• 교육심리연구
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• 제28권1호
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• pp.1-21
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• 2014

이 연구에서는 과제의 유용가치가 상황적 흥미와 재참여 의지에 미치는 영향이 자기효능감 수준에 따라 다르게 나타나는지 살펴보고자 유용가치를 단기 유용가치(proximal utility)와 장기 유용가치(distal utility)로 각각 구분하여 비교하였다. 연구 1에서는 대학생을 대상으로 연산 과제에 대한 유용가치의 시간적 근접성과 자기효능감의 상호작용이 흥미유발에 미치는 효과를 살펴본 결과, 자기효능감이 높을수록 장기적인 유용가치가 흥미 유발에 효과적인 것으로 나타났다. 연구 2에서는 대학생과 발달적으로 차이가 있으며 학습 환경에서 수학이 필수적인 요소인 고등학생을 대상으로 교실학습 상황에서 연구를 수행하였다. 연구 결과, 대학생과 마찬가지로 자기효능감이 높을수록 장기적인 유용가치가 흥미 유발에 효과적인 것으로 나타났다. 이상의 연구 결과들은 과제에 대한 상황적 흥미를 증진시키기 위해 유용가치를 제공하는 경우 시간적 근접성과 자기효능감을 함께 고려해야 한다는 점을 시사한다.

• 대한족부족관절학회지
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• 제19권2호
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• pp.51-57
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• 2015

Purpose: Minimal incision distal metatarsal osteotomy (MIDMO) is known to be an effective surgical procedure for mild to moderate hallux valgus. However, the result of MIDMO on moderate to severe hallux valgus is controversial; therefore, we investigated the radiological and clinical results of MIDMO on moderate to severe hallux valgus. Materials and Methods: We reviewed 51 feet (48 patients) with moderate to severe hallux valgus. The mean age was 67.0 years and the mean follow-up period was 32.2 months. Radiological data of hallux valgus angle, first intermetatarsal angle, and distal metatarsal articular angle on plain radiographs were analyzed. Recurrence, union, lateral translation of distal fragment and angulation were also analyzed. The clinical data were obtained using American Orthopaedic Foot and Ankle Society (AOFAS) score of preoperation and last follow-up. Receiver operating characteristic (ROC) curve was used to determine a cut-off value. Results: The mean hallux valgus angle measured at preoperation was $37.7^{\circ}$ and $15.9^{\circ}$ at last follow-up. The mean first intermetatarsal angle of preoperation and last follow-up were $15.2^{\circ}$ and $8.3^{\circ}$. The mean distal metatarsal articular angle changed from $12.6^{\circ}$ at preoperation to $7.8^{\circ}$ at last follow-up. Preoperative hallux valgus angle (p=0.0051) and distal metatarsal articular angle (p=0.0078) were statistically significant factors affecting postoperative AOFAS score. Cut-off value of each was $37^{\circ}$ and 13o, respectively. Lateral translation of distal fragment in 5 recurrent cases was 23.0% compared to 45.3% of 46 non-recurrent cases. The result was statistically significant and the cut-off value was 38%. Conclusion: Sufficient lateral translation over 38% in MIDMO on moderate to severe hallux valgus patients with preoperative hallux valgus angle under $37^{\circ}$ and distal metatarsal articular angle under $13^{\circ}$ can lead to good clinical results without recurrence.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.66-71
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• 2021

Background: Extra-articular distal humerus locking plates (EADHPs) are precontoured anatomical plates widely used to repair distal humeral extra-articular diaphyseal fractures. However, EADHPs frequently cause distal protrusion and resulting skin discomfort. The purpose of this study was to predict the occurrence of anatomic fit mismatch. We hypothesized that the smaller the humerus size, the greater the anatomic fit mismatch with EADHP. Methods: Twenty humeri were analyzed in this study. Humeral length and distal humeral width were used as parameters of humeral size. Plate protrusion was measured between the EADHP distal tip and the distal humerus. We set the level of unacceptable EADHP anatomic fit mismatch as ≥10 mm plate protrusion. Results: A significant negative linear correlation was also confirmed between humeral size and plate protrusion, with a coefficient of determination of 0.477 for humeral length and 0.814 for distal humeral width. The cutoff value of humeral length to avoid ≥10 mm plate protrusion was 293.6 mm (sensitivity, 88.9%; specificity, 81.8%) and for distal humeral width was 60.5 mm (sensitivity, 100%; specificity, 81.8%). Conclusions: Anatomic fit mismatch in distal humeral fractures after EADHP fixation has a negative linear correlation with humeral length and distal humeral width. For patients with a distal humeral width <60.5 mm, ≥10 mm plate protrusion will occur when an EADHP is used, and an alternative implant or approach should be considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권2호
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• pp.95-101
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• 2003

