자아탄력성 척도의 심리측정학적 특성

김응준( Kim, Eung-Joon) 한국웰니스학회 2016 한국웰니스학회지 Vol.11 No.1

본 연구는 선행연구에서 개발되어진 운동선수용 자아탄력성 척도를 문항반응이론을 적용하여 심리측정학적 특성을 분석하는데 목적이 있다. 이 목적을 달성하기 위해 서울, 경기, 강원 등 수도권에 위치한 1000명의 대학교 운동선수들을 대상으로 조사를 실시하였다. 이준석(2013)에 의하여 다시 개발된 자아탄력성 척도를 조사도구로 사용하였다. 수거된 자료 중 832명의 자료를 SPSS 23.0 프로그램을 이용하여 빈도분석, 기술통계분석을 실시하였고, 문항적합도는 문항반응이론을 적용하기 위하여 WINSTEPS 3.74 (Linacre, 2012)을 사용하여 피험자 신뢰도, 문항신뢰도, 척도수의 적절성, 문항적합도와 문항난이도를 산출하였다. 연구목적에 따른 연구결론으로는 첫째, 자아탄력성 척도의 피험자 신뢰도와 척도자체의 신뢰도는 내-외적합도 1.00∼1.03 으로 적합하였다. 둘째, 척도 범주수의 적절성에서는 단계지수로 판단한 결과 7점 척도가 적합하였다. 셋째, 문항적합도와 문항난이도 분석에서는 총 2개 문항에서 문제점이 발견되었다. 따라서, 대학교 남녀 운동선수들의 능력분포와 척도자체의 난이도면에서 판단할 때 자아탄력성 척도는 부분적으로 적절하지 못한 것으로 확인되었다 The purpose of this study was to investigate the ego-resilience questionnaire’s psychometric properties in undergraduate student athletes. To accomplish study purpose, complete enumeration survey and statistical analysis were conducted for 832 student athletes enrolled metropolitan area university. A research tool used in this study was an ego-resilience scale developed by Joon-Seok LEE (2013). Total 14 questions were used with 7 point Likert scale and high point stands for higher the ego-resilience. Frequency analysis was conducted with SPSS 23.0. WINSTEPS 3.74(Linacre, 2012) was used for calculating item goodness-of-fit and subject reliability, scale propriety, item goodness-of-fit and item level of difficulty were calculated. Statistical analysis showed results as follows. First, it was reported to be suitable for subject infit/outfit in the ego-resilience as 1.01~1.03 and the ego-resilience"s scale infit/outfit as 1.00~1.01. Second, 7 scale was suitable for scale propriety resulting from stage index judgment. Third, 2 questions (item 10, item 13) showed problems in item goodness-of-fit; consequently, scale propriety was reported to be inappropriate for considering undergraduate student athletes" ability distribution and scale level of difficulty.

단일공법 복강경하 질식자궁절제술 110예의 고찰 및 다공법과의 비교

박병준 ( Byung Joon Park ),김용욱 ( Yong Wook Kim ),노덕영 ( Duck Yeong Ro ),김태응 ( Tae Eung Kim ),류기성 ( Ki Sung Ryu ),김장흡 ( Jang Heup Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.7

