노인의치보철사업 담당자의 주관적 인식 조사 -근무지역과 경력별 관점에서-

최문실 ( Moon Sil Choi ),이병진 ( Byung Jin Lee ),김동기 ( Dong Kie Kim ) 대한예방치과·구강보건학회 2010 大韓口腔保健學會誌 Vol.34 No.3

Objectives. As the population of the elderly grows rapidly, the government has been providing the denture prosthetic program since 2002 to help improve the quality of their life. This study was to introduce data for improve denture prosthetic program by analyzing working location and awareness of public health center worker (dental hygienist) who are responsible for government subsidized denture prosthetic program. Methods. The survey of respondents are 52 of 71 dental hygienists performing a denture prosthetic program in a public health center located in 5 cities including Seoul, Gwang-ju, Gyeong-gi, Chonbuk and Kyongnam. The system of questioning is composed of 23 questions that are awareness according to location by the Likert scale. The responding subjects were divided into two groups; one group with at least 10 years of employment career and the other with less than 10 years and the data analysis using the chi-square tests. Results. Of the respondents, 80% indicated that the level of cooperation of the dentists was very high, irrespective of the population size of the region. Among the hygienists with more than 10 years of employment experience, 10.9% indicated the dentists`cooperation was high (p>0.05). The subjects in smaller cities have more favorable view of the oral healthcare program than those in larger cities by 34.5% (p<0.05). The regular checkup rate for the denture prosthetic patients is approximately 30% respondents higher for the with more than 10 years of work experience (p<0.05). Approximately 80% of the denture prosthetic users complained about the inconvenience of using the denture (p>0.05). At least 85% of the denture users expressed that the quality of their life has improved as a result of using the denture prosthetic. Conclusions. The study indicated that we need to institute a system that regularly conducts the education on the use of denture prosthetics and evaluates the effects of oral healthcare program to improve the quality of life for the elderly.

한국 노인의 보철상태에 따른 건강관련 삶의 질

박정혜 ( Jeong Hye Park ),이민경 ( Min Kyung Lee ),이정화 ( Jung Hwa Lee ),진혜정 ( Hye Jung Jin ) 한국치위생과학회 2014 치위생과학회지 Vol.14 No.3

The aim of this study was to evaluate the relationship between prosthetic status and health related quality of elderly by using EuroQol-5 dimension(EQ-5D) which is a standardized instrument used as a measure of health outcome. Data from 1,179 elderly subjects (over 65 years old) from the fifth Korea National Health and Nutrition Examination Survey were used in our analysis. Oral examination were conducted to obtain wearing prosthetic and needed prosthetic. EQ-5D is a widely used health condition measuring instrument. It consists of the five dimensions: Mobility, Self-care, Usual activities, Pain/discomfort and Anxiety/depression. EQ-5D index is a score calculated out of a weighting system. In this study, the mean score of the EQ-5D index among the elderly was 0.86. For EQ-5D index gender, female showed statistically significantly lower quality of life than male. The related factors EQ-5D index, when the lower demand for fixed prosthodontics and full denture. Wearers in partial and complete denture than non-wearers showed higher EQ-5D index. In order to improve EQ-5D index among the elderly who demand prosthetic status, which has lost its function through providing proper dental prostheses.

