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Comparison of Gas Exchange Parameters between Same Volume of $N_2-O_2$ and Heliox Inhalation (동일한 상시 호흡량의 $N_2-O_2$ 및 Heliox 투여 시 가스교환지표의 비교)

  • Sohn, Jang-Won;Lim, Chae-Man;Koh, Youn-Suck;Lee, Jong-Deog;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.169-175
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    • 1998
  • Background: Heliox is known to decrease $PaCO_2$ in patients with increased airway resistance by increasing minute ventilation and reducing work of breathing(WOB). Besides these effect, heliox is expected to decrease functional anatomic dead space owing to improvement of peak expiratory flow rate(PEFR) and enhancement of gas distribution. We investigated whether heliox can decrease $PaCO_2$ even at the same minute ventilation (VE) and WOB with $N_2-O_2$ to speculate the effect of the heliox on the anatomic dead space. Material and Method: The subjects were 8 mechanically ventilated patients with asthma or upper airway obstruction(M : F=5 : 3, $68{\pm}10$years) who were under neuromuscular paralysis. The study was consisted of three 15-minutes phases: basal $N_2-O_2$ heliox and washout Heliox was administered via the low pressure inlet of servo 900C, and respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). To obtain the same tidal volume(Vt) in heliox phase, the Vt on monitor was adjusted by the factor of relative flow rate of heliox to $N_2-O_2$. Dead space was calculated by Bohr equation. Results: 1) Vt, VE, peak inspiratory pressure(PIP) and peak inspiratory flow rate(PIFR) were not different between $N_2-O_2$ and heliox. 2) PEFR was higher on heliox($0.52{\pm}0.19$L/sec) than $N_2-O_2$($0.44{\pm}0.13$L/sec)(p=0.024). 3) $PaCO_2$(mmHg) were decreased with heliox($56.1{\pm}14.1$) compared to $N_2-O_2$($60.5{\pm}15.9$)(p=0.027). 4) Dead space ventilation(%) were decreased with heliox($73{\pm}9$ with $N_2-O_2$ and $71{\pm}10$ with heliox)(p=0.026). Conclusion: Heliox decreased $PaCO_2$ even at the same VE and WOB with $N_2-O_2$, and the effect was considered to be related with the reduction of anatomic dead space.

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Diurnal Changes of Leaf Water Potential in Cuttings (삽수(挿穗)의 Leaf Water Potential의 변화(變化))

  • Hong, Sung Cheon
    • Journal of Korean Society of Forest Science
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    • v.38 no.1
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    • pp.27-32
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    • 1978
  • The diurnal pattern of leaf water potential in cuttings by Dye Method was as follows: 1. Diurnal pattern of leaf water potential (${\psi}_l$) in Viburnum Awabuki K. Koch and Daphne odora Thunb. was shown the pattern of the curves without mutual relation with soil classes when soil water potential (${\psi}_s$) was 0 bar. When ${\psi}_s$ was above -0.01 bar, the cuttings in the loamy sand (L.S.) was shown by the maximum values than that in sandy clay (S.C.) by about -1 bar gap (Fig. 1). 2. The diurnal changes of ${\psi}_l$ was shown the most high from two to eight O'clock in the morning, the maximum value was -3 bars when ${\psi}_s$ was above -0.01 to -0.02 bar, and was -4 bars below -0.03 bar. The diurnal the lowest values of ${\psi}_l$ showed -20 to -22 bars from one to two O'clock in the afternoon. In the fifteenth day after cutting V.A., the staying time in the diurnal maximum values of ${\psi}_l$ is about half in comparison with it in the fifth day. The curves of recovery of water stress (Fig. 1), the former reached to the diurnal maximum values -1 to -2 bars lately every hours comparing with it of the latter. The general diurnal pattern of ${\psi}_l$ was most clearly related to change with air temperature and the relative humitidy. 3. Comparing the treatment block by IAA 50 ppm with controlled block in fifteenth day after V.A. cuttings, in case of treatment reached to maximum values -2 to -3 bars lately as shown Fig. 2., and also staying times was only half in comparison with controlled block. 4. The cuttings 4 leafs was much rootings than 2 leafs in V.A. (Table. 1), and the former reached maximum value -2 to -3 bars lately every hours comparing with the latter. 5. In case of Buxus microphylla var. Koreana as shown Fig. 3., comparing the pattern curves of in the cuttings 8 leafs with 4 leafs, the former reached to maximum values -2 to -3 bars lately in comparison with the latter, but reffering to the amount of rooting (Table. 2), the former is less than the latter.

