이로에 관한 소고 -영국보통법을 중심으로

김종석(Jong-Suk Kim) 한국해양비즈니스학회 2009 해양비즈니스 Vol.- No.14

Under common law, the shipowner is under an implied obligation to carry the cargo to the agreed destination directly without any deviation. The implied obligation of not to deviate is regarded as a condition of the contract and deviations are regarded as the fundamental breach of contract. But in certain circumstances at common law, departure from the proper route is permissible. The two main situations are deviating to save human life and for the purpose of avoiding danger to the ship or cargo. The deviate for the purpose of saving life is always justifiable. However, the deviate for the purpose of saving property only is not justifiable. The danger to the vessel or cargo may include natural causes, such as storms, ice, or flog, or political, such as the outbreak of war or the fear of capture by hostile forces. Whereas Korean Commerical Code allows the carrier to deviate for the purpose of saving life and property only. Considering the risks in the carriage of goods by sea, this regulation permits the carrier to deviate within the narrow scope. And Korean Commerical Code does not regulate on the effect of unjustifiable deviation. Therefore it is necessary to have various regulations on justifiable deviation and the effect of unjustifiable deviation like common law. The standard of justifiable deviation must be considered all terms and conditions existing at the time of deviation and the terms in the contract plus the causes above mentioned and must be decided. I would like to present the standard on justifiable deviation as follow. First, is the deviation happened expressly acknowledged in the contract? Second, if it not acknowledged in the contract, is it permitted in the commercial customs? Third, even if it is not allowed in the commercial customs, is it reasonable? Forth, if it is not reasonable, does not the voyage compulsively cease owing to causes by perils on the sea, acts of gods, arrest or restraint of princes, war and etc.? If there is a negative answer on above questions, I think, the deviation is unjustifiable and the shipowner and carrier are responsible for unjustifiable deviation. On the other hand, even if there are deviation clauses in the voyage charterparty or Bill of Lading, deviating is not allowed unconditionally but permitted within the scope of justifiable deviation.

도시음악축제에서 나타나는 일탈성 양상 연구 - ACC월드뮤직페스티벌을 중심으로 -

최언회,이무용 한국예술경영학회 2019 예술경영연구 Vol.0 No.50

The purpose of this study is to examine the patterns of deviation in urban music festival through the theories and a case study. A deviation help contemporary people in the routine of daily life to give a lot of energy. Such a deviation is strongly experienced from the festival. So it is important to study the patterns of deviation in urban festival. For this purpose, the relation between deviation and festival is examined first. And then the patterns of deviation in festival are drawn from the preceding research and case studies. The patterns of deviation in festival are identified as spatio-temporal deviation, active deviation, and situational deviation. Spatio-temporal deviation is divided into non-dailiness, space separation, and space appropriation. Active deviation is divided into make-over and expression. Situational deviation is divided into overturning and new meeting. This patterns of deviation applies to case study of ACC world music festival held in Gwangju metropolitan city with a content analysis methodology. The research finding is that Spatio-temporal deviation is most evident in ACC world music festival, on the other hand active deviation and situational deviation are weak or no evident. It is expected that various deviant elements presented in this study will be used strategically in festival planning to help strengthen the festivity of modern urban festivals. 본 연구는 도시음악축제에서 일탈성이 어떤 식으로 나타나고 있는지를 이론과 사례를 통해 분석하고자 하였다. 반복적인 일상을 살아가는 현대인들에게 일탈은 삶의 활력을 제공할 수 있는데, 그러한 일탈성을 강하게 체험할 수 있는 곳이 축제현장이다. 따라서 도시축제에서 나타나는 일탈성 양상 분석은 중요한 의의를 지닌다. 이를 위해 우선 일탈과 축제의 관계를 정리하고, 선행 연구 및 축제 사례를 바탕으로 축제에서 나타나는 일탈성의 양상들을 도출하였다. 축제의 일탈성 양상은 크게 시공간적 일탈, 행위적 일탈, 상황적 일탈로 분류할 수 있었다. 각 양상들을 세분화해보면, 시공간적 일탈은 비일상성, 공간 분리, 공간 전유로 분류되었고, 행위적 일탈은 변신과 발산(표출)으로, 상황적 일탈은 역할 전도와 새로운 만남으로 각각 분류되었다. 이러한 분류 결과를 적용하여 광주광역시에서 열리고 있는 ACC월드뮤직페스티벌에 나타난 일탈성 양상을 분석하였다. 분석은 사진, 기사 등을 이용한 내용 분석 방법을 실시하였다. 분석 결과 ACC월드뮤직페스티벌에서는 시공간적 일탈이 가장 뚜렷하게 나타난 반면, 행위적 일탈이나 상황적 일탈은 약하거나 거의 나타나지 않았다. 이 연구를 바탕으로 본 연구에서 제시한 다양한 일탈성 요소를 전략적으로 축제기획에 활용하여 현대 도시축제의 축제성을 강화하는데 도움이 될 것으로 기대한다.