3D프린팅을 이용한 사용자 맞춤형 의수 개발

문미경 한국융합신호처리학회 2018 융합신호처리학회 논문지 (JISPS) Vol.19 No.3

The development of prosthetic hand or prosthetic leg equipment is steadily taking place globally. Though it would be difficult to create or feel the same way as a human hand, it would be a great for the amputated person if they can pick things up or do some movement as they want. It has become possible to develop low-cost prosthetic hand according to development of 3D printing technology. If people can develop personalized prosthetic equipment at similar prices to meet this trend, the utilization and penetration rate will be much higher. In this study, it describes how to develop a user-customizable prosthetic hand using 3D printing. To do this, the transformational parameters of prosthetic hand shape modeling are extracted as variability values, and the functions for controlling prosthetic hand motion are designed as software design patterns. This allows people who need a prosthetic hand to have their own prosthetic hand at a fast and affordable price 의수나 의족장치 개발은 전 세계적으로 꾸준히 이루어지고 있으며, 사람의 손과 똑같이 만들어 내거나 감각을 느끼게하는 것은 힘들겠지만, 물건을 집거나 몇 가지 움직임을 마음먹은 대로 할 수 있다면 절단 장애인들에게는 큰 도움이 될 것이다. 3D프린팅 기술의 발달로 저렴한 의수개발이 가능해졌으며, 이러한 추세에 맞추어 개인맞춤형 의수를 비슷한 가격에 개발할 수 있다면 활용도 및 보급률이 훨씬 높아질 것이다. 본 논문에서는 3D프린팅을 이용하여 사용자 맞춤형 의수를 개발하는 방법에 대해 기술한다. 이를 위해 의수 외형 모델링의 변형수치를 가변값으로 추출하고, 의수 동작을 제어하는 기능을 소프트웨어 디자인 패턴을 이용하여 설계한다. 이를 통해 의수를 필요로 하는 사람들이 각자 원하는 자신만의 의수를 빠르고 저렴한 가격에 갖출 수 있도록 한다.

대퇴 절단 장애인용 생체모방형 인공발의 개발

김현철,조현석,장윤희,신현준,박세훈,조언정 한국재활복지공학회 2023 재활복지공학회논문지 Vol.17 No.4

최근 하지 절단자용 인공발은 저가형 sach foot 또는 복합소재를 활용한 에너지 저장형 인공발이 주로 사용되고 있다. sach foot은 탄성력이 낮은 반면에 에너지 저장형 인공발은 에너지 저장성이 높아 활동성이높은 하퇴 절단자에게 적합하다. 지난 연구에서는 토션 스프링을 활용한 중족지관절 기능형 인공발을 개발하여 제품화하였으나 장시간 보행 시 스프링의 피로 파단이 발생하였다. 이와 같은 결과로 스프링의 강성을낮춤으로써 피로 파단 문제는 해결하였으나 에너지 저장 성능이 감소하였다. 본 연구에서는 고탄성 오토클레이브 적층식 S2-Glass 복합소재 킬재의 구조 설계 최적화를 통해서 이전에 개발된 인공발에서 부족했던보행 추진력을 개선하였다. 정상 보행 입각기 말기에서 중족지관절이 약 20도 굽혀질 때 체중에 약 100% 정도의 수직 하중이 걸린다. 이 역학적 조건을 기준으로 구조해석을 수행하여 킬재의 복합소재 적층 설계및 형상 최적화를 수행하였다. 제작된 인공발 시제품의 국제 시험규격 ISO 10328의 인공발 내구성 시험(P5 레벨; 130kgf, 1Hz, 200만 회)을 통과하여 공인 시험성적서를 획득하였다. 개발된 인공발은 성능 평가를 위하여 대퇴 절단자 1명을 대상으로 실내/외 다양한 환경에서 보행 적응훈련을 거쳐 보행 분석을 실시하였다. 이 결과, 생체모방형 인공발에서 기존 인공발 보다 보행 추진력이 37.5% 향상된 것을 확인하였다. Recently, energy storage prosthetic foot using low-cost Sach foot or composite materials have been mainly used as prosthetic foot for cutting the lower extremities. While the Sach foot has low elasticity, Energy storage prosthetic feet are suitable for active transtibial amputees due to their high energy efficiency, but are inefficient for the trans-femoral amputees with their low athletic ability. In the last study, a metatarsal joint functional prosthetic foot using a torsion spring was developed and commercialized, but fatigue fracture of the spring occurred when walking for a long time. To compensate for this, the fatigue fracture problem was solved by lowering the stiffness of the spring, but the energy storage performance was reduced. In this study, the walking propulsion, which was lacking in existing artificial feet, was improved by optimizing the structural design of the highly elastic autoclave laminated S-2 Glass composite material. with autoclave lamination as keel materials for the purpose of improving artificial foot performance. At the end of the stance phase of normal walking, when the metatarsophalangeal joint is bent about 20 degrees, a vertical load of about 100% of the body weight is applied. Structural analysis was performed based on these mechanical conditions to design and optimize the shape of the keel and it’s composite material lamination. The manufactured prosthetic foot prototype passed the prosthetic foot durability test (P5 level; 130kgf, 1Hz, 2 million times) of the international test standard ISO 10328 and obtained a test report. To evaluate the performance of the developed prosthetic foot, gait analysis was conducted on one trans-tibial amputee through gait adaptation training in various indoor and outdoor environments. As a result, the walking propulsion of the biomimetic prosthetic foot was improved by 37.5% compared to that of previous developed prosthetic foot.