The purpose of this study was to evaluate the patterns of skeletal changes of proximal and distal segments after one jaw surgery and two jaw surgery with posterior impaction using SSRO on mandible in order to determine the skeletal origin of relapse and compare the stability of surgical methods in anterior open bite. The points and lines from lateral cephalometrics were measured before, after surgery, and at least 6-month follow up period. And then, the positional change of the proximal and distal segment were evaluated respectively. The results obtained were as follows; In cases of two jaw surgery, the results were stabler because they had less relapse factors. In cases of one jaw surgery, the value of APD were increased but it didn't relapse to the original value. Both of proximal and distal segments were responsible for the relapse tendency. But in one jaw surgery, the rotation of proximal segment was more responsible, and in two jaw surgery, the rotation of distal segment was.

• 대한족부족관절학회지
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• 제9권1호
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• pp.74-80
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• 2005

Purpose: A retrospective review of the radiographs of the proximal metatarsal osteotomy and distal soft tissue procedure for hallux valgus, evaluating the correction of the tibial sesamoid, was undertaken. We evaluated the correlation between the reduction of the tibial sesamoid and the clinical outcomes. Materials and Methods: 17 patients (23 cases) with moderate to severe hallux valgus deformity underwent the proximal metatarsal osteotomy and distal soft tissue procedure. The preoperative and last follow-up radiographs were reviewed according to the tibial sesamoid grade classification recommended by the Research Committee of the American Orthopedic Foot and Ankle Society (AOFAS). We divided them into two groups according to the reduction of the tibial sesamoid. We anaylyzed the clinical outcomes in each group according to Mayo Clinic Forefoot Scoring System (FFSS). Results: In all of the patients, the preoperative tibial sesamoid position were grade 2 or greater. At the last follow-up, 52% (n=12) were grade 1 or less (Group I) and 48% (n=11) were grade 2 or greater (Group II). In group I, the forefoot score was improved from preoperative mean value of 32.0 points to final follow-up value of 66.3 points. In group II, the forefoot score was improved from preoperative mean value of 31.7 points to final follow-up value of 65.9 points. There was no statistical significance between postoperative, average scores in group I and II (p>0.05). Conclusion: The position of the tibial sesamoid was corrected insufficiently in almost half of all cases. In view of clinical outcomes, there was no significant difference between the corrected group and the other group.

• 한국동물학회지
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• 제33권3호
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• pp.322-329
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• 1990

한국산 도롱뇽 유생의 다리재생에 미치는 retinoic acid의 효과를 알아보았다. 도롱뇽 유생의 다리를 distal zeugopodium 또는 distal stylopodium 부위에서 절단하고 절단 후 4일째에 복강내 주사방법으로 RA를 처리한 결과 근원위 축상에서 재생된 골격이 복제되어 근위부화한 형태를 나타내었다. RA처리에 따른 골격 재생이 평균 근위 부화정도는 처리량이 증가와 더불어 증가하였으며 또한 절단부위를 달리하였을 경우에도 영향을 받았다. 근원위 축상에서 평균 근위부화정도의 최대치에 근접한 값은 처리량을 150 $\mu$ g/g body wt.로 했을 때 얻어졌으며 이 처리량을 넘어서는 경우에는 재생의 저해 혹은 주변으로부터의 골격복제 현상이 나타났으며 그 빈도 역시 처리량의 증가와 함께 상승하였다. 이러한 실험결과는 RA처리에 의하여 유발되리라고 보여지는 positional value의 변화가 근원위축을 비롯한 3개의 주요 축상에서 점진적으로 일어남을 시사하며, zeugopodium의 복제가 stylopodium의 복제보다 쉽게 일어난다는 사실은 근원위축상에서 세포들의 RA에 대한 민감성이 동이하지 않거나 혹은 positional value의 배열양상이 직선적이 아님을 시사하고 있다.

