적층가공을 이용한 임시의치 제작 및 기존방식의 임시의치와의 비교 증례

김현아,임현필,강현,양홍서,박상원,윤귀덕,Kim, Hyun-Ah,Lim, Hyun-Pil,Kang, Hyeon,Yang, Hongso,Park, Sang-Won,Yun, Kwi-Dug 대한치과보철학회 2019 대한치과보철학회지 Vol.57 No.4

디지털치의학의 발달과 함께 computer-aided design and computer-aided manufacturing (CAD/CAM)을 이용한 3D 제작산업이 최근 급격한 성장을 하고 있다. 디지털 방식을 이용한 의치 제작 또한 최근의 디지털치의학 기술의 발전으로 증가하는 추세에 있다. CAD/CAM 제작방법은 크게 두가지 타입으로 나눌 수 있다: 절삭가공, 적층가공, 밀링과 같은 절삭가공은 블록 형태의 재료를 깎아 제조하는 기술을 토대로 하며, 3D printing과 같은 적층가공은 재료를 적층 방식으로 쌓아 올려 제조하는 기술을 토대로 한다. 적층가공은 밀링이 어려운 복잡한 구조의 제작에 적용할 수 있다. 본 증례에서, 적층가공방법이 레진상 총의치 제작에 이용되었다. 디지털방식을 적용한 의치의 사용기간동안 기능적, 심미적으로 만족할 만한 결과를 보여주었다. With development of digital dentistry, the 3-dimensional (3D) manufacturing industry using computer-aided design and computer-aided manufacturing (CAD/CAM) has grown dramatically in recent years. Denture fabrication using digital method is also increasing due to the recent development of digital technology in dentistry. The 3D manufacturing process can be categorized into 2 types: subtractive manufacturing (SM) and additive manufacturing (AM). SM, such as milling is based on cutting away from a solid block of materal. AM, such as 3D printing, is based on adding the material layer by layer. AM enables the fabrication of complex structures that are difficult to mill. In this case, additive manufacturing method was applied to the fabrication of the resin-based complete denture to a 80 year-old patient. During the follow-up periods, the denture using digital method has provided satisfactory results esthetically and functionally.

노인(老人) 내과환자(內科患者)의 임상통계적(臨床統計的) 고찰(考察)

김현아,정지천,이원철,Kim, Hyeon-Ah,Jeong, Ji-Cheon,Lee, Won-Chul 대한한방내과학회 1992 大韓韓方內科學會誌 Vol.13 No.1

Clinical observation was done on 496cases of the Out-patients and 136cases of the In-patients more than 65 years of age in Department of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from March 1991 to February 1992. The results were as follows; 1. The ratio of senile (more than 65 years of age) was 16.4% in total Out-patients, was 38.1% in total In-patients. 2. The ratio of male to female was 1:1.1 in the Out-patients, In-patients was 1.2:1. The age distribution showed the large number in the 65-69 year group, the female more than the male in 70 th's group. 3. The diagnostic distribution was noted in the Out-patients as follows, Respiratory Dis. 50.6%, Cardiovascular Dis 16.4%, Brain Neurogic Dis. 14.5%, Gastrointestinal Dis. 8.1%. in the In-patients. Brain Neurogic Dis. was 76.5%, Cardiovascular Dis was 19.8%. 4. The ratio of the season distribution in the Out-patients was as follows, spring 40.2%, winter 21.2%, summer 20.9%, in the In-patients. winter was 35.9%, autumn was 25.0%, spring was 19.9%. 5. The utilization of therapeutic clinic before coming the Oriental Medical Hospital in Dong Guk Univ, was as follows, the ratio of the Out-patients was noted a hospital or clinic was 57.1%, no-treatment 22.9%, a oriental medical hospital or clinic was 8.3%. In the admission was noted no-treatment was 38.3%, a oriental medical hospital or clinic was 35.3%. 6. The ratio of the periods from onset to Out-patients department was noted within 5days was 7.3%, over 1 year was 52.6%. In the admission was noted within 1 day was 41.9%, within 7 days was 71.8%. 7. The ratio of the therapeutic periods in the Out-patients department was noted within 10 days was 48.3%, over 60 days was 7.1%. 8. The ratio of the admission periods was noted within 10 days was 45.6%, the median of the admissio was 10.8 days. Brain Neurogic Dis's median was 20.2 days. 9. The therapeutic result was noted the case of improvement was 75.7% in the admission. 10. The ratio of the Out-patients department after discharging was 53.7%, in the case of Brain Neurogic Dis. was 60.7%.