실패복구에 대한 고객반응, 믿으니까 남고 미우니까 떠난다!: Double Deviation vs. Recovery Paradox 현상에 대한 비교분석

라선아 ( Suna La ) 한국소비자학회 2012 소비자학연구 Vol.23 No.4

실패복구와 관련된 흥미로운 두 가지 현상은 리커버리 패러독스와 이중이탈 현상이다. 리커버리 패러독스는 ‘실패를 겪은 고객이 만족스런 복구를 경험함으로써 과거보다 오히려 만족도가 높아지고 결과적으로 충성도가 높아지는 현상 또는 전혀 불만족을 경험하지 않은 고객보다 더 충성적으로 변화하는 현상’이다. 이에 반해 이중이탈 현상은‘이미 제품, 서비스의 실패로 인해 불만족한 고객에게 형편없는 복구수행으로 말미암아 또 다시 불만족을 겪게 함으로써 고객의 전반적인 평가를 악화시키는 현상’이다. 본 연구는 실패복구의 결과로 발생할 수 있는 상반된 두 현상을 고객-기업 관계의 회복과 추락이라는 관점에서 대조하고 비교분석하였다. 설문조사를 통해 수집된 실패 이전과복구 이후의 충성도 변화량 및 복구만족도 수준을 기준으로 두 집단을 분리, 추출한 후 불일치 패러다임과 관계마케팅 관점을 적용하여 두 집단 간의 공통점과 차이점을 분석하였다. 두 집단에 공통적으로 분배적, 상호작용적 리커버리불일치가 리커버리만족에 유의한 영향을 미치고, 리커버리만족을 거쳐 고객애정, 고객신뢰와 같은 관계의 질적변화가 도출되며, 관계의 질적 변화에 의해 충성도가 결정되는 경로구조를 적용했을 때, 이중이탈 집단에서 고객신뢰의 충성도에 대한 경로가 비유의적으로 분석된 것을 제외하고 다른 모든 경로구조는 유의하게 나타났다. 두 집단간 차이로서, 이중이탈 집단에서는 리커버리불일치가 고객애정에 대해 리커버리만족을 통한 간접적 영향 외에도 직접적인 spill-over 효과를 발휘한다는 점과, 고객애정의 추락만으로 직접 충성도가 추락되는 효과가 나타난다는 점을 발견하였다. 리커버리 패러독스 집단에서는 리커버리불일치의 고객애정에 대한 직접적인 spill-over 효과가 나타나지 않았으며 고객애정의 회복과 신뢰의 회복을 통해 충성도가 회복되는 과정을 거치는 데, 이 때 이중이탈 집단에 비해 고객애정의 충성도에 대한 직접 영향은 유의하게 더 작고, 고객신뢰의 충성도에 대한 영향은 유의하게 더 크다는 점이 발견되었다. 요컨대 충성도의 추락은 신뢰의 문제라기보다는 애정의 문제여서, 결국 고객은 믿음이 사라져서 기업을 떠난다기보다는 미움이 솟구쳐서 떠나는 것으로 이해된다. 반면, 실패복구 이후 고객이 기업에 남기로 결정하는 것은 우호적 감정에만 의존한 결정이 아니라 이성적 판단 결과도 함께 고려한 결정인 것이다. 그 외에도 두 집단 간 표본의 특성을 살펴보면, 리커버리 패러독스집단에서는 실패의 심각성이 더 낮고, 과거의 관계 강도가 더 약한 고객들이 상대적으로 높은 복구만족을 경험하면서 복구 이후의 충성도가 과거 수준 이상으로 증가되는 경향을 보이는 것으로 밝혀졌으며, 이중이탈 집단은 실패의 심각성이 더 크고 과거의 관계 강도가 더 높은 고객들이 상대적으로 낮은 복구만족을 갖게 되면서 이른바 ‘배반효과’를 나타내는 것으로 밝혀졌다. 본 연구는 실패복구 이후의 두 상반된 현상에 대한 본격적인 대조, 비교연구로서 의의를 가질 뿐만 아니라 학계와 실무계에 유용한 시사점을 제공한다. Even though companies endeavor to deliver perfect products or services, failures are inevitable to some degree. When failures occur, the primary objective is to prevent customer from defecting and to return dissatisfied customers into normal. If failure recovery is performed successfully, then the firm can regain customer loyalty and, in better cases, it can enhance loyalty more than that of the past. When recovery is successful, customers become even more loyal to the company than before. However, when the recovery of failure fails again, customers feel angry, betrayed or frustrated, and finally negative recovery disconfirmation accompanied by aforementioned negative emotions leads to drop in loyalty or to customer defection. The better cases are called ‘Recovery Paradox’ and the worse cases are called ‘Double Deviation.’ The study attempts to contrast and compare the different characteristics between these two opposite phenomena by employing relationship marketing perspective and disconfirmation paradigm. Some of Dissatisfied customer from the initial failure of product or service may come to a happy ending but some meet a disastrous catastrophic ending via poor recovery. Recovery of failure is a moment of truth (MOT) both to company and to customer. The research framework is founded on the idea that recovery is a process that a dissatisfied customer passes through, from recovery disconfirmation, to perceived recovery performance determining the level of customer recovery satisfaction, and then rebuilding of relationship quality such as customer affection and trust, and finally rebuilding of customer loyalty. The study developed hypotheses in two ways. One is basic paths structure and the