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      • KCI등재

        수종의 불소방출 수복재의 탈회억제 효과 및 불소침투에 관한 연구

        김송이,최성철,최영철,김광철,박재홍 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.3

        자이오머(Giomer)는 레진강화형글라스아이오노머에 견줄 만큼 불소방출량이 많다고 하나, 우식예방 효과에 관한 연구들이 많지 않아 임상적용에 대한 근거가 부족한 실정이다. 본 연구는 자이오머(BF 군)를 포함하여 레진강화형글라스아이오노머(FF 군), 콤포머(DA 군)와 대조군인 콤포짓(FZ 군)의 우식억제 효과와 주변 치질로의 불소침투 양상을 비교하기 위하여, 공초점레이저주사현미경과 전자탐침미세분석기를 이용하여 각 수복재의 우식예방 효과를 비교하였으며, 다음과 같은 결과를 얻었다. 1. 수복물 주위 이차 인공우식에서 법랑질 외측병변의 깊이는 FZ 군에서 가장 깊었으며, BF 군이 가장 작게 나타났다(p<0.05). 2. 수복물과 법랑질 계면에 나타난 탈회억제층의 두께를 관찰한 결과 FZ 군이 가장 작게 나타났으며, FF, DA, BF 간에는 유의성 있는 차이를 보이지 않았다(p<0.05). 3. 법랑질에 침투된 불소농도는 BF, FF, DA의 순으로 높게 나타났다. 4. 상아질에 침투된 불소농도는 DA, BF, FF의 순으로 높게 나타났으며, 이는 상아질-수복물의 접착 계면에 영향 받는 것으로 보인다. The purpose of this study was to evaluate the effect of light cured fluoride-releasing materials on the inhibition of demineralization. In addition, the pattern of fluoride uptake of adjacent tooth structure was analyzed with EPMA. Eighty intact premolars were restored with Filtek Z250(control group, composite), Fuji Filling LC(RMGI), Dyract AP (compomer) and Beautifil II(giomer). Restored teeth were stored in distilled water for 30 days. Thensixty teeth(n=15) were exposed to demineralizing solution(pH 4.3). Demineralized teeth were bisected and polished. The specimens were observed with confocal laser scanning microscope. The depth of outer lesion and the thickness of inhibition zone were measured. Remained twenty teeth(n=5) were bisected for fluoride uptake analysis. The fluoride analysis were taken at enamel-restoration interface and dentin-restoration interface by electron probe micro-analyzer. The results are as follows: 1. The depth of outer lesion of Fuji Filling LC, Dyract AP, Beautifil II was shallower than that of Filtek Z250 at the margin of restoration(p<0.05). 2. The thickness of caries inhibition zone of Fuji Filling LC, Dyract AP, Beautifil II was greater than that of Filtek Z250 at the margin of restoration(p<0.05). 3. Fuji Filling LC, Dyract AP, Beautifil II groups showed the greater fluoride uptake into enamel and dentine around restoration than Filtek Z250 group. 4. In dentin the difference of fluoride concentration were greater than in enamel, and Dyract AP showed the greatest fluoride concentration in dentin.

      • KCI등재

        정신과 입원환자의 서비스 만족척도의 개발

        김철권,이지연,송영선,김규호,김경률,김제원,이동기,최병무 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

