• 제목/요약/키워드: statement analysis

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2022 개정 중학교 과학과 교육과정과 과학교육표준(KSES)의 연관성 분석 (Analysis of the Relationship Between the 2022 Revised Middle Science Curriculum and Korean Science Education Standards (KSES))

  • 정도준;김민수
    • 과학교육연구지
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    • 제48권1호
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    • pp.1-14
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    • 2024
  • 미래세대 과학교육표준(KSES)은 과학적 소양을 과학교육 맥락에서 구현하기 위한 실천 방안으로, 미래사회 및 환경변화에 부응하는 국내 과학교육계획 수립을 지원하기 위하여 개발되었다. 이에 이 연구에서는 KSES와 최근 고시된 2022 개정 중학교 과학과 교육과정의 학습 내용 및 학습 목표의 연관성을 분석하고, 교육과정의 성공적인 현장 안착을 위한 시사점을 얻고자 하였다. 연구 결과, 2022 개정 중학교 과학과 교육과정의 내용 체계는 KSES의 지식 차원과 높은 연관성을 보여주었다. 또한 새롭게 추가된 과학과 사회 영역에서의 내용 요소를 통해 과학의 본성과 관련된 내용을 다루고자 하는 시도도 확인되었다. 성취기준의 경우 KSES의 수행기대 일부 영역에 치중되는 경향을 나타냈으나, 성취기준의 진술 수준은 KSES에서 제시하고 있는 중학교 학생들의 수준에 알맞게 진술되어 있었다. 이러한 결과로부터 2022 개정 과학과 중학교 교육과정과 KSES의 높은 연관성과 함께 미래 과학교육계획 수립을 위한 국제적 지표로서 KSES의 활용가능성을 확인할 수 있었다.

국내 연구자 커뮤니티 구성원의 부실 학술지 인식에 대한 연구 (A Study on the Perception of Predatory Journals among Members of the Korea Researcher Communities)

  • 홍명아;심원식
    • 정보관리학회지
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    • 제41권2호
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    • pp.97-130
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    • 2024
  • 최근 학술 생태계의 새로운 이슈 중 하나인 부실 학술지를 두고 판별 기준의 모호성에 대한 논쟁이 불거지고 있다. 이러한 논란은 연구자들에게 부실 학술지의 부실성이 무엇인지에 대해 혼란을 주고 있다. 이에 본 연구는 국내 연구자들이 부실 학술지를 어떻게 인식하고, 또 어떻게 판별하고 있는지를 파악하고자 했다. 이를 위해 한국의 대표적인 연구자 커뮤니티인 생물학연구정보센터(BRIC), 하이브레인넷, 김박사넷, 건전학술활동지원시스템(SAFE)을 대상으로, 2023년 11월까지 작성된 관련 게시글과 댓글 총 2,484건을 수집하였다. 수집된 텍스트 데이터에 대한 주제 분석을 위해 먼저 데이터를 3개의 큰 범주인 학술지, 출판사, 연구자로 구분하였고, 해당 범주에 따라 11가지의 세부 주제 태그로 분류하였다. 이후 세부 주제 태그의 조합에 근거하여 다음과 같은 부실학술지 관련 6개의 주요 논쟁점을 도출하였다. 첫째, 부실 학술지에 대한 연구자들의 혼란과 연구 실적에 대한 논란이다. 둘째, 부실 학술지에 대해 부정적인 인식을 가진 연구자들의 견해이다. 셋째, 부실 학술지에 대해 긍정적인 인식을 가진 연구자들의 견해이다. 넷째, 학술지 수준에 대한 평가 기준과 국내 학술지 수준에 대한 문제 제기이다. 다섯째, OA 확산에 따른 출판 관행의 변화와 이에 따른 문제 제기이다. 여섯째, 학술 생태계의 전반적인 문제에 대한 논의이다. 본 연구는 국내의 연구자들의 부실 학술지에 대한 인식을 정성적 측면에서 고려한 연구로서, 국내의 부실 학술지 논란에 대한 근본적인 이해를 형성하는 데 도움이 될 것으로 기대한다.