other is group difference. The structure of basic paths is identically adopted to both recovery paradox and double deviation groups. One of group differences is hypothesized as direct spill-over effect of recovery disconfirmation to customer affection for double deviation group. The rationale is based on ``negativity bias effect`` stemming from negative recovery disconfirmation accompanied by negative emotions. The other aspect of group difference is viewed on the path from customer affection to loyalty and from customer trust to loyalty. The direct path impact of customer affection on loyalty is hypothesized to be stronger for double deviation group than for recovery paradox group, but the direct impact of customer trust on loyalty is hypothesized to be stronger for recovery paradox group than double deviation group. The research model is shown in Empirical test was conducted by using 507 survey data. Confirmatory Factor Analysis (CFA) of the measurement model was supported with adequate fit indices: χ 2(194)=615.890(p=.00), χ 2/df=3.175, CFI=.968, NNFI= .962, SRMR=.035, RMSEA=.066. Groups should be divided in advance to running the Structural Equation Model(SEM). The scores of loyalty change between the two timelines, that is, the time before the failure occurred and the time after the recovery performed, was used for grouping. If the scores were ‘0’ and more than ‘0’, the respondents were categorized into Group_Recovery Paradox. 175 respondents belonged to Group_Recovery Paradox. If the scores were less than ‘0’ and also the level of recovery satisfaction was lower than ‘5’, indicating the mid-point of the 9-point Likert type scale, that was measured with BTWT method (better than expected/worse than expected). Finally, 233 respondents belonged to Group_Double Deviation. Mean(S.E.) Group_Double t-value Deviation Group_Recovery Paradox Failure Severity 6.921(.110) 5.811(.156) 5.986* Distributive Recovery Disconfirmation 3.157(.128) 4.479(.145) -6.846* Interactional Recovery Disconfirmation 3.411(.123) 4.792(.153) -7.056* Recovery Satisfaction 3.250(.126) 4.639(.176) -6.597* Prior Customer Affection 6.223(.123) 4.871(.149) 6.994* Prior Customer Trust 7.048(.091) 5.833(.129) 7.935* Prior Customer Loyalty 6.659(.101) 4.601(.149) 11.813* *p < .01 <Table 1> Group Characteristics <Table 1> shows the group characteristics. Distributive recovery disconfirmation, interactional recovery disconfirmation and recovery satisfaction of Group_Double Deviation were found to be relatively lower than those of Group_Recovery Paradox as expected. Contrarily, failure severity, prior customer affection, prior customer trust and prior customer loyalty of Group_Double Deviation were found to be relatively higher than those of Group_Recovery Paradox. Betrayal effect serves as the most plausible explanation for the differences in characteristics between two groups. Existing customers with relatively strong relational bond to the company seem to feel betrayed easily when ‘reciprocity norm’ is violated by the partner company. This could be seen as a ‘potential dark side of strong relationship’ between customer and company. To the contrary, customers who have relatively lighter bonding with the company in the past show more paradoxical tendency after an appropriate recovery was provided. The key causes of