심부하복벽 천공지 유리피판을 이용한 즉시 유방재건술

김준형,박지웅,조상헌,어수락,Kim, Jun-Hyung,Park, Ji-Ung,Cho, Sang-Hun,Eo, Su-Rak 대한미세수술학회 2008 Archives of reconstructive microsurgery Vol.17 No.2

In the past decade, there has been increasing breast reconstructions after mastectomy, and the abdomen has been the gold standard for donor site. TRAM (transverse rectus abdominis myocutaneous), MSTRAM (muscle sparing transverse rectus abdominis myocutaneous), DIEP (deep inferior epigastric artery perforator), SIEA (superficial inferior epigastric artery) flap has been widely used nowadays. Among them, DIEP free flap spares the whole rectus abdominis muscle and anterior rectus sheath resulting in decreased donor site morbidity. Between March of 2006 and February of 2008, six patients had undergone immediate breast reconstructions using DIEP free flap. The mean age of patients was 48.5 years. All patients had unilateral breast reconstructions. We dissected two perforators which were included in the unilateral pedicle. Thoracodorsal artery and its venae comitantes were chosen as recipient vessels. For venous anastomosis, we used the GEM Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Inc., Birmingham, Ala.) in four cases. All flaps were survived completely except one who showed fatty abdomen in old age. She showed repetitive vascular spasm intraoperatively. None of the patients had abdominal hernia, bulge or weakness. We believe that DIEP free flap provides a reliable method for autologous breast reconstruction if the patients are selected appropriately and performed by a skillful surgeon.

소아 안면열상 환자의 치료에 있어서 유용한 봉합술

김준형,권순범,어수락,조상헌,Kim, Jun-Hyung,Kwon, Soon-Beom,Eo, Su-Rak,Cho, Sang-Hun,Markowitz, Bernard L. 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.4

Purpose: Lacerations requiring formal wound closure compose a significant number of all childhood injuries presenting to the emergency department. The problem with conventional suture technique are that suture removal is quite cumbersome, especially in children. Unwanted soft tissue damage can result in the process of suture removal, which calls for sedation, stressful for both medical personnel and child. The purpose of this study is to introduce the convenient suture technique for pediatric facial lacerations. Methods: Children under the age of four, presenting to the emergency department with facial lacerations were enrolled in the study. From March 2008 to June 2009, 63 patients (41 males and 22 females) with an average age of 1.4 years were treated with our convenient suture technique using utilized a loop suspended above a double, flat tie. Clean, tension free wounds were treated with our technique, wounds with significant skin defect and concomitant fractures were excluded. Results: The Patients were followed-up in 1, 3 and 5 days postoperatively. On the third hospital visit, suture removal was done by simply cutting the loop suspended above the wound margin and gently pulling the thread with forceps. There were no significant differences in the rates of infection and dehiscence compared with conventional suture technique. Conclusion: The use of our technique was to be simple with similar operative time compared with conventional suture technique. Removal of suture materials were easy without unwanted injuries to the surrounding tissue which resulted in less discomfort for the patient and greater parental satisfaction, minimized the complications. It can be considered as a viable alternative in the repair of pediatric facial lacerations.

Infrared Camera를 활용한 가열 아스팔트 혼합물의 효율적인 다짐관리 방안

김준형,이석홍,김완상,Kim. Jun-Hyung,Lee. Suck-Hong,Kim. Wan-Sang 한국방재학회 2007 한국방재학회 학술발표대회논문집 Vol.2007 No.1

아스팔트포장의 수명 및 공용성 확보를 위한 품질관리 대책의 하나로 아스팔트포장 포설면의 온도 불균형(Thermal Segregation) 현상 최소화를 위하여 균질한 다짐밀도를 확보하기 위한 연구가 미국에서 수행되고 있다. 특히, 적외선 카메라(Infrared Camera)를 이용하여 포설 또는 다짐작업 중인 아스팔트포장 표면의 온도분포를 파악하여 품질관리 기준으로 활용하고 있다. 국내에서도 온도분포 파악을 통한 아스팔트포장의 효율적인 다짐관리 방안이 필요하고 이에 대한 연구가 현재 수행되고 있다. In resent years, temperature segregation has been identified as one of the most important concepts concerning segregation. An Infrared Camera is one of the tools that have been recognized to be effective in identifying temperature segregation. Several state of USA have recognized the problem and have enacted Specifications, and/or test procedures to eliminate temperature segregation. The major objective of this study is to investigate effective compaction method of hot mix asphalt during road construction using Infrared Camera.

