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Analysis of Oral Pathogenic Microorganisms by Elderly’s Systemic and Oral Health Status of the Elderly Over 65 Years
Biomed Sci Letters 2018;24:372-379
Published online December 31, 2018;  https://doi.org/10.15616/BSL.2018.24.4.372
© 2018 The Korean Society For Biomedical Laboratory Sciences.

Min-Kyung Lee1,*, Su-Bin Yu2,*, and Hye-Jin Kim1,†,*

1Department of Biomedical Health Science, Dong-eui University, Busan 47340, Korea,
2Department of Oral Anatomy, School of Dentistry, Pusan National University, Busan 50612, Korea
Correspondence to: Hye-Jin Kim. Department of Biomedical Health Science, Dong-eui University, 176 Eongwangno (gayadong san24), Busanjin-gu, Busan 47340, Korea. Tel: +82-51-890-4237, Fax: +82-50501826878, e-mail: khj1126@deu.ac.kr
Received November 12, 2018; Revised December 10, 2018; Accepted December 11, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

Korean society is experiencing rapid growth due to industrialization and urbanization, and the aging of population is emerging. Degradation of the masticatory muscle due to aging and reduction of the number of mastications causes dry mouth syndrome with decreased saliva in the elderly. Changes in the amount and composition of saliva cause various oral diseases, especially, periodontal disease is closely related to the microorganisms that form the plaque. In the elderly education, stimulation saliva was collected at the first visit and the last visit to observe changes in microorganisms in the oral cavity. For the collection of the probes, the paraffin wax was chewed for 5 minutes. The samples were immediately refrigerated in a 50 cc plastic tube and then stored at -20°C until the next use. The subjects of this study were the elderly people aged 65 years or older, and the study was conducted on 16 persons, 3 males and 13 females. The distribution of saliva microorganisms according to rolling brushing method showed significant difference in all three groups (Aa & Red complex, Orange complex and Green complex) before and after the education. In the group who answered that they had dentures, it was confirmed that the amount of microorganisms before and after education was significantly reduced in all three groups. There was a significant decrease in the amount of microorganisms in the Aa & Red complex and Orange complex group in the case of hypertension related to systemic disease. In conclusion, the higher the interest of oral health and general health of the subjects, the more effective the education.

Keywords : Aged, Microbial, Periodontitis
꽌 濡

븳援궗쉶뒗 궛뾽솕 諛 룄떆솕濡 湲됯꺽븳 꽦옣쓣 씠猷④퀬 엳쑝硫, 洹몄뿉 뵲瑜 뿬윭 궗쉶씤援щЦ젣媛 몢릺怨 엳떎. 뿬꽦쓽 궗쉶吏꾩텧利앷 諛 궗쉶쟻 吏쐞 긽듅쑝濡 異쒖궛쑉씠 빐留덈떎 媛먯냼븯怨 엳쑝硫, 洹 寃곌낵 슦由 궗쉶뒗 2017뀈 65꽭 씠긽쓽 끂씤씤援ш 李⑥븯뒗 鍮꾩쑉씠 빟 14%뿉 떖븯뒗 怨좊졊솕 궗쉶濡 吏꾩엯븯떎(Cho, 2017). 삉븳 쓽猷뚭린닠쓽 諛쒖쟾쑝濡 씤媛꾩쓽 湲곕닔紐낆씠 利앷븯怨, 끂뀈 궣쓽 吏덉쓣 寃곗젙吏볥뒗 嫄닿컯뿉 븳 愿떖怨 슃援щ뒗 젏젏 利앷븯怨 엳뒗 異붿꽭씤 諛섎㈃, 끂씤뱾 젇 뿰졊痢듭뿉 鍮꾪빐 嫄닿컯愿젴젙蹂대 뒿뱷븷 닔 엳뒗 湲고쉶媛 留롮 븡쑝硫 삉븳 뿬윭 뵒吏꽭 留ㅼ껜 씠슜뒫젰룄 遺議깊븯뿬 嫄닿컯뿉 븳 슃援щ 異⑹”븷 닔 엳뒗 닔떒怨 湲고쉶媛 젣븳맂떎(Park, 2011). 씠윭븳 씠쑀뱾濡 씤빐 끂씤蹂듭봽濡쒓렇옩 諛 끂씤援ш컯嫄닿컯愿由 봽濡쒓렇옩씠 媛쒕컻릺怨 엳쑝굹 媛떆쟻씤 슚怨쇰뒗 誘몃명븳 떎젙씠떎.

씤媛꾩 끂솕쁽긽뿉 뵲씪 硫댁뿭湲곕뒫怨 吏덈퀝뿉 븳 쉶蹂듬젰씠 젇 뿰졊痢듭뿉 鍮꾪빐 쁽븯寃 궙떎. 뵲씪꽌 끂씤痢듭뿉꽌 諛쒖깮븷 닔 엳뒗 뿬윭 궗꽦 諛 눜뻾꽦 蹂묐 쟾떊嫄닿컯쓣 쐞삊븷 肉먮쭔 븘땲씪 援ш컯議곗쭅쓽 蹂솕룄 珥덈옒븯硫, 쟾떊吏덊솚 移섎즺젣 蹂듭슜怨 옉洹 눜솕 諛 옉슏닔 媛먯냼 벑쓽 슂씤 끂씤痢듭뿉꽌 븸웾씠 媛먯냼븯뒗 援ш컯嫄댁“利앹쓣 쑀諛쒗븯寃 릺뒗뜲 洹 鍮꾩쑉씠 빟 56%濡 蹂닿퀬맂 諛붿엳떎(Yang et al., 2008; Joung and Cho, 2017). 븸웾 媛먯냼뒗 援ш컯 궡 옄젙옉슜쓣 媛먯냼떆耳, 移섏븘슦떇利 諛 移섏<吏덊솚쓽 쑀蹂묐쪧쓣 利앷떆궎怨, 誘멸컖옣븷, 援ъ랬瑜 쑀諛쒗븳떎(Meyerowitz, 1991). 援ш컯 궡遺뒗 뒿븯怨, 븸 궡 뭾遺븳 쁺뼇遺꾩쑝濡 씤븯뿬 닔留롮 깮由ъ쟻 諛 蹂묒쟻 誘몄깮臾쇱씠 議댁옱븯硫, 븸웾씠굹 議곗꽦쓽 蹂솕뒗 誘몄깮臾쇱쓽 빆긽꽦쓣 뙆愿댄븯뿬 뿬윭 援ш컯吏덊솚쓣 쑀諛쒗븳떎(Roh and Kim, 2018). 듅엳 옣뀈痢듬꽣 끂뀈痢듦퉴吏 떎諛쒗븯뒗 援ш컯긽蹂묒씤 移섏<吏덊솚 援ш컯 궡 蹂묒썝꽦 誘몄깮臾쇱씠 援곕씫쓣 씠猷 移섎㈃꽭洹좊쭑뿉 쓽빐꽌 諛쒕퀝릺硫, 移섏<吏덊솚 쑀諛쒓퇏씠 떖삁愿吏덊솚怨 瑜섎쭏떚뒪 愿젅뿼 벑쓽 뿬윭 쟾떊吏덊솚쓽 쐞뿕씤옄濡 諛앺吏 諛 엳떎(Lim et al., 2004; Choi and Cho, 2015). 꽑뻾뿰援(Lee et al., 2008)뿉꽌뒗 移섏<吏덊솚 쑀諛쒓퇏 以 媛옣 以묒슂븳 洹좎<씤 Porphyromonas gingivalis媛 궗엺 룞留 룊솢洹쇱쑝濡 移⑤쾾 媛뒫븳 寃껋쓣 諛앺깉떎. 쐞쓽 洹쇨굅뱾濡 끂솕쁽긽쑝濡 씤븳 쟾떊嫄닿컯쓽 蹂솕뒗 援ш컯嫄닿컯怨 遺덇遺꾩쓽 愿怨꾩뿉 엳떎怨 蹂 닔 엳쑝硫, 援ш컯쐞깮愿由щ뒗 嫄닿컯쓽 泥숇룄濡 뿬寃⑥쭏 留뚰겮 以묒슂꽦쓣 媛吏꾨떎. 끂씤쓽 쟾떊嫄닿컯 怨 援ш컯嫄닿컯怨 뿰愿씠 엳怨 援ш컯嫄닿컯 議곌굔씠 쟾떊嫄닿컯쓣 쑀吏븷 닔 엳뒗 泥숇룄媛 맆 닔 엳떎.

