• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.203-244
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• 1998

The human mandible is always under the condition of loading by the various forces extorted by the attached muscles. The loading is an important condition of the stomatognathic system. This condition is composed of the direction and amount of forces of the masticatory muscles, which are controlled by the neuromuscular system, and always influenced by the movement of both opening and closing. Mandible is a strong foundation for the teeth or various prostheses, nevetheless it is a elastic body which accompanies deformation by the external forces on it. The elastic properties of the mandible is influenced by the various procedures such as conventional restorative treatments, osseointegrated implant treatments, reconstructive surgical procedures and so forth. Among the treatments the osseointegrated implant has no periodontal ligaments, which exist around the natural teeth to allow physiologic mobility in the alveolar socket. And so around the osseointegrated implant, there is almost no damping effect during the transmission of occlusal stress and displacements. If the osseointegrated implants are connected by the superstructure for the stabilization and effective distribution of occlusal stresses, the elastic properties of mandible is restricted according to the extent of 'splinting' by the superstructure and implants. To investigate the change of elastic behaviour of the mandible which has osseointegrated implant prosthesis of various numbers of implant installment and span of superstructre, a three dimensional finite element model was developed and analyzed with conditions mentioned above. The conclusions are as follows : 1. The displacements are primarily developed at the area of muscle attachment and distributed all around the mandible according to the various properties of bone. 2. The segmentation in the superstructure has few influence on the distribution of stress and displacement. 3. In the load case of ICP, the concentration of tensional stress was observed at the anterior portion of the ramus($9.22E+6N/m^2$) and at the lingual portion of the symphysis menti($8.36E+6N/m^2$). 4. In the load case of INC, the concentration of tensional stress was observed at the anterior portion of the ramus($9.90E+6N/m^2$) and the concentration of tensional stress was observed at the lingual portion of the symphysis menti($2.38E+6N/m^2$)). 5. In the load case of UTCP, the relatively high concentration of tensional stress($3.66E+7N/m^2$) was observed at the internal surface of the condylar neck.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.48-54
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• 1997

Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

• The Journal of Internal Korean Medicine
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• v.15 no.1
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• pp.176-209
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• 1994

1. The Jung-Sa(正邪) of the Excessive Liver-Symptoms belongs to the eleven symptoms, there are blue face, blue thin fingernail, anger, fancy of larg body, dizziness, eye flame, Bell's palsy, hard swelling pain at braest, side pain going on the belly from the side, side pain and movement at the left side. 2. The Mi-Sa(微邪) of the Excessive Liver-Symptoms belongs to the four symptoms, there are meat in eye, edema in cheek, lack of appetite and diarrhea. 3. The Juk-Sa(賊邪) of the Excessive Liver-Symptoms belongs to the only one symptom, this is nosebleeding. 4. The Hu-Sa(虛邪) of the Excessive Liver-Symptoms belongs to the three symptoms, there are scrotum constraction, strain in belly and constipation. 5. The Sil-Sa(實邪) of the Excessive Liver-Symptoms belongs to the twenty eight symptoms, there are red eye, raised eyes(兩眼上?), spitting blood, sternocostal turgid pain, turgidity in belly, drooping testis, vomiting water acid, sickening, belching, confusion, impatience, frequent forgetfulness, headache, giddness, eye pain, deaf, ringing in the ear, feeling inverse, drying mouth, stuffiness sensation in the chest, chest pain, stuffiness sensation in the belly, bellyache, quadriplegia, spasm of extremities, tremor, alternate spells of fever and chills, high fever and strain in muscle. 6. Those symptoms, Red corner of the eye, red face, swelling on the forehead, stiff-neck and back strong, opisthotonos, constracture of the limbs, vomiting yellow bitter water, speech impediment, epilepsy, depression, strong tongue, different thing in throat, fullness and distention of the gastric region, feeling sick and tenesmus, have no connected with the Excessive Liver-Symptoms(肝實證) 7. The Excessive Liver-Symptoms(肝實證) is connected with the ganjabyoung(肝自病) and Hwa(火) which the pathology is, than because Mock(木) is excessive and Mock-Saeng-Hwa(木生火), the ganjabyoung(肝自病) and Sil-Sa(實邪) are many. 8. There are the sixteen symptoms with the exception of The Excessive Liver-Symptoms(肝實證), because supposed that the scholars in medicine included the union syndroms(合病), the combine syndroms(兼病) and the analysis of symptoms(辨證) in The Analysis of Five Visceral Symptoms. 9. During consideration of the symptoms at the above statements, where are many causes by Gan-Pung(肝風), there is difficult of distinction between the excessive Liver-Symptoms(肝實證) and C.V.A(Cerebral Vascular Attack). Because than NaeKyung(內經) distinguished between the excessive Liver-Symptoms(肝實證) and C.V.A., the future medical specialists connected with the excessive Liver-Symptoms(肝實證) and C.V.A.. 10. An appearance of Sang-Hwa(相火) that the liver possessed is divided into an appearance of Hwa(火), there will be making a study att the more necessary. 11. The cuases of each syndroms are consist of the origins of syndroms, its pathology and the positions where the syndroms appeared, I consider that is the various ways how judge the syndroms except the Five Pathogenic Factors(五邪). 12. If more than study will be achieved in all, the new definition will be standed about the Excessive and Deficient Five Visceral Syndroms(五臟虛實證), I consider this will be the foundation data that study the Oriental Medicine and the important data that is a judgement standard of clininc.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.2
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• pp.186-195
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• 1994

Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.891-895
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• 2001

Objective : Although surgical clipping of intracranial aneurysm is the definite method of treatment, there remains a small number of patients in whom surgical clipping is not technically possible. In such difficult cases, surgeon has to consider other therapeutic alternatives. In this report, we analyze our aneurysmal cases treated by wrapping and coating method and evaluate their surgical outcome and follow-up results. Method : Among the total of 877 patients operated from 1990 to 1999 for intracranial aneurysms at our hospital, 40 cases(4.6%) were treated by wrapping and coating method. They included 24 cases of single ruptured aneurysms and 16 with unruptured ones in multiple aneurysms. Wrapping with temporalis muscle and/or muslin gauze and coating with bioadhesive agent such as fibrin glue were performed. Result : Wrapping and coating method was performed mostly to the anterior communicating artery aneurysm (35%), and mostly because of the broad-based neck of an aneurysm(43%). At the time of discharge, 30 out of 40 patients(80%) showed favourable outcome and three cases died. The patients were monitored for average of 37 months(3-75 months). Among 24 cases with single ruptured aneurysm, 4 cases(17%) had early rebleeding within 6 months from the initial hemorrhage, and such rebleeding occurred within the first postoperative month in 3 cases. However, there was no rebleeding after the 6 months. Among 16 patients whose aneurysms were unruptured ones, none of them showed bleeding episode. Conclusion : It seems likely that the wrapping and coating method would be some help to prevent the rebleeding of an intracranial aneurysm. In order to obtain more accurate results regarding the efficacy of such method, it will be necessary to perform a multi-center study for longer follow-up periods and various wrapping and coating materials.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.4
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• pp.109-115
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• 2019

Cervical dystonia (CD) is a disorder characterized by sustained or intermittent, involuntary muscle contractions which cause twisting, repetitive movements and abnormal postures. In this case report, a CD patients was treated with transfer energy capacitive and resistive (TECAR) therapy and conventional Korean medicine, which consists of acupuncture, Chuna manual medicine, pharmacopuncture and herbal medicine. For outcome measures, this study evaluated Cobb's angle, EuroQol five dimension scale (EQ-5D), numerical rating scale (NRS), neck disabillity index (NDI) and cervical range of motion. As a result, improvements were found in Cobb's angle ($18.65^{\circ}$ to $15.90^{\circ}$), EQ-5D score (0.808 to 0.862), NRS (5 to 3), NDI (16 to 8) and angle of cervical lateral bending ($15^{\circ}$ to $25^{\circ}$). In conclusion, this study shows that combined therapy of conventional Korean medicine treatment and TECAR therapy can be effective for CD patients.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.512-518
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• 2021

Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5^th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

• Parasites, Hosts and Diseases
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• v.27 no.4
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• pp.261-270
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• 1989

