• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.151-156
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• 2006

Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1273-1278
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• 2009

Purpose:Congenital muscular torticollis (CMT), a common musculoskeletal disorder in infants, is characterized by the rotation and flexion deformity of the neck caused by sternocleidomastoid muscle shortening. We investigated the clinical courses and perinatal risk factors of CMT. Methods:Less than 6-month-old patients (98; M:F = 60:38) diagnosed with CMT between February 2007 and August 2008 were classified into 2 clinical subgroups, namely, SMT (sternocleidomastoid tumor) and POST (postural torticollis). All the patients were physically and neurologically examined prospectively and their cervical X-rays and ultrasonographies were obtained. Their medical histories about perinatal problems were recorded. Of the 98 patients, 45 with normal range of motion were taught passive physical exercises and 43 were referred to the Department of Rehabilitation for undergoing manual stretching therapy. Results:The mean age at initial assessment was 2.2 months (SMT: $1.4{\pm}1.0$, POST: $2.7{\pm}1.6$). SMT presented earlier than POST. All ophthalmologic examinations and cervical X-rays were normal. SMT was associated with higher incidence of caput succedaneum and cephalhematoma. POST was highly associated with plagiocephaly. Mean duration of rehabilitative physical therapy was 3.7 months (SMT: $4.6{\pm}2.5$, POST: $2.6{\pm}1.9$). POST resolved earlier than SMT. Of the 88 patients with follow-up, 87 had total resolution and only 1 had residual torticollis. Conclusion:All the patients received early treatment with passive stretching exercises. CMT was associated with perinatal problems and had various risk factors such as obstetrical problems.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.81-84
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• 2017

Langerhans cell histiocytosis (LCH) is a heterogeneous disease, characterized by accumulation of dendritic cells with features similar to epidermal Langerhans cells. It is a rare entity that may involve various organ levels such as the skeletal, pulmonary, hematopoietic and lympho-vascular systems. The patient was a 1-year-old female presented with fever associated with otorrhea and palpable cervical lymph node for 4 days. Neck ultrasonography and Computed tomography imaging revealed multiple enlarged lymph nodes suggesting suspicious malignant morphology. Lymph node biopsy was performed under general anesthesia. Histological and immunophenotypic examination showed the lymph node to be consistent with LCH. The patient was given chemotherapy.

• Korean Journal of Head & Neck Oncology
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• v.8 no.2
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• pp.91-96
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• 1992

The efficacy of the fine needle aspiration biopsy and cytological examination(FNABC) under ultrasonographic(US) guides for the diagnosis of cervical tuberculous lymphadenitis was assessed. There were one hundred and one patients whose neck masses were proven to be tuberculous lymphadenites with cytologic and/or histologic diagnosis. The physical characteristics shown by US revealed that all the cases were multiple lesions. Multiregional lesions were found in 80 cases(79.1%) and 19 cases(18.8%) were the bilateral lesion. The region V was the most prevalent site(n=69, 68.3%). US findings revealed 92 cases(90.9%) showed hypoechoic lesions and 9(9.1%) showed mixed echo patterns. There was no hyperechoic lesion (p<0.05). The sensitivity of FNABC was 77.2% and specificity was 99.0%. Diagnostic accuracy was 85.0%. There was no complication during the procedures. FNABC for the diagnosis of cervical tuberculous lymphadenitis is a safe, convinient procedure and has a high specificity. The pitfall of FNABC the low sensitivity, seemed to be compensated by US evaluations.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.15-24
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• 2009

Objectives : The purpose of this study is to compare the effectiveness between myofascial release technique and ultrasound in subjects with myofascial pain syndrome. Method : Twenty subjects with myofascial pain syndrome were randomly assigned to a myofascial release technique group(n=10) or an ultrsound group(n=10). The Cervical Range of Motion(C-ROM) instrument was used to measure cervical range of motion. Electromyography(EMG) was used to measure muscle power sternocleidomastoid and upper trapezius. Result : The result of this study shows there were no significant differences in ROM increase and muscle power increase between the myofascial release technique group and the ultrasound group. In the group with Myofascial Release Technique, the average score was $61.40{\pm}11.12$ in SCM flexion of C-ROM and $127.87{\pm}4.24$ in Rt. upper trapezius extension of EMG. In the group with ultra sound, the average score was $68.60{\pm}10.02$ in SCM flexion of C-ROM and $131.50{\pm}5.45$ in Rt. upper trapezius extension of EMG. Conclusion : The results suggest that there was no significant difference between two therapeutic techniques.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.4
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• pp.257-267
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• 2009

