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CAD-CAM을 이용한 RPD 지대치의 retrofit crown 제작 증례 (Fabricating retrofit crowns to an existing removable partial denture by CAD-CAM: a case report)

  • 이혁순;김성아;방주혁;김성용;장희원;이근우;이용상
    • 대한치과보철학회지
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    • 제62권2호
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    • pp.140-145
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    • 2024
  • 가철성 국소의치를 사용하는 환자의 잔존 치아가 우식, 마모, 부식, 파절 등의 이유로 보철 수복이 필요한 경우가 있다. 가철성 국소의치의 구조물과 접촉하는 부분이 많은 지대치의 보철 수복이 필요한 경우, 서베이드 크라운을 제작 후 가철성 국소의치를 새로 제작하는 것이 통상적인 방법이다. 이럴 경우, 환자가 적응하기까지 오랜 시간이 걸리고, 시간적, 경제적 비용이 발생한다. 한편, 손상된 치아 외에 구강 내 다른 부분에서 가철성 국소의치의 지지, 유지 및 안정을 일부분 제공하는 경우 기존 국소의치의 사용은 임상적으로 양호하다. 이 때 기존 국소의치를 유지하면서 해당 치아를 보철 수복한다면, 환자는 불편과 비용을 줄이면서 기존 가철성 국소의치를 사용할 수 있다. 이처럼 국소의치에 맞추어 보철을 제작하는 retrofit crown 제작과정에서 Computer Aided Design-Computer Aided Manufacturing(CAD-CAM)의 발전과 지르코니아의 물리적 성질이 개선되면서 디지털 방식이 적용되고 있다. 본 증례는 하악에서 가철성 국소의치를 사용하는 환자의 지대치가 심하게 마모되어 국소의치에 맞추어 지르코니아 크라운을 제작한 케이스로, 환자와 술자 모두 만족하는 결과를 얻었기에 본 증례를 보고하는 바이다.

원격의료서비스 수용요인의 구조적 관계 실증연구 (Structural Relationships Among Factors to Adoption of Telehealth Service)

  • 김성수;류시원
    • Asia pacific journal of information systems
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    • 제21권3호
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

SVM을 이용한 시스템트레이딩전략의 선택모형 (Selection Model of System Trading Strategies using SVM)

  • 박성철;김선웅;최흥식
    • 지능정보연구
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    • 제20권2호
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    • pp.59-71
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    • 2014
  • KOSPI200 선물 트레이딩을 위해 업계에서는 여러 전략으로 포트폴리오를 구성해서 운용한다. 동일한 전략 모음을 갖고 있더라도 포트폴리오를 어떻게 구성하느냐에 따라 수익은 크게 차이가 난다. 시장 상황에 맞는 전략들로 포트폴리오를 구성하는 것은 오랜 경험과 탁월한 노하우가 있어야하는 어려운 작업이다. 본 논문에서는 SVM을 활용하여 쉽고 빠르게 적절한 전략 포트폴리오를 구성하는 방법을 제시하였다. 본 논문에서 제안한 시스템의 성과는 벤치마킹의 성과와 비교하여 2배 이상의 수익을 내는 것을 확인하였다. 1990.01.03~2011.11.04 동안의 KOSPI200 데이터 중 이전 80%의 데이터로 학습을 하고 최근 20%의 데이터로 성능을 시험하였다. 각 전략별로 선택여부를 판별하는 SVM모델을 만들고 그 결과를 바탕으로 포트폴리오를 구성하였다. 벤치마킹을 위해 KOSPI200 선물을 2계약 매수한 경우의 수익, 시험 시작 직전 30일간 최고 수익을 낸 2개 전략의 수익, 실제 최고 수익을 낸 전략 2개를 보유했을 때의 수익과 비교하였다. 매매 비용을 반영하지 않을 때는 벤치마킹은 132.2~510.37pt의 수익을 냈고, 본 시스템은 1072.36~1140.91pt의 수익을 보여주었다. 그리고 거래비용을 감안하면 벤치마킹은 130.44~502.41pt의 수익을 냈고, 본 시스템은 706.22pt~768.95pt의 수익을 나타내었다. 본 논문은 기계학습을 통한 전략 포트폴리오를 구성하는 방안이 유의미하며 실전에 활용할 수 있음을 보여주었다. 이를 바탕으로 여러 전략과 다양한 시장에 적용해서 안정성을 검증하면 견고한 상용 솔루션으로 발전시킬 수 있을 것이다. 그리고 자금관리 기법을 더 반영한다면 수익을 더욱 크게 향상시킬 수 있을 것이다.

