• 대한치과교정학회지
• /
• 제40권6호
• /
• pp.411-420
• /
• 2010

관절융기의 높이와 후면의 경사는 교합과 긴밀한 관계를 유지하며 하악 운동 시 하악과두의 이동 경로를 결정하는 중요한 역할을 한다. 본 연구의 목적은 성장기 아동에서 연령별로 관절융기의 높이 및 경사의 변화를 평가하는 것이다. 양호한 골격을 보이는 5.9세부터 19.7세까지 총 160명(남자 71명, 여자 89명)의 대상자가 선정되었고, 이들의 측두하악관절 단층방사선사진에서 관절융기의 높이, 관절융기 후면의 경사가 측정되었다. 남녀 각각 9.0세 미만(Group 1), 9.0 - 10.9세(Group 2), 11.0 - 12.9세(Group 3) 13.0 - 14.9세(Group 4), 15.0 - 16.9세(Group 5), 17.0세 이상(Group 6)의 6군으로 나누었고, 그룹 간 비교를 위해 일변량분산분석, 남녀 간 비교를 위해 Mann-Whitney 검정을 실시하였다. 각 연령 그룹의 평균 관절융기 높이는 남자에서 4.8 mm, 6.1 mm, 6.4 mm, 7.0 mm, 8.0 mm, 9.2 mm 였고, 여자에서 4.8 mm, 5.4 mm, 6.4 mm, 6.9 mm, 7.6 mm, 7.1 mm 였다. 각 연령 그룹의 평균 관절융기 경사는 남자에서 $29.5^{\circ}$, $34.4^{\circ}$, $35.5^{\circ}$, $37.6^{\circ}$, $40.3^{\circ}$, $42.6^{\circ}$였고, 여자에서 $29.7^{\circ}$, $31.7^{\circ}$, $34.7^{\circ}$, $37.4^{\circ}$, $39.3^{\circ}$, $36.2^{\circ}$였다. 관절융기의 높이와 경사는 남자에서는 Group 5까지, 여자에서는 Group 4까지 유의성 있게 증가하였다. 남녀 간 비교에서는 Group 6에서만 남자가 여자보다 유의하게 컸다. 관절융기의 성장가속기는 여자가 남자보다 4년 가량 빨랐고, 남자는 여자보다 더 늦은 나이까지 성장하였다. 성장기 중 관절융기의 높이와 경사는 매우 많은 변화를 보였으며, 따라서 이 시기에 교정치료 시 기능적인 정상교합을 달성하기 위해서는 관절융기의 연령적 변화와 성장 양상을 이해하는 것이 중요하다고 생각한다.

• 융합정보논문지
• /
• 제10권9호
• /
• pp.43-52
• /
• 2020

본 연구의 목적은 견관절 환자를 대상으로 동영상 교육을 개발하고 관절가동범위, 통증 및 삶의 질에 미치는 효과를 평가하기 위함이다. 본 연구는 2020년 1월부터 6월까지 G시 소재 대학병원의 정형외과 외래에 내원한 견관절 환자 중 실험군 30명, 대조군 26명을 대상으로 하였다. 자료분석은 SPSS를 이용하여 두 그룹의 일반적 특성 및 종속변수에 대한 사전 동질성 검정은 𝑥²-test, t-test로 분석하였다. 연구결과, 대상자의 사전 사후 점수 변화는 관절가동범위의 내회전 정도와 통증점수에서 유의한 차이가 있는 것으로 나타났으며, 관절가동범위의 굴곡, 외전 정도와 삶의 질에서는 유의한 차이가 없는 것으로 나타났다. 본 연구에서 동영상 교육의 임상 적용은 외래 뿐만 아니라 병동에서도 간호사의 환자교육에 소비되는 시간을 절약할 수 있어 간호 실무를 개선하는 방안으로 제시될 수 있다.

• 대한장애인치과학회지
• /
• 제9권1호
• /
• pp.42-45
• /
• 2013

저자는 de Grouchy 증후군을 가진 4세 여자 환아에 대한 임상적 및 방사선학적 관찰을 통해 다음과 같은 지견을 얻었다. 1. 환아는 de Grouchy 증후군의 증상인 심장 및 발가락의 기형, 근긴장의 저하, 뇌량의 부분적인 무형성, 시각 장애와 청각 장애, 지적 능력의 저하, 성장 발달의 지연 등을 나타낸다. 2. 환아의 구강 및 두개악안면 소견으로 상악골 열성장과 전치부 반대교합을 보이며, 불량한 구강 위생으로 인한 다발성 치아우식증이 관찰된다. 3. 환아의 구강 위생 관리 및 치료 부위의 유지를 위하여 주기적인 치과 검진이 필요하며, 상악골 열성장과 전치부 반대교합을 개선하기 위해 추후 교정 치료가 필요할 수 있다.

