• 대한방사선치료학회지
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• 제21권1호
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• pp.17-23
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• 2009

목 적: 두경부암의 치료에 있어 상부 두경부의 양측면조사면과 하경부의 전방조사면의 접합부위에 균등한 선량을 조사하는 것은 매우 중요하다. 접합부위의 선량분포개선을 위하여 하경부 전방조사면의 치료시 Field-in-Field technique을 이용하여 부족선량(under dose)과 초과선량(over dose)으로 인한 선량불균등을 개선하고 일반치료와의 비교를 통하여 두경부암치료에 적용하고자 한다. 대상 및 방법: 상부 두경부의 양측면 조사시 빔의 확산으로 일어나는 입사점과 출사점의 선량차이를 알아보기 위하여 인체모형팬톰을 이용하였다. 인체모형팬톰을 전산화단층촬영하고 전산화치료계획에서 관심점의 선량비교를 시행하였고, 하경부 접합부위의 선량비율을 계산하여 이를 보정하였다. 조사면 접합부위의 선량분포를 알아보기 위하여 하경부의 접합부위에 저감도 필름을 놓고 일반적인 치료인 상부 두경부의 양측면조사와 하경부의 전방조사시 선량분포를 측정하였다. 또한, 상부 두경부 양측면 조사에 따른 빔의 확산을 고려한 Field-in-Field technique을 이용하여 하경부 전방조사를 할 때의 접합부위의 선량분포 차이를 측정하여 비교하였다. 접합부위의 관심점 선량을 알아보기 위하여 열형광선량계를 이용하여 인체모형팬톰내의 관심점에서의 선량변화를 비교, 분석하였다. 결 과: 전산화치료계획에서 하경부의 접합부위에 Field-in-Field technique을 적용하여 치료계획시 상부 두경부 양측면 조사와 선량합성을 한 경우 부족선량 영역의 선량이 4.7~8.65% 이상 증가하였다. 초과선량 영역의 선량도 2.75~10.45% 감소하였다. 또한, 저감도 필름을 이용한 측정에서는 부족선량영역에서 11.3% 증가, 초과선량영역에서 5.3% 감소한 것으로 나타났다. 열형광선량계를 이용한 관심점선량측정에서도 Field-in-Field technique 적용시 부족선량을 최소 7.5%에서 최대 17.6%까지 보정해주는 것으로 나타나 불균등한 선량분포를 개선할 수 있었다. 결 론: 전산화치료계획시 빔의 확산을 고려한 Field-in-Field technique을 적용하면 접합부위의 선량보정을 통해 냉점(cold spot)과 온점(hot spot)을 줄일 수 있었으며 특히, 빔의 확산에 따른 입사점의 부족선량을 보정할 수 있었다. 본 실험을 통해 Field-in-Field technique의 임상적용시 경부임파절의 저선량으로 인한 임파절전이에 대한 위험도를 감소시킬 수 있을 것으로 사료된다.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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• pp.1-9
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• 2020

Objective: This study aimed to investigate the immediate effects of intervention using neuromuscular control, self-stretching (SS), and neck stabilization exercises (NSEs) on neck pain, range of motion (ROM), and proprioception of position sense in adults with neck discomfort. Design: Three-group pretest-posttest design. Methods: Forty-four adults who complained of neck pain participated in the experiment. They were randomly assigned to the following groups: neuromuscular control exercise (NMCE) group (n=15), SS group (n=14) and NSE group (n=15). The NMCE group did rolling with only upper limb pattern on both sides. The SS group performed neck stretching on each side, 3 sets of 30 seconds for each muscle. The NSE group had the pressure biofeedback applied with increases in pressure by 2 mmHg at a time from 20-30 mmHg while in the hook-lying position. All groups performed exercises for 10 minutes. Neck pain, ROM, and proprioception were measured to determine differences between the intervention methods. Results: Intra-group comparisons showed significant improvement after exercise in pain, ROM, and proprioception in the NMC group (p<0.05). In the comparison between groups, the NMC group had a significant decrease in pain compared to the other two groups (p<0.05). There was no difference in ROM between the groups but the NMC group showed significant improvement in left rotation compared to the stabilization exercise group (p<0.05). For proprioception, the NMC group had significantly lower error than the other two groups (p<0.05). Conclusions: NMCEs through upper extremity pattern rolling exercise is effective in improving neck pain, ROM, and proprioception.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제55권5호
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• pp.301-303
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• 2012

Reports of ingested foreign bodies migrating to the neck are rare. We encountered a case of fish bone that migrated out of the upper digestive tract to the thyroid gland. This foreign body was identified by computed tomography and ultrasonography about two weeks after onset, and successfully removed via neck exploration and the patient recovered well.