뵲씪꽌 蹂 뿰援щ뒗 援ш컯嫄닿컯愿젴 젙蹂 뒿뱷 寃쎈줈媛 긽쟻쑝濡 뼱졄怨, 援ш컯蹂묒뿉 痍⑥빟븷 媛뒫꽦씠 넂 65꽭 씠긽 끂씤쓣 긽쑝濡 援ш컯嫄닿컯愿由 援먯쑁 썑 븸怨 誘몄깮臾 닔 蹂솕瑜 議곗궗븯怨, 듅엳 끂씤쓽 쟾떊 諛 援ш컯嫄닿컯긽깭 븸쓽 蹂솕, 援ш컯 궡 誘몄깮臾 遺꾪룷 蹂솕쓽 愿젴꽦쓣 뙆븙븯뿬 異뷀썑 끂씤援ш컯嫄닿컯利앹쭊쓣 쐞븳 湲곗큹옄猷뚮 젣怨듯븯怨좎옄 븳떎.

뿰援щ긽 諛 諛⑸쾿

뿰援щ긽

蹂 뿰援щ뒗 遺궛떆뿉 嫄곗<븯硫 뿰援ъ쓽 痍⑥ 紐⑹쟻쓣 씠빐븯怨 꽕臾몄뿉 룞쓽瑜 뼸 65꽭 씠긽 끂씤 20紐낆쓣 긽쑝濡 2018뀈 3썡 14씪遺꽣 룞뀈 4썡 24씪源뚯 뿰援щ 닔뻾븯쑝硫 쟾떊吏덊솚쑝濡 嫄닿컯뿉 臾몄젣媛 엳뒗 寃쎌슦瑜 젣쇅븯怨 옄쓽쟻쑝濡 諛⑸Ц븯뿬 4二 援먯쑁쓣 紐⑤몢 諛쏆 16紐낆쓣 理쒖쥌 뿰援 긽옄濡 븯떎.

뿰援щ갑踰

꽕臾몄“궗: 씪諛섏쟻 듅꽦怨 援ш컯嫄닿컯愿由ы뻾깭, 二쇨쟻쑝濡 뙋떒븯뒗 援ш컯긽깭, 쟾떊吏덊솚뿉 븳 궡슜쑝濡 꽕臾몄“궗瑜 떎떆븯쑝硫 끂씤쓣 긽쑝濡 븳 援ш컯蹂닿굔援먯쑁 留ㅼ< 1쉶 珥 4쉶 諛⑸Ц븯뿬 諛섎났 援먯쑁쓣 떎떆븯떎. 援먯쑁궡슜 끂씤援ш컯吏덊솚(移섏<蹂, 援ъ랬, 援ш컯怨 쟾떊吏덊솚)怨 땲愿由щ쾿씠떎.

援ш컯 궡 誘몄깮臾 寃궗: 끂씤 援먯쑁 떆 泥 諛⑸Ц怨 留덉留 諛⑸Ц뿉 옄洹뱀꽦 븸쓣 梨꾩랬븯뿬 援ш컯 궡 誘몄깮臾 蹂솕瑜 愿李고븯떎. 寃梨 梨꾩랬뒗 5遺 룞븞 뙆씪 셼뒪瑜 뵻寃 븯뿬 50 cc 뵆씪뒪떛 뒠釉뚯뿉 옄洹뱀꽦 븸쓣 諛쏆븘 利됱떆 깋옣 蹂닿 븯怨, 쑀쟾옄寃궗湲곌뿉 蹂대궦 썑 떎쓬 궗슜 떆源뚯 -20°C뿉꽌 蹂닿릺뿀떎.

Real-time PCR뿉 쓽븳 젙웾遺꾩꽍: NEXprep™ Cell/Tissue Genomic DNA kit瑜 씠슜븯뿬 젣議곗궗쓽 吏떆뿉 뵲씪 genomic DNA瑜 異붿텧븯떎. 援ш컯誘몄깮臾쇱쓽 젙웾遺꾩꽍쓣 쐞븯뿬 PerioGen™ Perio Real-Time PCR Kit (Microis, Korea)瑜 씠슜븯떎. 援ш컯 궡 議댁옱븯뒗 쟾泥 誘몄깮臾쇱쓽 寃異쒖쓣 쐞빐꽌뒗 16s rDNA 떒렪쓣 利앺룺븯怨, 媛곴컖쓽 誘몄깮臾 寃異쒖쓣 쐞빐꽌뒗 functional gene (rgp, waa, gtf)쑝濡쒕꽣 specific primer瑜 젣옉븯뿬 빟 200 bp 궡쇅쓽 DNA 떒렪쓣 媛곴컖 利앺룺븯떎. Multiplex real-time PCR뿉 궗슜맂 probe뱾 꽌濡 媛꾩꽠쓣 怨좊젮븯뿬 뙆옣씠 寃뱀튂吏 븡뒗 3醫(FAM, Cy5, HEX)쓣 꽑깮븯怨, 媛 諛섏쓳뿉꽌 遺꾩꽍긽 洹좎쥌뱾 以 3醫낆뵫 臾띠뼱꽌 꽕 醫낅쪟쓽 panel쑝濡 援ъ꽦븯怨 Table 1뿉 굹궡뿀떎. Real-time PCR 諛섏쓳 슜븸 異붿텧븳 total DNA 2 μL瑜 媛곴컖쓽 primer set 10 pmol, probe 셿異⑹슜븸, 1 unit Hot-start Taq DNA polymerase (GeneAll, Korea)쓣 샎빀븯뿬 珥 20 μL媛 릺룄濡 젣議고븯떎. 96 well뿉 遺꾩< 썑 ABI 7500 Fast Real-Time PCR System (Applied Biosystems, Life Technologies, Carlsbad, CA, USA)쓣 씠슜븯뿬 젙웾遺꾩꽍쓣 떆뻾븯떎.

