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후기 급성호흡곤란증후군환자에서 스테로이드의 사용 효과 (The Effect of Steroid Therapy in Patients with Late ARDS)

  • 허진원;임채만;제갈양진;이상도;김우성;김동순;김원동;고윤석
    • Tuberculosis and Respiratory Diseases
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    • 제52권4호
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    • pp.376-384
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    • 2002
  • 연구배경: 급성호흡곤란증후군(ARDS)환자에서의 고용량 및 단기간이 스테로이드의 사용은 사망률은 감소시키지 못하나 최근 섬유증식기로 진행한 후기 급성호흡곤란증후군 환자의 일부에서 스테로이드의 투여가 환자의 예후를 개선시킨다는 몇몇 연구 보고가 있었다. 이에 후기 급성호흡곤란증후군 환자에게 투여한 스테로이드가 사망률 및 호흡 역학에 미치는 영향을 후향적으로 분석하였다. 방 법: 1998년 1월부터 2001년 7월까지 서울중앙병원 내과계 중환자실에 입원한 급성호흡곤란증후군 환자들 중 일주일 이상 기계호흡을 했고 이전에 스테로이드를 쓴 적이 없으면서 기계환기, 복와위, 폐포모집술(recruitment maneuver), 산화질소 흡입 요법 등의 치료에도 급성호흡곤란증후군 진단 8일째 PF ratio가 200이하인 48명 중 스테로이드 치료군 14명과 비치료군 34명의 임상적, 생리적 지표들을 비교 분석했다. 평균${\pm}$표준편차로 표기했다. 결 과: 스테로이드 치료군과 비치료군 사이의 급성호흡곤란증후군의 원인, 연령, 급성호흡곤란증후군 진단 당시와 8일째 PF ratio, LIS, 폐 정적 탄성(static compliance), SAPS II score들의 통계학적 차이가 없었다. 스테로이드 치료군과 비치료군의 생존군만 비교시 치료 후 7일째 PF ratio, GOCA, APACHE III score가 스테로이드 치료군에서 의미 있게 호전되었고 사망률 역시 치료군에서 유의하게 낮았다(42.4% vs 73.5% p=0.02). 결 론: 후기 급성호흡곤란증후군 환자에서 스테로이드의 사용은 호흡역학 및 예후를 개선시킬 것으로 사료된다.

가상 공동체 사용자의 전자상거래 수용에 대한 연구 (A Study on EC Acceptance of Virtual Community Users)

  • 이형용;안현철
    • Asia pacific journal of information systems
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    • 제19권1호
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    • pp.147-165
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    • 2009
  • Virtual community(VC) will increasingly be organized as commercial enterprises, with the objective of earning an attractive financial return by providing members with valuable resources and environment. For example, Cyworld.com in Korea uses several community services to enable customers of Cyworld to take control of their own value as potential purchasers of products and services. Although initial adoption is important for online network service success, it does not necessarily result in the desired managerial performance unless the initial usage is continuously related to the continuous usage and purchase. Particularly, the customer who receives relevant online services and is well equipped with online network services, will trust the online service provider and perceive less risk and experience more activities such as continuous usage and purchase. Thus, how to promote continued online service usage or, alternatively, how to prevent discontinuance is a critical issue for VC service providers to consider. By aggregating a wide range of information and online environments for customers and providing trust to its members, the service providers of virtual communities help to reduce the perceived risk of continuous usage and purchase. Drill down, online service managers realize that achieving strong and sustained customers who continuously use online service and purchase on it is crucial. Therefore, the research into this online service continuance will identify the relationship between the initial usage and the continuous usage and purchase. The research of continuous usage or post adoption has recently emerged as an important issue in the IS literature. Individuals' information systems(IS) continuous usage decisions are congruent with consumers' repeat purchase decisions. The TAM(Technology Acceptance Model) paradigm has been strongly confirmed across a wide range from product purchase on EC to online service usage contexts. The analysis of IS usage based on TAM has proven to be successful across almost online service contexts. However, most of previous studies have focused on only an area (i.e., VC or EC). Just little research has tried to analyze the relationship between VC and EC. The effect of some factors on user intention, captured through several theories such as TAM, has been demonstrated. Yet, few studies have explored the salient relationships of VC users' EC acceptance. To fill this gap between VC and EC research, this paper attempts to develop a research model that extends the TAM perspective in view of the additional contributions of trust in the service provider and trust in members on some factors that affect EC and VC adoption. In this extension, we applied the TAM-to-TAM(T2T) model, and analyzed the transfer effect of trust between these two TAMs. The research model was empirically tested on the context of a social network service. The model was to extend TAM with the trust concept for the virtual community environment from the perspective of tasks. By building an extended model of TAM and examining the relationships between trust and the existing variables of TAM, it is aimed to explain a user's continuous intention to use VC and purchase on EC. The unit of analysis in this paper is an individual user of a virtual community. The population of interest is the individual with the experiences in virtual community. The data for this paper was made available via a Web survey of VC users. In total, 281 cases were gathered for about one week, but there were some missing values in the sample and there were some inappropriate cases. Thus, only 248 cases were finally analyzed. We chose the structural equation analysis to test the hypotheses and it is better suited for explaining complex relationships than the other methods. In this test, AMOS was used to test the Structural Equation Model (SEM). Noticeable results have been found in the T2T model regarding the factors affecting the intention to use of virtual community and loyalty. Our result showed that trust transfer plays a key role in forming the two adoption beliefs. Overall, this study preliminarily confirms the salience of trust transfer in online service.

