• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Journal of Korean Philosophical Society
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• no.119
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• pp.129-159
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• 2017

The study of Freud's Moses and the background of the establishment of monotheism has become a subject of attention in the new atmosphere of the spreading of political theology and the recent rediscovery of Egyptology. This paper examines the publishing background and intentions of Freud's last book, Moses and Monotheism. And it will emphasize the fact that the Moses-Egyptian theory and his criticism of monotheism hid political theological intentions to prevent the spread of anti-Semitism in Nazi Germany. According to the Egyptologist Jan Assmann, there is a difference in that Moses' Judaism is monotheism, but Akhenaten's Aton-religion is a cosmotheism, and while Freud emphasizes Moses the 'historical figure' of that name, Assmann refers to Moses as a 'mnemohistorical figure.' Just as Freud said that the source of Jewish hatred is in Moses himself who established monotheism, Assmann argues also, monotheism is based on the so-called "Mosaic distinction" that distinguishes between true religion and false religion, thus it is possible to dismantle oppression and violence through the abolition of the Mosaic distinction. Assmann estimates that Freud had a clear stance to stop the spread of anti-Semitism as "the most explicit opponent of the Mosaic distinction." While anti-Semitic hatred spread to Christians in the Nazi era, Freud regards the real founder of Christianity, a jew Paul, as both a "Judaism destroyer" and a "successor to Judaism." At this point, Taubes began to see Paul's theology from a political theological point of view, and Assmann succeeded it. The "historical Moses" described by Freud are not "Prophet Moses" but "Moses as lawmaker and political reformer", and Jewish hatred has arisen in his distinction. Thus, Freud's monotheistic criticism as "disintegration by historical reduction"(Nietzsche) has political theological power. Just as Taubes interpreted Paul as a political theologian, Assmann found political theological elements in Freud's criticism of monotheism.

• Journal of Bio-Environment Control
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• v.28 no.3
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• pp.243-254
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• 2019

With the recent accelerated policy-making and interests in new renewable energy, plans to develop and supply the new renewable energy have been devised across multiple regions in Korea. Solar energy, in particular, is being applied to small-scale power supply in provincial areas, as solar cells are used to convert solar energy into electric energy to produce electric power. Nonetheless, in the case of solar power plants, the need for a large stretch of land and considerable sum of financial support implies that the planning step should take into consideration the most suitable meteorological and geographical factors. In this study, the proxy variables of meteorological and geographical factors associated with solar energy were considered in analyzing the vulnerable areas regarding the photovoltaic power generation facility across the nation. GIS was used in the spatial analysis to develop a map for assessing the optimal location for photovoltaic power generation facility. The final vulnerability map developed in this study did not reveal any areas that exhibit vulnerability level 5 (very high) or 1 (very low). Jeollanam-do showed the largest value of vulnerability level 4 (high), while a large value of vulnerability level 3 (moderate) was shown by several administrative districts including Gwangju metropolitan city, Jeollabuk-do, Chungcheongbuk-do, and Gangwon-do. A value of vulnerability level 2 (low) was shown by the metropolitan cities including Daegu, Ulsan, and Incheon. When the 30 currently operating solar power plants were compared and reviewed, most were found to be in an area of vulnerability level 2 or 3, indicating that the locations were relatively suitable for solar energy. However, the limited data quantity for solar power plants, which is the limitation of this study, prevents the accuracy of the findings to be clearly established. Nevertheless, the significance of this study lies in that an attempt has been made to assess the vulnerability map for photovoltaic power generation facility targeting various regions across the nation, through the use of the GIS-based spatial analysis technique that takes into account the diverse meteorological and geographical factors. Furthermore, by presenting the data obtained for all regions across the nation, the findings of this study are likely to prove useful as the basic data in fields related to the photovoltaic power generation.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.1-11
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• 2019

Purpose: Congenital hypothyroidism (CH) is the most common congenital endocrine disorder. The purpose of the present study was to determine the incidence of CH in South Korea during the period from January 1991 to March 2004. Methods: Central data from each city branch of SCL (Seoul Clinical Reference Laboratories) in Yongin, South Korea, was gathered and collectively analyzed. Newborn screening (NBS) for CH was based on measuring the levels of neonatal thyroid stimulating hormone (TSH) and free T4 (a cut-off of 20 mIU/L and less than 0.8 ng/dL, respectively). Results: During the study period, 671,805 live births were screened for CH based on TSH and free T4 ELISA assays. A total of 159 newborns were deemed positive for CH out of 671,805, with a corresponding incidence of 1 in 4,225. When a cut-off of 20 mIU/L was used in TSH assays, the associated sensitivity, specificity, and positive predictive values (PPV) were 100.0%, 99.7%, and 10.8%, respectively. When a cut-off of 0.8 ng/dL in free T4 assays was used, the associated sensitivity, specificity, and PPV were 100.0%, 98.5%, and 3.9%, respectively. Conclusion: CH incidence in South Korea as evidenced by the results of NBS was compared with its incidence and comparable to the other countries prior to 2004.

