanishi, A.,
“Development of a Sensor System towards the Acquisition of Quantitative
Information of the Training Progress of Surgical Skills,” Proceedings of the
IEEE/RSJ International conference on Biomedical Robotics and Biomechatronics,
pp. 340-345, 2008.
[40]
Jorge Solis, Nobuki Oshima, Hiroyuki Ishii, Noriyuki Matsuoka, Kazuyuki Hatake
and Atsuo Takanishi,” Towards understanding the suture/ligature skills during the
training process using WKS-2RII”, International Journal of computer assisted
radiology and surgery, vol(3), no.3-4, pp. 231-239.
[41]
Noh, Y., Nagahiro, K., Ogura Y., Solis, J., Hatake, K., Takanishi, A.,” Design of
Airway Management Training System,” Proceedings of the International Special
Topic Conference on Information Technology Applications in Biomedicine, IO119,
2006.
[42]
Noh, Y., Nagahiro, K., Ogura Y., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
Development of Airway Management Training System which embeds array of
sensors on a conventional mannequin,” IEEE/RSJ International Conference on
Intelligent Robots and Systems, pp. 1296–1301
[43]
Noh, Y., Segawa, M., Shimomura, A., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
Reproducing Difficulties of Airway Management on Patients with Restricted
Opening Mouth using the WKA-1,” Proceedings of the International Special Topic
Conference on Information Technology Applications in Biomedicine, pp. 115–118,
2007.
[44]
Noh, Y., Segawa, M., Shimomura, A., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
Determination of Effective Evaluation Parameters on the Airway Training System
322
Referencem
WKA-1R,” Proceedings of the International Conference of the International Society
for Gerontechnology, vol. 7, no.2, pp. 174, 2008.
[45]
Noh, Y., Segawa, M., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,” Improvements
on the sensor system on the WKA-1R to identify the evaluation parameters of the
airway management,” Proceedings of Computer Assited Radiology and Surgery 22nd
International Cogress and Exhibition, pp. S209-210, 2008.
[46]
Noh, Y., Segawa, M., Shimomura, A., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
Development of the Evaluation System for the Airway Management Training System
WKA-1R,” Proceedings of the IEEE/RSJ International Conference on Biomedical
and Biomechatronics, pp. 574-579, 2008.
[47]
Noh, Y., Segawa, M., Shimomura, A., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
WKA-1R Robot Assisted Quantitative Assessment of Airway Management,”
International Journal of Computer Assisted Radiology and Surgery, vol. 3, no. 6,
543-550, 2008.
[48]
Noh, Y., Segawa, M., Shimomura, A., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
Development of the Airway Management Training System WKA-2 which can
reproduce the Cases of Difficult Airway,” Proceedings of IEEE International
Conference on Robotics and Automation, pp. 3833–3838, 2009.
[49]
Noh, Y., Sato, K., Shimomura, A., Segawa, M., Ishii, H., Solis, J., Hatake, K.,
Takanishi, A.,” Mechanism Design Improvements of the Airway Management
Training System WKA-2”, Proceedings of the 17th CISM-IFToMM Symposium on
Robot Design, Dynamics and Control, pp.103-110, 2008.
[50]
Noh, Y., Shimomura, A., Segawa, M., Ishii, H., Solis, J., Hatake, K., Takanishi, A.,”
Development of Tension/Compression Detection Sensor System Designed to Acqure
323
盧
博士論文
uantitative Force Information while Training the Airway management,” Proceedings
of IEEE/ASME International Conference on Advanced Intelligent Mechatronics,
pp.1264 – 1269, 2009.
[51]
Noh, Y., Sato, K., Shimomura, A., Segawa, M., Ishii, H., Solis, J., Hatake, K.,
Takanishi, A.,” Mechanism Design Improvements of the Airway Management
Training System WKA-3,” Proceedings of 18th CISM-IFToMM Symposium on
Robot Design, Dynamics and Control, pp.183-190, 2010.
[52]
Noh, Y., Shimomura, A., Sato, K., Segawa, M., Ishii, H., Solis, J., Hatake, K.,
Takanishi, A.,” Development of Patient Scenario Generation which can Reproduce
Characteristics of the Patient for Simulating Real-World Conditions of Task for
Airway Management Training System WKA-3,” Proceedings of IEEE/RSJ
International Conference on Intelligent Robots and Systems, pp.331-336, 2010.
[53]
Noh, Y., Shimomura, A., Sato, K., Segawa, M., Ishii, H., Solis, J., Hatake, K.,
Takanishi, A.,” Development of the Airway Management Training System WKA-3:
Integration of Evaluation Module to Provide Assessment of Clinical Competence and
Feedback Module to Reproduce Different Cases of Airway Difficulties,”
Proceedings of IEEE/RSJ International Conference on Intelligent Robots and
Systems, pp.337-342, 2010.
