유리전완피부피판의 혈관변이로 인해 전외측 대퇴유리피판을 대체 적용한 구강 내 재건 증례

윤상용,김성희,송재민,이주민,남수봉,김욱규,Yoon, Sang-Yong,Kim, Sung-Hee,Song, Jae-Min,Lee, Ju-Min,Nam, Su-Bong,Kim, Uk-Kyu 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.4

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

상하악 치조골 결손 환자에서 전신 마취 전 발생한 혈관미주신경성 실신

윤상용,윤지영,김철홍,Yoon, Sang-Yong,Young, Yoon-Ji,Kim, Cheul-Hong 대한치과마취과학회 2011 Journal of Dental Anesthesia and Pain Medicine Vol.11 No.2

Vasovagal syncope accounts for the majority of adverse events that occur in dental offices and is normally related to emotional or somatic factors. The factors trigger intense parasympathetic state, leading to bradycardia and hypotension. We experienced a case of vasovagal syncope just before general anesthesia. A 49-year-old woman with alveolar bone deficiency on maxilla and mandible was planned to undergo an alveolar bone graft with mandibular body under general anesthesia. She didn't have any histories of disease, medication or syncope. Though she showed a little anxiety from admission, she had no pre-operative medication. After she was guided to the operating room, she had signs and symptoms of vasovagal syncope without any prodromes. The patient was resuscitated soon only by the conservative treatment and was operated under general anesthesia.

내면아이치료 중심의 통합적 단기상담 질적 사례연구

윤상용(Sang-Yong Yoon) 한국부부가족상담연구학회 2022 부부가족상담연구 Vol.3 No.2

본 연구는 아동기에 경험한 애착 외상의 영향으로 불안을 호소하는 내담자의 상담 경험을 탐색하고, 내면아이치료 중심의 통합적 상담 접근이 애착방식 변화에 어떻게 영향을 미치는지 이해하고자 이루어 졌다. 이를 위해 애착 외상으로 불안을 호소하며 지역 센터에 방문한 중년 여성 내담자 두 명에게 내면아이치료 중심의 통합적 상담 기법을 적용하여 총 8회기 상담을 진행한 기록과 6개월 후 심층면접을 진행한 자료들을 참여자들의 동의를 얻어 질적 사례연구방식으로 분석하고 결과를 도출하였다. 결과를 통해 본 연구는 내면아이치료를 중심으로 한 통합적 단기상담이 아동기 경험한 애착외상과 관련된 불안을 주호소로 하는 내담자들의 변화와 성장에 긍정적으로 영향을 미칠 수 있음을 실제 사례를 통해 확인할 수 있었다. 이러한 결과를 바탕으로 연구의 의의, 한계점 및 추후 연구를 위한 논의와 시사점을 제시하였다. This study was conducted to explore the counseling experience of clients who complain of anxiety due to the influence of childhood attachment trauma and to understand how an integrated counseling approach centered on inner child therapy affects changes in attachment styles. To this end, two middle-aged female clients who visited a regional center complaining of anxiety due to attachment trauma applied an integrated counseling technique centered on inner child therapy for a total of 8 counseling sessions and data from an in-depth interview six months later. With the consent of the participants, the qualitative case study was analyzed and the results were derived. Through the results, this study confirms through actual cases that integrated short-term counseling centered on inner child therapy can positively affect the change and growth of clients whose main complaint is anxiety related to attachment trauma experienced in childhood. there was. Based on these results, the significance and limitations of the study and discussions and implications for future studies were presented.