these contrasts are the severity of failure and recovery satisfaction. <Table 2> shows the results of hypotheses testing. H7 was partly supported and H9 was rejected but all other hypotheses were accepted. The basic paths structure was mostly supported for both groups except for the path from customer trust to customer loyalty for Group_Double Basic Paths Hypothesis Unstandardized Coefficient (t-value) Result Group_Double Deviation Group_Recovery Paradox Distributive Recovery Disconfirmation → Recovery Satisfaction H1 .296*** (4.267) .233** (2.204) accepted Interactional Recovery Disconfirmation → Recovery Satisfaction H2 .392*** (5.057) .440*** (4.409) accepted Recovery Satisfaction → Customer Affection H3 .202*** (2.656) .422*** (5.199) accepted Recovery Satisfaction → Customer Trust H4 .223*** (5.691) .267*** (6.382) accepted Customer Affection → Customer Trust H5 .759*** (16.745) .758*** (14.264) accepted Customer Affection → Customer Loyalty H6 .711*** (7.154) .343** (2.043) accepted Customer Trust → Customer Loyalty H7 -.039 (.699) .471*** (2.818) partly accepted Groups Difference Group_Double Deviation Group_Recovery Paradox △χ2(1, p-value) Spill-over effect Distributive Disconfirmation → Customer Affection for Group_Double Deviation H8 .285(3.801)*** .050(.469) marginally 3.218(1, p=.073)* accepted Interactional Disconfirmation → Customer Affection for Group_Double Deviation H9 .213(2.480)*** -.008(-.076) rejected 2.639(1, p=.104) Comparison of path impact Customer Affection → Customer Loyalty : Group_Double Deviation > Group_Recovery Paradox H10 .711(7.154)*** .343(2.043)** marginally 3.390(1, p=.066)* accepted Customer Trust → Customer Loyalty : Group_Double Deviation < Group_Recovery Paradox H11 -.039(.699) .471(2.818)*** accepted 6.301(1, p=.012)** * p < .10, ** p < .05, *** p < .001 <Table 2> Results of Hypotheses Test Deviation. This means that the drop in customer trust has no significant impact to loyalty drop. Instead, drop in customer affection directly affect loyalty drop, which is comparatively more fatal to decrease in customer loyalty than that of Group_Recovery Paradox. The spill-over effect of recovery disconfirmation was significant only for the Group_Double Deviation. Customers who experience double deviation appear to follow emotional route more strongly in response to recovery than the other group. Their hierarchy of effects seems to be relatively more immediate and short. However, customers who rebuild the relationship via recovery satisfaction seem to follow more rational route to loyalty rebuilding. Their hierarchy of effects is longer and the nature of recovered customers appears to be more prudent and reserved so that they won``t be dominated by the affect or emotions related to the recovery itself. For the customers who were dissatisfied due to the initial failure to determine their future behavioral intention toward the company that committed the transgression, more time and more elaborative processing appear to be required for retention, however, less time and less elaborative processing appear to work for defection. Trust rebuilding makes people stay but affection drop may lead to customer defection in the recovery of failure. Further discussions and implications are detailed. Research limitations and future research ideas are also presented.