목적: 통상적인 복강경기구만을 사용한 단일공법 복강경하 질식자궁절제술을 다공법 복강경하 질식자궁절제술과 비교하여 안전성 및 유용성을 평가하고자 하였다. 연구 방법: 2007년 4월부터 2009년 11월까지 인천성모병원에서 자궁근종 또는 자궁샘근증의 질환으로 단일공법 복강경하 질식 자궁절제술을 시행받은 환자 110명과 다공법 복강경하 질식자궁절제술을 시행받은 환자 110명, 총 220명의 환자를 대상으로 하였다. 우리는 모든 수술에서 통상적으로 사용되는 구부러지지 않는 일직선의 복강경기구를 사용하였다. 또한 단일공법 및 다공법 복강경하 질식자궁절제술 둘 다에서 수술자 (Kim, YW)의 이름을 따서 명명한 새로운 질단부 봉합 방법인 김씨 질구개 현수법 (Kim`s Vaginal Vault Suspension Method)을 사용하였다. 결과: 환자 나이, 수술 시간, 자궁의 무게, 혈색소 수치의 변화, 수혈 빈도, 수술 후 발열에서 두 군 간에 유의한 차이를 보이지 않았다. 환자들의 평균 나이는 46.7±7.0세(단일공법)와 45.5±6.3세(다공법)이었다. 평균 수술 시간은 87.2±21.0분(단일공법)과 83.3±20.3분(다공법), 평균 자궁의 무게는 261.4±139.7 g(단일공법)과 257.8±132.9 g(다공법), 평균 혈색소 수치의 변화는 1.1±0.7 g/dL(단일공법)와 1.2±0.6 g/dL(다공법)이었다. 두 군 모두에서 수술 중 장 또는 요로의 손상은 없었다. 두 군 모두에서 각각 한 건의 개복수술로의 전환이 있었다. 단일공법을 시행한 군에서 입원 기간이 유의하게 짧았다(2.6±0.6일 [단일공법], 3.3±0.7일 [다공법], P<0.05). 결론: 통상적으로 사용하는 구부러지지 않는 일직선의 복강경기구를 이용한 단일공법 복강경하 질식자궁절제술은 다공법 복강경하 질식자궁절제술에 대한 안전하고 유용한 대체 수술이 될 수 있다. Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary`s Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim`s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. Results: There was no significant difference in patients` age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients` mean age was 46.1±7.0 years (SPA-LAVH) and 45.5±6.3 years (MPA-LAVH). The mean operating time was 87.2±21.0 minutes (SPA-LAVH) and 83.3±20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4±139.7 g (SPA-LAVH) and 257.8±132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1±0.7 g/dL (SPA-LAVH) and 1.2±0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6±0.6 days [SPA-LAVH] and 3.3±0.7 days [MPA-LAVH], P<0.05). Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.

확대된 여가제약 척도의 최적범주

이창진(Lee, Chang-Jin),김응준(Kim, Eung-Joon) 한국웰니스학회 2017 한국웰니스학회지 Vol.12 No.1

본 연구는 김응준(2012)이 Rasch 모형을 적용하여 선행연구에서 개발된 확대된 여가 제약 척도의 심리측정학적 특성 결과를 바탕으로 최적범주를 탐색하는데 목적이 있었다. 이 목적을 달성하기 위해 대학교 410명의 학생들을 대상으로 조사를 실시하고 통계분석하였다. 사용된 척도는 Crawford와 Godbey(1987)에 의해 제시된 여가제약 척도를 지현진과 이철원(2003)이 수정 보완하고, 김응준(2006)에 의하여 타당화 시킨 확대된 여가 제약 척도를 조사도구로 사용하였다. 수거된 자료 중 410명의 자료를 SPSS 23.0프로그램을 이용하여 빈도분석, 기술통계분석을 실시하였다. 최적범주를 탐색하고자 WINSTEPS 3.92 (Linacre, 2016)을 사용하여, 척도수의 적절성, 문항적합도와 문항난이도 등을 산출하였다. 연구목적에 따른 연구결론으로는 첫째, 문항의 반응범주는 문제가 있는 것으로 확인되어 기존 5점 범주 대신 4점 범주로 수정되는 것이 타당하였다. 둘째, 문항적합도를 분석한 결과 22문항은 적합하였다. 셋째, 척도의 응답자 신뢰도가 낮게 확인되어 문항난이도를 고려한 문항순서의 변경이 필요하였다. 넷째, 개인 능력점수와 난이도를 교차하여 비교한 결과, 개인 능력점수 분포와 문항난이도 분포는 적절하였다. The purpose of this study was to investigate the extended leisure constraint questionnaire’s optimal categorization in undergraduate students. To accomplish study purpose, complete enumeration survey and statistical analysis were conducted for 410 students enrolled university. A research tool used in this study was an extended leisure constraint scale developed by Eung-Joon KIM (2012), which was originally from Crawford & Godbey(1987). Total 22 questions were used with 5 point Likert scale and high point stands for higher the leisure constraint. Frequency analysis was conducted with SPSS 23. An assumption to test Rasch Model, which is satisfaction of unidimensionality, is regarded through theoretical aspects, and WINSTEPS 3.92(Linacre, 2016) program is used to test the goodness-of-fit of items. Statistical analysis showed results as follows. First, 4-point rating scale was appropriate for the extended leisure constraint scale. Second, 22 items of the extended leisure constraint scale were suitable in item fitness and item difficulty to undergraduate students. Third, the extended leisure constraint scale was somewhat suitable in person reliability of item separation. Fourth, the person ability score of the extended leisure constraint scale was distributed appropriately.