장애인 최저소득보장제도 국제 비교 연구: 최저소득보장체계의 국가간 유형화에 기초한 유사 국가군의 비기여 소득보전급여 내용분석을 중심으로

윤상용 ( Yoon Sang Yong ) 한국보건사회연구원 2013 保健社會硏究 Vol.33 No.2

2007년 새로운 장애급여로서 장애인연금이 도입된 이후, 장애인연금은 장애연금과 함께 장애에 대응하는 독립적인 소득보전급여로서의 위상을 갖게 된 동시에 장애연금 내에 최저소득보장장치가 부재한 상황에서 유일한 장애인 최저소득보장제도로서의 위치를 확 보하고 있다. 더불어 장애인연금은 전체 장애인 소득보장체계를 구성하고 있는 급여들 중에서 가장 늦게 도입되었으면서도 수급자 및 소요재원의 규모라는 제도의 내용 측면에서 여타의 장애 급여를 능가하고 있다는 점에서 현재 우리나라의 가장 대표적인 장애인 소득보장제도라고 할 수 있다. 본 연구는 장애인연금이 갖고 있는 이러한 대표성과 신정부가 장애인연금을 기초노령연금과 통합하여 기초연금으로 전환하는 방안을 밝힌 후 이슈의 한 가운데에 있다는 점에 주목하여 장애인연금의 바람직한 개선 방안을 마련하는 근거로서 국제 비교적 관점에서 장애인연금의 현 수준을 진단하는 것을 목적으로 하고 있다. 이를 위해 적절한 비교 대상 국가군을 확보하기 위한 작업으로서 우리나라를 비롯 한 16개 OECD 회원국에서 운용하고 있는 장애인 최저소득보장체계에 관한 국가간 유형 화를 시도한 결과, 개별 국가에서 운용하는 기여 최저소득보장제도 및 비기여 최저소득보장제도의 종류 및 위계적 구조 형태에 따라 총 5가지 유형으로 구분할 수 있었다. 이러한 유형화에 기초하여 장애인연금과 제도적 유사성을 갖고 있는 비기여 최저소득보장제도를 운용하고 있는 9개 국가의 급여 내용을 분석한 결과, 우리나라의 장애인연금은 낙후된 장애 평가 시스템으로 인해 다른 국가와 비교할 때 대상 효율성이 매우 취약하였으며, 지급액에 있어서는 평균소득대비 비중이 3.0%로 비교 대상 국가의 1/8에 불과한 것으로 파악되는 등 소득보장정책의 핵심 평가 요소인 포괄성, 충분성, 형평성 등에서 제도적 후진성을 보였다. 이러한 연구 결과에 비추어 볼 때, 장애인 소득보장체계의 발전을 위한 방안으로서 기여 최저소득보장제도의 도입, 장애급여 지급대상 확대, 장애급여 지급액 인상, 장애급여 체계 개편 등이 추진되어야 할 것이다. Since the Disabled Pension has been introduced in 2007, the Disabled Pension is considered as the representative minimum income benefit for people with disabilities in terms of the number of recipients and budgetary scale. The objectives of this study is to assess the level of the Disabled Pension by way of cross-national comparative study and suggest the reformation plan on minimum income provision system for people with disabilities including the Disables Pension. To achieve this, first above all this study attempts to classify minimum income provision system for people with disabilities in selected 16 OECD countries on basis of type of contributory benefit and non-contributory benefit and their hierarchical structure. The Results of the classification shows that there are five types. The results of comparative study on non-contributory minimum income benefits of 9 OECD countries that have institutional parallels shows that the Disabled Pension of Korea does not emerge from backwardness in terms of income maintenance policy`s effectiveness. This study therefore suggest that there is a strong need for introducing the contributory minimum income provision for the disabled, expanding the coverage of disability benefits and increasing the level of disability benefits.

장애인 거주시설 이용적격성 심사도구 평가영역과 항목, 시설배치 방안에 관한 탐색적 연구

윤상용(Yoon, Sang-Yong),서동명(Seo, Dong-Myung) 비판과 대안을 위한 사회복지학회 2016 비판사회정책 Vol.- No.51

본 연구는 원가정에서 생활할 수 없는 장애인이 대안적으로 이용할 수 있는 적합한 장애인거주시설유형을 결정하는 합리적 방안이 부재한 상황을 극복할 수 있는 방안으로 장애인복지법에서 장애인 거주시설의 이용 절차로 규정하고 있는 ‘장애인거주시설 이용적격성 심사도구’의 개발에 필요한 평가 영역과 항목, 그리고 심사 결과에 따른 합리적인 시설 배치 방안을 제안하는 것을 목적으로 하고 있다. 현재 우리나라 장애인거주시설 서비스 이용은 해당 시군구에서 입소 희망 장애인의 욕구조사와 적격성여부 심사를 한 후 대상 시설에 입소 의뢰를 하도록 하는 규정이 있음에도 불구하고 실제로는 시군구가 아닌 장애인거주시설이 대행하고 있으며, 대부분의 거주시설이 이용적격성 심사도구가 없거나, 심사도구가 있는 경우에도타당성과 신뢰성 측면에서 매우 미흡한 초보적인 수준의 도구를 가지고 제한적으로 활용하는 상황이라는 것이 밝혀졌다. 이러한 상황에서 본 연구에서는 홍콩의 장애인 거주시설 사정 도구와 다른 주요 국가에서 활용하고 있는 장애인 돌봄 및 지원서비스 욕구 사정도구를 기반으로, 장애인 거주시설 실무자 대상 설문조사와 초점집단인터뷰 결과 등을 종합하여 우리나라 장애인 거주시설 이용적격성 심사도구의 평가영역 및 항목을 제안하고, 평가 결과에 따른 합리적 시설 배치 방안을 제안하였다. 구체적으로 본 연구에서는 장애인거주시설 이용적격성 심사도구의 평가영역은 개인적 특성, 장애특성, 간호서비스 욕구, 기능손상 정도(일상생활기능), 문제행동, 보호자(가족)지원체계, 지역사회지원체계 등 7개 영역으로 제안하였으며, 이용적격성 평가에 따른 거주시설 배치방안을 신체적 장애인과 발달장애인으로 구분하여 제안하였다. 나아가 이용적격성 심사도구의 효과적 적용을 위한 장애인 거주시설의 합리적 유형 개편 등 장애인 거주시설 관련 정책의 개선방안을 제언하였다. This study is to suggest an eligibility screening tool that can be used to determine appropriate type of residential facility for the disabled. In this study, while based on the standardized assessment tool for residential services for people with disabilities in Hong Kong turn out to be best practices in international comparative perspective, along with considering disability care and support needs assessment tools that are utilized in the major countries and results of surveys and focus group interviews for practitioners of Korean residential facilities for the disabled, we proposed assessment areas and items and a rational placement process in accordance with the evaluation results. Specifically, assessment areas are composed of personal characteristics, disability characteristics, nursing service needs, degree of impairment(activities of daily living), problem behavior, caregivers(family) support systems, community support systems. Also for the effective application of eligibility screening tool, we suggested restructuring Korean residential facilities for the disabled.

