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.

투습도 측정방법에 따른 스포츠웨어용 투습직물의 투습특성

김현아,김승진,Kim, Hyun-Ah,Kim, Seung-Jin 한국의류산업학회 2017 한국의류산업학회지 Vol.19 No.4

This study investigated water vapor permeability of the 73 breathable fabrics for sports-wear according to the materials, finishing methods and fabric structural parameters. The water vapor permeability by KS K 0594 method of PET breathable fabric was superior than that of nylon one, in addition, water vapor permeability of coated or laminated breathable fabrics were higher than those of hot melt or dot laminated fabrics. The water vapor permeability of breathable fabric was dependent on the thickness, weight and density, which was consistent with measuring method. However, water vapor permeability according to materials and finishing method showed different results according to measuring method. The correlation coefficient of WVP of PET breathable fabrics between ISO and KS K measuring methods was -0.83 and the correlation coefficient of WVP of coated breathable fabrics was -0.72 and -0.71 for KS K and ASTM and -0.72 for KS K and ISO in hot melt laminated breathable fabrics. According to regression analysis, WVP of PET breathable fabric by both KSK and ISO measuring methods was highly dependent upon on the density and weight. In addition, WVP of hot melt laminated breathable fabric was highly dependent upon thickness, weight and density. Therefore, relevant measuring method for WVP of breathable fabrics has to be adopted to measure precise breathability.

아그로박테리움을 이용한 Actinobacillus pleuropneumoniae ApxIIA (ApxII toxin) 유전자 발현 옥수수 형질전환체 개발

김현아,유한상,양문식,권석윤,김진석,최필선,Kim, Hyun-A,Yoo, Han-Sang,Yang, Moon-Sik,Kwon, Suk-Yoon,Kim, Jin-Seog,Choi, Pil-Son 한국식물생명공학회 2010 식물생명공학회지 Vol.37 No.3

To develop edible vaccines for swine, the embryogenic calli (type II) derived from HiII genotype were inoculated with A. tumefaciens strain C58C1 containing the binary vector pMYV611, 613, 616, and V621, 622 and 623 respectively. Six of those vectors carry nptII gene which confers resistance to paromomycin and apxIIA gene producing ApxII toxin which is generated in various serum types of A. pleuropneumoniae as a target gene. The 4,120 callus clones for pMYV611, 5,959 callus clones for pMYV613, 7,581 callus clones for pMYV616, 52,329 callus clones for V621, 48,948 callus clones for V622, and 56,188 callus clones for V623 were inoculated. The frequency of positive response clone was confirmed into range of 2.3% - 4.4% for each vectors by NPTII ELISA kit assay, and the selected callus clones of them were finally 3 callus clones from pMYV611 (0.07%), 4 callus clones from pMYV613 (0.07%), 2 callus clones from pMYV616 (0.03%), 51 callus clones from V621 (0.1%), 72 callus clones from V622 (0.15%), and 102 callus clones from V623 (0.18%) respectively. From the selected callus clones of each binary vector, the integration of the apxIIA gene into maize genome was detected from 2 plants of pMYV613 and 2 plants of V623 by Southern blot analysis. 돼지 흉막폐렴백신을 개발하기 위해 옥수수 HiII genotype 으로부터 유도한 type II형의 배발생캘러스를 식물발현벡터 pMYV611, pMYV613, pMYV616, V621, V622 및 V623로 형질전환시킨 Agrobacterium (C58C1)과 공동배양 하였다. 이들 식물발현벡터는 paromomycin 항생제 저항 유전자인 NPTII 선발마커와 표적 유전자로서 흉막폐렴균의 여러 가지 혈청을 생산하는 apxIIA유전자로 재조합하여 구축하였다. 식물발현벡터pMYV611, pMYV613, pMYV616, V621, V622 및V623의 경우 각각 4,120개, 5,959개, 7,581개, 52,329개, 48,948개 및 56,188개의 캘러스 클론을 Agrobacterium과 공동한 후 NPTII assay kit에 의해 nptII유전자의 발현빈도를 조사한 결과 각 벡터별로 2.3-4.4%의 캘러스 클론에서 항체결합 양성반응을 보였고, 이들 중 최종적으로 선발된 형질전환 캘러스 클론은 pMYV611에서 3개 (0.07%), pMYV613에서 4개 (0.07%), pMYV616에서 2개 (0.02%), V621에서 51개 (0.1%), V622에서 72개 (0.15%) 및 V623에서 102개 (0.18%)를 각각 얻었다. 형질전환된 캘러스 클론으로부터 재분화된 식물체에서 유전자 도입여부를 Southern 분석으로 통해 확인한 결과 pMYV613에서 2개 식물체 및 V623에서 얻은 2개 식물체에서 각각 확인되었다.