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Learning Material Bookmarking Service based on Collective Intelligence (집단지성 기반 학습자료 북마킹 서비스 시스템)

  • Jang, Jincheul;Jung, Sukhwan;Lee, Seulki;Jung, Chihoon;Yoon, Wan Chul;Yi, Mun Yong
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.179-192
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    • 2014
  • Keeping in line with the recent changes in the information technology environment, the online learning environment that supports multiple users' participation such as MOOC (Massive Open Online Courses) has become important. One of the largest professional associations in Information Technology, IEEE Computer Society, announced that "Supporting New Learning Styles" is a crucial trend in 2014. Popular MOOC services, CourseRa and edX, have continued to build active learning environment with a large number of lectures accessible anywhere using smart devices, and have been used by an increasing number of users. In addition, collaborative web services (e.g., blogs and Wikipedia) also support the creation of various user-uploaded learning materials, resulting in a vast amount of new lectures and learning materials being created every day in the online space. However, it is difficult for an online educational system to keep a learner' motivation as learning occurs remotely, with limited capability to share knowledge among the learners. Thus, it is essential to understand which materials are needed for each learner and how to motivate learners to actively participate in online learning system. To overcome these issues, leveraging the constructivism theory and collective intelligence, we have developed a social bookmarking system called WeStudy, which supports learning material sharing among the users and provides personalized learning material recommendations. Constructivism theory argues that knowledge is being constructed while learners interact with the world. Collective intelligence can be separated into two types: (1) collaborative collective intelligence, which can be built on the basis of direct collaboration among the participants (e.g., Wikipedia), and (2) integrative collective intelligence, which produces new forms of knowledge by combining independent and distributed information through highly advanced technologies and algorithms (e.g., Google PageRank, Recommender systems). Recommender system, one of the examples of integrative collective intelligence, is to utilize online activities of the users and recommend what users may be interested in. Our system included both collaborative collective intelligence functions and integrative collective intelligence functions. We analyzed well-known Web services based on collective intelligence such as Wikipedia, Slideshare, and Videolectures to identify main design factors that support collective intelligence. Based on this analysis, in addition to sharing online resources through social bookmarking, we selected three essential functions for our system: 1) multimodal visualization of learning materials through two forms (e.g., list and graph), 2) personalized recommendation of learning materials, and 3) explicit designation of learners of their interest. After developing web-based WeStudy system, we conducted usability testing through the heuristic evaluation method that included seven heuristic indices: features and functionality, cognitive page, navigation, search and filtering, control and feedback, forms, context and text. We recruited 10 experts who majored in Human Computer Interaction and worked in the same field, and requested both quantitative and qualitative evaluation of the system. The evaluation results show that, relative to the other functions evaluated, the list/graph page produced higher scores on all indices except for contexts & text. In case of contexts & text, learning material page produced the best score, compared with the other functions. In general, the explicit designation of learners of their interests, one of the distinctive functions, received lower scores on all usability indices because of its unfamiliar functionality to the users. In summary, the evaluation results show that our system has achieved high usability with good performance with some minor issues, which need to be fully addressed before the public release of the system to large-scale users. The study findings provide practical guidelines for the design and development of various systems that utilize collective intelligence.