욕창 예방 및 치유를 위한 의료용 로봇 침대 제어 시스템 (The Control System of a Medical Robot Bed for Prevention and Healing of Pressure Ulcer)

  • 이영대;김창영;장창준;김정애;임재영
    • 문화기술의 융합
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    • 제6권3호
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    • pp.353-359
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    • 2020
  • 본 연구에서는 욕창 예방과 치유를 위해 개발된 의료용 로봇 침대의 제어기 구조와 제어 알고리즘에 대해 기술한다. 상용의 기존 욕창 예방 매트리스는 수동으로 동작하고 잔존 최대 체압이 욕창 발생 임계 체압을 넘어서기 때문에 이론적으로는 항상 욕창이 발생할 여지가 있지만, 본 연구에 개발된 시스템은 능동형 전기구동 건반을 사용하여 침대의 건반이 하강하면 체압이 0으로 떨어져서 욕창이 발생하지 않는다. 또한, 침대의 건반이 상승하여 욕창 임계 체압 이상이더라도 지속시간을 욕창 발생 임계시간 이내로 하도록 기구와 제어 알고리즘이 설계되어 있어서 욕창 발생 자체가 일어나지 않으며, 이는 바로 상용화가 가능한 욕창 예방 로봇 침대임을 뜻한다. 침대 건반의 모터는 의료용으로 적합한 BLDC 서보 드라이버를 설계한 모터로 되어있고 전장이 단순하여 쉽게 사용할 수 있도록 설계되었으며, CAN(Car Area Network)방식으로 서로 통신한다. 제작된 시스템은 욕창 예방에 효과적인 새로운 의료용 로봇 침대로 욕창으로 고통받는 많은 환자들에게 제공될 수 있도록 보급할 예정이다.

치과기공사의 분진노출 수준 및 개인보호구 착용 실태 - 대구지역을 중심으로 - (Assessment of dust exposure and personal protective equipment among dental technicians)

  • 박수철;전만중;사공준
    • 대한치과기공학회지
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    • 제33권1호
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    • pp.93-102
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    • 2011
  • Purpose: The study aimed to evaluate working environment for dental technician by measuring dust level, ventilation conditions and the use of personal protective equipment and to provide basic information required to improve working environment and develop health education programs for dental technician. Methods: A total of 240 dental technician who are registered with the Daegu Association of Dental technician and working at 34 dental laboratories participated in the study. And the dust level was measured at 21 different spots in 16 dental laboratories out of 34. Results: Of 34 dental laboratories, 31 (91.2%) were equipped with a ventilator, but the remaining 3 (8.8%) did not have a ventilator. By the number of ventilator, 1 to 3 ventilators were found in 22 dental laboratories (71.0%), 4 to 6 ventilators were in 7 laboratories (22.5%) and more than 7 ventilators in 2 laboratories(6.5%). According to the frequence of changing filters in dust collector, 20 dental laboratories (58.9%) changed filters every four weeks, 10 laboratories (29.4%) changed them every six weeks and 4 laboratories (11.7%) changed them every eight weeks. Of total respondents, 114 (61.3%) said they wore a mask all the time while working, 56 (29.6%) said they frequently wore a mask, 19 (10.1%) said they did not wear a mask. As for the type of masks, 159 (84.1%) used a disposable mask, 25 (13.2%) used a cotton mask and 5 (2.7%) used an anti-dust mask. For dust sat on their outfits while working, 102 (54.0%) shook their uniforms inside workplace to keep dust off the uniforms, 64 (33.9%) did not anything until they wash their uniforms and 23 (12.1%) shook their uniforms outside workplace to keep dust off the uniforms. Of total respondents, 182 (96.3%) had a particle in their eyes while carrying out grinding work. Based on the measurement of floating dust at workplace, 3 dental laboratories showed dust concentration exceeding the minimum level of 10 mg/$m^3$ allowed under the permit for environment. Of those, 1 laboratory had the dust concentration that was more than 1.5 times higher than the minimum level. Dust concentration was higher in laboratories that used a dust collector with 0.5 horse power and changed filters more than 3 weeks ago. Dust comprised of nickel (more than 70%), chrome (9%) and others. The mean chrome concentration was more than twice higher than the minimum permissible level of 0.5 mg/$m^3$. There were two laboratories that showed chrome concentration exceeding the level of 0.4 mg/$m^3$. Like dust concentration, chrome level was higher in laboratories that used a dust collector with 0.5 horse power and changed filters more than 3 weeks ago. There were six laboratories that had nickel concentration exceeding the minimum permissible level of 1 mg/$m^3$. Of those, one laboratory had nickel concentration that was more than three times higher than the minimum permissible level. Nickel concentration was also higher in laboratories that used a dust collector with 0.5 horse power and changed filters more than 3 weeks ago. Conclusion: It is not likely that heavy metal concentrations found in the study constitute respiratory dust. It is however necessary for health of dental technician to apply the Industrial Safety and Healthy Law to dental laboratories and make recommendations for the use of personal protective equipment, installation of a proper number of ventilators, more frequent change of filters in dust collector and improved ventilation for polishing work. At the same time, dental technician need education on how to use personal protective equipment and how to efficiently remove dust from their uniforms.