The bacteria strains used in this study

 Division   Target strain
A PanelAggregatibacter actinomycetemcomitans KCTC 3698
Porphyromonas gingivalis KCTC 5352
Tannerella forsythia KCTC 5666

B PanelTreponema denticola KCTC 15104
Prevotella intermedia KCTC 5692
Fusobacteríum nucleatum KCTC 2640

C PanelParvimonas micra ATCC 33270
Campylobacter rectus KCTC 5636
Eikenella corrodens KCTC 15198

D PanelEubacterium codatum KCTC 15015
Prevotella nigrescens KCTC 5690
Total bacteria 16s rDNA control

援ш컯 궡 誘몄깮臾 遺꾨쪟: 移섏<吏덊솚쓣 씪쑝궎뒗 썝씤 꽭洹좊뱾쓽 듅吏, 긽샇 뿰愿꽦, 뿼깋諛섏쓳, 吏묐씫쓽 삎깭 諛 깋냼쓽 깮꽦 쑀臾 諛 엫긽쟻 吏몴 벑쓣 湲곗쑝濡 Red complex, Orange complex, Green complex, Yellow complex, Purple complex쓽 5媛 깋源 蹂꾨줈 遺꾨쪟븯굹(Socransky et al., 1998) 蹂 뿰援ъ뿉꽌뒗 Red complex, Orange complex, Green complex 3媛쒖쓽 援곗쑝濡쒕쭔 遺꾨쪟븯떎. 移섏<吏덊솚怨 愿젴꽦씠 엳뒗 移섏뿰븯쓽 꽭洹 以 P. gingivalis, T. forsythia, T. denticola瑜 Red complex씪 븯쑝硫, 씠 complex뒗 移섏<궘 源딆씠 깘移 떆 異쒗삁怨 媛숈 移섏<吏덊솚 吏몴 媛뺥븳 긽愿愿怨꾨 媛吏꾨떎怨 蹂닿퀬븯떎(Socransky et al., 1998). 移섏<吏덊솚怨 愿젴씠 源딆 Orange complex뿉뒗 P. intermedia, F. nucleaum, P. micra, C. rectun쑝濡 遺꾨쪟맂떎. Green complex뒗 珥덇린뿉 吏묐씫쓣 씠猷⑤뒗 援곗쑝濡 A. actinomycetemcomitans, E. corrodens濡 遺꾨쪟릺怨 엳쑝硫, Orange complex 愿젴씠 엳뒗 寃껋쑝濡 諛앺議뚮떎.

遺꾩꽍諛⑸쾿

닔吏묓븳 옄猷뚮 씠슜븯뿬 SPSS statistics v. 23쓣 씠슜븯뿬 寃곌낵遺꾩꽍 븯떎. 꽦蹂, 뿰졊 鍮덈룄 諛깅텇쑉쓣 젣떆븯怨, 꽦蹂꾩뿉 뵲瑜 援ш컯誘몄깮臾 遺꾪룷뒗 궗쟾 寃궗 룞吏덉꽦 寃利(룆由쏀몴蹂 t寃利)쓣 넻빐 솗씤븯떎. 嫄닿컯愿由ы뻾깭, 援ш컯긽깭, 쟾떊吏덊솚 쑀臾댁뿉꽌 援ш컯嫄닿컯愿由 援먯쑁 쟾怨 썑뿉 뵲瑜 援ш컯 궡 誘몄깮臾 遺꾪룷뒗 Wilcoxon’s signed rank test瑜 떎떆븯쑝硫 嫄닿컯愿由ы뻾깭, 援ш컯긽깭, 쟾떊吏덊솚怨쇱쓽 愿젴꽦쓣 뙆븙븯湲 쐞빐 Correlation analysis뒗 Spearman 닚쐞 긽愿遺꾩꽍쓣 떎떆븯떎.

寃 怨

뿰援 긽옄쓽 꽦蹂꾩뿉 뵲瑜 뿰졊 遺꾪룷

蹂 뿰援 긽옄쓽 꽦蹂꾩뿉 뵲瑜 뿰졊 遺꾪룷瑜 Table 2뿉 굹궡뿀떎. 뿰援щ긽 65꽭 씠긽쓽 끂씤 뿰졊痢듭씠怨, 궓옄 3紐, 뿬옄 13紐낆쑝濡 珥 16紐낆쓣 긽쑝濡 뿰援щ 떆뻾븯떎. 洹 以 80꽭 씠븯 끂씤鍮꾩쑉씠 50%, 81~85꽭 끂씤鍮꾩쑉씠 37.5%, 86꽭 씠긽 끂씤쓽 鍮꾩쑉 12.5%떎. Table 3 꽦蹂꾩뿉 뵲瑜 援ш컯誘몄깮臾 遺꾪룷쓽 궗쟾 룞吏덉꽦쓣 寃궗븳 寃곌낵 Aa & Red complex뒗 궓옄媛 6.07, 뿬옄媛 8.52, Orange complex뒗 궓옄媛 18.00, 뿬옄媛 21.42, Green complex뒗 궓옄媛 4.01, 뿬옄媛 3.88濡 꽦蹂꾩뿉 뵲씪 꽭 洹몃9씠 넻怨꾩쟻쑝濡 李⑥씠媛 뾾뒗 寃껋쑝濡 룞吏덊븯떎怨 빐꽍븯떎.

