• Title/Summary/Keyword: 장애영향평가

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Finite Element Analysis of Bone Stress Caused by Horizontal Misfit of Implant Supported Three-Unit Fixed Prosthodontics (3차원 유한요소법에 의한 임플란트 지지 3본 고정성 가공 의치의 부적합도가 인접골 응력에 미치는 영향 분석)

  • Lee, Seung-Hwan;Jo, Kwang-Hun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.147-161
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    • 2012
  • This study is to assess the effect of horizontal misfit of an implant supported 3-unit fixed prosthodontics on the stress development at the marginal cortical bone surrounding implant neck. Two finite element models consisting of a three unit fixed prosthodontics and an implant/bone complex were constructed on a three dimensional basis. The three unit fixed prosthodontics were designed either shorter (d=17.8mm model) or longer (d=18.0mm model) by 0.1mm than the span of two implants placed at the mandibular second premolar and second molar areas 17.9mm apart. Fitting of the fixed prosthodontics onto the implant abutments was simulated by a total of 6 steps, that is to say, 0.1mm displacement per each step, using DEFORM 3D (ver 6.1, SFTC, Columbus, OH, USA) program. Stresses in the fixed prosthodontics and implants were evaluated using von-Mises stress, maximum compressive stress, and radial stress as necessary. The d=17.8mm model assembled successfully on to the implant abutments while d=18.0mm model did not. Regardless if the fixed prosthodontics fitted onto the abutments or not, excessively higher stresses developed during the course of assembly trial and thereafter. On the marginal cortical bone around implants during the assembly, the peak tensile and compressive stresses were as high as 186.9MPa and 114.1MPa, respectively, even after the final sitting of the fixed prosthodontics (for d=17.8mm model). For this case, the area of marginal bone subject to compressive stresses above 55MPa, equivalent of the $4,000{\mu}{\varepsilon}$, i.e. the reported threshold strain to inhibit physiological remodeling of human cortical bone, extended up to 2mm away from implant during the assembly. Horizontal misfit of 0.1mm can produce excessively high stresses on the marginal cortical bone not only during the fixed prosthodontics assembly but also thereafter.

Long-Term Results of 2-Dimensional Radiation Therapy in Patients with Nasopharyngeal Cancer (이차원방사선치료를 시행한 코인두암 환자의 장기 추적 결과 및 예후인자 분석)

  • Lee, Nam-Kwon;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Suk;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.193-204
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    • 2010
  • Purpose: To analyze the treatment outcomes, complications, prognostic factors after a long-term follow-up of patients with nasopharyngeal carcinoma treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Materials and Methods: Between December 1981 and December 2006, 190 eligible patients with non-metastatic nasopharyngeal carcinoma were treated at our department with a curative intent. Of these patients, 103 were treated with RT alone and 87 patients received CCRT. The median age was 49 years (range, 8~78 years). The distributions of clinical stage according to the AJCC 6th edition included I: 7 (3.6%), IIA: 8 (4.2%), IIB: 33 (17.4%), III: 82 (43.2%), IVA: 31 (16.3%), IVB: 29 (15.3%). The accumulated radiation doses to the primary tumor ranged from 66.6~87.0 Gy (median, 72 Gy). Treatment outcomes and prognostic factors were retrospectively analyzed. Acute and late toxicities were assessed using the RTOG criteria. Results: A total of 96.8% (184/190) of patients completed the planned treatment. With a mean follow-up of 73 months (range, 2~278 months; median, 52 months), 93 (48.9%) patients had relapses that were local 44 (23.2%), nodal 13 (6.8%), or distant 49 (25.8%). The 5- and 10-year overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 55.6% and 44.5%, 54.8% and 51.3%, in addition to 65.3% and 57.4%, respectively. Multivariate analyses revealed that CCRT, age, gender, and stage were significant prognostic factors for OS. The CCRT and gender were independent prognostic factors for both DFS and DSS. There was no grade 4 or 5 acute toxicity, but grade 3 mucositis and hematologic toxicity were present in 42 patients (22.1%) and 18 patients (9.5%), respectively. During follow-up, grade 3 hearing loss in 9 patients and trismus in 6 patients were reported. Conclusion: The results of our study were in accordance with findings of previous studies and we confirmed that CCRT, low stage, female gender, and young age were related to improvement in OS. However, there are limitations in the locoregional control that can be achieved by CCRT with 20 conventional radiation therapy. This observation has led to further studies on clarifying the efficacy of concurrent chemotherapy by intensity modulated radiation therapy.

