• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.17-25
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• 2021

Background: The purpose of this study is to investigate basic data about the effects of muscle energy technique on the shoulder complex range of motion and posture alignment in the round shoulder posture. Methods: The subjects included 15 women that gave consent to participate in the study voluntarily. They performed the muscle energy technique for 30 minutes twice. The round shoulder posture was measured with a straight edge ruler. The shoulder complex range of motion was measured with the apley scratch test. The forward head posture was measured with ImageJ. The pectoralis minor muscle length was measured with a tape measure. Results: There were statistically significant differences in the round shoulder posture both right and left (p<.05). The experiment group showed statistically significant differences in the pectoralis minor muscle length (p<.05). There were significant differences in the shoulder complex range of motion including flexion, left lateral flexion, right lateral flexion, left side bending, and right side bending (p<.05), but no significant differences were found in extension (p>.05). The forward head posture showed significant differences in CVA changes (p<.05) and no significant differences in CRA changes (p>.05). Conclusion: These findings demonstrate that the muscle energy technique relaxed muscles around the shoulders and increased the shoulder complex range of motion. The technique is also expected to prevent pain in the neck and shoulders and lower injury risk. In conclusion, the muscle energy technique can be applied as an effective intervention for round shoulder posture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.291-314
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• 2021

Squamous cell carcinoma (SCC) of the retromolar trigone (RMT) is a rare but potentially fatal disease that carries a poor prognosis due to its unique anatomic position. RMT SCCs tend to spread to vital nearby structures, including the tonsillar pillar, masticatory muscles, and underlying mandibular bone, even in their early stages, and aggressive treatment is often warranted. This systematic review appraises and qualitatively analyzes all available literature regarding the survival outcomes and prognosis of RMT SCC. Four databases were searched to identify all eligible articles published since January 1980. Of the 1,248 studies, a total of 15 studies representing 4,838 cases met the inclusion criteria. The evaluated patients had a high rate of advanced tumor stage (T3 or T4: 61.4%), lymph node metastasis (38.8%), and mandibular bone invasion (24%) at the time of diagnosis. Aggressive surgical treatments such as lip-splitting (92%), segmental mandibulectomy (61.1%), radical neck dissection (44.1%), and reconstruction using free flaps (49.5%) was undertaken for 92% of the pooled patient population. The mean rates for local, regional, and systemic recurrence were 23.40%, 8.40%, and 8.50%, respectively. The mean 5-year overall survival rate was 38.90%. Osteonecrosis was noted in 11.6% of the 328 patients who received radiotherapy. In conclusion, RMT SCC is generally associated with high recurrence, low survival, and high postoperative complication rates. Early diagnosis and aggressive treatment are thus warranted. However, significant methodological problems hamper current knowledge. Future studies of this topic that use randomized or cohort designs are thus needed.

• Journal of the Korea Society of Computer and Information
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• v.28 no.5
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• pp.95-102
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• 2023

The purpose of this study was to the effects of the Sling Neurac stabilization exercise(SNSE) on pain, cervical lordosis angle(CLA), and cervical gravity line(CGL) in young adults with a forward head posture. The subjects of the study were selected as SNSEG(n=10) and control group(n=10), they were conducted for 70 minutes three times a week for 8 weeks. Study results showed that pain(p<.001), CGLe(p<.01) were significantly decreased and CLA(p<.001) were also significantly increased in the SNSEG. In conclusion, SNSE is effective in improving the proprioceptive sense of the LM group and activating the muscle. Co-activation with the GM group was found to be effective in improving the CLA and CGL. Therefore, reactivation of the deep neck flexors and suboccipital muscles is an important factor in pain control and postural alignment, and is suggested as an effective intervention method to improve forward head posture.

• Clinical Pain
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• v.18 no.2
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• pp.92-96
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• 2019

Torticollis is an abnormal, asymmetric head or neck position which usually caused by imbalance of paracervical muscles. The traumatic torticollis can be caused by following events; atlantoaxial rotatory subluxation, atlantoaxial dislocation, cervical vertebral fractures, and injury to the cervical musculature. Especially, acute traumatic atlantoaxial rotatory subluxation usually presents limitation of cervical range of motion without pain or neurologic deficit. We report a case of a 58 year-old man who developed the acute atlantoaxial rotatory subluxation right after the chiropractic therapy, which induced the limitation of cervical range of motion to 52.5% of normal range. The magnetic resonance image revealed the facture of the odontoid process and the partial injury in transverse ligaments of the atlas. He underwent intramuscular botulinum toxin injection and 10 days of continuous cervical traction 15 hours a day using a 5 kg weight. The range of the cervical motion restored up to 90.2% of normal range.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.23-30
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• 2023