Purpose：The purpose of this study is to examine the effectiveness of ultrasound and myofascial release in patients who have opening mouth limitation and temporomandibular disorder. Methods：Twenty students were randomly assigned to a myofascial release group(n=10) or an ultrasound group(n=7). Each group was treated for 15 minutes per a every treatment session for four weeks. Cervial range of motion(CROM) was used to measure cervical R.O.M., and a mm(millimeter) graduated ruler was used to measure opening mouth limitation. Results：Results of the follows : 1. The neck extension of range of motion of both groups was significantly increased in length of time (p<.05). 2. The neck flexion of range of motion of both groups was significantly increased (p<.05). 3. The quantity of opening mouth of temporomandibular joint of both groups was significantly increased (p<.05). Conclusion：These data suggest that myofascial release and ultrasound are beneficial to increasing a functional recovery of neck(flexion and extension) and opening mouth.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.10-17
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• 2016

Purpose: The diagnosis of Kawasaki disease depends on clinical symptoms, which makes it difficult to diagnose early in patients with only cervical lymphadenopathy. The purpose of this study is to understand the clinical characteristics of cervical-lymph-node-first presentation of Kawasaki disease and compare them with those of typical Kawasaki disease. Methods: We surveyed 283 patients who were admitted to Hallym Sacred Heart Hospital and were diagnosed with Kawasaki disease from January 2012 to December 2014. The patients were divided into two groups: cervical-lymph-node-first presentation of Kawasaki disease (LKD, N=24) and typical Kawasaki disease (KD, N=259). The medical records were retrospectively reviewed. Results: The mean age of the LKD group was higher than that of the KD group (P=0.04). At admission, the LKD patients had on average 1.62 out of 5 symptoms, whereas the KD patients had 3.47. The time from fever to diagnosis and administration of IV immunoglobulin was longer in the LKD group than in the KD group (P<0.001). The mean C-reactive protein of the LKD group was higher than that of the KD group (P=0.01). There were no statistical differences in the presence of coronary artery complications between the two groups at two weeks or at two months after diagnosis (P=0.52, P=0.08). Conclusions: The Kawasaki disease patients with fever and cervical lymphadenopathy usually do not present obvious clinical symptoms, which makes it hard to diagnose in the early phase of disease. Clinician must pay attention when examining these patients.

• The Journal of the Acoustical Society of Korea
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• v.28 no.6
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• pp.542-547
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• 2009

In this in vivo study, correlations of lumbar and femoral bone mineral densities (BMDs) with calcaneal speed of sound (SOS) were investigated in 36 osteoporotic women. Areal BMDs of the L2-L4 lumbar spine and the right femoral neck were measured by using dual energy X-ray absorptiometry (DEXA). SOS of the right calcaneus was measured by using ultrasound bone densitometry. Pearson's correlation coefficient (r) and level of significance (p) were used to evaluate the correlations between measurements. Lumbar BMD was highly correlated with femoral BMD (r=0.81). Lumbar and femoral BMDs exhibited similar comparable negative correlations with age (r=-0.52 and r=-0.55). A moderate negative correlation was found between calcaneal SOS and age (r=-0.45). Calcaneal SOS was significantly correlated with lumbar and femoral BMDs, with a higher correlation with femoral BMD rather than with lumbar BMD (r=0.54 and r=0.62). However, calcaneal SOS may not be an optimum index for the estimation of BMD of the most important fracture sites, such as the lumbar and the femur, because it showed lower correlations with lumbar and femoral BMDs compared to that with calcaneal BMD. Therefore, the development of a quantitative ultrasound technology for the direct measurement of acoustic properties at the lumbar and the femur is required to estimate BMD of these sites more accurately.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.479-486
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• 2015

This study was conducted to investigate the effects of upper thoracic joint mobilization technique using Kaltenborn-Evjenth concept on the range of cervical and thoracic motion and pain in patients with chronic neck pain. The subjects were divided into a thoracic joint mobilization group(n=7) and a conservative physical therapy group(n=7). Each of the groups received thoracic joint mobilization or conservative physical therapy three times a week lasted for four weeks. The measurements were performed for the range of thoracic segmental motion(SpinalMouse), the pain(visual analogue scale) and the range of cervical joint motion(Inclinometer, Dualer IQ). They were made four times: before experiment, at 2weeks, 4weeks, and 4weeks after experiment.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.267-274
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• 2006

The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.