• 한국전문물리치료학회지
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• 제24권2호
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• pp.9-18
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• 2017

Background: Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management. Objects: The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS). Methods: Thirty-three women with SHS were randomly assigned to either group-1 ($n_1=17$) that underwent the neural mobilization technique or group-2 ($n_2=16$) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring's electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application). Results: There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): $69.70{\pm}8.14^{\circ}$ to $74.14{\pm}8.07^{\circ}$ and group-2: $68.66{\pm}7.42^{\circ}$ to $70.52{\pm}7.92^{\circ}$] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: $1.12{\pm}.30{\mu}N$ to $.69{\pm}.31{\mu}V$ and group-2: $1.19{\pm}.49{\mu}V$ to $1.13{\pm}.47{\mu}V$)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05). Conclusion: These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.

• Strategy21
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• 통권44호
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• pp.323-351
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• 2018

Adopted in Western Pacific Naval Symposium(WPNS) 2014, Code for Unplanned Encounters at Sea(CUES) has been the most valuable output of WPNS history. Written and suggested by Australian Navy in 1999, the goal of CUES is to decrease the possibility of the naval conflict by establishing the code among international navies in the Western Pacific region. Facing many oppositions and requirement of People's Liberation Army Navy(PLAN) in WPNS 2012 and 2013, but it finally adopted in WPNS 2014, with many changes in detailed provisions. From then, navies in the Western Pacific region have followed CUES to prevent maritime conflicts in the region, CUES, however, sometimes does not work correctly. Contents of CUES is the mixture of the parts of Multinational Maritime Tactical Signal and Maneuvering Book(MTP) and International Regulations for Preventing Collision at Sea 1972(CORLEGs). There are means of radio communications such as frequency and signals, instructions for maneuvering and so on. Thus, it is not a new document for the U.S. Navy and its allies, but it requires training to implicate at sea for navies other than U.S. allies, like PLAN. Lots of provisions in CUES were changed because of the opposition of PLAN, and CUES has many shortcomings and practical limitations. First, since CUES is non-legally binding, and there are no methods to force the naval assets on the sea to follow. Second, CUES is only applied to naval assets; naval ships - warships, naval auxiliaries, and submarines - and naval aircraft. Third, the geographical scope in CUES is not clear. Fourth, there is no provision for submerged submarines. Finally, CUES has no time-based framework or roadmap for training. In this regard, there would be six recommendations for improvement. First, CUES should be reviewed by WPNS or other international institutions, while keeping non-binding status so that WPNS could send signals to the navies which do not answer CUES on the sea. Second, the participation of Maritime Law Enforcements(MLEs) such as coast guard is inevitable. Third, navies would use full text of MTP rather than current CUES, which extracts some parts of MTP. Fourth, CUES needs provisions with respect to submerged submarines, which recognizes as offensive weapons themselves. Fifth, the geographic scope of CUES should be clear. Since there are some countries in which claim that a rock with a concrete structure is their territory, CUES should be applied on every sea including EEZ and territorial seas. Finally, the detailed training plan is required to implicate CUES at sea. Rim of the Pacific (RIMPAC) is a good exercise to train CUES, because almost all WPNS member countries except six countries are participating in RIMPAC. CUES is a meaningful document not only for navies but also for nation-states in the region. To prevent escalation of conflict in the region, potentially caused by an unplanned collision at sea, CUES should be applied more strictly. CUES will continue to be in subsequent WPNS and therefore continue to improve in the effectiveness as both an operational and diplomatic agreement.

• 우울조울병
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• 제16권3호
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• pp.134-139
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• 2018

Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.

• 동남아시아연구
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• 제28권4호
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• pp.161-196
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• 2018

이 글의 목적은 미얀마 민간정부의 정치발전 양상을 결손민주주의 개념에서 분석하고, 정치발전을 지체 또는 정체시킨 주체들과 주체들 간의 상관관계를 규명하는 것이다. 나아가 이 글에서는 현재와 같은 정치구도와 행태를 돌파하여 긍정적인 정치발전을 위해 요구되는 과제를 제시하고자 한다. 2016년 민간정부가 출범했으나 권력 행사와 의사결정구조에 있어서 정부의 행동 양식은 군부 권위주의의 행태를 탈피하지 못함으로써 긍정적인 정치발전의 성과를 달성하지 못했다. 정부 차원에서 특정 인물 1인이 모든 권력을 장악하고 각 권력기관에 대한 수평적 책임을 지지 않으므로 위임민주주의와 후견민주주의가 강화된다. 국방과 치안에서 지분을 장악한 군부는 버마족 중심의 배타적 민주주의와 군부가 제정한 비민주적 헌법을 수호하며 비자유적 민주주의를 추구한다. 결손민주주의가 나타나는 근본적인 원인은 장기간 군부통치로 인해 민주적 제도를 운영할 집단의 부재, 민간에 의한 군부통제라는 민간우위의 원칙을 지킬 수 없는 권력구도의 한계로 요약된다. 따라서 미얀마 정치발전의 과제는 군부의 병영 복귀와 권위주의적 질서에 길들여진 민간정부의 권력구도와 정치행태를 민주적으로 전환하는 것이다.

