젊은 여성에서 발견된 충수돌기선암

심진석,윤상남,김지수,윤소영,김완섭,임소덕 대한외과학회 2006 대한외과학회 학술대회 초록집 Vol.2006 No.5

1930年代 韓國文檀의 小設論

心鎭奭 西原大學校湖西文化硏究所 1987 湖西文化論叢 Vol.4 No.-

항문 외괄약근 피로도 지수의 임상적 의의에 대한 재평가

성무경,심진석 대한대장항문학회 2009 Annals of Coloproctolgy Vol.25 No.2

Purpose: The fatigue rate index (FRI) has been developed to access sustained voluntary contraction of the external anal sphincter. This study is designed to refine the technical aspects of measuring the FRI and to re-evaluate its clinical significance. Methods: Thirty-eight patients with fecal incontinence (19 males, 19 females) and 37 (21 males, 16 females) controls were studied. Anal manometry was performed by using standard protocols. Fatigue was measured over a 20-sec squeeze at a high-pressure zone. The FRI was calculated from the maximum squeeze pressure (MXSP) and the fatigue rate. For the accuracy of the calculation, the mean resting pressure (MRP) was calibrated to zero before the metric procedure, representative segments of the calculation were selectively designated as those denoting sustained squeeze, and representative channels were designated from among 8 channels by using 3 or more of those showing typical sustaining-pressure curves. Results: No difference in demographic factors was detected between the two groups. Basic manometric parameters were significantly different between the two groups (MRP, 29.4±21.3 vs. 44.4±17.8 mmHg, P=0.0015; MXSP, 205.9±98.0 vs. 274.2±106.5 mmHg, P=0.0051). The FRI was also significantly different (29.8±14.3 vs. 86.3±127.1 sec, P=0.0108). The areas under the receptor operating-characteristic curves for the MRP, the MXSP, and the FRI were 0.72, 0.69, and 0.84, respectively. The sensitivity and the specificity of the FRI for detecting fecal incontinence were 80% and 65% at 40 sec as a cut-off point. Conclusion: The FRI was proven to be more accurate than the MRP and the MXSP in detecting incontinence. With adequate modifications of the measuring method, measurement of the FRI could be done more easily and conveniently, but its cutoff point for detecting fecal incontinence was lower than previously reported. Purpose: The fatigue rate index (FRI) has been developed to access sustained voluntary contraction of the external anal sphincter. This study is designed to refine the technical aspects of measuring the FRI and to re-evaluate its clinical significance. Methods: Thirty-eight patients with fecal incontinence (19 males, 19 females) and 37 (21 males, 16 females) controls were studied. Anal manometry was performed by using standard protocols. Fatigue was measured over a 20-sec squeeze at a high-pressure zone. The FRI was calculated from the maximum squeeze pressure (MXSP) and the fatigue rate. For the accuracy of the calculation, the mean resting pressure (MRP) was calibrated to zero before the metric procedure, representative segments of the calculation were selectively designated as those denoting sustained squeeze, and representative channels were designated from among 8 channels by using 3 or more of those showing typical sustaining-pressure curves. Results: No difference in demographic factors was detected between the two groups. Basic manometric parameters were significantly different between the two groups (MRP, 29.4±21.3 vs. 44.4±17.8 mmHg, P=0.0015; MXSP, 205.9±98.0 vs. 274.2±106.5 mmHg, P=0.0051). The FRI was also significantly different (29.8±14.3 vs. 86.3±127.1 sec, P=0.0108). The areas under the receptor operating-characteristic curves for the MRP, the MXSP, and the FRI were 0.72, 0.69, and 0.84, respectively. The sensitivity and the specificity of the FRI for detecting fecal incontinence were 80% and 65% at 40 sec as a cut-off point. Conclusion: The FRI was proven to be more accurate than the MRP and the MXSP in detecting incontinence. With adequate modifications of the measuring method, measurement of the FRI could be done more easily and conveniently, but its cutoff point for detecting fecal incontinence was lower than previously reported.