Distrubution of gender and age

 Group~8081~8586~Total
Male1 (33.3)1 (33.3)1 (33.3)3 (100.0)
Female7 (53.8)5 (38.5)1 (7.7)13 (100.0)

Total8 (50.0)6 (37.5)2 (12.5)16 (100.0)

Pre- equivalence check of oral microorganisms distribution by gender

 GroupAa & Red complext(P)Orange complext(P)Green complext(P)
Male6.07±3.73-1.22718.00±6.59-1.2194.01±.58.112
Female8.52±3.31(.240)21.42±4.94(.243)3.88±1.80(.912)

뿰援 긽옄쓽 援ш컯嫄닿컯愿由ы뻾깭뿉 뵲瑜 븸 궡 誘몄깮臾 遺꾪룷

Table 4뒗 긽옄쓽 援ш컯嫄닿컯愿由ы뻾깭 뵲瑜 븸 궡 誘몄깮臾 遺꾪룷 寃곌낵瑜 굹궡뿀떎. 援ш컯嫄닿컯愿由ы뻾깭뒗 移レ넄吏 諛⑸쾿, 移レ넄吏 슏닔, 떐湲 쑀臾댁뿉 븯뿬 꽕臾명븯떎. 븸 궡 誘몄깮臾쇱 移섏<吏덊솚 쐞뿕 湲곗뿬룄뿉 뵲씪 꽭 洹몃9쑝濡 굹늻뿀怨, 援ш컯蹂닿굔援먯쑁 쟾, 썑 誘몄깮臾쇱쓽 珥앸웾뿉 李⑥씠媛 엳뒗吏瑜 議곗궗븯떎. 移レ넄吏 諛⑸쾿뿉 뵲瑜 븸 誘몄깮臾 遺꾪룷 웾 議곗궗 寃곌낵 쉶쟾踰뺤궗슜怨 Orange complex (P=0.019) 洹몃9 媛 援먯쑁 쟾, 썑 쑀쓽븳 李⑥씠媛 엳뿀쑝硫, 븘臾대젃寃뚮굹 移レ넄吏덉쓣 븯뒗 寃쎌슦뿉꽌뒗 Aa & Red complex (P=0.005), Orange complex (P=0.007)뿉꽌 援먯쑁 쟾, 썑 쑀쓽븳 李⑥씠媛 엳뿀떎. 1씪 移レ넄吏 鍮덈룄媛 3쉶씪怨 쓳떟븳 援곗뿉꽌뒗 Aa & Red complex (P=0.005), Orange complex (P=0.028)뿉꽌 援먯쑁 쟾, 썑 쑀쓽븳 李⑥씠媛 엳뿀쑝硫, 瑜 떐뒗 洹몃9뿉꽌룄 Aa & Red complex (P=0.002), Orange complex (P=0.003)뿉꽌 援먯쑁 쟾, 썑 李⑥씠瑜 蹂댁떎.

Distribution of oral microorganisms according to oral health management behavior

DivisionAa & Red complexOrange complexGreen complex



Pre-eduPost-eduZ(P)Pre-eduPost-eduZ(P)Pre-eduPost-eduZ(P)
Methods of toothbrushingRolling methods14.52 ±3.435.15 ±2.16-1.604 (.109)24.51 ±4.8515.53 ±4.36-1.604 (.019)5.69 ±0.124.55 ±0.47-1.604 (.109)
Vertical + Horizontal12.12 ±3.888.91 ±4.31-.535 (.593)25.82 ±8.2624.20 ±0.52.000 (1.000)3.60 ±3.144.00 ±0.74.000 (1.000)
Do at random13.59 ±1.808.95 ±3.25-2.803 (.005)25.50 ±5.0521.37 ±3.99-2.701 (.007)4.22 ±1.793.69 ±2.01-1.481 (.139)

Frequency of toothbrushing~2 times16.37 ±2.778.22 ±0.90-1.342 (.180)27.79 ±2.2720.07 ±5.23-1.342 (.180)4.5 ±1.785.08 ±0.09-.447 (.655)
3 times12.92 ±2.398.10 ±3.47-2.824 (.005)24.66 ±5.9121.06 ±4.97-2.197 (.028)4.12 ±2.083.61 ±1.78-1.778 (.075)
4 times14.00 ±0.609.00 ±6.48-1.342 (.180)27.26 ±1.4820.00 ±0.82-1.342 (.180)5.77 ±0.044.54 ±0.02-1.342 (.180)

Tongue brushingYes13.90 ±2.217.86 ±3.34-3.059 (.002)25.30 ±5.1219.96 ±4.84-2.981 (.003)4.54 ±1.753.90 ±1.88-1.867 (.062)
No12.26 ±3.159.33 ±3.95-1.095 (.273)25.61 ±6.5123.32 ±1.89-.365 (.715)3.89 ±2.633.93 ±0.47-.368 (.713)

뿰援 긽옄쓽 援ш컯긽깭뿉 뵲瑜 븸 궡 誘몄깮臾 遺꾪룷

Table 5뒗 긽옄쓽 援ш컯긽깭뿉 뵲瑜 븸 궡 誘몄깮臾 遺꾪룷 寃곌낵瑜 굹궡뿀떎. 援ш컯긽깭뒗 쓽移섏옣李 쑀臾, 援ъ랬 쑀臾, 엲紐명넻利 쑀臾, 移섏븘넻利 쑀臾대줈 援щ텇븯떎. 쓽移섎 옣李⑺븳떎뒗 쓳떟援곗뿉꽌 Aa & Red complex 洹몃9쓽 援먯쑁 쟾, 썑 誘몄깮臾쇱쓽 뼇씠 쑀쓽븯寃 以꾩뼱뱺 寃껋쓣 솗씤븯쑝硫(P=0.025), 쓽移섎 옣李⑺븯吏 븡 洹몃9뿉꽌뒗 꽭 洹몃9 紐⑤몢뿉꽌 誘몄깮臾쇱뼇씠 쑀쓽븯寃 媛먯냼븯뒗 寃껋씠 솗씤릺뿀떎(P=0.012, P=0.017, P=0.025). 援ъ랬媛 뾾떎怨 쓳떟븳 寃쎌슦 Aa & Red complex Orange complex 洹몃9뿉꽌留 쑀쓽븳 李⑥씠媛 엳뿀떎(P=0.002, P=0.008). 삉븳 엲紐명넻利앷낵 移섏븘넻利앹뿉꽌 넻利앹씠 뾾떎怨 쓳떟븳 寃쎌슦뿉꽌 Aa & Red complex, Orange complex 誘몄깮臾쇱쓽 뼇쓽 쑀쓽븳 媛먯냼瑜 솗씤븷 닔 엳뿀떎(P=0.005, P=0.019), (P=0.004, P=0.013).

