• Journal of Chest Surgery
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• 제55권1호
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• pp.10-19
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• 2022

Background: According to the eighth TNM (tumor-node-metastasis) staging system, the presence of separate tumor nodules in the same lobe is designated as a T3 descriptor. However, it remains unclear whether adjuvant chemotherapy confers survival advantages in this setting. Methods: We retrospectively identified 142 pathologic T3N0M0 patients with additional pulmonary nodules in the same lobe from a single-institutional database from 2004 to 2019. The main outcomes were overall survival and recurrence-free survival. Multivariable Cox regression was used to identify the benefit of adjuvant chemotherapy while adjusting for other variables. Results: Sixty-one patients received adjuvant chemotherapy (adjuvant group) and 81 patients did not receive adjuvant therapy after surgery (surgery-only group). There were no demonstrable differences between the 2 groups regarding hospital mortality and postoperative complications, indicating that treatment selection had not significantly occurred. However, the use of adjuvant chemotherapy was associated with improved 5-year overall survival (70% vs. 59%, p=0.006) and disease-free survival (60% vs. 46%, p=0.040). A multivariable Cox model demonstrated that adjuvant chemotherapy was associated with a survival advantage (adjusted hazard ratio, 0.54; p<0.001). In exploratory analyses of subgroups, the effect of adjuvant chemotherapy seemed to be insufficient in those with small main tumors (<4 cm). Conclusion: Adjuvant chemotherapy was associated with better survival in T3 cancers with an additional tumor nodule in the same lobe. However, the role of adjuvant chemotherapy in patient subgroups with small tumors or those without risk factors should be determined via large studies.

• 대한통합의학회지
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• 제10권4호
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• pp.121-136
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• 2022

Purpose : Marine therapy is an activity that promotes public health such as constitution improvement, immunity improvement, and anti-aging by utilizing marine therapeutic resources such as seawater, mud, seaweed, salt and sea climate. In Europe developed countries, the marine therapy industry has been developing for centuries, with France, Germany, and Israel leading the way. Currently, it has achieved great industrial achievements and is of great help in improving the human health. The purpose of this study is to investigate how marine therapeutic resources benefit to human health, as well as how to study and utilize their efficacy. We analyzed previous research articles related to the effects of marine therapeutic resources. Methods : The study included a total of 830 published literatures in the last 20 years from the Republic of Korea and other contries. PubMed and Google Scholar were utilized to collect the foreign source while the local scientific publications were accessed through the Korean Education and research Information Service (KERIS) and Korean studies Information Service System (KISS). The keywords used to search foreign literature were "marine therapy", "Thalassotherapy", "seawater", "deep seawater", "saline groundwater", "sand therapy", "mud therapy", "hydrotherapy", "seaweed", "Sun light", "sea salt", "marine animal", and "marine microorganisms" were combined, and for the domestic literature, the keywords were "marine therapy", "marine therapeutic resources", "seawater", and "sand". Results : A total of 830 research papers were found as a result of searching for domestic and international papers related to marine therapeutic resources. The collected documents were classified into 175 seawater resources, 259 marine mineral resources, 41 marine environment, and 355 marine organisms. The efficacy of each marine therapeutic resources was analyzed. By resources type, there were about 213 papers on the efficacy of seaweed, followed by about 175 papers on seawater, 142 on microorganisms, 124 on mud/peat, and sand, salt, minerals and others are appeared in order (Table 1). Conclusion : Korea has the highest marine biodiversity index, excellent tidal flats, four distinct seasons, and various sea environments of the East sea, Yellow sea, South sea and Jeju sea. For this reason, Korea has a much more diverse marine therapeutic resources than other advanced countries in the marine therapy industry. prebiously, we thought that the sea was only valuable as a shipping port and fishery industry. But now, it been shown that the ocean can become a new industrial field which can contribute to human health and well-being by providing healing and therapy to people through the gift of marine resources.

