• PNF and Movement
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• 제20권2호
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• pp.147-156
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• 2022

Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1279-1288
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• 2021

Objective: To assess the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 treatment response algorithm (TRA) for the evaluation of hepatocellular carcinoma (HCC) treated with transarterial radioembolization. Materials and Methods: This retrospective study included patients who underwent transarterial radioembolization for HCC followed by hepatic surgery between January 2011 and December 2019. The resected lesions were determined to have either complete (100%) or incomplete (< 100%) necrosis based on histopathology. Three radiologists independently reviewed the CT or MR images of pre- and post-treatment lesions and assigned categories based on the LI-RADS version 2018 and the TRA, respectively. Diagnostic performances of LI-RADS treatment response (LR-TR) viable and nonviable categories were assessed for each reader, using histopathology from hepatic surgeries as a reference standard. Inter-reader agreements were evaluated using Fleiss κ. Results: A total of 27 patients (mean age ± standard deviation, 55.9 ± 9.1 years; 24 male) with 34 lesions (15 with complete necrosis and 19 with incomplete necrosis on histopathology) were included. To predict complete necrosis, the LR-TR nonviable category had a sensitivity of 73.3-80.0% and a specificity of 78.9-89.5%. For predicting incomplete necrosis, the LR-TR viable category had a sensitivity of 73.7-79.0% and a specificity of 93.3-100%. Five (14.7%) of 34 treated lesions were categorized as LR-TR equivocal by consensus, with two of the five lesions demonstrating incomplete necrosis. Interreader agreement for the LR-TR category was 0.81 (95% confidence interval: 0.66-0.96). Conclusion: The LI-RADS version 2018 TRA can be used to predict the histopathologic viability of HCCs treated with transarterial radioembolization.

• Korean Journal of Radiology
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• 제22권3호
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• pp.297-307
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• 2021

Objective: To compare the performance of simulated abbreviated breast MRI (AB-MRI) and full diagnostic (FD)-MRI in distinguishing between benign and malignant lesions detected by MRI and investigate the features of discrepant lesions of the two protocols. Materials and Methods: An AB-MRI set with single first postcontrast images was retrospectively obtained from an FD-MRI cohort of 111 lesions (34 malignant, 77 benign) detected by contralateral breast MRI in 111 women (mean age, 49.8. ± 9.8; range, 28-75 years) with recently diagnosed breast cancer. Five blinded readers independently classified the likelihood of malignancy using Breast Imaging Reporting and Data System assessments. McNemar tests and area under the receiver operating characteristic curve (AUC) analyses were performed. The imaging and pathologic features of the discrepant lesions of the two protocols were analyzed. Results: The sensitivity of AB-MRI for lesion characterization tended to be lower than that of FD-MRI for all readers (58.8-82.4% vs. 79.4-100%), although the findings of only two readers were significantly different (p < 0.05). The specificity of AB-MRI for lesion characterization was higher than that of FD-MRI for 80% of readers (39.0-74.0% vs. 19.5-45.5%, p ≤ 0.001). The AUC of AB-MRI was comparable to that of FD-MRI for all readers (p > 0.05). Fifteen percent (5/34) of the cancers were false-negatives on AB-MRI. More suspicious margins or internal enhancement on the delayed phase images were related to the discrepancies. Conclusion: The overall performance of AB-MRI was similar to that of FD-MRI in distinguishing between benign and malignant lesions. AB-MRI showed lower sensitivity and higher specificity than FD-MRI, as 15% of the cancers were misclassified compared to FD-MRI.

• 한국의학물리학회지:의학물리
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• 제27권4호
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• pp.180-188
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• 2016

