• Archives of Plastic Surgery
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• 제49권1호
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• pp.91-98
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• 2022

Background Predicting the need for post-traumatic reconstruction of lower extremity injuries remains a challenge. Due to the larger volume of cases in adults than in children, the majority of the medical literature has focused on adult lower extremity reconstruction. This study evaluates predictive risk factors associated with the need for free flap reconstruction in pediatric patients following lower extremity trauma. Methods An IRB-approved retrospective chart analysis over a 5-year period (January 1, 2012 to December 31, 2017) was performed, including all pediatric patients (<18 years old) diagnosed with one or more lower extremity wounds. Patient demographics, trauma information, and operative information were reviewed. The statistical analysis consisted of univariate and multivariate regression models to identify predictor variables associated with free flap reconstruction. Results In total, 1,821 patients were identified who fit our search criteria, of whom 41 patients (2.25%) required free flap reconstruction, 65 patients (3.57%) required local flap reconstruction, and 19 patients (1.04%) required skin graft reconstruction. We determined that older age (odds ratio [OR], 1.134; P =0.002), all-terrain vehicle accidents (OR, 6.698; P<0.001), and trauma team activation (OR, 2.443; P=0.034) were associated with the need for free flap reconstruction following lower extremity trauma in our pediatric population. Conclusions Our study demonstrates a higher likelihood of free flap reconstruction in older pediatric patients, those involved in all-terrain vehicle accidents, and cases involving activation of the trauma team. This information can be implemented to help develop an early risk calculator that defines the need for complex lower extremity reconstruction in the pediatric population.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.63-69
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• 2023

Background An increasing number of nonbinary patients are receiving gender-affirming procedures due to improved access to care. However, the preferred treatments for nonbinary patients are underdescribed. The purpose of this study was to investigate the goals and treatments of nonbinary patients. Methods A retrospective study of patients who self-identified as nonbinary from our institutional Gender Health Program was conducted. Patient demographics, clinical characteristics, surgical goals, and operative variables were analyzed. Results Of the 375 patients with gender dysphoria, 67 (18%) were nonbinary. Over half of the nonbinary patients were assigned male at birth (n = 57, 85%) and nearly half preferred the gender pronoun they/them/theirs (n = 33, 49%). A total of 44 patients (66%) received hormone therapy for an average of 2.5±3.6 years, primarily estrogen (n = 39). Most patients (n = 46, 69%) received or are interested in gender-affirming surgery, of which, almost half were previously on hormone therapy (n = 32, 48%). The most common surgeries completed or desired were facial feminization surgery (n = 15, 22%), vaginoplasty (n = 15, 22%), mastectomy (n = 11, 16%), and orchiectomy (n = 9, 13%). Nonbinary patients who were assigned male at birth (NB-AMAB) were more often treated with hormones compared to nonbinary patients assigned female at birth (NB-AFAB) (72% vs. 30%, p = 0.010). Conversely, patients who were AFAB weremore likely to complete or desire surgical intervention than those who were AMAB (100% vs. 63.0%, p < 0.021). Conclusion Majority of nonbinary patients were assigned male at birth. NB-AFAB patients all underwent surgical treatment, whereas NB-AMAB patients were predominantly treated with hormone therapy.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.62-70
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• 2024

Background: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

• Archives of Plastic Surgery
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• 제51권2호
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• pp.251-257
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• 2024

Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p-values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.

• 디자인학연구
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• 제13권2호
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• pp.95-102
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• 2000

