• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.146-153
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• 1992

In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

• 한국운동역학회지
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• 제15권3호
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• pp.95-104
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• 2005

To know the proper setup posture for the various clubs, changes of setup variables according to the change of golf club length was investigated. Swing motions of three male low handicappers including a professional were taken using two high-speed videocameras. Four clubs iron 7, iron 5, iron 3 and driver (wood 1) were selected for this experiment. Three dimensional motion analysis techniques were used to get the kinematical variables. Mathcad and Kwon3D motion analysis program were used to analyze the position, distance and angle data in three dimensions. The variables divided into three categories 1) position and width of anterior-posterior direction 2) position and width of lateral direction 3) angles and evaluated based on the theories of many good golf teachers. Major findings of this study were as follows. 1.The stance (distance between ankle joints) was increased as the length of the club increased but the increasing width was not large. It ranges from 5cm to 10cm and professional player showed small changes. 2. Forward lean angle of trunk was decreased (more erected) as the length of the club increased. It ranges from 30 degrees for iron7 to 25 degrees for driver. 3. Angle between horizontal and right shoulder were increased as the length of the club increased. It ranges from 10 degrees to 20 degrees and professional player showed small changes. 4. Anterior-posterior position of the shoulders were located in front of the foot for all clubs and the difference between the shoulder and knee position was decreased as the length of the club increased. 5. Anterior-posterior position of grip (hand) was located almost beneath the shoulders (2.5cm front) for iron7, but it increased to 10cm for the driver. This grip adjustment makes the height of the posture increased only 5cm from iron7 to driver. 6. Lateral position of grip located at 5cm left for the face of iron7, but it located at the right side (behind) for the face of driver. 7. Lateral position of the ball located at the 40%(15cm) of stance from left ankle for iron7 and located at the 10% (5cm) of stance for driver. 8. Head always located at the right side of the stance and the midpoint of the eyes located at the 37% of stance from the right ankle for all clubs. This means that the axis of swing always maintained consistently for all clubs. 9. Left foot opened to the target for all subject and clubs. The maximum open angle was 25 degrees. Overall result shows that the changes of the setup variables vary only small ranges from iron7 to driver. Paradoxically it could be concluded that the failure of swing result from the excessive changes of setup not from the incorrect changes. These findings will be useful for evaluating the setup motion of golf swing and helpful to most golfers.

• Restorative Dentistry and Endodontics
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• 제35권6호
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• pp.429-435
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• 2010

연구목적: 본 연구의 목적은 한국인의 근관 작업장에 대한 ISO규격의 근관 치료용 기구의 길이가 적절성을 평가하기 위한 것이다. 연구 재료 및 방법: 2006-2008년까지 경희의료원 동서신의학병원 보존과에서 구치부의 근관 치료를 받은 환자를 670명 선발하였다. 모든 근관 치료는 한 명의 술자에 의해 시행되었으며 통법의 와동을 형성하였고 변연 융선부터 0.5 mm의 교합면삭제를 시행하였다. 근관장은 전자 근관장 측정기(Root ZX)를 이용하여 측정하였고 방사선 사진으로 보정하였다. 근관장의 길이는 근관 성형 정도에 따라 달라지기 때문에 이 실험에서는 초기 근관장만을 이용하였다. 심한 우식이 있거나 보철물이 있는 경우, 근관이 석회화 되어서 정상적인 근관 치료를 할 수 없는 경우, 상악 대구치의 근심 설측 근관과 하악의 C-shape 근관을 가진 치아는 실험군에서 제외하였다. 총 487개 소구치 근관과 870개 대구치 근관의 근관장을 측정하였고 각각의 평균 및 표준편차를 측정하였다. 또한 각 길이별 빈도 분포 및 정규 분포를 관찰하였다. 결과: 1. 소구치 근관에서 20 mm 이하의 근관장을 갖는 경우는 전체의 66.5%였으며 22 mm 이하의 근관장을 갖는 경우는 전체의 95.4%였다. 2. 한국인의 소구치 근관장을 측정한 결과, 현재 시판중인 21 mm, 25 mm의 기구보다는 23 mm의 기구가 더 적절하였다. 결론: 한국인의 소구치 근관 치료시 21 mm, 25 mm의 기구보다는 23 mm의 기구가 더 적절하였으며 대구치의 경우 21 mm의 기구의 사용이 적절하다고 사료된다.

• 대한치과보철학회지
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• 제60권1호
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• pp.44-54
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• 2022

다수 치아의 상실 상태로 장시간 지속시 구치부 지지의 부족 및 치아들의 과정출이 발생되어 교합 부조화, 수직고경 상실 및 기능 장애 등의 심각한 문제가 초래된다. 본 증례는 장기간 다수치아 결손으로 인하여 대합치가 정출하면서 교합평면의 붕괴가 일어난 환자의 완전 구강 회복에 관한 증례이다. 상기 환자는 서울대학교 치과병원 치과보철과로 내원한 68세 남환으로 오래된 상악 의치를 빼다가 치아가 함께 발거되었으며, 하악 전치부가 상악 전치부와 강하게 닿아서 불편함을 호소하며 내원하였다. 여러가지 평가를 통해 수직고경을 4 mm 거상하였으며, 무치악부는 진단 및 치료계획시 설계한 최종 보철 수복물 제작을 고려하여 정확한 임플란트 식립을 위해 CAD-CAM (Computer-aided design-computer-aided manufacturing) 기술을 이용한 Computer guided implant surgery를 시행하고, 임플란트 고정성 보철 수복으로 진행하였고, 환자는 저작, 기능 및 심미 모두 큰 개선에 만족하였다.