Acuros XB advanced dose calculation algorithm (AXB, Varian Medical Systems, Palo Alto, CA) has been released recently and provided the advantages of speed and accuracy for dose calculation. For clinical use, it is important to investigate the dosimetric performance of AXB compared to the calculation algorithm of the previous version, Anisotropic Analytical Algorithm (AAA, Varian Medical Systems, Palo Alto, CA). Ten volumetric modulated arc therapy (VMAT) plans for each of the following cases were included: head and neck (H&N), prostate, spine, and lung. The spine and lung cases were treated with stereotactic body radiation therapy (SBRT) technique. For all cases, the dose distributions were calculated using AAA and two dose reporting modes in AXB (dose-to-water, $AXB_w$, and dose-to-medium, $AXB_m$) with same plan parameters. For dosimetric evaluation, the dose-volumetric parameters were calculated for each planning target volume (PTV) and interested normal organs. The differences between AAA and AXB were statistically calculated with paired t-test. As a general trend, $AXB_w$ and $AXB_m$ showed dose underestimation as compared with AAA, which did not exceed within -3.5% and -4.5%, respectively. The maximum dose of PTV calculated by $AXB_w$ and $AXB_m$ was tended to be overestimated with the relative dose difference ranged from 1.6% to 4.6% for all cases. The absolute mean values of the relative dose differences were $1.1{\pm}1.2%$ and $2.0{\pm}1.2%$ when comparing between AAA and $AXB_w$, and AAA and $AXB_m$, respectively. For almost dose-volumetric parameters of PTV, the relative dose differences are statistically significant while there are no statistical significance for normal tissues. Both $AXB_w$ and $AXB_m$ was tended to underestimate dose for PTV and normal tissues compared to AAA. For analyzing two dose reporting modes in AXB, the dose distribution calculated by $AXB_w$ was similar to those of AAA when comparing the dose distributions between AAA and $AXB_m$.

• 한국항해항만학회지
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• 제45권3호
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• pp.173-180
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• 2021

회계는 기업 경영의 핵심 분야 중 하나임에도 해운사의 회계와 관련된 연구는 많이 이루어지지 않았다. 또한, 선박금융, 금융리스 등 금융을 많이 활용하는 해운사에 있어서 재무보고는 매우 중요함에도 불구하고 해운사의 재무보고, 특히 이익조정에 관한 연구는 찾아보기 어렵다. 본 논문의 목적은 해운사의 발생액 이익조정 행태를 분석하는 것이다. 부채비율이 높고, 당기순손실 기업은 이익조정의 유인이 있다고 알려져 있다. 해운사는 산업의 특성으로 인해 부채비율이 높고, 당기순손실을 보고하는 경우가 많다. 따라서 해운사는 이익조정을 많이 할 것으로 예상된다. 2001년부터 2020년까지 한국거래소에 상장된 KOSPI 기업을 대상으로 분석한 결과 해운사는 비 해운사에 비해 이익조정을 많이 하는 것으로 나타났다. 이익조정의 대리변수는 재량적발생액을 사용하였다. 재량적발생액은 Dechow et al.(1995)의 수정Jones모형과 Kothari et al.(2005)의 성과대응모형을 사용하여 측정하였다. 본 연구는 회계처리 행태 중 대표적인 이익조정에 관해 해운사와 비 해운사를 비교 분석함으로써 유의미한 결과를 도출하였다. 외부감사인, 투자자, 금융기관, 애널리스트, 정부당국 등 이해관계자는 상장 해운사의 외부감사, 재무분석, 감독 등에 있어 해운사의 이익조정 행태에 대해 인지할 필요성이 있다. 마지막으로, 상장 해운사는 회계원칙에 입각한 보다 엄정한 회계처리를 해야 할 것이다.

• 재활치료과학
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• 제11권3호
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• pp.7-22
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• 2022

목적 : 본 연구는 연하장애를 가진 뇌졸중 환자에게 적용된 혀 운동을 체계적으로 분석한 논문이다. 혀 운동에 대한 전반적인 효과를 검증하고, 현재 이루어지고 있는 혀 운동에 대한 경향을 파악하는데 그 목적을 가지고 근거를 제공하고자 한다. 연구방법 : PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 체크리스트 및 흐름도를 이용하여 체계적 고찰을 시행하였다. 데이터베이스는 PubMed, MEDLINE, CINAHL, RISS, e-article 을 통해 문헌 검색을 진행하였다. 본 연구에 사용된 문헌의 수는 총 6편이었고, 문헌의 질을 평가하기 위하여 PEDro scale(Physiotherapy Evidence Database scale)을 사용하였다. 결과 : 분석된 논문 6편에서 3가지의 중재 방법이 포함되었다. 혀 운동의 종류로는 혀 근력훈련 3편, 혀 근력 및 정확도 훈련 2편으로 모두 아이오와 구강 수행 도구를 통한 중재를 시행하였고, 혀 신장훈련을 적용한 논문이 1편이었다. 조사된 문헌에서 시행한 중재 별 치료 효과는 모두 효과가 있는 것으로 확인되었다. 하지만 대부분 표본수가 적어 일반화 시키기는 어려울 것으로 생각되며, 실험군과 대조군 비교 시 몇몇 그룹 간에 유의한 차이가 발견되지 않은 결과들이 있는 만큼 전통적 연하재활치료도 구강기 연하장애를 가지고 있는 환자들에게 적절한 치료 방법으로 판단된다. 결론 : 본 연구는 작업치료사들이 연하장애를 가진 뇌졸중 환자들에게 혀 운동을 적용함에 있어 효율적인 연하재활치료를 제공하는데 도움을 줄 수 있을 것이며, 혀 운동의 효과를 알아보기 위해 더 많은 연구축적이 이루어져야 할 것으로 생각된다.