본 연구는 도시공원내 벤치의 배치장소가 이용자의 선호도에 어떻게 영향을 주고 있는가를 파악하고자 하였다. 이를 위해 도시근린공원내 벤치의 대표적인 배치장소의 유형을 크게 4가지로 구분하고 각 배치장소별 시각적 특성과 형용사 항목들의 차이 등을 설명하고자 분산분석과 던칸분석을 실시하였다. 이상의 결과를 요약해 보면 아래와 같다. 1.벤치의 배치장소별 시각적 특성을 구성하는 인자는 감정적요인,시각적요인,물리적/개성적요인,명료성 요인,밀도요인 등 모두 5가지 요인으로 구분되었다. 이들 5가지 요인들의 설명력은 60.40%였으며,이들 요인중 심리적반응을 표현하는 감적적 요인이 가장 높게 평가되었다.2. 앞의 요인분석 결과로부터 도출된 5가지의 요인별 시가적 특성은 형용사 변인들이 배치장소별로 다르게 지각되고있는 것으로 확인되었다. 특히 조사결과 대부분의 형용사 이미지 변인들이 통계적인 유의성을 보이며 Spot1->Spot Spot 4->spot 2-> spot3의 순으로 평균점수를 나타내고 있어,벤치의 배치장소가 수변과 인접해 배치된 유형을 가장 선호하고 있는 것으로 나타났으며, 인공재료 및 인위적인 공간과 연계되어 배치되었을 것으로 나타났으며,인공재료 및 인위적인 공간과 연계되어 배치되었을 때의 선호도가 낮아지고 있음을 확인할 수 있었다. 한편, 본연구는 앞으로 검토되어야 할 것 으로 첫째 제한된 설문대상자 외에도 연령별,계층별로 다각적인 접근을 통한 선호도 조사가 지속적으로 수행되어야 한다. 둘째 본 실험에 사용된 대표적인 4가지 유형외에도 실험 대상을 확대시킬 필요가 있다. 셋째 보여지는 대상과 장소의 시각적 특성 뿐만 아니라 벤치에 앉았을 때 관찰되는 주변경관의 시각적 특성 등에 대한 조사 연구도 동시데 뒷받침될 필요가 있다.그럼에도 불구하고 본 연구결과를 통해 공원시설물 디자인을 함에 있어 유용한 자료로 활용을 기대할 수 있을 것이다.고 있다.석한후 그 결과를 종합적으로 해석함으로써 더 유효성이 높은 접근 가능성을 모색하고자 하였다. 시스템 에서 포도당을 낮은 level로 유지할 수 있었으나, 초산의 과도한 축적으로 항체 생산성의 향상은 예상에 비해 크지 않았다. 81%), C18 0(12.38%), C18: 1(25.93%), C22:6(9.95%)이며 결합지방질(結合脂肪質)은 C14 : 0(11.60%), C16 : 0(18.94%), C16: 1(10.42%). C18 : 1(10.89%), C22 : 6(23.44%)이었다. 총필수지방산(總必須脂肪酸) 함량(含量)은 극성지방질(極成脂肪質)$(20.14{\sim}31.12%)$이 비극성지방질(非極成脂肪質)$(6.97{\sim}11.13%)$보다 훨씬 높았고, 결합지방질(結合脂肪質)이 유리지방질(遊離脂肪質)보다 높았으며 부위별(部位別)로는 피부(皮部)$(15.18{\sim}15.41%)$가 육질부(肉質部)$(6.97{\sim}11.13%)$보다 높았다. 또${\omega}3$고도부포화지방산(高度不飽和脂肪酸) 함량(含量)은 육질부(肉質部)$(15.15{\sim}28.32%)$가 피부(皮部)$(6.77{\sim}18.18%)$나 내장부(內臟部)$(8.35{\sim}9.74%)$보다 높았으며, 육질부(肉質部)에서는 극성지방질(極成脂肪質)$(26.28{\sim}34.18%)$이 비극성지방질(非極成脂肪質)$(15.15{\sim}28.32%)$보다 높았다.veral world-wide prediction models. Based on the analysis, we can easilty know the importance of the model

• 디자인학연구
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• 제18권4호
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• pp.257-266
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• 2005