[54]
Noh, Y., Ebihara, K., Shoji, S., Segawa, M., Ishii, H., Solis, J., Hatake, K., Takanishi,
A.,” Development of the Airway Management Training System WKA-4: for
Improving Reproduction of High Fidelity of Real Patient and Improving Tongue
Mechanism and Mandible Mechanism,” Proceedings of IEEE International
Conference on Robotics and Automation, pp. 2028-2033, 2011.
324
Referencem
[55]
Holm-Knudsen RJ, Rasmussen LS, “Paediatric airway management: basic aspects,”
Journal of Acta Anaesthesiol Scand., vol. 53, no.1, pp.1-9, Jan. 2009.
[56]
P. P. Bredmose, J.-K. Heltne,” Pre-hospital airway management guidelines: we need
more,” Journal of Acta Anaesthesiol Scand., vol. 54, no.1, pp. 122–123, Jan. 2010.
[57]
Charles D Deakin, Tom Clarke, Jerry Nolan, David A Zideman, Carl Gwinnutt,
Fionna Moore, Michael Ward, Carl Keeble, Wim Blancke,”Crtical reassessment of
ambulance service airway management in prehospital care: Joint Royal Colleges
Ambulance Liaison Committee Airway Working Group, June 2008”, Emergency
Medicine Journal, vol. 27, no. 4, pp. 226-233, 2010.
[58]
Granholm T, Farmer DL,” The surgical airway,” Journal of Respiratory Care Clinics
of North America, vol 7, no. 1, pp. 13-23, Mar. 2001.
[59]
Dr. Divatia J. V., Dr. Bhowmick K., “Complications of endotracheal intubation and
other airway management procedures,” Indian journal of anaesthesia, vol. 49, no. 4,
pp. 308-318, 2007.
[60]
Loh KS, Irish JC., “Traumatic complications of intubation and other airway
management procedures,” Journal of Respiratory Care Clinics of North America, vol
20. no.2, pp. 953-969, 2002.
[61]
Domino KB, Postner KL, Caplan RA, Cheney FW, “Airway injury during
anesthesia,” Journal of Anesthesiology, vol 91, no. 3, pp. 1703-1711, 1999.
[62]
Seitz PA, Gravenstein N., “Endobronchial rupture from endotracheal reintubation
with an endotracheal tube,” The Journal of Clinical Anesthesia, vol. 1, no. 9, pp. 214,
1989.
325
盧
[63]
博士論文
Wagner DL, Gammage GW, Wong ML., “Tracheal rupture following insertion of a
disposable double-lumen tube,” Journal of Anesthesiology, vol. 63, no. 12, pp. 698,
1985.
[64]
Kapadia FN, Bajan KB, Raje KV, “Airway accidents in intubated ICU patients: An
epidemiological study,” Journal of Critical Care Medicine, vol. 28, no. 3, pp. 659664, 2000.
[65]
Sunanda Gupta, Rajesh Sharma KR, Dimpel Jain, “Airway assessment: predictors of
difficult airway,” Indian Journal of Anaesthesia, vol 49, no. 4, pp. 257-262, 2005.
[66]
Benumof JL., Definition and incidence of the difficult airway: Principles and
practice, 3rd Edition, St Louis Mosby, pp. 121-125, 1996:.
[67]
Robert C. Luten, Robert E. Schneider, Manual of Emergency airway management
2nd Editon, Lippincott William and Wilkins, 2005.
[68]
Rade B. Vukmir, Airway Management in the critically ill, 2nd Edition, Parthenon
publishing, 2005.
[69]
Nishikawa, K, Young-Kwang Park, Aizuddin. M, Yoshinaga.K, Ogura K, Umezu M,
Takanishi A,” Development of Carbon Microcoils (CMC) Sensor System with High
Sensitivity for Effective Acquisition of Tactile Information,” Procceedings of the
International Conference on Intelligent Robots and Systems, pp. 110-115, 2005.
[70]
Yoshiharu T., Naoya, A., Hiroyuki, S., “A study on tactile resolution of human skin,”
Procceedings of the SICE Annual Conference, pp.3137-3139, 2002
[71]
J Rubens, “Testing Airway Management Skills: Interactive Video Courseware vs
ACLS Instructor,” Journal of Respiratory Care, vol. 36, no. 8, pp. 849-856, Aug
1991.
[72]
MedED Inc., [Online]. Portal https://www.mededportal.org/publication/631
326
Referencem
[73]
M. Polansky, “Airway Management: The Basics of Endotracheal Intubation,”
Internet Journal of Academic Physician Assistants, vol. 1, no. 1, pp.210-218, 1997.
[74]
Ron M. Walls Michael F. Murphy, Manual of Emergency Airway Management, 3rd
Edition, Wolters Kluwer Lippincott Williams and Wilkins, 2009.
[75]
Jay P. Goldsmith,Edward H. Karotkin, Assisted ventilation of the neonate, 5th Edition,
SAUNDERS, 2011.
[76]
J Rubens, “Testing Airway Management Skills: Interactive Video Courseware vs
ACLS Instructor,” Journal of Respiratory Care, vol. 36, no. 8, pp. 849-856, Aug.
1991.