비중격 골절을 동반한 단순 비골 골절의 치료에 있어 비중격 교정술의 중요성: 비강 통기도 검사를 이용한 평가

김준형,신동우,최태현,손대구,한기환,Kim, Jun-Hyung,Shin, Dong-Woo,Choi, Tae-Hyun,Son, Dae-Gu,Han, Ki-Hwan 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.5

Purpose: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. Methods: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment methods: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. Results: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. Conclusion: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.

외측대퇴회선동맥 상행가지의 천공지피판을 이용한 대전자부 욕창의 재건

김준형,어수락,조상헌,Kim, Jun-Hyung,Eo, Su-Rak,Cho, Sang-Hun 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.5

Purpose: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. Methods: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. Results: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was $6{\times}4\;cm$. The largest flap dimension was $14{\times}7\;cm$. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. Conclusion: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.

실시간교통정보 이용에 따른 차량의 CO, VOC, NOx 저감효과 평가

김준형,엄정섭,Kim, Jun-Hyung,Um, Jung-Sup 한국환경영향평가학회 2011 환경영향평가 Vol.20 No.2

This paper was inspired by the fact that Real-time Traffic Information Service could play a key role in reducing incomplete combustion time remarkably since it can provide traffic jam information in real-time basis. Emission characteristics of experimental engines were studied with variable travel distances and speed of car in terms of traffic information provided. 12 Km distance road of Susung district in Daegu is taken as an experimental area to examine this new approach. The emission was tested while the driving was done at 8 AM, 3 PM, 6 PM which represents various traffic conditions. The reduced emission has been measured for a travel distance running at different loads (conventional shortest route and Real-time Traffic Information) and various loads (CO, VOC and NOx) are all inventoried and calculated in terms of existing emission factors. The emission has been shown to reduce linearly with travel distance : carbon monoxide (20.56%), VOC (29.21%), NOx(8.86%).

딤플을 적용한 평판에 대한 항력 감소 연구

백부근(Bu-Geun Paik),편영식(Young-Sik Pyun),김준형(Jun-Hyung Kim),김경열(Kyung-Youl Kim),김기섭(Kim1 ?Ki-Sup),정철민(Chul-Min Jung),김찬기(Chan-Ki Kim) 대한조선학회 2012 大韓造船學會 論文集 Vol.49 No.4

인터넷게임장애 환자에서 자기상에 대한 양가감정의 특성

김준형(Jun-Hyung Kim),김민경(Min-Kyeong Kim),정영훈(Young Hoon Jung),신유빈(Yu-Bin Shin),김병훈(Byung-Hoon Kim),김은주(Eun Joo Kim),김재진(Jae-Jin Kim) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.1

Objective : This study aimed to evaluate the characteristics of ambivalence of self-image and its relationship with other characteristics in patients with an internet gaming disorder (IGD). Methods : The level of ambivalence of actual and ideal self-image was evaluated numerically in 20 patients diagnosed with IGD as well as 22 normal controls. The ambivalence scores of the two groups were compared, and their correlations with psychometric scales were counted in each group. Results : Patients with IGD showed a significantly higher level in ambivalence of ideal self-image than did the controls, but not in their ambivalence of actual self-image. Both the actual and ideal ambivalence scores in the IGD group did not have a significant correlation with each other or other scales. In the control group, however, there were significant correlations of the actual ambivalence score and the ideal ambivalence score with the scales representing the level of self-esteem, self-concept clarity, impulsivity, basic psychological needs (autonomy, competence, relatedness), and of the ideal ambivalence score with the scales representing the level of impulsivity, situational motivation (amotivation, external regulation) and basic psychological needs (competence). Conclusion : This study suggested that patients with IGD might feel more intense ambivalence of ideal self-image and patients with IGD independently possess ambivalence of self-image.