본 연구는 기독교 예배공간 강단부 이미지를 대상으로 피험자를 통해 나타나는 감성반응을 연구하고, 감성 자극 요소가 감성반응에 미치는 기여도를 정량화하여 향후 예배공간 강단부 계획에 있어 감성의 공간을 구현하기 위한 기초자료를 제시하는데 그 목적이 있다. 연구 방법으로는 예배공간을 대상으로 추출한 감성 표현어휘 23개와 선정한 예배공간 강단부 이미지 32개와의 상관관계를 분석하기 위해 기독교인 143명을 대상으로 설문조사를 시행 하였다. 통합된 데이터를 수량화이론 III류 분석법을 이용해 2차원분산 분포도로 나타내었으며, 분석 결과, 이미지의 '단순복잡성'을 나타내는 가로(x)축과 이미지의 '독창성'을 나타내는 세로(y)축으로 성립됨을 밝혀내었다. 더불어 분석 결과에 따른 감성 반응치(反應値)와 감성 자극요소와의 인과관계를 수량적으로 추출하기 위해 클러스터 분석에 의한 유사도를 기준으로 가로축의 대표 감성어 소박한, 장엄한 과 세로축의 전형적인 독창적인 을 4개의 감성 어휘 그룹으로 선정하였으며, 해당하는 감성어휘 평가치의 총계를 기준변수로 하고, 예배공간 강단부의 감성 자극 요소를 독립변수로 하는 수량화 이론 I류 분석법을 이용해 분석하였다. 강단부의 감성 자극 요소의 구체적 부분은 벽의 색상, 형태, 마감과 바닥의 형태와 마감, 천장의 형태, 색채, 창의 형태, 상징적 요소의 유(有) 무(無) 9가지로 선정하였으며, 그에 따른 하부 카테고리 31개를 선정하여 감성 자극 요소가 감성반응에 미치는 기여도를 분석하였다. 그 결과 벽면의 색상과 마감이 피험자의 감성반응에 가장 많은 영향을 미치는 것으로 나타났으며, 상징적 요소의 유(有) 무(無)와 천장의 색상은 크게 영향을 미치지 않은 요소임을 밝혀내었다. 본 연구는 예배공간의 종교적 숭고미와 관련되는 감성적 요구를 표현하는데 있어 디자이너의 주관적인 해석을 객관화, 정량화시켜 사용자의 감성적 만족을 높이고 공간의 유형과 목적을 만족시킬 수 있는 공간 디자인 접근에 도움이 되리라 본다.

• 디자인학연구
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• 제18권3호
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• pp.5-14
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• 2005

과거의 소비자는 있어야 하는 진에 대한 결핍상태로부터 원래의 균형상태로 나아가고자 하는 공리적(utilitarian)이고 방어적인(defensive) 소비를 추구하였다. 그러나 오늘날의 소비자는 이를 넘어서서, 감각(sensation) 그 자체는 아닐지라도 쾌락적(hedonic)이고 창의적인(creative) 이유로 더 많은 소비를 하고 있다. 제품, 서비스의 특징이나 사용편익, 품질 등을 통해 기본적 욕구를 충족시키는 소비에서 제품, 서비스 등이 제공하는 독특한 가치체계와 생활양식 그리고 이를 사용하면서 얻게 되는 총체적인 '경험(experience)'을 더 중요하게 추구하는 '경험소비의 시대'를 맞게 된 것이다. 오늘날 경험은 온 오프라인을 아우르는 다양한 영역에서 활용기고 있다. 이러한 시대적 요구는 디자인의 영역에서도 경험을 전략적으로 활용하고자 하는 경험디자인(experience design)을 탄생시켰고, 그에 대한 기초연구가 점차 증가하고 있다. 그러나 경험디자인이 어떠한 개념을 가지고 있으며, 어떠한 목적을 가지고 있는지 조차 이해하지 못한 채 수행되는 연구나 적용은 그 과정이나 방법이 본질을 벗어날 가능성이 있다. 따라서 본 연구에서는 오늘날 경험을 경제적 가치로 인식하고 이를 실질적으로 활용하고 있는 분야를 중심으로 경험의 활용 개념과 한계를 밝혀 디자인 영역에서 적용될 수 있는 경험의 의미적 체계를 확립하고 수용되고 소통될 수 있는 경험디자인의 개념과 목전을 제시하고자 하였다. 연구결과 온라인 환경에서 활용되는 경험의 주된 개념은 오프라인 환경에 익숙해져 있는 사용자 경험을 온라인 환경에 반영하여 그 환경을 친밀감 있고 익숙하게 구현해줌으로써 그 매체를 사용자가 편하게 사용할 수 있도록 해주는 사용성 증진을 위한 개념임을 알 수 있었다. 이것은 사용자를 놀랍게 만든다 거나 흥미와 재미를 유발시키는 경험이 아니라 사용자를 편하게 만들 수 있는 경험이어야 한다는 것이다. 오프라인 환경에서 활용되는 경험의 개념은 사용자의 감성을 충족시킬 수 있는 도구로써, 미래지향적 새로운 소비자 가치를 창조하고자 하는 노력으로 요약될 수 있었다. 이는 소비자 행동에 대한 이해를 기반으로 더욱 뛰어난 감각적 경험과 감성적 경험 등을 복합적으로 제공함으로써 소비자의 소비 경험을 극대화하고 고정된 제품 특성에서 확장된 새로운 경험을 창조하도록 하여 기존 경험을 강화하고자 한다. 또 즐거움과 재미, 기타 독특한 체험을 통해 소비자에게 유희라는 쾌락적 경험을 제공하고자 한다.