Study on Development of Acute Index Through Peripheral Blood Test in Total Body Irradiation Patients (방사선 전신조사 환자의 말초혈액 검사를 통한 급성장애 지표개발에 관한 연구)

  • Park, Young-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.91-103
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    • 2001
  • In those patients who underwent radiation therapy with 10 MV X-ray for bone marrow transfer, compared the effect of high dose irradiation on peripheral blood were investigated in randomly selecting 18 patients. thus, changes in the levels of peripheral blood (WBC, Seg. neutrophil, Lymphocyte, RBC, Hemoglobin, Hematocrit ratio, GOT, GPT) were observed for 25 days after irradiation with the peripheral blood levels before irradiation in these patients and in 32 controls. Among changes in peripheral blood, the level of WBC was $8.63\%$ after radiation therapy with as much decrease as $0.22{\times}103{\pm}0.19{\times}103/mm^3$ compared with $2.51{\times}103{\pm}1.29{\times}103/mm^3$ before radiation therapy, and was only $6.35\%$ of $7.17{\times}103/mm^3{\pm}1.46{\times}103/mm^3$ in the controls, showing statistical significance (P<0.01, r2=0.9151). In the morphologic test of WBC, the level of Seg. neutrophil was decreased as much as to $20.53\%$ with $14.17{\pm}21.60\%$ compared with $69.00{\pm}25.60\%$ before irradiation, and decreased down to $24.39\%$ compared with $58.09{\pm}7.62\%$ in the controls (P<0.05, r2=0.6316). The number of lymphocyte increased as much as 3.94 folds at $79.91{\pm}27.30\%$ compared with $20.29{\pm}21.15\%$ before irradiation and was 2.39 times higher than $33.46{\pm}6.79\%$ in the controls (P<0.05, r2=0.7337). Although the change in the number of RBC was little with $3.18{\times}106{\pm}0.41{\times}106/mm^3$ before irradiation and $4.66{\times}106{\pm}0.43{\times}106/mm^3$ in the controls, no statistical significance was present (P>0.05). In addition, The number of hemoglobin was low compared with before irradiation and with the controls, but none showed statistical significance (P>0.05). Similarly, although the hematocrit ratio was low compared with before irradiation and with the controls, no statistical significance was present (P>0.05). In the values of the histologic examinations GOT and GPT, there is statistical significance between those from with before irradiation and with the controls (P<0.05). Thus, among peripheral blood, the number of WBC decreased drastically for a certain period after total body irradiation with high dose radiation, and the levels of Seg. neutriphil and lymphocyte decreased significantly after irradiation in the lymphocyte morphologic test. The results of the present study suggest that the possibility of developing the first to determine initially those patients who might develop radiation acute impairment using the usual peripheral blood test of patients to be exposed to high dose irradiation.

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Factors Associated with Care Burden among Family Caregivers of Terminally Ill Cancer Patients (말기암환자 가족 간병인의 간병 부담과 관련된 요인)

  • Lee, Jee Hye;Park, Hyun Kyung;Hwang, In Cheol;Kim, Hyo Min;Koh, Su-Jin;Kim, Young Sung;Lee, Yong Joo;Choi, Youn Seon;Hwang, Sun Wook;Ahn, Hong Yup
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.61-69
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    • 2016
  • Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.

Effect of Water Volume and Temperature on Muscle Activity of the Supra and Infrahyoid Muscles (물의 양과 온도가 목뿔위근육과 목뿔아래근육의 근활성도에 미치는 영향)

  • Kim, Taehoon;Kim, Dahye
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.2
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    • pp.1-8
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    • 2017
  • Objectives : This study was conducted to investigate the activity of the supra and infrahyoid muscles according to the temperature and the amount of water in healthy adults. Methods : The amount of water was set to 3 mL and 20 mL, and the temperature was subdivided into $4^{\circ}C$, $22^{\circ}C$, and $40^{\circ}C$ in order to compare the activity of the supra and infrahyoid muscles in twenty-seven healthy adults. We used the mean value of the activity of the supra and infrahyoid muscles while they were swallowing saliva in order to set the reference voluntary contraction (%RVC). Results : Muscle activity was significantly increased when they swallowed 20 mL of water rather than 3 mL in the left infrahyoid muscles at $4^{\circ}C$, $22^{\circ}C$ and $40^{\circ}C$ (p=.00; p=.00; p=.00), the right infrahyoid muscles at $22^{\circ}C$and $40^{\circ}C$ (p=.01; p=.01), the left suprahyoid muscles at $4^{\circ}C$ (p=.03). Muscle activity of the right suprahyoid muscles was significantly decreased at $40^{\circ}C$ compared to $4^{\circ}C$ and $22^{\circ}C$ when they swallowed 20 mL of water (p=.04). Conclusion : In the future, other variables such as viscosity and taste should be considered, and further studies on patients with impaired nervous system as well as healthy subjects will be needed.

