• 대한치과보철학회지
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• 제49권1호
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• pp.38-48
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• 2011

연구 목적: 본 연구는 고정성 국소의치 제작을 위한 상악 좌측 제2소구치 및 제2대구치의 지대치 삭제에 대하여 인체공학적으로 안정된 진료 자세를 확립하고, 치과의사의 일반적 작업 자세와 비교, 분석하고 인체공학적으로 안정된 자세의 임상적용 가능성을 알아보고 이를 이용하여 향후 치과의사 교육의 기초 자료로 활용하기 위함이다. 연구 재료 및 방법: 상악 좌측 고정성 국소의치를 위한 인체공학적으로 안정된 자세를 고안하고 임상 경력 3-6년의 보철과 전공의 과정에 있는 치과의사 8명을 선정하여 임의의 자세로 상악 좌측 고정성 부분의치 지대치 삭제를 시행하고 연구 대상자들에게 인체공학적으로 안정된 자세를 교육하고 연구 대상들에게 인체공학적으로 안정된 자세로 상악 좌측 고정성 국소의치 지대치 삭제를 시행하였다. 임의의 자세로 삭제 시행한 치아와 인체공학적으로 안정된 자세로 삭제 시행한 치아를 KHDP 3-dimensional measuring device를 사용하여 계측해 교합면 삭제량, 변연의 폭경, 변연의 깊이 축면 경사도. 그리고 삭제시간을 측정 비교하였다. 모든 계측된 결과를 윈도우즈용 SPSS 통계 프로그램 (ver. 18.0, SPSS, Chicago, IL, USA)을 이용하여 교합면 삭제량, 변연의 폭 및 깊이, 축면 경사도, 치아 삭제 시간을 평균값 및 표준편차 분석하고 T-test를 Random Position 와 Home Position에 따른 차이 검정하였다. 결과: 와(fossa) 부위에서의 교합면 삭제량은 상악 좌측 제2소구치 및 제2대구치 모두에서 지시삭제량에 비해 적었으며, 교두정에서의 삭제량은 지시삭제량 1.7 mm에비해 많았으나, Random position과 Home position간에 유의차는 없었다 (P > .05). 변연 폭의 삭제량은 상악 좌측 제2소구치 및 제2대구치 모두에서 지시삭제량에 비해 많았으며, Random position과 Home position간에 유의차는 없었다 (P > .05). 변연 깊이의 삭제량은 상악 좌측 제2소구치 및 제2대구치 모두에서 Random position이 Home position에 비하여 지시삭제량보다 깊었다 (P < .05). 축면경사각은 상악 좌측 제2소구치 및 제2대구치 모두에서 Home position의 축면 경사각이 Random position의 축면경사각보다 작았으나 유의차는 없었다 (P > .05). 피어슨 상관분석 결과, Random position에서 교합면 삭제량, 변연 깊이, 축면경사각은 서로에게 영향을 주고 있었으나, Home position에서는 측정결과 들이 거의 독립적으로 서로에게 영향을 주지 않았다 (P < .05). Home position 삭제 횟수가 많아질수록 삭제소요 시간은 줄어들었고, 이는 실험에 참여한 8명 모두에서 Random position 삭제시간과 비슷해지거나 더 짧았다. 결론: 고정성 국소의치를 위한 상악 좌측 제2소구치 및 제2대구치 삭제의 경우, 교합면 삭제량, 변연의 폭, 변연의 깊이, 축면 경사각에 있어서 Home position과 Random position 간에는 큰 차이가 없었다. 삭제시간, 인접치 인접면 손상 정도는 Home position이 Random position보다 적었다. 또한 자세분석을 한 결과 Home position이 Random position에 비하여 곧은 자세로 인체에 무리를 주지 않았다. 따라서 인체공학적으로 안정된 자세인 Home position의 임상적용 가능성이 높다고 생각된다.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.532-537
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• 2009

Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.691-700
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• 2017

Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.