• Journal of Environmental Impact Assessment
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• v.28 no.3
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• pp.183-200
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• 2019

In this study, the characteristics of seasonal $PM_{2.5}$ behavior in South Korea and other Northeast Asian regions were analyzed by using the $PM_{2.5}$ ground measurement data, weather data, WRF and CMAQ models. Analysis of seasonal $PM_{2.5}$ behavior in Northeast Asia showed that $PM_{2.5}$ concentration at 6 IMS sites in South Korea was increased by long-distance transport and atmospheric congestion, or decreased by clean air inflow due to seasonal weather characteristics. As a result of analysis by applying BFM to air quality model, the contribution from foreign countries dominantly influenced the $PM_{2.5}$ concentrations of Baengnyeongdo due to the low self-emission and geographical location. In the case of urban areas with high self-emissions such as Seoul and Ulsan, the $PM_{2.5}$ contribution from overseas was relatively low compared to other regions, but the standard deviation of the season was relatively high. This study is expected to improve the understanding of the air pollutant phenomenon by analyzing the characteristics of $PM_{2.5}$ behavior in Northeast Asia according to the seasonal weather condition change. At the same time, this study can be used to establish the air quality policy in the future, knowing that the contribution of $PM_{2.5}$ concentration to the domestic and overseas can be different depending on the regional emission characteristics.

• Korean Journal of Environmental Agriculture
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• v.37 no.3
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• pp.189-196
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• 2018

BACKGROUND: Water quality management of river requires quantification of pollutant loads and implementation of measures through monitoring study, but it requires labour and costs. Therefore, many researchers are performing nonpoint source pollution analysis using computer models. However, calibration of model parameters needs observed data. Nitrogen concentration in rainfall is one of the factors to be considered when estimating the pollutant loads through application of the nonpoint source pollution model, but the default value provided by the model is used when there are no observed data. Therefore, this study aims to provide the representative nitrogen concentration of the rainfall for the administrative district ensuring rational modeling and reliable results. METHODS AND RESULTS: In this study, rainfall monitoring data from June 2015 to December 2017 were used to determine the nitrogen concentration in rainfall for each administrative district. Range of the $NO_3{^-}$ and $NH_4{^+}$ concentrations were 0.41~6.05 mg/L, 0.39~2.27 mg/L, respectively, and T-N concentration was 0.80~7.71 mg/L. Furthermore, the national average of T-N concentration in this study was $2.84{\pm}1.42mg/L$, which was similar to the national average of T-N 3.03 mg/L presented by the Ministry of Environment in 2015. Therefore, the nitrogen concentrations suggested in this study can be considered to be resonable values. CONCLUSION: The nitrogen concentrations estimated in this study showed regional differences. Therefore, when estimating the pollutant loads through application of the nonpoint source pollution model, resonable parameter estimation of nitrogen concentration in rainfall is possible by reflecting the regional characteristics.

• Journal of Climate Change Research
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• v.5 no.1
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• pp.83-94
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• 2014

Gangnam-gu, where the survey of residents' consciousness has been made in this study, is the district shows the highest rate of the energy consumption and greenhouse gas emission per unit area except some industrial districts such as Gwangyang, Ulsan, and Pohang. The greenhouse gas emission amount of Gangnam-gu is 4,863,765 $tCO_2$ which accounts for 10 % of the total discharging amount of Seoul, 50,330,356 $tCO_2$, which is ranked the top greenhouse gas emission rate in the commercial category and the 2nd place in the household category. The average recognition rate for the 5 subjects of the global warming phenomenons has indicated to be 83.58%. A survey questioning about the main agent to reduce the greenhouse gas, in all age groups except 20s have replied that it should be done by themselves, the residents of Gangnam-gu. For the question of the role of local government to respond to the climate change, the necessity of establishing infrastructure which is suitable for walking and biking. For the other question about the educational facilities to cope with the climate change, many answered the relevant education should be processed from the middle and high schools. For the practical activities in daily life to respond to the climate change, many replies have shown that the energy and resource conservation has been practiced pretty well broadly, but the ecomileage (former carbon mileage) has not been practiced well. Also, many replies have pointed that there were no benefits or rewards for the people who practiced the eco-mileage in their daily lives, which indicates that a kind of incentive is necessary for the efforts to respond to the climate change from the local government to execute the policy substantially and effectively. This study has the purpose to search the political countermeasures to improve the potentiality to reduce the green house gas emission rate through the residents conscious survey about climate change and the political solution by the local government to improve the certain items which showed the lower awareness rate.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.87-93
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• 2018