Distribution of oral microorganisms according to oral health status

DivisionAa & Red complexOrange complexGreen complex



Pre-eduPost-eduZ(P)Pre-eduPost-eduZ(P)Pre-eduPost-eduZ(P)
DentureYes13.11 ±2.887.94 ±3.67-2.240 (.025)26.14 ±5.6122.05 ±3.50-1.680 (.093)3.50 ±2.453.16 ±2.02-.339 (.735)
No13.86 ±2.128.51 ±3.40-2.521 (.012)24.61 ±5.1519.55 ±5.23-2.380 (.017)5.25 ±0.464.66 ±0.53-2.240 (.025)

HalitosisYes13.58 ±0.799.76 ±1.95-1.342 (.180)23.38 ±7.9421.39 ±4.62-.447 (.655)5.20 ±0.075.01 ±0.42-.447 (.655)
No13.47 ±2.658.01 ±3.59-3.045 (.002)25.66 ±5.1420.72 ±4.64-2.668 (.008)4.26 ±2.043.75 ±1.68-1.503 (.133)

Gum painYes14.17 ±1.628.90 ±3.80-1.826 (.068)25.82 ±5.6521.25 c±2.80-1.461 (.144)3.94 ±2.663.31 ±2.22-1.604 (.109)
No13.26 ±2.728.00 ±3.45-2.824 (.005)25.22 ±5.3820.65 ±5.03-2.353 (.019)4.52 ±1.744.11 ±1.44-1.177 (.239)

Tooth painYes14.08 ±1.977.34 ±2.66-1.604 (.109)25.70 ±6.9121.48 ±3.38-1.069 (.285)3.33 ±2.892.91 ±2.54-1.342 (.180)
No13.35 ±2.628.43±3.65-2.900 (.004)25.30 ±5.1620.65 ±4.81-2.481 (.013)4.62 ±1.704.14 ±1.38-1.363 (.173)

뿰援 긽옄쓽 쟾떊吏덊솚 쑀臾댁뿉 뵲瑜 븸 궡 誘몄깮臾쇰텇룷

Table 6 긽옄쓽 쟾떊嫄닿컯긽깭뿉 뵲瑜 븸 궡 誘몄깮臾 遺꾪룷 寃곌낵瑜 굹궡뿀떎. 쟾떊吏덊솚 쑀臾댁뿉꽌 怨좏삁븬, 怨⑤떎怨듭쬆, 떖삁愿怨꾩쭏솚, 쐞옣옣븷 벑쓽 吏덊솚쓣 븪怨 엳뒗吏뿉 뵲씪 媛 誘몄깮臾 遺꾪룷 웾씠 援먯쑁 쟾, 썑 뼱뼚븳 李⑥씠瑜 蹂댁씠뒗吏 솗씤븯떎. 洹 寃곌낵, 怨좏삁븬 쑀臾댁뿉꽌뒗 怨좏삁븬쓣 븪怨 엳뒗 寃쎌슦뿉꽌 Aa & Red complex Orange complex 洹몃9쓽 誘몄깮臾 뼇씠 쑀쓽븯寃 媛먯냼븯뒗 寃껋쓣 솗씤븯怨(P=0.018, P=0.018), 怨좏삁븬쓣 븪吏 븡뒗 援곗뿉꽌뒗 Aa & Red complex留 쑀쓽븯寃 媛먯냼븯떎(P=0.015). 怨⑤떎怨듭쬆 씠솚릺뼱 엳吏 븡떎怨 쓳떟븳 援곗뿉꽌 Aa & Red complex Orange complex 洹몃9쓽 誘몄깮臾 뼇씠 쑀쓽븯寃 媛먯냼릺뒗 寃껋씠 솗씤릺뿀쑝硫(P=0.006, P=0.019), 떖삁愿怨꾩쭏솚 쑀臾댁뿉꽌뒗 吏덊솚씠 뾾떎怨 쓳떟븳 援곗뿉꽌 꽭 洹몃9 紐⑤몢 쑀쓽븳 李⑥씠媛 엳뿀떎(P=0.001, P=0.002, P=0.050). 쐞옣옣븷 쑀臾댁뿉꽌 쐞옣옣븷媛 뾾뒗 寃쎌슦 Aa & Red complex Orange complex 洹몃9뿉꽌 쑀쓽븳 李⑥씠媛엳뿀떎 P=0.005, P=0.023).

Distribution of oral microorganisms according to systemic disease

DivisionAa & Red complexOrange complexGreen complex



Pre-eduPost-eduZ(P)Pre-eduPost-eduZ(P)Pre-eduPost-eduZ(P)
HypertensionYes13.86 ±3.337.92 ±3.33-2.366 (.018)25.48 ±4.8119.58 ±3.86-2.366 (.018)5.12 ±.934.68 ±.53-1.183 (.237)
No13.20 ±2.468.47 ±3.69-2.429 (.015)25.29 ±5.8821.76 ±4.93-1.718 (.086)25.29 ±5.8821.76 ±4.93-1.262 (.207)

OsteoporosisYes15.01 ±5.167.89 ±3.09-1.826 (.068)25.99 ±5.8321.50 ±2.31-1.461 (.144)4.68 ±1.383.37 ±2.31-1.826 (.068)
No12.98 ±2.408.34 ±3.66-2.746 (.006)25.17 ±5.3220.57 ±4.47-2.353 (.019)4.27 ±2.124.09 ±1.41-.889 (.374)

Cardiovascular diseaseYes11.93 ±3.758.78 ±3.83-1.069 (.285)24.57 ±2.3623.56 ±7.15-.535 (.593)2.80 ±.872.65 ±.36.000 (1.000)
No13.85 ±2.138.10 ±3.49-3.180 (.001)25.57 ±1.3720.17 ±4.49-3.110 (.002)4.74 ±1.584.20 ±1.37-1.962 (.050)

Gastrointestinal disorderYes14.18 ±1.866.47 ±4.74-1.826 (.068)26.64 ±5.5420.35 ±3.65-1.826 (.068)3.83 ±2.613.09 ±2.08-1.633 (.102)
No13.26 ±2.688.81 ±2.91-2.824 (.005)24.95 ±5.3520.95 ±4.88-2.275 (.023)4.56 ±1.754.18 ±1.44-1.177 (.239)

쟾떊嫄닿컯 諛 援ш컯嫄닿컯긽깭, 援ш컯 궡 誘몄깮臾쇨낵쓽 愿젴꽦

Table 7 쟾떊嫄닿컯愿由 援먯쑁 쟾怨 썑쓽 援ш컯 궡 誘몄깮臾 珥앸웾, 移レ넄吏 뻾깭, 援ш컯嫄닿컯긽깭, 쟾떊嫄닿컯긽깭쓽 긽愿愿怨꾨 遺꾩꽍븳 寃곌낵씠떎. 援먯쑁 쟾 誘몄깮臾쇱쓽 珥앸웾怨 쑀쓽븳 쓬쓽 긽愿愿怨꾨 媛吏뒗 슂씤쑝濡쒕뒗 1씪 移レ넄吏덈퉰룄(r=-.680, P=0.004), 쐞옣옣븷(r=-.519, P=0.040)媛 엳뿀怨, 援먯쑁 쟾 誘몄깮臾쇱쓽 뼇 쓽移섏옣李 쑀臾댁뒗 쑀쓽븳 뼇쓽 긽愿愿怨꾨 媛吏뒗 寃껋쑝濡 솗씤릺뿀떎(r=.550, P=0.027). 삉븳 엲紐명넻利앷낵 怨좏삁븬씠(r=-.509, P=0.044) 쑀쓽븳 뼇쓽 긽愿愿怨꾨 媛議뚮떎.

