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    DNA ์˜ค๋ฆฌ๊ฐ€๋ฏธ ๊ตฌ์กฐ์ฒด์˜ ํ˜•์ƒ ์„ค๊ณ„๋ฅผ ์œ„ํ•œ ๊ธฐ๊ณ„์  ์‘๋ ฅ ์กฐ์ ˆ ๊ธฐ์ˆ 

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    ํ•™์œ„๋…ผ๋ฌธ(๋ฐ•์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :๊ณต๊ณผ๋Œ€ํ•™ ๊ธฐ๊ณ„ํ•ญ๊ณต๊ณตํ•™๋ถ€,2020. 2. ๊น€๋„๋…„.In this thesis, we describe two design strategies that engineer mechanical stress to program static or dynamic conformations of the DNA origami structure. DNA origami nanotechnology facilitated the self-assembly of DNA strands into any conceivable shape encoded by their rationally designed sequences. Mechanics-based design approaches have played an important role in improving the structural diversity of the DNA origami structures. Due to low twist controllability and limited reconfiguration mode, however, they have still limitations in achievable diversity or complexity in structural shapes and their reconfigurations and their applications. To this end, first, we developed a design strategy for fine control of twisted DNA origami structures by considering not only amount of geometrical perturbations but also their arrangements within the structures. With the configurational design of geometrical perturbations, we can program various distributions of the mechanical stress enabling a fine control over twist rate of DNA origami structures. Second, we developed a design strategy that transforms a two-dimensional structure into three-dimensional supercoiled one on demand. We employed the topological invariant property to convert a simple twist deformation into complex bending one leading to supercoiling of the DNA origami structure. We expect that our mechanical stress programming strategies can be utilized to design DNA origami structures with desired shapes or reconfiguration motions and enhance the performance of functional structures.๋ณธ ํ•™์œ„๋…ผ๋ฌธ์€ ๋ชฉํ‘œํ•˜๋Š” ์ •์  ๋ฐ ๋™์  ํ˜•์ƒ์„ ์ง€๋‹Œ DNA ์˜ค๋ฆฌ๊ฐ€๋ฏธ ๊ตฌ์กฐ ์ œ์ž‘์„ ์œ„ํ•œ ๊ธฐ๊ณ„์  ์‘๋ ฅ ์กฐ์ ˆ ๊ธฐ์ˆ ์— ๊ธฐ๋ฐ˜ํ•œ ์„ค๊ณ„๋ฐฉ๋ฒ•์„ ์ œ์‹œํ•œ๋‹ค. DNA ์˜ค๋ฆฌ๊ฐ€๋ฏธ ๋‚˜๋…ธ๊ธฐ์ˆ ์€ DNA ๊ฐ€๋‹ฅ๋“ค์˜ ์ž๊ฐ€์กฐ๋ฆฝ ๊ณผ์ •์„ ํ†ตํ•ด ๊ธฐ์กด์— ์ œ์ž‘์ด ์–ด๋ ค์› ๋˜ ๋‹ค์–‘ํ•œ ํ˜•์ƒ์˜ ๋‚˜๋…ธ๊ตฌ์กฐ๋ฌผ์„ ์†์‰ฝ๊ฒŒ ๋งŒ๋“ค ์ˆ˜ ๋งŒ๋“ค ์ˆ˜ ์žˆ๋‹ค. ์ด๋ฅผ ํ™œ์šฉํ•ด ๋ชฉํ‘œ ํ˜•์ƒ์˜ ๋‚˜๋…ธ๊ตฌ์กฐ๋ฌผ์„ ๋งŒ๋“ค๊ธฐ ์œ„ํ•ด ๋‹ค์–‘ํ•œ ์„ค๊ณ„ ๋ฐฉ๋ฒ•๋“ค์ด ์ œ์‹œ๋˜์–ด ์™”๋‹ค. ์ด์ค‘ ์—ญํ•™์  ์›๋ฆฌ์— ๊ธฐ๋ฐ˜ํ•œ ์„ค๊ณ„ ๋ฐฉ๋ฒ•์€ ๊ตฌ์กฐ ๋‚ด๋ถ€์— ์˜๋„์ ์œผ๋กœ ๊ธฐ๊ณ„์  ์ŠคํŠธ๋ ˆ์Šค๋ฅผ ๋ฐœ์ƒ์‹œ์ผœ ๊ตฌ์กฐ์˜ ๋น„ํ‹€๋ฆผ, ๊ตฝํž˜ ๋“ฑ์„ ์ •๋Ÿ‰์ ์œผ๋กœ ์กฐ์ ˆํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋งŒ๋“ค์–ด, ์ œ์ž‘ ๊ฐ€๋Šฅํ•œ ํ˜•์ƒ์˜ ๋ฒ”์ฃผ๋ฅผ ๋„“ํžˆ๋Š”๋ฐ ํฌ๊ฒŒ ๊ธฐ์—ฌํ•˜์˜€๋‹ค. ํ•˜์ง€๋งŒ ๊ธฐ์กด ๋ฐฉ๋ฒ•๋“ค์€ ์„ธ๋ฐ€ํ•œ ๋น„ํ‹€๋ฆผ ํ˜•์ƒ ์ œ์–ด๊ฐ€ ์–ด๋ ต๋‹ค๋Š” ์  ๊ทธ๋ฆฌ๊ณ  ์ œํ•œ๋œ ์ข…๋ฅ˜์˜ ํ˜•์ƒ๋ณ€ํ™”๋งŒ์ด ๊ฐ€๋Šฅํ•˜๋‹ค๋Š” ๋ฌธ์ œ์ ์œผ๋กœ ์ธํ•ด ๋ชฉํ‘œ ํ˜•์ƒ์„ ์ง€๋‹Œ ์ •์  ํ˜น์€ ๋™์  ๊ตฌ์กฐ์˜ ์ œ์ž‘ ๋ฐ ์ด๋Ÿฌํ•œ ๊ตฌ์กฐ๋“ค์˜ ํ™œ์šฉ์— ์–ด๋ ค์›€์ด ์กด์žฌํ•œ๋‹ค. ์ด์— ํ•ด๊ฒฐ์ฑ…์œผ๋กœ์จ ๋ณธ ์—ฐ๊ตฌ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๊ธฐ๊ณ„์  ์‘๋ ฅ ์กฐ์ ˆ ๊ธฐ์ˆ ๋“ค์„ ์ œ์‹œํ•œ๋‹ค. ์ฒซ์งธ, ๊ตฌ์กฐ ๋‚ด ๊ธฐํ•˜ํ•™์  ์„ญ๋™์˜ ๋ถ„ํฌ ์„ค๊ณ„ ํ†ตํ•ด DNA ์˜ค๋ฆฌ๊ฐ€๋ฏธ ๊ตฌ์กฐ๋ฌผ์˜ ์„ธ๋ฐ€ํ•œ ๋น„ํ‹€๋ฆผ ํ˜•์ƒ ์กฐ์ ˆ์„ ์œ„ํ•œ ์„ค๊ณ„ ๋ฐฉ๋ฒ•์„ ์ œ์‹œํ•œ๋‹ค. ์ด๋ฅผ ์ด์šฉํ•œ ๊ตฌ์กฐ ๋‚ด ๋ณ€ํ˜• ์—๋„ˆ์ง€์˜ ์กฐ์ ˆ์„ ํ†ตํ•ด, ๋ฏธ์„ธํ•œ ๋น„ํ‹€๋ฆผ ํ˜•์ƒ ์กฐ์ ˆ์ด ๊ฐ€๋Šฅํ•ด์ง„๋‹ค. ๋‘˜์งธ, ๋‹จ์ˆœํ•œ 2์ฐจ์› ๊ตฌ์กฐ๋ฌผ์„ ๋ณต์žกํ•œ 3์ฐจ์› ํ˜•์ƒ์˜ ๊ตฌ์กฐ๋ฌผ๋กœ ๋ณ€ํ™˜์‹œํ‚ค๋Š” ํ˜•์ƒ ๋ณ€ํ™˜ ๋ฉ”์ปค๋‹ˆ์ฆ˜์„ ์ œ์•ˆํ•œ๋‹ค. ์–‘๋์ด ์ด์–ด์ง„ ๋‹ซํžŒ ๊ตฌ์กฐ๊ฐ€ ์ง€๋‹Œ ์œ„์ƒํ•™์  ๋ถˆ๋ณ€์„ฑ์„ ์ด์šฉํ•ด, ๊ตญ๋ถ€์  ๋น„ํ‹€๋ฆผ์„ ์ „์—ญ์  ๊ตฝํž˜ ๋ณ€ํ˜•์œผ๋กœ ๋ณ€ํ™˜์‹œํ‚ด์œผ๋กœ์จ, DNA ์˜ค๋ฆฌ๊ฐ€๋ฏธ ๊ตฌ์กฐ์˜ ์Šˆํผ์ฝ”์ผ๋ง ํ˜„์ƒ์„ ์ œ์‹œํ•œ๋‹ค. ์ด๋Ÿฌํ•œ ๊ธฐ๊ณ„์  ์‘๋ ฅ ์กฐ์ ˆ ๊ธฐ์ˆ ๋“ค์€ ์›ํ•˜๋Š” ํ˜•์ƒ ๋ฐ ๋ณ€ํ™” ์›€์ง์ž„์„ ์ง€๋‹Œ DNA ๋‚˜๋…ธ๊ตฌ์กฐ๋ฌผ์˜ ์„ค๊ณ„์— ํ™œ์šฉ๋˜์–ด ๊ธฐ๋Šฅ์„ฑ ๋‚˜๋…ธ๊ตฌ์กฐ๋ฌผ๋“ค์˜ ์„ฑ๋Šฅ์„ ํ–ฅ์ƒ์‹œํ‚ค๋Š”๋ฐ ๊ธฐ์—ฌํ•  ๊ฒƒ์ด๋ผ๊ณ  ๊ธฐ๋Œ€๋œ๋‹ค.Abstract 1 Table of contents 3 List of tables 5 List of figures 6 Chapter 1. Introduction 9 1.1. Research background 9 1.1.1. DNA origami nanotechnology 9 1.1.2. Self-assembly of DNA origami structure 12 1.1.3. Structural motifs 14 1.1.4. Computational design and analysis tools 16 1.2. Design strategy for DNA Origami structure 18 1.2.1. Lattice-based design 18 1.2.2. Flexible hinge-assisted design 19 1.2.3. Mechanical stress-assisted design 20 1.3. Research motivation 23 1.4. Thesis overview 25 Chapter 2. Methodology 28 2.1. Computational modeling and analysis 28 2.1.1. FE simulation for DNA origami structures 28 2.1.2. MD simulation for DNA origami structures 30 2.2. Fabrication and characterization 31 2.2.1. Self-assembly of DNA origami structures. 31 2.2.2. Agarose gel electrophoresis. 32 2.2.3. AFM imaging 33 2.2.4. TEM imaging 34 Chapter 3. Mechanical stress engineering for fine shape control 35 3.1. Limitation in the design of twisted structures 35 3.2. Configurational design approach 37 3.3. Twist angle variation 41 3.4. Fine control over twist rate 68 3.5. Twist control assisted by mechanical relaxation using gaps 76 3.6. Summary 83 Chapter 4. Mechanical stress engineering for shape reconfiguration 84 4.1. Limitation in the reconfiguration mechanisms 84 4.2. Buckling-induced homeomorphic transformation 86 4.3. Supercoiling of the 6HB ring 91 4.4. Computational analysis of the buckling-induced supercoiling 104 4.5. Reconfiguration control by local defects 110 4.6. Summary 112 Chapter 5. Concluding remark 113 Appendix 115 A1. Calculation of twist angles of 6HB structures 115 A2. Relation between twist angle and trans-ratio (TR) 118 A3. FE simulation of a coiling of a dsDNA ring 120 Bibliography 122 ๊ตญ ๋ฌธ ์ดˆ ๋ก 132 Acknowledgments 134Docto