• 대한기관윤리심의기구협의회지
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• 제4권2호
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• pp.36-41
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• 2022

Purpose: The purpose of this study is to evaluate how university hospital Institutional Review Boards (IRBs) in Korea classify risk when reviewing clinical trial protocols. Methods: IRB experts (IRB chairman, vice chairman, IRB administrator) in the university hospitals obtaining a Human research protection program (HRPP) or IRB accreditation in Korea were asked to fill out the Google Survey from September 1, 2020 to October 10, 2020. Result: Among the 23 responder hospitals, 8 were accredited by the American Association for Human Research Protection Program (AAHRPP) and 8 were accredited by the HRPP of Ministry of Food and Drug Safety (MFDS). Seven were accredited by Forum for Ethical Review Committees in Asia and the Western Pacific or Korea National Institution for Bioethics Policy. Thirteen of 23 hospitals (56.5%) had 4 levels (less than minimal, low, moderate, high risk), 4 hospitals had 3 levels (less than, slightly over, over than minimal risk), 1 hospital had 5 levels (4 levels plus required data safety monitoring board), and 1 hospital had 2 levels (less than, over than minimal risk) risk classification system. Thirteen of 23 hospitals (56.5%) had difficulty classifying the risk levels of research protocols. Fourteen hospitals (60.9%) responded that different standards among hospitals for risk level determination associated with clinical trials will affect the subject protection. Six hospitals (26.1%) responded that it will not. Three hospitals (13.0%) responded that it will affect the beginning of the clinical trial. To resolve differences in standards between hospitals, 14 hospitals (60.9%) responded that either the Korean Association of IRB or MFDS needs to provide a guideline for risk level determination in clinical trials: 5 hospitals (21.7%) responded education for IRB members and researchers is needed; 3 hospitals (13.0%) responded that difference among institutions needs to be acknowledged; and 1 hospital (4.3%) responded that there needs to be communication among IRB, investigator, and sponsor. Conclusion: After conducting a nationwide survey on how IRB in university hospital determines risk during review of clinical trials, it is reasonable to use 4-level risk classification (less than minimal, low, moderate, high risk); the most utilized method among hospitals. Moreover, personal information and conflict of interest associated with clinical trials have to be considered when reviewing clinical trial protocols.

• 한국엔터테인먼트산업학회논문지
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• 제13권1호
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• pp.11-24
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• 2019

본 논문은 남북한 공연프로그램 교류·협력에 있어서 향후 예상되는 문제점을 북한저작권법상 공연 관련 조항을 중심으로 살펴보았다. 북한의 저작권법은 국제사회의 보편적인 규정과는 상당한 차이가 있거나 미비된 것이 많았다. 즉, 북한 저작권법의 기조와 원칙의 문제, 체제에 반하는 저작물의 불인정 문제, 남한저작물의 저작권리에 대한 호혜평등의 문제, 저작 인접권 및 재산권의 문제, 저작인격권의 무기한 보호문제, 온라인 저작물에 대한 권리보호의 불비문제 등이다. 한편, 단기적으로 상호 교류협력이 가능한 공연프로그램은 민족가극, 연극 및 뮤지컬, 축제이벤트 등이다. 그러나 지속적인 교류·협력 활성화하기 위해서는 남북한 상이한 저작권 규정 내용에 대한 법적·제도적 개선방안이 필요하다. 대외적으로는, 남북한이 각종 국제저작권 사용계약을 공동 체결하는 등 국제저작권 무대에서 공조할 필요성도 있으며, 이를 통해서 쌍방이 신뢰를 구축하고 민족정서를 담은 공연프로그램의 해외 진출까지도 염두해야 할 것이다.

• 한국농촌건축학회논문집
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• 제24권4호
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• pp.41-48
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• 2022