• Journal of Acupuncture Research
• /
• 제21권3호
• /
• pp.283-302
• /
• 2004

Background : Angiogenesis is the proliferation of a network of blood vessels emanating from pre-existing vessels, supplying nutrients and oxygen and removing waste products. Angiogenesis occurs in a variety of normal physiologic and pathologic conditions and is regulated by a balance of stimulatory and inhibitory angiogenic factors. Excessive angiogenesis should be suppressed. However, if blood supply is insufficient, it should be encouraged. Hyul-Mek(血脈) or Hyul-Rark(血絡), known as blood vessels in western medicine, is deeply related to Chung-Ki-Hyul(精 氣 血). The goal of this study is to review the effects of herbal medicines on angiogenesis that is involved in wound healing and enhancement of blood supply. Methods : We conducted a systematic and comprehensive literature search for the identification, retrieval, and bibliographic management of independent studies to locate information on the topic. A computerized search of the published literature of Korea(KISS, RISS), China(CNKI), Japan(Kampo medicine, etc), and western countries(MEDLINE) was performed, and further supplemented with manual searches of print sources(1999 to 2003). Results : The herbal medicines with angiogenic activity were mainly found among herbs that carry replenish Shin-Cheng(補腎益精), foster Eum and improve the circulation of blood(養陰活血), or warm and circulate Kyung-Rark(溫經通絡). In particular, herbs with improve the circulation of blood and clear blood(活血化瘀) activity contain a significant amount of tannin, saponin, and pyrazine. Conclusion : Replenish Ki-Hyul(補氣血) and circulate Kyung-Rark(通經絡) could contribute to the induction of angiogenesis because various growth factors and proliferation, differentiation, and migration of vascular endothelial cells are involved in angiogenic activity.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제22권4호
• /
• pp.430-435
• /
• 2000

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

• 대한치과교정학회지
• /
• 제22권3호
• /
• pp.509-529
• /
• 1992

Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.

• Journal of Korean Neurosurgical Society
• /
• 제63권1호
• /
• pp.89-98
• /
• 2020

Objective : Ossification of posterior longitudinal ligament (OPLL) in the thoracic spine may cause chronic compressive myelopathy that is usually progressive, and unfavorable by conservative treatment. Although surgical intervention is often needed, the standard surgical method has not been established. Recently, it has been reported that posterior decompression with dekyphosis is effective surgical technique for favorable clinical outcome. The purpose of this study was to evaluate the surgical outcomes in patients with thoracic OPLL according to dekyphosis procedure and to identify predictive factors for the surgical results. Methods : A total of 25 patients with thoracic OPLL who underwent surgery for myelopathy from May 2004 to March 2017, were retrospectively reviewed. Patients with cervical myelopathy were excluded. We assessed the clinical outcomes according to various surgical approaches. The modified Japanese orthopedic association (JOA) scores for the thoracic spine (total, 11 points) and JOA recovery rates were used for investigating surgical outcomes. Results : Of the 25 patients, 10 patients were male and the others were female. The mean JOA score was 6.7±2.3 points preoperatively and 8.8±1.8 points postoperatively, yielding a mean recovery rate of 53.8±31.0%. The mean patients' age at surgery was 52.4 years and mean follow-up period was 40.2 months. According to surgical approaches, seven patients underwent anterior approaches, 13 patients underwent posterior approaches, five patients underwent combined approaches. There was no significant difference of the surgical outcomes related with different surgical approaches. Age (≥55 years) and high signal intensity on preoperative magnetic resonance (MR) image in the thoracic spine were significant predictors of the lower recovery rate after surgery (p<0.05). Posterior decompression with dekyphosis procedure was related to the excellent surgical outcomes (p=0.047). Dekyphosis did not affect the complication rates. Conclusion : In this study, our result elucidated that old age (≥55 years) and presence of intramedullary high signal intensity on preoperative MR images were risk factors related to poor surgical outcomes. In the meanwhile, posterior decompression with dekyphosis affected favorable clinical outcome. Posterior approach with dekyphosis procedure can be a recommendable surgical option for favorable results.