ITS2 DNA Sequence Analysis for Eight Species of Delphacid Planthoppers and a Loop-mediated Isothermal Amplification Method for the Brown Planthopper-specific Detection (멸구과 8종의 ITS2 DNA 염기서열 비교 분석과 고리매개등온증폭법(LAMP)을 이용한 벼멸구 특이 진단법)

  • Seo, Bo Yoon;Park, Chang Gyu;Koh, Young-Ho;Jung, Jin Kyo;Cho, Jumrae;Kang, Chanyeong
    • Korean journal of applied entomology
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    • v.56 no.4
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    • pp.377-385
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    • 2017
  • Estimates of evolutionary sequence divergence and inference of a phylogenetic tree for eight delphacid planthopper species were based on the full-length nucleotide sequence of the internal transcribed spacer 2 (ITS2) region. Size of the ITS2 DNA sequence varied from 550 bp in Sogatella furcifera to 699 bp in Nilaparvata muiri. Nucleotide sequence distance ($d{\pm}S.E.$) was lowest between N. muiri and N. bakeri ($0.001{\pm}0.001$), and highest between Ecdelphax cervina and Stenocranus matsumurai ($0.579{\pm}0.021$). Sequence distance between N. lugens and other planthoppers ranged from $0.056{\pm}0.008$ (N. muiri) to $0.548{\pm}0.021$ (S. matsumurai). In the neighbor-joining phylogenetic tree, all planthoppers were clustered separately into a species group, except N. muiri and N. bakeri. The ITS2 nucleotide sequence of N. lugens was used to design four loop-mediated isothermal amplification (LAMP) primer sets (BPH-38, BPH-38-1, BPH-207, and BPH-92) for N. lugens species-specific detection. After the LAMP reaction of three rice planthoppers, N. lugens, S. furcifera, and Laodelphax striatellus, with the four LAMP primer sets for 60 min at $65^{\circ}C$, LAMP products were observed in the genomic DNA of N. lugens only. In the BPH-92 LAMP primer set, the fluorescence relative to that of the negative control differed according to the amount of DNA (0.1 ng, 10 ng, and 100 ng) and incubation duration (20 min, 30 min, 40 min, and 60 min). At $65^{\circ}C$ incubation, the difference was clearly observed after 40 min with 10 ng and100 ng, but with a 60-min incubation period, the minimum DNA needed was 0.1 ng. However, there was little difference in fluorescence among all DNA amounts tested with 20 or 30 min incubations.

The Effect of Cutting Positions and Temperature on the Rooting of Bitter Gourd (여주 삽목 시 삽수절단 위치와 온도조건이 발근에 미치는 영향)

  • Lee, Hee Ju;Lee, Sang Gyu;Kim, Sung Kyeom;Choi, Chang Sun;Kim, Sang Beom
    • Journal of Bio-Environment Control
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    • v.25 no.3
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    • pp.162-167
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    • 2016
  • This study was carried out to investigate proper stem cutting position and air temperature to regenerate roots from cuttings of bitter gourd. 'NS454' (NS) and 'Dragon' (DR) cultivars were tested and the cutting position was cut at the 3rd node in the stem (treatment I) and cut at the central part (stem segment) between 3rd leaf and 4th leaf in the stem (treatment II). The air temperature was maintained at 18, 23, 28 and $35^{\circ}C$ in the growth chambers, respectively. The photosynthetic photon flux at the ground of a chamber was maintained in approximately $150-200{\mu}mol\;m^{-2}s^{-1}$ during the 16-hour photoperiod. The relative humidity in the chambers was maintained over 85%. After 10 days of cuttings, regardless of cutting position, DR and NS cultivars showed 100% the survival rate in the $18^{\circ}C$ or $23^{\circ}C$ treatments, however, most of plants $18^{\circ}C$ treatment had not rooting. In the $28^{\circ}C$ treatment, regardless of cutting position, DR and NS cultivars showed 100% of the rooting rate. In the $23^{\circ}C$ treatment, for DR cultivar, the node cutting showed 90% of rooting rate and the stem segment cutting showed 40% rooting rate. For NS cultivar, the node cutting showed 50% of rooting rate and the stem segment cutting showed 40% rooting rate. DR and NS cultivars have high rooting rate, while the rooting rate remarkably decreased in the $35^{\circ}C$ treatment. For DR cultivar, the stem segment cutting showed 5.3 of the highest rooting number and the node cutting showed 2.7 rooting number in the $28^{\circ}C$ treatment. NS cultivar was not significantly different the rooting regardless of cutting position. The results suggested that cutting at the stem segment cutting of bitter gourd is an effective cutting method for increasing survival rate and the air temperature should be maintained at $28^{\circ}C$.

Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2013 (설비공학 분야의 최근 연구 동향 : 2013년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.26 no.12
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    • pp.605-619
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    • 2014
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2013. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering have been reviewed as groups of fluid machinery, pipes and relative parts including orifices, dampers and ducts, fuel cells and power plants, cooling and air-conditioning, heat and mass transfer, two phase flow, and the flow around buildings and structures. Research issues dealing with home appliances, flows around buildings, nuclear power plant, and manufacturing processes are newly added in thermal and fluid engineering research area. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the results for general analytical model for desiccant wheels, the effects of water absorption on the thermal conductivity of insulation materials, thermal properties of Octadecane/xGnP shape-stabilized phase change materials and $CO_2$ and $CO_2$-Hydrate mixture, effect of ground source heat pump system, the heat flux meter location for the performance test of a refrigerator vacuum insulation panel, a parallel flow evaporator for a heat pump dryer, the condensation risk assessment of vacuum multi-layer glass and triple glass, optimization of a forced convection type PCM refrigeration module, surface temperature sensor using fluorescent nanoporous thin film. In the area of pool boiling and condensing heat transfer, researches on ammonia inside horizontal smooth small tube, R1234yf on various enhanced surfaces, HFC32/HFC152a on a plain surface, spray cooling up to critical heat flux on a low-fin enhanced surface were actively carried out. In the area of industrial heat exchangers, researches on a fin tube type adsorber, the mass-transfer kinetics of a fin-tube-type adsorption bed, fin-and-tube heat exchangers having sine wave fins and oval tubes, louvered fin heat exchanger were performed. (3) In the field of refrigeration, studies are categorized into three groups namely refrigeration cycle, refrigerant and modeling and control. In the category of refrigeration cycle, studies were focused on the enhancement or optimization of experimental or commercial systems including a R410a VRF(Various Refrigerant Flow) heat pump, a R134a 2-stage screw heat pump and a R134a double-heat source automotive air-conditioner system. In the category of refrigerant, studies were carried out for the application of alternative refrigerants or refrigeration technologies including $CO_2$ water heaters, a R1234yf automotive air-conditioner, a R436b water cooler and a thermoelectric refrigerator. In the category of modeling and control, theoretical and experimental studies were carried out to predict the performance of various thermal and control systems including the long-term energy analysis of a geo-thermal heat pump system coupled to cast-in-place energy piles, the dynamic simulation of a water heater-coupled hybrid heat pump and the numerical simulation of an integral optimum regulating controller for a system heat pump. (4) In building mechanical system research fields, twenty one studies were conducted to achieve effective design of the mechanical systems, and also to maximize the energy efficiency of buildings. The topics of the studies included heating and cooling, HVAC system, ventilation, and renewable energies in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment is mostly focused on indoor environment and building energy. The main researches of indoor environment are related to infiltration, ventilation, leak flow and airtightness performance in residential building. The subjects of building energy are worked on energy saving, operation method and optimum operation of building energy systems. The remained studies are related to the special facility such as cleanroom, internet data center and biosafety laboratory. water supply and drain system, defining standard input variables of BIM (Building Information Modeling) for facility management system, estimating capability and providing operation guidelines of subway station as shelter for refuge and evaluation of pollutant emissions from furniture-like products.

A Study on Gradual Attitudes Change College of Nursing Students (간호대학생의 학년별 태도 변화에 관한 연구)