Research on the Quality Characteristics of Domestic Colostrum according to the Processing Methods Employed (국내산 초유의 가공방법에 따른 품질특성 연구)

  • Jeong, Seok-Geun;Ham, Jun-Sang;Kim, Dong-Hun;Ahn, Chong-Nam;Chae, Hyun-Seok;You, Young-Mo;Jang, Ae-Ra;Kwon, Il-Kyung;Lee, Seung-Gyu
    • Food Science of Animal Resources
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    • v.29 no.4
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    • pp.457-465
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    • 2009
  • The characteristics of Holstein colostrum according to the methods that were employed in processing it were analyzed in this study to improve its industrial utilization. Colostrum samples were collected from the dairy farm of the National Institute of Animal Science (NIAS). The milk fat, protein, lactose, and SNF contents of colostrum were 4.34, 6.99, 3.37, and 11.10%, respectively. The effects of spray drying, freeze drying, freezing, acidification, and inoculation of lactic-acid bacteria on the characteristics of colostrum were then compared. The freezing of colostrum was found to be proper for long-term storage in a farm. Freeze-dried colostrum powder could not meet the processing requirements and the component standards for animal products in terms of the total bacterial and coliform bacteria counts, but spray-dried colostrum powder could meet the microbiological requirements because of its bactericidal effect during the spray-dry treatment. The inoculation of lactic-acid bacteria showed a better inhibitory effect on coliform than the acidification treatment, but protein precipitation appeared because of the low pH and the high acidity. To estimate the effects of the processing methods employed on the IgG of colostrum, the IgG contents of the milk treated by long temperature long time (LTLT) ($65^{\circ}C$, 30 min), by inoculating the lactic acid bacteria starter, by spray drying, and by freeze drying were measured. The IgG contents of the colostrum were changed significantly by the processing treatment employed, from 53.98 mg/mLto 33.28, 34.82, 21.98, and 36.89 mg/mL, respectively.

The Effect of Percutaneous Multiple Puncture BCG Vaccination on PPD 1TU, 2TU and 5TU Tuberculin Skin Test (경피용 BCG 백신의 PPD 1TU, 2TU 및 5TU 결핵 피부반응 검사에 대한 영향)

  • Kim, Bo Sun;Hwang, Min Ho;Kim, Chang Hwi;Park, Jae Ok;Shin, Sang Man
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.175-180
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    • 2001
  • Purpose : Recently in Korea since 1998, 2TU has been used instead of 5TU, which caused a confusion in interpreting tuberculin skin tests. We compared the tuberculin skin reaction to PPD(purified protein derivatives) 1TU, 2TU and 5TU. Methods : We studied tuberculin skin reaction to PPD 1TU, 2TU and 5TU on 92 infants who were vaccinated with percutaneous multiple puncture BCG vaccine(Tokyo 172 strain, Japan BCG Laboratory Co.) in neonatal period. Diameters of indurations were measured in millimeters 48~72 hours after the intradermal injection of PPD 1TU, 2TU and 5TU. Results : Among 92 infants(male : 56, female : 36), 1TU was used on 31 infants, 2TU on 31 infants and 5TU on 30 infants for tuberculin skin test. The mean diameter of induration for PPD 1TU, 2TU and 5TU were $5.7{\pm}4.2mm$, $7.1{\pm}3.7mm$, and $9.2{\pm}4.2mm$, respectively. There was no statistical difference in mean diameter of induration between 1TU and 2TU. However, when tested with 5TU, the diameter of induration was significantly larger than those of PPD 1TU and 2TU(P<0.05). Six subjects(19.4%) tested with 1TU, 9 subjects(29%) tested with 2TU and 16 subjects(53.3%) tested with 5TU had diameter of 10 mm or more. There was no statistical difference between 1TU and 2TU but for 5TU, number of subjects with diameter of 10 mm or more was significantly higher than PPD 1TU and 2TU(P<0.05). Number of subjects with induration diameter of 5 mm or more for 1TU, 2TU and 5TU was 19(61.3%), 22(71.0%) and 26(86.7%), respectively. However, there was no statistical difference. Conclusion : A new standard criteria for interpreting the tuberculin skin test with PPD 2TU should be established for clinical diagnosis of tuberculosis.