• 대한두경부종양학회지
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• 제33권2호
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• pp.75-79
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• 2017

Bronchogenic cysts are congenital malformations of the bronchial tree, a type of bronchopulmonary foregut malformation. The presentation of the bronchogenic cyst is variable, making pre-operative diagnosis difficult. They aremostly asymptomatic orarefound incidentally when the chest is imaged. They can present as lower neck massesor mediastinal masses that may enlarge. They cause mass effect due to local compression and may result in tracheo-bronchial obstruction leading to air trapping and respiratory distress. The treatment is somewhat controversial, and in general,these lesions are treated using the transcervical or transbronchial approach. When these cysts arelocalized in the upper mediastinum, it may be possible to removethemusing the transcervical approach. In our three cases, the patientscomplained of mild dysphagia, foreign body sensation, and dyspnea. We report three cases of a large bronchogenic cyst in the lower neck and the upper mediastinum treated using the transcervical approach.

• 한국전문물리치료학회지
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• 제20권3호
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• pp.19-26
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• 2013

The smart-phone has become a necessity for most people. In this study, we determined that using a smart-phone for 20 minutes can cause increased neck and shoulder muscle activities and fatigue. Seventeen healthy male smart-phone users who attended Yonsei University played a smart-phone game for 20 minutes and changes in their bilateral cervical erector spinae and upper trapezius muscle activities and fatigue were measured. To assess muscle activities and fatigue, we used the following variables: the median frequency, the 50th percentile Amplitude probability distribution function (APDF) value (median load), and the discrepancy in the 90th percentile APDF value and the 10th percentile APDF value (APDF range). A paired t-test was used to compare pre-smart-phone-use status with post-smart-phone-use-status. The median frequency of the bilateral cervical erector spinae and the upper trapezius decreased significantly after 20 minutes of smart-phone use (p<.05). In addition, the 50th percentile APDF value of the bilateral cervical erector spinae and the right upper trapezius increased significantly (p<.05). The APDF range of the bilateral cervical erector spinae and the upper trapezius also increased significantly (p<.05). However, the 50th percentile APDF range of the left upper trapezius was not significantly different (p>.05). These findings suggest that using smart-phones for 20 minutes can induce muscle fatigue and increased neck and shoulder muscle activities.

• 한국전문물리치료학회지
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• 제30권3호
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• pp.211-220
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• 2023

Background: Smartphone addiction has emerged as a significant social problem. Numerous studies have indicated the association between smartphone use and discomfort in the musculoskeletal system of the upper extremities. Objects: This cross-sectional survey aimed to compare the characteristics of musculoskeletal pain in the neck, trunk, and upper limbs between individuals with smartphone addiction and those without addiction. Methods: We collected a total of 326 healthy individuals' data from China and Korea who had owned and used smartphones for more than 5 years between 20-50s through an online questionnaire consisting of 84 questions in four major sections. The first part contained basic information on the participant's personal characteristics and smartphones. The second part contained questions about smartphone use and posture. The third part was the smartphone addiction. The fourth part was to investigate musculoskeletal pain in various upper body parts. Results: Smartphone addiction has a weak negative correlation with age (r = -0.20, p < 0.01) and a weak positive correlation with the hours of smartphone use (r = 0.376, p < 0.01). Frequent musculoskeletal pain symptoms related to smartphone use were observed in the neck, shoulder, lower back, and wrists. The hours of smartphone use was slightly positively associated with the prevalence of musculoskeletal pain in the shoulder (r = 0.162, p < 0.05) and lower back (r = 0.125, p < 0.05). The prevalence of musculoskeletal pain in the neck (χ² = 3.993, p < 0.05), shoulder (χ² = 6.465, p < 0.05), and wrist (χ² = 4.645, p < 0.05) was significantly higher among females than males. Conclusion: The results suggest that smartphone addiction should be recognized as a dual concern encompassing both physical health and psychosocial aspects. Furthermore, healthcare professionals, including physicians and physical therapists, should consider clients' smartphone usage patterns when assessing and treating with musculoskeletal pain.

• 대한두경부종양학회지
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• 제10권2호
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• pp.212-217
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• 1994

The Horner's syndrome includes anisocoria as a result of miosis of the involved pupil with ptosis of the upper and lower lids, which results in slight narrowing of the palpebral fissure. Ipsilateral facial hyperemia and anhidrosis over the face and neck are less common features. The findings with Horner's syndrome are a result of the loss of sympathetic innervation to the ipsilateral eye and face. Recently we experienced 3 cases of Horner's syndrome that developed postoperatively and report briefly with literature.