  • 한정석
    • Journal of Korean Academy of Nursing
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    • v.3 no.2
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    • pp.121-132
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    • 1973
  • Introduction : Nursing as a profession is gelling wide acceptance today, especially among independent -minded women with necessary physical, mental and academic qualifications. This is particularly true of "comprehensive nursing", which requires to total dedication on the part if the nurse herself-physical, mental and sociocultural. Such comprehensive approach is like-wise called for in the institutional training of professional nurses. Undergraduate nursing courses nowadays place an increasing emphasis on the microscopic approach of training a nurse as an intelligent and well-balanced human being with an optimum degree of cultural sophistication. Greater attention then ever before is now paid to close observation of the individual traits and aptitude of nursing students, so as to permit full development of individual capabilities, interests and propensities within the concept of "comprehensive human education. " Purpose of study 1. To determine the degree of understanding of the part of nursing students of the various aspects of the subject taught in undergraduate nursing course. 2. To determine the motivation of nursing students in choosing the profession and possible subsequent change or attitude and outlook in the course of under graduated studies, as a means of presenting a new practical approach in nursing training based on the concept of "comprehensive human education. " Problems of study 1. The environments of nursing training will impinge on individual nursing students with different psychological impacts from lower to upper classes of under graduated studies. 2. Educational environments will have varying psychological impacts on students: a. Difference in religious faith among students. b. Difference in campus environments. c. Difference in domestic (family) circumstances. d. Difference in innate capabilities of students, 3. The understanding and attitude of individual nursing students towards the science of nursing will Have a close correlation with their respective motivations in choosing-nursing as a profession, and will also be closely influenced by the peculiarities of the subject taught, tile campus environments, etc, Delimitations of the study 1. Two universities offering 4-year nursing courses were selected. Due to the limited number of potential subjects, the optimum conditions of sample collection could not be fulfilled. 2. Subjects were confined to two classes in each university (sophomores and seniors) but without regard to the ages or scholastic achievements of individual students. 3. The conclusions derived from this study should be limited in application to the subject groups covered by the present study: they should not in any event be extended or applied to other groups. Procedures 1. Subjects: 40 nursing students each from the sophomore and senior classes of the "Y" and "K" universities situated in Seoul, aggregating 160 students altogether. 2. Instruments: Use has been made of questionnaires on (1) family backgrounds and (2) general information concerning. 3. Statistical Method: The findings of the present survey have been subjected to critical analysis as to the means, percentages, Cgi squares (X), standard deviations and the significance of the difference in means. Findings 1. Nursing students have chosen their subject of study with a confident outlook towards their future in society. 2. Horsing students have the necessary abilities to complete the prescribed courses of study. 3. The campus life of nursing students has been judged as very constructive, not with-standing certain in adequacies in the available educational facilities and the shortages of teaching staff. 4. The achievement levels of nursing trainees varied greatly according to their respective educational environments as well as their school years. 5. Clear and definite distinctions were discernible between the two universities as regards certain aspects of this survey, while no signifiant difference was observed in other: a. Sophomores and seniors in both universities gave nearly identical answers to questions concerning (1) motivation in choosing nursing as a profession, and (2) the way of spending leisure hours. b. Both universities revealed similar respective differences between sophomores and seniors as regards the abilities of fulfilling academic requirements ill the basic subjects. c. Educational environments have been found to be somewhat superior in the "Y"university to those of the "K" university, particularly as regard general campus and dormitory conditions. d. The high degree of dissatisfaction with the faculty, found in both universities, was considered to be a consequence of the universal phenomenon of "brain drain" and the relative neglect of the "comprehensive approach"in education.

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The Effect of K-IFRS Adoption on Goodwill Impariment Timeliness (K-IFRS 도입이 영업권손상차손 인식의 적시성에 미친 영향)

