• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.169-174
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• 2001

Purpose : The problems of late deterioration of sensation and a double sensibility phenomenon are a known deficiency of the original neurovascular island flap. To eliminate this problems, the authors was performed to assess the results of Thumb-pulp loss reconstruction with a heterodigital neurovascular island Flap Using a Nerve Disconnecting-Reconnecting Technique Material and Methods : Between July. 1987 and November. 2000, we have used a disconnecting-reconnecting technique for heterodigital island flaps in which divided nerve of the transferred island flap is sutured to original nerve of the thumb in 9 patients. 9 patients with a mean follow-up period of 3.6 years were examined, while 7 patients were follow-up for 2years or more. Evaluation of results was based on flap quality, donor site quality, classic two-point sensory discrimination(2PD), and location of sensation(double sensibility), donor site cold intolerance, neuroma formation, scar contractures, total active movement(TAM) of the thumb and donor digit and subjective results and objective results. Results : The two-point discrimination was average 6.7 mm. Donor site paresthesia was observed more frequently in a short postoperative period. Sensation was referred to the thumb in all cases and the recovery occurred over a period of a two months. There were no flap complication or failures and the length of the thumb tip was preserved in all cases. Conclusion : This technique was found to provide well-vascularized pulp of the thumb with proper cortical representation in one operative stage.

• 한국노년학
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• 제40권4호
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• pp.659-689
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• 2020

본 연구는 연령차별을 경험한 노인들이 스스로 부정적 차별 인식을 내면화하는 일련의 과정에 집중하는 연구이다. 노인들이 일상생활에서 경험하는 연령차별의 모습을 규명하고 이같은 차별경험이 '자기연령주의(self-ageism)'를 통해서 어떤 결과로 이어지는지를 탐색하기 위해 근거이론방법을 활용하였다. 분석결과에 따르면 노인들은 명시적 차별 뿐 아니라 암묵적 차별에도 반응하는데 이 과정에서 노인의 고통(빈곤, 질병, 무위, 고독)의 강도가 높고 객관적인 차별상황에 속에서 차별대응에 실패한 기억이 강할수록 더욱 높은 수준의 자기연령주의를 갖게 되는 것으로 나타났다. '자기연령주의'는 나이에 의한 '차별'을 당한 노인들이 스스로에 대한 부정적 이미지를 내재화함으로써, 현실에서 다양한 거부/분리/멈춤 등의 행동을 통해 삶의 질적 측면에서의 불이익을 감수하는 현상이다. 건강, 제도적 지원, 보듬어주는 사람들과 같은 지지적 자원들이 존재하는 경우에 노인들은 보다 적극적인 방식으로 작용/상호작용을 통해 자기연령주의를 극복할 여지를 보이지만, 반면 이러한 자원들의 부족으로 스스로 동기부여하지 못하는 노인들의 경우 자기연령주의로 인한 부정적 환류에 갇혀버리게 됨으로서 침체되고 위축된 삶을 살아가게 된다. 이런 상태에서 스스로를 동기화(motivation)해서 신체, 인지, 정서, 사회적 반응을 해나가는 것은 매우 쉽지 않은 일이다. 그러므로 분석과정에서 특별히 두 가지 부분, 맥락적 조건과 중재적 조건에 주목하며 미시적으로는 노인의 동기화와 회복력(resilience) 향상을 위한 프로그램을 제안하였고, 거시적으로는 전 생애주기와 관련한 복지 및 건강서비스 체계 보완, 커뮤니티케어를 통한 접근성과 통합성 확대, 인식개선과 차별금지법과 같은 시스템 마련의 필요성을 주장하였다.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.93-98
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• 2001

Purpose : This describes our experience with a tenocutaneous free flap from the dorsum of the foot or radial forearm to reconstruct the dorsal skin and extensor tendons of the hand. Material and Methods : Between february 1987 and July 1998, we treated 9 patients with composite tissue loss on the dorsal hand caused by crushing injury. Nine men had an average age of 26.4 years(range, $19{\sim}47$). We treated 5 patients with the free dorsalis pedis flap including the extensor tendons and the superficial peroneal nerve and 4 patients with reverse forearm flap including the brachioradialis tendon and/or superficial radial nerve. Flap size was average 4.4(3,2cm. Evaluation of the results was based on the survived flap rate, the recovery rates for range of motion of the metacarpophalageal joints in the operated fingers. two-point discrimination. Results : All flaps were well vascularized and survived completely. Recovery rates for range of motion of the metacarpophalageal joints in operated fingers range from $78%{\sim}99%$(average, 90%). Two-point discrimination of the transferred flaps in 5 patients average $20{\pm}3.5mm$. Conclusion : The advantages of this procedure are mass action reconstruction with tendon, one-stage operation, faster healing with less adhesion formation, and early mobilization.

• Archives of Plastic Surgery
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• 제39권6호
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• pp.637-642
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• 2012

Background Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques. Methods This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods. Results Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was $1.7{\times}1.5$ cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps. Conclusions The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries.

• 대한전기학회논문지:전력기술부문A
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• 제51권5호
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• pp.247-254
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• 2002

This paper describes a fault location algorithm in real combined transmission systems with underground power cable. The algorithm to calculate the fault location was developed using DWT wavelet transform and travelling wave occurred at fault point. And the proposed algorithm is also used the transient signal of one end in stead of the signal information of two ends. On the other hand, in this papers, the method to discriminate fault point between overhead line and cable section is also Proposed. Variety simulations were carried out to verify the accuracy and effectiveness of the proposed algorithm using EMTP/ATFDraw and Matlab. Simulation results show that the proposed method has the excellent ability for discrimination of fault section and fault location in combined transmission systems with power cables.

• 한국아동복지학
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• 제36호
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• pp.231-259
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• 2011

본 연구는 어린이집을 이용하는 부모의 이용만족도를 측정하기 위한 척도 개발을 위한 것으로, 신뢰도와 타당도가 검증된 김용석(2009)의 사회복지서비스 이용자 만족도 척도(Client Satisfaction Scale: CSS)가 보육서비스에 적용 가능한지 평가하는 것을 목적으로 하였다. 이를 위해 CSS 문항을 보육서비스의 특성에 맞게 수정한 21개의 문항, 2개 차원으로 이루어진 어린이집 이용만족도 예비척도를 구성하고, 만 1세부터 만 5세까지의 자녀가 어린이집을 이용하는 학부모 652명을 대상으로 조사를 실시하였다. 구인타당도 검증을 위한 요인분석 결과 2개 요인이 수렴되었으나, 각 요인에 해당하는 문항들은 CSS와 차이가 있었다. 2차원으로 구성된 본 척도의 동시타당도와 내적타당도 검증 결과 적절한 수준이었으며, 문항변별도 검증 결과 또한 모든 문항의 변별력 높은 것으로 나타났다. 이상의 결과를 통해 볼 때 어린이집 이용만족도 척도는 보육서비스를 이용하는 부모들에게 적용될 수 있는 타당성 있는 도구로 판단되는바, 추후 어린이집 이용만족도를 측정하는데 활용될 수 있을 것이다.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.527-532
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• 2008

Purpose: Transverse type or volar oblique type of defect of thumb tip can be covered by Moberg flap or second toe pulp free flap. We compared these two methods in functional result, patients' satisfaction, and sensation, etc. to find a better way to cover the defect of the thumb tip. Methods: From 2003 to 2006, we chose the patients randomly with preoperative pictures. The patients had the defect of the thumb tip which is either transverse or volar oblique type. The 6 patients were treated with Moberg flap and other 6 patients were treated with second toe pulp free flap. We have analyzed the results by 2 point discrimination, side pinching power test, pulp to pulp pinching power test, pain scales (visual analogue scale), satisfaction scales of the patients (functional and aesthetic), the degree of the range of motion, etc. Results: All flaps survived without any complications. In the cases of Moberg flaps, the value of static 2 point discrimination test was 5.6 mm, and the value of moving 2 point discrimination test was 4.8 mm. In the cases of second toe pulp free flaps, the values were 9.6 mm and 9.3 mm. In the cases of Moberg flaps, the value of the Side pinch power test was 6.6 kg, 4.4 kg. In the case of second toe pulp free flaps, the values were 4.8 kg and 2.5 kg. The value of aesthetic satisfaction scale of the patients in Moberg flaps was 5.6, the value of functional satisfaction scale of the patients was 3.6. In cases of second toe pulp free flaps, the values were 5.6 and 3.6. The active range of motion of Interphalangeal joint in the cases of Moberg flaps was 46.6 degree, and the active range of motion of metacarpophalangeal joint was 55 degree, in the cases of second toe pulp free flaps, the values were 36.6 degree and 59 degree. Conclusion: As a result, when the defect of the thumb tip is transverse or volar oblique type, we suggest that the operators choose Moberg flap to cover the defect of the thumb tip.