    ์‹์‚ฌ ๋นˆ๋„ ๋ฐ ์‹์ด ์˜์–‘ ์„ฑ๋ถ„๊ณผ ๊ทผ์œก๋Ÿ‰์˜ ์—ฐ๊ด€์„ฑ(๊ตญ๋ฏผ๊ฑด๊ฐ•์˜์–‘์กฐ์‚ฌ 2008-2009)

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋ณด๊ฑด๋Œ€ํ•™์› : ๋ณด๊ฑดํ•™๊ณผ(๋ณด๊ฑดํ•™์ „๊ณต), 2013. 8. ์กฐ์„ฑ์ผ.- ์—ฐ๊ตฌ ๋ฐฐ๊ฒฝ ์—ฐ๋ น ์ฆ๊ฐ€์— ๋”ฐ๋ผ ๊ทผ์œก๋Ÿ‰์€ ๊ฐ์†Œํ•˜๊ฒŒ ๋˜๊ณ , ์ด๋Š” ์‹ ์ฒด ๊ธฐ๋Šฅ ๋ฐ ๋…๋ฆฝ์ ์ธ ์ผ์ƒ ์ƒํ™œ ๋Šฅ๋ ฅ์„ ์ €ํ•˜์‹œํ‚ค๋Š” ์ค‘์š”ํ•œ ์š”์ธ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค. ๊ทผ์œก๋Ÿ‰ ๋ณ€ํ™”์™€ ๊ด€๋ จํ•œ ์š”์ธ์œผ๋กœ ์„ฑํ˜ธ๋ฅด๋ชฌ, ์„ฑ์žฅํ˜ธ๋ฅด๋ชฌ, ์ธ์Š๋ฆฐ ์ด‰์ง„์ธ์ž ํ˜ธ๋ฅด๋ชฌ, ์‹ ์ฒดํ™œ๋™, ์˜์–‘ ์„ญ์ทจ, ๋งŒ์„ฑ ์†Œ๋ชจ์„ฑ ์งˆํ™˜ ์ดํ™˜, ์‹ ๊ฒฝ๊ณ„ ์ด์ƒ ๋“ฑ์ด ์žˆ๋‹ค. ์ด ์ค‘ ์‹์ด ๋นˆ๋„์™€ ์‹์ด ์˜์–‘ ์„ฑ๋ถ„์€ ์˜์–‘ ์š”์ธ์œผ๋กœ์„œ, ์‹์ด ๋นˆ๋„์˜ ์ฆ๊ฐ€ ๋ฐ ๋‹จ๋ฐฑ์งˆ์„ ๋น„๋กฏํ•œ ํ•ญ์‚ฐํ™” ๋ฌผ์งˆ์˜ ์„ญ์ทจ๋Š” ๊ทผ์œก์˜ ๋‹จ๋ฐฑ์งˆ ํ•ฉ์„ฑ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๊ฒŒ ๋œ๋‹ค. - ์—ฐ๊ตฌ ๋ชฉ์  ์‹์ด ๋นˆ๋„์™€ ๊ทผ์œก๋Ÿ‰์˜ ์—ฐ๊ด€์„ฑ์— ๋Œ€ํ•œ ๊ตญ๋‚ด์™ธ ์—ฐ๊ตฌ๋Š” ๋ถ€์กฑํ•œ ์‹ค์ •์ด๋ฉฐ, ๋Œ€๋ถ€๋ถ„์€ ์†Œ๊ทœ๋ชจ๋กœ ์ด๋ฃจ์–ด์ง„ ๊ฒƒ๋“ค์ด ๋งŽ๋‹ค. ์‹์ด ์˜์–‘ ์„ฑ๋ถ„๊ณผ ๊ทผ์œก๋Ÿ‰์˜ ๊ด€๊ณ„๋ฅผ ๋ณธ ๋Œ€๋‹ค์ˆ˜์˜ ์—ฐ๊ตฌ์—์„œ๋Š” ์ฃผ๋กœ ๋‹จ๋ฐฑ์งˆ์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค. ์šฐ๋ฆฌ์˜ ์—ฐ๊ตฌ๋Š” ๊ทผ์œก๋Ÿ‰๊ณผ ๊ด€๋ จํ•œ ์—ฌ๋Ÿฌ ์š”์ธ ์ค‘ ์‹์‚ฌ ๋นˆ๋„, ๊ฐ„์‹ ๋นˆ๋„, ์‹์‚ฌ์™€ ๊ฐ„์‹์„ ํ•ฉํ•œ ์‹์ด ์„ญ์ทจ ๋นˆ๋„์™€ ๊ทผ์œก๋Ÿ‰์˜ ์—ฐ๊ด€์„ฑ, ์‹์ด ์˜์–‘ ์„ฑ๋ถ„๊ณผ ๊ทผ์œก๋Ÿ‰์˜ ์—ฐ๊ด€์„ฑ์„ ์•Œ์•„ ๋ณด๊ณ ์ž ํ•˜์˜€๋‹ค. - ์—ฐ๊ตฌ ๋ฐฉ๋ฒ• 2008๋…„, 2009๋…„ ๊ตญ๋ฏผ๊ฑด๊ฐ•์˜์–‘์กฐ์‚ฌ ์ž๋ฃŒ๋ฅผ ์ด์šฉํ•˜์—ฌ ์—ฐ๊ตฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ ๋Œ€์ƒ์ž๋Š” ๋งŒ 20์„ธ ์ด์ƒ ์„ฑ์ธ์œผ๋กœ ์ •ํ•˜์˜€๊ณ , ์ด์ค‘ ์—๋„ˆ์ง€ ๋ฐฉ์‚ฌ์„  ํก์ˆ˜๊ณ„์ธก(DEXA: dual energy X-ray absorptiometry) ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ๊ฐ€ ๋ˆ„๋ฝ๋œ ์ž, ์‹์ด ์Šต๊ด€, ์‹์ด ์˜์–‘, ํ‚ค, ๋ชธ๋ฌด๊ฒŒ, ์ฒด์งˆ๋Ÿ‰์ง€์ˆ˜ ์ž๋ฃŒ๊ฐ€ ์—†๋Š” ์ž, ์•”ํ™˜์ž, ์ž„์‚ฐ๋ถ€๋ฅผ ์ œ์™ธํ•œ ์ด 6,481๋ช…์ด ํฌํ•จ๋˜์—ˆ๋‹ค. ๋…๋ฆฝ๋ณ€์ˆ˜๋Š” ์‹์‚ฌ ๋นˆ๋„(<2/day, 2-<3/day, 3/day), ๊ฐ„์‹๋นˆ๋„(โ‰ค1/day, 2/day, โ‰ฅ3/day), ์‹์‚ฌ ๋นˆ๋„์™€ ๊ฐ„์‹ ๋นˆ๋„๋ฅผ ํ•ฉํ•œ ์‹์ด ์„ญ์ทจ ๋นˆ๋„(โ‰ค3/day, 4/day, โ‰ฅ5/day), ์ฒด์ค‘๋‹น 1์ผ ์„ญ์ทจํ•œ ์˜์–‘ ์„ฑ๋ถ„์œผ๋กœ ์ •ํ•˜์˜€๋‹ค. ๊ฒฐ๊ณผ๋ณ€์ˆ˜๋Š” ์‚ฌ์ง€ ๊ทผ์œก๋Ÿ‰์œผ๋กœ์„œ, ์ด์ค‘ ์—๋„ˆ์ง€ ๋ฐฉ์‚ฌ์„  ํก์ˆ˜๊ณ„์ธก ๊ฒ€์‚ฌ๋ฅผ ์‹œํ–‰ํ•˜์—ฌ ์–ป์€ ์‚ฌ์ง€ ์ œ์ง€๋ฐฉ๋Ÿ‰์„ ํ‚ค๋กœ ๋‚˜๋ˆˆ ๊ฐ’(appendicular lean mass index, kg/m2)์œผ๋กœ ์ •ํ•˜์˜€๋‹ค. ๋‹ค์ค‘ ๋กœ์ง€์Šคํ‹ฑ ํšŒ๊ท€๋ถ„์„์˜ ๊ฒฐ๊ณผ๋ณ€์ˆ˜๋Š” ์‚ฌ์ง€ ์ œ์ง€๋ฐฉ๋Ÿ‰์„ ๋‚จ๋…€๋ณ„๋กœ ํ‰๊ท ์น˜ ๋ฏธ๋งŒ, ์ด์ƒ์ธ ๊ตฐ์œผ๋กœ ๋ฒ”์ฃผํ™”ํ•œ ๊ฒƒ์œผ๋กœ ์ •ํ•˜์˜€๋‹ค. ๋ณด์ • ๋ณ€์ˆ˜๋กœ๋Š” ์„ฑ, ์—ฐ๋ น, ์ฒด์งˆ๋Ÿ‰์ง€์ˆ˜, ๊ต์œก์ˆ˜์ค€, ํก์—ฐ, ์Œ์ฃผ, ์‹ ์ฒดํ™œ๋™, ์‹์ด ๋ณด์ถฉ์ œ ๋ณต์šฉ ์—ฌ๋ถ€, ๊ณ ํ˜ˆ์•• ํ˜„์žฌ ์œ ๋ณ‘์—ฌ๋ถ€, ๊ณ ์ง€ํ˜ˆ์ฆ ํ˜„์žฌ ์œ ๋ณ‘์—ฌ๋ถ€, ๋‹น๋‡จ๋ณ‘ ํ˜„์žฌ ์œ ๋ณ‘์—ฌ๋ถ€, 1์ผ ์„ญ์ทจํ•œ ์—๋„ˆ์ง€, ์‹์‚ฌ ๋นˆ๋„(๋…๋ฆฝ๋ณ€์ˆ˜๊ฐ€ ๊ฐ„์‹ ๋นˆ๋„์ธ ๊ฒฝ์šฐ) ๋˜๋Š” ๊ฐ„์‹ ๋นˆ๋„(๋…๋ฆฝ๋ณ€์ˆ˜๊ฐ€ ์‹์‚ฌ ๋นˆ๋„์ธ ๊ฒฝ์šฐ), ํ˜ธ๋ฅด๋ชฌ ๋Œ€์ฒด ์š”๋ฒ• ์œ ๋ฌด(์—ฌ์„ฑ์˜ ๊ฒฝ์šฐ)๋ฅผ ๊ณ ๋ คํ•˜์˜€๋‹ค. ๊ธฐ์ดˆ ํ†ต๊ณ„ ๋ถ„์„์€ ๋‚จ๋…€ ๋ณ„๋กœ ์—ฐ์† ๋ณ€์ˆ˜ ๋น„๊ต๋ฅผ ์œ„ํ•˜์—ฌ t-test๋ฅผ, ๋ฒ”์ฃผํ˜• ๋ณ€์ˆ˜ ๋น„๊ต๋ฅผ ์œ„ํ•˜์—ฌ x2-test, ANOVA๋ฅผ ์‹œํ–‰ํ•˜์˜€๋‹ค. ๋…๋ฆฝ๋ณ€์ˆ˜์™€ ๊ฒฐ๊ณผ ๋ณ€์ˆ˜์˜ ์—ฐ๊ด€์„ฑ ํ‰๊ฐ€๋ฅผ ์œ„ํ•˜์—ฌ ๋‹ค์ค‘ ๋กœ์ง€์Šคํ‹ฑ ํšŒ๊ท€๋ถ„์„(multiple logistic regression), ํŽธ์ƒ๊ด€ ๋ถ„์„(partial correlation)์„ ์‹œํ–‰ํ•˜์˜€๊ณ , ํ†ต๊ณ„์  ์œ ์˜์„ฑ์€ p value<0.05์œผ๋กœ ์ •ํ•˜์˜€๋‹ค. SPSS 13.0์„ ์ด์šฉํ•˜์˜€๋‹ค. - ์—ฐ๊ตฌ ๊ฒฐ๊ณผ ๋Œ€์ƒ์ž๋Š” ๋‚จ์ž 2,612๋ช…, ์—ฌ์ž 3,869๋ช…์ด์—ˆ๊ณ , ๋‚จ๋…€ ํ‰๊ท  ๋‚˜์ด๋Š” 49์„ธ์˜€๋‹ค. ๊ต์œก ์ˆ˜์ค€, ์Œ์ฃผ, ํก์—ฐ, ์‹ ์ฒดํ™œ๋™, ์‹์ด ๋ณด์ถฉ์ œ ๋ณต์šฉ, ์—ฌ์„ฑํ˜ธ๋ฅด๋ชฌ ์น˜๋ฃŒ, ๊ณ ํ˜ˆ์••, ๊ณ ์ง€ํ˜ˆ์ฆ, ๋‹น๋‡จ๋ณ‘ ํ˜„์žฌ ์œ ๋ณ‘ ์—ฌ๋ถ€ ๋“ฑ์˜ ๋ณ€์ˆ˜๋“ค์ด ์‚ฌ์ง€ ๊ทผ์œก๋Ÿ‰ 4๋ถ„์œ„ ๊ทธ๋ฃน๊ฐ„ ์ฐจ์ด๋ฅผ ๋ณด์˜€๋‹ค. ๊ต๋ž€ ๋ณ€์ˆ˜๋ฅผ ํ†ต์ œํ•˜์—ฌ ๋‹ค์ค‘ ๋กœ์ง€์Šคํ‹ฑ ํšŒ๊ท€๋ถ„์„์„ ํ•œ ๊ฒฐ๊ณผ ๋‚จ์ž์—์„œ๋Š” ์‹์‚ฌ ๋นˆ๋„, ๊ฐ„์‹ ๋นˆ๋„, ์‹์ด ์„ญ์ทจ์™€ ๊ทผ์œก๋Ÿ‰ ์‚ฌ์ด ์œ ์˜ํ•œ ์—ฐ๊ด€์„ฑ์ด ์—†์—ˆ์œผ๋‚˜, ์—ฌ์ž์—์„œ๋Š” ํ•˜๋ฃจ 2ํšŒ ๋ฏธ๋งŒ ์‹์‚ฌํ•œ ๊ตฐ์— ๋น„ํ•˜์—ฌ 3ํšŒ ์‹์‚ฌํ•œ ๊ตฐ์—์„œ ์‚ฌ์ง€ ๊ทผ์œก๋Ÿ‰์ด ํ‰๊ท  ์ด์ƒ์ผ odds ratio๊ฐ€ 1.17(CI 1.01-1.37)์ด์—ˆ๊ณ , ์ด ์‹์ด ๋นˆ๋„๊ฐ€ 4ํšŒ, 5ํšŒ ์ด์ƒ์ธ ๊ตฐ์ด 3ํšŒ ์ดํ•˜์ธ ๊ตฐ์— ๋น„ํ•˜์—ฌ odds ratio๊ฐ€ ๊ฐ๊ฐ 1.33(CI 1.08-1.63), 1.21(CI 1.02-1.43)๋กœ ์ฆ๊ฐ€ํ•˜์˜€๋‹ค. ์‹์ด ์˜์–‘ ์„ฑ๋ถ„๊ณผ ๊ทผ์œก๋Ÿ‰์— ๋Œ€ํ•˜์—ฌ ๊ต๋ž€ ๋ณ€์ˆ˜๋ฅผ ๋ณด์ •ํ•˜์—ฌ ํŽธ์ƒ๊ด€ ๋ถ„์„์„ ์‹œํ–‰ํ•˜์˜€๊ณ , ๋‚จ์ž์—์„œ๋Š” ๋‹จ๋ฐฑ์งˆ, ์ง€๋ฐฉ, ํƒ„์ˆ˜ํ™”๋ฌผ, ์ธ, ๋น„ํƒ€๋ฏผ B2(riboflavin), ๋‚˜์ด์•„์‹ ์˜ ์„ญ์ทจ๋Ÿ‰๊ณผ ์‚ฌ์ง€ ๊ทผ์œก๋Ÿ‰ ์‚ฌ์ด์— ์–‘์˜ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ์žˆ์—ˆ๊ณ  ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜์˜€๋‹ค. ์—ฌ์ž์—์„œ๋Š” ๋‹จ๋ฐฑ์งˆ, ํƒ„์ˆ˜ํ™”๋ฌผ, ์„ฌ์œ ์งˆ, ์ธ, ์นผ๋ฅจ, ๋น„ํƒ€๋ฏผ B1(thiamine), ๋น„ํƒ€๋ฏผ B2(riboflavin)์™€ ์‚ฌ์ง€ ๊ทผ์œก๋Ÿ‰ ์‚ฌ์ด์— ์œ ์˜ํ•œ ์–‘์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ณด์˜€๋‹ค. - ๊ฒฐ๋ก  ๋‚จ์ž์—์„œ๋Š” ์‹์ด ๋นˆ๋„์™€ ์‚ฌ์ง€ ๊ทผ์œก๋Ÿ‰ ์‚ฌ์ด์— ์œ ์˜ํ•œ ๊ด€๋ จ์„ฑ์ด ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜์œผ๋‚˜, ์—ฌ์ž์—์„œ๋Š” ์‹์ด ๋นˆ๋„์™€ ๊ทผ์œก๋Ÿ‰ ์‚ฌ์ด์— ์œ ์˜ํ•œ ๊ด€๋ จ์„ฑ์ด ์žˆ์—ˆ๋‹ค. ์‹์ด ์˜์–‘ ์„ฑ๋ถ„ ์ค‘์—๋Š” ๋‚จ๋…€ ๊ณตํ†ต์ ์œผ๋กœ ๋‹จ๋ฐฑ์งˆ, ํƒ„์ˆ˜ํ™”๋ฌผ, ๋น„ํƒ€๋ฏผB2๊ฐ€ ๊ทผ์œก๋Ÿ‰๊ณผ ์–‘์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ณด์˜€๋‹ค. ์ด๋Ÿฌํ•œ ๊ฒฐ๊ณผ๋Š” ์‹์‚ฌ ๋นˆ๋„๊ฐ€ ์ฆ๊ฐ€ํ•  ์ˆ˜๋ก ๊ทผ์œก ๋‚ด ๋‹จ๋ฐฑ์งˆ ๋ถ„ํ•ด๊ฐ€ ๊ฐ์†Œํ•˜๊ณ , ๋‹จ๋ฐฑ์งˆ ๋ฐ ํ•ญ์‚ฐํ™” ๋ฌผ์งˆ์„ ์„ญ์ทจํ•˜๋Š” ๊ฒฝ์šฐ ๊ทผ์œก์˜ ๋‹จ๋ฐฑ์งˆ ํ•ฉ์„ฑ์ด ์ฆ๊ฐ€ํ•œ๋‹ค๋Š” ๊ธฐ์ „์œผ๋กœ ์„ค๋ช…๋˜์–ด์งˆ ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋‹ค.์ œ 1 ์žฅ ์„œ๋ก  1 ์ œ 1 ์ ˆ ์—ฐ๊ตฌ ๋ฐฐ๊ฒฝ 1 1. ๊ทผ์œก๊ฐ์†Œ์ฆ์˜ ์ •์˜ ๋ฐ ์—ญํ•™ 1 2. ๊ทผ์œก๊ฐ์†Œ์ฆ๊ณผ ๊ด€๋ จํ•œ ์š”์ธ 3 3. ๊ทผ์œก๊ฐ์†Œ์ฆ์ด ๊ฑด๊ฐ•์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ 5 4. ๊ทผ์œก๋Ÿ‰๊ณผ ์‹์ด ์š”์ธ์— ๋Œ€ํ•œ ์—ฐ๊ตฌ ๊ณ ์ฐฐ 6 4.1์‹์‚ฌ ๋นˆ๋„ ๋ฐ ์‹์ด ์˜์–‘ ์„ฑ๋ถ„์˜ ๊ทผ์œก๋Ÿ‰ ๋ณ€ํ™”์— ๋Œ€ํ•œ ๊ธฐ์ „ 6 4.2์‹์‚ฌ ๋นˆ๋„์™€ ๊ทผ์œก๋Ÿ‰ 6 4.3 ์‹์ด ์˜์–‘ ์„ฑ๋ถ„๊ณผ ๊ทผ์œก๋Ÿ‰ 7 ์ œ 2 ์ ˆ ์—ฐ๊ตฌ ๋ชฉ์  9 ์ œ 2 ์žฅ ์—ฐ๊ตฌ ๋ฐฉ๋ฒ• 10 ์ œ 1 ์ ˆ ์—ฐ๊ตฌ ๋Œ€์ƒ 10 ์ œ 2 ์ ˆ ๋ณ€์ˆ˜ ์ •์˜ 11 1. ์กฐ์‚ฌ ๋ฐฉ๋ฒ• 11 2. ๋…๋ฆฝ ๋ณ€์ˆ˜ 11 3. ๊ฒฐ๊ณผ ๋ณ€์ˆ˜ 12 4. ๋ณด์ • ๋ณ€์ˆ˜ 12 ์ œ 3 ์ ˆ ๋ถ„์„ ๋ฐฉ๋ฒ• 14 ์ œ 3 ์žฅ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ 15 ์ œ 1 ์ ˆ ๋Œ€์ƒ์ž์˜ ์ผ๋ฐ˜์  ํŠน์„ฑ 15 ์ œ 2 ์ ˆ ๋Œ€์ƒ์ž์˜ ์‹์ด ์š”์ธ ๋ฐ ๊ทผ์œก๋Ÿ‰ 16 ์ œ 3์ ˆ ๊ทผ์œก๋Ÿ‰๊ณผ ๊ด€๋ จํ•œ ์š”์ธ ๋ถ„์„ 20 ์ œ 4 ์ ˆ ์‹์ด ๋นˆ๋„์™€ ๊ทผ์œก๋Ÿ‰์˜ ์—ฐ๊ด€์„ฑ 25 ์ œ 5 ์ ˆ ์‹์ด ์˜์–‘ ์„ฑ๋ถ„๊ณผ ๊ทผ์œก๋Ÿ‰์˜ ์—ฐ๊ด€์„ฑ 28 ์ œ 4 ์žฅ ๊ณ ์ฐฐ 31 ์ฐธ๊ณ ๋ฌธํ—Œ 37 Abstract 44Maste