        목적 본 연구의 목적은 국내 정신의료기관(정신병원, 종합병원 정신과)에서 간편하게 사용할 수 있는 신뢰도와 타당도가 검증된 입원환자의 서비스 만족척도를 개발하기 위한 것이다. 방법 여러 단계를 거쳐 국내 실정에 맞는 문항을 개발하였고,정신병원, 종합병원, 대학병원 정신과 병동에서 퇴원하는 348명의 환자들을 대상으로 신뢰도와 타당도를 조사하였다. 요인분석 결과 5개의 요인이 추출되었으며 전체 변량의 63.04%를 설명하였다. 내적 일관성에 대한 신뢰도 계수 (Crohnbach's α)는 0.95로 상당히 높은 수준이었고, 수정된 개별문항-총점 상관계수는 0.50부터 0.72까지의 범위에 속하였다. 요인분석을 통해 추출된 서비스 만족척도의 각 하위척도 점수와 서비스 만족척도에 첨부된 각 영역에 대해 전반적인 만족도를 묻는 세 개의 문항 점수 간의 상관성 역시 유의하게 높았다. 결과 진단명에 따른 서비스 만족척도의 전체 점수에서는 불안/신체형/강박장애 환자군과 기분장애 환자군이 각각 정신분열병 및 기타 정신병 환자군과 알코올중독 장애 환자군에 비하여 유의하게 높은 점수를 보였으며, 입원형태에 있어서는 자발적 입원군이 강제 입원군에 비하여 전체 만족점수가 유의하게 높았다. 그러나 성별, 월수입, 학력, 직업, 종교, 결혼상태 등의 변수에서는 서비스 만족척도의 전체 점수에서 유의한 차이가 발견되지 않았으며, 마찬가지로 연령, 입원일수, 입원횟수, 첫 발병나이, 유병기간 등의 임상적 변수에서도 서비스 만족척도의 전체 점수와 유의한 관계를 보이지 않았다. 서비스 만족척도의 전체점수에서 대학병원 환자군이 정신병원 환자군과 종합병원 환자군에 비하여 각각 유의하게 높았다. 결론 결론적으로 국내 정신의료기관에 입원한 환자들의 서비스 만족을 평가하기 위한 목적으로 개발된 본 척도는 높은 수준의 신뢰도와 타당도를 보였으며, 또 국내 정신의료 환경에 맞는 요인구조를 보였다. 따라서 정신의료 서비스에 대한 정신과 환자의 만족도에 대한 연구가 거의 없는 실정에서 본 척도의 개발은 향후 국내 정신의료의 질과 치료결과를 높이는 도구로 활용될 수 있을 것으로 기대된다. Objectives : To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale : SSS) for routinely assessing the quality of service in psychiatric ward inpatients. Methods : A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and University hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. Results : Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. Conclusion : SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring Satisfaction of psychiatric inpatients in Korea.

      • 항갑상선제로 치료한 그레이브스병 환자의 관해예측인자

        남일송,윤여일,김선규,김용현,이주영,목지오,윤석기,김철희,김영선,변동원,서교일,유명희 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

        Background: Most cases of Graves' disease have been treated by antithyroid drugs in Korea. The major drawbacks of antithyroid drugs are the relative high rate of relapse and the inconvinience of long term therapy. Measurement of TBII and TRH stimulation test have been considered as the most reliable tests predicting relapse, but the predictive power is not high enough to use in clinical situation. This study was performed to find good prognostic indicators in Graves' disease patients after the discontinuation of antithyroid drug therapy. Subjects and methods : We restrospectively evaluated 96 patients with Graves' disease who showed normal TRH test at the end of antithyroid drug therapy and were followed for more than one year. Serum T3, T4, T3/T4 ratio, TBII, Anti-TPO Ab and TGAb levels were measured at the time of diagnosis and at the end of therapy. Two to three months after withdrawal of antithyroid medication, serum TSH and free T3 responses to TRH were examined. These parameters were compared between the relapse group and the remission group. Results : Among the 96 patients, 22 patients(22.9%) relapsed(Group Ⅱ) and 74 patients(77.1%) remained in remmision(Group Ⅰ). No significant difference was observed between the relapse and the remission group in clinical parameters, serum T3, T4, TSH, T3/T4 ratio, TBⅡ and Anti-TPO Ab determined before and after treatment. Serum TSH and free T3 levels measured after TRH stimulation were also similar in both groups. Serum TGAb levels determined at the end of treatment were significantly higher in the remission group(p<0.05). Relapse following the discontinuation of therapy occured within 24 months in 72.7% of the relapsed cases. After 24 months, relapse rate was reduced significantly. Conclusion : These results suggest that high serum TGAb levels could be a favorable prognostic indicator for the long term remission of Graves' disease treated with antithyroid drugs, and may suggest that Hashimoto's thyroiditis is combined with Graves' disease in those patients.

      • 전기자동차 동력발생장치의 성능예측을 위한 이론연구

        김철호,이정환,송성화 서울産業大學校 2005 논문집 Vol.54 No.2

        Air pollution especially in the urban area is serious issue to be solved all through the world. As well known, main source of air pollution is urban transportation such as public buses, taxis and private vehicles that uses conventional gasoline and diesel engines. Because not only for the pollution problem but for the shortage of the clued oil people has been studied on the development of alternative fuels for the vehicles. One of the alternative energy sources is electric energy that is renewable source from nature. For the last decade, several major automotive manufacturers in the world have been spent huge budget for R&D to develop lower emission power train system and it is now released to the market as hybrid engine which operates both conventional gasoline or diesel engine in half and an electric motor on the other half. However, the hybrid engine still consumes HC fuel and produces the pollution. Now people are interested in the development of electric vehicle that uses only electricity as fuel. The electric energy is clean and renewable from several sources in nature such as solar, wind, hydro-power, fuel cell etc. In this study, an analytical simulation algorithm is developed to estimate the performance of power train system of an electric vehicle that is propelled by electric energy storied in a rechargeable battery. The theoretical concept is based on the conservation of energy and several experimental data such as rolling resistance, mechanical efficiency of power transmission etc are incorporated to have the power required for the electric vehicle designed. From calculation, the running resistance of designed vehicle is obtained with the change of the inclined angle of road and gear ratio of transmission.