형질변형성장인자가 손상골 재생능에 미치는 영향에 관한 실험적 연구 (THE EFFECTS OF TGF-$\beta$1 ON THE BONE REGENERATION IN GUINEA PIG MANDIBLE)

  • 이병도;황의환;이상래;홍정표
    • 치과방사선
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    • 제25권2호
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    • pp.423-435
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    • 1995
  • The purpose of this study was to observe the effect of TGF-βl, which promotes differentiation and proliferation of osteoblasts, on bone regeneration. Experimental bone defects that measured 3 mm in diameter were created on the mandibles of guinea pig by removal of bone with the use of trephine burs. In one side of mandibular body, the experimental groups, bone defects were grafted with Biogran(Orthovita Co., U.S.A) and TGF-β1(R&D System Co., U.SA). In the remaining side of the mandiblar body, the control groups, bone defects were grafted with only Biogran. Guinea pigs in the control and experimental groups were serially terminated by fours on the 3 days, the 1 week, the 2 weeks, the 3 weeks, and the 4 weeks after experiment, and both sides of the mandibular bodies were removed and fixed with 10% neutral formalin. They were decalcified and embedded in paraffin as using the usual method. The specimen sectioned and stained with hematoxylin and eosin. Also, they were radiographed with a soft X -ray apparatus. The obtained results were as follows; 1. Hemorrhagic condition, observed in the granulation tissues, disappeared on the 1 week after experiment in both groups, and more prominent in the experimental group. The granulation tissues of the experimental group had larger number of cells than those of the control group. 2. Osteoblastic differentiation in the margin of grafted material and adjacent bone was observed on the 1 week after experiment in both groups. Also, bone formation was observed in immature form on the 1 week after experiment. and more prominent in the experimental group. 3. In the polarizing microscopic examination, bone matrix was very loose on the 1 week after experiment, but increase in density with time, and more prominent in the experimental group. 4. In the microradiographic examination, newly formed bone was observed in the experimental group on the 2 weeks after experiment, and this was observed earlier than in the control group. Newly formed bone was increased with time and defected area was markedly decreased on the 4 weeks after experiment.

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減數分裂, 最近의 進步(I) (Recent Advancement on the Knowledges of Meiotic Division (I))