[77]
American Heart Association, Instructor’s manual for advanced cardiac life support,
2nd Edition, Dallas Tx: AHA. 1987.
[78]
Aoyama, K., Tracheal Intubation Visual Manual of Clinical Basic Techniques, 1st
Edition, Japan: Yodosya, pp.14-15, 2005.
[79]
Martin, J.L, Bucx, M.J.L., van de Vegt, M.H, Snijders C.J., Stijnen, T.,Wesselink, P.,
“Transverse forces exerted on the maxillary incisors during laryngoscopy,”
Canadian Journal of Anaesthesia, vol. 43, no. 7, pp. 665-671, 1996.
[80]
P. Sengupta, D.I. Sessler, “Endotracheal tube cuff pressure in three hospitals, and the
volume required to produce an appropriate cuff pressure,” Jounal of BMC
Anesthesiology, vol. 23, no.4, pp.345-340, 2004.
[81]
Balakrishnama, S., Ganapathiraju, A., “Linear Discriminant Analysis-A Brief
Tutorial,” Institute for Signal and Information Processing, Dep. of Electrical and
Computer Engineering, Mississippi State University, 2006.
[82]
Ferdinand P. Beer, E. Russell, Jr. Johnston, Mechanics of Materials, 5th Edition,
McGraw-Hill Science/Engineering/Math, 2000.
327
盧
[83]
博士論文
Ishihara T, Hasegawa S, AI M., Mandibular Movement and Articulators (in
Japanese), Tokyo, Japan,. HYORON, p 103, 1975.
[84]
Edgar N. Starcke, “The History of Articulators: Scribing Articulators: Those with
Functionally Generated Custom Guide Controls Part I,” Journal of Prosthodontics,
vol 13, no. 2, pp 118-128, 2004.
[85]
Joseph Brimacombe, Christian Keller, Karl H. Kunzel Othmar Gaber, Michael
Boehler, and Fredrich Puhringer, “Cervical Spine Motion During Airway
Management: A Cinefluoroscopic Study of the Posteriorly Destabilized Third
Cervical Vertebrae in Human Cadavers,” Journal of Anesthesia and Analgesia, vol.
91, no.5, pp. 1274 -1278, 2000.
[86]
Miwako Honma, “Relations between the bolus size and hyoid movement seen during
natural ingestive behavious in humans,” Japan Nigata dental journal, vol. 36 no. 6,
pp. 97, 2001.
[87]
坂東永一, 三谷英夫, 上村修三郎ほか編, “顎機能障害新しい診断システムと治
療指針,” 医歯薬出版株式会社, pp. 140-141, 1978.
[88]
Hiroyuki Ishii, Hiroki Koga, Yuichi Obokawa, Jorge Solis, Atsuo Takanishi and
Akitoshi Katsumata, “Path generator control system and virtual compliance
calculator for maxillofacial massage robots,” International Journal of Computer
Assisted Radiology Surgery, vol. 5, no. 1, pp. 77-84. 2009.
[89]
LeGrand SA, Hindman BJ, Dexter F, Weeks JB, Todd MM, “Craniocervical notion
during direct laryngoscopy and orotracheal intubation with the Macintosh and Miller
blades: an in vivo cinefluoroscopic study,” Journal of Anesthesiology, vol.107, no.6,
pp. 884-91, 2007.
328
Referencem
[90]
Bruce N. Epker, Timothy Turvey, and Leward C. Fish, “Indications forsimultaneous
mobilization of the maxilla and mandible for thecorrection of dentofacial
deformities,” Journal of Oral Surgery, Oral Medicine, Oral Pathology, vol.54, no. 4,
pp. 369-381, 1982.
[91]
“Practice Guidelines for Management of the Difficult Airway – An Updated Report
by the American Society of Anesthesiologists Task Force on Management of the
Difficult Airway - SPECIAL ARTICLE,” Journal of Anesthesiology, vol. 98, no.5,
pp. 1269–1277, 2003.
[92]
Edward T. Crosby, “Airway Management in Adults after Cervical Spine Trauma,”
journal of Anesthesiology, vol. 104, no. 34, pp. 1293–1318, 2006.
[93]
Michael A. Seropian, “ General Concepts in Full Scale Simulation:Getting Started,”
Journal of Anesthesia and Analgesia, vol. 97, no. 6, pp. 1695–1705, 2003.
[94]
J. Haase, E. Boisen, “Neurosurgical training: more hours needed or a new learning
culture?,” Journal of Surgical Neurology, vol 72, no. 1, pp. 89-95, 2004
[95]
Kiat, T., Mei, T., & Nagammal, S., “A review of learners’ experience with
simulation based training in nursing,” Singapore Nursing Journal, vol. 34, no. 4, pp.
37-43, 2007.
[96]
Turkstra TP, Pelz DM, Shaikh AA, Craen RA., “Cervical spine motion: a
fluoroscopic comparison of Shikani Optical Stylet vs Macintosh laryngoscope,”
Canadian Journal of Anesthesia, vol. 54, no. 6, pp. 441-447, Jun 2007.