동복호 (同福湖) 유입하천의 조류증식능에 (藻類增植能) 관한 연구

김현아,이나나,유춘만,위성욱,주현수,이종빈,위인선 ( Hyun Ah Kim,Na Na Lee,Chun Man Yu,Seong Uk Wui,Hyun Soo Joo,Jong Bin Lee,In Sun Wui ) 한국환경생물학회 1995 환경생물 : 환경생물학회지 Vol.13 No.1

On filtered and autoclaved water samples from the upper stream of Lake Tong-Bok, physico-chemical analysis and algal growth potential (AGP) test using Selenastrum capricornutum Printz were performed from October, 1991 to July, 1992 in order to assess fertility potential of the lake and to identify possible limiting nutrients. Water temperature of the lake was fluctuated from 3.8℃ to 30.7℃, the range of pH was 6.0 to 8.0, the level of dissolved oxygen ranged from 5.5㎎/ℓ to 14.4㎎/ℓ, biochemical oxygen demand varied from 0.3㎎/ℓ to 7.6㎎/ℓ, and suspended solides was fluctuated from 0.7 ㎎/ℓ to 24.5㎎/ℓ. Results of nutrient analysis were as followings. The level ammonia was from ND(<0.01㎎/ℓ) to 0.74㎎/ℓ, nitrite and nitrate were ND(<0.01㎎/ℓ) - 0.06 ㎎/ℓ, 0.09㎎/ℓ - 1.33㎎/ℓ respectively. The range of phosphate level varied from ND(<0. 01㎎/ℓ) -0.24㎎/ℓ, and total phosphorus was fluctuated 0.04㎎/ℓ - 0.63㎎/ℓ. Algal growth potentials of the filtered and filtered after autoclaved samples were 0.1 ㎎/ℓ - 21.0㎎/ℓ and 2.9㎎/ℓ - 13.9㎎/ℓ respectively during surveyed period. AGP of the filtered after autoclaved were higer than those of the filtered only except some specific sites. The points of maximum growth were measured after addition of N, P, Fe and EDTA each in comparison with unenriched (control) samples. Phosphate appeared to be the major limiting element in AGP test for a tested organism throuhgout the year, especially during spring and summer. According to trophic level by Sudo(1980), it was estimated that Tong-Bok stream was eutrophic, Nae-Puk stream was oligo-mesotrophic, and all other streams of Lake Tong-Bok were mesotropic.

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

빠르게 진행하는 망막하 농양을 동반한 내인성 세균성 안내염

김현아,최경식,Hyun A Kim,Kyung Seek Choi 대한안과학회 2013 대한안과학회지 Vol.54 No.11

Purpose: To report a case of a rapidly progressive endogenous endophthalmitis with subretinal abscess that involved the macula and was treated with early vitrectomy. Case summary: A 42-year-old man with liver cirrhosis, hepatic cellular carcinoma and diabetes, who underwent regular fundus checkup for diabetic retinopathy presented with reduced vision, ocular pain in the left eye and headache. Indirect ophthalmoscopy showed subretinal abscess approximately five times the optic disc size and surrounding retinal hemorrhage in the nasal upper quadrant. A provisional diagnosis of bacterial endophthalmitis was made based on systemic disease and funduscopic findings. Treatment with topical and systemic empirical antibiotics was initiated along with intravitreal vancomycin and ceftazidime injection. Despite the treatment, after 24 hours the abscess size increased to approximately 10 times the optic disc size and began to involve the macula. The patient underwent diagnostic and therapeutic pars plana vitrectomy as well as vitreous and abscess content cultures. MRSA was found in a blood culture test. Five days postoperatively, the patient’s vision and symptoms improved significantly and the residual lesion was cleared, with retinal scars. Conclusions: In a patient with endogenous endophthalmitis with subretinal abscess, presence of macular invasion and rate of progression is important in determining the time and method of operation. In this case, early vitrectomy was a good choice to preserve macular structure and the patient’s visual acuity. J Korean Ophthalmol Soc 2013;54(11):1794-1799