• 대한물리의학회지
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• 제4권3호
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• pp.201-207
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• 2009

Purpose：The purpose of this study was to investigate the effect of $\alpha$-wave music and art appreciation on hand function in stroke with hemiplegia. Methods：A total of 32 stroke with hemiplegia participated in this study experimental group(16 subjects) received $\alpha$-wave music and art appreciation with general neurologic therapy. Control group(16 subjects) received general neurologic therapy. All subjects were assessed for hand function(manual dexterity, power grip, pinch grip, two point discrimination(parm, finger), tactile sense(parm, finger) using a purdue pegboard, dynamometer, pinch gauge, two-point anethesiometer and semmes-weinstein monofilament wire. The data were analyzed using paired and independent t-test. Results：The results were as follows : 1. In the experimental group, manual dexterity were significantly increased between pre and post intervention(p<.05). 2. In the experimental group, tactile sesne in finger were sifnificantly increased between pre and post intervention(p<.05). Conclusion：The results of this study shows that $\alpha$-wave music and art appreciation affect the hand function of hemiplegic side with regard to manual dexterity and tactile sense.

• 제어로봇시스템학회논문지
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• 제14권3호
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• pp.248-253
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• 2008

This paper presents a sensing system for smart home which can detect an location transition events such as entrance/exit of a member and identify the user in a group at the same time. The proposed system is compose of two sub-systems; a wireless sensor network system and a database server system. The wireless sensing system is designed as a star network where each of sensing modules with ultrasonic sensors and a Bluetooth RF module connect to a central receiver called Bluetooth access point. We propose a method to discriminate a user by measuring the height of the user. The differences in the height of users is a key feature for discrimination. At the same time, the each sensing module can recognize whether the user goes into or out a room by using two ultrasonic sensors. The server subsystem is a sort of data logging system which read the detected event from the access point and then write it into a database system. The database system could provide the location transition information to wide range of context-aware applications for smart home easily and conveniently. We evaluate the developed method with experiments for three subjects in a family with the installation of the developed system into a real house.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권3호
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• pp.250-257
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• 2001

Sensory dysfunction following the injury of the inferior alveolar nerve requires objective examination to get a reproducible data and to provide necessary treatment. This study was designed to evaluate if the SEP(somatosensory evoked potentials) of the mental nerve can be used as an objective method for the diagnosis of nerve injury and sensory disturbances. The subjects were nineteen patients ($37.4{\pm}11.3$ years old) who had been suffered from sensory disturbance of the unilateral lower lip and mental region for over 6 months after the inferior alveolar nerve injuries confirmed by the microsurgical explorations. The clinical neurosensory tests as SLTD(static light touch discrimination), MDD(moving direction discrimination), 2PD(two point discrimination), PPN(pin prick nociception) and accompanied pain were preceded to electro-physiologic examinations as SEP. The score of sensory dysfunction (sum score of all sensory tests) ranged from 0 to 8 were compared to the latency differences of the mental nerve SEPs. The correlation between clinical sensory scores and SEPs were tested by Spearman nonparametric rank correlation analysis, the differences in SEP latency by Kruskal-Wallis test and the latency differences according to PPN and accompanied pain by Mann-Whitney U test. This study resulted that the difference of the latencies between normal side and affected side was $2.22{\pm}2.46$ msec and correlated significantly with the neurosensory dysfunction scores (p=0.0001). Conclusively, the somatosensory evoked potentials of the mental nerve can be a useful diagnostic method to evaluate the inferior alveolar nerve injuries and the change of sensory dysfunction to be reproduced as an objective assessment.