The present study is intended to observe the chronologic changes of experimental sparganosis by histopathological observation and detection of circulating anti-sparganum IgG antibody using ELISA. Each of 25 mice was infected with aye spargana, and they were examined after 1, 2, 4, 10 weeks or 6 months from infection. The followings are summarized results. - 1. The plerocercoids were detected in the subcutaneous tissue of the trunk, neck or axilla, but a few often extended into the skeletal muscle. The recovery rates were 72% at the first week, 80% at the second week, 95% at the fourth week, 92% at the tenth week and 100% at .the sixth month. The larvae grew slowly in both length and weight until 6 months. 2. Histopathologically, most of the larvae were observed alive in the soft tissue or skeletal muscle. Numerous eosinophils, neutrophils, Iymphocytes and plasma cells were infiltrated focally around the worms by the second week, but they surrounded the worms to form a layer of inflammatory reaction after 4 weeks of infection. Also histiocytes and fibroblasts began to appear around the inflammatory cells at 4 weeks. After 10 weeks, the worms encircled by a thin fibrous layer were found. After 6 months, the worms were surrounded by either fibrous tissue or active inflammatory cells. The inflammation looked more severe in the tracks left by the worms, rather than around the worms. 3, The level of anti-sparganum IgG antibody in the serum showed an increase by the fourth week, and a rapid and continuous increase was observed thereafter by the tenth week after infection. The high level of the IgG antibody was maintained up to 6 months forming a plateau curve. The present results suggest that the tissue reaction and antibody production in subcutaneous sparganosis become distinctive by the fourth week after infection.

• Sleep Medicine and Psychophysiology
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• v.24 no.2
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• pp.106-117
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• 2017

Objectives: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is characterized by repetitive collapse or partial collapse of the upper airway during sleep in spite of ongoing effort to breathe. It is believed that OSA is usually worsened in REM sleep, because muscle tone is suppressed during REM sleep. However, many cases showed a higher apnea-hypopnea index (AHI) during NREM sleep than during REM sleep. We aimed here to determine the characteristics of REM sleep-dependent OSA (REM-OSA) and NREM sleep-dependent OSA (NREM-OSA). Methods: Five hundred sixty polysomnographically confirmed adult OSA subjects were studied retrospectively. All patients were classified into 3 groups based on the ratio between REM-AHI and NREM-AHI. REM-OSA was defined as REM-AHI/NREM-AHI > 2, NREM-OSA as NREM-AHI/REM-AHI > 2, and the rest as sleep stage-independent OSA (IND-OSA). In addition to polysomnography, questionnaires related to subjective sleep quality, daytime sleepiness, and emotion were completed. Chi-square test, ANOVA, and ANCOVA were performed. Results: There was no age difference among subgroups. The REM-OSA group was comprised of large proportions of mild OSA and female OSA patients. These patients experienced poor sleep and more negative emotions than other two groups. The AHI and oxygen desaturation index (ODI) were lowest in REM-OSA. Sleep efficiency and N3 percentage of REM-OSA were higher than in NREM-OSA. The percentage of patients who slept in a supine position was higher in REM-OSA than other subgroups. IND-OSA showed higher BMI and larger neck circumference and abdominal circumference than REM-OSA. The patients with IND-OSA experienced more sleepiness than the other groups. AHI and ODI were highest in IND-OSA. NREM-OSA presented the shortest total sleep time and the lowest sleep efficiency. NREM-OSA showed shorter sleep latency and REM latency and higher percentage of N1 than those of REM-OSA and the highest proportion of those who slept in a lateral position than other subgroups. NREM-OSA revealed the highest composite score on the Horne and ${\ddot{O}}stberg$ questionnaire. With increased AHI severity, the numbers of apnea and hypopnea events during REM sleep decreased, and the numbers of apnea and hypopnea events during NREM sleep increased. The results of ANCOVA after controlling age, sex, BMI, NC, AC, and AHI showed the lowest sleep efficiency, the highest AHI in the supine position, and the highest percentage of waking after sleep onset in NREM-OSA. Conclusion: REM-OSA was associated with the mild form of OSA, female sex, and negative emotions. IND-OSA was associated with the severe form of OSA. NREM-OSA was most closely related to position and showed the lowest sleep efficiency. Sleep stage-dependent characteristics could provide better understanding of OSA.

• 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.