• Progress in Medical Physics
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• v.14 no.2
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• pp.90-98
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• 2003

Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

• Food Science and Preservation
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• v.19 no.3
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• pp.376-384
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• 2012

This study was conducted to investigate the food purchasing management of school food services. The subjects consisted of 271 school dietitians in the Daegu and Gyeongbuk area. The percentages of ready-to-use vegetables actually being used were as follows: root of balloon flowers, 88.4%; garlic, 87.8%; blanched bracken, 80.1%; raw lotus root, 65.7%; burdock, 63.5%; small green onion, 63.5%; stem of taro, 57.6%; ginger, 35.1%; radish root, 30.6%; blanched asterscaber, 29.2%; large type welsh onion, 25.8%; carrot, 25.5%; onion, 21.4%; and potato, 8.9%. The percentages of HACCP-certified products being used were as follows: meat, 75.9%; eggs, 66.7%; soybean curds, 65.5%; ready-to-use seafood, 55.1%; starch jellies, 49.9%; spice, 44.9%; kimchi, 30.9%; ready-to-use vegetables, 22.7%; and fruits, 6.9%. The percentages of environment-friendly food items being used were as follows: eggs, 31.0%; meat, 28.7%; soybean curds, 22.1%; and fruits, 17.7%. Of these food items, meat and ready-to-use seafood were being used the most in the elementary schools. The percentages of imported food items being used were as follows: starch jelly, 29.2%; ready-to-use seafood, 24.7%; soybean curds, 20.5%; spice, 15.9%; and fruits, 10.1%. The food items requiring HACCP certification were as follows: beef and pork, 81.5%; chicken, 80.1%; ready-to-use seafood, 78.6%; frozen dumplings, 73.8%; soybean curds, 71.6%; peeled eggs, 70.8%; fish paste, 69.4%; starch jelly, 65.7%; milk, 63.1%; kimchi, 54.6%; spice, 50.6%; frozen noodle, 45.4%; ready-to-use vegetables, 44.3%; and bean sprouts, 29.5%. It was confirmed that 8.1% of the sanitation monitoring results were intentionally misreported. Therefore, to supply good and safe foods to schools, active management is needed in schools and food manufacturing and delivery companies.

• The korean journal of orthodontics
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• v.37 no.4
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• pp.272-282
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• 2007

The purposes of this study were to evaluate the nasolabial angle changes between closed lip position at centric occlusion and relaxed lip position at which the bite is open so that the lips do not touch and to elucidate the significance of the relaxed lip position for dentofacial diagnosis. Methods: The subjects consisted of 60 (35 Males, 25 Females) skeletal Class III malocclusion adult patients (mean age 23.3 years) with anterior crossbite. Results: In Class III malocclusion adult patients, there were significant differences in the nasolabial angle changes between closed lip position and relaxed lip position. Using the cluster analysis, the subjects were divided into three groups according to the pattern of nasolabial angle change: Group 1 (N = 27, 45%, $-8\;{\sim}\;1$), Group 2 (N = 30, 50%, $2^{\circ}\;{\sim}\;17$), and Group 3 (N = 3, 5%, over 18). Conclusion: The results showed that the pattern of the nasolabial angle change between closed lip position and relaxed lip position varies in skeletal Class III malocclusion patients. Thus, relaxed lip position should be taken into account when diagnostic records are obtained and analyzed to accurately to evaluate the facial soft tissues and predict facial esthetics after surgical-orthodontic treatment.

• The korean journal of orthodontics
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• v.29 no.5 s.76
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• pp.575-587
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• 1999