• Journal of Trauma and Injury
• /
• 제29권4호
• /
• pp.129-138
• /
• 2016

Purpose: Due to recent advances in internal fixation techniques, instrumentation and orthopedic implants there is an increasing number of humeral shaft fracture treated operatively. As a consequence, an increased number nonunion after operative fixation are being referred to our center. The aim of this study is to report the common error during osteosynthesis that may have led to nonunion and present a systematic analytical approach for the management of aseptic humeral shaft nonunion. Methods: In between January 2007 to December 2013, 20 patients with humeral shaft nonunion after operative procedure were treated according to our treatment algorithm. We could analysis x-rays of 12 patients from initial treatment to nonunion. In a subgroup of 12 patients the initial operative procedure were analyzed to determine the error that may have caused nonunion. The following questions were used to examine the cases: 1) Was the fracture biology preserved during the procedure? 2) Does the implant construct have enough stability to allow fracture healing? Results: In 19 out of 20 patients have showed radiographic evidence of union on follow up. One patient has to undergo reoperation because of the technical error with bone graft placement but eventually healed. There were 2 cases wherein the treatment algorithm was not followed. All patients had problems with mechanical stability, and in 13 patients had biologic problems. In the analysis of the initial operative fixation, only one of 12 patients had biologic problems. Conclusion: In our analysis, the common preventable error made during operative fixation of humeral shaft fracture is failure to provide adequate stability for bony union to occur. And with these cases we have demonstrated a systematic analytic management approach that may be used to prevent surgeons from reproducing the same fault and reduce the need for bone grafting.

• 대한치과교정학회지
• /
• 제29권2호
• /
• pp.147-156
• /
• 1999

동양권 특히 한국인에게서 자주 발견되는 제III급 부정교합은 하악과성장, 상악열성장 또는 혼합형으로 나눌 수 있다. 그 중 골격성 제III급 부정교합은 대부분이 상악골의 열성장을 동반하고 있으며, face mask는 상악골 열성장을 나타내는 성장기 아동에서 주로 쓰이는 악정형 장치이다. face mask는 전치부 반대교합과 상악골의 위치를 개선하여 대부분 적절한 교합관계를 이루어 양호한 안모를 얻을 수 있으나 어떤 경우는 상하순이 전방으로 돌출된 듯한 바람직하지 않은 안모를 얻는 경우도 있다. 따라서 치료 전 어떠한 환자의 조건이 치료 후 바람직한 교합관계와 안모를 얻을 수 있는지를 술자가 알 수 있다면 face mask 치료의 결과 예측과 한계에 대하여 보다 잘 판별할 수 있을 것이다. 본 연구는 성장기 제 III 급 부정교합 아동의 치료 후 양호한 안모를 얻는데 도움을 주고자 시행하였으며 상악골 전방견인 치료후 양호한 안모를 보이는 군(Group 1, n=12)과 양호하지 못한 안모를 보이는 군(Group 2, n=14)으로 나누고, 치료 전과 치료 후의 측방 두경부 방사선 계측 항목을 이용한 후향적인 연구로 통계처리를 시행한 결과 다음과 같은 결론을 얻었다. 1. 골격성 부조화로 인해 상악전치가 이미 순측경사되어 전돌되어있을 수록 치료 후 안모는 좋지 않았으며, 상악전치와 관련된 전방 치조골(prosthion)의 전돌 또한 안모에 영향을 주었다. 2. 치료 전 상악골과 하악골이 이루는 각도가 작을수록(NL-ML) 좋은 안모를 나타내었다. 3. 치료 전 하순의 돌출도가 클수록 치료 후 bialveolar protrusion되는 경향을 나타내었다. 4. 치료 후 하악골의 후하방회전정도가 클 수록 좋지 못한 안모를 보였다.

• 대한물리의학회지
• /
• 제4권3호
• /
• pp.175-182
• /
• 2009

Purpose：The purpose of this study is to investigate the effects of Taekwondo training causing leg-muscular strength for elementary school children. Methods：The subjects were Taekwondo group (n=20) and non-Taekwondo group (n=20) from 5-6 graders of elementary school. The Tkd group exercised Taekwondo and the non-Taekwondo group exercised free gymnastics. The subjects were measured 3 times(pre, mid and after)during the 8weeks program. The leg muscular strength peak torque and average power were measured. And the extension-flection of angular speed 60 deg/sec and 180 deg/sec was measured. Results：The results of this study can be summarized as follows: 1. Compared with the Tkd group, the non-Tkd group showed no significant difference in tests statistically in case of right-left of pre-4weeks. The leg muscle's peak torque did not show significant difference in the extension angular 60 deg/sec(p>.05). 2. The score of flection angular speed 60deg/sec was not different in tests leg strength of right-left to pre-4weeks(p<.05), but the muscle was increased according to the amount of time spent in case of the 4-8weeks. 3. Compared with the Tkd group, the non-Tkd group showed no significant difference in tests statistically in case of right-left of pre-4weeks. The leg muscle's peak torque did not show significant difference in the extension angular 180deg/sec(p>.05). The right leg muscular strength was increased in case of the 4-8weeks. The left leg showed no difference. 4. Leg muscular strength was increased in the case of the pre-4weeks in the right of flection angular speed 180deg/sec. The left did not show difference. The right leg muscle in case of the 4-8weeks showed no difference. The left showed significant difference. Conclusion：Taekwondo training is effective for leg-muscular strengthing for elementary school children.