• 디자인학연구
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• 제19권2호
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• pp.53-62
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• 2006

빠른 '통신수단 '정도로만 여겨왔던 이메일이 온라인 마케팅의 핵심으로 떠오르고 있다. 이로 인해 기업들은 고객과의 Communication을 통해 지속적인 고객관리를 해야 하는 시점에서 이메일 마케팅은 강력한 의사교환 수단이며 고객의 성향과 구매습관, 취향 등을 분석하여 개인화된 일대일(One To One) 마케팅1)을 가능케 해준다. 정확한 타겟팅이 무엇보다 중요한 패션 산업에 있어서 일대일 마케팅 도구로서 또는 고객과의 커뮤니케이션 할 수 있는 가장 효과적인 방법으로서 이메일 마케팅은 매우 중요한 전략중 하나이다. 이에 본 연구에서는 일대일(One To One) 마케팅 도구로 부각되고 있는 이메일을 대상으로 인터넷 패션쇼핑몰에서 2005년 6월 12일부터 7월 30일까지 발송한 이메일을 대상으로 실제 사례분석을 통해 이메일 발송 후 매출 신장 효과를 살펴보고 이메일 반응에 미치는 영향을 오픈율을 기준으로 세부 반응을 분석하였다. 연령대별, 성별 오픈율은 20대 후반 여성이 평균 21.66%로 가장 높게 나타났고, 평균 3.5%의 매출 신장 효과가 있었다. 매출 현황에서도 20대 후반의 매출액이 28.10%로 가장 높게 나타나 오픈율이 많은 그룹에서 매출도 많이 일어나는 것을 알 수 있었다. 이메일 제목에 따른 반응은 [케주얼] 이라는 상품 카테고리를 표시한 이메일 제목이 가장 높게 나타났고, 요일에 따른 반응은 화요일 발송 메일이 가장 높게 나타났다. 정기 메일과 섹션 메일의 연관성은 섹션 메일에서 오픈율이 더 높게 나타났고, 시간대별 오픈율은 14시(오후2시)에 20대 후반 여성에게 발송한 메일의 오픈율이 20.93%로 가장 높게 나타났다. 실용적 정보와 흥미로운 요소들로 수신자들의 관심을 끌어 사이트의 방문을 유도하는 형태로 가는 것이 바람직하다고 볼 수 있다. 결론적으로, 이메일 발송이 매출 신장에 효과적인 수단임을 알 수 있었다. 또한, 효과를 더욱 높이기 위해서는 기존 메일 발송 결과를 분석한 데이터를 차기 메일 발송에 꾸준히 적용함으로써 성공적인 이메일 마케팅 결과를 얻을 수 있을 것으로 기대된다.

• 기록학연구
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• 제12호
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• pp.81-135
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• 2005