• 구강회복응용과학지
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• 제25권3호
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• pp.255-265
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• 2009

즉시 하중에 대한 관심과 시도가 증가되고 있지만, 명확한 술식이 정립되어 있지는 않다. 본 연구에서는 상악 전치부 임플란트에서 즉시 하중시에 골과 임플란트에 나타나는 응력분포 양상을 3차원 유한요소법을 이용하여 알아보고자 하였다. 골질이 D3인 상악 전치부의 골모형을 구성하고, 서로 다른 길이(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm)의 직경 4.0 mm 나사형 임플란트를 식립한 모형을 제작하였다. 해석 절차의 간소화를 위하여 모든 물성은 등방성, 선형탄성, 균질성으로 가정하였다. 골-임플란트 계면은 접촉 요소법으로 처리하여 골유착이 일어나기 전 상태로 구성하였다. 지대주 장축에 120도의 각도로 지대주의 구개 절단각 중앙부에 176 N의 정하중을 가하고 응력분포를 관찰하였다. von Mises stress를 이용하여 응력을 분석한 결과 모든 모형에서 순측 피질골에 응력이 집중되었으며 피질골과 망상골의 경계부에서 최대 응력값을 나타내었다. 길이에 따른 비교시 8.5 mm 모형에서 가장 큰 최대 응력값을 나타냈으며, 임플란트 길이가 증가될수록 좀 더 양호한 응력 분포를 나타내었다. 상악 전치부 즉시 하중시에 피질골의 존재 유무는 매우 중요하며, 길이가 긴 임플란트를 식립하는 것이 유리하며, 가능하면 13.0 mm 이상의 임플란트를 식립하는 것이 즉시하중을 시행할 때 응력 분산에 유리한 것으로 판단된다.

• 한국광학회지
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• 제10권6호
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• pp.500-506
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• 1999

레이저 다이오드와 수신광검출기가 집적된 소자를 V-홈을 가진 실리콘 광학벤치에 flip-chip 본딩하고, 경사면을 가진 하나의 단일모드 광섬유와 수동정렬하는 방법을 사용하여 가입자망을 위한 저가의 양방향 송수신 모듈을 설계, 제작하였다. 광섬유의 단면 경사각에 따른 송신광결합 효율과 수신광결합 효율사이의 병목점을 찾기 위해 Gaussian빔 모델을 사용하여 수평정렬거리, 광섬유 단면 경사각, 수직정렬오차등의 변수에 따른 광결합계수를 계산함으로써, 최적의 광정렬조건을 예측하였다. 또한 실리콘 광학벤치에서 광결합효율을 측정하여 광섬유의 수직정렬오차에 따른 광결합계수의 감소가 광섬유의 경사각에 의해 보상될 수 있다는 계산결과의 타당함을 확인하였다. 실제의 sub-module 제작 및 광결합 실험에서 송신빔이 광섬유 단면에 반사되어 PD로 입사되는 것을 최소화하기 위하여 광섬유 단면을 경사절두원추형으로 제작함으로써 PD의 수신 잡음을 $30mu$m 이상의 정렬거리에서 -35dB이하로 유지할 수 있었다. 같은 조건에서 단면 경사각이 $12^{\circ}$인 광섬유에 의해 -12.1dB의 송신출력과 0.2A/W의 responsivity를 얻을 수 있었다.

• 대한물리의학회지
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• 제17권4호
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• pp.1-13
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• 2022