노인성치매(老人性痴呆)에 대(對)한 문헌적(文獻的) 고찰(考察)

김현아,정지천,이원철,Kim, Hyun-Ah,Jeong, Ji-Cheon,Lee, Won-Chel 대한한방내과학회 1992 大韓韓方內科學會誌 Vol.13 No.2

The study has been carried out to investigate of the senile dementia by referring to 35 literratures. The results were as follows ; 1. In oriental medical science, senile dementia is belong to the category of dullness(매病), insanity(癲狂證), weak(虛勞), amnesia(健忘), etc. 2. The cause of senile dementia summarize the phlegm preventid-heart hole(痰迷心竅), marrow lack(髓海不足), aged follow weaking of body and disfunction of the internal organs(年老體弱과 臟腑機能 失調), the bad blood with vatal block(氣滯血瘀), feeling inharmony, etc in the view of oriental medical science and make the vanishment of the cerebral atrophy and the cerebral cell but havn't indicated the remarkable cause in that of western medical science. The diseases with cause make a point of Alzheimer's dementia, frequent infarction dementia, etc and psychological and environmental factor too. The marrow lack is related to Alzheimer's dementia, the feeling inharmony, psychologic and environmental factor, the phlegm prevented-heart hole and bad blood with vatal block, frequent infarction dementia. 3. The senile dementia is related cleary to the function of the internal organs in oriental medical sciences respect Especially in relation to kidney and marrow, it is presented new cause view to solve the cure problem of western medical science is studying its cause only the anatomic pathology with cerebrum and is thinking to solve cure possibility. 4. The symptom of senile dementia is as follows. The obstacle of a aspect of the Language, Emotion, Behavior. mute, speech inversion, sometimes a laugh sometimes a cry, behavior strange, failure of memory etc. 5. The treatment of senile dementia is follows. The methodes of cure apply phlegm changed-mud(豁痰化濁), self-kidney and added marrow(補腎益髓), self-energy and nutritive blood(益氣補血), vital blood(祛瘀活血), peace of mind and relief(安神情志). The medicines of cure make the most of (sesimtang, jwagui-hwan, tonggwuhwalhuel tang) add and subtract, daeboweonjeon, guibitang, and so on.

Long-Term Risk of Cardiovascular Disease Among Type 2 Diabetes Patients According to Average and Visit-to-Visit Variations of HbA1c Levels During the First 3 Years of Diabetes Diagnosis

김현아,Jung Da Young,이승환,조재형,임현우,Kim Hun-Sung 대한의학회 2023 Journal of Korean medical science Vol.38 No.4

Background: It remains unclear whether a combination of glycemic variability and glycated hemoglobin (HbA1c) status leads to a higher incidence of cardiovascular disease (CVD). Therefore, to investigate CVD risk according to the glucose control status during early diabetes, we examined visit-to-visit HbA1c variability among patients with type 2 diabetes (T2DM). Methods: In this 9-year retrospective study, we measured HbA1c levels at each visit and tracked the change in HbA1c levels for 3 years after the first presentation (observation window) in newly diagnosed T2DM patients. We later assessed the occurrence of CVD in the last 3 years (target outcome window) of the study period after allowing a 3-year buffering window. The HbA1c variability score (HVS; divided into quartiles, HVS_Q1–4) was used to determine visit-to-visit HbA1c variability. Results: Among 4,817 enrolled T2DM patients, the mean HbA1c level was < 7% for the first 3 years. The group with the lowest HVS had the lowest rate of CVD (9.4%; 104/1,109 patients). The highest incidence of CVD of 26.7% (8/30 patients) was found in HVS [≥ 9.0%]_Q3, which was significantly higher than that in HVS [6.0–6.9%]_Q1 (P = 0.006), HVS [6.0–6.9%]_Q2 (P = 0.013), HVS [6.0–6.9%]_Q3 (P = 0.018), and HVS [7.0–7.9%]_Q3 (P = 0.040). Conclusion: To our knowledge, this is the first long-term study to analyze the importance of both HbA1c change and visit-to-visit HbA1c variability during outpatient visits within the first 3 years. Lowering glucose levels during early diabetes may be more critical than reducing visit-to-visit HbA1c variability.