용접잔류응력장을 전파하는 피로균열 개구거동에 대한 유한요소해석법의 제안

김응준,박응준 한밭대학교 생산기반기술연구소 2004 생산기반기술연구소 논문집 Vol.5 No.1

The opening behaviour of fatigue crack propagating through welding residual stress fields is investigated in this study by finite element analysis using ABAQUS. The finite element model with contact elements for the crack plane and plane stress elements for the base material and the analytical method based on the superposition principle to estimate crack opening behaviour subjected to uploading were used. The result of the analysis showed that crack opening behaviour caused by uploading were changed depending on the configuration of residual stress distribution. When the crack existed in the region of compressive residual stress and the configuration of compressive residual stress distribution were inclined, a partial crack opening just behind of a crack tip occurred during uploading. Based on the above results, it was clarified that the crack opening behaviour and the stress distribution adjacent to the crack in the residual stress field could be predicted accurately by the finite element analysis using these analytical method and model.

累積合管理圖의 健全性 改善을 위한 代案管理圖

金鍾傑,李應準 成均館大學校 科學技術硏究所 1992 論文集 Vol.43 No.2

This paper evaluates alternative control charts for improving the robustness of CUSUM control chart in terms of ARL(Average Run Length). ARL is compared by Markov chain approach. The occasional outlier's practical existence is simulated by way of contaminated distribution, and adaptation of trimmed mean in terms of robustness is tested. CUSCORE scheme is more sensitive and robust than other CUSUM control charts.

직장암 수술 후 국소재발과 예후

김태윤,백무준,김성용,신응진,박내경,이문수,김창호,송옥평 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Locally recurrent rectal cancer is a difficult clinical problem. Local recurrence following treatment for rectal cancer is a major cause of morbidity and mortality. The reported range of local recurrence rates following surgical treatment for rectal cancer has varied from 4% to 50%. We retrospectively reviewed the charts of 142 rectal cancer patients from January 1991 to December 1999. Analysis of patients factors included age, gender, type of surgery, and adjuvant therapy. Tumors were assessed for level, stage, and grade. Local recurrence and distant metastases were also documented. Variables influencing local recurrence in this group were identified and disease-free survival is determined. Of the 142 patients(74 males, 68 females; mean age 62.6 years), 137 consecutive patients operated on for rectal cancer and followed up to December 2000 (range 23-118months) were analyzed. Local recurrence rate was 18.3%. Age and sex of patients, type of surgery, location of tumor in the rectum, size, morphology and grading of the tumor were all unrelated to the event under investigation. At Cox regression, the Dukes stage and the postoperative radiotherapy were the only independent prognostic factors for local recurrence, and Dukes stage (Hazard ratio=2.89, p<0.001) and local recurrence (Hazard ratio=3.31, p<0.01) were the only independent factors associated with improved survival.

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

위팔근육 위축 양측마비 2예

안준성,김민아,김상진,김응규 인제대학교 2006 仁濟醫學 Vol.27 No.-

Brachial amyotrophic diplegia, a relatively stable variant of motor neuron disease, is characterized by weakness that is isolated to upper limbs and spared lower extremities, respiratory and bulbar musculature. This disease should be differentiated from other disease such as multifocal motor neuropathy, amyotrophic lateral sclerosis, monomelic amyotrophy and progressive muscular atrophy. We report two cases of brachial amyotrophic diplegia.

세균성 수막염에서 발생한 치명적 뇌경색 1례

안준성,김민아,김상진,김응규 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bacterial meningitis is frequently fetal or lead to severe neurological impairment. Cerebral infarction is a well known sequele of meningitis, occurring in as many as 10-20% of patients. But fetal cerebral infarction in bacterial meningitis is rare. We report a 61 year old woman who was admitted due to fever, headache and mental change for 3 days. On admission 7 days follow up Brain-CT revealed large and massive infarctions on both hemispheres. When bacterial meningitis is caused by Streptococcus pneumonia, there is a high prevalence of cerebral infarctions. The underlying mechanisms of cerebral infarction in bacterial meningitis are vasculitis, thrombosis, arachnoiditis, and compression of the arterial supply at the foramen magnum by herniation of the cerebellar tonsil.