Background: Flexion of cervical and lumbar joints is required when viewing a smartphone screen. Thus, these joints are overused, together with the surrounding joints and muscles. Long-term use of smartphones will cause changes in cervical and lumbar posture. The effect on forward head posture will vary, depending on the angle of cervical flexion start position in relation to the smartphone. This study investigated how forward head posture changes over time when using a smartphone at 20° and 40° cervical flexion start positions. Design: Cross-sectional study. Methods: Twenty-five subjects with a forward head posture angle of 35° or less participated in the study. A Forward Head Posture app on the participants' smartphones measured forward head posture 5 and 10 minutes after watching videos on their smartphones. Cervical range of motion was used to set a smartphone watching start posture of 20° and 40° of cervical flexion. Results: There was no significant difference in forward head posture, irrespective of cervical flexion start position, but the angle of forward head posture increased more at cervical flexion of 40° than at cervical flexion of 20°. There was no significant difference in what according to smartphone video viewing times, but the angle of forward head posture increased over time. Conclusion: An increase in forward head posture over time with smartphone usage poses a potential risk of neck and shoulder pain. Therefore, smartphone users should avoid prolonged screen time.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.72-79
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• 2024

Background Congenital muscular torticollis (CMT) is a common musculoskeletal disorder in children. Secondary scoliosis can occur in patients with CMT; however, the extent of inclination and improvement of scoliosis after surgical correction of CMT have not been adequately studied. In this study, we aimed to evaluate and measure the improvement in vertebral tilting after surgical correction according to age at the time of surgery. Methods Between June 2007 and January 2020, 831 patients with CMT underwent sternocleidomastoid release. Among them, 426 patients were enrolled, and their medical records were retrospectively reviewed. Ultimately, 210 patients available for radiological evaluation and analysis were enrolled in this study. The patients were divided into four groups according to age at the time of surgery to determine the relationship between age and changes in scoliosis. Results Our findings showed an improvement in scoliosis in all age groups after surgery. The results for follow-up after 1 year confirmed long-term improvement in vertebral tilting. The degree of improvement in scoliosis was significantly higher in the younger age group than in patients aged 18 years or older. Conclusion The effect of surgical release on scoliosis was significant in all age groups. The findings of this study suggest that CMT should be corrected before the age of 3 years to ensure an optimal surgical mitigation of scoliosis. Furthermore, in cases of neglected CMT, surgical release should be actively attempted because there is significant improvement.

• Hip & pelvis
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• v.34 no.1
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• pp.10-17
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• 2022

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The cross-sectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion: Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

• Journal of the Korean Society of Radiology
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• v.85 no.5
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• pp.943-947
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• 2024

Kimura's disease (KD) is a rare, chronic inflammatory disorder characterized by angiolymphoid hyperplasia, peripheral eosinophilia, and elevated serum immunoglobulin E levels. It primarily affects young Asian males and typically involves the head and neck region, especially near the mandible and postauricular regions. Orbital involvement is unusual and extraocular muscle (EOM) involvement is exceedingly rare, with only a few cases reported in the literature. The present report describes a case of surgically confirmed KD in a 16-yearold male, involving the bilateral EOM, lacrimal gland, and left parotid gland.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1094-1102
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• 2001

