• 재활복지
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• v.22 no.1
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• pp.169-194
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• 2018

The aim of this study is to examine changes in swallowing function and quality of life with therapeutic singing-based music therapy for patients with dysphagia. The music therapy program was based on the previous study (Kim, 2010), and designed to improve breathing, phonation, and swallowing functions focusing on laryngeal elevation. Three patients with dysphagia participated in this study and each participant received a total of 11 or 12 individual music therapy sessions and each session was conducted for 30 minutes. In this study, three kinds of measurements were used. First, the measures of maximum phonation time (MPT), fundamental frequency, average intensity, jitter, shimmer, noise to harmonics ratio (NHR) by Praat test, second, laryngeal-diadochokinesis (L-DDK) to investigate laryngeal elevation, and last, the Swallowing-Quality of Life (SWAL-QOL) was measured. These cases have shown improved breathing, phonation, swallowing function, and the scores of SWAL-QOL in all of the patients. It suggests that this music therapy intervention was effective on laryngeal elevation, and the music intervention with therapeutic singing can be effectively implemented in further research for patients with dysphagia.

• Journal of Oral Medicine and Pain
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• v.18 no.1
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• pp.55-62
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• 1993

The author has synchronously recorded the average electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muacles and the masseter muscles. The marious levels of occlusal force were checked during clenching the resin plates which are made to fit each of the maxillary and the mandibular teeth. These activities were recorded in order to study the EMG activity pattern of the sternocleidomastoid muscle during the masticatory function of the jaw in 11 healthy subjects. The obtined results were as follows : 1. The electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muscles and the masseter muscles were increased as the occlusal force increased, and the sternocleidomastoid muscles have a lineal correlationship with the occlusal force. 2. The sternocleidomastoid muscles and the masseter muscles showed higher EMG activity during clenching at the ventroflexed head position rather than at the extended head position. (p<0.05) However the EMG activities of the anterior temporal muscles showed no difference between the ventroflexed position and the extended position of the head. 3. The electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muscles and the masseter muscles during clenching are similar at the habitual position and at the retruded condylar position. 4. The electromyographic activities of the sternocleidomastoid muscles, the anterior temporal muscles and the masseter muscles on the working side during mastication of gum and almonds are significantly higher than on the balancing side except the masseter muscles during mastication of almonds. (p<0.05, P<0.01) 5. The asymmetry of gum are lower than that during mastication of almonds. (p<0.05) The asymmetry indices of the sternocleidomastoid muscles are higher than those of the anterior temporal muscles and masseter muscles.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.45-55
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• 2005

As people prefer to use right or left hand, some have preferred chewing side while others do not. Totally, 82 volunteers composed of students and staffs from Dental Hospital College of Dentistry Yonsei University participated in this study for the investigation of influence of preferred chewing habit, that has lasted for more than a year, on electromyographic(EMG) activity of masticatory muscles and bite force. Among the 82 volunteers, 46 had preferred chewing habit while the other 36 did not. Prior to the investigation, those with factors that could affect the study, such as, general disease, irregular dentition and malocclusion, were screened and excluded by questionnaire and clinical examination. The results were as follows: 1. There was no significant difference in EMG activities between chewing side and non-chewing side of preferred chewing subjects at rest as well as maximal voluntary contraction(MCV)(p>0.05). 2. Asymmetrical coefficient of temporal and masseter muscle EMG activities between preferred chewing subjects and non-preferred chewing subjects at rest was not significantly different(p>0.05). 3. Asymmetrical coefficient of masseter EMG activity was significantly higher(p<0.05) than that of non-preferred chewing subjects at MCV, whereas that of anterior temporal muscle showed no difference(p<0.05). 4. In preferred chewing subjects, there was no significant difference in average bite force and occlusal contact area between chewing side and non-chewing side(p>0.05). 5. There was no significant difference in Asymmetrical coefficients of average bite force and occlusal contact area between preferred chewing subjects and non-preferred chewing subjects (p>0.05). Consequently, preferred chewing habit can be considered as physiological asymmetry with normal function rather than to have influence on EMG muscle activity of masticatory muscles, average bite force and occlusal contact area. Objective standardization to differentiate preferred chewing subjects and non-preferred chewing subjects should be established in the further study.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.1
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• pp.31-38
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• 2020

Objective : The purpose of this study is to investigate the effects of bilateral chewing exercise applied for 6 weeks on occlusion force and masseter muscle thickness in the elderly living in the community. Methods : This study recruited 25 community residents. All participants performed bilateral chewing exercise using equipment developed for the purpose of oral chewing exercise. The chewing exercise was divided into isometric and isotonic type and applied for about 20 minutes a day, five times a week for six weeks. For the evaluation, the masseter muscle thickness and the maximum occlusion force were measured three times at three week intervals using a portable ultrasound instrument and an occlusion force gauge. Results : As a result of the change in masseter muscle thickness, baseline, 3 weeks later, and 6 weeks later referred to 7.51±0.43, 7.63±0.44, and 7.83±0.46, respectively (F=3.819, p<.05). The post hoc test resulted in a significance between baseline and 6 weeks later (p=0.023). Similarly, as a result of the change in occlusion force, baseline, 3 weeks later, and 6 weeks later referred to 265±9.22, 268±9.57, and 271.59±10.16, respectively (F=3.031, p<.05). The post hoc test resulted in a significance between baseline and 6 weeks later (p=0.048). Conclusion : This study confirmed that bilateral chewing exercise was effective for increasing masseter muscle thickness and occlusion force in the elderly. Therefore, bilateral chewing exercise can be applied as a therapeutic exercise method for improving oral function.