2개의 동시성 선암을 동반한 대장의 증식성 용종증

성무경,심진석,황태숙,김지훈 대한대장항문학회 2009 Annals of Coloproctolgy Vol.25 No.3

Hyperplastic polyps are common large-bowel tumors, are frequently detected in middle- to old- aged people, and usually are minuscule lesions in the distal colon and rectum. Most hyperplastic polyps have no malignant potential, but recent studies suggest that some hyperplastic polyps can progress to colorectal cancers, possibly by the so-called serrated pathway. Hyperplastic polyposis is a rare syndrome characterized by multiple hyperplastic polyps, primarily in the proximal colon. Different from sporadic hyperplastic polyps, hyperplastic polyposis is alleged to have high potential for malignancy because patients with this syndrome may frequently have conventional adenomas, serrated adenomas, and adenocarcinomas. We report the case of a patient with hyperplastic polyposis, who had two synchronous colon cancers, as well as sessile serrated adenomas and tubular adenomas. Hyperplastic polyps are common large-bowel tumors, are frequently detected in middle- to old- aged people, and usually are minuscule lesions in the distal colon and rectum. Most hyperplastic polyps have no malignant potential, but recent studies suggest that some hyperplastic polyps can progress to colorectal cancers, possibly by the so-called serrated pathway. Hyperplastic polyposis is a rare syndrome characterized by multiple hyperplastic polyps, primarily in the proximal colon. Different from sporadic hyperplastic polyps, hyperplastic polyposis is alleged to have high potential for malignancy because patients with this syndrome may frequently have conventional adenomas, serrated adenomas, and adenocarcinomas. We report the case of a patient with hyperplastic polyposis, who had two synchronous colon cancers, as well as sessile serrated adenomas and tubular adenomas.

