• Journal of the Ergonomics Society of Korea
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• v.30 no.2
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• pp.339-347
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• 2011

Objective: The purpose of this study was to evaluate of various material of pillows by using biomechanical variables such as the cervical stability, head pressure distribution, and muscle activity. Method: Eight subjects participated in the experiment. Three different materials such as polyester sponge, memory foam and the buckwheat shell used for Korean traditional pillow were tested. Electro-goniometer, six channels of electromyography(EMG), ten channels of the head pressure sensors were used to measure the biomechanical responses. Surface electrodes were attached to the right/left semispinals capitis(RSC, LSC), the right/left sternocleidomastoid(RSM, LSM), the right/left upper trapezius(RUT, LUT). The cervical stability was evaluated by the angle deviated from the standing neck position. The head pressure distribution was evaluated by the pressure per unit area recorded on the sensors and the intensity of peak pressure. Electromyography(EMG) data were analyzed by using root mean square(RMS) and mean power frequency(MPF). Results: The buckwheat shell material showed a higher stability in the cervical spine then the other pillows during spine position. In terms of head pressure distribution, the memory form indicated the lowest pressure at supine position, buckwheat shell material indicated the lowest pressure during lying down to side, and polyester cushion recorded the highest pressure at all postures. Conclusion: The buckwheat shell material has a biomechanical advantage to maintain a healthy neck angle and reduce the pressure on the head, which means the buckwheat shell is a potential material for ergonomic pillow design. The pillow with memory form showed second best biomechanical performance in this study. Application: The shape of the buckwheat shell pillow and the characteristics of materials can be used to design the pillow preventing neck pain and cervical disk problems.

• Journal of Korean Physical Therapy Science
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• v.6 no.2
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• pp.1063-1073
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• 1999

Objective: Poor head and neck support during sleep can exacerbate the neck pain. Based on the ideal sleep posture and pillow suggested by Cyriax, we designed a new cervical pillow and compared the degree of pain reduction, quality of sleep and pillow satisfaction with a low hospital pillow and a high pillow. Method: The newly designed pillow has a built-in pressure-adjustable air bag in the cervical area and provides normal cervical lordotic curve in supine position and maintains cervical and thoracic vertebrae to form a horizontal line in side-lying position. Thiry-four patients with cervical pain used low hospital pillows for the first week of 3-week randomized crossover design study. They were subsequently randomly assigned to use each of the other two pillows for 1-week period. Outcomes were measured using Visual analog scale, Sleep questionaire, a pillow satisfaction scale. Result: Compared with other 2 types of pillow, Subjects using the newly desinged pillow showed much reduced pain intensity, increased duration of sleep and better satisfaction. Conclustion: We desinged a cervical pillow with built-in pressure adjustable air bag and it can significantly reduce pain intensity and improve quality of sleep in patients with cervical pain.

• The Korean Journal of Pain
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• v.32 no.2
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• pp.120-128
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• 2019

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.697-701
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• 2018

Background and Objectives The aim of this study was to evaluate surgical completeness in endoscopic total thyroidectomy with central neck dissection via unilateral axillo-breast approach (UABA) compared with bilateral axillo-breast (BABA) and open approach (OA) by means of the radioactive iodine uptake (RAIU) ratio and thyroglobulin (Tg) of remnant thyroid. Subjects and Method From July 2010 to March 2013, 82 patients who had underwent total thyroidectomy with central neck dissection and postoperative radioactive iodine (RAI) ablation for papillary thyroid carcinoma were enrolled. Of these patients, 27 patients underwent UABA, 24 patients BABA, and 31 patients OA. Clinicopathologic data, surgical outcome, stimulated Tg and RAIU ratio on the first postoperative RAI ablation scan were compared among 3 groups. Results Patients in the endoscopic surgery groups (UABA, BABA) were younger than those in the OA groups. Invasiveness such as operation time, postoperative pain, and drain amount in UABA was less than that in BABA and severer than that in OA. Other variables regarding clinicopathologic and surgical data were not significantly different. Stimulated Tg and RAIU ratio did not show significant differences among 3 groups (p=0.659 and p=0.664). Conclusion The completeness of UABA was comparable with that of BABA and OA. The UABA may be a safe option for patients who need endoscopic thyroidectomy for papillary thyroid carcinoma.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.114-118
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• 1999