장애연금 수급 요건으로서 근로능력 개념 및 평가 방법에 대한 일고찰

윤상용(Sang Yong Yoon) 충북대학교 생활과학연구소 2013 생활과학연구논총 Vol.17 No.2

The object of this study is to provide improvement guidelines on assessment of work capacity as benefit entitlement requirement of National Pension Scheme by analyzing similarities and differences of definition and assessment process of work capacity in some OECD countries's disability pension scheme. The results of international comparison shows that most OECD countries state the loss of work capacity or earning capacity as legal definition of disability and functional and/or rehabilitative operationalization with medical operationalization of disability. In case of National Pension Scheme its legal definition of disability is the loss of work capacity but operationalization of work capacity applies only medical perspective. To solve the inconsistency in current assessment system of work capacity, this study suggests functional and/or rehabilitative operationalization in combination with medical operationalization in National Pension Scheme.

장애인연금 수급요건으로서 근로능력평가 도입

윤상용(Sang Yong Yoon) 충북대학교 생활과학연구소 2015 생활과학연구논총 Vol.19 No.2

The purpose of this study is to present a rational direction for improving eligibility of Disabled People Pension to be reflected in a comprehensive disability assessment tool as an alternative after abolition of disability grading system in the near future. The comparative analysis of the work capacity assessment as a core requirements of non-contributory disability benefits in 13 OECD countries shows that all countries but Japan have the requirements combining medical assessment with functional work capacity assessment or employability assessment or combining socio-environment assessment. In that it is difficult to establish a system to assess employability or socio-environment in a short period of time, introducing functional work capacity assessment in addition to present medical evaluations is the most reasonable way to improve eligibility of Disabled People Pension.

장애인복지서비스 전달체계의 분석과 발전적 대안 모색

윤상용(Sang Yong Yoon) 충북대학교 생활과학연구소 2012 생활과학연구논총 Vol.16 No.1

During these ten years the supply of social service for people with disabilities have been increased consistently. But the delivery system of social service for people with disabilities was not improved relatively. Government has been endeavoring to reform the delivery system of social service for people with disabilities focused on gate keeping system. The objective of this study is to find a desirable way to improve the delivery system of social service for people with disabilities on the basis of the analysis of outcomes and limitations of recent five years’s reforming actions titled with “Reforming the infra-structure of the disability welfare services”. The results of the analysis of the delivery system of social service for people with disabilities showed that in disability assessment system there was an outcome enhancing objectivity of disability eligibility evaluation, however the definition of disability is still leaning toward medical model of disability and there are many people in places where they can't enroll as an disabled person legally and in needs assessment system there are still an lack of rationality and the functions of comprehensive need assessment and case management. Government has been pushing forward establishing the disability service center as the one-stop gate keeping system for these five years, however, it is uncertain whether disability service center will be set up or not in the future. Here are two reasons. The first reasons is that there is an aversion about establishing an independent delivery system of social service for people with disabilities within governments. And the second reason is that there is additional financial burden needed for set them up throughout the nation. At this point in time, the best way to solve many problems occurred under present delivery system of social service for people with disabilities is to establish an independent comprehensive services delivery system for people with disabilities by way of using the National Pension Services Institution as an operating body of disability assessment and personal assistant services for people with disabilities.

장애인정책 및 서비스 변화에 따른 장애인복지인력 보수교육체계 진단과 제언

윤상용(Sang-yong Yoon) 충북대학교 생활과학연구소 2022 생활과학연구논총 Vol.26 No.3

Background/Objectives: Under the rapidly changing service paradigm for the disabled, this study aims to present improvement measures to update the remuneration education and training system for welfare personnel to ensure that they can effectively utilize their professional capabilities to maintain the expertise required to satisfy the needs of the disabled. Methods: The method followed herein is a nonsystematic literature study, a qualitative secondary research method, used to analyze primary literature such as academic journals, research reports, and Internet data of government and private institutions in depth. Results: Analysis results reveal that although various curricula for welfare personnel for the disabled are being used in the public and private sectors, the lack of quality education, lack of connection between curricula, and the focus on irregular education are inherent problems therein. Conclusion/Implications: To improve the remuneration education system for welfare personnel for the disabled, first, a core of their competencies should be established along with the principles and values that should be applied to the welfare practice process to be followed for the disabled. Second, the curriculum pertaining to services for the disabled in the public sector should be strengthened. Third, professional instructors must be trained to guarantee the quality of the curriculum . Finally, diversify both the online and field-led curricula.

주요 OECD 회원국의 근로능력평가 유형화 및 한국형 근로능력평가 모형 탐색

윤상용(Yoon Sang Yong) 경기연구원 2019 GRI 연구논총 Vol.21 No.3