외국인 유입이 지역에 미치는 영향: 외국인 인구와 내국인 인구 변화간 관계를 중심으로

김준형 ( Jun Hyung Kim ) 한국감정평가학회 2016 감정평가학논집 Vol.15 No.1

최근 나타난 외국인 인구의 증가 현상은 내국인이 거주하고 있는 근린에 새로운 영향을 미칠 수 있다. 본 연구는 이 영향들이 최종적으로 내국인 인구의 변화에 영향을 준다는 판단 하에, 행정자치부 및 법무부 체류외국인통계자료를 활용하여 외국인인구와 내국인인구 변화간의 상관관계를 분석하였다. 분석결과, 외국인 인구는 일반적으로 내국인 인구의 증가를 동반하고 있었다. 이는 외국인의 유입이 내국인 인구의 감소를 촉발할 정도로 부정적인 영향을 발생시킨다고 보기 어려움을 시사한다. 그러나 세부집단별로 나누어 살펴보면, 외국인근로자나 유학생, 교육·연수나 비전문취업의 체류자격, 중국이나 타이완, 동남아시아, 남부아시아 지역 국적의 외국인들의 증가는 내국인의 증가와 연동되지 않았다. 이는 비전문직이거나 후진국 출신, 혹은 동포가 아닌 외국인의 유입은 그 지역에 부정적 영향을 발생시킬 가능성이 존재함을 시사한다. 특히 내국인 중에서는 60~70대의 고령인구가 이 외국인 집단의 부정적 영향에 민감하게 반응하는 것으로 나타난다. Recent growth in foreign population may produce new positive or negative impacts in the neighborhood. Based on the hypothesis that these impacts finally bring about the migration of residents, this paper analyzes the relationship of population change between internationals and nationals. The correlation coefficients show that, in general, the increase of internationals is related to that of nationals. This implies that overall immigrants in Korea have not yet produced significant negative effects on the neighborhood. However, the coefficients of subgroup analyses report that there is no statistically significant relationship of population change for foreign workers, students, foreigners with education and training visa or unskilled employment visa, and people from China, Southeast and South Asia region. This means that immigrants who are unprofessional, ethnic or from less developed countries are considered to produce negative effects on their neighborhood. In particular, older residents who are in sixties or seventies are much sensitive to the negative effects of the foreign population.

가정환경, 학교환경, 학생행동요소가 학업 성취에 미치는 영향: 요소간 보완성과 대체성을 중심으로

김준형 ( Jun Hyung Kim ) 한국노동경제학회 2021 勞動經濟論集 Vol.44 No.3

본 연구에서는 학생의 학업성취 발달에 학생의 가정환경, 학교환경, 행동요소가 어떠한 역할을 하는지, 또 대체탄력성을 추정하여 각 생산요소의 생산성을 분석하였다. 한국교육종단연구 데이터를 사용하여 CES 생산함수를 추정한 결과, 대부분의 경우 세 요소 사이 상호 대체적인 관계가 있는 것으로 나타났다. 고등학교 시기보다 중학교 시기에, 남학생, 학업성취도가 낮은 학생, 그리고 사회경제적 위치가 더 낮은 환경에 속한 학생일수록 대체탄력성이 크게 추정되어 요소생산성이 큰 것으로 나타났다. 마지막으로 힉업성취도가 낮을수록 가정환경이나 학교환경보다는 학생의 행동요소의 중요성이 더 부각되었다. 따라서 학생 스스로가 학업성취에 투자를 늘릴 수 있도록 하는 방법에 주목할 필요가 있다. We investigate the role of home environment, school environment and students’ behavioral skill in the production of students’ academic achievement, with a focus on the complementarity among the three inputs. Specifically, we estimate constant elasticity of substitution production function using Korean Education Longitudinal Study data. We find that the elasticity of substitution is greater than 1, suggesting that the inputs are substitutes. The elasticity estimates are higher in middle school period, for male students, low-achieving students, and students from low-SES background, suggesting higher productivity. In addition, the importance of behavioral skill is found to be greater for low achievers. Our results suggest that it may be important to focus on improving behavioral skills of students.