• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.26-32
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• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.56 no.3
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• pp.233-243
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• 2011

This experiment was conducted to investigate the effect of future climate change on growing period and temperature in different rice maturity types as global warming progressed, where Odaebyeo, Hwaseongbyeo, Ilpumbyeo were used as a representative cultivar of early, medium, and medium-late rice maturity type, respectively, and A1B scenario was applied to weather data for future climate change at 57 sites in Korea. When cropping season was not adjusted to climate change, entire growing period and growing temperature were shorten and risen, respectively, as global warming progressed. On the other side, when cropping season was adjusted to climate change, growing period and temperature after heading date were not changed in contrast to growing period and growing temperature before heading which were more seriously shortened and risen as global warming progressed than in not adjusted cropping season. It is supposed that adjusting cropping season to climate change can alleviate rice yield reduction and quality deterioration to some degree by improving growing temperature condition during grain-filling period, but also still have a limit such as seriously shortened growing period indicating that there need to develope actively new rice cultivation methods and varieties for future climate change.

• Korean Journal of Ecology and Environment
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• v.38 no.1 s.110
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• pp.54-62
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• 2005

The present study was to determine how seasonal rainfall intensity influences nutrient dynamics, ionic contents, oxygen demands, and suspended solids in a lotic ecosystem. Largest seasonal variabilities in most parameters occurred during the two months of July to August and these were closely associated with large spate of rainfall. Dissolved oxygen (DO) had an inverse function of water temperature (r = = = - 0.986, p<0.001). Minimum pH values of<6.5 were observed in the late August when rainfall peaked in the study site, indicating an ionic dilution of stream water by precipitation. Electrical conductivity (EC) was greater during summer than any other seasons, so the overall conductivity values had direct correlation (r = 0.527, p<0.01) with precipitation. Ionic dilution, however, was evident 4 ${\sim}$ 5 days later in short or 1 ${\sim}$ 2 weeks in long after the intense rain, indicating a time-lag phenomenon of conductivity. Daily COD values varied from 0.8 mg $L^{-1}$ to 7.9 mg $L^{-1}$ and their seasonal pattern was similar (r = 0.548, p<0.001) to that of BOD. Total nitrogen (TN) varied little compared to total phosphorus (TP) and was minimum in the base flow of March. In contrast, major input of TP occurred during the period of summer monsoon and this pattern was similar to suspended solids, implying that TP is closely associated (r = 0.890, p<0.01) with suspended inorganic solids. Mass ratios of TN : TP were determined by TP (r= -0.509, p<0.01) rather than TN (r= -0.209, p<0.01). The N : P ratios indicated that phosphorus was a potential primary limiting nutrient for the stream productivity. Overall data suggest that rainfall intensity was considered as a primary key component regulating water chemistry in the stream and maximum variation in water quality was attributed to the largest runoff spate during the summer monsoon.

• The Journal of the Petrological Society of Korea
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• v.15 no.4 s.46
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• pp.180-193
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• 2006

The Gilan area in the central-northern part of Uiseong Block of Cretaceous Gyeongsang Basin is composed of Precambrian metamorphic rocks, Triassic Cheongsong granite, Early Cretaceous Hayans Group, and Late Cretaceous-Paleocene igneous rocks. In this area, the faults of various directions are developed: Oksan fault of $NS{\sim}NNW$ trend, Gilan fault of NW trend, Hwanghaksan fault of WNW trend, and Imbongsan fault of EW trend. Several fracture sets with various geometric indicators, which determine their relative timing (sequence and coexistence relationships) and shear sense, we well observed in the Cheongsong granite, the basement of Gyeongsang Basin. The aim of this study is to determine the development sequence of extension fractures and the movement sense of shear fractures in the Gitan area on the basis of detailed analysis of their geometric indicators (connection, termination, intersection patterns, and cross-cutting relations). This study suggests that the fracture system of the Gilan area was formed at least through seven different fracturing events, named as Pre-Dn to Dn +5 phases. The orientations of fracture sets show (W) NW, NNW, NNE, EW, NE in descending order of frequency. The orientation and frequency patterns are concordant with those of faults around and in the Gilan area on a geological map scale. The development sequence and movement sense of fracture sets are summarized as follows. (1) Pre-Dn phase: extension fracturing event of $NS{\sim}NNW$ and/or $WNW{\sim}ENE$ trend. The joint sets of $NS{\sim}NNW$ trend and of $WNW{\sim}ENE$ trend underwent the reactivation histories of sinistral ${\rightarrow}$dextral${\rightarrow}$sinistral shearing and of (dextral${\rightarrow}$) sinistral shearing with the change of stress field afterward, respectively. (2) Dn phase: that of NW trend. The joint set experienced the reactivations of sinistral${\rightarrow}$dextral shearing. (3) Dn + 1 phase: that of $NNE{\sim}NE$ trend. The joint set was reactivated as a sinistral shear fracture afterward. (4) Dn +2 phase: that of $ENE{\sim}EW$ trend. (5) Dn +3 phase: that of $WNW{\sim}NW$ trend. (6) Dn+4 phase: that of NNW trend. The joint set underwent a dextral shearing after this. (7) The last Dn +5 phase: that of NNE trend.