• Journal of Korea Trade
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• 제24권4호
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• pp.49-70
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• 2020

Purpose - The UCP is recognized as the governing law for L/C transactions, but it covers only the general details of the transaction and does not cover all complex practices. In view of this limitation, this paper examines a negotiation transaction which is most actively utilized in L/C transactions via a thorough review of the UCP provisions, analyzes the problems of the negotiation clause in the UCP, and suggests appropriate countermeasures to deal with unnecessary litigation costs. By doing so, the parties involved in the negotiation transaction would be able to avoid financial costs such as having to pay for lawsuits. Design/methodology - The present study first differentiates the general types of L/Cs (e.g., sight payment L/C, deferred payment L/C, acceptance L/C, and negotiation L/C), explains and the Article 2 and Article 12(b) of the UCP 600 where the term 'negotiation' is used, digs into the drawbacks of 'negotiation' occurring under the UCP 600, and discusses solutions to the problems found by analyzing the drawbacks descriptively. Findings - After a review of the UCP provisions on negotiation in detail, several possible problems which may occur in practice were discovered. First, as the UCP stipulates, the negotiating bank will want to delay payment to the maximum extent possible and make payment on the banking day on which the issuing bank reimburses the amount. This may lead the beneficiary towards bankruptcy or put it in financial crisis. Second, when a fraudulent transaction occurs, the negotiating bank can neither request the issuing bank to reimburse nor can it exercise its recourse right against the beneficiary because it has obtained all the rights of the beneficiary by purchasing the documents. Third, there is a practice in which the beneficiary sells the documents to its transaction bank which is not the nominated bank if the nominated bank specified in the credit is located in a third country or the exporter has no relationship with the nominated bank in the credit. In this case, whether to accept this and reimburse the non-nominated negotiating bank entirely depends on the issuing bank's decision even though such practice frequently occurs in Korea. Originality/value - There has been little research effort pertaining to negotiation transactions in detail even though negotiation L/C transactions account for around 70% in world trade notwithstanding deferred payment L/Cs and acceptance L/Cs that are also negotiated in practice. Thus, if the negotiations clause under the UCP 600 provisions were reviewed and the drawbacks of the negotiation transactions most actively used in L/C transactions were identified and examined, specific countermeasures could ultimately help smoothen the operation of L/C transactions and prevent financial losses.

• 의료법학
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• 제16권1호
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• pp.155-190
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• 2015

법원은 2014년에도 의료와 관련된 의미 있는 판결들을 선고하였다. 법원은 수술 시 의료기구를 본래의 용도와 달리 사용하던 중 부러진 경우 이로 인한 사고에 의료진의 과실을 추정하였고, 설명의무와 관련하여 안전성이 검증되지 않은 수술을 시행하는 경우 설명의무 위반과 부작용 발생 사이의 인과관계를 인정하여 전손해배상이 인정될 수 있다는 점, 미용수술의 경우 일반적인 의료행위에 비하여 설명의무의 대상이 확대되어야 하는 점, 예상할 수 없는 범위에까지 설명의무를 인정할 수는 없는 점 등을 판시하였다. 또한 법원은 환자의 자기결정권과 의사의 진료의무 사이에 충돌이 발생한 경우 자기결정권 행사의 요건과 한계를 제시하였으며, 자동차보험계약이란 자동차사고와 관련된 배상 책임은 보험회사가 부담하기로 하는 계약이므로 비록 의료법에 위반되어 설립된 사무장 병원이라 하더라도 환자를 치료하고 보험금을 수령하는 것은 불법행위에 해당하지 않는다고 판시하였다. 의료기관 자체가 부당한 경제적 이익을 얻었을 뿐 의료기관 종사자들이 별다른 이익을 얻지 않은 경우, 리베이트 수수를 금지하는 의료법에 따라 의료기관 종사자들을 처벌할 수 없다는 견해를 밝힌 판결도 눈에 띈다. 그리고 법원은 업무정지처분을 받은 의료기관을 폐업하더라도 같은 장소에서 같은 운영자가 새로이 의료기관을 개설하는 경우 처분의 효과가 미친다고 판시하였고, 의사가 스스로 개설한 의료기관 외에서 진료행위를 할 수 있는 요건에 대하여 판시하였으며, 의료법을 위반한 혐의로 유죄 판결이 확정되기 전에는 이를 이유로 행정처분을 할 수 없다고 판시하였다.