Backgrouds: Cervical epidural blocks were used as part of a comprehensive multimodal treatment program for patients with chronic pain in the head, neck and upper extremities. The depth of the epidural space beneth the skin surface varies at different levels of the spinal column in the same patient. It also varies from patient to patient at the same vertebral level. We studied the distance the skin to the cervical epidural space in adults patients at different intervertebral spaces. Methods: Date were gathered from 628 patients having cervical epidural block for relief of cervical and upper extrimity pain. All blocks were performed using hanging drop method after loss of resistance with saline at C5-6, C6-7, C7-T1 intervertebral space. Results: Mean distances for skin to cervical epidural space (DSES) were 5.42 cm, 5.06 cm, 4.68 cm in male, 5.00 cm, 4.61 cm, 4.10 cm in female at C7-T1, C6-7, C5-6 intervertebral space. DSES correlated with body weight, neck circumference and body mass index significantly. Conclusion: In the cervical spine, DSES varies from space to space. The longest DSES were noted at C7-T1 level in male, and the shortest DSES were at C5-6 in female. DSES has significant relationships with weight, neck circumference and body mass index.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1897-1902
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• 2019

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.171-183
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• 1995

This study was carried out to investigate the relationship between tensed mandibular positions, muscle tenderness and EMG activity, respectively, and between range of motion of the neck and sternocleidomastoid muscle tenderness. Under stressful conditions, most of people take several types of behavioral patterns. Two of them observed frequently are clenching of teeth and grasping of fist. Prolonged clenching or grasping should increase electromyographic activity of associated muscle, especially muscles of mastication and neck muscles and will cause hyperfunction, dysfunction and muscle pain. So it is necessary to relate EMG activity with muscle pain. The author performed routine clinical examination in 47 patients with Temporomandibular Disorders, especially for presence or absence of muscle tenderness. Mandibular rest position was used as a baseline reference position and two more position in which EMG activity was taken were rest postion with grasping of fist and teeth clenching position. BioEMG of Biopak system (Bioresearch Inc, USA) was used for measuring of integrated EMG in masseter, anterior temporalis, anterior belly of digastic muscle and sternocleidomastoid muscle. To measure of the range of neck motion. CROM(Cervical-Range-of Motion, USA) was used. The obtained results were as follows : 1. EMG activity of all muscles except in masseter was higher in grasping of fist than those in rest position and there were significant correlation in EMG activity between the two position except in anterior belly of digastric muscle. 2. When comparing EMG activity between tender and non-tender muscle, all examined muscles did not show any significant difference. From this data, we could conclude that EMG activity was generally not changed with tenderness, of couse, it might be dependent with degree of muscle tenderness. 3. Number of tender points in examined muscles was also not significantly different between in patients with masticatory muscle disorders and in patients with internal derangement. 4. Cervical posture and range of motion of the neck was not differed significantly between in patients with and in patients without tenderness of sternocleidomastoid muscle.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.104-108
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• 2018

Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

• Journal of the Korea Convergence Society
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• v.9 no.11
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• pp.209-216
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• 2018

This study aimed to investigate the association of the muscle activity around the neck of the operator(dental hygienists') according to the change in the patient's neck angle during a direct visual inspection on the maxillary right-side molar palatal surface. The operators were $4^{th}$ year dental hygiene students, who are future dentalhy gienists, having accurate understanding on and awareness of the location of the operation site, hand fixation, and how to use the tools. Data on the change in the muscle activity around the neck were collected by using surface electromyography and neck goniometer. SPSS statistics 20 was used for statistical analyses including Shapiro-wilk test and one-way ANOVA. As a result, the activities of the operator upper trapezius, cervical erector spinae, and levator scapulae muscles significantly decreased when the patient's head was angled compared to when it was not. For the angle of the operator head, the head bend significantly decreased when the patient's head was angled than when it was not. Based on the study results, it is expected that angling the patient's head when treating his or her teeth will decrease the excessive muscle activity around the neck of the operator, and will reduce muscle fatigue. Therefore, angling the head of the patient while treating his or her teeth is recommended. This suggests that muscle pain caused by repetitive actions in the wrong posture can be reduced.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.11-16
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• 2009

OPD based laryngeal procedures offers a new avenue to the modern laryngologist, incorporating new technology in the office setting. With the development of flexible fiberoptic endoscopes, compact video system, and short acting anesthetics and sedatives allow these procedures. The success or failure of procedures are depend on excellent topical anesthesia. An inadequately anesthetized patient is apt to be uncomfortable, anxious and hyperresponsive and therefore unlikely to tolerate the procedure. On the other hand, a patient who is well informed, reassured, and thoroughly anesthetized can complete procedures. Therefore, optimal anesthesia is obligatory for excellent surgical results. The phonosurgeon should choose the anesthetic and sedative agents based on duration of action, time of onset of action, and any medical contraindications that the patient may have. And should be familiar with the properties and interaction of the agents used, as well as the signs of toxicity.