      • KCI등재

        하악 영구 견치의 의원성 매복에 대한 증례 보고

        김송이,최성철,최영철,박재홍 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

        상악 영구 견치의 매복에 비해 하악 영구 견치의 매복은 매우 드물게 일어난다. 치아가 매복된 경우 장애물 존재 여부와 매복 위치와 방향,맹출 가능한 공간의 유무,치근의 형성 단계 등의 요소에 따라 매복 치아의 발거 혹은 장애물의 제거 후 주기적 관찰,맹출이 지연된 치아의 외과적 노출,교정적 견인 등의 방법으로 치료하게 된다. 본 증례는 하악골의 골절 부위에 시행된 골간 강선 결찰과 미니 플레이트에 의해 하악 좌측 견치가 매복되어 있었던 경우로 CT 검사 결과 하악 정중부위 플레이트의 스크류가 맹출을 방해하고 있는 것으로 판단되어 전선 마취 하에 플레이트를 제거하였다. 이후 자연적인 맹출을 기대하였으나,맹출력이 부족하여 교정적 견인으로 양호한 결과를 얻었기에 보고하는 바이다. When a delayed eruption of tooth is diagnosed, the causative factor should be detected before an establishment of treatment plan, if possible. Although a panoramic radiograph is enough to evaluate the position of tooth and the stage of tooth development, a 3-D Dental CT would be a powerful tool to reveal a spatial relationships between objects. The reported case showed a delayed eruption of lower left permanent canine and a mini-plate with screws adjacent to the impacted canine. Although the screws adjacent to the root of impacted tooth showed a close proximity, it was not presumed that these screws would interfere the eruption of the tooth. The impacted canine did not show any spontaneous eruption during observation. After the mini-plate and screws were removed, an orthodontic traction using elastic power chain was performed. The position of mini-plates and screws should be carefully designed to avoid damaging the tooth follicles or tooth roots in the jaw. Also the screws should be removed before an orthodontic traction to prevent damaging the root surface of impacted tooth.

      • 榮山湖의 水系에 對한 生態學的 硏究

        金喆洙,宋泰坤 木浦大學校沿岸生物硏究所 1984 沿岸生物硏究 Vol.1 No.1

        Ecological studies were carried out and the water quality was determined by the biological indicators and physicochemical factors at seven stations of Sandong Bridge, Hwangryong River, Nampyong Bridge, Kwangju Chon, Yongsanpo, Myongsan and Yongsan Lake from August, 1983 to March, 1984 in Yongsan River. The physicochemical water quality qas clear in the upper stream and though being polluted in Kwangju Chon and Yongsanpo, but recovered from pollution in the down stream by self-purification. The benthic invertebrates collected were composed of 44 species in 15 drders, and the number of species was more abundant in the upper stream than in the lower stream of Yongsan River. The species composition of the attached algae was 75 species in 38 genera. Diatoms appeared in all stations, but the green algae and the blue green algae occurred mainly in the upper stream. Estimation of saprovity from attached algae showed that the water quality was oligosaprobic orβ-mesosa-probic in the middle and lower stream of Uongsan River, and polysaprobic in Kwang-ju Chon.

      • KCI등재후보

        계획에 없던 중환자실 재입실 실태 및 원인

        송동현,이순교,김철규,최동주,이상일,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.1

        Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1)The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2)Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3)Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4)The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5)About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6)Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7)Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%)(P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.

