• 치과방사선
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• 제18권1호
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• pp.81-136
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• 1988

The aim of this study was to determine whether T.M.J. tomographic examination yielded significant differences in condyle positions among asymptomatic, myalgia, derangement, and arthrosis groups of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows. 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substantial range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P<.05). Also that of left central section existed between derangement and myalgia groups, and that of left medial section existed between derangement and myalgia groups (P<.05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main- symptom sides, and only between derangement and myalgia groups in central section of contra-lateral sides (P<.05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia groups (P<.05). Condyle position in derangement group was more posterior. The distribution of the condyle position of contra-lateral side in patients with unilateral symptoms was similar to that of main-symptom side in each symptomatic group. No significant difference existed between main-symptom and contra-lateral sides. 5. For internal derangement subgroups, condyle position in reducible disc displacement group was more posterior than non-reciprocal and locking groups, but there was no significant difference. 6. From 16 to 25 years, significant difference for mean condyle position of medial section of main-symptom side of each symptomatic group existed between myalgia and derangement groups (P<.05).

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.55-66
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• 2003

Background: The purpose of this study was to evaluated results of arthroscopic treatment of the traumatic recurrent unidirectional posterior subluxation. Materials and Methods: We treated twenty-seven patients who had traumatic recurrent unidirectional posterior subluxation of the shoulder by arthroscopic labral repair and posterior capsular shift and prospectively evaluated for a mean of thirty-nine months (range,24 to 85 months). Patients who had posteroinferior instability, multidirectional instability, atraumatic onset, or revision cases were excluded. There were twenty-five male and two female patients with the mean age of twenty-one years (range, 14 to 33 years). All patients were involved in sports activity. All had a significant traumatic event prior to the onset of the instability. Stability, motion, three objective measurement (UCLA, ASES, and Rowe scores) and two subjective measurements (pain and function visual analogue scale) were evaluated. Results: The most common finding in magnetic resonance image-arthrogram was separation of the posteroinferior labrum without displacement in 9 patients, In arthroscopic examination, all patients had one or more lesions in the posterior inferior labrum and capsule. The most common finding was incomplete stripping of the posterior inferior labrum (18 patients). The posteroinferior capsule subjectively appeared to be stretched in twenty-two patients. At follow-up, all patients had improved shoulder function and scores(p < 0.01). All patients had stable shoulder by subjectivel and objectivel measurements, except one patient who had recurrent subluxation. All but one patient with postoperative recurrence were able to return to their prior sports activity with little or no limitation. Twenty-four patients were graded as having more than 90％ of shoulder function. Their were twenty-one excellent, five good, and one fair UCLA. scores. Pain sore improved from 4.5 to 0.2 point(p : 0.0001). Mean loss internal rotation was one vertebral level. None had operative complications. Conclusion: In conclusion, treatment outcomes of the traumatic unidirectional recurrent posterior subluxation are consistently reliable with respect to the stability, pain relief, and functional restoration by the arthroscopic posterior capsular shift procedure.

• 한국산학기술학회논문지
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• 제21권1호
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• pp.1-7
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• 2020

일반라멘가교의 거동에 영향을 미치는 여러 하중들 중에서 온도하중은 중요한 하중임에도 불구하고 이에 대한 충분한 검토가 부족한 실정이다. 일반라멘가교의 온도하중에 의한 응력을 감소시키기 위해서는 열변형으로 인한 거더의 수평변위는 자유롭고, 발생내력은 최소가 되도록 하여야 한다. 슬라이딩가교는 일반라멘가교와 달리 온도하중으로 인한 축방향 변형을 허용하여 축응력을 감소시키고 휨응력은 전달시키는 구조이다. 본 연구는 슬라이딩거더를 가진 라멘가교의 온도거동과 구조효율성을 일반라멘가교와 비교하여 분석하였다. 분석을 위하여 경간장 10, 20, 30, 40m, 교각높이 2, 4, 6m의 경우에 대하여 일반라멘가교와 슬라이딩가교의 구조해석을 수행하였다. 하중은 연직 고정하중과 축방향 온도하중을 재하하고, 마찰계수는 매끄러운 상태와 윤활상태의 중간인 0.4를 적용하였다. 구조해석결과 슬라이딩가교는 온도하중 증가에 관계없이 경간장 증가에 따라 응력이 증가하며 일반라멘가교는 온도가 증가하거나 경간장이 증가할수록 응력이 증가하였다. 일반라멘가교에 비해 슬라이딩가교의 거더 중앙부 응력은 20에서 50%, 교각 하단부 응력은 50에서 90% 감소하였다. 따라서 온도하중이 작용하는 슬라이딩가교는 축응력이 감소하며 동일 제원의 일반라멘가교와 비교하여 구조효율성을 확보할 수 있다.