The purpose of this study is to present the implications of the rural living area setting and rural spatial structure analysis of the rural spatial strategy plan through case analysis. Following the decentralization of autonomy and the promotion of the transfer of state affairs to local areas, some of the general agricultural and fishing village development projects of the Ministry of Agriculture, Food and Rural Affairs were transferred to local areas. In addition, in 2020, the Ministry of Agriculture, Food and Rural Affairs introduced a rural agreement system for 113 cities and counties. However, since the understanding of the field is still low, this study attempted to present implications through a case analysis of the structure of rural space and the establishment of rural living areas in three local governments in Chungcheong. As a result of the study, in the stage of establishing the living zone, it is necessary to comprehensively review the contents reviewed in the analysis of the current status and conditions. However, the two local governments had insufficient interpretation of the axis by function and the establishment of the base area, or were using the upper plan as it was. Second, the source of the data used in the survey on the distribution status of living SOC facilities is unclear. Since the distribution status of living SOC facilities overlaps with accessibility analysis, OD data analysis, and resident survey results and is used as the basis for setting living areas, the data source should be clearly marked, and verification should be possible. Third, amenity (facility) resources were classified and analyzed according to the conditions and characteristics of local governments. The local government that applied the guidelines as they were was A local government, and the remaining local governments conducted surveys and analysis according to the current status. Forth, since the establishment of the rural living area is the minimum unit supported by government policies through future rural agreements, it is necessary to distinguish them based on quantitative standards in the process of establishing them. Only one case area presented clear grounds and standards, and the rest of the case areas presented standards but are based on non-quantitative standards. In order for rural agreements to be sustainable in the future and benefit local residents, it is necessary to use or establish a government-level institution that can collect and produce objective data. In addition, it is necessary to find ways to specify and standardize the standards for setting the living area and specify them in the guidelines.

• 환경영향평가
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• 제32권6호
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• pp.488-502
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• 2023

생태계서비스 계정은 생태계 공급 기능과 수요, 그리고 그 사이에서 발생하는 실제 서비스 흐름을 측정해야 한다. 흐름을 측정하기 위해서는 공급과 수요 관계를 정의해야 하며, 복잡한 연결 관계를 객관화 할 수 있는 방법론이 필요하다. 국내에서는 생태계서비스에 대한 연구가 다양하게 진행되어 왔으나, 생태계서비스 계정화에 관한 연구는 부족하다. 본 연구의 목적은 환경경제통합계정(SEEA)의 실험적 생태계계정(EEA)에서 연구된 EU 방법론을 적용하여 홍수조절 생태계서비스를 평가하고 이를 토대로 생태계 계정 도입 방안을 모색하는데 있다. 연구수행을 위해 생태계의 유출량 보유 잠재력, 홍수조절에 대한 사회·경제적 수요, 그리고 그 사이의 관계로부터 형성되는 실제 서비스 혜택 흐름을 공간 기반으로 모델링하고 정량화하였다. 홍수조절 생태계서비스 실제 흐름을 산정한 결과, 국내 전체 서비스량은 165,595ha로 산출되었으며 많은 부분이 농경지에 집중되고 있음을 확인할 수 있었다. 향후 국내 홍수조절 서비스 계정 정밀화 도입을 위해서는 토지피복도와 같은 핵심 공간자료가 지속해서 구축 관리되어야 하며, 국가, 지역, 유역 등 다양한 공간 범위에서 적용 가능한 입력자료 및 방법론에 대한 연구가 필요할 것으로 보인다.

• 한국심리학회지 : 문화 및 사회문제
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• 제8권1호
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• pp.165-187
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• 2002

본 연구는 생명공학과 관련 기술의 활용에 대한 일반 국민들의 인식과 태도, 그리고 그 인식과 태도에 영향을 미치는 심리적 요인들에 대해 탐색해 보려 하였다. 대학생과 일반 성인집단을 대상으로 생명공학과 기술에 대한 자유연상 반응 및 질문지 응답을 통해 얻어진 결과를 분석하였다. 생명공학 연구 및 기술활용과 관련한 한국 성인들의 인식 내용은 '인간의 존엄성 손상' '인체에 유해한 부작용' '도덕적 혼란' '상업적 악용' 등의 불확실성이나 부작용에 대한 염려와 '질병치료' '수명연장' '식량문제 해결' 등의 긍정적 기대를 중심으로 표상되어 있었다. 생명공학 및 그 기술 활용과 관련한 대학생들의 관심과 인지도는 비교적 높았고, 관련 정보를 얻는 주된 출처는 'TV'와 '신문' 및 '인터넷' 등이었으며, 생명공학이 사회에 미치는 영향의 판단에 대해 신뢰하는 집단으로 '과학자'와 '시민단체'를 들고 있었다. 생명공학 기술의 적용에는 호의적인 태도를 보이지만, '유전자변형 콩으로 만든 두부'의 부작용을 염려하고 먹지 않겠다는 반응이 많았다. 또 개인 유전정보를 사회적이나 공적으로 이용하거나 관리하는 데 대해서는 매우 부정적인 태도를 보이고 있었다. '급진성'과 '행동활성화 체계의 민감성' 및 '신뢰감'과 '적개심' 등의 심리적 속성들이 생명공학 및 그 기술의 활용과 관련한 '관심과 인지도' 및 '기술의 활용의도'와 의미 있게 관련되어 있었다. 또 생명공학에 대한 인지도가 높다고 해서 호의적인 태도가 높은 것은 아니었다. 끝으로 본 연구에서 얻어진 결과의 의미와 추후 연구에 대해 논의하였다.