<고산구곡가>식 대칭표현형 연시조들의 유형성과 개별성

양희철(Hee-cheol, Yang) 어문연구학회 2010 어문연구 Vol.64 No.-

This treatise looked upon the typicality and individuality of the linked Si-Jos having the pattern of the symmetrical expression in Gosangugokga, using the method of the internal deviation and the tertiary deviation. The four typicality of the linked Si-Jos follow as; First typicality is the fact that the prefacial Si-Jo of the linked Si-Jo is exposed by the deviational expression. This typicality is realized by the individuality which is the deviation from the norm(“○曲은 어드?오 …”) in Gosangugokga, the deviation from the norm(“○曲은 어드메오”) in Hwangsangugokga, the deviation from the norm(‘-노라’) in Ouga, the deviation from the norm(하오리라’) in Byeongsanlyukgok, the deviation from the norm(‘ ㅎ-’) in Pungsanpyeolgok, and the deviation(‘?노라’) in Jeogokjeongapalgok. Second typicality is the fact that the symmetrical axis and the symmetrical expression are composited by the deviation and the norm. There are two Si-Jo which are not included to the symmetrical axis and the symmetrical expression in Jeogokjeongapalgok only. Third typicality is the fact that last Si-Jo of the linked Si-Jo have the closing devices. Those closing devices function as the supplementary devices of the lacked closing Si-Jo. Fourth typicality is the fact that one Si-Jo of the linked Si-Jo in the symmetrical axis have a meaningful position in the work’s form, content, space, and emotion. This typicality is realized by the individuality that the sixth Si-Jo of the symmetrical axis have a meaningful position of the form, content, and space in Gosangugokga, and Hwangsangugokga, that the fourth Si-Jo of the symmetrical axis have a meaningful position of the form, content, and space in Ouga, that the fourth Si-Jo of the symmetrical axis have a meaningful position of the form and content in Byeongsanlyukgok and Pungsanpyeolgok. Exceptionally the sixth Si-Jo of the symmetrical axis have a meaningful position of the emotion in Jeogokjeongapalgok.

간헐외사시에서 수술 당일 측정한 수술 전 사시각의 변동성

서의종,정승아 대한안과학회 2015 대한안과학회지 Vol.56 No.10

Purpose: To evaluate the characteristics and surgical outcomes of children with intermittent exotropia whose preoperative angle of deviation changed on the day of surgery. Methods: The medical records of 323 children with intermittent exotropia who underwent lateral rectus recession in both eyes were reviewed. The records were classified according to the difference of 8 prism diopters (PD) or more between the largest angle of deviation measured within 3 months prior to the operation and that on the day of surgery into the increased, same, or decreased groups. The frequency, characteristics, and surgical outcomes of each group were analyzed. The surgical amount was determined based on the largest angle of deviation measured at distance within 3 months before surgery. Results: The angle of deviation at distance on the day of surgery was increased in 5 patients (1.5%) and decreased in 6 (1.9%). The near angle was increased in 19 (5.9%) and decreased in 22 (6.8%) patients. The groups in which distant deviation was changed had a greater distant angle and more patients with anisometropia. The group in which near deviation decreased was older than the same group and 81.8% of the patients were school-aged. In the group with changes in either distant or near deviation, the angle on the day of surgery changed toward decreasing disparity of near-distant deviation. On the last follow-up, the rate of overcorrection of 10 PD or more was 13.6% in the decreased near deviation group, which was significantly high (p = 0.039). Conclusions: The angle of deviation on the day of surgery could be different compared to the largest preoperative angle in some patients with intermittent exotropia. In patients with decreased near deviation, the rate of postoperative overcorrection might be high. 목적: 간헐외사시 환아에서 수술 당일 측정한 수술 전 사시각의 변동성을 평가하고, 그 변동에 따른 수술 결과의 차이를 알아보고자하였다. 대상과 방법: 간헐외사시로 두 눈 외직근후전술을 받은 323명을 대상으로, 수술 전 3개월 이내 측정된 최대 사시각과 수술 당일 측정한 사시각을 비교하였다. 수술 당일 사시각이 8프리즘디옵터(PD) 이상 증가, 감소 혹은 동일하였던 군으로 나누어, 각 군의 빈도와임상양상, 수술 결과를 조사하였다. 수술량은 수술 전 3개월 이내 측정된 최대 원거리 사시각을 기준으로 정하였다. 결과: 수술 당일 원거리 사시각은 5명(1.5%)에서 증가하고, 6명(1.9%)에서 감소하였으며, 근거리 사시각은 19명(5.9%)에서 증가하고, 22명(6.8%)에서 감소하였다. 원거리 사시각에 변동이 있었던 군은 동일군보다 원거리 사시각이 컸고, 굴절부등이 있는 경우가 많았다. 근거리 사시각 감소군은 동일군에 비해 나이가 많았으며, 특히 취학 아동의 비율이 81.8%로 높았다. 수술 당일 사시각에 변동이 있었던 군은 수술 전 최대 사시각에 비해 사시각의 원근 차이가 감소하였다. 최종 경과관찰에서 근거리 사시각 감소군에서는 10PD 이상과교정된 경우가 13.6%로, 유의하게 많았다(p=0.039). 결론: 일부 간헐외사시 환아에서는 수술 당일 사시각에 변동이 있을 수 있으며, 근거리 사시각이 감소하는 경우 수술 후 과교정되는빈도가 상대적으로 높았다.