    Characteristics and Safety of Cardiopulmonary Exercise Testing in Elderly Patients with Cardiovascular Diseases in Korea

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    PURPOSE: Clinical use of cardiopulmonary exercise tests (CPETs) is increasing in elderly patients with cardiovascular (CV) diseases. However, data on Korean populations are limited. In this study, we aimed to examine the characteristics and safety of CPET in an elderly Korean population with CV disease. MATERIALS AND METHODS: We retrospectively analyzed records of 1485 patients (older than 65 years in age, with various underlying CV diseases) who underwent CPET. All CPET was performed using the modified Bruce ramp protocol. RESULTS: The mean age of patients was 71.6ยฑ4.7 years with 63.9% being men, 567 patients aged 60-65 years, 818 patients aged 70-79 years, and 100 patients aged 80-89 years. The mean respiratory exchange ratio was 1.09ยฑ0.14. During CPET, three adverse cardiovascular events occurred (total 0.20%), all ventricular tachycardia. All subjects showed an average exercise capacity of 21.3ยฑ5.5 mL/kg/min at peak VOโ‚‚ and 6.1ยฑ1.6 metabolic equivalents of task, and men showed better exercise capacity than women on most CEPT parameters. A significant difference was seen in peak oxygen uptake according to age group (65-69 years, 22.9ยฑ5.8; 70-79 years, 20.7ยฑ5.1; 80-89 years, 17.0ยฑ4.5 mL/kg/min, p<0.001). The most common causes for CPET termination were dyspnea (64.8%) and leg pain (24.3%), with higher incidence of leg pain in octogenarians compared to other age groups (65-69 years, 22.4%; 70-79 years, 24.6%; 80-89 years, 32.0%, p<0.001). CONCLUSION: CPET was relatively a safe and useful modality to assess exercise capacity, even in an elderly Korean population with underlying CV diseases.ope