개발사업의 경관영향 검토를 위한 주요 조망점 선정 방법에 관한 연구 (The Method of Selecting Landscape Control Points for Landscape Impact Review of Development Projects)

  • 신지훈;신민지;최원빈
    • 한국조경학회지
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    • 제46권1호
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    • pp.143-155
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    • 2018
  • 2006년 자연환경보전법 개정에 따라 자연경관심의 제도가 도입되었다. 자연경관심의제도는 자연경관 내 개발사업 및 개발계획 시행 시 사업의 규모와 형태 배치로 인한 스카이라인과 경관보전, 경관자원, 조망축 등의 항목을 검토하는 제도이다. 그러나 경관영향평가를 위한 조망점의 선정은 모든 평가마다 기준의 일관성이 미흡하여 영향 평가 결과의 정확도와 신뢰도가 크게 저하되고 있는 실정이다. 이처럼 조망점의 위치에 따라 지각되는 경관의 모습이 현저하게 변화하게 되고, 불명확한 선정기준은 경관영향평가 결과에도 시각적 영향이 과소평가되므로 합리적인 선정기준이 필요하다. 본 연구는 개발사업 진행으로 인한 경관 변화가 예상될 때 경관영향을 평가하기 위한 객관적이고 합리적인 조망점 선정기준을 제시하고, 궁극적으로는 개발사업에 대한 경관영향 검토 및 향후 경관 모니터링을 위한 기초적인 분석방법을 제시하는데 목적을 갖고 있다. 환경영향평가서의 자연경관 내 시행되는 개발사업 중 단일건축물 및 소규모 개발을 하는 사례를 조사하고, 그 중 점적 개발사업 4곳을 대상으로 경관영향평가 부분을 분석하여 주요 조망점 선정과정에 대해 제안하였다. 기존 가시지역 분석방법의 결과인 지형 변화에 따라 가시지역 범위를 반영하지 못하는 한계를 극복하기 위해 조망 대상물 기준 가시지역 분석방법은 가시 범위를 확대하여 영향력이 높은 유효한 조망점을 선정할 수 있는 가능성을 판단하였다.

병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구 (A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance -)

  • 이숙자;이진경;유호신
    • 가정간호학회지
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    • 제6권
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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2015 개정 중학교 공통 교과와 가정과 교육과정에 제시된 '기능'과 '성취기준' 비교 분석 (A Comparative Analysis of 'Function' and 'Achievement Standard' Presented in the 2015 Revised Middle School Common Curriculum and Home Economics Curriculum)

  • 김은경;이영선;감경원;차지혜;박미정
    • 한국가정과교육학회지
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    • 제33권1호
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    • pp.17-35
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    • 2021
  • 본 연구의 목적은 2015 개정 중학교 공통 교육과정에 제시된 '기능'과 '성취기준'을 가정과 교육과정과 비교 분석하여 차기 가정과 교육과정 개발을 위한 시사점을 도출하는 데 있다. 이러한 연구 목적을 달성하기 위해 2015 개정 중학교 가정과 교육과정을 포함한 14개 교과의 '기능'과 '성취기준'을 키워드 네트워크로 분석하였으며 연구 결과는 다음과 같다. 첫째, 2015 개정 중학교 공통 교육과정의 '기능'에서는 '분석, 활용, 표현'이 연결 중심성과 위세 중심성이 모두 높은 핵심적인 기능 키워드로 나타났다. 둘째, 2015 개정 중학교 공통 교육과정의 '성취기준'에서는 '이해, 설명, 표현, 분석, 활용'의 기능형 키워드가 높은 빈도로 등장했고, 실천적 문제해결 능력과 연관이 있는 '실천, 문제해결, 탐색, 추론' 등이 출현했다. 위세 중심성이 상대적으로 높은 '감상, 해결, 실현'은 '성취기준'에서 사용된 핵심적인 기능형 키워드로 확인되었다. 셋째, 2015 개정 중학교 가정과 교육과정의 '기능'과 '성취기준'의 연관성을 비교한 결과, 실과(기술·가정)의 기능 키워드 15개 중에서 7개가 가정과 '성취기준'의 기능형 키워드에 사용되지 않아 '기능'과 '성취기준'의 연계성이 부족한 것으로 나타났다. 또한 중학교 공통 교육과정과 비교하였을 때 '성취기준'에 활용된 기능형 키워드의 다양성도 부족한 것으로 평가되었다. 이에 차기 가정과 교육과정에서 '기능'과 '성취기준'의 연계성 강화와 '분석, 표현, 비교, 이해, 해석, 탐구, 감상, 해결' 등의 다양한 기능(형) 키워드 활용을 제안한다.