The relationship between general health and oral health

  Division*123456789101112
Amount of1
microorganism (pre)
Amount of microorganism (post)-.337 (.202)1
Frequncy of toothbrushing-.680 (.004).339 (.198)1
Methods of toothbrushing.120 (.659)-.143 (.597).971 (.097)1
Halitosis.288 (.279)-.062 (.821).971 (.097).285 (.278)1
Gum pain-.314 (.236)-.157 (.562).289 (.278).435 (.092).218 (.417)1
Tooth pain-.157 (.562)-.209 (.438).971 (.097).362 (.168).303 (.255).832 (.001)1
Denture.550 (.027)-.196 (.467)-.249 (.352)-.015 (.957).355 (.178).135 (.617).225 (.402)1
Hypertension.343 (.194).012 (.098)-.252 (.346)-.142 (.599)-.333 (.207)-.509 (.044)-.424 (.102).089 (.744)1
Cardio vascular disease-.261 (.328)-.122 (.653).320 (.227)-.282 (.291)-.182 (.501)-.277 (.298).231 (.298)-.488 (.055)-.101 (.710)1
Osteoporosis.141 (.601)-.314 (.237)-.289 (.278)-.145 (.592).218 (.417).971 (.097).092 (.733)-.169 (.531)-.218 (.417).092 (.733)1
Gastro intestinal disease-.519 (.040).094 (.729).289 (.278).199 (.459)-.218 (.417).333 (.207).092 (.733)-.220 (.413)-.218 (.417)-.277 (.298).092 (.733)1

*1. Amount of microorganism (pre), 2. Amount of microorganism (post), 3. Frequncy of toothbrushing, 4. Methods of toothbrushing, 5. Halitosis, 6. Gum pain, 7. Tooth pain, 8. Denture, 9. Hypertension, 10. Cardio vascular disease, 11. Osteoporosis, 12. Gastro intestinal disease


怨 李

蹂 뿰援щ뒗 65꽭 씠긽 끂씤 뿰졊痢듭쓣 긽쑝濡 끂씤援 媛뺤쭏솚愿由 諛 땲愿由щ쾿뿉 븳 援ш컯蹂닿굔援먯쑁 닔뻾 쟾, 썑뿉 媛곴컖 梨꾩랬븳 븸 궡 誘몄깮臾 뼇쓽 蹂솕瑜 솗씤븯怨, 誘몄깮臾 蹂솕媛 뼱뼚븳 쟾떊 諛 援ш컯嫄닿컯 듅꽦怨 愿젴 엳뒗吏 솗씤븯怨좎옄 닔뻾븯떎. 蹂 뿰援ъ뿉꽌 議곗궗븳 슂씤 뿰졊怨 꽦蹂 벑쓽 씪諛섏쟻 듅꽦, 援ш컯嫄닿컯愿由ъ뒿愿, 蹂몄씤씠옄媛곹븯뒗 援ш컯嫄닿컯긽깭 洹몃━怨 쟾떊吏덊솚 蹂댁쑀 쑀臾대 솗씤븯떎. 蹂 뿰援 긽옄씤 65꽭 씠긽쓽 끂씤뱾뿉寃 移섏<蹂, 援ъ랬, 援ш컯怨 쟾떊吏덊솚 愿젴꽦뿉 븳 씠濡좎떇, 移レ넄吏 諛⑸쾿, 엯泥댁“, 땲愿由щ쾿뿉 븳 援ш컯嫄닿컯愿由 援먯쑁쓣 留ㅼ< 1쉶 珥 4쉶 떆뻾븯怨, 援먯쑁 쟾怨 썑쓽 븸쓣 媛곴컖 梨꾩랬븯뿬 븸 궡 誘몄깮臾쇱쓽 珥 뼇쓣 議곗궗븯떎. 븸 궡 誘몄깮臾쇱 珥 11醫낆쓣 솗씤븯쑝硫 끂씤痢듭뿉 쑀蹂묐쪧씠 넂 移섏<吏덊솚 쐞뿕 湲곗뿬룄뿉 뵲씪 꽭 洹몃9쑝濡 굹늻뼱 遺꾩꽍븯떎. Red complex뿉 빐떦븯뒗 誘몄깮臾 洹좎<뱾 떖媛곹븳 移섏<吏덊솚怨 愿젴씠 엳쑝硫, 移섏<궘 삎꽦뿉 겕寃 愿뿬븯뒗 寃껋쑝濡 븣젮졇 엳떎(Rôças et al., 2001; Da silva-boghossian et al., 2011). 듅엳 Porphyromonas gingivalis뒗 移섏뿰븯 移섎㈃꽭洹좊쭑뿉 議댁옱븯硫 吏㏃ 留됰紐⑥뼇쓣 븳 鍮꾪솢룞꽦, 셿쟾삉湲곗꽦, G(-)떒媛꾧퇏쑝濡, 삉븳 湲됱꽦 · 留뚯꽦 移섏<뿼怨 愿젴꽦씠 넂怨 룆꽦씠 넂 꽭洹좎씠떎(Nishihara and Koseki, 2000). 씠 뜑遺덉뼱 Aggregatibacter actinomycetemcomitans 洹좎<뒗 red complex뿉 냽븯吏 븡吏留 몴쟻씤 湲됱쭊꽦 移섏<吏덊솚 蹂묒씤洹좎쑝濡 援냼쟻쑝濡 怨듦꺽쟻씠硫 吏꾪뻾 냽룄媛 鍮좊Ⅸ 寃껋쑝濡 븣젮졇 엳떎(Stanley and Jeffrey, 2005). Orange complex뿉 빐떦븯뒗 洹좎< 洹몃9 꽦씤뿉꽌 諛쒖깮븯뒗 移섏<뿼쓽 二쇱슂 蹂묒씤쑝濡 븣젮졇 엳떎(Roberts et al., 2002). 蹂 뿰援ъ뿉꽌 議곗궗븳 誘몄깮臾 洹좎< 以 Green complex뿉 빐떦븯뒗 寃껋 Eikenella corrodens媛 엳쑝硫, 씠 洹몃9뱾 꽌濡 긽샇옉슜븯硫 移섏<吏덊솚쓣 吏꾪뻾떆궎뒗 寃껋쑝濡 븣젮졇 엳떎(Carrouel et al., 2016). 뵲씪꽌 蹂 뿰援ъ뿉꽌뒗 援ш컯嫄닿컯愿由ы뻾깭 옄媛곹븯뒗 援ш컯긽깭, 쟾떊吏덊솚 쑀臾댁뿉 뵲瑜 꽕臾몄“궗瑜 떆뻾븯怨 媛 슂씤蹂꾨줈 援먯쑁 쟾, 썑 誘몄깮臾 꽭 洹몃9쓽 珥앸웾씠 쑀쓽븯寃 蹂솕븯뒗吏瑜 솗씤븯怨좎옄 븯떎.

