• Imaging Science in Dentistry
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• 제47권4호
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• 한국콘텐츠학회논문지
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• 제21권1호
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• pp.465-474
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• 2021

'심각한 급성 호흡기 증후군 코로나 바이러스 2(SARS-CoV-2)'에 의한 질병인 코로나-19는 2020년 3월 세계 보건기구에서 세계적인 전염병 대유행으로 선언되었고, 대부분의 나라에서 선별 및 확진을 위한 진단검사법으로 실시간 중합효소 연쇄반응 검사를 시행한다. 그러나 국가별 목표유전자 및 프로토콜이 다를 뿐만 아니라 진단결과의 판독절차도 다양해서 국가별로 확진자의 기준 역시 다르다. 이에 본 종설에서는 세계보건기구에서 고시한 국가별 목표유전자 및 검사기법, 진단기준을 비교하였고, 검사의 특이도와 민감도, 최소검출 한계, 양성 및 음성 대조군, 교차반응 후보군, 검체 대조군 설정 등의 특이사항도 함께 살펴보았다. 또한 각국의 검사기법과 한국의 검사기법의 특징을 고찰하였다. 마지막으로 향후 전세계가 '심각한 급성 호흡기 증후군 코로나 바이러스 2'에 대한 동일한 진단결과를 얻기 위하여 코로나-19 진단에 대한 표준화된 진단방법 및 결과판독 등을 제언하였다.

• The Korean Journal of Pain
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• 제31권1호
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• pp.27-38
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• 2018

Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

• 융합보안논문지
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• 제13권6호
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• pp.83-89
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• 2013

웹 해킹 대책을 적용할 경우 어느 한가지 기술이나 방법보다 통합된 대책을 구성하고 정보보안을 단계적으로 실행하는 방법이 필요하다. 웹 해킹 대응을 어느 한가지 방법에만 의존 시 많은 보안 공백을 발생 시킬 수 있다. 본 연구에서는 Cross-site scripting 공격 프로세스를 진단하여 웹 해킹 대응절차를 설계한다. 대응체계는 프레임워크를 구성하고 정보보안을 단계적으로 실행하는 방법이다. 단계적 대응모델은 대책의 구조를 시스템 설계단계, 운용단계, 사용단계로 구성하는 방법이다. 시스템 설계단계는 방법은 개발 라이프 사이클에 기초하여 시큐어코딩 설계로 보안 효율성을 높인다. 사용단계에서는 사용자의 보안 이행사항을 체계화한다. 본 방법론을 실무현장에 적용할 경우 현장에서 필요한 종합적인 접근방법론 모델로 활용할 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.975-981
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• 2014

Cervical cancer is an issue of foremost importance globally, specifically affecting the developing nations. Significant advances have taken place with regard to diagnosis of cervical cancer, especially with screening. Appropriate screening measures can thus reduce the incidence of cervical cancer. The most desirable screening technique should be less invasive, easy to perform, cost-effective and cover a wide range of diagnostic icons. Manual liquid based cytology (MLBC) can be considered as one of the suitable technique for screening with the above-mentioned benefits. The aim of the current study was to compare two cervical screening techniques on the basis of different morphological parameters and staining parameters by using modified acetic acid Pap staining to see the possibility of reducing time economy involved in conventional Pap staining (CPS). The study was conducted on a total 88 cases and all were analyzed with both MLBC and CPS. Forty eight cases that were regarded as satisfactory on the basis of Bethesda system by both methods were further recruited for investigation. Their morphological parameters and staining quality were compared and scored according to a scoring system defined in the study. Quality indices was calculated for both staining procedures and smear techniques.

• 대한기관식도과학회지
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• 제10권2호
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• pp.28-34
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• 2004

Background : Esophageal perforation due to a traumatic endoscopy or intubation is exceedingly rare. If riot noticed immediately or treated promptly, however, the morbidity and mortality is significant. We performed a retrospective review of patients with iatrogenic hypopharyngo-esophageal perforation to assess the outcome of current management techniques. Material and Methods : We retrospectively analyzed all cases iatrogenic hypopharyngo-esophageal perforation diagnosed at our hospital from January, 1999, through April, 2004. The study group consisted of 11 patients (4 men) with a mean age of 47.6 years (range, 21-83 yr). We reviewed the 11 patients with perforated injuries of the hypopharynx or esophagus during the diagnostic or therapeutic procedures. Result: Perforations were due to diagnostic gastroscopy ($54.5\%$, 6/11), esophageal dilation ($27.3\%$, 3/11), endoscopic port insertion ($9.1\%$, l/11), and tracheal intrathoracic ($9.1\%$, 1/11). Seven patients had intrathoracic and 4 had cervical perforations. Treatment included incision and drainage (5), resection and reconstruction (4), drainage only (1), and observation (2). Nonfatal complications included transient pneumonia (1), and wound infection (1). They occurred in advanced mediastinal abscess ]patients. Mortality was $9.1\%$ (1/11) in old patient who managed medically in cervical esophageal perforation. Conclusions : Current mortality rates in iatrogenic esophageal perforation were improved compared to previous published rates of $19\%\;to\;66\%$ for all patients with this condition. We concluded that aggressive and definitive surgery for thoracic esophageal perforations improving the survival rate, whether diagnosed early or late.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권2호
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• pp.223-226
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• 2024

Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid and minimally invasive approach than open procedures. Common complications associated with this peripheral puncture include hematoma, bleeding, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, inadvertent venous puncture, dissection, etc. The retrograde femoral access is currently the most frequently used arterial access as it is technically straightforward, allows for the use of larger size sheaths and catheters, allows repeated attempts, etc. Although being technically less challenging, grave complications can occur due to hardware failure. Here, we present a case of unruptured posterior inferior cerebellar artery (PICA) aneurysm, who underwent uneventful diagnostic cerebral digital substraction angiography (DSA) via right femoral artery route on first attempt, but on second attempt for therapeutic intervention, landed up with stuck guide wire and faced decannulation difficulty due to unravelling of guide wire and multiple knot formation, which was finally removed after multiple attempts at pulling and improvised manoeuvres. Such cannulation and decannulation difficulties have been reported multiple times for central venous access, but extremely rarely for femoral routes, making this case a rarity and worth reporting.

• 문화기술의 융합
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• 제10권2호
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• pp.511-516
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• 2024

최근 제정된 궤도시설의 성능평가에 관한 세부지침에서 궤도성능평가의 평가절차 및 실시방법 등에 관한 필요사항을 제시하였다. 그러나 외관조사(육안조사)에 의해 레일표면손상의 등급이 결정되며, 점검자의 주관적인 판단으로 정성적인 평가에만 의존할 수밖에 없는 실정이다. 따라서 본 연구에서는 레일표면손상을 이용하여 레일내부결함까지 진단할 수 있는 진단애플리케이션을 개발하고자 하였다. 현장조사에서는 레일표면손상을 조사하고 패턴을 분석하였다. 또한 실내시험에서는 레일내부손상 이미지 데이터를 구축하기 위하여 SEM 시험을 이용하였으며, 균열 길이, 깊이 및 각도를 정량화하였다. 본 연구에서는 현장조사와 실내시험에서 구축한 이미지 데이터를 적용한 딥러닝 모델(Fast R-CNN)을 애플리케이션에 적용하였다, 스마트기기에서 사용이 가능한 딥러닝 모델을 이용한 레일표면손상 진단 애플리케이션(App)을 개발하여 향후 궤도진단 및 성능평가 업무에 활용 가능한 레일표면손상 스마트 진단시스템을 개발하였다.

• Clinical Endoscopy
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• 제57권1호
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• pp.1-10
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• 2024

Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

• 한국학교수학회논문집
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• 제18권2호
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• pp.223-240
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• 2015

본 논문의 목적은 미적분에 관한 보충학습을 요하는 이공계 대학생들을 위하여 공업수학의 벡터미적분 교육을 중심으로 개념적 이해와 계산 과정의 단계별 풀이를 보여주는 웹 기반 이러닝 콘텐츠를 설계 및 개발하는 것이다. 이를 위하여 먼저 수학교육용 소프트웨어에 관한 고찰을 하였으며 학교 수학에서 등장하는 문제해결의 과정을 규칙 재작성으로 처리함으로써 화이트박스 형태의 콘텐츠 제작에 관한 이론적 토대를 살펴보았다. 구체적으로 Mathematica의 패턴 매칭을 이용하여 미분과 적분 연산자를 구현하였고, 이를 벡터미적분에서 등장하는 매개변수화된 곡선에 대한 길이 구하기 문제에 적용함으로써 콘텐츠 개발의 예를 제시하였다. 튜토리얼 형태로 개발된 이러닝 콘텐츠는 단계별 풀이 과정이 나오는 실습하기 콘텐츠와 퀴즈 문제를 통하여 학습자의 과정을 진단해 주는 형성평가 모듈로 구성되었다. 끝으로 개발된 이러닝 콘텐츠의 특징과 이공계 대학생들의 수학에 관한 기초학력을 증진하는데 활용될 수 있는 장점을 살펴보았으며 향후 연구 방향을 제시하였다.