This study was designed to evaluate the correlations between tongue with skeletal pattern and intermaxillary space in Class II malocclusion adult patients. Craniofacial skeletal pattern was analyzed on the lateral cephalometric radiograph and the subjects were devided two groups by facial ratio, the 30 subjects of hyperdivergent group and the 30 subjects of hypodivergent group. The size and posture of tongue and intermaxillary space were measured on the lateral cephalometric radiograph. These data were statistically analyzed to examine significant differences between both groups and compared the correlation between tongue with skeletal measurements and intermaxillary space in each group. The results of this study were as follows. 1. In comparison of the tongue and intermaxillary space, the measurement of TS/IS showed significantly larger in hyperdivergent group and PIH and IS showed significantly larger in hypodivergent group. There were no statistically significant differences in the measurements of the height and posture of tongue. 2. In correlation between tongue with craniofacial skeletal measurements, the length and height of tongue showed the highest correlation with AFH(anterior facial height) in both groups(p<0.01). And that measurements showed high correlation with PFH(posterior facial height) in hypodivergent group. 3. In both groups, most measurements of tongue showed high correlation with intermaxillary space and the height and space of tongue showed high correlation with AIH and PIH(p<0.01).

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.41-52
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• 2016

PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.55-65
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• 1996

This study was performed to investigate the effects of head posture and occlusal splint on the vertical dimension in mandibular rest position and swallowing. Thirty health dental students ware selected lot this study and BioEGNⓡ(Bioresearch Inc., USA) was used for measuring interocclusal distance during rest - swallowing - rest - tapping movement. This swallowing movements were observed in both normal head posture(NHP) and forward head posture (FHP). Thickness of occlusal splint was about 2mm at posterior molar area and even tooth contact were achieved on light biting. The four mandibular positions at which interocclusal distance measured were swallowing position, after swallowing position in which interocclusal distance was maximum, rest position follows swallowing, and tapping position after rest. Changes of distance in each position were measured for three mandibular planes, that is, sagittal, frontal, and horizontal plane, respectively. The results obtained were as follows : 1. In normal head posture, the mandible was raised 1.03mm without splint, and 0.77mm with splint on swallowing, and there was no significant difference between the two. In horizontal plane, however, mandible was displaced more anteriorly in both swallowing position and tapping position with splint. 2. In forward head posture, the mandible was less raised with splint on swallowing, but features in horizontal plane were almost same as those in normal head posture. 3. In natural dentition, significant difference between NHP and FHP were observed in horizontal plane trajectory for swallowing and tapping position. But the difference for same positions were observed in frontal trajectory with splint. 4. Total amount of mandibular movement of two groups classified with sagittal interocclusal distance of swallowing position generally showed significant difference between the higher and the lower height group in head posture without splint. 5. Correlationship among total amount of mandibular movement for three mandibular planes were observed between sagittal plane and horizontal plane, and between sagittal plane and frontal plane in head posture without splint.

• The korean journal of orthodontics
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• v.29 no.1 s.72
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• pp.37-49
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• 1999

Forty-four females with normal temporomandibular joint were compared with fifty-one females with abnormal temporomandibular joint. An orthodontic study model and lateral cephalometric radiographic were used to investigate the relationship between TMD group and non-TMD group in long face patterns. The result were followed that ; 1. There were no significant in overbite and overjet amount. 2. A mandibular 1'st molar inclination and height to the mandibualr plane were more mesial inclined in TMD groups. 3. The functional factors, which were craniocervical posture , tongue posture and hyoid bone position, were no significant.

• Journal of Oral Medicine and Pain
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• v.20 no.2
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• pp.489-496
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• 1995

The purpose of this study was to evaluate an effect of change on head posture initial occlusal contacts with measuring the distances between initial occlusal contacts and maximum intercuspal position at different head posture in TMDs patient. For this study, 24 patients from age 13 to 36 were selected, they were examined health history taken, patients who have sign and symptoms of TMDs were examine before the study. For the normal group, 21 adults from age 23 to 25 were selected. They have normal or class I molar relationship, and have no other prosthetic restorations. Difference on distance between initial occlusal contact and maximum intercuspal position with mandibular kinesiograph$(MKG^R)$(K6 diagnostic system, Myo-tronic Inc, USA) in upright, supine, 45$^{\circ}$ extension, 30$^{\circ}$ flexion position of the head were measured. The Frankfort horizontal plane was used as a reference plane. The results were as follows : 1. There were significant differences between initial occlusal contacts of the normal and patient group on upright position and 30$^{\circ}$ flexion of the head(p<0.05, p<0.01) 2. The position of the initial occlusal contacts have a tendency to place anterior and inferior to maximal intercuspal position in upright position and 30( flexion of the head as well as posterior and inferior in supine position and 45$^{\circ}$ extension of the head in the normal and patient groups. 3. There were significant differences among the initial occlusal contacts between uptight and supine position; upright and 45$^{\circ}$ extension of the head(p<0.05); supine position and 30$^{\circ}$ flexion of the head, .and 30(flexion and 45$^{\circ}$ extension of the head in the patient group(p<0.01) The result have shown that after treatment on the supine position, it may be necessary to check occlusal contact on the upright position as well ass flexion of the head. It may need careful adjustment in occlusal condition on upright position of TMDs patient.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.195-204
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• 1995