Background and Objectives : Laryngopharyngeal reflux disease (LPRD) is relatively common disease. N-acetyl cysteine (NAC) has both mucolytic and antioxidant effect, also may be beneficial in inflammatory airway diseases. The purpose of this study was to evaluate the efficacy and safety of inhaled NAC therapy in LPRD. Materials and Method : We retrospectively reviewed the medical records of 525 LPRD patients at 12 medical centers. Finally 401 patients subjected to inhaled NAC therapy for 2 months were enrolled in the study. We analyzed the change of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) after use of NAC for 4 weeks and 8 weeks in addition to the patient's compliance of the treatment. Results : The RSI score significantly decreased from $19.87{\pm}6.34$ to $12.78{\pm}6.93$ after 4 weeks and to $10.65{\pm}7.47$ after 8 weeks. The RFS score also significantly decreased from $9.29{\pm}3.4$ to $7.17{\pm}3.41$ after 4 weeks and to $6.1{\pm}3.73$ after 8 weeks (p<0.05). During the treatment periods, 42 patients (10.4%) reported to have 80 episodes of discomfort. Throat discomfort (33%) and nausea (28%) were most common complaints, but the duration of discomfort was usually less than 4 weeks. Conclusion : Inhaled NAC treatment is highly effective for the reduction of both subjective and objective findings in LPRD patients. This study will provide the evidence of new treatment option for patients with LPRD. However, further studies will be needs to assess the real effect of inhaled NAC therapy as a standard treatment regimen of LPRD.

• Korean Journal of Heritage: History & Science
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• v.42 no.3
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• pp.66-87
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• 2009

The definition of the structure of wooden chamber tomb(piled stone-type) is as follows. It is a tomb with wooden chamber, and stones were piled on top of the wooden chamber, and then a wooden structure was placed on top of the piled stones, and more stones were piled on top of the wooden structure, and sealed with clay. Of course this definition can vary according to periods, the buried, etc. Gyeongju-style piled stone type wooden chamber tombs have some distinguished characteristics compared to general definition of piled stone type wooden chamber tombs. Outside the wooden chamber, either stone embankments or filled-in stones were layed out, and pilet-in stones are positioned right above the wooden chamber, and almost every class used this type, and finally, it is exclusively found in Gyeongju area. First generations of this Gyeongju-style piled stone type wooden chamber tombs appeared in first half of 5th century. These tombs inherited characteristics like ground plan, wooden chamber, double chamber(inner chamber and outer chamber), piled stones, burial of the living with the dead, piled stones, from precedent wooden chamber tombs. However these tombs have explicit new characteristics which are not found in the precedent wooden chamber tombs such as stone embankments, wooden pillars, piled stones(above ground level), soil tumuluses. stone embankments and wooden pillars are exclusively found on great piled stone type above-ground level wooden chamber tombs such as the Hwangnamdaechong(皇南大塚). Stone embankments, wooden pillars, piled stones(above ground level) are all elements of building process of soil tumuluses. stone embankments support outer wall of above-ground level wooden chambers and disperse the weight of tumuluses. Wooden pillars functioned as auxiliary supports with wooden structures to prevent the collapse of stone embankments. Piled stones are consists of stones of regular size, placed on the wooden structure. And after the piled stones were sealed with clay, tumulus was built with soil. Piled stones are unique characteristics which reflects the environment of Gyeongju area. Piled stone type wooden chamber tombs are located on the vast and plain river basin of Hyeongsan river(兄山江). Which makes vast source of sands and pebbles. Therefore, tumulus of these tombs contains large amount of sands and are prone to collapse if soil tumulus was built directly on the wooden structure. Consequently, to maintain external shape of the tumulus and to prevent collapse of inner structure, piled stones and clay-sealing was made. In this way, they can prevent total collapse of the tombs even if the tumulus was washed away. The soil tumulus is a characteristic which emerges when a nation or political entity reaches certain growing stage. It can be said that after birth of a nation, growing stage follows and social structure will change, and a newly emerged ruling class starts building new tombs, instead of precedent wooden chamber tombs. In this process, soil tumulus was built and the size and structure of the tombs differ according to the ruling class. Ground plan, stone embankments, number of the persons buried alive with the dead, quantity and quality of artifacts reflect social status of the ruling class. In conclusion, Gyeongju-style piled stone type wooden chamber tombs emerged with different characteristics from the precedent wooden chamber tombs when Shilla reached growing stage.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.24-30
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• 2019

Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.