• Korean Journal of Acupuncture
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• 제31권2호
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• pp.66-78
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• 2014

목적 : 경혈의 임피던스를 측정하여 경혈의 특이성을 확보하고자 다수 연구가 진행되어왔다. 직류전압과 교류전압을 자극하여 단순히 경혈이 위치한 피부 임피던스를 측정하는 방식이 아닌 Multi-Frequency Body Impedance analysis(MF BIA) 기법을 이용하여 생체 구조 성분(세포 외액, 세포내액의 저항성분 그리고 세포막의 용량성분)을 추출하는 방법을 이용하여 경혈의 특이성을 확보하고자 한다. 인체 내 생체 이온 변화가 발생하였을 시, 경혈이 비경혈에 발생 전/후 높은 변화율이 관찰될 것이라는 가정을 하에, 생체 이온 변화를 유도하기 위하여 근피로를 유발하였으며, 유도 전/후의 생체 구조 성분을 비교 분석하였다. 방법: 대퇴직근에 근피로를 유도하기 위하여 건강한 대학생에게 Knee extension/flexion의 등속도 운동을 통하였다. 생체 이온 변화를 확인하기 위하여 젖산을 측정하였으며, 피험자마다 동일한 근피로를 유발하기 위하여 EMG(electromyogram) 분석을 통하여 peak torque와 median frequency를 분석하였다. 근피로 유발 24시간 이후까지 젖산과 peak torque와 median frequency을 측정하였으며, 각 단계마다 복토(ST32), 음시(ST33) 과 인접한 비경혈 2개에 대하여 생체 구조 성분 또한 측정하였다. 결과 : 젖산과 peak torque와 median frequency은 24시간 이후 근피로 유발 전으로 회복되었다. 세포외액 저항성분의 경우 비경혈에 비하여 복토(ST32)에서 생체 이온 변화에 따라 높은 변화율이 관찰되었으나, 음시(ST33) 에서는 비경혈에 비하여 낮은 변화율이 관찰되었다. 세포내액 저항성분은 경혈과 비경혈 사이 유의한 차이가 관찰되지 않았다. 복토(ST32)에서 세포막의 용량성분이 높은 변화율이 관찰되었지만, 음시(ST33)와 인접한 비경혈간의 뚜렷한 차이가 확인되지 않았다. 결론 : 생체 이온 변화에 따라 인접한 비경혈과 비교해보았을 시, 경혈에서의 상대적으로 높고 낮은 혹은 유사한 변화율이 관찰되었다. 따라서 경혈의 특이성을 확보하지 못하였으며, 생체 구조 성분 추출을 통하여 세포 이온 변화에 따른 경혈의 특이성을 확보하기에는 한계점을 가지고 있다고 결론을 내렸다.

• 대한정형외과 초음파학회지
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• 제2권2호
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• pp.68-73
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• 2009