泥 踰덉㎏ 슂씤씤 援ш컯嫄닿컯愿由ы뻾깭 愿젴븯뿬 꽕臾명븳 궡슜 移レ넄吏 諛⑸쾿, 移レ넄吏 슏닔, 떐湲 쑀臾댁뿉 븯뿬 議곗궗븯쑝硫 移レ넄吏덉쓣 쉶쟾踰뺤쑝濡 떆뻾븳떎뒗 쓳떟援곗뿉꽌 援먯쑁 쟾, 썑 orange complex 誘몄깮臾쇱쓽 珥앸웾씠 쑀쓽븯寃 媛먯냼븯뒗 寃껋쓣 솗씤븷 닔 엳뿀怨, 1씪 移レ넄吏 슏닔 援먯쑁 쟾, 썑 誘몄깮臾 珥앸웾쓽 媛먯냼 愿빐꽌뒗 移レ넄吏덉쓣 3李⑤ 븯뒗 쓳떟援곌낵 瑜 떐뒗떎뒗 쓳떟援곗뿉꽌 援먯쑁 쟾, 썑 Aa & Red complex, orange complex 誘몄깮臾 珥앸웾씠 쑀쓽븯寃 媛먯냼릺뿀떎. 꽑뻾뿰援ъ뿉 뵲瑜대㈃ 끂씤슂뼇떆꽕뿉꽌 洹쇰Т븯뒗 슂뼇蹂댄샇궗뱾쓣 긽쑝濡 援ш컯蹂닿굔吏떇룄 援ш컯蹂닿굔 뻾깭쓽 긽愿愿怨꾨 遺꾩꽍븳 寃곌낵 뼇(+)쓽 愿젴꽦씠 엳떎怨 굹궗떎(Bae et al., 2014). 씠윭븳 寃곌낵뒗 蹂 뿰援 긽옄媛 湲곗〈뿉 蹂댁쑀븯怨 엳뜕 援ш컯嫄닿컯愿젴吏떇씠 넂쓣닔濡, 援ш컯嫄닿컯뿉 븳 愿떖룄媛 넂쓣닔濡 援먯쑁궡슜쓣 異⑹떎엳 떆뻾븯뿬 슚怨쇨 엳뒗 寃껋쑝濡 궗猷뚮맂떎.

몢 踰덉㎏ 슂씤씤 援ш컯긽깭뿉 뵲瑜 援먯쑁 쟾, 썑 誘몄깮臾 珥앸웾 媛먯냼슚怨쇰 솗씤븳 寃곌낵, 쓽移섎 옣李⑺븯怨 엳떎怨 쓳떟븳 援곗 Aa & Red complex뿉꽌 援먯쑁 쟾, 썑 誘몄깮臾쇱씠 쑀쓽븯寃 媛먯냼븯뒗 寃껋쓣 솗씤븯怨, 쓽移섎 옣李⑺븯吏 븡 쓳떟援곗 꽭 洹몃9 紐⑤몢뿉꽌 誘몄깮臾쇱씠 쑀쓽븯寃 媛먯냼맂 寃껋쓣 솗씤븷 닔 엳뿀떎. 援ъ랬媛 뾾떎怨 쓳떟븳 援곗뿉꽌룄 Aa & Red complex, orange complex뿉꽌 援먯쑁 쟾, 썑 誘몄깮臾쇱씠 媛먯냼븯뒗 寃껋쓣 솗씤븷 닔 엳뿀떎. Lee (2016)쓽 쓽移섏옣李⑷낵 援ъ랬쓽 옄媛씤吏룄뿉 愿븳 뿰援ъ뿉 뵲瑜대㈃ 쓽移섏옣李 洹몃9뿉꽌 援ъ랬媛 궃떎뒗 옄媛씤吏 젙룄媛 넂븯쑝硫, 援ш컯 嫄닿컯吏떇씠 넂쓣닔濡 愿떖룄媛 넂怨 援ш컯嫄닿컯쓣 쐞븳 뻾룞 떎泥쒖쑉씠 넂븘 떎젣 援ъ랬諛쒖깮瑜좎 궙떎뒗 寃곌낵媛 엳뿀떎. 씠윭븳 꽑뻾뿰援ш 議댁옱븯吏留 蹂 뿰援ъ뿉꽌 솗씤맂 寃곌낵뒗 꽑뻾뿰援ъ뒗 쑀궗븯寃 룄異쒕맂 寃곌낵媛 뾾뿀쑝硫, 쓽移섏옣李 쑀臾댁 援ъ랬 쑀臾댁 愿젴븯뿬 援먯쑁 쟾썑 誘몄깮臾쇱쓽 媛먯냼슚怨쇱뿉 뼱뼚븳 쓽誘몃 遺뿬븯湲곗뿉뒗 븳怨꾧 엳뒗 寃껋쑝濡 궗猷뚮릺뼱 異뷀썑 遺媛쟻씤 뿰援ш 닔뻾릺뼱빞 븷 寃껋씠떎.