    HLA Allele Frequencies in 5802 Koreans: Varied Allele Types Associated with SJS/TEN According to Culprit Drugs

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    PURPOSE: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are very serious forms of drug-induced cutaneous adverse reaction. SJS/TEN induced by certain drug is well known to be associated with some human leukocyte antigen (HLA) gene type. We aimed to explore HLA allele frequencies and their association with SJS/TEN according to culprit drugs in Korea. MATERIALS AND METHODS: We enrolled 5802 subjects who had results of HLA typing test from August 2005 to July 2014. Total 28 SJS/TEN patients were categorized based on culprit drugs (allopurinol, lamotrigine, carbamazepine) and identified the presence of HLA-B*58:01, HLA-B*44:03, HLA-B*15:02, and HLA-A*31:01. RESULTS: HLA-A*24:02 (20.5%), HLA-B*44:03 (10.0%), and HLA-Cw*01:02 (17.1%) were the most frequent type in HLA-A, -B, and -C genes, respectively. Allele frequencies of HLA-B*58:01, HLA-B*44:03, HLA-A*31:01, and HLA-B*15:02 were 7.0%, 10.0%, 5.0%, and 0.3%, respectively. In 958 allopurinol users, 9 subjects (0.9%) were diagnosed with SJS/TEN. Among them, 8 subjects possessed HLA-B*58:01 allele. SJS/TEN induced by allopurinol was more frequently developed in subjects with HLA-B*58:01 than in subjects without it [odds ratio: 57.4; confidence interval (CI) 7.12-463.50; p<0.001]. Allopurinol treatment, based on screening by HLA-B*58:01 genotyping, could be more cost-effective than that not based on screening. HLA-B*44:03 may be associated with lamotrigine-induced SJS/TEN (odds ratio: 12.75; CI 1.03-157.14; p=0.053). Among carbamazepine users, only two patients experienced SJS/TEN and possessed neither HLA-B*15:02 nor HLA-A*31:03. CONCLUSION: HLA gene frequencies varied in Korea. Screening of HLA-B*58:01 before the use of allopurinol might be needed to anticipate probability of SJS/TEN.ope

    Apple-dependent exercise-induced anaphylaxis

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    Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of anaphylaxis that requires both vigorous physical activity and the ingestion of specific causative foods. In particular, occurrence for FDEIA is rarely associated with apples. A 17-year-old male experienced generalized urticaria, dyspnea, headache, vomiting, and presyncope after ingestion of an apple and then 2 hours of exercise. The skin prick test showed a strong positive reaction to apple crude allergen extract, whereas the results of an open food challenge and exercise provocation tests were negative. However, the exercise test after apple consumption provoked a positive reaction with generalized urticaria, dyspnea, and presyncope. We detected 17 kD IgE-reactive protein band in immunoblotting assay with apple crude extract and patient's serum.ope

    The Case of Isolated Double Atrial Septum with Persistent Interatrial Space

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    Double atrial septum is very rare atrial septal malformation which has double layered atrial septum with persistent interatrial space between the two atria. Clinically, most cases of this anomaly are asymptomatic unless manifest as thromboembolic complications, such as stroke, or transient ischemic attack, that thrombus may be originated from this interatrial space. We report a case of a 69-year-old man who was diagnosed with isolated double atrial septum by transthoracic echocardiography.ope

    Effectiveness Analysis Through Enzyme-Linked Immunosorbent Assay Examination of Antibody After Pandemic H1N1 2009 Influenza Vaccination