정보시스템 사용과 성과에 있어서 자발성의 조절효과에 관한 연구 (A Study on the Moderating Effect of Perceived Voluntariness in the Organizational Information System Usage and Performance)

  • 이승창;이호근;정창욱;정남호;서응교
    • Asia pacific journal of information systems
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    • 제19권2호
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    • pp.195-221
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    • 2009
  • According to an industry report, a large number of organizations have invested in Organizational Information System(OIS) in the past few years. Several research results indicate that successful investments in OIS lead to productivity enhancement, while failed ones result in undesirable consequences such as financial losses and dissatisfaction among employees. In spite of huge investments, however, many organizations have failed in achieving the hoped-for returns from OIS. Thus, understanding user acceptance, adoption, and usage of new IS(Information Systems) is an important issue for IS practitioners. Indeed, study of the user acceptance of new information system has been one of the most important research topics in the contemporary IS literature. Several theoretical models are tested to examine 'user acceptance' and 'usage behavior' in IS context. While many research models incorporate 'ease of use' or 'usefulness' as important factors in explaining user acceptance, Technology Acceptance Model(TAM) has been one of the most widely applied models in user acceptance and usage behavior. Even in recent IS studies that employ theories of innovation diffusion in the area of IS implementation, a major focus has been on the user's perception of information technologies. In this research, we study 'voluntariness' as an important factor in IS acceptance by users. Voluntariness is defined as "the degree to which the use of the innovation is perceived as being voluntary, or of free will" When examining the diffusion of accepting OIS, a thoughtful consideration should be given to 'perceived voluntariness.' Current article has following research questions: 1) What models are appropriate to explain the success of OIS? and 2) How does the 'voluntariness' affect the success of OIS? In order to answer these questions, a research model is proposed to describe the detailed nature of association among three independent variables (IT usage level, task interdependency, and organizational support), a mediating variable (IS usage), a dependent variable (perceived performance), and a moderating variable(perceived voluntariness). The central claim of this article is that organizations hardly realize expected returns from OIS investments unless perceived voluntariness is effectively managed after operating OIS. As an example of OIS in this study we have selected the Intranet of Republic of Korea Air Force (ROKAF). ROKAF has implemented the Intranet in an attempt to improve communication and coordination within the organization. To test our research model and hypotheses, survey questionnaires were first sent out to 400 Intranet users. With the assistance of ROKAF, Intranet users were initially identified among its members, and subjects were randomly drawn from the pool. 377 survey responses were finally returned. The unit of measurement and analysis in this research is a personal level. Path analysis based on structural equation modeling was used to test research hypotheses. Construct validity represents accordance between the theoretical base concept of constructs and its measurement items. Tests for the reliability and discriminant validity are accepted, thus verifying our survey instrument. In this research, we have proposed a conceptual framework to highlight the importance of perceived voluntariness after organization deploys OIS. The results of our analysis present several key finding. First, all three independent variables (IT usage level, task interdependency, and organizational support) have significant effects on IS usage, which will eventually improve performance. Thus, IS usage plays a mediating role between antecedent variables (IT usage level. task interdependency, and organizational support) and performance improvement. Second, the effect of the task dependency was the highest for IS usage among the three antecedent variables. This is highly plausible since one of the Intranet's major capabilities is to facilitate communication among members within an organization. Accordingly, we conclude that the higher the task dependency, the higher Intranet usage. The effect of user's IT usage level was the second, while the effect of the organizational support was the third. Finally, the perceived voluntariness plays a pivotal role in enhancing perceived performance in personal level after launching the Intranet. Relationships among investigated variables were significantly different between groups with a high level and a low level of voluntariness. The impact of the Intranet usage on the performance was greater in the higher level voluntariness group than in the lower one. For the lower level voluntariness group, the user's IT usage had the highest effect on the Intranet usage among the three antecedent variables. In short, our study suggests that the higher the perceived voluntariness is the more IS usage will be. Perceived voluntariness was found to have a moderating effect on the relationships among user IT usage level, task interdependency, IS usage, and perceived performance, supporting all the hypotheses on the moderating effect. Most of all, user IT usage level has the strongest influence on IS usage, indicating that users with superior IT usage are more likely to enjoy a high level of perceived performance.

