• 재활복지
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• 제20권3호
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• pp.179-193
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• 2016

저항성 고개 숙이기 운동과 shaker 운동은 목뿔위근의 강화를 사용되는 중재법이다. 이전의 연구들에서는 삼킴 장애가 있는 환자들 대상으로 두 운동을 비교하지 않았다. 본 연구는 삼킴장애를 가진 뇌졸중 노인 환자에게 저항성 고개 숙이기 운동과 shaker 운동이 목뿔위근, 목빗근에 미치는 효과를 알아보고자 하였다. 10명의 삼킴 장애가 있는 뇌졸중 노인 환자가 자발적으로 연구에 참가하였다. 모든 대상자들은 저항성 고개 숙이기 운동(등척성, 등속성), shaker 운동(등척성, 등속성)을 순서대로 수행하였으며, 10회 반복하였다. 저항성 고개 숙이기를 수행한 후, 대상자들은 근피로를 최소화하기 위하여 5분간 휴식을 하였다. 두 운동 동안 목뿔위근과 목빗근의 활성을 표면 근전도를 이용하여 분석하였다. 윌콕슨 부호 순위 검정은 그룹 내 저항성 고개 숙이기와 shaker 운동에서 근활성에 대한 차이를 평가하기 위하여 사용하였다. 저항성 고개 숙이기 운동과 shaker 운동은 목뿔위근에서 유의한 차이를 보이지 않았다(p>.05). 저항성 고개 숙이기 운동은 shaker 운동보다 목빗근에서 유의하게 낮은 활성을 보였다(p<.05). 삼킴 장애가 있는 뇌졸중 노인환자에게 저항성 고개 숙이기 운동이 shaker 운동보다 삼킴 기능 향상을 위한 더 효과적인 치료방법으로 사용될 수 있을 것이다.

• Journal of Chest Surgery
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• 제15권2호
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• pp.139-147
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• 1982

In case of segmental injury of trachea, the primary repair is very difficult, because the trachea is fixed in place without movability from the surrounding tissue. In addition to special anatomical situation of trachea, any ideal artificial prosthesis for tracheal replacement is not still appeared. Many authors proposed several procedures for the tracheal repair, but satisfactory results were few. Among the proposed procedures end to end anastomosis of trachea was noted superior when both ends of trachea could be approximated by mobilization of upper and lower injured trachea. The author's experiment was designed to determine the effect about decreased tension on trachea when the hyoid bone was released downward from the surrounding muscular structures. The experimental dogs were divided into two groups, suprahyoid releasing group (SH R) and control group of intact hyoid. SH R group was subdivided into two groups accord ing to he degree of tension. The experimental results were as follow; 1. SH R group: In view of X-ray, the distance between the angle of mandible and the displaced hyoid bone was lengthened downward. And it's range was from 1.3cm (38%) minimally to 2.7cm(108%) maximally. 2. Control group: The distance between the angle of mandible and hyoid was same in both pre and postoperation. As the result of this experiment study, the suprahyoid release technique seems to be the efficient method that enable of release the trachea maximally. And it should be expected that the SH R technique is applicable clinically.

• 대한치과교정학회지
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• 제22권2호
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• pp.389-412
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• 1992

Along with form and function relationship of craniofacial growth comes a concern for the masticatory muscles with postnormal occlusion. It is the aim of this study to grope the certain differences upon the electromyographic activities of the masticatory muscles between normal occlusion and class II malocclusion during the varieties of oral functions. 26 persons of normal occlusion whose mean age were 18.9-25.6 years and another 26 persons of class II malocclusion whose mean age were 19.0-28.9 years served for this study. The electromyographic recordings processed by $Medelec^{\circledR}$ MS 25 EMG apparatus were taken from the anterior and posterior temporal, and anterior and posterior masseter muscles of both sides, and suprahyoid muscles as well. Analyses of the data toward such specific activities as mandibular rest, maximal biting, chewing gums and swallowing peanuts turned out the following summary and conclusions. 1. The maximal mean amplitude of the posterior temporalis showed significant augmentation in class II malocclusion, however the anterior temporalis, posterior masseter, and suprahyoid muscles manifested meaningful diminutions. 2. Stronger posterior temporalis and weaker anterior masseter and suprahyoid muscles were arranged in maximal biting with parameters of maximal mean amplitude. 3. The anterior temporalis of working side expressed smaller maximal mean amplitude in class II malocclusion. Significant swelling in duration were shown at anterior and posterior temporalis of working side, and posterior temporalis of balancing side in class II malocclusion, and marked reduction at anterior masseter of balancing side and posterior masseter of working side as well. The lessened latency were expressed at anterior masseter of working side, and anterior and posterior masseter of balancing side. Class II malocclusion group had significant prolongation of silent period duration. Mean silent period duration of 10.75 msec in normal occlusion and 24.37 msec in class II malocclusion were calculated. 4. Significant augmentations of maximal mean amplitude while swallowing peanuts were yielded at right anterior temporalis and posterior temporalis of both sides, however left anterior masseter and right posterior masseter showed diminution. No significant differences in duration showed at every muscle examined in class II malocclusion group.5. Weaker masseter and stronger temporalis were suggested as characteristics of class II malocclusion.