심폐소생술금지 동의 전·후 말기암환자의 연명치료 변화

김현아,박정윤,Kim, Hyun A,Park, Jeong Yun 한국호스피스완화의료학회 2017 한국호스피스.완화의료학회지 Vol.20 No.2

목적: 본 연구는 심폐소생술금지에 동의한 암환자를 대상으로 연명치료 변화를 확인하기 위해 시도된 후향적 조사연구이다. 방법: 연구대상자는 S시에 소재한 A종합병원에서 2013년 1월 1일부터 12월 31일까지 종양내과 병동에 입원치료하고 사망한 암환자로 심폐소생술금지에 동의한 250명이 선정되었으며, 이중 심폐소생술금지를 입원당일 동의하였거나(N=40) 동의 후 3일 이내 사망한(N=10) 경우는 제외하였다. 대상자의 특성과 연명치료의 변화를 의무기록을 통해 조사하였으며, 심폐소생술금지 지시 동의 전 1일과 심폐소생술금지 지시 동의 후 3일 혹은 사망시점까지 조사하여 유지, 중단, 추가로 연명의료 변화를 판정하였다. 수집된 자료는 SPSS Win 21.0 프로그램을 이용하여 분석하였다. 결과: 연구대상자는 총 200명으로, 50~59세 나이 군이 36.0%로 가장 많이 차지하였고 남자가 62%였다. 재원일은 15일이었고, 입원하여 10일되는 시점에서 심폐소생술금지에 동의하였다. 심폐소생술금지에 동의 후 35.7~100%에서 연명치료가 계속 유지되었다. 인공호흡기 치료는 중단되지 않고 100% 유지되었으며, 수혈(37%), 혈액검사(37.4%), 산소요법(23.5%) 순으로 추가되었다. 중단된 연명치료 중 가장 빈도가 높은 것은 수혈(13.5%)이었고, 다음으로 혈액검사(11.5%), 비경구성 영양제투여(8.5%) 순이었다. 결론: 심폐소생술 지시 동의 후에 대부분 연명치료는 계속되었고 중단되는 경우는 드물었다. 의료진과 가족들 간의 연명치료 범위에 대한 이견을 좁히고, 무의미한 연명치료 중단에 대한 결정을 합의하기 위한 적극적인 논의가 요구된다. Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

아메드 방수유출장치 삽입수술과 병합수술의 효과

김현아,박가희,박태관,온영훈,Hyun A Kim,Ka Hee Park,Tae Kwann Park,Young Hoon Ohn 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To evaluate surgical results after combined operation associated with Ahmed glaucoma valve (AGV) implantation. Methods: A retrospective review was performed for 71 eyes of 67 patients who underwent combined operation associated with AGV implantation from June 2003 to August 2012. Results: Pars plana vitrectomy or phacoemulsification combined with AGV implantation were performed for 16 eyes and AGV implantation alone was performed in 55 eyes. Mean IOP (mm Hg) and the number of antigluacoma agents for both the combined and single groups showed a statistically significant decrease (combined/single; <em>p</em> = 0.008/0.000, 0.002/ 0.000). Visual acuity (log MAR) was improved, but these differences were not statistically significant (combined/single; <em>p</em> = 0.309/0.052). Conclusions: Combined vitrectomy or phacoemulsification and AGV implantation for intractable glaucoma with vitreoretinal disease or cataract is considered to be the primary procedure because of its equivalent efficacy in lowering IOP, improving visual acuity and decreasing the number of glaucoma agents. J Korean Ophthalmol Soc 2014;55(4):578-584

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.

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.