의료서비스 마케팅을 위한 품질지각과 만족에 관한 연구 (A Study on Qulity Perceptions and Satisfaction for Medical Service Marketing)

  • 유동근
    • 간호행정학회지
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    • 제2권1호
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    • pp.97-114
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    • 1996
  • INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

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3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구 (Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital)

  • 유호신
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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국내에서 제작된 고정성 보철물의 수명과 실패 요인 및 양상 (LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA)

  • 신우진;전영식;이근우;이호용;한동후
    • 대한치과보철학회지
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    • 제43권2호
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    • pp.158-175
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    • 2005
  • Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.

반복하중에 따른 수종 임플란트의 피로파절에 관한 연구 (Fatigue fracture of different dental implant system under cyclic loading)

  • 박원주;조인호
    • 대한치과보철학회지
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    • 제47권4호
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    • pp.424-434
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    • 2009
  • 연구목적: 임플란트는 수직교합 하중에는 비교적 잘 견디나 측방하중에 대해서는 약한 역학적 성질을 갖고 있으므로 임플란트의 재료 특성과 기하학적 형태에 따른 응력 분석 연구의 필요성이 제기되고 있다. 연구재료 및 방법: 외부육각구조를 갖는 28개의 임플란트를 7개씩 4군으로 나누어 그 제품에 적합한 UCLA gold abutment를 이용해, 제3형 금합금으로 보철 물을 제작하였고, A군 (3i, FULL $OSSEOTITE^{(R)}$-Implant), B군 (Nobelbiocare, Branemark $System^{(R)}$Mk III Groovy RP), C군 (Neobiotec, $SinusQuick^{(TM)}$ EB), D군 (Osstem, US-II)으로 분류하였다. 고정체와 지대주나사, 지대주를 연결한 후 수직적으로 절단하여 연마한 후 미세경도계를 이용하여 10군데에서 경도측정을 실시하였고, 동적하중 피로시험기를 이용하여 60-600 N범위로 파절시까지 동적 하중을 가하였다. 주사전자현미경을 이용하여 지대주나사 및 고정체의 파절 양상과 파절 위치 등을 관찰하였고, 유한요소분석을 통해 고정체와 지대주 나사에 나타나는 응력 분포와 파절면을 비교 분석하였다. 결과: 1.고정체 경도는 A, B, C, D군에서 각각 245.3, 289.7, 281.3, 300.4 Hv로 D군이 가장 높았고, A군이 가장 낮았다. 지대주 나사의 경도는 A, B, C, D군에서 각각 340.00, 317.62, 306.5, 306.2 Hv로 A군이 가장 높고, D군이 가장 낮았다. 2. 모든 실험군에서 임플란트 고정체의 파절은 응력이 집중되는 고정체 3-4번째 나사산 홈 (valley) 부위 또는 내면의 사공간부와 일치하는 부위에서 발생되었고, 피로수명은 A, B, C, D군에서 각각 31585, 47311, 30141, 105371로 D군이 가장 높았으며, A, B, C군과는 유의한 차이가 있었다(P<.05). 3. 파절양상은 B군과D군에서는 고정체와 나사 모두에서 수직 (longitudinal)파절과 수평 (transverse)파절이 동시에 일어나는 복합 (complex mode) 파절이 관찰 되었고, A와 C군에서는 고정체에서 수평 (transverse mode) 파절만이 관찰되었다. 4. 유한요소분석 결과 인장응력이 가장 높은 고정체 표면부에서 피로 균열이 시발되어 압축응력이 가장 높은 반대편 부위로 피로균열이 전파되었으며, 최대 유효 응력값은 C군이 가장 높았고, B군에서 가장 낮았다. 결론: 피질골 높이와 일치하는 임플란트 고정체 부위에서 최대 인장 주응력이 발생되며, 고정체 사공간부 (dead space)가 최대 인장 주응력이 작용하는 지그 표면과 일치할 때 피로파절이 발생되었다. 따라서 악골에 식립된 임플란트의 신뢰성을 향상시키고 수명을 증대시키기 위해서는 가능한 임플란트 주위의 골소실이 일어나지 않도록 해야 할 것이나 골흡수가 일어나 사공간부 수준까지 진행된다면 임플란트의 파절 빈도가 증가될 수 있으므로 이에 대한 대처가 필요할 것으로 사료된다.