[97]
Al-alami AA, Zestos MM, Baraka AS.,”Pediatric laryngospasm: prevention and
treatment,” Journal of Curr Opin Anaesthesiol, vol 22, no. 3, pp. 388-395, Jun. 2009.
329
盧
[98]
博士論文
Greenland KB.,”The sniffing and extension-extension position: the need to develop
the clinical relevance,” Journal of Anaesthesia, vol. 63, no. 9, pp. 1013-1014, Sep.
2008.
[99]
Al-alami AA, Zestos MM, Baraka AS.,”Pediatric laryngospasm:prevention and
treatment,” Journal of Curr Opin Anaesthesiol, vol. 22, no. 3, pp. 388-395, Jul. 2009.
[100]
Solis, J., Obokawa, Y., Ishii, H., Koga, H., Takanishi, A., Katsumata, A.,
“Development of Oral Rehabilitation Robot WAO-1R Designed to Provide Various
Massage Techniques,” Proceedings of the IEEE 11th International Conference on
Rehabilitation Robotic, pp.457–462, 2009.
[101]
Bruce N. Epker, Timothy Turvey, and Leward C. Fish,”Indications for simultaneous
mobilization of the maxilla and mandible for the correction of dentofacial
deformities,” Journal of Oral Surgery, Oral Medicine, Oral Pathology, vol. 54, no. 4,
pp. 369-381, 1982.
[102]
Edward T. Crosby, “Airway Management in Adults after Cervical Spine Trauma,”
Journal of Anesthesiology, vol 104, no. 45, pp. 1293-1318, 2006
[103]
James W Youdas, Tom R Garrett, Vera J Suman, Connie L Bogard, Horace O
Hallman and James R Carey, ”Normal Range of Motion of the Cervical Spine: An
Initial Goniometric Study,” Journal of Physical Therapy, vol.72 no.l l, pp. 770-780,
1992.
[104]
Ichiro Takenaka, Kazuyoshi Aoyama, Tamao Iwagaki, Hiroshi Ishimura, Tatsuo
Kadoya, “The sniffing position provides greater occipitoatlanto-axial angulation than
simple head extension: a radiological study,” Canadian Journal of Anesthesia, vol 54,
no. 2, pp 129–133, 2007.
330
Referencem
[105]
Minna Silvennoinen, Liisa Kuparinen, Finland, “Usability Challenges in Surgical
Simulator Training”, Proceedings of the 31st International Conference on
Information Technology Interfaces, pp. 455-460, 2009.
[106]
Laks Raghupathi, Laurent Grisoni, Franc¸ois Faure, Damien Marchal, Marie-Paule
Cani, and Christophe Chaillou, “An Intestinal Surgery Simulator: RealTimeCollision Processing and Visualization”
IEEE
International
Journal:
Transactions on Visualization and Computer Graphics, vol 10, no. 6, pp.708-715,
2004.
[107]
Hideaki Takanobu, Akito Omata, Fumihiko Takahashi, Keishi Yokota, Kenji Suzuki,
Hirofumi Miura, Mutsumi Madokoro, Yoshikazu Miyazaki, Koutarou Maki, “Dental
Patient Robot as a Mechanical Human Simulator,” Proceedings of International
Conference on Mechatronics, pp 1-6, 2007.
[108]
Brandon S. Spencer, “Incorporating the Sense of Smell Into Patientand Haptic
Surgical Simulators,” IEEE International Journal: Transaction on Information
Technology in Biomedicine, vol. 10, no. 1, pp.168-173, Jan. 2006.
[109]
Yongho Hwang, Samsun Lampotang, Nikolaus Gravenstein, Isaac Luria‡ Benjamin
Lok,” Integrating Conversational Virtual Humans and Mannequin Patient Simulators
to Present Mixed Reality Clinical Training Experiences”, Proceedings of IEEE
International Symposium on Mixed and Augmented Reality and Technology,” pp.
197-198, 2009.
[110]
S. Ikeda, F. Arai, T. Fukuda, M. Negoro and K. Irie, I. Takahashi, “Patient-Specific
Neurovascular Simulator for Evaluating the Performance of Medical Robots and
Instrumens” Proceedings of IEEE International Conference on Robotics and
Automation, pp. 625-630, 2006.
331
盧
[111]
博士論文
Yoshiro Kitagawa, Tomohito Ishikura, Wei Song, Yasushi Mae, Mamoru Minami
and Kanji Tanaka, “Human-like Patient Robot with Chaotic Emotion for Injection
Training”, Proceedings of ICROS-SICE International Joint Conference, pp. 46354640, 2009.
[112]
Yuta Nakano and Tomoharu Nagao, “Automatic Construction of Moving Object
Segmentation from Video Image using 3D-ACTIT,” Proceedings of IEEE
International Conference, pp. 1153-1158, 2007.
[113]
Xiaojing Zhou and Zhengxu Zhao, “Construction of 3D Virtual Humans from 2D
Images,” Proceedings of IEEE International Conference on Networking, Sensing and
Control, pp. 719 – 724, 2008.