청소년의 스포츠활동 참여수준과 일탈수준과의 관계

염두승,이영민,윤상문 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

This study aimed to examine and analyze empirically juveniles' sports participation and deviation levels, by considering how much deviation level be influenced by juveniles' sports participation level and by considering pure-functional aspects of sports which sports participation would be effective to juveniles' deviation level, and furthermore to present an theoretical review and the basic data so as to compose any sports program for juveniles. Accordingly, as a result of survey and analysis of the 727 juvenile subjects who were living in Yeongdong Region, after dividing participation level into systematic participation and unsystematic participation and dividing deviation level into home life deviation and school life deviation and social life deviation in order to define deviation level according to sports activities participation level, this study had the following findings below. First, some difference was found in relationship between juveniles' sports activities participation level and home life deviation. Second, some difference was found in relationship between juveniles' sports activities participation level and school life deviation. Third, some difference was found in relationship between juveniles' sports activities participation level and social life deviation.

DR system에서 적정선량 평가를 위한 Deviation Index 활용의 유용성 연구

김선우(Sun-Woo Kim),김상현(Sang-Hyun Kim),대창민(Chang-Min Dae),민관홍(kwon-Hong Min) 대한영상의학기술학회 2015 대한영상의학기술학회 논문지 Vol.2015 No.1