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Effect of Acupuncture on Nasal Obstruction in Patients with Persistent Allergic Rhinitis: A Randomized Controlled Trial (지속성 알레르기비염의 비폐색에 대한 침치료의 효과: 무작위배정 대조군 연구)

  • Jo, Jeong-Hyo;Hong, Kweon-Eey;Kang, Wee-Chang;Choi, Sun-Mi;Park, Yang-Chun
    • Journal of Acupuncture Research
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    • v.22 no.6
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    • pp.229-239
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    • 2005
  • Objectives : Allergic rhinitis is a prevalent disease. Nasal obstruction is one of the main symptom in allergic rhinitis. It induces sleep disturbances, depression, attention deficit, memory impairments. Acupuncture treatment for rhinitis was mentioned in literature, but there is not enough report that provide evidence by well designed clinical study. The purpose of this research is to examine the effect of acupuncture treatment for nasal obstruction of allergic rhinitis. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with minimal acupuncture for the treatment of nasal obstruction owing to persistent allergic rhinitis. Acupoints used in active acupuncture group were I120($Y{\hat{o}}nghyang$), GV23($Sangs{\hat{o}}ng$), IL4(Hapkok). Volunteers who satisfied the requirements were enrolled in study. Total nasal volume(NV) and total nasal minimum cross-sectional area(MCA) were measured by acoustic rhinometry before and after treatments(0min, 7.5min, 15min). Results : 101 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, severity of persistent allergic rhinitis, number of positive antigen. After treatment(0min) total NV were significantly increased compared with before treatment in active acupuncture group(p=0.0007) and minimal acupuncture group(p=0.0175). After treatment(15min) total NV of minimal acupuncture group was decreased compared with before treatment(p=0.2560), but total NV of active acupuncture group was maintained increasing in degree of borderline significance(p=0.0871). After treatment(0min) total NV were significantly increased compared with before treatment in active acupuncture group(0.0007) and minimal acupuncture group(p=0.0175). After treatment(Omin) total MCA were significantly increased compared with before treatment in active acupuncture group(p<0.000l) and minimal acupuncture group(p=0.0005). After treatment(15min) total MCA of minimal acupuncture group was decreased compared with before treatment(p=0.6082), but total NV of active acupuncture group was maintained increasing in degree of borderline significance(p=0.0929). Conclusion : Acupuncture treatment reduced nasal obstruction in persistent allergic rhinitis. Further study in the form of long term is needed.

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Semi-Longitudinal Study on Growth Development of Children Aged 6 to 16 (한국인 정상아동 6세~16세의 악안면 성장에 관한 준종단적 연구)

  • Jeong, Mi;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.51-72
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    • 1999
  • In orthodontic field, it is very important to understand the normal growth. Such an understanding can be derived from observation of normal growth in various samples from childhood to adulthood, and this builds a foundation from which growth abnormality or variation can be defined. Thus, a broad data collection of normal children, as well as basic study reviewing such data become necessary. The relationship between the mean values of cephalometric measurements in Growth and Development was studied among the groups(boys and girls) of Korean chidren from the ages 6-years to 16-years. 220 boys 170 girls were chosen as subjects : Cephalometric X-ray were taken for 3 years and hard tissue analysis on McNamara and Ricketts Analysis which was divided into measurements of 5 parts(Cranial base, Cranial base and Maxilla & Mandible, Maxilla and Mandible, Mandible, Dental measurements). The relationship of craniofacial growth was studied. The following conclusions were obtained: 1. There were statistically significant differences in anterior cranial base between the two sexes of 14 and 15-year grouips. 2. In comparison of growth amounts among different age groups, statistically singnificant difference in Posterior facial height exhisted among $10\~11,\;12\~13\;and\;14\~15$ year-old interval groups. This pattern increased with aging. 3. Na perpendicular to A showed earlier growth peak in females(11-12years) than males(12-13years). When horizontal measurements of point A and Pogonion are compared, mandibular growth appeared to be greater. 4. Maximum growth peak of cranial base and mandible was earlier in females (11-12years) than males(13-14 years). 5. Upper central incisor flared out with aging, and there were increases in lower incisor to A-Pg, and lower incisor inclination There was significant difference between the two sexes in 10-year-old group.

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Utilization Rate and Related Factors of Unified Health Sub-center Among Rural Residents (통합보건지소 설치 전후 주민들의 보건지소 이용율 변화 및 관련요인)

  • Hwang, Tae-Yoon;Kang, Pock-Soo;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Young-Ah
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.107-126
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    • 2002
  • Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

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