[114]
Gamage, P., Xie, S.Q., Delmas, P., Xu, P., “3D Reconstruction of Patient Specific
Bone Models from 2D Radiographs for Image Guided Orthopedic Surgery,”
Proceedings of International Conference on Digital Image Computing: Techniques
and Applications, pp. 212-216, 2009.
[115]
Graf, H., Sang Min Yoon, Malerczyk, C., “REAL-TIME 3D RECONSTRUCTION
AND POSE ESTIMATION FOR HUMAN MOTION ANALYSIS,” Proceedings of
IEEE 17th International Conference on Image Processing, pp. 3981-3984, 2009.
[116]
Sehwun Kim, Etzm-Young Chun,Chung-Hyun Ahit and Woontuck Woo, “Imagebased Panoramic 3D Virtual Environment Using Rotating Two Multi-view
Cameras,” Proceedings of International Conference on Image Processing, pp. 917920, 2008.
[117]
Hamza-Lup, F.G.; Goeser, P.T.; Johnson, W.; Thompson, T.; Railean, E.; Popovici,
D.M.; Hamza-Lup, G., “Interactive 3D Web-Based Environments for Online
332
Referencem
Learning: Case Studies, Technologies and Challenges,” Proceedings of International
Conference on Digital Object Identifier, pp. 13-18, 2009.
[118]
Maria L. Pinto, Jose M. Sabater, Jorge Sofrony, F. Javier Badesa, Juan Rodriguez,
Nicolas Garcia, “Haptic Simulator for training of Total Knee Replacement,”
Proceedings
of
International
Conference
on
Biomedical
Robotics
and
Biomechatronics, pp. 221 – 226, 2008.
[119]
Zhiyong Yuan, Qian Yin, Jun Hu, Shikun Feng and Dengyi Zhang, “Study on VRBased Medical Image Deformation for Surgical Training System,” Proceedings of
the 4th International Conference, pp. 124 – 127, 2010.
[120]
Padilla, M.A., Teodoro, S., Lira, E.; Soriano, D., Altamirano, F., Arambula, F.,
“Virtual reality simulator of transurethral resection of the prostate,” International
Conference on Health Care Exchanges, pp. 116-119, 2009.
[121]
Chang-qing Yu, He-hua Ju, Yang Gao, “3D virtual reality simulator for planetary
rover operation and testing,” Proceedings of International Conference on Virtual
Environments, Human-Computer Interfaces and Measurements Systems, pp. 101-106,
2009.
[122]
Chen Xiaojun, Lin Yanping, Wang Chengtao, Wu Yiqun, Wang Xudong, Shen
Guofang, “An Integrated Surgical Planning and Virtual Training System using a
Force Feedback Haptic Device for Dental Implant Surgery,” Proceedings of
International Conference on Audio Language and Image Processing, pp. 1257 –
1261, 2010.
[123]
Wikipedia Inc., [Online].
Availiable: http://en.wikipedia.org/wiki/Airway_management
333
盧
[124]
博士論文
Z. Lin, M. Zecca, S. Sessa, L. Bartolomeo, H. Ishii, K. Itoh, and A. Takanishi,
“Development of an Ultra-miniaturized Inertial Measurement Unit WB-3 for Human
Body Motion Tracking,” Proceedings of IEEE/SICE International Conference, pp.
414-419, 2010.
[125]
A.J. Thexton and A.W. Crompton, “Control of swallowing, in Scientific Basis of
Eating,” Ed. R.W.A. Linden, Karger, Basel, pp. 168-222, 1999.
[126]
Smithard DG, Smeeton NC, Wolfe CD., “Long-term outcome after stroke: does
dysphagia matter?,” Age Ageing vol. 36, no. 1, pp. 90-94, 2008.
[127]
Brady A., “Managing the patient with dysphagia,” Journal of Home Healthc Nurse
vol. 26, no. 1, pp. 41–6, 2002.
[128]
Logemann, Jeri A., “Evaluation and treatment of swallowing disorders,” Austin, Tex:
Pro-Ed., 1998.
[129]
Shinichi Matsuzaki, Hitoshi Yamashita, Katsuaki Endou, Takehiko Araki, Satoshi
Ban, Katue Yoshida, Tamotsu Ishizuka, Sakae Maruta and Masatomo Mori,
“Aspiration Pneumonia Resulting from a Peanut,” Kitakanto Medical Journal, vol.
59, no. 12, pp. 161-163, 2009.
[130]
Yukihiro Iida, Akitoshi Katsumata and Masami Fujishita, “Effect of head rotation on
the pathway of a food bolus through the pharynx as evaluated by a videofluoroscopic
swallow study,” Journal of Oral Radiology, vol 12, no. 6, pp. 124-128, 2009.
[131]
Palmer JB, Kuhlemeier KV, Tippett DC, Lynch C., “A protocol for the
videofluorographic swallowing study,” Journal of Dysphagia, vol. 8, no.3, pp. 209214, 1993.
