• 제목/요약/키워드: Without reference points

검색결과 83건 처리시간 0.018초

하악전돌자에서 3차원영상을 이용한 하악지시상분할골절단술과 관련된 하악골의 해부학적 연구 (MORPHOLOGIC STUDY FOR SAGITTAL SPLIT RAMUS OSTEOTOMY USING 3-D IMAGE IN MANDIBULAR PROGNATHISM)

  • 박충열;국민석;박홍주;오희균
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권4호
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    • pp.350-359
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    • 2005
  • Sagittal split ramus osteotomy(SSRO) has been commonly performed in the mandibular prognathism. The previous studies of the mandibular anatomy for SSRO have mostly been used in dry skull without consideration of age, sex or jaw relationship of patients. This study was performed to evaluate the location of mandibular canal and the anatomy of ramus, such as the location of mandibular lingula and the ramal bone marrow, which were associated with SSRO procedures, in the patients with mandibular prognathism and normal young adults by using computerized tomographs(CT) and 3D images. The young adults at their twenties, who were considered to complete their skeletal growth, and seen in the Department of Orthodontics and Oral and Maxillofacial Surgery in Chonnam National University Hospital between March 2000 and May 2003, were selected. This study was performed in 30 patients (15men, 15women) who were diagnosed as skeletal class I normal relationship, and another 30 patients (15men, 15women) who were diagnosed as skeletal class III relationship upon clinical examination and lateral cephalometric radiographs. The patients were divided into 2 groups : Class I group, the patients who had skeletal class Ⅰ normal relationship(n=30, 15men, 15women), and Class III group, the patients who had skeletal class III relationship(n=30, 15men, 15women). Facial CT was taken in all patients, and pure 3D mandibular model was constructed by V-works version 4.0. The occlusal plane was designed by three points, such as the mesiobuccal cusp of both mandibular 1st molar and the incisal edge of the right mandibular central incisor, and used as a reference plane. Distances between the tip of mandibular lingula and the occlusal plane, the sigmoid notch, the anterior and the posterior borders of ramus were measured. The height of ramal bone marrow from the occlusal plane and the distance between mid-point of mandibular canal and the buccal or lingual cortex of the mandible in the 1st and 2nd molars were measured by V-works version 4.0. Distance(Li-OP) between the occlusal plane and the tip of mandibular lingula of Class III Group was longer than that of Class I Group in men(p<0.01), but there was no significant difference in women between both groups. Distance(Li-SN) between the sigmoid notch and the tip of mandibular ligula of Class III group was longer than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(Li-RA) between the anterior border of ramus and the tip of mandibular lingula of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Distance(Li-RP) between the posterior border of ramus and the tip of mandibular lingula of Class III Group was slightly shorter than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(RA-RP) between the anterior and the posterior borders of ramus of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Longer the distance(SN-AN) between the sigmoid notch and the antegonial notch was, longer the vertical ramal length above occlusal plane, higher the location of mandibular lingula, and shorter the antero-posterior ramal length were observed(p<0.01). Height of ramal bone marrow of Class III Group was higher than that of Class I Group in men and women(p<0.01). Distance between mandibular canal and buccal cortex of Class III Group in 1st and 2nd lower molars was shorter than that of Class I Group in men and women (p<0.05 in 1st lower molar in men, p<0.01 in others). These results indicate that there are some anatomical differences between the normal occlusal patients and the mandibular prognathic patients, such as the anterior-posterior length of ramus, the height of ramal bone marrow, and the location of mandibular canal.

일제강점기 강화 보문사 마애관음보살좌상 연구 (A Study of the Japanese Colonial Era Rock-Carved Seated Avalokiteśvara Statue at Ganghwa Bomunsa Temple)

  • 이주민
    • 헤리티지:역사와 과학
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    • 제53권3호
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    • pp.62-79
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    • 2020
  • 강화 보문사 마애관음보살좌상은 일제강점기였던 1928년에 조성된 거대한 규모의 마애불상으로 한국 근대 불교 조각사에서 중요한 위치를 차지하는 기년명 불상임에도 불구하고 그동안 근대 불교 조각에 대한 연구 부진으로 심도 있는 논의가 이루어지지 못하였다. 본고에서는 보문사 마애관음보살좌상이 근대기 불상으로서 갖는 의미를 다양한 측면에서 살펴보기 위해 마애불 주변에 있는 명문을 판독하여 조성 연대와 제작자 및 후원자를 확인하였으며, 바위의 형태와 지형이 불상의 조형성에 어떤 영향을 끼쳤는지 알아보기 위해 제작자와 참배객의 시점(視點)을 비교 분석하였다. 또한 제작자 후손들과의 인터뷰를 통하여 불상 조성 당시의 구체적 정황을 파악해 보았다. 보문사 마애관음보살좌상의 제작에는 금강산 승려 이화응(李華應)이 화주(化主)겸 화사(畫師)를 맡았고, 불상 조성이 시작되는 1928년에는 100여 명이 넘는 시주자가 공동으로 후원하였으며, 1937년 참배공간을 확장할 때는 간송 전형필(澗松 全鎣弼)이 단독 후원하였다. 이 마애불 조성을 계기로 강화 보문사는 양양 낙산사, 남해 보리암과 더불어 우리 나라 3대 관음 도량으로 손꼽히게 되었다. 불상의 제작 기간은 약 3개월이 소요되었으며 초(草)는 화주를 맡았던 이화응이 그리고 조각은 운송학(雲松學) 등 다섯 명의 강화 지역 석수가 참여하였는데, 화승이 그린 초를 바탕으로 조각이 이루어졌기 때문에 마애불 곳곳에서 선묘적 기법이 발견된다. 화사로서 이화응의 면모가 밝혀짐에 따라 석옹철유(石翁喆有)-화응형진(華應亨眞)-일옹혜각(一翁慧覺)으로 이어지는 화맥의 단초를 확인할 수 있게 되었다. 보문사 마애관음보살좌상은 보관을 쓰고 정병을 든 전형적인 관음보살로 방형의 큰 얼굴에 목이 짧고 전체적으로 투박하여 경직된 인상을 준다. 제작자는 높이 10m에 40°가량 기울어져 있는 바위에 마애불을 왜곡 없이 보이기 위해 최대한 동작을 절제하고 대칭성을 강조하여 세부 표현을 생략하였고, 머리와 신체 비례는 1:1에 가깝게 조정하여 시각적 왜곡 문제를 해결하였다. 특히, 본고에서는 보문사 마애관음보살좌상처럼 별도의 불단을 만들지 않는 '불상과 불단의 일체화'된 형식을 근대기 불교 조각의 특징으로 상정하였다. 그 외에 광배에 새겨진 6글자의 범자(梵字)를 그동안 육자대명왕진언(六字大明王眞言)으로 해석했으나, 정법계진언(淨法界眞言)과 사방진언(四方眞言)이 조합된 것임을 새롭게 밝혔다. 아울러 처마 바위에 박혀 있는 3개의 쇠고리는 제작 과정에서 다림추를 달아 초를 그릴 때 기준점으로 활용하였고, 이후에는 고리에 풍탁을 달아 보살상을 장엄하는 용도로 사용한 것을 확인하였다.

한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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