• 대한영상의학회지
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• 제83권4호
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• pp.876-886
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• 2022

목적 MicroPure 초음파 영상의 미세 석회 발견 성능을 평가하고, MicroPure 초음파 영상 소견을 이용하여 미세 석회의 특징을 파악하고자 하였다. 대상과 방법 유방촬영술과 B-mode 초음파에서 모두 보이며, 악성으로 의심되는 총 171개의 미세 석회를 대상으로 MicroPure 초음파 영상을 평가하였다. 미세 석회의 크기는 작거나(점상, 무정형, 미세 다형성, 미세 선형), 큰(거친 불균질) 군으로 구분하였고, 미세 석회의 범위는 좁거나(군집), 넓은(기타) 군으로 나누었다. MicroPure 초음파 영상 가시성은 B-mode와 MicroPure 초음파 영상의 미세석회 개수를 비교하여 4가지로 나누었다: B > M (B-mode에서 더 많은 병변이 보임), B = M (비슷한 개수가 보임), B < M (MicroPure에서 더 많은 병변이 보임), 음성(보이지 않음). MicroPure 초음파 영상의 가시성과 관련된 영상 소견들에 대해 다중비교를 시행하였다. 결과 171개 중 157개의 병변이 MicroPure 초음파 영상에서 확인되었다(91.8%). Breast Imaging Reporting and Data System (이하 BI-RADS) 범주 4A의 비율은 MicroPure 양성군에서 범주 4B의 비율은 MicroPure 음성군에서 유의하게 더 높았다(p = 0.035). 다른 영상 소견에는 차이가 없었다. MicroPure 양성 세부군에서 모든 특징은 유의한 차이를 보이지 않았다. 결론 MicroPure 초음파 영상은 B-mode 초음파에서 보이는 미세 석회의 91.8%를 발견하였다. MicroPure 초음파 영상 가시성은 미세 석회의 범주와 관련이 있었다.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제5권5호
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• pp.203-208
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• 2016

정보시스템 감리는 정보시스템을 성공적으로 구축하기 위한 요건이지만 정보시스템의 규모가 커질수록 감리작업 수행의 효율성이 저하되는 문제가 있다. 정보시스템 하위 감리 영역에도 동일한 문제가 존재하는데 본 논문에서는 데이터베이스 성능을 위한 SQL 감리 도구를 구현하여 데이터베이스 감리의 효율성 문제를 다루고자 한다. 본 본문에서 데이터베이스 성능을 위한 SQL 감리 도구를 설계하는 과정에서 SQL 감리작업에 필요한 요구사항들을 분석한다. 이를 바탕으로 SQL 감리 도구의 프로세스를 정보시스템 감리 절차에 따라 SQL 감리의 특성에 맞추어서 설계한다. 이후 데이터베이스 설계 방법론을 적용하여 SQL 감리 수행과정의 모든 정보를 저장하는 통합 레파지토리도 설계하였다. 구현하는 과정에서는 설계된 내용에 따라 감리작업 정의모듈, 감리작업 수행 모듈, 감리작업 결과 보고 모듈로 나누어 구현하였다. 구현한 도구를 활용하여 중국 모 전력 공사 프로젝트에 적용하여 보았고, SQL 감리에 활용할 수 있는 도구들과 비교해 보았다. 본 논문에서 구현한 SQL 감리 도구는 전반적인 SQL 감리 작업을 수행 할 수 있으며 데이터베이스 성능을 위한 감리 작업에 소요되는 비용을 줄이고 결과의 정확성을 높일 수 있을 뿐만아니라 SQL 파싱을 통해 검사규칙을 확장하여 적용할 수 있다.