목 적 : 디지털 방사선 시스템에서 제공되는 large database 중 Deviation Index(DI) 인자를 활용한 검사부위 및 mode별 분석을 통해 검사선량 적정성 평가의 유용성에 대해 알아보고자 한다. 대상 및 방법 : 식약처에서 선정한 DRL검사 중 본원에서 data 수집이 가능한 13가지 검사 (Skull ap/lat, C-spine ap/lat, Chest ap/pa, T-spine ap/lat, L-spine ap/lat, Abdomen sup/ere, Pelvis ap) 32,209건의 영상을 대상으로 하였다. 실험대상의 영상을 검사부위, mode 별로 분류하여 각 영상의 DI 값을 획득한 뒤, 통계프로그램을 이용한 Data 신뢰성 평가 및 각 그룹별 DI 값을 비교 분석하였다. 결 과 : AEC mode로 시행한 검사들은 manual mode로 시행한 검사보다 DI의 median value가 대부분 낮았다. Skull lat, C-spine ap/lat 검사만 1, -0.5, -3으로 같았고 Skull ap, Chest ap, T-spine ap/lat, L-spine ap/lat, Abdomen sup/ere, Pelvis ap는 AEC mode가 낮았다. Mode별 DI 편차는 AEC mode로 시행한 검사들이 manual mode로 시행한 검사보다 대부분 적었다. AEC mode의 DI 편차는 0.82 ~ 1.68 사이에 분포했고, manual mode의 DI편차는 1.24 ~ 2.53 사이에 분포했다. manual mode가 AEC mode보다 검사별로 평균 62% 편차가 컷다. 검사 부위별 분석 결과 AEC mode로 검사한 C-spine lat, T-spine lat, L-spine lat의 DI median value는 -3, -3, -1.5로 노출 부족이 가장 심했고, manual mode로 검사한 chest ap의 DI median value는 2.5로 과 노출이 가장 심했다. 결 론 : Deviation Index를 이용하여 mode별, 검사별 특징을 분석한 결과 AEC mode가 manual mode보다 조사 조건이 상대적으로 적었고 편차 또한 안정된 분포를 보였다. 그러 나 spine lateral 검사 시에는 manual mode가 AEC mode보다 적정선량에 더 많이 분포 하였다. 즉 DI value 분석을 통해 검사 부위에 따라 적절한 mode를 설정해 검사에 임해야 할 것이다. DAP를 이용한 선량관리는 환자에게 적정 선량이 조사 되었는지 파악하기가 어렵다. 향후 Deviation Index를 활용하여 환자 적정선량 연구가 같이 이루어진다면 좀 더 체계적인 환자선량 관리가 가능해 질 거라 사료된다. Purpose : To evaluate the usefulness of the exposure adequacy through the inspection site and mode Analysis by utilizing the argument of large database of DI provided by the digital X-ray imaging system. Materials and Methods : The data of 13 kinds of the images in 32,209 counts (Skull ap/lat, C-spine ap/lat, Chest ap/pa, T-spine ap/ lat, L-spine ap/lat, Abdomen sup/ere, Pelvis ap) were included in this study. Experimental subjects were classified by inspection sites, mode respectively and then, obtained the DI values of each image and compared analyzed Data reliability evaluation and each group by DI values using a statistical program. Result : Most of the examinations carried out in the AEC mode had lower median value of DI than the examinations carried out in the manual mode. Skull lat, C-spine ap/lat examinations had the only same results(1, -0.5, -3). The other examinations showed the lower results in AEC mode. DI deviation carried out in AEC mode were more less than carried out in manual mode. The values of AEC mode were distributed between 0.82 at 1.68, distributed between 1.24 at 2.53 in the case of manual mode. manual mode had greater average deviation ,62%, than AEC mode. DI median value of C/T/L-spine lat carried out in AEC mode showed the most underexposure as -3, -3, -1.5 respectively. DI median value of Chest ap carried out in manual mode showed the most overexposure as a 2.5. Conclusion : AEC mode had lower dose exposure than manual mode relatively and showed stable distribution of deviation. However, Spine Lateral examinations carried out in manual mode were distributed in the appropriate dose more than AEC mode. In other words, it needs appropriate mode setting up according to inspection sites. Dose management with DAP is difficult to determine whether the patient inspected by the irradiated dose. In the Future, by using Deviation Index, if the study of the proper dose carry out together, it would allow a systematic management of appropriated does to the patients.

Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin

CHOI, Hyo-Won,KIM, Bola,KIM, Jae-Young,HUH, Jong-Ki,PARK, Kwang-Ho Korean Association of Maxillofacial Plastic and Re 2019 Maxillofacial Plastic Reconstructive Surgery Vol.41 No.-