껌씹기가 저작근의 경도와 탄성도에 미치는 효과 (Muscle Stiffness and Elasticity of Masticatory Muscles on Gum Chewing)

  • 원태희;김미은;김기석
    • Journal of Oral Medicine and Pain
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    • 제32권4호
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    • pp.421-429
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    • 2007
  • 최근 tactile sensor 를 사용하여 근육의 경도와 탄성도를 조사하는 방법이 저작근의 새로운 평가방법으로 제시되고 있다. 본 연구의 목적은 촉각센서를 이용하여 일정시간 껌씹기를 시행전, 중, 후의 저작근의 경도와 탄성도를 조사하여 향후 턱관절 장애 환자의 저작근 평가를 위한 기초자료를 확보하는 데 있다. 건강한 성인 8명을 대상으로 양측 전측두근(anterior temporalis), 하교근(inferior masseter)의 경도와 탄성도를 촉각센서 (Venustron II, Axion Co., Japan)를 이용하여 다음과 같이 측정하였다. 피검자들을 unit-chair에 바로 앉힌 상태에서 양측 교근 및 측두근 부위를 촉진을 통해 전 측두근(temporalis anterior), 하 교근(masseter inferior) 두 부위를 펜으로 표시하였다. 실험의 재현성을 위하여 투명한 종이에 ala-tragus line을 표시한 후 두 부위를 투명종이 위에 표시하였다. 편안한 상태에서 촉각센서를 사용하여 양측 하 교근 및 전 측두근의 경도와 탄성도를 측정한 후, 껌(Excellent Breath, Taiyo Co., Japan)을 양측으로 씹게 하여 1초당 2회의 속도로 씹게 하였다. 껌을 40분동안 저작하는 동안 10분, 20분, 30분, 40분에 양측 하 교근 및 전 측두근의 경도와 탄성도를 측정하였다. 그 후 껌을 뱉게 하고 하악의 안정위 상태에서 10분, 20분, 30분, 40분 후 양측하 교근 및 전 측두근의 경도와 탄성도를 각각 측정하였다. 측정치들을 반복측정 이원분산분석과 다중비교를 통하여 비교하였다. 실험결과 측두근과 교근을 비교 시 탄성도, 경도 모두 교근의 변화가 유의하게 크다. 또한 저작하면 서서히 경도는 증가하며 탄성도는 반대로 감소한다. 탄성도 및 경도는 저작 시 신속히 증가하나 저작 종료 후에는 탄성도만 신속히 회복되나 경도는 약 10분 이상의 일정시간이 지나야 회복된다. 이상의 결과들을 보아 임상적으로 좀 더 다양한 연구와 기초자료가 확보된다면, 저작근의 근육 상태를 평가하는데, 근육의 탄성도와 경도를 조사하는 tactile sensor system은 유익한 기기로서 활용될 수 있을 것이다.