Rapidly growing non-tuberculous mycobacteria infection of prosthetic knee joints: A report of two cases

Kim, M.,Ha, C.W.,Jang, J.W.,Park, Y.B. Butterworth-Heinemann ; Elsevier Science Ltd 2017 The knee Vol.24 No.4

Non-tuberculous mycobacteria (NTM) cause prosthetic knee joint infections in rare cases. Infections with rapidly growing non-tuberculous mycobacteria (RGNTM) are difficult to treat due to their aggressive clinical behavior and resistance to antibiotics. Infections of a prosthetic knee joint by RGNTM have rarely been reported. A standard of treatment has not yet been established because of the rarity of the condition. In previous reports, diagnoses of RGNTM infections in prosthetic knee joints took a long time to reach because the condition was not suspected, due to its rarity. In addition, it is difficult to identify RGNTM in the lab because special identification tests are needed. In previous reports, after treatment for RGNTM prosthetic infections, knee prostheses could not be re-implanted in all cases but one, resulting in arthrodesis or resection arthroplasty; this was most likely due to the aggressiveness of these organisms. In the present report, two cases of prosthetic knee joint infection caused by RGNTM (Mycobacterium abscessus) are described that were successfully treated, and in which prosthetic joints were finally reimplanted in two-stage revision surgery.

인공판막 심내막염의 임상적 고찰

황성철,김준명,이승우,심원흠,조승연,이웅구,조범구,홍승록 대한내과학회 1990 대한내과학회지 Vol.38 No.3

Prosthetic valve endocarditis is an infrequent but a serious complication of cardiac valve replacement associated with unacceptablely high mortality. Although the incidence of prosthetic valve endocarditis may be declining, the absolute number of surgery. However, in Korea, there has been few reports concerning this matter, so we have carried out a clinical analysis of 24 patients with prosthetic valve endocarditis who were diagnosed and treated at Yonsei medical center from January 1980 through December 1988. The overall frequency of prosthetic valve endocarditis was approximately 2.6%. The frequency of early-and late-onset infection was 0.9% and 1.7% respectively. Male to female ratio was 2.4 to 1. There were no predilections as to the anatomic location of the replaced valves or the types of prostheses used in the operation. Common prosenting symptons were fever(79.2%), dyspnea(70. 8%), and anorexia(62.5%). Physical findings were often non-specific and they include newly developed or changing murmurs(66.7%), hepatomegaly(41.7%) and splenomegaly(25.8%). They seldom presented with Osler's node(20.8%), petechiae(16.7%) or Janeway's lesion(12.5%). In addition, abnormal laboratory features include anemia(75.0%), hematuria(62.5%), leukocytosis(50.0%) and non-specific electrocardiographic abnormalities. Vegetations were present in 6 of 17 patients who were examined echocardiographically. Identifiable predisposing factors or the possible sources of indection were dental manipulation or periodontal diseases, osteomyelitis of sternum, wound infection, pneumonia, periodontal diseases, urinary tract infection and infected intravenous catheters. The results of blood culture were positive in 17 of 24 cases(70.8%). Alpha-streptococcus was the most frequently isolated organisms accounting for 29.4% of the positive cultures and was generally associated with a good prognosis. In contrast, Staphylococcus coagulase negative, Pseudomonas aeruginosa, Staphylococcus epidermidis showed high incidence of resistance to conventional antibiotics and consequently resulted in poor prognosis. Complications were congestive heart failure(28.6%), embolism(28.6%), sepsis with shock(14.3%) and acute renal failure(3.6%). Common site of embolism was brain. Overall mortality among patients with prosthetic valve endocarditis was 50.0%; the mortality among patients with prosthetic valve endocarditis were 50.0% and 50. 0% respectively. Medical treatment was carried out in 20 patients and its mortality was 55.0%. Surgical intervention was carried out in 4 patients and it was successful in three cases.