상완골 과 상부 골절에서의 이중 긴장 대 기법을 이용한 수술적 치료

강호정,김홍희,심동준,한수봉,강응식 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 이중 긴장 대 기법을 이용한 상완골 과 상부 골절의 임상적 결과를 분석하여 그 유용성을 보고하고자 한다. 대상 및 방법 : 1992년 10월부터 2001년 9월까지 상완골 원 위부 골절로 치료한 환자 중 이중 긴장 대 기법을 시행한 14예를 대상으로 하였다. 골절의 원인으로서는 실족에 의한 단순 손상이 11예, 교통사고에 의한 손상이 2예, 직접 타격에 의한 손상이 1예가 있었다. AO/ASIF 분류 방법에 따라 분류하면 A2가 2예, A3이 1예,. C1이 6예, C2가 3예, C3이 2예였으며, 성별로는 남자가 5예, 여자가 9예였고, 평균 나이는 51.6 세 (최소 15세, 최대 88세)였다. 분쇄 골절이 심한 4예에서 주두 절골 술을 시행하였다. 술 후 고정기간은 평균 20.6일 이었고, 경화를 보인 시기는 술 후 평균 10.1주 였다. 65세 이상의 5예에 있어서는 술 전에 골 밀도 검사를 시행하였으며, 대퇴경부의 평균 T-score가 -3.65였고 요추부의 평균 T-score가 -2.97이였다. 평균 추 시 기간은 평균 16.4개월(최소 12개월, 최대 29개월) 이였다. 평가는 최종 외래 내원시 주관절의 운동 범위, 통증 유무, 환자의 만족도를 조사하였다. 결 과 : 최종 추후 결과를 분석하였으며, 운동범위는 Excellent군이 8예, Good군이 4예, Fair군이 2예 였으며, Poor군은 없었다. 10예에서는 술 후 통증이 전혀 없었으며, 4예에서는 가끔씩 통증을 호소하였다. 합병증으로는 1예에서 주두에 K-강선 삽입부위의 피부자극에 의한 통증으로 술 후 6개월째 조기 제거를 시행하였다. 척골신경 전방 전위 술을 8예에서 시행 하였으며, 시행하지 않은 6예 중에 2예에서 척골신경 자극증상이 있었다. 그 중 1예에서는 술 후 8개월째 척골신경 전방 전위 술을 시행 받았으나, 다른 1예에서는 대중적 치료로 증세가 호전되었다. 1예에서 K-강선 삽입부위에 부분적 피부괴사 소견이 보였으나 핀 제거 술 및 창상 치료 후 치유되었다. 결 론 : 이중 긴장 대 기법을 이용한 상완골 과 상부 골절의 치료가 수술이 간단하고 수술 시간을 단축시킬 수 있으며, 정복 시 골막의 박리 손상을 줄일 수 있어 골편의 탈활(devitalization)이 적으며, 골절부의 압축력을 얻을 수 있다. 특히 젊은 환자의 단순 과 상부 골절에서 과도한 술기를 피하고 조기 관절 운동을 하기위한 경우나, 술 전 골 밀도 검사상 골 다공 증을 동반한 분쇄가 심한 노령 환자의 과상부 및 과간 골절의 치료에 있어 이중 긴장 대 기법은 상완골 상부 골절의 치료에 유용한 방법이 될 수 있으리라 사료된다. PURPOSE : This study evaluated the clinical result of supracondylar fractures of the humans treated with double tension band osteosynthesis. MATERIALS AND METHODS : From October 1992 to September 2001, 14 patients with supracondylar fractures of the humerus were treated by method of double tension band osteosynthesis. eleven fractures were the results of slipped down injury and two traffic accidents and one direct trauma. All fractures were classified according to the AO fracture classification (A2; 2. A3; 1. C1; 6, C2; 3. C3; 2). There were 6 males and 9 females with average age of 51.6 age of 51.6 years (range 15 to 88). Olecranon osteotomy was performed in 4 patients with severe comminuted fractures. Postoperative immobiliza-tions were required for an average of 20.6 days and consolidations were noted after an average of 10.1 weeks. Before operation, bone marrow density studies were performed in five fractures above 65 years. Average T-score of the patients were -3.65 on femur neck and -2.97 on lumbar spine. All patients were re-examined after an average of 16.4 months. RESULTS : Union and consolidation was achieved in all 14 patients judged their results as excellent and four as good. Ten patients had no pain and four had only occasional discomfort. Early removal of K-wires was performed in one patient because irritation of one side K-wires were develop. Sensory change of the ulnar nerve was noted in two patients. Anterior transposition of ulnar nerve was performed in one patient and the other was improved spontaneously. Skin necrosis was developed in one patient but was healed after pin removal and conservative care. CONCLUSION : The advantages of double tension band wiring are an easier and faster procedure, less periosteal and muscle damage, and more symmetrical compression than double plating. Therefore, in the commiuted osteoporotic fracture with poor tolerance for internal fixation with the plate or the simple supracondylar fractures in young age, double tension band osteosynthesis can provide sufficient and secure stability to allow early functional exercise.