우리나라의 정상가격 산출방법 사전승인(APA) 제도 발전방안에 관한 연구

권용환,심진석,김태형 한국국제조세협회 2023 조세학술논집 Vol.39 No.3

다국적기업은 OECD BEPS 프로젝트의 후속조치에 따른 2-필라(Pillar) 입법, 국가 간 정치・외교 마찰 및 코로나19 이후의 경제 이슈까지 이전가격 거래 구조에 상당한 영향을 미치는 다양한 문제점에 직면해 있다. 따라서 대다수 다국적기업은 이전가격 거래와 관련한 법적 안정성과 예측가능성을 제고하기 위해 사전적 권리구제절차로서 APA를 적극 활용하고 있거나 계획하고 있는 것으로 나타났다. 이에 본 연구는 우리나라의 APA와 관련한 규정 및 운영실무를 먼저 살펴본 다음, OECD의 APA와 관련한 권고안과 주요국의 규정 및 운영실무 등과 비교해서 우리나라의 현행 APA 제도의 발전을 위한 고려사항을 제언하였다. 첫째, “쌍방 APA 신청의 활성화 제고”와 관련해서 쌍방 APA의 상대적인 장점을 고려하여 과세당국은 납세자가 일방 APA 신청 시 사전상담과 같이 초기 단계부터 쌍방 APA로의 전환 가능 여부에 대한 신속한 타당성 검토를 수행하고, 가능할 경우 납세자와 충분한 논의 후에 상대방 CA의 의향을 문의할 수 있도록 하는 절차와 관련한 입법적 및 행정적 기준을 마련하는 방안을 제언하였다. 다만, 쌍방 APA로의 전환이 가능하더라도 납세자가 동의하지 않을 경우에는 납세자의 결정에 따라 기존의 일방 APA 신청이 유지될 수 있어야 할 것으로 판단된다. 둘째, “APA 진행 절차의 효율성 및 예측가능성 제고”를 위해 APA 진행의 주요 단계별로 개선방안을 개진하였다. ①사전상담 단계에서 APA 담당 인력을 확충하는 방안, 사전상담 일자를 조율하는 방안, 표준화된 평가기준을 마련하는 방안 등, ②신청 및 개시 단계에서는 납세자가 양국 CA에게 제출하는 정보를 일원화하는 방안과 APA 신청의 수락 기한을 규정하는 방안 등, ③심사 및 협상 단계에서는 주요 단계별 처리기간의 목표를 설정하는 방안, CA 간에 커뮤니케이션 방법을 다각화하는 방안, 상호합의에서 통상적으로 요구하는 정보의 업데이트를 정례화하는 방안, 상호합의에서 논의된 주요 쟁점을 문서화하는 방안 등을 제언하였다. 셋째, “세무조사와의 관계 명확화”와 관련해서 불필요한 조세 분쟁이나 현재 진행 중인 APA 절차에 미치게 될 부정적인 영향을 최소화하기 위해 조사팀과 CA 간의 협력을 위한 정책 및 실무지침서를 마련하고, APA 절차의 상당 부분이 진행되었을 경우 세무조사의 결과가 APA 진행 과정에 미치게 될 영향을 선제적으로 검토함과 동시에 과세형평을 고려한 안전장치를 반영한 절차적 규정의 도입을 제언하였다. 또한 과세당국과 납세자 간의 APA 신청 건에 대한 징수유예를 합의할 수 있도록 하는 규정을 통해 현재의 실무행정을 개선하면서 APA 제도를 촉진할 수 있을 것으로 판단된다. 넷째, “다자간 APA의 처리를 위한 정책 수립”을 위해 향후 다자간 APA의 신청 및 진행에 관한 규정을 입법할 경우 우리나라 과세당국은 납세자가 기존에 신청한 일방 또는 쌍방 APA를 다자간 APA로 확대할 수 있다는 점, 복수의 체약상대국들과 협상 진행 시에는 원칙적으로는 다자간 접근방법을 채택하되 실질적인 APA 타결은 쌍방 접근방법을 통해 개별적인 쌍방 APA를 여러 번 체결해야 한다는 점을 고려할 필요가 있다고 제언하였다. 또한 다자간 APA의 목표 처리기간인 36개월을 달성하기 위해서는 다자간 APA의 처리를 위한 담당 조직과 인력의 신설 및 업무관리 체계의 수립이 선행되어야 하고, 다자간 APA 담당 인력이 조정 CA의 역할을 수 ... Multinational enterprises are currently faced with multiple challenges including the Two-Pillar legislation of the OECD BEPS project’s follow-up action, political and diplomatic disputes among countries, as well as various economic issues during the post-COVID era, which have a significant impact on the transfer pricing transaction structure. As a result, a number of multinational enterprises are actively utilizing or planning to apply for an APA as a proactive remedy to enhance legal certainty and predictability in transfer pricing transactions. Therefore, this study first examines the APA-related regulations and operational practices in Korea and proposes considerations for the development of the current regulations and operational practices in Korea by comparing the OECD’s recommendations and the regulations and operational practices of major countries. First, in relation to promoting bilateral APA applications, considering the relative merits of a bilateral APA compared to a unilateral APA, the Korean tax authority should establish legislative and administrative standards for procedures that allow taxpayers to conduct a prompt feasibility study on the possibility of converting to a bilateral APA at an early stage such as a pre-filing meeting for a unilateral APA application, and if possible, to inquire about the counterparty CA’s intentions after sufficient discussion with the taxpayer. However, even if the transition to a bilateral APA is possible, in case of the taxpayer’s disagreement, the existing unilateral APA application should be allowed to be maintained at the taxpayer's discretion. Second, in order to improve the efficiency and predictability of the APA process, various improvements were proposed for each major stage of the process. At the pre-filing meeting stage, it is recommended to expand the number of APA personnel, coordinate the dates of the pre-filing meeting, and establish standardized evaluation criteria. At the application and commencement stage, it is recommended to harmonize the information submitted by taxpayers to the CAs of both countries and to stipulate the deadline for acceptance of APA applications. At the examination and negotiation stage, it is recommended to set milestones for processing times for each key stage, to diversify communication methods between CAs, to regularize updates of information typically required in CA meetings, and to document key issues discussed in CA meetings. Third, with respect to clarifying the relationship with tax audits, it is recommended to establish policies and practice guidelines for cooperation between tax auditors and CAs to minimize unnecessary tax disputes or negative impacts on ongoing APA proceedings and to legislate procedural rules to proactively consider the impact of tax audit outcome on APA proceedings when a significant part of the APA process has been completed, while incorporating safeguards to ensure tax equity. In addition, a provision allowing tax authorities and taxpayers to agree on a suspension of tax collection for APA cases would also improve the current practice and promote the APA program. Fourth, in order to establish a policy for handling multilateral APAs, it is recommended that in the future, when legislating regulations on the application and execution of multilateral APAs, the Korean tax authority should consider that taxpayers can expand their existing unilateral or bilateral APAs into multilateral APAs, and also that when negotiating with multiple contracting parties, a multilateral approach should be adopted in principle, but the actual conclusion of the APA should be concluded based on multiple individual bilateral APAs through a bilateral approach. Furthermore, to achieve the target processing period of 36 months for multilateral APAs, it is recommended that the organization and personnel in charge of processing multilateral APAs should be newly established and a work management system should be put in place...

교육용 소프트웨어 개발에 적합한 하이퍼미디어 시스템에 관한 연구

박성한,정혜윤,한민규,심진석 한양대학교 공학기술연구소 1993 공학기술논문집 Vol.2 No.1

This paper presents a back-end system of hypermedia authoring system for courseware development. For the design, repersentative hypertext reference models, the Dexter model and the HAM(Hypertext Abstract Machine) which belongs to Campbell & Goodman model were analyzed. Based on those models, data objects, attributes, and operations of back-end system were designed and implemented. Because the application area of this system is on computer based education, the path mechanism is enforced for the various educational strategies. In order to reduce the user disorientation and cognitive overheads in navigating hypernetwork, filtering, backtracking and history mechanism were implemented.

Prediction and Classification of Pilot’s Cognitive Workload via Deep Learning of Multivariate Data

Jungon Hur(허준곤),Jinseok Sim(심진석) 대한인간공학회 2019 대한인간공학회 학술대회논문집 Vol.2019 No.10