스포츠 의류용 투습직물의 역학특성과 의류형성성능 특성

김현아,Kim, Hyun Ah 한국의류산업학회 2017 한국의류산업학회지 Vol.19 No.5

This study investigated garment formability of the 73 breathable fabrics for sports-wear garment and their fabric mechanical properties were measured using KES-FB and FAST systems. Predicted garment formability from the mechanical properties measured using KES-FB and FAST systems was compared and discussed with fabric structural parameters. In addition, virtual 3D simulation silhouette by I-designer CAD system wear appearance by simulation using 3D CAD system. And compared with FAST finger chart by mechanical properties of FAST system. The correlation coefficients of extensibility and shear modulus between KES-FB and FAST systems were high, however, bending rigidity and compressibility showed relatively low correlation coefficients. The correlation coefficient of garment formability of breathable fabrics between KES-FB and FAST systems was 0.82. It revealed that garment formability can be predicted from fabric mechanical properties by KES-FB and FAST systems. The garment formability of nylon breathable fabric was higher than that of PET one, and the garment formability of laminated breathable fabric showed the highest value compared to coated, dot and hot melt laminated breathable fabrics. It revealed that garment formability of breathable fabrics for sports-wear can be predicted from fabric mechanical properties and garment formability was dependent on the materials, finishing method and fabric structural parameters.

실수요자 중심의 청약 제도 개편의 실과 득

김현아,Kim, Hyeon-A 한국주택협회 2007 주택과 사람들 Vol.208 No.-

9월부터 분양가 상한제와 청약 가점제가 도입된다. 이는 주택 구입 능력이 없는 계층에게 과도한 인센티브를 부여했다는 점과 상대적으로 실수요자가 많은 1주택자들, 핵가족 도시 근로자나 이혼 가구, 신혼부부에게는 불리할 수 밖에 없어 현실성이 떨어진다는 지적이다.