  • 한창열
    • 식물조직배양학회지
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    • 제25권6호
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    • pp.453-475
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    • 1998
  • During the 100 years since the initial discovery of meiotic phenomenon many brilliant aspects have been elucidated, but further researches based on light microscopy alone as an experimental tool have been found to have some limits and shortcomings. By the use of electron microscopy and armed with the advanced knowledges on modern genetics and biochemistry it has been possible to applu molecular technology in gaining information on the detailed aspects of meiosis. As synapsis takes place, a three-layered proteinous structure called the synatonemal complex starts to form in the space between the homologous chromosomes. To be more precise, it begins to form along the paired chromosomes early in the prophase I of meiotic division. The mechanism that leads to precise point-by-point pairing between homologous chromocomes division. The mechamism that leads to precise point-by-point pairing between homologous chromosomes remains to be ascertained. Several items of information, however, suggest that chromsome alignment leading to synapsis may be mediated somehow by the nuclear membrane. Pachytene bivalents in eukaryotes are firmly attached to the inner niclear membrane at both termini. This attached begins with unpaired leptotene chromosomes that already have developed a lateral element. Once attached, the loptotene chromosomes begin to synapse. A number of different models have been proposed to account for genetic recombination via exchange between DNA strands following their breakage and subsequent reunion in new arrangement. One of the models accounting for molecular recombination leading to chromatid exchange and chiasma formation was first proposed in 1964 by Holliday, and 30 years later still a modified version of his model is favored. Nicks are made by endomuclease at corresponding sites on one strant of each DNA duplex in nonsister chromatid of a bivalent during prophase 1 of meiosis. The nicked strands loop-out and two strands reassociate into an exchanged arrangement, which is sealed by ligase. The remaining intact strand of each duplex is nicked at a site opposite the cross-over, and the exposed ends are digested by exonuclease action. Considerable progress has been made in recent years in the effort to define the molecular and organization features of the centromere region in the yeast chromosome. Centromere core region of the DNA duplex is flanked by 15 densely packed nucleosomes on ons side and by 3 packed nucleosomes on the other side, that is, 2000 bp on one side and 400 400 bp in the other side. All the telomeres of a given species share a common DNA sequence. Two ends of each chromosome are virtually identical. At the end of each chromosome there exist two kinds of DNA sequence" simple telpmeric sequences and telpmere-associated sequencies. Various studies of telomere replication, function, and behabior are now in progress, all greatly aided by molecular methods. During nuclear division in mitosis as well as in meiosis, the nucleili disappear by the time of metaphase and reappear during nuclear reorganizations in telophase. When telophase begins, small nucleoli form at the NOR of each nucleolar-organizing chromosome, enlarge, and fuse to form one or more large nucleoli. Nucleolus is a special structure attached top a specific nucleolar-organizing region located at a specific site of a particular chromosome. The nucleolus is a vertical factory for the synthesis of rRNAs and the assenbly of ribosome subunit precursors.sors.

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명청-근대시기 마카오 "수상인(水上人)"의 취락 및 건축유형 연구 (A Study on the Water-Faring Community and Architectural Forms of the 'Tanka People' in Macau from the Ming and Qing Dynasties to the Modern Period)

  • 홍서영;한동수
    • 건축역사연구
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    • 제32권3호
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    • pp.7-20
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    • 2023
  • The compositions of ethnic groups in Macau vary with time. Prior to the opening of the port, the majority of the residents in Macau were Chinese people, including those living on land and at sea. After the port was opened, with the increase of Portugal businessmen and missionaries, the population was divided into Chinese people and foreigners (so-called 'Yiren' or 夷人 in Chinese). Chinese people living on land were mainly of Hakka, Fujian, and Cantonese descent. Those living at sea were referred to as 'Tanka People' (named 'Danmin' or 蜑民in Chinese). They lived on floating boats for their entire lives and were similar to the 'drifters' in Japan. Since modern times, many refugees from mainland China and Southeast Asia flooded into Macau due to warfare. The development of industrialization required a larger number of laborers, and some 'coolies' entered Macau in legal or illegal ways, making it a multi-ethnic city. However, the Tanka people were not considered a minority ethnic group under the national ethnic policy of 56 ethnic groups since they did not have an exclusive language and shared dialects in different regions. As the ports inhabited by Tanka people gradually restored foreign trade, the boats and stilt houses used by Tanka people were dismantled to expand the infrastructure area of the ports. Many Tanka people began to live on land and marry people on land, leading to the disappearance of the Tanka group in Macau. The fishing boats and stilt houses used by Tanka people have also disappeared, with only a few remaining in areas such as Pearl River Delta and Hong Kong. This paper examines the natural and social environment of Tanka people in Macau from the Ming and Qing dynasties to the Republic of China, as well as the adaptive changes they adopted for the aforementioned environment in terms of living space and architectural type, on the basis of summarizing the historical activities of Tanka people. Finally, this study provides a layout plan and interior structure of the most commonly used boat for Tanka people from the Ming and Qing dynasties to the Republic of China, with the use of CAD and other technical software, along with reference to written historical documentation, and provides a case study for further research on the architectural history of Macau's inner harbor cities, from anthropological and folklore perspectives.

