• 한국의학물리학회지:의학물리
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• 제15권1호
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• pp.30-38
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• 2004

목적: 방사선 치료 시 환자의 움직임을 최대한 고정시켜 줄 수 있으며 환자 자세에 대한 Setup 오차를 감소시키고 환자 전신에 산재한 병소를 위치화하고 좌표화할 수 있는 전신 정위 고정장치 제작과 제작한 고정장치에 대한 고정효과 및 재현성을 나타내는 환자 자세의 Setup 오차를 평가하였다. 대상 및 방법: 자체 제작한 고정장치는 크게 기본판(base plate)과 고정틀(Immobilizer), Vacuum cushion, 벨트로 이루어진다. 기본판은 50${\times}$130${\times}$1 ㎤ 베크라이트로 고정틀은 견고한 아세탈 재질을 사용하여 제작하였다. 초기의 Lax frame의 경우, side panel에 부착되어 있는 좌표계(coordinates)를 기본판 바닥에 radiopaque catheter wire를 사용하여 N 타입으로 새겨서 넣어 위치측정이 가능한 좌표계로 적용할 수 있도록 하였다. 제작된 고정장치에 대한 성능실험으로 방사선 투과율 측정 실험과 가상표적을 부착한 지원 환자를 대상으로 표적에 대한 위치측정실험이 수행되었다. 그리고 CCTV 카메라와 Digital Video Recorder (DVR)를 이용하여 획득된 환자 영상을 Matlab 프로그램으로 환자 자세에 대한 Setup 오차를 분석하였다. 결과: 전신 정위 고정장치는 CT 촬영과 방사선치료 시 사용 가능성에 중점을 두고 제작되었다. 이 고정장치의 구조는 갠트리의 회전각의 변화에 따라 충돌하지 않게 제작되었고 측면으로 경사지게 입사되는 빔의 투과율을 최대화할 수 있게 제작되었다. 고정틀의 고정효과를 높여주는 고정벨트는 입사된 빔의 방향에 방해되지 않게 제작되었다. 고정장치에 대한 방사선 투과율은 10과 21 MV의 에너지에서 95, 95%로 측정되었고 지원 환자에 부착한 가상 표적의 위치는 CT 촬영으로 파악할 수 있었다. Matlab 프로그램으로 분석한 setup 오차는 흉부의 측면과 중심부위에서 3.69$\pm$1.60, 2.14$\pm$0.78 mm이고 복부의 측면과 중심부위에서 7.11$\pm$2.10, 6.54$\pm$2.22 mm이며 여자 환자 경우, 가슴 측면의 Setup 오차는 6.33$\pm$1.55 mm으로 측정되었다. 결론: 전신 정위 고정장치의 제작과 실험을 통해 extra-cranial 암에 대한 방사선수술에서 매우 실용적이고 유용하게 사용될 것으로 사료되며 표적 위치 결정과 환자 고정 도구로서 사용될 것이다. 더 많은 환자 치료자세의 Setup 오차 측정이 수행되면 정확한 환자의 Setup 오차의 결과를 향상시킬 수 있을 것으로 기대된다.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.383-387
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• 2010

Complete removal of three-compartment trigeminal schwannomas is a challenge to neurosurgeons. To expand exposure of each compartment, the combination and modification of skull base approaches are necessary. The 61-year-old woman was admitted with chronic headache. Preoperative magnetic resonance imaging showed $47{\times}50{\times}40\;mm$-sized tumor originating primarily in the middle cranial fossa extended to the posterior and the infratemporal fossa. We performed operation in five stage; 1. Zygomatic osteotomy, 2. Inferior temporal fossa plate removal and foramen ovale opening, 3. Cavernous sinus opening, 4. Tailored anterior petrosectomy, 5. Meckel's cave opening. Combination of skull base surgery should be concerned according to the patient. In this study, extradural basal extension with zygomatic osteotomy, interdural posterior extension with tailored anterior petrosectomy, and intracavemous exploration are reasonable options for remodeling three-compartment lesion into a single compartment. Tailoring of bone resection and exploring through natural pathway between meningeal layers accomplish single-stage operation for complete removal of tumors.