334
Referencem
[132]
Kuhlemeier KV, Yates P, Palmer JB., “Intra- and interrater variation in the
evaluation of videofluorographic swallowing studies,” Journal of Dysphagia, vol. 13,
no. 6, pp. 142-147, 1998.
[133]
Effrey B. Palmer, and Jennifer C. Drennan, “Evaluation and Treatment of
Swallowing Impairments,” American Family Physician, 2004.
[134]
AMO Bakheit, “Management of Neurogenic Dysphagia,” Postgrad Medical Journal,
Vol. 77, no. 6, pp. 694-699, 2001.
[135]
Iida Yukihiro, Katsumata Akitoshi, Fujishita Masami, “A Simulation System for
Dynamic Videofluoroscopic Swallow Examination,” Journal of Dental Radiology,
vol.44; no.3; pp. 152-160, 2004.
[136]
Kano M, Shimizu Y, Okayama K, Igari T, Kikuchi M, “A Morphometric Study of
Age-Related Changes in Adult Human Epiglottis Using Quantitative Digital
Analysis of Cartilage Calcification,” Journal of Cells Tissues Organs, vol. 180, no.
34, pp. 126-137, 2005.
[137]
Garon BR, Huang Z, Hommeyer M, Eckmann D, Stern GA, Ormiston C, “Epiglottic
dysfunction: abnormal epiglottic movement patterns,” Journal of Dysphagia, vol. 17,
no.1, pp. 57-68, 2002.
335
盧
博士論文
336
Research Achievements
種類別
題名
発表・発行掲載
誌名
発表・発行年月
連名者
1. 論文
Proceedings of
2011 IEEE
International
Conference on
Robotics and
Automation,
pp. 4676-4681,
2011
2011 年 5 月
ノヨハン
瀬川正尚
佐藤圭
Wang Chunbao
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
勝又明敏
飯田幸弘
Proceedings of
2011 IEEE
International
Conference on
Robotics and
Automation,
pp. 1726-1731,
2011
2011 年 5 月
ノヨハン
海老原一樹
瀬川正尚
佐藤圭
Wang Chunbao
石井裕之
ソリスホルヘ
高西淳夫
畠和幸
庄司聡
Development of the
Airway Management
Training System WKA3: Integration of
Evaluation Module to
Provide Assessment of
Clinical Competence
and Feedback Module
to Reproduce Different
Cases of Airway
Difficulties
Proceedings of
2010 IEEE/RSJ
International
Conference on
Intelligent Robots
and Systems,
pp. 337-342, 2010
2010 年 10 月
ノヨハン
佐藤圭
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
○ Development of Patient
Scenario Generation
which can Reproduce
Characteristics of the
Patient for Simulating
Real-World Conditions
of Task for Airway
Management Training
System WKA-3
Proceedings of
2010 IEEE/RSJ
International
Conference on
Intelligent Robots
and Systems,
pp. 331-336, 2010
2010 年 10 月
ノヨハン
佐藤圭
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Development of a
Robot which can
Simulate Swallowing
of Food Boluses With
Various Properties for
the Study of
Rehabilitation of
Swallowing Disorders
○ Development of the
Airway Management
Training System WKA4 : Improved HighFidelity Reproduction
of Real Patient
Conditions and
Improved Tongue and
Mandible Mechanisms
337
博士論文 m
盧
種類別
題名
論文の続
Mechanism Design
き
Improvements of the
Airway Management
Training System WKA3
Development of
Airway Management
Training System WKA3
発表・発行掲載
誌名
Proceedings of
17th CISMIFToMM
Symposium on
Robot Design,
Dynamics and
Control,
pp. 183-190, 2010
Proceedings of
2009 IEEE
International Crossdisciplinary
Symposium on
Micro-Nano
Systems, 2009
Development of
Tension/Compression
Detection Sensor
System Designed to
Acqure Quantitative
Force Information
while Training the
Airway management
Proceedings of
2009 IEEE/ASME
International
Conference on
Advanced
Intelligent
Mechatronics,
pp. 1264-1269,
2009
Development of the
Proceedings of
Airway Management
2009 IEEE
Training System WKA- International
2 which can reproduce
Conference on
the Cases of Difficult
Robotics and
Airway
Automation,
pp. 3833-3838,
2009
○ WKA-1R Robot
Assisted Quantitative
Assessment of Airway
Management
International
Journal of
Computer Assisted
Radiology and
Surgery, vol. 3, no.