The purpose of this study was to evaluate effect of head posture change on initial occlusal contacts through measuring the distances between initial occlusal contacts and maximum intercuspal position at different head posture. Two special devices were designed and constructed. Mandibular movement replicator was used to assess reliability of the K6 diagnostic system(MKG; Myo-tronic Inc, Seatle, USA) and head posture calibrator was used to maintain the constant head posture during experiment. We measured difference of distance between initial occlusal contact and maximum intercuspal position with MKG in upright, supine, 45 degrees extension, 30 degrees flexion, 30 degrees right and left bending postion of the head. The Frankfurt horizontal plane was used as a reference plane. 21 adults aged from 23 to 25 were selected, who have normal or class I molar relationship, and have no symptoms on TMJ and masticatory muscles, and have restorations less than 3 surfaces on each tooth, and have no other prosthetic restoration. The obtained results were as follows : The mean absolute distances between initial occlusal contact and maximum intercuspal postion were 0.39(0.18mm in the upright position, 0.65(0.37mm in the supine position, 0.59(0.33mm in the 45 degree extension, 0.70(0.53mm in the 30 degrees flexion, 1.12(1.10mm in the 30 degrees right bending and 1.94(0.67mm in the 30 degrees left bending of the head. The positions of the initial occlusal contacts have a tendency to locate anterior, left and inferior to maximal intercuspal position in upright position, posterior and inferior in supine position and 45 degrees extension, anterior and inferior in 30 degrees flexion, right and inferior in 30 degrees right bending, and left and inferior in 30 degrees left bending of the head. There were significant differences among the initial occlusal contacts in each head postures(P<0.0001). Therefore, we need to check initial occlusal contacts in the altered head posture during occlusal analysis and adjustment of occlusal appliance and dental occlusion for diagnosis and treatment of temporomandibular disorder.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.2
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• pp.15-20
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• 2014

Objective: The purpose of this study was to investigate the effects of sling exercise on the cervical lordotic angle, craniovertebral angle, and head rotation angle among adolescents in the forward head posture. Methods: The subjects include 22 adolescents that recorded a mild level or higher on the posture evaluation index by New York State. They were randomly divided to the hand exercise group (n=11) and the control group (n=11). The former group participated in the sling exercise program three times a week over four weeks in total with each session lasting 60 minutes, whereas the latter group was not included in the program. The cervical lordotic angle, craniovertebral angle, and head rotation angle were measured before and after the intervention. Results: The study compared the cervical lordotic angle between the two groups before and after sling exercise and found that the sling exercise group made an increase of $7.36^{\circ}$ from $21.91^{\circ}$ to $29.27^{\circ}$ after the intervention(p<.05). As for the comparison results of the craniovertebral angle, the sling exercise group made an increase of $5.64^{\circ}$ from $48.91^{\circ}$ to $54.55^{\circ}$ after the intervention (p<.05). As for the comparison results of the cranial-rotation angle, the sling exercise group made an decrease of $-7.73^{\circ}$ from $148.82^{\circ}$ to $141.09^{\circ}$ after the intervention (p<.05). The control group showed no differences before and after the intervention (p>.05). Conclusion: Those findings indicate that the application of sling exercise in the forward head posture can be a good program to maintain the right posture and improve or prevent an abnormal posture and raise a need for more clinical applications and ongoing researches.