• Journal of Periodontal and Implant Science
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• v.37 no.sup2
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• pp.339-351
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• 2007

Cytolethal distending toxin(CDT)은 세포 주기 중 G2에서 M 기로의 전환을 막아 세포의 증식을 억제할 수 있는 세균 단백 독소의 일종이다. 구강 미생물 중 유일하게 Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans)만이 이 CDT를 생성 할 수 있는 것으로 알려져 있다. A. actinomycetemcomitans는 localized aggressive periodontitis (LAP)의 원인균으로 여겨지며 비 운동성의 그람 음성 구간균이고 $37^{\circ}C$, 5% $CO_2$ 하에 성장이 왕성하다. A. actinomycetemcomitans의 CDT는 3개의 인접한 유전자인 cdtA, cdtB, cdtC에 의해 형성 되며 각각의 유전자에 대한 단백질의 기능은 아직 완전히 밝혀지지 않았다. 현재까지 연구에 의하면 cdtA는 CDT의 세포부착과 관련이 있는 것으로 여겨지며 이 유전자의 기능 이상 시 CDT의 독성 효과가 현저히 감소한다고 알려져 있다. 따라서 본 연구는 A. actinomycetemcomitans의 cdtA 유전자를 클로닝, 단백질 발현하여 향후 치주질환의 발병 과정에서 CdtA의 역할을 규명하고 질환의 예방 및 치료법에 도움을 주고자 하였다. A. actinomycetemcomitans Y4균주를 cdtA 유전자 클로닝을 위해 사용하였다. A. actinomycetemcomitans의 genomic DNA는 genomic DNA 추출 kit를 사용하여 분리하고 cdtA에 특이적인 primer를 이용하여 PCR을 통해 cdtA 유전자를 증폭하였다. 증폭된 cdtA 유전자를 T-vector에 클로닝 하였으며, 클로닝 된 cdtA 유전자는 단백질 발현을 위해 pRSET Avector에 서브클로닝 한 후 발현 균주인 BL21(DE3)를 이용하여 발현시켰다. 발현 후 Ni-NTA AP conjugate를 이용한 Western blot을 통해 pRSET-CDTA를 확인하였다.

• Journal of Digital Convergence
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• v.11 no.4
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• pp.303-309
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• 2013

TRAINER for Kids ($T4K^{TM}$, Myofunctional. Research Co, Australia) is a prefabricated myofunctional orthodontic appliance recommended to ClassII division1 malocclusion patients who have bad oral habits such as mouth breathing, tongue thrusting, inappropriate tongue position, thumb sucking and so on. Trainer has a soft texture and a small volume so that those advantages lead to an increase in the agreement rate of young patients of its use. This presentation is to analyze clinical efficacy of Trainer. The analysis is based on a result of regular follow-up on Class II division1 malocclusion patients who has been completely treated by Trainer in the Sanbon Dental Hospital of Wonkwang university. This case report is to present the satisfactory results gained by using Trainer on Class II patients. First, Trainer was applied in Class II malocclusion patients of mixed dentition with expected space insufficient to gain facial improvement. Second, excessive overjet, overbite were improved. Third, main effects are regarded to have been achieved by development of lingual slant of upper jaw, labial slant of lower jaw, and lower part of jaw bone.

• Radiation Oncology Journal
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• v.5 no.2
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• pp.105-110
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• 1987

Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, ad ulcer-oinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. $55\%$ of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was $58.7\%$ in contrast to $21.6\%$ in radiation alone group. Overall 5-year survival rate was $31\%$ In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control In stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation technique, 3 were completely controlled. 5-year survival rate of these implanted patients was $50\%,\;49.4\%$ of patients treated over 7,000cGy survived 5 years. This was significant in contrast to $6.4\%$ of the group treated below 7,000cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.2
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• pp.150-157
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• 2015

The purpose of this report is to suggest clinical managements of implant periapical lesions by presenting three clinical cases managed by either the infected form or the inactive form with the follow-up period of five to twelve years. One patient with no clinical symptom was regarded as inactive form. Two patients having pain were regarded as infected form and have been under the systemic antibiotic therapy. In one patient, the symptom subsided and the size of radiolucent lesion decreased. However, the other patient showed increased size of lesion causing the implant unstable, which leaded to remove the implant and to replace it. There was neither additional increase of the lesion nor functional problem for all three. It is important to detect implant periapical lesion in early stage before jeopardizing the stable implant and manage properly using systemic antibiotic therapy and surgical approach if needed, depending on infected form and inactive form.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.267-275
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• 1993

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery. And 70 patients received external irradiation only by $^{60}Co$ with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III+IV were 57 patients. Acturial overall survival rate at 3 years was $43.9\%,$ 3 year survival rates were $60.9\%$ for stage I + II, and $23.1\%$ for stage III+IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3+T4 or in any N stage although it was not statistically sufficient (p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially In the view of pertainig of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.339-352
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• 2008

Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.