  • Baek, Jeong-Han;Choi, Jong-Seo
    • Management & Information Systems Review
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    • v.35 no.1
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    • pp.51-68
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    • 2016
  • In this paper, we aim to analyze the effect of accounting policy change subsequent to the adoption of K-IFRS in Korea, whereby the firms are required to recognize impairment losses on goodwill on a periodic basis rather than to amortize over a specific period. As a principle-based accounting standard, the K-IFRS expands the scope of fair value measurement with a view to enhance the relevance and timeliness of accounting information. In the same vein, intangibles with indefinite useful life, of which goodwill is an example, are subject to regulatory impairment tests at least once a year. Related literature on the impact of mandatory change in goodwill policy document that impairment recognition is more likely to be practiced opportunistically, mainly because managers have a greater discretion to conduct the tests under K-IFRS. However, existing literature examined the frequency and/or magnitude of the goodwill impairment before versus after the K-IFRS adoption, failing to notice the impairment symptoms at individual firm level. Borrowing the definition of impairment symptoms suggested by Ramanna and Watts(2012), this study performs a series of tests to determine whether the goodwill impairment recognition achieves the goal of communicating timelier information under the K-IFRS regime. Using 947 firm-year observations from domestic companies listed in KRX and KOSDAQ markets from 2008 to 2011, we document overall delays in recognizing impairment losses on goodwill after the adoption of K-IFRS relative to prior period, based on logistic and OLS regression analyses. The results are qualitatively similar in robustness tests, which use alternative proxy for goodwill impairment symptom. Afore-mentioned results indicate that managers are likely to take advantage of the increased discretion to recognize the impairment losses on goodwill rather than to provide timelier information on impairment, inconsistent with the goal of regulatory authority, which is in line with the improvement of timeliness and relevance of accounting information in conjunction with the full implementation of K-IFRS. This study contributes to the extant literature on goodwill impairment from a methodological viewpoint. We believe that the method employed in this paper potentially diminishes the bias inherent in researches relying on ex post impairment recognition, by conducting tests based on ex ante impairment symptoms, which allows direct examination of the timeliness changes between before and after K-IFRS adoption.

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Immunocytochemical Study on the Change of the Activated T Cells in Peripheral Blood of the Pulmonary Tuberculosis Patients (폐결핵환자의 말초혈액에서 Activated T Cell의 변화)

  • Ryu, Gyeong-Ryeol;Park, Une-Sook;Park, Chong-Hwa;Jeoung, Pan-Joon;Hwang, Young-Sil;Lee, Yang-Jae;Chang, Ga-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.823-830
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    • 1995
  • Background: It has been found that Helper T cells in the peripheral blood are decreased in the cell mediated immunity in the pulmonary tuberculosis. But it has not been confirmed yet that only decrease in number of cells which has phenotype in the peripheral blood is defined to decrease in cell mediated immunity. The immunocytochemical study was performed to observe the change of the percentage of T-lymphocytes with their subsets and activated T cells in the peripheral blood of pulmonary tuberculosis and to know how many T cells would be activated, relative to resting cells in the peripheral blood. Methods: The peripheral blood obtained from twenty two patients and ten healthy controls were smeared on the gelatin coated slide glass prepared for of mononuclear cells. The double bridge technique of alkaline phosphatase-antialkaline phosphatase(APAAP) method was used. As the primary antibodies, $T_1$(anti-human T cell), $T_4$(anti-human helper/inducer T cells) and $T_8$(anti-human supressor/cytotoxic T cell) antibodies and interleukin-2 receptor (for early activated T cell), very late activation antigen (for activated cytotoxic T cell), T cell lineage specific activation antigen monoclonal actibodies were used. Results: 1) There were significantly decrease in the absolute number of $T_4$(+) cells but significantly increase of $T_8$(+) cells in the peripheral blood of pulmonary tuberculosis (p<0.05). 2) The percentage of $T_4$(+) cells showed significantly decrease in pulmonary tuberculosis but $T_8$(+)cells significantly increase(p<0.05). $T_4(+)/T_8(+)$ ratio showed significantly decrease in the peripheral blood of the pulmonary tuberculosis(p<0.05). 3) There were significantly increase in the absolute number of variable stages of activated T cells in the peripheral blood of the pulmonary tuberculosis(p<0.05). 4) The percentage of IL-2R, VLA-1, TLiSA were 6.45+1.56%, $7.64+1.34^*$, 10.45+1.16% in order which showed significantly increase in the peripheral blood of the pulmonary tuberculosis(p<0.05). Conclusion: We speculate that only a few percentage of T lymphocyte is activated in cell mediated immunity in pulmonary tuberculosis.

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Radiographic change of grafted sinus floor after maxillary sinus floor elevation and placement of dental implant (상악동저 거상술과 임플란트 식립 후 상악동저 변화에 대한 연구)

  • Cho, Sang-Ho;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.345-359
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    • 2006
  • Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p$MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p$ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.