• 대한가정학회지
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• 제43권10호
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• pp.179-190
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• 2005

The purpose of this study was to apply the three dimensional Replica method to the fabrication of dress forms of plus-sized women to attain proper ease through draping and based on the ease to develop good torso patterns with superior fit. The results were as follows. The physical characteristics of the dress forms of plus-sized women were divided into two: Types I and 11. The proper ease was calculated through draping using dummies of each somatotype and appropriate torso patterns were developed. The differences of the types for each pattern were as follows. The bust girth ease of Type II was 6cm as for Type I. As for the bust breadth 1.0cm was added to the anterior chest width, the armpit width was the actual measurement plus 0.5cm, and the back breadth was the posterior chest width plus 2.5cm. The bust breadth was smaller and the back breadth was bigger that those of Type I after improving the bust and back fit. The bust of Type I protrudes outwards relatively and so the shoulder dart of front-side of Type I was 1.2cm bigger than that of Type II which improved the bust region fit. Considering the characteristics of the protruding abdominal region the front- side waistline of type II was assigned W/4+3.5cm and the back-side waistline W/4cm, so that the sidelines divided the front and back properly. It was drafted so that the center-front became diagonal, thereby improving the middle-hip girth fit.

• 대한정형외과스포츠의학회지
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• 제7권2호
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• pp.67-74
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• 2008

반복적으로 던지는 동작은 주관절에 심한 기계적인 스트레스를 주며, 주된 기전은 외반력이며 그 결과 내측 인장력과 외측 압박력, 후방부의 충돌현상이 발생한다. 성장기나 청년기에 지속적인 스트레스는 주관절에 해부학적 변화를 유발할 수 있다는 위험성을 운동선수와 가족, 코치들은 반드시 잘 이해하고 있어야 한다. 스포츠와 관련된 주관절 손상을 막기 위하여 적절한 운동법 교육, 워밍업, 의학적 전문 지식, 보호 장구 등이 필요하다. 또한 손상 예방과 재활은 적절한 투구 동작, 근력 강화, 견갑골에 대한 조절, 관절 운동 범위의 적절한 유지가 필수적이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권3호
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• pp.282-288
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• 2010

Surgery with the computer navigation system can make it possible to identify important anatomical structures which are difficult to be confirmed with the naked eye in the operation, and has extended their applications in various surgical fields. The head and neck surgery especially requires detailed anatomical knowledges and these knowledges have influences on postoperative functions and esthetics of a patient. In the orthognathic surgery, we should take osteotomies in the precise locations of the jawbones and move segments to the intended positions. There are so many important anatomical structures around the osteotomy-sites in the orthognathic surgery that the prevention of damage to these structures to obtain satisfactory results without any complication. There are vessels of the pterygoid plexus posterior to the pterygoid plate in the maxilla and the mandibular nerve enters the mandibluar foramen in the mandibular ramus. These locations should be confirmed perioperatively to avoid any injury to these structures. The navigation-assisted surgery may be helpful for this purpose. We performed navigational orthognathic surgeries with preoperative CT images and obtained satisfactory results. The osteotomy was performed in the proper location and damaging the surrounding important anatomical structures was avoided by keeping the saw away from them with the real-time navigation. It may be required to develop proper devices and protocols for the navigation-assisted orthognathic surgery.

• 치과방사선
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• 제21권1호
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• pp.99-107
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• 1991

저자는 두부규격방사선사진 촬영기에서 건조 두개골 10개의 basal view와 lateral view상에서 측두골의 추체와 접형골의 후상상돌기가 악관절부위에 중첩되지 않는 수평면과 수직면에서의 입사각을 구하였고 Denar사의 Accurad-100의 형태대로 제작하고 고정장치와 cephalostat를 사용하여 촬영된 방사선사진의 재현성을 검토하여 다음과 같은 결과를 얻었다. 중심방사선의 입사각은 수직면에서는 24.5±4.1°, 수평면에서는 3.0±5.7°였으며 재현성을 검정하기 위해 건조두개골의 악관절부위에 임의의 3점을 계측하였든 바 Accurad-100의 형태대로 제작한 고정장치를 이용한 경우에는 AB간의 거리 24.60±0.25㎜, AC간의 거리 16.76±0.27㎜, BC간의 거리 8.79±0.18㎜이었고 cephalostat를 이용한 경우에는 AB간의 거리 29.03±0.14㎜, AC간의 거리 19.95±0.24㎜, BC간의 거리 10.08±0.07㎜로 나타났다. 따라서 이들은 상당히 양호한 재현성을 나타냈으며 특히 cephalostat를 이용한 경우 더욱 재현성이 좋았다.

• 대한치과보철학회지
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• 제51권3호
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• pp.221-225
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• 2013

임시 보철물의 적절한 관리는 보철의 성공에 있어서 중요한 요소이다. 상악 전치 결손부 임시 보철물은 장경간의 결손부가 존재하거나, 타원형의 악궁을 가진 환자에서 자주 탈락하게 된다. 이는 상악 전치부가 구치부에 비해서 수평적인 힘에 더 많이 노출되며, 부가적으로 전방 캔틸레버 효과가 임시 보철물의 유지를 저해하고, 상악 전치부 임시 보철물은 하악의 기능 운동시 적절한 전방 유도를 제공하여야 하기 때문이다. 또한 임시 보철물의 최대 감합위에서 교합접촉은 지점선의 반대편에 위치하게 되어 그 자체로 임시 보철물의 탈락을 야기한다. 본 증례에서는 임시 임플란트를 이용하여 상악 전치부 보철물에 대한 전술한 유해 작용을 피할 수 있었고, 발치 후 치유기간 동안 환자에게 편안함과 만족감을 부여하였으므로 이를 보고하는 바이다.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.273-278
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• 2011

Purpose: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. Methods: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. Results: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. Conclusion: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.