쟾떊吏덊솚 쑀臾댁 援먯쑁 쟾, 썑 誘몄깮臾 珥앸웾 媛먯냼뿉 愿븯뿬 議곗궗븳 寃곌낵, 怨좏삁븬씠 엳떎怨 쓳떟븳 援곗뿉꽌 Aa & Red complex Orange complex쓽 誘몄깮臾 珥앸웾씠 援먯쑁 쟾썑 쑀쓽븯寃 媛먯냼븯뒗 슚怨쇨 엳뿀떎. 삉븳 怨⑤떎怨듭쬆愿젴 吏덈Ц뿉꽌뒗 뾾떎怨 쓳떟븳 援곗씠 꽭 洹몃9 紐⑤몢 쑀쓽븳 媛먯냼슚怨쇨 엳뿀떎. 쐞옣옣븷愿젴 吏덈Ц뿉꽌룄 뾾떎怨 쓳떟븳 援곗뿉꽌 Aa & Red complex Orange complex쓽 쑀쓽븳 媛먯냼슚怨쇨 엳뿀떎. 썝(Won and Jin, 2003)뿉 쓽븯硫 쟾떊嫄닿컯怨 援ш컯嫄닿컯 諛젒븳 愿젴씠 엳쑝硫, 끂씤뱾 泥닿퀎쟻씤 援ш컯蹂닿굔援먯쑁씠 븘슂븯떎怨 븯떎. 븯(Ha and Choi, 2013)쓽 뿰援ъ뿉 뵲瑜대㈃ 蹂몄씤씠 옄媛곹븯뒗 嫄닿컯쓽 젙룄媛 醫뗭쓣닔濡 嫄닿컯뿉 븳 愿떖룄媛 넂怨, 愿떖룄媛 넂쓣닔濡 뻾쐞 떎泥 젙룄媛 넂 寃껋쑝濡 궗猷뚮맂떎怨 븯쑝굹, 蹂 뿰援ъ뿉꽌뒗 嫄닿컯뿉 븳 愿떖룄瑜 寃곗젙吏쓣 닔 엳뒗 슂씤씤 쟾떊吏덊솚 蹂댁쑀 쑀臾댁뿉 뵲瑜 援먯쑁 쟾, 썑 誘몄깮臾 媛먯냼슚怨쇰뒗 吏덈퀝쓽 쑀臾댁뒗 臾닿븯寃 Aa & Red complex, Orange complex쓽 誘몄깮臾 珥앸웾씠 媛먯냼븯뒗 슚怨쇨 엳뿀떎.

蹂 뿰援ъ뿉꽌 議곗궗맂 紐⑤뱺 蹂닔媛꾩쓽 긽愿愿怨꾨 遺꾩꽍븳 寃곌낵 援ш컯嫄닿컯愿젴 援먯쑁 쟾쓽 誘몄깮臾 珥앸웾怨 1씪 移レ넄吏 슏닔, 쐞옣옣븷 쑀臾대뒗 쓬쓽 긽愿愿怨꾨 媛吏꾨떎. 移レ넄吏 슏닔媛 留롮쓣닔濡, 쐞옣옣븷瑜 蹂댁쑀븳 궗엺씪닔濡 援먯쑁 썑 誘몄깮臾쇱쓽 珥앸웾씠 媛먯냼븯뒗 寃껋씠 蹂 뿰援ъ뿉꽌 룄異쒗븯怨좎옄븳 씠긽쟻씤 寃곕줎씠굹 援먯쑁 쟾 誘몄깮臾쇱뼇怨쇱쓽 긽愿愿怨꾨쭔 쑀쓽븯떎뒗 寃곌낵瑜 뼸뿀떎. 삉븳 엲紐명넻利앷낵 怨좏삁븬씠 쑀쓽븳 긽愿愿怨꾨 媛吏뒗 寃껋쑝濡 솗씤릺뿀떎. 씠뒗 怨좏삁븬씠씪뒗 吏덊솚씠 엲紐명넻利앹쓣 뜑슧 긽듅떆궎뒗 뜲뿉 뼱뼚븳 愿怨꾧 엳쓣 寃껋씠씪뒗 寃껋쓣 異붿륫븷 닔 엳떎. 洹몃윭굹 異뷀썑 蹂댁셿 뿰援ш 븘슂븳 떎젙씠떎. 긽愿愿怨 遺꾩꽍 寃곌낵 蹂 뿰援ъ뿉꽌 궗슜븳 슂씤媛 援먯쑁 쟾, 썑 슚怨쇱뿉 븳 愿젴꽦 뙆븙 뼱젮슫 寃껋쑝濡 궗猷뚮맂떎.

蹂 뿰援ъ뿉꽌 궗슜븳 援ъ랬, 엲紐명넻利, 移섏븘넻利앷낵 媛숈 蹂닔뒗 媛앷쟻쑝濡 吏꾨떒맂 寃껋씠 븘땶 꽕臾몄뿉 븳 긽옄쓽 쓳떟뿉 쓽議댄븳 젏, 뿰援 긽옄쓽 援먯쑁 쟾, 썑 슚怨 鍮꾧탳瑜 쐞빐 蹂닔瑜 젣쇅븳 떎瑜 議곌굔쓣 넻젣븯吏 紐삵븳 젏쓣 뱾 닔 엳쑝硫, 몴蹂 닔媛 16紐낆쑝濡 쟾泥 끂씤쓣 몴븯湲곗뿉뒗 옒뱾떎뒗 븳怨꾩젏씠 엳떎. 洹몃윭굹 씠 뿰援ъ쓽 寃곌낵뒗 移レ넄吏 諛⑸쾿, 鍮덈룄 벑怨 愿젴븳 援ш컯嫄닿컯 愿떖룄媛 넂쓣닔濡 援먯쑁쓽 슚怨쇨 엳뿀떎뒗 寃껋쓣 怨좊젮븯뿬 젣븳쟻쑝濡 뿰援 寃곌낵瑜 諛쏆븘뱾씪 닔 엳쓣 寃껋씠떎. 뵲씪꽌 뼢썑 蹂닔뿉 븳 媛앷쟻 젙蹂대 蹂댁셿븯怨 끂씤쓽 떎뼇븳 듅꽦쓣 怨좊젮븯뿬 泥닿퀎쟻씤 뿰援ш 씠猷⑥뼱졇빞 븷 寃껋씠떎. 洹몃읆뿉룄 遺덇뎄븯怨 끂씤쓽 二쇨쟻 援ш컯嫄닿컯愿由ы뻾깭 援ш컯嫄닿컯 諛 쟾떊吏덊솚뿉 뵲瑜 援ш컯蹂닿굔援먯쑁쓽 슚怨쇰 遺꾩꽍븯뿬 愿젴꽦쓣 솗씤븯怨 끂씤긽 援ш컯嫄닿컯利앹쭊쓣 쐞븳 봽濡쒓렇옩 諛 젣룄 媛쒕컻뿉 湲곗큹옄猷뚮 젣怨듯뻽떎뒗 뜲뿉 쓽쓽瑜 몦떎.

ACKNOWLEDGEMENT

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2017R1C1B5076722).

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

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