복부와 경부 관통상 환자에 대한 임상적 고찰 (Clinical Analysis of Patients with Abdomen or Neck-penetrating Trauma)

  • 노하니;김광민;박준범;류훈;배금석;강성준
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.107-112
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    • 2010
  • Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.

비위생리(脾胃生理)에 수용(授用)되는 황제내경(黃帝內經) 어구(語句)에 관(關)한 연구(硏究) (Studies on the phrases of Yellow Emperor's internal classic(黃帝內經) for the physiology on the spleen and stomach)

  • 원진희
    • 대한한의학회지
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    • 제16권2호
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    • pp.453-489
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    • 1995
  • The research of the phrases related with physiology of stomach and spleen in the contents of Huang Di Nei Jing(黃帝內經) known as the Bible of oriental medicine will make a contribution to a deep understanding of disease of stomach and spleen and a proper clinical diagnosis and treatment of them. In this research of the most appropriate glosses recorded nine kinds of representative medical books including Huang Di Nei Jing Somoon(黃帝內經素問) of Wang Bing(王氷) were picked out: The summaries of the selected contents are as follows: 1. The word 'saliva(涎)' in 'the spleen controls saliva(脾爲涎)' can be viewed as a generic term referring to oral cavity secretion gland as well as the secretion fluid of salivary gland. 2. The phases 'a large reservoir(太倉)', barn organs', 'a reserboir of food stuff', 'a stomach as the market(胃爲之市)', etc mean the function of stomach to receive food(胃主受納). 3. The phase 'generation of five tastes(五味出焉)' means both 'the function of stomach to transform food into chyme(胃主腐熟)' and 'the channelling function of spleen.(脾主運化)' 4. The flowing of the food-Qi(食氣) into stomach brings about spreading Jung(精) into liver and then percolating Jung(精) flow into channel. The channel-Qi(脈氣) flows into lung through channel. As a result, all kinds of channels gather together in lung and Jung(精) is sent into skin and hair. The assembly of Jung(精) with skins and channels moves Qi(氣) into fu-organ and so jung(精) and mental activity(神明) in fu-organ(府) come to be in four organs(四臟). Then if Qi(氣) comes back to power balance unit(權衡) being in the state of equilibrium(權衡以平), the hole of Qi(氣口) comes to determine the matter of life and death through achieving Chun-quan-chi(-寸-關-尺). The above mentioned phrases means the digestion, asorption and transmission of food. When food is taken in stomach, Jung-Qi(精氣) comes to be over flowed upward into spleen, back into lung, finally downward into bladders through water-conduit(水道) controlled by lung. When water- Jung(水精) radiates into whole body with channels of five organs(五臟), both of them fit together with and yin-yang(陰-陽). Therefore, the grasping of the rise and decline of yin-yang(陰C-陽) is necessary to consult patients. The above mentioned phrases is properly viewed to designate the asorption, transmission and excretion of food. 5. Spleen controls flesh(脾之合肉也), the state of spleen is known by human lips, and what this means is that liver plays functions of spread and expansion(肝主疏泄). 6. The phrase 'Jung Jung'((中精)) in 'gallbladder dominates Jung jung(膽主中精)', which in one of the specific expression of 'liver plays functions of spread and expansion(肝主疏泄). 7. It is right that the phase 'The eleven organs in all are determined by gallbladder'(凡十,一臟取決於膽也) is correctly paraphrased as 'only one of ten organs, spleen, is determined by gallbladder'.(凡十,一臟取決於膽也), 8. The small intestine is an organ. which receives the materials digested and sends them out. This means that the function of transforming materials(化物) factually refers to that of separating clearity and blur(泌別淸濁). And it is also thought to have the function of ascending clearity and descending blur(升淸降濁), 9. A large intestine is a transmitting organ(傳導之官) from which a change comes out(變化出焉). the phrase 'change'(變化) in this sentence means both the intake of water and nutrition and the formation procedure of stool through excretion of mucocele.