티타늄 임플란트의 표면처리가 골유착에 미치는 영향에 관한 조직형태계측학적 연구 (A histomorphometric study on the effect of surface treatment on the osseointegration)

  • 최웅재;조인호
    • 대한치과보철학회지
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    • 제47권4호
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    • pp.445-456
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    • 2009
  • 연구목적: 임플란트를 이용한 수복의 임상적인 성공에 중요한 역할을 하는 초기 골유착의 향상을 위해 티타늄의 표면 거칠기 조절과 함께 생체활성도를 가진 표면으로 변화시키는 방법에 관한 연구가 이루어지고 있다. 표면 거칠기의 적절한 증가는 조골세포의 활동을 증가시키고 골과 임플란트의 접촉과 유지를 촉진시킨다고 보고되고 있고 또한 알칼리와 열처리를 통하여 생체 활성 표면을 얻을 수 있는 것으로 보고되고 있다. 이에 본 연구에서는 알칼리 및 열을 이용한 티타늄 표면 처리가 골유착에 어떤 영향을 미치는지 알아보고자 하였다. 연구재료 및 방법: 기계절삭된 임플란트를 대조군으로 하여 (1군), 5 M NaOH 용액에 처리한 임플란트를 대기 중에서 열처리한 군 (2군)과 진공에서 열처리한 군 (3군)으로 분류하였다. 알칼리와 열처리를 시행한 임플란트들의 표면 특성을 관찰하고 가토에 식립하여 치유 기간에 따라서 조직학적 및 조직형태계측학적으로 비교하고 EPMA (Electron Probe Micro Analyzer)를 이용하여 치유 기간 별 골성분의 변화를 분석하였다. 결과 및 결론: 대기 중에서 열처리한 2군이 통계적으로 유의하게 (P<.05) 증가된 표면 거칠기를 보였다. 이렇게 만들어진 임플란트를 가토에 식립하여 조직 형태계측학적 분석을 시행한 결과 골-임플란트 접촉율은 전반적으로 치유기간이 경과하면서 증가하는 것으로 나타났으며 2군과 3군에서 통계적 분석결과 치유기간 간에 유의한 차이가 관찰되었고 (P<.05), 골-임플란트 면적율 (BA) 또한 골 임플란트 접촉율과 비슷한 양상을 보였으며 통계적 분석결과 2군에서만 치유기간별로 통계적으로 유의한 차이가 관찰되었다 (P<.05). 치유 기간별로 임플란트 주변 골에서 칼륨 (K), 인 (P), 칼슘 (Ca), 티타늄 (Ti)의 분포를 EPMA로 보았을 때 빈도의 편향은 관찰되지 않았으며 2군과 3군에서 초기에 칼슘과 인이 증가되는 것이 관찰되었다. 이상의 결과로 볼 때 알칼리 및 대기 중에서 열처리로 표면 처리된 임플란트의 사용은 초기에 안정된 골유착에 도움을 주며 임플란트 식립 후 기능까지의 시간을 감소시킬 것으로 사료된다.