• The Journal of Korean Society for Radiation Therapy
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• v.14 no.1
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• pp.1-5
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• 2002

I. 목적 : 방사선 치료 시 최적화된 체내 선량분포를 얻는 것은 정상조직의 장애를 줄이고 종양선량을 높여 치료 효율을 극대화하는데 매우 중요하다. 본원에서는 병변 부위가 한쪽으로 치우친 head&neck 환자 치료 시 정상조직(tongue)을 보호하기 위해 tongue displacer를 만들어 사용한다. 이에 본 저자는 tongue displacer사용의 치료 유용성을 평가 하고자 한다. II. 대상 및 방법 : head & neck 치료 환자 중 병변 부위가 인체의 정중선(MSP)을 기준으로 한쪽으로 치우친 환자를 대상으로 하였다. 사용된 실험재료로는 C-T (high speed advantage, GE,US), RTP System (3D RTP system, prowess, US), 치과용 인상제 주입기(caulk system, quixx, japan), tongue displacer 등이 있다. 실험 방법은 모의 치료나 planning C-T를 시행하기 전에 치료 환자에게 사용할 개인용 tongue displacer를 치과용 인상제로 자체 제작하였다. 제작 후 모의 치료를 시행하고 3D plan을 하기 위해 planning C-T를 촬영하게 되는데 이때 tongue displacer사용 유. 무에 따라 각각 촬영을 하였다. 촬영된 두 가지의 CT영상을 prowess를 이용하여 3D plan을 하게 되는데 이때의 plan parameter나 beam direction등 plan에서의 모든 조건은 모두 동일시하고 선량 분포 및 DVH(dose volume histogram)값을 비교하였다. III. 결과 : tongue displace의 사용 유. 무에 따른 3D plan상의 DVH 비교 결과 tumor volume 주위의 다른 organ들은 모두 비슷한 양상의 DVH를 보였으나 tongue에 있어서 큰 변화를 보였다. tongue displacer를 사용 시, 미 사용시 보다 tongue의 위치를 변화시켜 치료 부위 외의 tongue에 받는 방사선 피폭 면적을 줄일 수 있었고 그 결과 DVH상의 $50\%$ volume이 $16\%$ 정도 줄어드는 것이 확인되었다. IV. 결론 : tongue에 방사선을 조사하면 방사선 부작용으로 mucositis, ulcer, hemorrhage등의 pain(동통)이 수반되므로 치료환자의 음식물 섭취불량으로 체증감소 등 전신 쇠약으로 이어질 수 있다. head & neck 환자 중에서 병소 위치가 한쪽으로 치우쳐서 있을 경우 인상제를 이용하여 tongue displacer를 만들어서 사용하면 tongue 의 위치를 변화시켜 방사선 조사 야에서 제외시켜준다. 그러므로 방사선 치료 시 tongue의 부작용을 최소화 할 수 있고 환자의 방사선 치료 만족도를 높일 수 있다고 사료된다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.1
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• pp.43-47
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• 2017

Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.1
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• pp.57-67
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• 2006

Musculoskeletal neck dysfunction syndromes are common in outpatient musculoskeletal pain practice. The underlying musculoskeletal and neurologic causes of pain are variable. In the management of these patients, it is important to accurately identify and treat these pain generators to optimize patient outcome. It is the purpose of this review to discuss three main categories of functional anatomy, the role of superficial/deep muscular system and the scientific evidence for optimal physical therapy intervention for cervical dysfunction. Specifically there is evidence of lowered microcirculation in the upper trapezius muscle, morphological signs of disturbed mitochondrial function which appears to be limited to type I fibers and an increased cross-sectional area of type I muscle fibers despite a lower capillary to fiber area ratio. In acute neck pain syndrome, changes in muscle activity of painful muscles may result from segmental and supraspinal inhibitory effects. Muscle activation is closely related to the control of joint movements and postures and it is difficult to separate the influence of the two components. Both the altered muscle recruitment patterns and altered kinematics appear to be a poor adaptation for pain of the head - neck region, as they are likely to result in increased compressive loading in the cervical spine, affecting muscles, articular structures such as zygapophyseal joints, connective tissues and neural tissues which are all peripheral generators of referred pain. The rectus capitus posterior minor muscle shows that it is one of the most important muscles of the suboccipital region. In this article, i reviewed the anatomy, neurophysiology, function and dysfunction as well as the treatment of cervical dysfunction.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.2
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• pp.219-228
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• 2007