• 대한토목학회논문집
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• 제34권3호
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• pp.919-930
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• 2014

본 연구에서는 화이버 단면 요소를 이용하여 강재 보강된 숏크리트 합성부재의 하중지지력과 거동을 수치해석적으로 평가하였다. 강재 보강된 숏크리트 합성단면은 여러 개의 화이버로 분할되고, 각 화이버에 정의된 비선형 응력-변형률 관계에 의해 내력을 결정하게 된다. 사용된 유한요소모델의 검증을 위해 수치해석에 의한 숏크리트 라이닝의 하중-변위 변화를 기존 실험연구결과와 비교하였고, 이를 수치해석에 의한 강재와 숏크리트의 응력분포를 이용하여 함께 분석하였다. 그 결과 제안된 해석방법이 강지보와 숏크리트의 재료 비선형성을 고려하여 전체 거동과 강재 및 숏크리트 각각의 하중 저항력을 실질적으로 평가할 수 있음을 보였다. 또한, 단면 내 응력분포로부터 중립축 변화와 강재 및 숏크리트 각각의 휨 하중 분담률을 도출하였다. 하중 변화에 따른 강재의 휨 하중 분담률 변화를 확인하였고, 이를 통해 숏크리트 라이닝 설계에 강재의 휨 저항성능을 고려하는 것이 필요하다고 판단하였다.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.161-165
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• 2011

Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

• 한국지반환경공학회 논문집
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• 제10권6호
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• pp.19-25
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• 2009

본 연구에서는 산업부산물인 인산석고와 EPS 조각을 기존의 성토용 토사에 혼합하여 지반응력을 감소시킴으로써 고함수비로 준설매립된 공유수면 내 초연약지반의 침하, 활동파괴, 측방유동 등의 문제를 해결할 수 있는 경량혼합토를 개발하였다. 개발된 경량혼합토는 공유수면 매립지역에서 대량이용이 가능한 도로 및 교대의 성토재료, 각종 뒤채움재로의 사용에 대한 적용성을 평가하기 위하여 기본물성시험, 다짐시험, CBR시험, 전단강도시험 등 일련의 실내시험을 수행하였고 지반공학적 특성을 검토하였다. 시험결과, 경량혼합토의 최대건조단위중량은 $14.32{\sim}15.79kN/m^3$, 최적함수비는 21.91~24.23%로 일반 화강풍화토와 비교할 때 9.4~19.3%의 하중감소 효과가 있으며, 수정 CBR값은 10.4~18.4%로 국내 도로노상 및 뒤채움재에 대한 규정을 만족하는 것으로 나타났다. 또한 전단강도정수는 점착력 10.79~18.64kPa, 내부마찰각 $35.4{\sim}37.2^{\circ}$로 각각 나타나 국내에서 일반적으로 사용되는 성토재료 및 뒤채움재 범위를 충족시키는 것으로 평가되어 실제 성토재료 및 뒤채움재로 연약지반에서 효과적으로 활용이 가능할 것으로 판단되었다. 본 연구를 통하여 개발된 인산석고 경량혼합토는 하중감소 효과가 있으면서도 전단강도와 지지력면에서 큰 문제가 없어서 연약한 임해매립지반의 도로 노상토 및 뒤채움재로 사용될 수 있어 인산석고의 대량 재활용방안이 될 것으로 판단된다.

• 한국화재소방학회논문지
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• 제33권5호
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• pp.149-154
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• 2019

지진 발생 시 소방배관의 안전성은 무엇보다 중요하다. 국내의 경우 국가화재안전기준(NFSC)에 따라 사양위주의 설계를 하고 있지만 특별한 성능이 요구되는 건물에는 공학적인 성능위주 설계를 적용하고 있다. 소방배관의 경우 트리방식을 적용하여 왔다. 하지만 여러 단점으로 인해 최근에는 그리드방식, 루프방식을 적용하고 있다. 국내 소방 배관 내진설계는 NFPA 13 의 cook book 방식을 적용하고 있지만, 신뢰성을 확보하기 위해서는 공학적인 해석이 필요하다. 국내에서 적용 중인 NFPA 13 기준은 ASCE 와 ASME 의 지침을 준용한 것으로 지진이나 배관의 공학적 해석이 부족한 기술자들이 사용하도록 만들어 놓은 설계방식이다. 국내 내진설계는 버팀대에 대한 검토만 진행되고 있다. 하지만 신뢰성 있는 해석을 위해서는 배관의 내압, 지속 하중에 의한 힘, 지진과 같은 하중 조건에서의 다양한 해석이 요구된다. 공학적 내진해석을 통해 트리방식 배관은 그리드나 루프 방식의 배관에 비해 안전성이 떨어지는 것을 알 수 있었으며, 응력 기반의 내진해석 방식과 변형률 기반의 해석방식을 비교한 결과 변형률 해석이 Over Stress 범위에서는 보수적인 결과 값을 보였다. 배관의 내진해석은 일률적인 계산을 통한 해석보다 공학적 해석을 통해 엔지니어가 본인의 의도에 맞게 해석을 하는 것이 좀 더 합리적이며, 여러 가지 해석조건을 고려하여 분석되어야 한다.

• Journal of Acupuncture Research
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• 제32권2호
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• pp.23-33
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• 2015

Objectives : This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation. Methods : This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments. Results : Average admission duration was $28.00{\pm}12.85$ days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from $5.89{\pm}2.00$ to $3.42{\pm}1.87$(p<0.001) and radiating pain from $5.96{\pm}2.12$ to $3.38{\pm}1.83$(p<0.001). ODI decreased from $46.69{\pm}19.25$ to $35.69{\pm}16.67$(p<0.001), and EQ-5D index increased from $0.63{\pm}0.26$ to $0.71{\pm}0.20$(p<0.05) after treatment in lumbar disc patients. Conclusions : Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

• 대한소아치과학회지
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• 제25권1호
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• pp.127-133
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• 1998

An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.14.1-14.11
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• 2020

Background: The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods: We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond^® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results: Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion: Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.