PURPOSE: This study examined the effects of the craniovertebral angle, proprioception (joint error test), and the upper trapezius on the muscle tone when comparing cervical stabilization and scapula stabilization exercises and when two exercises were performed together. METHODS: The participants in this study agreed in advance, and this study was carried out by recruiting 27 university students in their twenties with mild frontal posture. The subjects were assigned randomly to three groups that performed cervical stabilization exercises, scapular stabilization exercises, and both cervical and scapular stabilization exercises. One-way repeated ANOVA was used to analyze the evaluation values of the 1^st, 3^rd, and 6^th weeks of exercise intervention within the group, and one-way ANOVA was used to compare the difference in the effects of exercise intervention among the three groups. RESULTS: Proprioception was significantly different in the cervical stabilization exercises (CSE) group and the cervical stabilization exercises + Scapular stabilization exercises (CSE+SSE) groups at three weeks, and there was a significant difference between the scapular stabilization exercises (SSE) group and the CSE+SSE group (p < .05). At six weeks, there was a significant difference between the CSE group and the CSE+SSE group, and there was a significant difference between the SSE group and the CSE+SSE group (p < .05). There was a significant difference between three and six weeks in the CSE group (p < .05). In the SSE group, there was a significant difference between pre and six weeks, and between three and six weeks (p < .05). In the CSE+SSE group, there was a significant difference between pre and three weeks, and between pre and six weeks (p < .05). On the other hand, there were no significant differences between CVA and muscular tone in all three groups (P > .05). CONCLUSION: In all groups, the proprioception (joint error test) showed significant improvement, and the CSE+SSE group showed greater improvement than the other groups. As a result, the appropriate combination of neck stabilization exercise and scapular stabilization exercise effectively improved proprioception in the presence of forward head posture (FHP).

• Journal of Acupuncture Research
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• 제25권3호
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• pp.221-228
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• 2008

Objectives : The purpose of this study is to understand the anatomical basis of the facial muscles and to apply this knowledge on the clinical practice of facial acupuncture. Methods : We searched both contemporary and the latest literatures on the practical application of facial muscle anatomy on Facial Acupuncture. Conclusions : Facial Acupuncture improves skin tone, texture and wrinkling by assisting the circulation of Ki. It stimulates the facial muscles directly to undo the stagnation of the meridians. To practice Facial Acupuncture, thorough understanding of facial anatomy is required. In this study the muscles of the head and neck, appropriate depth and angle of acupuncture needle, etc. were reviewed. The upper facial muscles including frontalis, procerus, corrugator supercilii and orbicularis oculi, the mid facial muscles including auricularis, nasalis, levator labii superioris, zygomaticus and so on, and the lower facial muscles including orbicularis oris, depressor labii inferioris, depressor anguli oris, mentalis and platysma etc. were reviewed in this study. For safer and more effective use of Facial Acupuncture, further study on the objective outcome of the technique should be done.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.231-238
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• 1994

저자들은 1예의 전두부 연조직 결손과 2예의 경부와 안면에 형성된 다발성의 반혼구축 환자에서 조직확장술올 이용하여 양호한 두경부의 연조직 재건을 얻을 수 있었다. 다양한 연조직의 결손이나 변형에서 적절한 증례를 선택하여 올바르게 적용할 경우 조직 확장술은 유용한 재건방법이 될 수 있을 것으로 생각된다.

• 한국치위생학회지
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• 제18권3호
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• pp.269-280
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• 2018

Objectives: The purpose of this study was to investigate the change in the posture of dental hygiene students and clinical dental hygienists when implementing dental scaling before and after posture correction training using the rapid upper limb assessment (RULA) method and 3D motion analysis. Methods: Thirty-two healthy volunteers performed dental scaling to remove artificial calculus on dental manikin. The movement and angle of the joints were verified by RULA and 3D motion analysis during the procedure. The subjects were also photographed for 1 minute during the procedure for 10 minutes while the calculus was removed. After the removal of the calculus, the subject and the instructor checked the video together. Posture correction training was conducted by the instructor so that the subject could perform the calculus removal operation in the correct posture. Artificial calculus of the adjacent teeth was then removed for the same period of time, and the change in posture was reviewed. Results: The total score of the posture change using RULA was $5.72{\pm}0.58$ before training and $4.31{\pm}0.10$ after training, showing a significant decrease after training (p<0.001), and upper arm, lower arm, wrist position, neck and waist position showed significant decrease after training. The three-dimensional motion analysis showed significant differences according to the criteria measured at all measurement sites except the left shoulder (p<0.05) Conclusions: It was confirmed through RULA and 3D motion analysis that postural correction training using calculus removal images was effective, and that correct postural education is essential to preventing musculoskeletal diseases caused by removal of calculus.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.77-84
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• 2006

Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.