• 대한족부족관절학회지
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• 제12권1호
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• pp.1-8
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• 2008

Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

• 한국신뢰성학회지:신뢰성응용연구
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• 제16권2호
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• pp.147-154
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• 2016

Purpose: To evaluate statistical differences among three measurements of range of motion (ROM) with Rapael Smart Glove (RSG) group 1, 2 and manual goniometer group. To investigate reference value of the kinematic analysis for range of motion (ROM) of distal upper extremity with Rapael Smart Glove (RSG). Methods: Sixteen normal persons without limitation of motion (LOM) enrolled in the study. The study was performed at two separate times and by two investigators on 16 normal adults. We compared ROM with RSG for measuring joint angles. We compared degrees of forearm supination/pronation, wrist flexion/extension and radial deviation/ulnar deviation during ROM of 16 participants using RSG. After one week, degrees of each motion were measured in the same way by other investigator to evaluate the reliability. Results: Statistical differences among three groups were showed. Most results of paired t-test between two RSG groups were over 0.05 and exceptions are supination, extension, and finger %. Conclusion: Our findings demonstrate that ROM of normal persons obtained by kinematic analysis with RSG are not valid as normal reference value for distal upper extremity motion. But, the reliability of between two RSG groups was showed with paired t-test and Pearson's correlation except supination, extension and finger %.

• 대한족부족관절학회지
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• 제22권3호
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• pp.95-99
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• 2018

Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

• 대한방사선치료학회지
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• 제30권1_2호
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• pp.35-40
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• 2018

목 적 : 본원에서 사용하는 양성자 에너지는 크기에 따라 도달거리가 달라지며, Compensator는 Distal 두께에 따라 Energy의 크기를 다르게 할 수 있으며 이로 인해 Dose rate이 변화된다. 따라서 Compensator distal의 두께를 변화시키면서 Dose 분포 및 Beam on time에 대한 영향을 평가해보고자 한다. 대상 및 방법 : 본원에서 양성자치료를 받은 에너지가 낮은 환자 5명을 대상으로 실험하였다. 선택된 환자들의 기존 치료 시 Beam on time을 확인하였으며 이 후 양성자치료계획시스템(TPS)을 통하여 Compensator의 Distal 두께를 기존 두께에서 2 cm씩 최대 14 cm까지 증가시켜가며 치료계획을 비교 평가하였다. Dose 분포를 평가하기 위하여 Target의 Conformity Index(CI)값과 Homogeneity Index(HI)값, Target 후면부의 Organ at risk(OAR)의 최대선량을 비교하였으며 치료시간에 대한 영향을 평가하고자 Compensator Distal 두께 별로 제작하여 Beam on time을 비교하여 평가하였다. 결 과 : Compensator의 Distal 두께를 증가시켜 Homogeneity Index, Conformity Index를 분석한 결과 모든 환자에서 동일한 수치가 나왔다. Target 후면부의 OAR을 비교한 결과 Abdomen의 Spine cord에 최대 7 cGy, Eyeball의 RT Lens에서 88 cGy, Nasal cavity의 RT Lens에 391 cGy, Mediastinum의 Trachea에 51 cGy, Pelvis의 Small bowl에 661 cGy 증가하였다. Beam on time을 비교한 결과 Abdomen의 경우 기존 126초에서 최대 62초, Eyeball의 경우 105초에서 37초, Nasal cavity의 경우 기존 187초에서 134초, Mediastinum의 경우 기존 100초에서 40초, Pelvis의 경우 기존 440초에서 118초로 감소하였다. 결 론 : 연구결과 Compensator의 distal 두께가 두꺼워질수록 에너지의 크기를 증가시킬 수 있으며 Dose rate이 증가하여 Beam on time이 감소하는 효과가 있었다. 이는 Beam on time이 많이 소요되는 호흡동조치료를 요하는 Liver, 마취를 하는 소아환자에게 적용한다면 치료시간 단축과 환자의 편의성 면에서 큰 도움을 줄 것으로 평가된다. 하지만 에너지의 크기가 증가할수록 Distal penumbra가 증가하기 때문에 Target 후면부에 OAR이 인접해 있는 경우는 양성자치료계획 시 Penumbra의 영향을 고려한 적절한 Compensator 두께를 설정할 필요가 있을 것으로 사료된다.