• Journal of Applied Biological Chemistry
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• v.61 no.3
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• pp.297-304
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• 2018

Coptis chinensis is used in oriental medicine for soothing, anti-inflammation, antimicrobial and antipyretic properties, and its main ingredient berberine is known to have strong antibacterial activity. In this study, we investigated the anti-microbial effect of hot water extract of Coptis chinensis (CW) on skin related microorganism and the airborne microbe, the antifungal effects of fungi, which are frequently detected in residential environments. CW showed antibacterial effect against Propionibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis, against the airborne microbe, which was collected in four different places. At the concentration of 100 mg/mL, the antimicrobial activity continued for 42 days, showed heat stability without change in the antimicrobial activity even after heat treatment. The MIC and MBC of CW against S. aureus was 0.03, 0.05 mg/mL, against S. epidermidis was 0.50, 0.75 mg/mL and against P. acne was 0.10, 0.15 mg/mL. As a result of measuring the MIC of four kinds of fungi with high detection frequency in the surrounding environment, Gliocladium virens was 65 mg/mL by determined as MIC which can inhibit one hundred percent of mycelial growth. The concentration 90 mg/mL was determined as MIC against Aureobasidium pullulans and 100 mg/mL against Penicilium pinophilum and Chaetomium globosum. CW was considered a safe extract that showed no irritation even in the ocular mucous membrane irritation evaluation test, a patch test. Therefore, these results suggest that Coptis chinensis has antimicrobial, antifungal and safety on human body and can be applied to the development of materials for cosmetic and residential environment industries.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.471-477
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• 1999

Background : Smoking and high-risk occupation have been known to be the risk factors of lung cancer. The carcinogen-metabolizing enzymes in human body such as glutathione S-transferase M1, T1 and N-acetyltransferase 1 have also been regarded as risk factors in many cancers, because the activities of those enzymes play a role in metabolizing the carcinogen. A case-control study was conducted to evaluate the genetic polymorphism of GSTM1, T1 and NAT1 in lung carcinogenesis in Korean men. Methods : The histologically proven lung cancer cases were recruited from Seoul National University Hospital. The patients of more than 40-year-old with the nonmalignant urinary tract diseases were recruited as controls from the same hospitals. The informations of demographical characteristics and smoking were obtained by interview or chart review and the genetic polymorphisms of GSTM1, T1 and NAT1 were determined by PCR-based assay. The statistical analyses were performed by linear logistic regression. Results : The number of case-control was 118 and 150, respectively. The smoking history was significantly higher in the lung cancer patients than the controls. The prevalence of GSTM1 null-type was statistically higher(OR=2.25 ; 95% CI=1.12-4.51) in squamous cell carcinoma than other genotypes, but other histologic types were not The prevalence of GSTT1 null-type were not statistically higher than other genotypes in all histologic types. The fast acetylator of NAT1 was more prevalent than normal(OR=2.13 ; 95% CI=1.04-4.40) in all lung cancer patients. Conclusion : The null-type of GSTM1 and fast acetylator of NAT1 are associated with development of lung cancer in Korean men.