The release of administrative information has been the challenge of our age following the maturation of democratic ideology in our society. However, differences of opinion and conflict still exist between the government and private sectors regarding the issue, and it seems that the technical and policy-related insufficiencies of information and record management that actually operate the release of information are the main causes. From the perspective of records management, records or information are variable in their nature, value, and influence during their life span. The most controversial issue is the records and information in the current stage of carrying out business activities. This is because the records and information pertaining to finished business are but evidence to ascertain the past, and have only a limited relationship to the ideal of the 'democratic participation' by citizens in activities of the public sector. The current information release policies are helpless against the 'absence of information,' or incomplete records, but such weakness can be supplemented by enforcing record management policies that make obligatory the recording of all details of business activities. In addition, it is understood that the installation of 'document offices("Jaryogwan")' that can manage each organization's information and records will be an important starting point to integrate the release, management, and preservation of information and records. Nevertheless, it seems that the concept of 'release' in information release policies refers not to free use by all citizens but is limited to the 'provision' of records according to public requests, and the concept of 'confidential' refers not to treating documents with total secrecy but varies according to the particulars of each situation, making the actual practice of information release difficult. To solve such problems, it is absolutely necessary to collect the opinions of various constituents associated with the recorded information in question, and to effectively mediate the collective opinions and the information release requests coming from applicants, to carry out the business more practically. Especially crucial is the management of the process by which the nature and influence of recorded information changes, so that information which has to be confidential at first may become available for inquiry and use over time through appropriate procedures. Such processes are also part of the duties that record management, which is in charge of the entire life span of documents, must perform. All created records will be captured within a record management system, and the record creation data thus collected will be used as a guide for inquiry and usage. With 'document offices(Jaryogwan)' and 'archives' controlling the entire life span of records, the release of information will become simpler and more widespread. It is undesirable to try to control only through information release policies those records the nature of which has changed because, unlike the ones still in the early stages of their life span and can directly influence business activities, their work has finished, and they have become historical records or evidences pointing to the truth of past events. Even in the past, when there existed no formal policy regarding the release of administrative information, the access and use of archival records were permitted. A more active and expanded approach must be taken regarding the 'usage' of archival records. If the key factor regarding 'release' lies in the provision of information, the key factor regarding 'usage' lies in the quality and level of the service provided. The full-scale usage of archival records must be preceded by the release of such records, and accordingly, a thorough analysis of the nature, content, and value of the records and their changes must be implemented to guarantee the release of information before their use is requested. That must become a central task of document offices and "Today's information" will soon become "yesterday's records," and the "reality" of today will become "history" of the past. The policies of information release and record management share information records as their common objective. As they have a mutual relationship that is supplementary and leads toward perfection, the two policies must both be differentiated and integrated with each another. It is hoped that the policies and business activities of record management will soon become normalized and reformed for effective and fair release of information.

• 기록학연구
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• 제12호
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• pp.179-235
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• 2005

In this article, the task of evaluating the official documents that were created and issued by the Joseon Governor General office during the Japanese occupation period, with new perspectives based upon the Macro-Appraisal approaches developed by the Canadian scholars and personnel, will be attempted. Recently, the Canadian people and the authorities have been showing a tendency of evaluating the meaning and importance of a particular document with perspectives considering the historical situation and background conditions that gave birth to that document to be a more important factor, even than considering the quality and condition of that very document. Such approach requires the archivists to determine whether they should preserve a certain document or not based upon the meaning, functions and status of the entity that produced the document or the meaning of the documentation practice itself, rather than the actual document. With regard to the task of evaluating the official documents created and issued by the Joseon Governor General office and involved the city plans devised by the office back then, this author established total of 4 primary tasks that would prove crucial in the process of determining whether or not a particular theme, or event, or an ideology should be selected and documents involving those themes, events and ideologies should be preserved as important sources of information regarding the Korean history of the Japanese occupation period. Those four tasks are as follow: First, the archivists should study the current and past trends of historical researches. The archivists, who are usually not in the position of having comprehensive access to historical details, must consult the historians' studies and also the trends mirrored in such studies, in their efforts of selecting important historical events and themes. Second, the archivists should determine the level of importance of the officials who worked inside the Joseon Governor General office as they were the entities that produced the very documents. It is only natural to assume that the level of importance of a particular document must have been determined by the level of importance(in terms of official functions) of the official who authorized the document and ordered it to be released. Third, the archivists should be made well aware of the inner structure and official functions of the Joseon Governor General office, so that they can have more appropriate analyses. Fourth, in order to collect historically important documents that involved the Koreans(the Joseon people), the archivists should analyze not only the functions of the Joseon Governor General office in general but also certain areas of the Office's business in which the Japanese officials and the Koreans would have interacted with each other. The act of analyzing the documents only based upon their respective levels of apparent importance might lead the archivists to miss certain documents that reflected the Koreans' situation or were related to the general interest of the Korean people. This kind of evaluation should provide data that are required in appraising how well the Joseon Governor General office's function of devising city plans were documented back then, and how well they are preserved today, utilizing a comparative study involving the Joseon Governor General office's own evaluations of its documentations and the current status of documents that are in custody of the National Archive. The task would also end up proposing a specialized strategy of collecting data and documents that is direly needed in establishing a well-designed comprehensive archives. We should establish a plan regarding certain documents that were documented by the Joseon Governor General office but do not remain today, and devise a task model for the job of primary collecting that would take place in the future.