      • KCI등재

        납착 방법이 치과용 금속의 성상에 미치는 영향에 관한 연구

        김철형,송영균,이종혁 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

        연구 목적: 본 연구는 치과영역에서 많이 사용되는 비귀금속 합금인 니켈-크롬 합금을 산소-아세틸렌 불꽃 납착법과 적외선 용접법을 이용해 용접하고 용접부 및 그 주변을 광학 현미경과 EPMA (Electron Probe Micro Analyzer, 전자미세현미분석기)를 통해 관찰하여 용접방법이 금속의 성상(性狀)에 미치는 영향을 조사하였다. 연구 재료 및 방법:니켈-크롬 합금을 이용하여 3.0 mm 직경, 30 mm 길이의 시편을 제작하였다. 시편은 산소-아세틸렌 불꽃 납착법, 적외선 용접법의 두 개의 그룹으로 분류하였다(n = 4). 시편을 low-speed disc로 자른 후 각각을 산소-아세틸렌 토치와 적외선 용접기를 이용해 용접하였다. 용접과 마무리 후에 시편을 광학현미경으로 용접부, 5 mm 떨어진 지점, 10 mm 떨어진 지점의 3개 부위에서 관찰하고EPMA를 이용하여 분석하였다. 결과: 광학 현미경 관찰 결과 용접부에서는 두 방법 모두 다수의 파절선이 관찰되었고, 10.0 mm 떨어진 거리에서는 두 방법 모두 시편의 표면에서 파절선이 발견되지 않았으나 5.0 mm 떨어진 거리에서는 적외선 용접법에서는 시편의 표면이 다소 거칠기는 했으나 파절선은 발견되지 않았고 산소-아세틸렌 불꽃 납착 표면에서는 다수의 파절선이 관찰되었다. EPMA분석에서 적외선 용접법에 의한 방법에서는 용접부위, 5.0 mm 떨어진 부위, 10.0 mm 떨어진 부위 모두에서 시편 금속의 구성성분 비율이 제조사의 구성성분 비율과 10.0%이내의 오차를 나타내었고, 산소-아세틸렌 불꽃 납착법에서는 5.0, 10.0 mm에서는 시편금속의 구성성분이 10.0%이내의 오차를 나타내었으나, 납착 부위에서는 Ni만이 검출되어 적외선 용접법과는 차이를 나타내었다. 이와 같은 분석결과를 살펴 볼 때 적외선 용접을 시행한 시편의 구성 성분이 모금속의 성분과 유사한 것을 알 수 있었다. 결론: 이상의 결과로 산소-아세틸렌 불꽃 납착법보다 적외선 용접법을 이용할 때, 금속의 결함 및 성분의 변화가 적어서 좀 더 우수한 금속 보철물의 제작이 가능할 것으로 사료된다. PURPOSE. The purpose of this study was to compare Ni-Cr alloy property of gas-oxygen torch soldering and infrared welding using optical microscope and Electron Probe Micro Analyzer (EPMA). MATERIALS AND METHODS. Ni-Cr alloys were casted for specimens. Specimens had 3.0 mm diameter, 30.0 mm length and were divided into two groups. Each group had 4 specimens. One group was for gas-oxygen torch soldering and the other was infrared welding. Specimens were cut with low-speed disc and soldered each other with gas-oxygen torch and infrared machine. After soldering and polishing, specimens were observed at 3 points (soldering point, 5 mm distance point, 10 mm distance point) with optical microscope and analyzed 3 points (soldering point, 5 mm distance point, 10 mm distance point with EPMA. RESULTS. The results of this study were as follows: 1. The observation of gas-oxygen torch soldering at 10 mm distance point under the optical microscope was not founded any specific surface properties, but some crack lines were observed at 5 mm distance and soldering point. 2. There were no crack lines were founded at the observation of infrared welding at 10 mm distance and 5 mm distance points under the optical microscope. However, at the 5 mm distance, the surface was not smooth enough compared with at 10 mm distance point. Some crack lines were observed at the welding point as well. 3. In the EPMA analysis of the gas-oxygen torch soldering, the component of Ni was increased by 4.5%, Cr was increased by 7.5% than that of the Ni-Cr alloy at the 10.0 mm distance. At the 5 mm distance, the component of Ni was decreased by 6.1%, Mo was increased by 9.0% than that of the Ni-Cr alloy but Cr was equally shown at the 5.0 mm distance. Only Ni was shown at the soldering point. 4. In the EPMA analysis of the infrared welding, the component of Ni was increased by 9.1%, Cr was increased by 0.4% than that of the Ni-Cr alloy but Al was equal at the 10.0 mm distance. At the 5 mm distance, the component of Ni was increased by 4.7%, Cr was increased by 4.7% and Al was increased by 0.1% than that of the Ni-Cr alloy. At the welding point, the component of Ni was increased by 8.8%, Cr was increased by 8.2% than that of the Ni-Cr alloy. CONCLUSION.From these results, at the 5 mm distance from the soldering point, the surface of the infrared welding was more smoother than that of the gas-oxygen torch soldering. On the EPMA analysis, the component of the specimens with infrared welding was more similar than that of the gas-oxygen torch soldering compared with the component of the Ni-Cr alloy.

      • Micro Blade용 Bond재료의 소결조건과 조성이 기계적 특성에 미치는 영향

        김송희,문종철 江原大學校 産業技術硏究所 2007 産業技術硏究 Vol.27 No.B

        Sintering condition and various chemical composition of bond materials for micro-blades were studied. The methods mixing of pure powders and using pre-alloyed powders for compaction and sintering were compared and optimized in terms of the evaluation of bending strength and fractographic study. The effect of the amount of graphite as a lubricant and diamond abrasive on the strength of sintered bond materials and fracture toughness was investigated. The strength decreased with increasing the amount of graphite and diamond abrasive.

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