• 대한치과교정학회지
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• 제24권1호
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• pp.199-220
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• 1994

This study was conducted to determine the electromyographic features in the perioral muscles of class II division 1 malocclusion with incompetent lips, and to grope the correlation between its activities and craniofacial morphology. Tn this study, 14 subjects with class II division 1 malocclusion with incompetent lips(mean age of 20.5 years) and 20 subjects with normal occlusion(mean age of 23.9 years) were investigated. Electromyographic data were recorded from orbicularis oris, mentalis, buccinator and suprahyoid muscles durig rest lip posture, lip position at sealing, maximum sealing, maximal blowing, maximal biting, sipping milk, sipping and swallowing milk, chewing gum, masticating almond, swallowing almond and phonation utilizing the Medelec MS-25 electromyographic apparatus. Lateral cephalometric radiographs were taken with the mandible in intercuspal position on all subjects. All data were recorded statistically processed. The findings of this study can be summerized as follows : 1. In class II division 1 malocclusion with incompetent lips, the overall augmentations of perioral muscle activities during various functionel movements set for lip sealing were manifested and particular swelling in mentalis activity at rest was detected. 2. On the other hand remarkable diminution of upper lip acitivities at lip sealing movements was drawn. 3. In Class II division 1 malocclusion with incompetent lips, negative correlations existed between the diversity of upper lip activities and upper incisor position and overjet as well in contrast to positive correlations in the lower lip. 4. It was suggested that the abnormal function of lower lip and mentalis muscle contributed somewhat the revelation of the characteristics of Class II division 1 malocclusion.

• Journal of Chest Surgery
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• 제28권2호
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• pp.156-161
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• 1995

Although there are many kinds of method in treatment of tracheal stenosis, tracheal resection and primary anastomosis can be performed for management of various kinds of tracheal stenosis because it is considered the most anatomical ideal therapeutic modality. During a 10-year period we performed 18 tracheal resection on 18 patients with no operative mortality and some morbidity. 13 patients had tracheal stenosis caused by endotracheal intubation [eight patients or tracheostomy [five patients ; and five patients caused by a variety of neoplastic lesions [four primary and one secondary . The length of tracheal stenosis were various from 1.5cm to 5.5cm and site of tracheal stenosis were cervical[17patients and thoracic [one patient . Operative techniques were tracheal resection and primary anastomosis[18 patients and additional procedures were cricoid cartilage reconstruction with costal cartilage [one patient , primary repair of esophagus[one patient and suprahyoid laryngeal release technique[eight patients without any complications. We have eight complications; tracheal restenosis were developed in five patients[growth of grannulation tissue at anastomotic site in three patients, delayed restenosis in two patients , anastomotic disruption in one patient, hoarseness and pneumonia in each of two patients. We managed tracheal complications with T-tube insertion in two patients, permanent tracheostomy in three patients and insertion of Gianturco tracheal stent in one patient, but tracheal stent did not reveal good result because it caused persistent production of sputum. We concluded that it is necessary to access full length of normal trachea including suprahyoid laryngeal release technique to avoid anastomotic tension in tracheal surgery and develope new ideal techniques to manage postoperative tracheal complications, because we suppose tracheal complications are developed due to anastomotic tension.

• 음성과학
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• 제13권1호
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• pp.85-94
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• 2006

The aim of this study was to examine the characteristics in duration and amplitude of the submental muscle activities during dry and wet swallowing. We examined the middle suprahyoid muscle activities in 32 normal adult women during three swallowing conditions, that is, dry as well as 5 mL & 10 mL water swallowings, using a surface EMG. From the results, there were significant differences in duration: the longest in dry swallowing and shortest in 5 mL water swallowing. However, the mean amplitude per msec increased as the duration decreased. This may imply motor equivalence in swallowing stating that duration and amplitude are complementary in order to achieve a given swallowing goal.

• The Journal of Korean Physical Therapy
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• 제13권3호
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• pp.769-776
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• 2001

This study were to review of muscle imbalance of head, cervical and shoulder region. Head, cervical and shoulder region is a complicated mechanical unit. interconnected by numerous soft tissue links. These links, or articulation are functionaly and reflexly interdependent on one another. The line of gravity falls anterior to the transverse axis of rotation for flexion and extension of the head and creates a flexion moment. which tends to tut the head forward, is counteracted by tension in the tectorial membrane, and ligamentum nuchae, and by activity of the neck extensors. Therefore, the flexion moment equilibrate with the extension moment. Changing of the equilibrium will make mid cervical straight. It will make forward head posture(FHP) also. FHP makes imbalance of suboccipital muscles, suprahyoid muscles and infrahyoid muscles. It has some relationship with temporomandibular joint, spine and equilibrium of pelvis.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1991년도 제25차 학술대회 연제순서 및 초록
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• pp.25-25
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• 1991