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삼량진 칼데라 지역의 항공자력특성 연구 (Aeromagnetic Characteristics of the Samryangjin Caldera Area)

  • 구성본;이태섭;박영수
    • 지구물리와물리탐사
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    • 제1권2호
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    • pp.101-109
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    • 1998
  • 항공자력탐사자료를 이용하여 경상분지 동남부 유천소분지의 화산암류 분포지 내에 발달되는 삼량진 칼데라지역에 대한 자력특성을 고찰하였다. 연구방법은 자력탐사 자료를 이용하여 잔여자력도, 자극화변환도, 수평미분도와 수직 2차미분도를 작성하여 자력 암상특성을 분대하고 칼데라구조 및 단층과 관련된 지질구조적 양상에 대한 자력구조 특성을 고찰하는 정성적 해석을 실시하였다. 또한 칼데라 구조를 북동-남서방향으로 종단하는 14.5 km의 단면선에 대해 forward modelling을 실시함과 동시에 전지역에 3-D Euler deconvolution방법을 이용하여 자력 이상체의 심부 발달상태 및 특성을 고찰하는 정량적 해석을 실시하였다. 이들 결과에 의하면 본역의 자력암상특성은 4개의 unit로 분대되며 이들은 일반적으로 본역의 지질분포와 잘 일치되나 삼량진 칼데라 북측 경계부에 관입한 흑운모화강암은 고자력을 보이므로 인접의 여타 저자력 흑운모 화강암체와 자력암상특성에서 분명한 차이를 보인다. 따라서 이 흑운모화강암은 삼량진 칼데라의 화산작용과 밀접한 관계가 있으며 칼데라림을 따라 발달된 구조대를 따라 관입한 것으로 해석된다. 본역의 삼량진 칼데라 구조 및 단층선 구조는 각종 자력 이상도에서 분명한 자력구조로 인지가 가능하며 지형특성도 이들 구조를 잘 반영한다 할 수 있다. 본 역의 심부 자력 이상체 발달상태를 규명하기 위한 자력단면선의 forward modelling결과, 경상퇴적분지의 심도는 칼데라 내에서 평균 약 6 km이며(최고 약 10 km) 칼데라의 외측으로 갈수록 화강암류의 천부 관입에 따라 심도가 얕아짐을 보인다. Euler deconvolution 방법을 이용한 자력이상체의 3차원적 위치 및 심도특성을 고찰한 결과도 칼데라 구조 및 단층구조선을 잘 나타내며 화산암류와 관계된 비교적 천부의 자력 이상체는 주로 동-서와 북동방향으로 발달하고 있음에 반하여 심부의 자력 이상체는 주로 북서 방향으로 발달하고 있음을 알 수 있었다.

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Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

  • Kim, Mi-Ae;Kim, Dong-Kyu;Yang, Hyeon-Jong;Yoo, Young;Ahn, Youngmin;Park, Hae-Sim;Lee, Hyun Jong;Jeong, Yi Yeong;Kim, Bong-Seong;Bae, Woo Yong;Jang, An-Soo;Park, Yang;Koh, Young-Il;Lee, Jaechun;Lim, Dae Hyun;Kim, Jeong Hee;Lee, Sang Min;Kim, Yong Min;Jun, Young Joon;Kim, Hyo Yeol;Kim, Yunsun;Choi, Jeong-Hee;Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology
    • Allergy, Asthma & Immunology Research
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    • 제10권6호
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    • pp.648-661
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    • 2018
  • Purpose: Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea. Methods: Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE. Results: A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS. Conclusions: This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

단일 수복물과 3본 고정성 수복물 지대치 모델에서 삼차원 분석을 통한 구강 스캐너의 정확도 비교 (Comparison of the accuracy of intraoral scanner by three-dimensional analysis in single and 3-unit bridge abutment model: In vitro study)

