• Archives of Reconstructive Microsurgery
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• v.10 no.2
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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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• v.40 no.4
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• pp.659-689
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• 2020

This study focuses on the process of internalizing the perception of negative discrimination among elderly people who have experienced age discrimination. The grounded theory method was used to identify the age discrimination experienced by the elderly in their daily lives and to explore the consequences of such discrimination through self-ageism. According to the analysis results, the elderly respond not only to explicit discrimination but also to implicit discrimination. In this process, the stronger the pain of old age (poverty, disease, ignorance, and solitude) and the stronger the memory of failing to respond to discrimination, the higher the level of self-ageism. "Self-ageism" has internalized the negative image of the elderly, who have been discriminated against by age, resulting in disadvantages in terms of quality of life through various reject/separate/suspension actions in reality. In the presence of supportive resources such as health, institutional support, and caregivers, the elderly have room to overcome self-ageism through more active ways. However elderly people who cannot motivate themselves and they lack these resources, elderly are trapped in negative reflux caused by self-ageism and sustained a depressed and shrinking life. In this state, it is not easy to motivate themselves and make physical, cognitive, emotional and social responses. Therefore, in this analysis, we specifically noted two aspects, contextual conditions and interventional conditions, and proposed programs for synchronizing senior citizens and improving resiliency from a microscopic point of view, and argued for the need to develop systems such as supplementing welfare and health service systems related to the entire life cycle, expanding accessibility and 'age-integration' through 'Community Care', awareness improvement and anti-discrimination laws.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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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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• v.39 no.6
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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.

• The Transactions of the Korean Institute of Electrical Engineers A
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• v.51 no.5
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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.

• Journal of the Korean Society of Child Welfare
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• no.36
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• pp.231-259
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• 2011

The purpose of this study is to examine the validity and reliability of the Parental Satisfaction Scale for Child Care Centers, which modified the Client Satisfaction Scale (CSS; Kim, 2009). The subjects of the study were 652 parents of children who were between the ages of one to five and who attended child care centers. The five-point rating scale consisted of 21 items with two sub-dimensions. The results from an exploratory factor analysis identified that there are two dimensions in this scale. Thus, in terms of the face validity of this scale, a two-dimensional scale with 21 items is found to be appropriate. However, the items that consist of the two sub-dimensions are found to be different from that of CSS. The concurrent validity and internal consistency reliability of the revised scale are relatively high. Also, the mean between the upper and lower groups with regard to item discrimination show significant difference. We conclude that the original CSS with minor revisions can be used as a valid and reliable instrument to assess parental satisfaction on child care centers.

• Archives of Plastic Surgery
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• v.35 no.5
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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.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.3
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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.

• Journal of Institute of Control, Robotics and Systems
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• v.14 no.3
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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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• v.27 no.3
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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.