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    Background: A pandemic influenza outbreak started in 2009 by the number of patients discharged each year. But the result of H1N1 influenza vaccination is maintained for research and less state. The purpose of this study was to measure the antibody titers after H1N1 influenza vaccination toestimate demands of different standard vaccination in patients with chronic diseases and elderly patients. Methods: From March 2010 to February 2011, we retrospectively reviewed the medical records of 55 patients admitted to a tertiary hospital. The H1N1 virus antibody titer of each patient was measured through enzyme-linked immunosorbent assay. Titers were measured post vaccination on day 1 and at 1, 3 and 6 months. Results: A total of 55 patients were enrolled in this study. The comorbidities looked at were malignancy, cardiovascular disease, diabetes mellitus, renal disease, cerebrovascular disease, hematologic disease and infectious disease. Five patients (9.1%) had no comorbidities. Patients in their 50โ€™s had the highest positive response rate (58.3%). The antibody titers at 1 month after vaccination were not associated with the number of comorbidities. The ratio of positive response increased gradually at baseline (16.4%) to 1 month (47.8%). After 6 months, there remained no positive response. Conclusion: The H1N1 antibodies were unstable as the values of the titer changed at follow-up (1 month, 3 months, and 6 months). The positive response rates of those in their 50โ€™s and those who had chronic diseases were higher than others. The positive response rates showed that the ability to generate antibodies did not decrease with age or disease conditions.ope

    Successful Treatment of Severe Aortic Stenosis With Transcatheter Aortic Valve Implantation in a Centenarian Patient

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    Transcatheter aortic valve implantation (TAVI) is a less invasive procedure to treat severe aortic valve stenosis than conventional surgical aortic valve replacement. Furthermore, TAVI has shown similar clinical outcomes as surgical treatment with less mortality and morbidities in elderly patients at high risk for conventional surgery. In this report, we describe case of successful TAVI using a CoreValve in a 103-year-old patient with symptomatic severe aortic valve stenosis.ope

    Radiographical studies on the maxillo-facial bone fractures

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    ์˜ํ•™๊ณผ/์„์‚ฌ[ํ•œ๊ธ€] [์˜๋ฌธ] Although many studies on the various aspects of Maxillo-facial bone fractures have been reported, the author has analyzed locations, age, sex and monthly distribution of occurrence radiographically. Special attention was given to the fracture line and eruptive pattern of lower third molar in the fracture of mandibular angle region. 81 cases from oral surgery department of the Dental Infirmary of the Dental College of Yonsei Univ. were used for the study. The results are as follows: 1. The highest incidence of Jaw bone fracture was observed in the age group of the second decade (35.8%), and male cases (72 cases) were eight times as many as female (9 cases And two major etiologic factors for jaw bone fracture were fist blow (37.0%), and traffic accident (30.9%). In the case of blow, the mandible was most frequently involved. Middle facial bone were caused most often by traffic accident and middle facial bone with mandible were most peculiar to fall accidents. 2. In the mandible frature, a single fracture line was abserved in 59.4 percent, of the cases, double and triple fracture lines appeared in 34.3 percent and 6.3 percent of cases respectively. The most frequent fractured region was the mandibular angle region (24.5%) and the left side (42.6%) was more involved compared with right side (37.0%) in all cases. 3. The fracture of the mandibular symphysis was most frequent in cases with a single fracture line. The double fracture lines appearing in the right and left anterior regions of one side and the opposite angle portion were the most frequent combination of fractures. Triple fracture lines were observed in mandibular condylar neck fracture more than the other regions. 4. 91.3% of the fracture line in the mandibular angle region were associated with the lower third molar tooth. There were more fracture lines passing distally (65.2%) then mesially (17.4%) and centrally (17.4%) to the third molar tooth. 5. In the middle facial bone fractures, LeFort type โ…  fractures were seen most frequently (30%) and the least frequent cases were the LeFort type โ…ก fractures(11.5%)> 6. In the monthly distribution of patients with fractures, October appeared the highest incidence (17.3%) and December was the lowest incidence (3.7%). Autumn was the most frequent incidence (37.0%) of the year.restrictio

    (The) influence of collar design and surface roughness on peri-implant marginal bone loss