  • 황미양;손큰바다;이완선;이규복
    • 대한치과보철학회지
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    • 제57권2호
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    • pp.102-109
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    • 2019
  • 목적: 이 연구의 목적은 단일 수복물 지대치와 3본 고정성 수복물 지대치 모델에서 3종류의 구강 스캐너에 따른 정확도를 평가하는 것이다. 재료 및 방법: 본 연구에서는 단일 수복물 지대치와 제1대구치가 상실된 3본 고정성 수복물 지대치를 제작하고, 이를 주모형으로 설정하였다. 제작된 주 모형은 산업용 삼차원 스캐너로 스캔하였고, 이를 참조 스캔 데이터로 설정하였다. 3종류의 구강 스캐너(CS3600, CS3500, 그리고 EZIS PO)를 이용하여 주 모형을 5회 스캔 하였다. 이를 평가 스캔 데이터로 설정하였다. 삼차원 비교분석(Geomagic control X)에서 지대치의 스캔 정확도를 평가하기 위해 분할된 지대치를 선택하여 분석하였다. 통계분석은 SPSS 소프트웨어를 이용하여 분석하였다 (${\alpha}=.05$). 구강 스캐너 정확도는 kruskal-wallis test를 실시하여 비교하였고, pairwise test로 사후 검정을 실시하였다. 단일 수복물 지대치 모델과 3본 고정성 수복물 지대치 모델의 정확도 차이는 mann-whitney U test로 분석하였다. 결과: 구강 스캐너에 따른 정확도의 측정결과는 모두 유의한 차이를 보였다 (P < .05). 그리고 단일 수복물 지대치 모델과 3본 고정성 수복물 지대치 모델의 진도(trueness)는 통계적으로 유의한 차이를 보여주었으며, 단일 수복물 지대치에서 더 좋은 진도를 나타냈다 (P < .05). 정밀도(precision)에서는 유의미한 차이가 없었다 (P = .616). 결론: 단일 수복물과 3본 고정성 수복물 지대치의 정확도를 비교한 결과, 스캔 영역이 늘어날수록 지대치 스캔의 오류는 증가하였고, 3종류의 구강 스캐너에서 3본 고정성 수복물 지대치 모델의 스캔 정확도는 임상적으로 허용 가능하다.

도항리목관묘(道項里木棺墓) 안사국(安邪國) (A Study of Dohang-Ri wooden coffin and Anya-Kuk)