목적: 견관절 충돌 증후군에서 초음파 영상을 이용한 견봉하 점액낭내 스테로이드 국소 주사의 임상적 결과를 후향적으로 알아보고자 하였다. 대상 및 방법: 2006년 3월부터 2009년 4월까지 견관절 충돌 증후군으로 치료 받은 62명 66예의 견관절을 대상으로 하였다. 견관절 내회전으로 견봉하 점액낭을 앞쪽으로 위치하게 하는 변형 크라스 자세를 취하고 5~12 MHz 고해상도 초음파영상 감시하에 스테로이드를 점액낭내에 정확하게 주사 하였다. 주사 전과 후 1년 간의 임상적 결과를 평가 하였다. 주사 후 견관절 거상운동(shoulder elevation exercise)을 시행하였다. 1년 간 견관절의 운동범위와 동통 VAS 점수를 측정하였고 Neer/Hawkins 및 외전 내회전 충돌검사 등의 충돌 징후 검사를 하였다. 통계학적 검정은 SAS를 이용하여 ANOVA와 Tukey's post-hoc test로 유의성을 조사하였으며 유의 수준은 5%로 하였다. 결과: 시술 직 후, 6주, 3개월, 1년 후에 전 예에서 제한 없는 견관절 운동 범위를 나타내었다. VAS 점수는 시술 전 평균 6.47(2-10)점이, 시술 직 후 3.50(0-7)점으로 향상되었고, 6주째 평균 2.78(0-6), 3개월째 평균 2.83(0-6), 1년째는 평균 2.85(0-6)으로 시술 전 보다 의미 있게 향상되었다(p<0.0001). 1회 주사 직 후 전예에서 충돌징후가 나타나지 않았고, 6주 후 6예에서 다시 나타났으나 재주사 후 모두 사라졌다. 치료 초기와 1년 후 견관절 운동 범위, VAS 점수 및 충돌 징후 검사에서 임상적 결과의 향상을 나타내었고, 합병증은 발생하지 않았다. 결론: 초음파를 이용한 견봉하 점액낭내 스테로이드 주사로 치료한 모든 환자가 1년 추시 관찰한 결과 임상 증상이 호전되어 수술을 필요로 하지 않았으며, 견관절 충돌 증후군의 비수술적 치료로 매우 유용한 방법으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제67권2호
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• pp.88-94
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• 2009

Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

• 안보군사학연구
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• 통권15호
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• pp.57-86
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• 2018

The ROKAF has been training for a number of exercise for victory in the war, but the lack of aviation ammunition has become a big issue every year. However, due to the limitation of defense resources, there are many difficulties in securing and stockpiling ammunition for the war readiness. Therefore, there is a need to find a way to secure aviation ammunition for war readiness in a more economical way, so In this study, we analyze the precedent research case and the case of the reduction of the purchase cost of weapon system of other countries, and then I have suggested a plan that is appropriate for our situation. As a result of examining previous research cases for this study, there were data that KIDA studied in 2012, Precision-guided weapons acquisition cost reduction measures pursued by US Air Force And the use of procurement agencies that are being implemented by NATO member countries. Based on this study, the following four measures were proposed to reduce the purchase cost of aviation ammunition. First, the mutual aid support agreement was developed to sign the ammunition joint operation agreement. Second, join the NATO Support & Procurement Agency (NSPA) Third, it builds a purchasing community centered on the countries operating the same ammunition Fourth, participating in the US Air Force's new purchase plan for ammunition and purchase it jointly. The main contents of these four measures are as follows. 1. the mutual aid support agreement was developed to sign the ammunition joint operation agreement. Korea has signed agreements on mutual logistics support with 14 countries including the United States, Israel, Indonesia, Singapore, Australia, and Taiwan. The main purpose of these agreements is mutual support of munitions and materials, also supporting the training of the peace time and promoting exchange and cooperation. However, it is expected that there will be many difficulties in requesting or supporting mutual support in actual situation because the target or scope of mutual aid of ammunition is not clearly specified. Thus, a separate agreement on the mutual co-operation of more specific and expanded concepts of aviation ammunition is needed based on the current mutual aid support agreements 2. join the NATO Support & Procurement Agency (NSPA) In the case of NATO, there is a system in which member countries purchase munitions at a low cost using munitions purchase agencies. It is the NATO Purchasing Agency (NSPA) whose mission is to receive the purchasing requirements of the Member Nations and to purchase them quickly and efficiently and effectively to the Member Nations. NSPA's business includes the Ammunition Support Partnership (ASP), which provides ammunition purchase and disarming services. Although Korea is not a member of NATO, NSPA is gradually expanding the scope of joint procurement of munitions, and it is expected that Korea will be able to join as a member. 3. it builds a purchasing community centered on the countries operating the same ammunition By benchmarking the NSPA system, this study suggested ways to build a purchasing community with countries such as Southeast Asia, Australia, and the Middle East. First, it is necessary to review prospectively how to purchase ammunition by constructing ammunition purchasing community centered on countries using same kind of ammunition. 4. participating in the US Air Force's new purchase plan for ammunition When developing or purchasing weapons systems, joint participation by several countries can reduce acquisition costs. Therefore, if the US Air Force is planning to acquire aviation ammunition by applying it to the purchase of aviation ammunition, we will be able to significantly reduce the purchase cost by participating in this plan. Finally, there are some limitations to the method presented in this study, but starting from this study, I hope that the research on these methods will be actively pursued in the future.