• 한국산학기술학회논문지
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• 제18권2호
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• pp.600-608
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• 2017

본 연구는 한국채택 국제회계기준(K-IFRS)이 본격 도입된 2011년 이후 금융감독원에 전자공시시스템(DART)에 공시된 공신력 있는 회계보고서를 바탕으로 축산업 농업법인의 경영지표 및 부채비율과 경영성과에 관하여 분석하였다. 첫째, 주요 경영지표를 분석한 결과, 안전성 지표는 유동비율, 부채비율, 유동부채비율이 낮아지고, 자기자본비율은 높아진 것으로 나타났다. 수익성 지표는 총자산순이익율, 자기자본순이익율, 매출액순이익율이 모두 2013년에 비해 2014년에 약간 증가한 것으로 나타났고, 성장성 지표는 전체적인 성장성 및 외형적인 성장성 모두 증가하지 않은 것으로 나타났다. 둘째, 부채비율과 경영성과를 분석한 결과, 부채비율은 경영성과 변수인 총자산순이익률(ROA)과 매출액순이익률(ROS)에 모두 부(-)의 영향을 미치는 것으로 나타났다. 이는 우리나라 축산업 농업법인의 부채사용이 외형적인 성장에는 기여하였으나 경영성과로는 이어지지 않고 오히려 무리한 부채사용이 경영성과에 부정적인 영향을 미친 것으로 해석할 수 있다. 분석결과를 종합해보면 축산업 농업법인의 수익성 및 성장성 개선을 위하여 원가절감과 같은 경영개선을 통한 매출액 증대 방안이 모색되어야 할 것으로 보인다. 또한 부채사용이 외형적인 성장에는 기여하였으나 경영성과로는 이어지지 않는 만큼 무리한 부채사용을 줄이고 기술개발 보급 등에 의한 농업경영비 절감으로 매출 및 수익 증대 방안이 모색되어야 할 것이다.

• 가정간호학회지
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• 제4권
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• pp.30-40
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• 1997

The change in health care environment increases the importance of Visiting Nursing Services Program. It has been performed by nurses of district health centers in Seoul since 1991. The Achievement of Visiting Nursing Services Program will be dependent upon their activities. The purpose of this study was to identify the Performance of Visiting Nurses and Job satisfaction of district health centers in Seoul. Therefore, it was to provide the fundamental data development of Visiting Nursing Services Program. The subjects were 214 Visiting Nurses of district health centers in Seoul. The data was collected by self reporting questionnaire from April 15 to April 30, 1997. Their performances and various supportive factors were measured with the instruments developed by the researcher. Job satisfaction were also measured by the instrument developed by Slavitt et al. (1978) was used. The data were, analyzed by Cronbach Alpha, mean, standard deviation, percentage, t -test, ANOVA Duncan test, Correlation Coefficient, and Stepwise Multiple Regression with SAS program. The results of this study were as follows: 1. The average of budget of Visiting Nursing Services Program of district health centers was 0.9% and the average of visiting nursing services personnel of district health centers was 10.1%. 2. With regard to the job satisfaction of Visiting Nurses the mean score was 2.92 out of 5. While the level of Job prestige / status presented as a mean score of 3.48 which was the largest among the 7 components of job satisfaction, the level of administration was the lowest showing 2.57 scores respectively. There were significant differences in the job satisfaction by age, working career of health centers(p<0.01, 0.001). 3. The average of the performance level of Visiting Nurses variables was 2.29; The variable with highest degree of performance was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was the directive nursing services. The significant difference was found in performance level according to age, structure type of visiting nursing services, working career of health centers and working career of visiting nursing services(p<0.05). 4. With regard to the perception of the performance expertise by the Visiting Nurses the mean score was 2.37 : The variable with highest degree of performance expertise was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was management of home-environment. The significant difference was found in performance expertise according to working career outside of health centers(p<0.05). 5. With regard to the perception of the performance necessity by the Visiting Nurses the mean was 2. 40 : the variable with highest degree of performance necessity was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was directive nursing services. The significant difference was found in performance necessity according to working career of visiting nursing services(p<0.05). 6. A positive correlation was found between job satisfaction and performance level(r=.3731, P<0.001). Also, a weak positive correlation was found between the components of job satisfaction and performance level. 7. Stepwise multiple regression analysis revealed that the most powerful predictor was the variance of job satisfaction(R=.3557, $R^2$=.1265). Structure type of visiting nursing services and working career of visiting nursing services accounted for 19.0% of the variance in performance level in nurses. In conclusion, Job satisfaction, Structure type of visiting nursing services and Working career of visiting nursing services variables had influenced on performance level in health centers. Further research is required to confirm these findings.