위탁급식업체 중간관리자의 감성리더십 효과성 검증

김현아,정현영,Kim, Hyun-Ah,Jung, Hyun-Young 한국식품영양과학회 2007 한국식품영양과학회지 Vol.36 No.4

본 연구는 위탁급식 종사자를 대상으로 감성리더십의 수행 인식 정도, 감성지능 수준과 조직 및 종사자 관련변인, 조직성과에 대한 가설을 토대로 감성리더십의 효과성 모형과 감성지능의 효과성 모형을 구축하고 구조방정식(SEM)을 이용하여 이를 검증하고자 하였다. 위탁급식업체 중간관리자의 감성리더십 수준은 종사자들의 태도와 행동에 영향을 미치는 것으로 파악되었으며, 단체급식업계의 감성리더십 수행수준은 위탁급식업체 본사 근무자들이 자신의 상사인 리더를 평가할 때 '조직의 관계와 원칙의 이해'에 있어서 높은 점수를 주었고, '설득력 있게 사람의 마음을 잡아끄는 능력'에 대해서는 가장 낮은 점수를 주어, 위탁급식업계 본사의 중간관리자의 경우 원칙과 조직을 이해하는 능력은 강하나, 부하직원의 마음을 이끄는 능력은 부족한 것으로 분석되었다. 위탁급식업계 본사 근무자들의 조직몰입 수준은 보통을 약간 상회하는 수준으로 '충성도'에 대한 몰입이 '일체감'에 대한 수준보다 높은 것으로 나타나, 조직구성원들이 회사를 향해 가지는 몰입정도는 높은 반면, 회사와 종사자들의 하나됨은 다소 부족한 것으로 분석되었다. 조직성과는 보통을 상회하는 수준이었다. 조직성과 항목 중 가장 높은 항목은 '비용절감노력'으로 분석되었고, '인사관리에 있어서의 공정성', '직책에 상관없이 공정한 대우'에 있어서는 낮은 성과를 보였다. 감성리더십 수행수준과 조직구성원 관련변수인 직무만족, 조직몰입, 조직성과, 이직의사간의 관련성을 파악하기 위하여 상관분석을 실시한 결과, 감성리더십 수준과 직무만족, 조직몰입, 조직성과 수준과는 정(+)의 상관관계를, 이직의사와는 부(-)의 상관관계를 보여 리더의 감성리더십 수준이 종사자들의 직무태도와 직무수행에 유의적인 영향을 기치는 것으로 분석되었다. 감성리더십의 수행수준은 본사 근무자들의 직무만족과 조직몰입, 조직성과는 높여주는 동시에 이직의사는 낮춰주는 것이 조직이 효율적으로 운영되는데 일조하고 있는 것으로 사료되었으며, 감성리 더십 효과성 연구모형을 분석해 본 결과 감성리더십의 수행수준은 종사자의 '직무만족도'와 '조직몰입'에 영향을 미쳐 결국 '조직성과'에 유의 적으로 작용하는 것으로 나타났다. 이상을 종합하여 볼 때, 감성리더십은 아직은 조금 생소한 개념으로 받아들여지고 있으나, 최근 대기업을 중심으로 조직의 경영전반에 적용하려는 노력이 활발하게 이루어지고 있다. 리더를 감정관리자(emotional manager)로서 조직의 감성을 이해하고 배려함과 동시에 구성원들의 태도와 조직의 성과에까지 영향을 미치는 것으로 규명하였다. 감성리더십은 리더가 스스로 자신의 능력과 감정을 제어하고, 조직내에서 동조화를 통해 스스로의 영향력을 이해하고 인간관계 관리 능력을 발휘하여 조직을 긍정적으로 이끌어 내는 능력이다. 이는 현대 조직사회가 과거의 소수 최고위층 관리자에 의한 의사결정으로 이루어지는 조직에서 모든 계층 특히 중간관리자의 리더역할을 통해서 차별적인 역량의 영역을 창조하고 영향력을 발휘토록 하는 조직으로 변화하는 시점에서 그 중요성이 특히 강조된다. 특히 인적의존도가 높은 위탁급식업계에서 효율적인 리더십의 양성과 효과성 발휘를 위해, 감성능력에 초점을 두고 있는 감성리더십에 관심을 가지고 교육프로그램에 접목 경영활동에 적용하는 것이 필요할 The purposes of this study were to: a) provide evidences concerning the effects of emotional leadership b) examine the impacts of emotional leadership on employee-related variables, 'job satisfaction', 'organizational commitment', 'organizational performance' and 'turnover intention', and c) identify a conceptual framework underlying emotional leadership. A survey was conducted from August 23 to November 3, 2005 to collect data from mid-level managers in food service company headquarters (N=219). Statistical analyses were completed using SPSS Win (12.0) for descriptive, reliability, factor and correlation analyses and AMOS (5.0) for confirmatory factor analysis and structural equation modeling. The main results of this study were as follows. First, the managers gave the highest point to their leaders in the emotional leadership competence 'organizational awareness : reading the currents, decision networks, and politics at the organizational level' and gave the lowest point in the emotional leadership competence 'influence: wielding effective tactics for persuasion'. Second, the means of job satisfaction was above the midpoint (3 points). Employees' job satisfaction with 'coworkers' was relatively high. However, the extents of satisfaction with 'payroll' 'promotion', and 'work environment' were relatively low. Third, the organizational commitment was above the midpoint (3 points). In the organizational commitment, 'loyalty' factor was higher than 'commitment' factor. Fourth, the means of organizational performance was above the midpoint. The highest organizational performance variable was 'internal efficiency; trying to reduce cost' and the lowest organizational performance variable was 'internal fairness ; equitable treatment and all are treated with respect with no regard to status and grade'. Fifth, most respondents intended on 'thinking of quitting ; towards turnover process'. Sixth, the test of hypothesis using structural equation modeling found that emotional leadership produced p[Isitive effects on job attitude and job performance. Emotional leadership enhanced job satisfaction and organizational commitment, and in turn, employees' attitude positive effects on organizational performance; emotional leadership also had a direct impact on organizational performance

미세정자주입술로 임신이 된 남자태아의 Y 염색체 미세결실의 Vertical Transmission, de novo, 그리고 Expansion의 연구

김현아,이숙환,조성원,정혜진,손수민,강수진,배성근,김수희,윤태기,Kim, Huyn-Ah,Lee, Sook-Hwan,Cho, Sung-Won,Jeong, Hye-Jin,Son, Soo-Min,Kang, Soo-Jin,Bae, Seong-Keun,Kim, Soo-Hee,Yoon, Tae-Ki 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.2