• 의료법학
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• 제24권4호
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• pp.37-63
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• 2023

의료소송에서 의사의 환자에 대한 '설명'이 문제되는 경우는 다양하다. 진단의 초기부터 시작하여 수술 등의 치료과정, 치료를 위해 입원이 필요한 경우, 입원 중과 퇴원 시, 그리고 퇴원 후에 이르기까지 의학적인 설명과 지도가 의사에게 요구된다. 나아가 의료행위로 인하여 발생하게 될 경제적 비용에 대하여도 의사 혹은 의료기관의 고지가 요청되기도 한다. 우리나라 사법부는 이와 같은 의사의 설명에 대하여 진료의 단계 및 의료법 등 관계법령을 고려하여 의료행위에 대한 동의를 구하기 위한 설명과 환자의 요양방법 지도와 관련된 진료상 설명을 구분하여 법리를 전개해 오고 있다. 또한 헌법재판소는 경제적 비용에 관한 설명과 연계된 비급여 비용 고지 제도에 관하여 최근 판단하기도 하였다. 그런데 의사의 설명이 불충분하였다는 것만을 이유로 의사에게 책임을 추궁을 하는 것은 임상현실의 실제 상황과 부합하지 않는 측면이 존재하고, 오히려 의권의 위축을 초래하는 반사적인 불이익이 있을 수 있다. 따라서 의사의 설명은 환자의 자기결정권 보장과 의권 보호라는 양측면에서 살펴보아야 할 필요가 있다.

• 벤처혁신연구
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• 제7권1호
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• pp.17-39
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• 2024

본 연구는 정부의 R&D 지원과 벤처기업의 스톡옵션제도 활용이 벤처기업의 혁신, 즉 혁신역량 및 혁신성과에 미치는 영향을 분석하고자 하였다. 이를 위해 국내 벤처확인기업을 대상으로 진행된 벤처기업정밀실태조사 자료를 활용해 부분최소제곱 구조방정식모델링(PLS-SEM) 방법으로 실증분석을 실시하였다. 분석 결과, 정부 R&D 지원의 수혜 여부는 벤처기업의 혁신역량 강화에 정(+)의 영향을 미치는 것으로 나타났으며, R&D 지원은 벤처기업의 혁신성과에도 정(+)의 영향을 미치는 것으로 나타났다. 또한 벤처기업의 스톡옵션제도 활용은 기업의 혁신역량 강화에 정(+)의 영향을 미치고, 벤처기업의 혁신성과에도 정(+)의 영향을 미치는 것으로 나타났다. 벤처기업의 혁신역량은 정부의 R&D 지원 및 벤처기업의 스톡옵션제도 활용과 기업의 혁신성과 사이를 유의하게 매개하는 것으로 나타났다. 이러한 분석결과들은 벤처기업의 혁신에 있어서 정부의 R&D 지원과 스톡옵션 제도의 활용이 의미있는 역할을 할 수 있음을 보여주며, 아울러 혁신의 프로세스에서 벤처기업의 혁신역량이 중요한 의미가 있음을 보여준다. 따라서 벤처기업에 대한 R&D 지원의 기조를 꾸준히 이어나가면서 동시에 기업의 역량강화를 지원하는 다면적 정책수단을 투입할 필요가 있으며, 스톡옵션제도의 활성화를 위한 법적·제도적 정비와 정책적 지원이 지속적으로 이루어질 필요가 있을 것으로 보인다.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.