Objective : During the trans-condylar or trans-jugular approach for the lesion of cranio-cervical junction(CCJ), its necessary to identify the accurate locations of vertebral artery(VA), internal jugular vein(IJV) and its related lower cranial nerves. These neurovascular structures can also be damaged during the operation for vascular tumor or traumatic aneurysm around extra-jugular foramen, because of their changed locations. To reduce the neurovascular injury at the operation for CCJ, morphometric relationship of its surrounding neurovascular structures based on the tip of the transverse process of atlas(C1 TP), were studied. Materials & Methods : Using 10 adult formalin fixed cadavers, tip of mastoid process(MT) and TPs of atlas and axis were exposed bilaterally after removal of occipital and posterior neck muscles. Using standard caliper, the distances were measured from the C1 TP to the following structures : 1) exit point of VA from C1 transverse foramen, 2) branching point of muscular artery from VA, 3) entry point of VA into posterior atlanto-occipital membrane(AOM), 4) branching point of C-1 nerve. In addition, the distances were measured from the mid-portion of the posterior arch of atlas to the entry point of the VA into AOM and to the exit point of the VA from C1 transverse foramen. After removal of the ventrolateral neck muscles, neurovascular structures were exposed in the extra-jugular foraminal region. Distances were then measured from the C1 TP to the following structures : 1) just extra-jugular foraminal IJV and lower cranial nerves, 2) MT and branching point of facial nerve in parotid gland. In addition, distance between MT and branching point of facial nerve was measured. Results : The VA was located at the mean distance of 12mm(range, 10.5-14mm) from the C1 transverse foramen and entered into the AOM at the mean distance of 24mm(range, 22.8-24.4mm) from the C1 TP. The mean distance from the mid portion of the C1 posterior arch was 20.6mm(range, 19.1-22.3mm) to the entry point of the VA into AOM and 38.4mm(range, 34-42.4mm) to the exit point of the VA from C1 transverse foramen. Muscular artery branched away from the posterior aspect of the transverse portion of VA below the occipital condyle at the mean distance of 22.3mm(range, 15.3-27.5mm) from the C1 TP. The C-1 nerve was identified in all specimens and ran downward through the ventroinferior surface of the transverse segment of VA and branched at the mean distance of 20mm(range, 17.7-20.3mm) from the C1 TP. The IJV was located at the mean distance of 6.7mm(range, 1-13.4mm) ventromedially from the lateral surface of the C1 TP. The XI cranial nerve ran downward on the lateral surface of the IJV at the mean distance of 5mm(range, 3-7.5mm) from the C1 TP. Both IX and X cranial nerves were located in the soft tissue between the medial aspect of the internal carotid artery(ICA) and the medial aspect of the IJV at the mean distance of 15.3mm(range, 13-24mm) and 13.7mm(range, 11-15.4mm) from the C1 TP, respectively. The IX cranial nerve ran downward ventroinferiorly crossing the lateral aspect of the ICA. The X cranial nerve ran downward posteroinferior to the IX cranial nerve and descended posterior to the ICA. The XII cranial nerve was located between the posteroinferior aspect of the IX cranial nerve and the posterior aspect of the ICA at the mean distance of 13.3mm(range, 9-15mm) ventromedially from the C1 TP. The distance between MT and C1 TP was 17.4mm(range, 12.5-23.9mm). The VII cranial nerve branched at the mean distance of 10.2mm(range, 6.8-15.3mm) ventromedially from the MT and at the mean distance of 17.3mm(range, 13-21mm) anterosuperiorly from the C1 TP. Conclusion : This study facilitates an understanding of the microsurgical anatomy of CCJ and may help to reduce the neurovascular injury at the surgery around CCJ.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.24 no.1
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• pp.4-12
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• 2015

Purpose: Due to the presence of various muscles around lips, variety of facial expression can be made and changes from aging process such as wrinkles can develop on the facial skin by the action of multiple muscles. In animals, skin and muscles are developed in the entire body. On contrast, they are well developed only in the face and just one is present in the neck and the palm. Alar band was defined as outer wrinkle formed by zygomaticus minor muscle, which is common in Koreans. This study aimed to investigate clinical prevalence of alar band. Materials & Methods: Subjects were chosen from 780 new patients who visited private clinic in Gyeonggi province for orthodontic treatment. Presence of alar band was examined from the smile extraoral photos. Correlation among skeletal form, lip protrusion, gender, and age were evaluated. Results: Prevalence of alar band was higher in women (27.9%) than in men (18.5%) with statistical significance (p<0.05). With respect to age, prevalence of alar band was 19.4% in age 0-9 y, 16.9% in age 10-19 y, 31.2% in age 20-29 y, 39.5% in age 30-39, 56.5% in age 40-49. Prevalence was gradually increased from patients in their 20s to patients in their 40s and statistical significance was found (p<0.001). Concerning SN_NP, prevalence was 26.2% in normodivergent facial type, 22.0% in hyperdivergent facial type, and 32.2% in hypodivergent facial type. Hypodivergent facial group had higher prevalence but statistical significance was not observed. Statistically significant difference was not found regarding upper lip. However, prevalence of the alar band was 26% in patients with normal lower lip, 14.7% in patients with pretruded lower lip, and 33.3% in retruded lower lip. The prevalence was higher in patients with retruded lower lip with statistical significance (p<0.05). Conclusions: 27.8% on previous anatomical study and this study showed 27.8% prevalence of alar band in clinical smile photographs. Clinical photograph study showed that alar band was more prominent in women, older people, and people with retruded lips with statistical significance. This will provide valuable diagnostic information for esthetic consideration.