치근면 활택술후 2% minocycline gel의 치료효과 (Effects of 2% minocycline gel as an adjunct to scaling and root planing on the treatment of adult periodontitis)

  • 권영혁;박지원;허익;박준봉
    • Journal of Periodontal and Implant Science
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    • 제28권4호
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    • pp.531-545
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    • 1998
  • The objective of the present study was to evaluate the clinical and microbiological effects of scaling and root planing combined with local application of 2% minocycline gel to patients with moderate to advanced chronic adult periodontitis. 27 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. The quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the splitmouth design. All patients received standardized oral hygiene instructions at the beginning of the study. Subsequently scaling and root plaining was performed on all remaining teeth until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3week in the test side. The normal saline was irrigated subgingivally for about 30 seconds in the control side. The clinical and microbiological analysis was carried out at 0, 4, 8, and 12weeks. The results of this st udy were as follows; 1.2% minocycline gel delivered subgingivally as an adjunct to scaling and root planing provided benefit in reducing sulcular bleeding index and pocket depth than the use of normal saline. 2. The relative proportion of cocci and non-motile bacteria was increased in the test and control groups with time, and there was no statistically significantdifference between two groups. 3. The proportion of spirochetes was slowly reduced in the control group, but, inthe test group, they were remarkably reduced from the 4th week, and there was a statistically significant difference between two groups. 4. In both groups, the relative proportion of motile rods was notably decreasedat the beginning of the study, and remained until 12th week in the test group,but, in the control group, they were slowly increased from the 4th weekand finally similar to that of the initial examination. In conclusion, local application of 2% minocycline gel may be effective in the clinical and microbiological aspects as an adjunct to scaling and root planing in periodontal disease sites.

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조선왕실 현판 글자의 금색 안료와 재현 실험 연구 (Pigments in the Letters of Hanging Boards of the Joseon Royal Court and Reproduction Experiments)

  • 이혜연;이민혜;이희승
    • 헤리티지:역사와 과학
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    • 제56권3호
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    • pp.118-135
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    • 2023
  • 조선왕실의 현판은 궁궐, 종묘 등 왕실과 관련된 건물에 걸어 건물의 위계와 성격을 나타낸다. 현판은 조선왕실 의궤에 제작 방법이나 재료 등을 기록하고 있어 당시 제작기술이나 재료 변화를 연구하는데 중요한 자료이다. 그러나 현재 남아 있는 현판은 전각의 화재나 전란 등으로 여러 차례 개·보수 되면서 원형과 재료가 변화되었다고 추정된다. 조선왕실의 현판은 어제·어필 현판이 많아 검은색 바탕에 금색 글자로 이루어진 형태가 주요하다. 본 연구는 조선왕실 현판 중 금색 글자로 추정되는 44점을 대상으로 글자에 남아 있는 안료를 분석하였다. 분석 결과를 바탕으로 글자 표면에 남아 있는 금색 안료의 현재 상태와 검출된 구성성분에 따라 분류하였다. 글자 안료의 분석 결과 금(Au) 성분이 주요하게 검출된 현판은 양각 24점과 음각 5점이며, 양각 15점은 황동(Cu, Zn) 성분이 주요하게 검출되었다. 황동 성분이 검출된 현판 중 일부는 금색 안료가 아닌 청록색 안료만 남아 있는 상태이다. 황동 안료는 문헌에 기록이 없고 현재 단청 안료로 사용하고 있지 않아 황동 안료의 적용 가능성을 알아보기 위해 재현실험을 실시하였다. 재현실험은 재료의 한계로 황동안료의 적용 유무와 사용 방법을 확인하기 어려웠으나 앞으로 황동 안료의 사용 시기와 방법에 대한 연구가 필요한 것으로 판단된다.