• 대한치과교정학회지
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• 제19권2호
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• pp.95-108
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• 1989

This study intended to calculate the cephalometric norms of Korean adult and to compare those with norms of the North American Caucasian by Moyers. Cephalometric headplates of 41 males and 31 females ranged in age from eighteen to twenty-six with normal occlusion and pleasing face were employed for this investigation. The tracings of the standard lateral cephalograms were analyzed by Moyers' method. As a result of this study, the following conclusion can be made. 1. Norms of Korean adult male and female were calculated. 2. There was no significant sexual difference in the basic craniofacial morphology. 3. The size of craniofacial skeleton was larger in male than in female. 4. The Korean male showed lower value of mandibular plane angle to craial base than that of the Caucasian male. 5. There was no significant difference in the anterior total facial height, however, in the posterior facial height the Korean male was larger than the Caucasian male, which manifested that the Korean male held more square-shaped profile. 6. The anteroposterior length of anterior and posterior cranial base, maxillary and mandibular skeletal and dentoalveolar effective length of the Korean male were shorter than those of the Caucasian male, and this suggested that the craniofacial profile depth of the Korean male was shorter than that of the Caucasian male.

• Imaging Science in Dentistry
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• 제44권2호
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• pp.165-169
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• 2014

An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.282-288
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• 2021

Objective : Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery. Methods : We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1-5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side. Results : Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40). Conclusion : This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.

• 대한치과의사협회지
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• 제15권3호
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• pp.199-204
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• 1977

The patient, 19 years old female, complained of protrusion of upper and lower anterior teeth. Teeth lining was good except slight crowding in lower anterior teeth. Teeth lining was good except slight crowding in lower incisors, but distocclusion in the region of right buccal segment was present. Cephalometric analysis revealed normal relation between maxilla and cranial base. The labial inclination of upper and lower anterior teeth was severe, so diagnosed as bialveolar protrusion case. She was treated by means of multibanded system under the extraction of four first bicuspids. After 1 year and 4 months. She gained good interdigitation of buccal segments and attractive facial profile because the labioversion of incisors was reduced properly.

• 대한치과교정학회지
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• 제19권1호
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• pp.123-135
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• 1989

This study was undertaken to investigate the relationship between the depth of antegonial notch and the craniofacial morphology, and to predict the mandibular growth direction & potential in class III malocclusion. The computerized analyses were carried out on longitudinal lateral cephalometric radiographs of 50 children with class III malocclusion, divided into two groups ; 30 deep notch subjects (more than 2.6mm) and 20 shallow notch subjects (less than 1.5mm). The conclusions were as follows: 1. The mandibular growth direction in deep notch group was more vertically directed than in shallow notch group. 2. Deep notch group had shorter anterior & posterior cranial base than shallow notch group. 3. There was not significant difference between deep & shallow notch groups in the amount of mandibular growth during treatment period. 4. Notch depth increased in both deep & shallow notch groups during treatment period.

• Journal of Trauma and Injury
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• 제25권1호
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• pp.28-31
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• 2012

Pencils are common instruments for children to use and play with. This report describes an unusual penetrating orbitocranial injury in a 5-year-old girl who was struck in her facewith a pencil. She was holding it at a desk, and her friend pushed her back. The pencil penetrated the left lower eyelid and went deep into the right frontal lobe through the base of the skull. It was removed at the emergency room, after which brain CT was performed to detect the development of an intracranial hematoma. No complications occurred after conservative management with antibiotics and an antiepileptic drug. Pencils can be hazardous to children, and a penetrating head injury with a pencil may be managed without cranial surgery.

• 대한치과의사협회지
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• 제25권9호통권220호
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• pp.847-854
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• 1987

Genioplasty may considerably change a person's face which needs surgical correction of deformed chin. Comprehensive treatment planning is therefore decisive for the treatment to be successful. A three-dimensional analysis of chin relative to cranial base, upper and lower jaws using the frontal and lateral facial photographs and cephalographs permits classification of the defective chin position and provides a basis for operation planning and deciding upon the operation method. A chin miniplate system has been developed for intraoperative registration securing the sagittal, vertical and horizontal position of the osteotomized chin and ould reduce the relapse rate.

• 대한치과교정학회지
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• 제4권1호
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• pp.7-12
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• 1974

The author analyzed 64 males and 65 females with normal occlusion from the childhood to the juvenile korean roentgenocephalometrically. And following conclusions were obtained by means of linear analyses. 1. Maxillo-facial structure growth continued quite rapidly until puberty from childhood, and growth of male was increased than that of female after Hellman dental age IV A significantly. 2. The order of growth increments were mandibular, maxillary, and cranial base length in both sexes. 3. In both sexes, the growth of anterior face was more rapid than that of posterior face, and lower facial growth was greater than upper facial growth of anterior and posterior face. 4. The maxillo-facial height growth was rapid than that of the depth in both sexes.