• Journal of the Korean Geographical Society
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• v.51 no.5
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• pp.613-632
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• 2016

The recent diagnosis of the Anthropocene challenges public understanding of nature as a pure and singular entity removed from society, as the diagnosis confirms the earth-changing force of humans. In geography, the nature-society divide has been critically interrogated long before the diagnosis of the Anthropocene, developing several ways of theorizing nature-society relations. This paper introduces a new frontier for such theoretical endeavors: more-than-human geography. Inspired by the material and performative turn in geography and the social sciences around the 2000s, more-than-human geographers have sought to re-engage with the livingness of the world in the study of nature-society relations. Drawing on actor-network theory, non-representational theory (NRT) and vitalism, they have developed innovative ways of thinking about and relating to nature through the key concepts of 'nonhuman agency' and 'affect'. While more-than-human geography has been extensively debated and developed in recent Euro-American scholarship on cultural and economic geography, it has so far received limited attention in Korean geographical studies on nature. This paper aims to address this gap by discussing the key concepts and seminal work of more-than-human geography. I first outline four theoretical strands through which nature-society relations are perceived in geography. I then offer an overview of more-than-human geography, discussing its theoretical foundations and considering ontologies, epistemologies, politics and ethics associated with nature-society relations. Then, I compare more-than-human geography with political ecology, which is the mainstream critical approach in contemporary environmental social sciences. I would argue that more-than-human geography further challenges and develops political ecology through its heightened attention to the affective capacity of nonhumans and the methodological ethos of doing a careful political ecology. I conclude by reflecting on the implications of more-than-human geography for Korean studies on nature-society relations.

• Clean Technology
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• v.18 no.1
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• pp.102-110
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• 2012

In this study, the production of bio-diesel from animal oil by esterification and trans-esterification was investigated. There were three different extraction methods for oil extraction from raw animal fat. Heterogeneous catalysts such as Amberlyst-15 and Amberlyst BD-20 and a homogeneous catalyst such as sulfuric acid were used for esterification. Among three catalysts, the removal efficiency of Free Fatty Acid (FFA) was the highest in sulfuric acid. Response surface method was carried out to find the optimal esterification condition of sulfuric acid and methanol. After the esterification under the optimal condition, this animal fat was used for the trans-esterification. Animal oil used for trans-esterification was below 1% of FFA content and 0.09% of water content. The catalysts for trans-esterification were KOH, NaOH and $NaOCH_3$. To investigate the effects of catalyst type and amount on trans-esterification, The amount of catalyst were changed with 0.3, 0.6 and 0.9 wt%. The molar ratio of methanol/oil was changed with 4, 6, 9 and 12. The amount of catalyst was fixed to 0.8 wt%. The KOH catalyst showed the highest FAME conversion for trans- esterification, and the optimal methanol/oil weight ratio was 6. In the experiments of various catalysts and methanol molar ratios, the highest content of FAME is 96%. However, this FAME content was below Korean bio-diesel standard which is 96.5% of FAME content. After distillation, FAME content increased to 98%.

• Korean Journal of Plant Resources
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• v.27 no.1
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• pp.80-88
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• 2014

This study was carried out to understand the effect of sowing date on growth characteristics, flower duration of a total of 6 domestic rapeseed cultivars, "Sunmang", "Tammiyuchae", "Tamlayuchae", "Naehanyuchae", "Yongsanyuchae" and "Hallayuchae" with different sowing dates (25 Sept., 5 Oct., 15 Oct., 25 Oct., 5 Nov.) in Muan, Jeollanamdo, Republic of Korea. The results obtained were summarized as the follows: The number of seedling stand after overwintering was decreased in all 6 cultivars. It changed little until 5 Oct., and then showed continuously largely decrease as the sowing date being delayed. As the sowing date was being delayed, plant height was decreased while Silique length and thousand seed weight were increased. Seed yield in all 6 cultivars decreased almost linearly with late sowing date. In correlation analysis between the delaying sowing date and growth characteristics, it was inversely correlated with plant height ($r=-0.769^{**}$), No. of branches/plant ($r=-0.760^{**}$), No. of siliqua/panicle ($r=-0.631^{**}$) and seed yield ($r=-0.946^{**}$), while showed a positive correlation with silique length (r=0.635), seed diameter ($r=0.629^{**}$) and thousand grain weight ($r=0.422^*$). No. of seeds/silique and seed set percentage were not significantly correlated with the delaying sowing date. The flower duration was long in order of Sunmang, Tammiyuchae, Yongsanyuchae, Naehanyuchae, Hallayuchae and Tamlayuchae. Varietal variation of flowering date was larger with early sowing date than with delaying sowing date. The range of flower duration across all cultivars was from 1 day of Tamlayuchae to 14 days of Sunmang according to the sowing date, and the end flowering date was able to be extended from 2 to 9 days, compared to normal date of end flowering.