6, pp. 543-550,
2008
338
発表・発行年月
連名者
2010 年 7 月
ノヨハン
佐藤圭
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
2009 年 11 月
ノヨハン
佐藤圭
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
2009 年 7 月
ノヨハン
佐藤圭
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
ノヨハン
佐藤圭
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
2009 年 5 月
2008 年 11 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Research Achievements m
種類別
題名
論文の続
Development of the
き
Evaluation System for
the Airway
Management Training
System WKA-1R
発表・発行掲載
誌名
発表・発行年月
連名者
Proceedings of
IEEE/RSJ
International
Conference on
Biomedical and
Biomechatronics,
pp. 574-579, 2008
2008 年 9 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Improvements on the
sensor system on the
WKA-1R to identify
the evaluation
parameters of the
airway management
Proceedings of
2008 Computer
Assited Radiology
and Surgery 22nd
International
Cogress and
Exhibition,
pp. s209-s210
2008 年 6 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Determination of
Effective Evaluation
Parameters on the
Airway Training
System WKA-1R
Proceedings of 6th
Conference of the
International
Society for
Gerontechnology,
2008
2008 年 5 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Reproducing
Difficulties of Airway
Management on
Patients with Restricted
Opening Mouth using
the WKA-1
Proceedings of 6th
International
Special Topic
Conference on
Information
Technology
Applications in
Biomedicine,
pp. 115-118
2007 年 11 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Development of
Airway Management
Training System which
embeds array of sensors
on a conventional
mannequin
Proceedings of
2007 IEEE/RSJ
International
Conference on
Intelligent Robots
and Systems,
pp. 1296-1301,
2007
2007 年 10 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
339
盧
種類別
博士論文 m
題名
論文の続
Design of Airway
き
Management Training
System
発表・発行掲載
誌名
Proceedings of
5th International
Special Topic
Conference on
Information
Technology
Applications in
Biomedicine,
pp. 102-107, 2006
発表・発行年
月
連名者
2006 年 10 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気道管理教育訓練シス
テム WKA-4 の開発
－動作パターンの生成
アルゴリズムと筋肉の
再現可能なシステム制
御－
第 11 回計測自動
2010 年 12 月
制御学会システム
インテグレーショ
ン部分講演会予稿
集
ノヨハン
海老原一樹
佐藤圭
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
嚥下障害を再現した患
者ロボット WKA-2 の
開発－物性特性が異な
る食べ物により嚥下障
害患者への影響－
第 11 回計測自動
2010 年 12 月
制御学会システム
インテグレーショ
ン部分講演会予稿
集
ノヨハン
海老原一樹
佐藤圭
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
臨場感を再現した気管
挿管訓練システムの開
発
第 40 回日本救急
医学学会
ノヨハン
海老原一樹
佐藤圭
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気道管理教育訓練シス
テムWKA-4 の開発
－気道管理における患
者状態の再現機能を有
するハードウェアの設
計･製作－
第 28 回日本ロボ
2010 年 9 月
ット学会学術講演
会予稿集
2. 講演
340
2010 年 10 月
海老原一樹
瀬川正尚
ノヨハン
佐藤圭
石井裕之
高西淳夫
庄司聡
畠和幸
Research Achievements m
種類別
題名
講演の続
訓練者の定量的な手技
き
評価と患者の臨場感の
再現ができる気管挿管
訓練用頭部モデル
WKA-3 の開発
発表・発行掲載
誌名
42 回日本医学教
育学会
発表・発行年
月
連名者
2010 年 7 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練システム
の力センサの開発－手
技評価用センサと力制
御用センサの開発－
27 回日本ロボッ
2009 年 9 月
ト学会学術講演会
予稿集
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練システム
WKA-3 の開発－患者の
状態が再現できるシナ
リオ再現アルゴリズム
の開発－
第 27 回日本ロボ
2009 年 9 月
ット学会学術講演
会予稿集
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練システム
WKA-3 の開発－症例再
現機能と手技計測機能