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    ์น˜์˜ํ•™๊ณผ/์„์‚ฌ[ํ•œ๊ธ€] ์ž„ํ”Œ๋ž€ํŠธ ์ฃผ์œ„ ๋ณ€์—ฐ๊ณจ์˜ ํก์ˆ˜๋Š” ์ž„ํ”Œ๋ž€ํŠธ์˜ ๊ธฐ๋Šฅ์  ๋ฐ ์‹ฌ๋ฏธ์  ์„ฑ๊ณต์— ํฐ ์žฅ์• ๊ฐ€ ๋˜๋Š” ์š”์ธ์ด๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์ž„ํ”Œ๋ž€ํŠธ collar ๋ถ€์œ„์˜ ํ˜•ํƒœ์™€ ํ‘œ๋ฉด ๊ฑฐ์น ๊ธฐ๊ฐ€ ์ฃผ์œ„ ๋ณ€์—ฐ๊ณจ ํก์ˆ˜์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๋Œ€ํ•ด ์•Œ์•„๋ณด๊ณ ์ž ํ•˜์˜€๋‹ค. 6์ข…๋ฅ˜์˜ ์ž„ํ”Œ๋ž€ํŠธ ์ด 175๊ฐœ๋ฅผ ์‹๋ฆฝํ•œ ํ™˜์ž 102๋ช…์—์„œ ์ž„ํ”Œ๋ž€ํŠธ ์‹๋ฆฝ ํ›„ ๋ณด์ฒ ๋ฌผ ์žฅ์ฐฉ๊นŒ์ง€์˜ ๊ณจ ๋ณ€ํ™”๋Ÿ‰(phase 1), ์žฅ์ฐฉ ํ›„ 6๊ฐœ์›”๊นŒ์ง€์˜ ๊ณจ ๋ณ€ํ™”๋Ÿ‰(phase 2), ์žฅ์ฐฉ 6๊ฐœ์›” ํ›„๋ถ€ํ„ฐ ์žฅ์ฐฉ 12๊ฐœ์›” ํ›„ ๊ณจ ๋ณ€ํ™”๋Ÿ‰(phase 3)๊ณผ ๊ณจ ํก์ˆ˜ ๊ฐ๋„๋ฅผ ์ธก์ •ํ•˜์˜€๋‹ค. ๊ณ ์ •์ฒด์™€ ์ง€๋Œ€์ฃผ์˜ ์—ฐ๊ฒฐ ํ˜•ํƒœ๊ฐ€ external connection type์ธ ์ž„ํ”Œ๋ž€ํŠธ(Branemark, Silhouette External Hex)์™€ internal connection type์ธ ์ž„ํ”Œ๋ž€ํŠธ(Silhouette IC, Silhouette IC Laser-LokTM, ITI standard, ITI esthetic plus)์—์„œ ์—ฐ๊ฒฐ ํ˜•ํƒœ์— ๋”ฐ๋ฅธ ๋ณ€์—ฐ๊ณจ ํก์ˆ˜๋Ÿ‰์„ ๋น„๊ตํ•ด ๋ณด๊ณ  ์ƒ๋ฌผํ•™์  ํญ๊ฒฝ์„ ์ถฉ๋ถ„ํžˆ ํ™•๋ณดํ•œ ์ž„ํ”Œ๋ž€ํŠธ(ITI standard)์™€ ์ƒ๋ฌผํ•™์  ํญ๊ฒฝ์ด ๋ถ€์กฑํ•œ ์ž„ํ”Œ๋ž€ํŠธ(Branemark, Silhouette External Hex, Silhouette IC, Silhouette IC Laser-LokTM, ITI esthetic plus)์—์„œ ๋ณ€์—ฐ๊ณจ ํก์ˆ˜์˜ ์ฐจ์ด๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ž„ํ”Œ๋ž€ํŠธ ์ฃผ์œ„ ๋ณ€์—ฐ๊ณจ์˜ ํก์ˆ˜์— ๋Œ€ํ•œ laser๋ฅผ ์ด์šฉํ•œ ๋ฏธ์„ธ๋‚˜์‚ฌ์‚ฐ์˜(Silhouette IC Laser-LokTM) ์˜ํ–ฅ์„ ์•Œ์•„๋ณด๊ณ  ๋‹ค์Œ์˜ ๊ฒฐ๋ก ์„ ์–ป์—ˆ๋‹ค. 1. External connection type์ธ Branemark system๊ณผ Silhouette External Hex ์ž„ํ”Œ๋ž€ํŠธ๋Š” Internal connection type ์ž„ํ”Œ๋ž€ํŠธ์— ๋น„ํ•ด ๋†’์€ ๋ณ€์—ฐ๊ณจ ํก์ˆ˜๋Ÿ‰์„ ๋ณด์˜€๋‹ค. 2. Silhouette IC์™€ ITI esthetic plus๋Š” Branemark system๊ณผ Silhouette External Hex ์ž„ํ”Œ๋ž€ํŠธ์— ๋น„ํ•ด ๋‚ฎ์€ ๊ณจํก์ˆ˜๋ฅผ ๋ณด์˜€์ง€๋งŒ ITI standard์™€ Silhouette IC Laser-LokTM์— ๋น„ํ•ด์„œ๋Š” ๋†’์€ ๊ณจํก์ˆ˜๋ฅผ ๋ณด์˜€๋‹ค. 3. Branemark system์˜ 65%์™€ Silhouette External Hex ์ž„ํ”Œ๋ž€ํŠธ์˜ 77%์—์„œ ๋ถ„ํ™”๊ตฌ ํ˜•ํƒœ์˜ ๊ณจํก์ˆ˜ ์–‘์ƒ์„ ๋ณด์˜€๋‹ค. ์ด์ƒ์˜ ๊ฒฐ๊ณผ๋ฅผ ๋ณผ ๋•Œ ๊ณ ์ •์ฒด์™€ ์ง€๋Œ€์ฃผ์˜ ์—ฐ๊ฒฐ ๋ฐฉ์‹์ด external connection type์ธ ๊ฒฝ์šฐ ๊ทธ๋ฆฌ๊ณ  ์ƒ๋ฌผํ•™์  ํญ๊ฒฝ์ด ๋ถ€์กฑํ•œ ๊ฒฝ์šฐ์—๋Š” ๋” ๋งŽ์€ ์ž„ํ”Œ๋ž€ํŠธ ์ฃผ์œ„ ๋ณ€์—ฐ๊ณจ์˜ ํก์ˆ˜๊ฐ€ ์žˆ์—ˆ์Œ์„ ๋ณด์—ฌ์ฃผ๊ณ  ์žˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ microgroove๊ฐ€ ๋ถ€์—ฌ๋œ ์ž„ํ”Œ๋ž€ํŠธ์—์„œ๋Š” collar์˜ ๊ฑฐ์น ๊ธฐ์™€ laser microtexturing ๋“ฑ์˜ ํŠน์ง•์— ์˜ํ•ด ์ƒ๋ฌผํ•™์  ํญ๊ฒฝ์ด ๋ถ€์กฑํ•˜์—ฌ๋„ ์ž„ํ”Œ๋ž€ํŠธ ์ฃผ์œ„ ๋ณ€์—ฐ๊ณจ์˜ ํก์ˆ˜๊ฐ€ ์ ๊ฒŒ ์ผ์–ด๋‚œ ๊ฒƒ์ด ๊ด€์ฐฐ๋˜์—ˆ๋‹ค. [์˜๋ฌธ] Peri-implant marginal bone loss is an important factor that affects the success of implants in esthetics and function. The purpose of this study was to examine the influence of collar design and surface roughness on peri-implant marginal bone loss. Radiographical marginal bone loss were examined in patients treated with implant-supported fixed partial dentures. Changes in marginal bone levels were examined with 6 kinds of total 175 implant fixtures installed in 102 patients at three periods(at the time of implantation, prosthetic treatment, 6-month after loading and 12-month after loading). Resorption angles at 12-month after loading were examined too. The differences of marginal bone loss between implants(Branemark, Silhouette External Hex) with external connection type and implants(Silhouette IC, Silhouette IC Laser-LokTM, ITI standard, ITI esthetic plus) with internal connection type have been compared. Also, the differences of bone loss between implants(ITI standard) with enough biologic width and implants(Branemark, Silhouette External Hex, Silhouette IC, Silhouette IC Laser-LokTM, ITI esthetic plus) with insufficient biologic width have been compared. Effect of microthread on peri-implant marginal bone loss were also examined. Within the limitation of this study, the following results were drawn. 1. The marginal bone loss of external connection type implant(Branemark system and Silhouette External Hex) was more than that of internal connection type implants. 2. The marginal bone loss of Silhouette IC and ITI esthetic plus was less than that of Branemark system and Silhouette External Hex implant but more than that of ITI standard and Silhouette IC Laser-LokTM implant. 3. 65% of Branemark system and 77% of Silhouette External Hex show saucerization The implant design with external connection type and insufficient biologic width shows more marginal bone loss. However, it was observed that microgroove and rough surface are helpful in the preservation of marginal bone.ope
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