• International journal of advanced smart convergence
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• 제7권1호
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• pp.33-41
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• 2018

This study was designed to provide basic data for developing exercise program that helps correcting posture by knowing the effect of strengthening and elongation exercises of upper extremity muscle to forward head posture correction. In this study determined subjects whether they had forward head posture or not. On the basis of the New York state posture rating, if a subject's posture is match up with the normal standard posture, gives 5 points and if the posture is slightly get out of the normal standard posture, gives 3 points and if the posture is apparently get out of the standard, gives 1 points. When determining the forward head posture, if talus, humerus and outer ear center are on the same line, it is determined as normal and if outer ear center is off the line less than 1.0cm, it is a slight deformation and if outer ear center is off the line more than 1.0cm, it is a high deformation. In the study selected people who have more than 1 cm gap between two vertical lines start from outer ear center and acromion separately as subjects. Length between the ideal alignment line measured by using goniometer and temporal region showed statistically significant decrease as $2.36{\pm}1.07cm$ before the intervention and $1.06{\pm}0.88cm$ after the intervention. After 4 weeks of neck and chest extensor muscle exercise, the group who exercised both showed increase in range of neck joint motion and neck flexion of the forward head posture. Meanwhile the group who only exercised neck extensor muscle only and the group who only exercised chest extensor muscle didn't showed statistically significant result. That only the group who exercised both muscles showed significant result is the different with studies before. Because this study didn't target patient who had a lesion, couldn't compare effect of the conservative manner and exercise. However, this study provides the fact that the group who exercised both neck and chest muscle had more effect than the control group.

• 대한통합의학회지
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• 제7권3호
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• pp.159-169
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• 2019

Purpose: The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods: The subjects were divided into the following three groups according to the intervention received: cervix-stabilizing exercise (n=12, group 1), transcranial direct current stimulation (n=12, group 2), and cervix-stabilizing exercise combined with transcranial direct current stimulation (n=12, group 3). The intragroup and intergroup differences in muscle characteristics and neck disability index were compared and analyzed. Results: The comparison and analysis of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius and suboccipitals in groups I and III, and statistically significant intergroup differences in the upper trapezius, with greater changes in group III than in group II, and in the suboccipitals, with greater changes in groupIII than in groups Iand II. The comparison and analysis of the change in muscle stiffness and post hoc analysis revealed a statistically significanti ntra group decrease in the upper trapezius in group Iand suboccipitals in group III, and a statistically significant intergroup difference in both muscles, with greater change in group III than in group II. The comparison and analysis of change in neck disability index and post hoc analysis revealed a statistically significant intragroup decrease in all the three groups and a statistically significant intergroup difference, with greater change in group III than in groups I and II. Conclusion: The neck-stabilizing exercise and transcranial direct current stimulation were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle durability, and in improving the movement and limitation of joint range of motion by decreasing muscle tone and stiffness.

• 대한통합의학회지
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• 제9권2호
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• pp.43-52
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• 2021

Purpose : Chronic neck pain negatively impacts the quality of life and causes various problems in daily life due to pain, insomnia, and sleep disturbances in patients with this condition. Therapeutic interventions to solve these problems in rehabilitation and physical therapy are being introduced; however, the evidence of the efficacy of myofascial release (MFR) is still insufficient. This study aimed to investigate the effects of applying MFR on pain, insomnia, and sleep disturbances in patients with chronic neck pain. Methods : Ten patients with chronic neck pain were randomly selected and grouped into the experimental group (n₁ = 10) and control group (n₂ = 10) by cross-over design. Pain was measured before and after MFR intervention. Moreover, insomnia was measured only after MFR intervention. Polysomnography was performed after MFR intervention. Wilcoxon signed rank test and Mann-Whitney U test were used for the visual analog scale (VAS). Independent sample t-test was separately performed to measure insomnia and sleep. Results : After MFR intervention, the VAS score of the experimental group (p = 0.005) significantly decreased than that of the control group (p = 0.002). The insomnia score of the experimental group significantly decreased than that of the control group (p = 0.001). The total sleep time (p = 0.001), sleep efficiency (p = 0.001), and sleep latency (p = 0.001) of the experimental group significantly increased than those of the control group in the polysomnographic measurement. Conclusion : The application of MFR of the neck and upper trunk may have a positive effect on pain, insomnia, and sleep disturbances in patients with chronic neck pain. It was also suggested that an objective and quantitative polysomnography can be used more often in the field of rehabilitation and physical therapy.