を有するハードウェア
の設計•製作－
第 27 回日本ロボ 2009 年 9 月
ット学会学術講演
会予稿集
佐藤圭
下村章宏
ノヨハン
瀬川正尚
石井裕之
ソリスホルヘ
高西淳夫
畠和幸
ロボットによる嚥下時
口腔咽頭形態再現の可
能性
日本歯科放射線学 2009 年 9 月
会第 209 回関東
地方会・第 29 回
北日本地方会
第 17 回合同地方
会
勝又明敏
飯田幸弘
藤下昌己
ノヨハン
石井裕之
高西淳夫
341
盧
種類別
博士論文 m
題名
講演の続
症例·個体差が再現でき
き
る気管挿管手技訓練ロ
ボットWKA-2 の開発
―張力センサの開発と
仮想コンプライアンス
制御への応用―
発表・発行掲載
発表・発行年月
誌名
連名者
ロボティクス‧メ 2009 年 5 月
カトロニクス講演
会 2009 予稿集
ノヨハン
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
ワイヤ制御を用いてヒ
トの症例個体差が再現
可能な気管挿管訓練用
頭部モデル WKA-2 の開
発
第 9 回計測自動制 2008 年 12 月
御学会システムイ
ンテグレーション
部分講演会予稿集
瀬川正尚
ノヨハン
石井裕之
SOLIS Jorge
高西淳
畠和幸
気管挿管訓練用頭部モ
デル WKA-2 の開発
第 17 回日本コン 2008 年 12 月
ピュータ外科学会
大会講演会予稿集
瀬川正尚
ノヨハン
石井裕之
SOLIS Jorge
高西淳夫
畠和幸
気管挿管手技訓練シス
テムの開発－咀嚼筋等
の顎口腔周りの筋を模
したワイヤにより，
個体差および開口障害
などの気管挿管困難症
が再現可能なシステム
の製作－
第 19 回日本咀嚼
学会学術大会
2008 年 9 月
瀬川正尚
NOH Yohan
下村彰宏
石井裕之
SOLIS Jorge
畠和幸
高西淳夫
訓練者手技の評価が可
能な気管挿管手技訓練
システムの開発
第 28 回日本臨床
麻酔学会
2008 年 9 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Development of
Airway Management
Training System
WKA-1R which
enables to evaluate
operators’ task
performance
第 38 回日本救急
医学学会
2008 年 9 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
342
Research Achievements m
種類別
題名
発表・発行掲載
発表・発行年月
誌名
連名者
気管挿管訓練手技評価
第 26 回日本ロボ
2008 年 9 月
システムの開発(第 3
ット学会学術講演
報)-気管挿管手技評価関会
数の開発
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練用頭部モ
第 26 回日本ロボ
2008 年 9 月
デル WKA-2 の開発－気ット学会学術講演
管挿管困難症と多様な
会
口腔形状の再現が可能
なハードウェアの設
計・製作－
瀬川正尚
ノヨハン
石井裕之
ソリスホルヘ
高西淳夫
畠和幸
2008 年 7 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練手技評価
第 25 回日本ロボ
2007 年 9 月
システムの開発(第 2
ット学会学術講演
報)-気管挿管訓練頭部モ会
デルの製作
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管手技訓練シス
テムの開発－咀嚼障害
による開口障害を再現
し気管挿管の定量的な
情報が得られるシステ
ムの製作
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
Development of
Evaluation System
for Airway
Management Training
System
WKA-1R
40 回日本医学教
育学会講演会
第 18 回日本咀嚼
学会
343
2007 年 7 月
盧
種類別
博士論文 m
題名
講演の続
気管挿管手技の定量的
き
評価が可能なトレーニ
ング用頭部モデルの開
発,
3. 招待
講演
発表・発行掲載
発表・発行年月
誌名
第 39 回日本医学
教育学会講演会
連名者
2007 年 7 月
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練手技評価
第 24 回日本ロボ
2006 年 9 月
システムの開発(第 1
ット学会学術講演
報)-全体構想とセンシン会
グシステムの設計
ノヨハン
下村章宏
瀬川正尚
石井裕之
ソリスホルヘ
畠和幸
高西淳夫
気管挿管訓練システム
の開発
第 6 回日本シミュ
レーション学会
2009 年 10 月
ノヨハン
Development of
Airway Management
training System
WKA-3
TOULOUSE cedex
04, France
2010 年 7 月
ノヨハン
気管挿管訓練装置
特願 2006-239817
特開 2008-64824
2008 年 3 月
ノヨハン
長弘考司
瀬川正尚
石井裕之
ソリスホテル
高西淳夫
畠和幸
4. 特許
344
Research Achievements m
種類別
題名
特許の続
光学式力センサ
き
発表・発行掲載
発表・発行年月
誌名
連名者
特願 2008-85233
特開 2009-236799
2009 年 10 月
ノヨハン
下村彰宏
瀬川正尚
石井裕之
ソリスホテル
高西淳夫
畠和幸
力センサ及びセンシン
グシステム
特願 2009-54311
特開 2010-210294
2010 年 9 月
ノヨハン
石井裕之
ソリスホテル
高西淳夫
位置検出装置，そのプ
ログラム，モニタリン
グシステム，及び気管
挿管訓練装置
特願 2008-254328
特開 2010-85687
2010 年 4 月
ノヨハン
下村彰宏
瀬川正尚
石井裕之
ソリスホテル
高西淳夫
畠和幸
気管挿管訓練装置
WO/2009/113196
2009 年 9 月
ノヨハン
下村彰宏
瀬川正尚
石井裕之
ソリスホテル
高西淳夫
畠和幸
時間経過による患者の
状態変化が再現できる
気管挿管訓練用頭部モ
デル WKA-3 の開発
日本コンピュータ 2010 年 3 月
外科学会 2009 年
度講演論文賞受賞
佐藤圭
ノヨハン
下村彰宏
瀬川正尚
石井裕之
ソリスホテル
高西淳夫
畠和幸
5. 受賞
345
盧
種類別
博士論文 m
題名
発表・発行掲
載誌名
発表・発行年月
連名者
受賞の続
き
気道管理教育訓練シ
ステム WKA-4 の開
発
第 11 回計測自動
制御学会システ
ムインテグレー
ション部分講演
会優秀講演賞
346
2010 年 12 月
ノヨハン
海老原一樹
瀬川正尚
佐藤圭
石井裕之
高西淳夫
庄司聡
畠和幸
Research Achievements m
Award Certificate
347
盧
博士論文 m
348
Research Achievements m
349
盧
博士論文 m
350

Download Report