Objective : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscle, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• PNF and Movement
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• v.5 no.2
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• pp.1-10
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• 2007

Purpose : The purpose of this study was conducted to find treatment of forward head posture and shoulder instability with proprioceptive neuromuscular facilitation concept. Methods : This is literature study with books, seminar note and international course. Results : Forward head posture and shoulder instability has related each other. Forward head posture will make muscle instability, weakness and stiffness on neck and shoulder girdle. It will make pain also. Important muscle are suboccipital muscles, omohyoid muscle, sternoclaidomastoid muscle, scaleni, pectoralis minor, levator scapular and digastric. Conclusion : Treatment of the forward head posture and shoulder instability is provided. It is that treatment of stiff muscle with eccentric muscle work, muscle elongation, muscle strengthening at the structure level and at the functional level for daily activities.

• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.215-217
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• 2011

Salivary gland calculi account for the most common disease of the salivary glands. We experienced a rare case of submandibular duct(Wharton's duct) calculi of unusual size and shape in a 40 year-old male patient, who presented with pain and swelling in the region of submandibular gland. The author describes the management of this patient and reviews the literature.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.57-64
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• 2018

Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.

• Journal of Korean Medical classics
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• v.23 no.1
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• pp.47-58
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• 2010

"Sanghanron(傷寒論)" can be approached through the understanding of the formulas. It is very important to correlate the efficacy of drugs and pathogenesis of syndrome. In this sense, the author examines the Paeoniae Radix Alba's efficacy. The Paeoniae Radix Alba[芍藥] used in Gyejitang(桂枝湯), Galgeuntang(葛根湯), Sogeonjungtang (小建中湯), Jagyakgamchotang(芍藥甘草湯) all have a similar effect. The Paeoniae Radix Alba supplies the tendon and blood meridian with bodily fluids, so it treats the stiffness and pain of the head and neck[頭項强痛], stiffness of the neck and back[項背强几几] and acute pain in the abdomen[腹中急痛] etc. Meanwhile, the Paeoniae Radix Alba treats difficulty in urination. It moistens the path to the excretion of urine included among drugs which increase digestion and transformation.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.2
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• pp.83-90
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• 2017

Purpose : The purpose of this study was to investigate the correlation between shoulder gradient, range of motion of the neck, and subjective pain level of the potential risk group of smart-phone addiction. Methods : The subjects of this study were 90 women's who had potential risk of smart-phone addiction. VAS was used to measure subjectively pain intensity. Global Postural System was used to measure forward head posture. CROM was used to measure flexion, extension, lateral flexion of cervical range of motion. Results : The results of this study showed that was significant positive correlation between the both shoulder gradient, and cervical range of motion(p<.05). Statistically significant negative correlation between the VAS and left lateral flexion(p<.05). Conclusions : The difference between the gradient of both shoulders increased with the use of smart-phone addiction, and the cervical left lateral flexion decreased as the pain increased. This suggests that recognition on decrease of using smart phone and postural correction is necessary.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.231-234
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• 1999

Until several years ago we didn't think seriously about cervical problems as a cause of headaches, but since the publication of articles by Bogduk et al they have gotten more attention. Cervical headaches are associated with movement abnormalities of the structures of the neck such as cervical nerve roots, discs, joints and soft tissues. Considering this, we thought that the atlanto-axial joint could be one of the causes of these headaches. Headaches originating from this joint can be recognized by the fact that the pain worsens with rotation of the head in the horizontal plane. Pain can also be referred to the frontal area or around the orbit. We did atlanto-axial joint blocks using a posterior approach on 10 patients who suffered from this type of headache. The results were promising with 9 out of 10 patients showing more than 50% improvement on the numeric rating scale. There were no serious complications observed. We concluded that the atlanto-axial joint block can be an effective procedure in treating this specific type of headache.