구강보건 실태와 치과보철치료의 상관관계에 관한 연구

이종도,김정숙 대한치과기공학회 2008 대한치과기공학회지 Vol.30 No.1

The Status of oral health and dental prosthetic treatment in Daegu and Gyoung Buk area was examined. To investigate the correlation between factors such as demographic and socioeconomic characteristics and status of oral health and knowledge about oral preventive measures, a survey was performed. After analyzing the effects of knowledge levels about dental prosthetic treatment on the oral health status and preventive measures, following results were obtained. A Total of 625 people participated in the survey for three months from October 2007 to January 2008. The responses from the survey were then analyzed to assess whether those with less knowledge of preventive measures tended to have more dental prosthetic work. Of those that took part in the survey: 30.2% were in their twenties 56.2% were married 51.4% of respondents had at least a college degree 42.4% had monthly incomes below one million Won 24.3% were students 55.8% were from urban areas After studying the relationship between oral health and various demographics, researchers concluded that respondents’ sex, income, job and place of residence had no effect on the overall status of their oral health. However, those that were divorcees or widows (1.95+/- 0.32), over the age of 70 (1.67+/-0.31), or had little education (0.82+/-0.28), all demonstrated a statistically significant effect on their oral health with a significance level of 0.05.Cross analysis revealed a p-value of 0.000. The correlation between knowledge of oral preventive measures and other factors was examined. No difference was found between men and women but people who were divorced or lost their spouse, people over the age of 60, and people with no education, the results of knowledge of oral preventive measure was poor as 1.74 0.44, 1.85 0.40, 1.85 0.44,and 1.60 0.47 separately. Cross analysis showed that p-value was 0.000 and correlation between knowledge of oral preventive measures and those factors were statistically significant at significance level of 0.05. The status of dental prosthetic treatment was investigated. Women, people with higher income, and married people had more dental prosthetic treatment and it was related to education, income, residential area, and the status of dental prosthetic treatment. The returns of those factors was 32.7%. Respondents°Ø oral hygiene status and knowledge of oral preventive measures was related to demographic or socioeconomic factors. Therefore, a preventive program for oral health care needs to be developed in advanced countries. Knowledge of oral health is below the international average and more research and effort needs to be put in to develop public knowledge of dental prosthetic treatment. Government intervention such as enacting an oral health initiative or dental insurance that covers prosthetic treatments is urgently needed.