최근 교통사고의 증가, 심폐술의 보편화 및 보조호흡을 필요로 하는 환자의 증가에 따라 경구적 혹은 기관절개술을 통해 기관내 삽관을 장기간 유치하는 경우가 많아져서 이에 따른 합병증으로 기관협착증의 빈도가 높아지게 되었다. 기관내 삽관후 기관협착증을 초래하는데에는 관의 외경, 삽관시 외상, 삽관유치기간, 기계적 보조호흡시 관의 이동, cuff 의 압력 등의 요인이 작용한다. 이러한 요인에 의해 기관내 삽관을 장기간 유치시 기관점막에 대한 지속적인 압박으로 점막하부의 압박괴사 및 혈관의 폐쇄로 인해 기관연골의 무혈성 괴사를 초래하여 환상의 기관협착이 병발하게 된다. 기관협착증에 대한 치료방법으로서는 여러 가지가 있으나 환상의 기관협착증인 경우는 협착부위의 절제 및 단단문합술을 시행하고 절제부위가 광범위한 경우는 release technique 을 이용하여 문합부위의 장력을 줄여주는 것이 효과적인 치료방법으로 알려져 있다. 저자들은 최근 기관내 삽관후에 병발한 환상기관협착증 3례(다발성 골절 1례, 기관지 천식 1례, 약물중독 1례)에 대해 기관절제 및 단단문합술을 경험하였기에 보고하고자 한다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1995년도 이비인후과 종합학술대회 초록집
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• pp.90.2-90
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• 1995

기관 협착증은 기관 삽관, 기관절개술 혹은 외상 등에 의해 주로 발생하고 드물게 종양이나 염증성 질환에 의해 생길 수 있다. 치료의 원칙은 정상 발성기능을 가진 충분한 기관강을 유지하는데 있으며 여러 치료방법 중 기관절제 및 단단문합술은 다른 방법이 실패하였거나 협착정도가 심한 경우에 시행할 수 있고, 정상기관강을 유지함으로써 해부, 생리학적으로 가장 이상적인 수술방법으로 알려져 있다. 저자들은 1990년부터 1994년까지 경부기관 8례, 경부 및 흉부기관을 동반한 기관협착증 1례에서 기관 절제 및 단단문합술을 실시하였다. 전례에서 suprahyoid release를 시행하였으며, 술중 가능한한 회귀신경은 확인하지 않았으며 술후 2일째 기관발거를 실시하였다. 합병증으로 술후 1례에서 일측성대마비가 있었으며 문합부 육아조직 형성이 2례가 있었으나 전례에서 성공적인 기관발거가 가능하였다.

• 대한지역사회작업치료학회지
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• 제7권2호
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• pp.1-8
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• 2017

목적 : 본 연구는 정상 성인을 대상으로 삼킴 시 물의 온도와 양에 따른 목뿔위근육과 목뿔아래근육의 활성도를 측정하여, 임상에서 삼킴장애를 평가하기 위한 기초자료로 활용하고자 하였다. 연구 방법 : 건강한 성인 27명을 대상으로 물의 양과 온도에 따른 목뿔위근육과 목뿔아래근육의 근활성도를 비교하기 위하여 양은 3 mL, 20 mL로, 온도는 $4^{\circ}C$, $22^{\circ}C$, $40^{\circ}C$로 각각 설정하였고, 대상자별로 기준값(reference voluntary contraction, %RVC)을 설정하기 위하여, 침을 삼키는 동안 오른쪽 및 왼쪽 목뿔위근육과 목뿔아래근육의 활성도를 3회 측정하여 평균값을 사용하였다. 연구 장비는 안드로이드 기반 근전도 측정 장비인 2EM(4D-MT, Relive, Gimhae, Korea)을 이용하여 자료를 수집, 처리하였다. 결과 : 양을 기준으로 비교했을 때 왼쪽 목뿔아래근육은 $4^{\circ}C$, $22^{\circ}C$, $40^{\circ}C$에서 (p=.00; p=.00; p=.00), 오른쪽 목뿔아래근육은 $22^{\circ}C$와 $40^{\circ}C$에서 (p=.01; p=.01), 왼쪽 목뿔위근육은 $4^{\circ}C$에서 (p=.03), 3 mL 물보다는 20 mL 물을 삼킬 때 근활성도가 증가하였다. 온도를 기준으로 분석한 결과 20 mL의 물을 삼킬 때 $4^{\circ}C$, $22^{\circ}C$ 보다는 $40^{\circ}C$ 조건에서 오른쪽 목뿔위근육의 근활성도가 유의하게 감소하였다 (p=.04). 결론 : 20 mL가 3 mL보다 오른쪽 및 왼쪽 목뿔아래근육, 왼쪽 목뿔위근육에서 근활성도가 유의하게 증가하였고, $40^{\circ}C$가 $4^{\circ}C$, $22^{\circ}C$보다 오른쪽 목뿔위근육에서 근활성도의 유의한 감소를 보였으나, 양과 온도를 모두 고려한 일부조건에서만 의미가 있었다. 추후에는 점도, 맛 등의 다른 변수를 고려하여 건강한 대상자 뿐 아니라 신경계 손상환자를 대상으로 한 임상연구가 더 필요할 것이다.