Objectives: Despite severe oligospermia, males with Y chromosome microdeletion can achieve conception through ICSI (Intracytoplasmic Sperm Injection). However, ICSI may not only result in the transmission of microdeletions but also the expansion of deletion to the offspring. The purpose of this study was to screen vertical transmission, expansion of microdeletions and de novo deletion in male fetuses conceived by ICSI. Materials and Methods: A total of 32 ICSI treated patients with their 33 (a case of twin) male fetuses conceived by ICSI were used to make this study group. Sequence-tagged sites (STSs)-based PCR analyses were performed on genomic DNA isolated from peripheral blood of fathers and from the amniocytes of male fetuses. Ten primer pairs namely, sY134, sY138, MK5, sY152, sY147, sY254, sY255, SPGY1, sY269 and sY158 were used. The samples with deletions were verified at least three times. Results: We detected a frequency of 12.5% (4 of the 32 patients) of microdeletions in ICSI patients. In 4 patients with detected deletions, two patients have proven deletions on single STS marker and their male fetuses have the identical deletion in this region. Another two patients have two and three deletions, but their male fetuses have more than 3 deletions which include deletions to their father's. Meanwhile, seven male fetuses, whose fathers were analyzed to have all 10 STS markers present, have deletions present in at least one or more of the markers. Conclusions: Although the majority of deletions on the Y chromosome are believed to arise de novo, in some cases a deletion has been transmitted from the fertile father to the infertile patient. In other cases the deletion was transmitted through ICSI treatment, it is likely that one sperm cell is injected through the oocyte's cytoplasm and fertilization can be obtained from spermatozoa. Our tests for deletion were determined by PCR and our results show that the ICSI treatment may lead to vertical transmission, expansion and de novo Y chromosome microdeletions in male fetuses. Because the sample group was relatively small, one should be cautious in analyzing these data. However, it is important to counsel infertile couples contemplating ICSI if the male carries Y chromosomal microdeletions.

치조제 흡수가 심한 무치악 환자에서 흡착원리를 이용한 총의치 수복 증례

김현아,윤귀덕,조유진,양홍서,박상원,박찬,Kim, Hyun-Ah,Yun, Kwi-Dug,Jo, Yu-Jin,Yang, Hongso,Park, Sang-Won,Park, Chan 대한치과보철학회 2020 대한치과보철학회지 Vol.58 No.2

흡착원리를 이용한 총의치 제작은 연하나 저작 등의 운동 시 의치 내면의 음압이 형성되어 의치연 주변의 봉쇄를 이루어 유지와 안정을 향상시키고자 소개된 방식이다. 하악 흡착의치는 특히 변형되기 쉬운 후구치융기를 안정 상태에서 채득하여 개구 시 탈락력을 감소시킨다. 이 증례에서는 하악 치조제 흡수가 심한 무치악 환자에서 흡착원리를 통한 총의치 제작을 통해 의치의 향상된 유지력과 안정 및 환자의 만족도를 얻었다. Fabrication of complete denture with suction mechanism was introduced to enhance the retention and stability of denture by sealing around the denture border by forming negative pressure on the inner side of denture base during functional movement such as swallowing or masticating. Mandibular suction dentures reduce denture dislodging force during opening by taking preliminary impression without pressure on retromolar pad area in rest position. In this case, fabrication of complete denture using suction mechanism for an edentulous patient with severe alveolar bone resorption allowed us to clinically enhance retention and stability of denture and improve satisfaction of patient.

鼻茸(Nasal Polyp)에 對한 文獻的 考察

김현아,Kim, Hyun-Ah 대한한방안이비인후피부과학회 1999 한방안이비인후피부과학회지 Vol.12 No.1

In the treatment of Nasal Polyps. which are produced with allergic rhinitis, chronic paranasal sinusitis at clinic. Herb-med., acupuncture and some medicine for external application have been used. The symptoms, however, has taken a turn for the better in temporary, the nasal polyps was not removed in completely. So the origin treatment was impossible by the use of herb-med.. acupuncture and medicine. Although a surgical operation (excision) of western-medicine is effective for a specified period of time (about 6 months), the nasal polyps tend to recur. Because of that the second and third operation might be needed, so we cannot consider the operation as the treatment of nasal polyps. The study was observed to investigate the nasal polyps treatment, and to search practical attempt for the clinic application through a literature study on Bisikyuk and Bithch which are similar with nasal polyps. As results, the practical application of external treatment for the nasal polyps treatment in clinic might be more necessary, and internal use of the Herb-med. with the external treatment might be treated as supplementary treatment.