Background: The relationship between the lateral deviation of chin and the upper and middle facial third asymmetry is still controversial. The purpose of this study is to evaluate the correlation of upper and middle facial third asymmetry with lateral deviation of chin using 3-dimensional computed tomography. The study was conducted on patients who underwent orthognathic surgery from January 2016 to August 2017. A total of 40 patients were included in this retrospective study. A spiral scanner was used to obtain the 3-dimensional computed tomography scans. The landmarks were assigned on the reconstructed 3-dimensional images, and their locations were verified on the axial, midsagittal, and coronal slices. The Pearson correlation analysis was performed to evaluate the correlation between chin deviation and difference between the measurements of distances in paired craniofacial structures. Statistical analysis was performed at a significance level of 5%. Results: In mandible, the degree of chin deviation was correlated with the mandibular length and mandibular body length. Mandibular length and mandibular body length are shorter on the deviated-chin side compared to that on the non-deviated side (mandibular length, r = -0.897, p value < 0.001; mandibular body length, r = -0.318, p value = 0.045). In the upper and middle facial thirds, the degree of chin deviation was correlated with the vertical asymmetry of the glenoid fossa and zygonion. Glenoid fossa and zygonion are superior on the deviated-chin side than on the non-deviated side (glenoid fossa, r = 0.317, p value = 0.046; zygonion, r = 0.357, p value = 0.024). Conclusion: Lateral deviation of chin is correlated with upper and middle facial third asymmetry as well as lower facial third asymmetry. As a result, treatment planning in patients with chin deviation should involve a careful evaluation of the asymmetry of the upper and middle facial thirds to ensure complete patient satisfaction.

A three-dimensional investigation of mandibular deviation in patients with mandibular prognathism

Kazuaki Osawa,Hideyoshi Nishiyama,Kojiro Takahashi,Ayako Honda,Chihiro Atarashi,Ritsuo Takagi,Tadaharu Kobayashi,Isao Saito,Jun Nihara 대한악안면성형재건외과학회 2023 Maxillofacial Plastic Reconstructive Surgery Vol.45 No.-

Background Craniofacial disharmony in cases of jaw deformity associated with abnormal lateral deviation of the jaw mostly involves both the maxilla and mandible. However, it has been still difficult to capture the jaw deviation aspect in a 3-dimensional and quantitative techniques. In this study, we focused on 3-dimensional mandibular morphology and position of the condylar head in relation to the base of the skull in patients with mandibular prognathism, one of the most common jaw deformities. We used cluster analysis to quantify and classify deviation and clarified its characteristics. We also investigated the degree of correlation between those findings and menton (Me) deviation measured on frontal cephalograms, which is a conventional indicator of jaw deformity. Results Findings obtained from 100 patients (35 men, 65 women) were classified into the following three groups based on mandibular morphology and condylar position relative to the skull base. Then, reclassification using these parameters enabled classification of cluster analysis findings into seven groups based on abnormal jaw deviation characteristics. Comparison among these seven groups showed that the classification criteria were ramus height, mandibular body length, distance from the gonion to the apex of the coronoid process, and the lateral and vertical positions of the mandible. Weak correlation was also found between Me deviation on frontal cephalograms and each of the above parameters measured on 3D images. Conclusions Focusing on mandibular morphology and condylar position relative to the skull base in patients with mandibular prognathism, we used cluster analysis to quantify and classify jaw deviation. The present results showed that the 3D characteristics of the mandible based on mandibular morphology and condylar position relative to the skull base can be classified into seven groups. Further, we clarified that Me deviation on frontal cephalograms, which has been used to date, is inadequate for capturing jaw deviation characteristics.

해리수직편위에서 단안 수술의 효과

박상우,정태선.Sang Woo Park. M.D.. Tae Sun Jeong. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.6

Purpose: To investigate changes in the unoperated eye of patients who underwent unilateral surgery for asymmetrical dissociated vertical deviation. Methods: We performed superior rectus recession and inferior oblique anterior transposition in the case of asymmetrical dissociated vertical deviation, and lateral rectus recession in the case of dissociated horizontal deviation. We excluded patients having a history of previous operation on the vertical rectus muscles, oblique muscle in the unoperated eye, nystagmus, neurologic problems, and imprecise measurement of deviation angle. Changes in the unoperated eyes of 11 patients who underwent unilateral surgery to correct asymmetrical dissociated vertical deviation in the other eye, from May 2003 to April 2004 were analyzed retrospectively at 1 year postoperative. Results: Not all cases of preoperative latent dissociated vertical deviation manifested such deviation in the unoperated eye postoperatively. Conclusions: Unilateral surgery is an effective treatment in patients with asymmetrical dissociated vertical deviation and does not affect the unoperated eye.