Application of Nickel Titanium in Prosthetic Heart Valves : Suggestion of a Micro-Robot Device

Seong Hoon Kam,Ga Hyun Kim,Ki Woo Song 국제과학영재학회 2016 APEC Youth Scientist Journal Vol.8 No.1

This paper suggests a new model, for prosthetic heart valve implantation surgery using shape memory alloy (SMA), as the solution to the current existing limitations. It is true that prosthetic heart valve technology improved significantly since its first introduction in the 1950s. Nevertheless, the surgery is invasive because it requires opening one's heart. This not only increases the risk of the surgery itself, but restrains the elderly from receiving such surgical procedures. The research is divided into three sections. Researchers begin by introducing the current procedure of prosthetic heart valve implantation, and conduct a comparative analysis of SMA. Second, the limitations that exist in the current status quo of implantation surgery, are examined. Third, based on the comparative analysis of SMA, researchers suggest a new model of conducting a prosthetic heart valve surgery, and elaborate on future expectations. As this study is approaching the matter theoretically, further discussion is needed on the issue of practicality and feasibility in application.

인공삼첨판막의 혈전에 의한 삼첨판막 협착증의 임상상과 치료

한규록(Kyoo Rok Han),송종민(Jong Min Song),최성주(Sung Joo Choi),한기훈(Ki Hoon Han),박선수(Sun Soo Park),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),노정일(Chung Il 대한내과학회 1994 대한내과학회지 Vol.46 No.4

N/A Background: Thrombosis of prosthetic valve occurs more frequently in the mechanical prosthetic valve than tissue valve and more frequently in right-side heart than left-side heart. This study shows the clinical characteristics and treatment of bileaflet prosthetic valve thrombosis in the tricuspid position. Methods: Patients with bileaflet prosthetic valve in tricuspid position were followed till clinically significant tricuspid stenosis due to thrombosis develops. Five patients had clinically significant thrombotic tricuspid stenosis. Diagnosis was based on history taking, physical examaination, echocardiograpy and cinefluoroscopy. Results: Anticoagulation therapy was inadequate in 4 of 5 patients. Prosthetic valve replacement was undertaken in one patient and four patients were treated with thrombolytic therapy using urokinase. Three patients among 4 patients managed with thrombolytic therapy were successfully treated. There was no serious complication. Cinefluoroscopy and echocardiography were useful in diagnosis and evaluation of the thrombolysis. Conclusions: Thrombolytic therapy is useful as an initial treatment of thrombosed tricuspid prosthetic valve stenosis without major complications.

흉벽 재건에서 합성 물질의 피복을 위한 부분 근피판 조합의 효용성

류석태,변재경,임소영,문구현,방사익,오갑성 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.3

Purpose: Reconstruction of chest wall has always been a challenging problem. Muscle flaps for chest wall reconstruction have been helpful in controling infection, filling dead space and covering the prosthetic material in this challenge. However, when we use muscle flaps, functional and cosmetic donor site morbidities could occur. The authors applied and revised various partial muscle flaps and combination use of them to cover the prosthetic material for the chest wall reconstruction and evaluated the usefulness of partial muscle flaps. Methods: This study included 7 patients who underwent chest wall reconstruction using partial muscle flap to cover prosthetic material from 2004 to 2008. The pectoralis major muscle was used in anterior 2/3 parts of it leaving lateral 1/3 parts of it. The anterior 2/3 parts of the pectoralis major muscle were used while lateral 1/3 parts were left. In case of the rectus abdominis muscle flap, we used upper half of it, or we dissected it around its origin and then advanced to cover the site. The latissimus dorsi muscle flap was elevated with lateral portion of it along the descending branch of the thoracodorsal artery. If single partial muscle flap could not cover whole prosthetic material, it would be covered with combination of various partial muscle flaps adjacent to the coverage site. Results: Flap coverage of the prosthetic material and chest wall reconstructions were successfully done. There occurred no immediate and delayed post operative complications such as surgical site infection, seroma,deformity of donor site and functional impairment. Conclusion: When we use the muscle flaps to cover prosthetic material for chest wall reconstruction, use of the partial muscle flaps could be a good way to reduce donor site morbidity. Combination of multiple partial flaps could be a valuable and good alternative way to overcome the disadvantages of partial muscle flaps such as limitation of volume and size as well as flap mobility.