  • 이주헌
    • 헤리티지:역사와 과학
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    • 제37권
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    • pp.5-37
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    • 2004
  • 삼한시대(三韓時代)의 성격과 성립시기(成立時期)에 대하여서는 다양한 견해가 제시되어 있는 상황이나 모두 나름대로의 한계를 가지고 있다고 볼 수 있다. 문헌자료의 기록과 고고자료상에서 서로 공통적으로 관련지어 볼 수 있는 것은 모두 전국시대(戰國時代)의 철기문화(鐵器文化)를 근간으로 하고 있다는 점이며, 연(燕)의 철기문화(鐵器文化)를 갖춘 위만조선(衛滿朝鮮)의 성립은 근본적으로 한반도 북부지역 뿐 만 아니라 중 남부지역에 이르기까지 큰 파장을 미쳤던 것으로 볼 수 있다. 철기문화(鐵器文化)의 도입단계에는 철기(鐵器)의 실용적이고 희소적인 가치에 의해서 매장유구(埋葬遺構)에는 쉽게 부장되지 않았을 것으로 보이나 기원전 2세기 전반경부터는 일부 한정된 철기(鐵器)만이 매장유구(埋葬遺構)에 부장되는 경향이다. 따라서 삼한시대(三韓時代)의 성립시기는 철기의 도입과 보편적인 활용으로 보아야하며 목관(木棺)을 사용한 서북한지방(西北韓地方)의 토광묘문화(土壙墓文化)를 포함하여 중남부지역(中南部地域)에 있어서 목관(木棺)의 흔적이 확인되고 있는 적석목관묘(積石木棺墓) 단계, 즉 기원전 3세기전반대의 어느 시점으로 파악되어야 한다. 한편 함안(咸安) 도항리고분군(道項里古墳群)에서 확인된 목관묘(木棺墓)는 목관(木棺)의 형태에 있어서 판재조립식목관(板材組立式木棺)과 통나무목관(木棺)의 2종류가 확인되며, 판재목관(板材木棺)의 사용 비율이 3배 이상 높은 편이다. 출토유물(出土遺物)은 비교적 단순한 조합상(組合相)을 보이고 있는데, 이는 영남지역(嶺南地域)을 중심으로 한 목관묘유적(木棺墓遺蹟)에서도 모두 확인되고 있는 특징이므로 전반적으로 변(弁) 진한사회(辰韓社會)의 매장문화는 동일한 흐름 속에서 전개된 것으로 볼 수 있다. 특히 통나무로 제작한 목관(木棺)은 적석목관묘(積石木棺墓)에서부터 보이기 시작하므로 한국식동검문화(韓國式銅劍文化)와 함께 목관(木棺)의 전통이 이어져 내려온 것으로 생각되며, 다호리유적(茶戶里遺蹟)과 도항리목관묘(道項里木棺墓)에서만 이러한 목관(木棺)의 존재가 확인되고 있는 것은 변한사회내(弁韓社會內)에서 양지역간(兩地域間)의 유기적인 관계를 살피는데 있어서 주목되어야 한다. 도항리목관묘(道項里木棺墓)에서 출토되고 있는 철기류((鐵器類)도 거의 다호리유적(茶戶里遺蹟)의 그것들과 유사한 경향을 보이고 있다. 도항리(道項里) 67호묘(號墓) 출토 주조철부(鑄造鐵斧)는 다호리 1호분에서 출토된 주조철부(鑄造鐵斧)와 같은 지금(地金)의 기능을 했던 것으로 보이며, 소형철부(小形鐵斧)의 구성비율이 다른 철기류에 비해서 월등히 높은 것과 기경구(起耕具)로 이용되는 철제따비의 출토가 거의 없는 것으로 보아 도항리목관묘(道項里木棺墓)단계에는 목제농기구(木製農器具)의 제작과 사용이 활발하였던 것으로 생각된다. 결국 다호리유적(茶戶里遺蹟)에 비해 절대적으로 빈약한 철기유물은 안사국(安邪國)의 내적(內的)인 한계(限界)를 보여주는 것이며 소국(小國) 수장(首長)의 신분적(身分的)인 상징(象徵)으로서 사용하였던 동경(銅鏡)과 의기류(儀器類)의 출토가 전혀 확인되지 않고 있는 것으로 보아 도항리목관묘(道項里木棺墓)를 조영한 집단(集團)은 당시 대외문화교류(對外文化交流)의 중심적인 선진지역(先進地域)에 비해서 사회문화적(社會文化的)인 변동(變動)이 덜한 주변 지역적인 성향이 강한 집단(集團)일 것으로 생각된다. 기원후 2세기 후반경 영남지역의 목관묘(木棺墓)는 목곽묘단계(木槨墓段階)로 변화되었을 것으로 생각되는데, 도항리(道項里)와 다호리유적(茶戶里遺蹟)에서도 목관묘(木棺墓)는 2세기대를 종점(終點)으로 사라진다. 고고자료상으로도 3세기에서 4세기대에 해당되는 적극적인 유구가 확인되지 않고 있으므로 이에 대한 근본적인 해석이 요구된다. 따라서 이러한 현상을 3세기 전반 이후 한반도 남부지역에서 일어났던 포상팔국(浦上八國)의 전쟁과 관련지어 합리적으로 추론하고자 한다. 즉 변한사회내(弁韓社會內)에서 도항리(道項里)와 다호리유적(茶戶里遺蹟)의 양집단(兩集團)은 낙동강(洛東江)과 남강수계(南江水系)를 장악한 교역(交易)의 중심지(中心地)로서 서로 경제적(經濟的) 정치적(政治的)인 공조체제(共助體制)가 형성되었을 것으로 생각된다. 기록에 보이는 포상팔국(浦上八國)의 대상국은 가나(加羅)와 아라국(砑羅國)이며, 가나(加羅)는 다호리집단(茶戶里集團)이 중심을 이루고 있는 것으로 파악된다. 그리고 포상팔국(浦上八國)의 전쟁시기도 기원 3세기 전반대의 상황을 비교적 자세하게 다루고 있는 "삼국지(三國志)" 위서(魏書) 동이전(東夷傳)에 이 전쟁에 대한 언급이 없는 것으로 보아 3세기 전반대 이후의 사건으로 파악될 수 있으며, 4세기 후반에 이르기까지 양지역(兩地域)에서 뚜렷한 목곽묘(木槨墓)의 축조가 이루어지지 않고 있는 점도 두 집단(集團)이 전쟁(戰爭)의 피해를 직접 받은 당사자였음을 암시하는 것으로 생각된다.