• 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.

• Journal of Life Science
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• v.24 no.12
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• pp.1371-1377
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• 2014

Superoxide dismutase is a family of important antioxidant metalloenzymes and catalyzes the dismutation of toxic superoxide anions into dioxygen and hydrogen peroxide. A recent study identified the partial superoxide dismutase (SOD) gene in olive flounder (Paralichthys olivaceus). The same study reported that it strongly induced benzo[a]pyrene and that it was an indicator of aquatic oxidative stress responses. However, its transcriptional response against viral infection has not been investigated. In the present study, the spatial and temporal expression profiles were analyzed to investigate the function of Of-SOD in the antiviral response. The Of-SOD transcripts were ubiquitously detected at various levels in diverse tissues in a real-time PCR. The expression of Of-SOD was significantly higher in the muscles, liver, and brain but extremely low in the stomach and spleen. Following a VHSV challenge, the expression of Of-SOD increased within 3 h in the kidneys and decreased to the original level 2 days postchallenge. In muscle, liver, and brain, Of-SOD mRNA was similarly up-regulated at 3-6 h postchallenge and then decreased to the basal level. Although the expression pattern and induction time differed slightly depending on the tissue, the transcript of Of-SOD consistently increased in the acute infection response, but the expression was low in the chronic response. The expression of Of-SOD was induced after the VHSV infection, and Of-SOD was probably involved in the immune response against the viral challenge. These results suggest that SOD may play important roles in the immune defense system of P. olivaceus and perhaps contribute to the protective effects against oxidative stress in olive flounder.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.752-759
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• 1997

Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.468-477
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• 2009

Purpose: Hydrodynamic-based procedure is a simple and effective gene delivery method to lead a high gene expression in liver tissue. Non-invasive imaging reporter gene system has been used widely with herpes simplex virus type 1 thymidine kinase (HSV1-tk) and its various substrates. In the present study, we investigated to image the expression of HSV1-tk gene with 5-(2-iodovinyD-2'-deoxyuridine (IVDU) in mouse liver by the hydrodynamicbased procedure. Materials and Methods: HSV1-tk or enhanced green fluorescence protein (EGFP) encoded plasmid DNA was transferred into the mouse liver by hydrodynaminc injection. At 24 h post-injection, RT-PCR, biodistribution, fluorescence imaging, nuclear imaging and digital wholebody autoradiography (DWBA) were performed to confirm transferred gene expression. Results: In RT-PCR assay using mRNA from the mouse liver, specific bands of HSV1-tk and EGFP gene were observed in HSV1-tk and EGFP expressing plasmid injected mouse, respectively. Higher uptake of radiolabeled IVDU was exhibited in liver of HSV1-tk gene transferred mouse by biodistribution study. In fluorescence imaging, the liver showed specific fluorescence signal in EGFP gene transferred mouse. Gamma-camera image and DWBA results showed that radiolabeled IVDU was accumulated in the liver of HSV1-tk gene transferred mouse. Conclusion: In this study, hydrodynamic-based procedure was effective in liver-specific gene delivery and it could be quantified with molecular imaging methods. Therefore, co-expression of HSV1-tk reporter gene and target gene by hydrodynamic-based procedure is expected to be a useful method for the evaluation of the target gene expression level with radiolabeled IVDU.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.6 no.3
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• pp.142-151
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• 2001

Detailed interpretation of some high-resolution seismic profiles in Yosu Strait reveals that Late Quaternary deposits consist of three allostratigraphic units (UH, LH, PL) formed by fluvial and tidal controls. The top mud unit, UH, thins onshore, and overlies the backstepping modem Seomjin delta deposits, which is interpreted as a transgressive systems tract (757) related to Holocene relative sea-level rise. The unit LH below the unit UH is composed of delta, valley- and basin-fill facies. The delta facies (Unit $LH_1$) occurs only in Gwangyang Bay and shows two prograding sets retrogradationaly stacked, thus it is also interpreted as a transgressive systems tract(757). On the contrary, the valley- and basin-fill facies (Unit $LH_2$), interpreted as 757, occur between the units UH and PL (Pleistocene deposits) in Yosu Strait. The bounding surface between UH and $LH_2$ can be interpreted as a tidal ravinement surface on the basis of trends thinning toward inner bay and becoming young landward. Furthermore its geomorphological pattern is similar to that of recent tidal channels. This allostratigraphy in'ffsu Strait suggests that two 757 deposits (UH and $LH_2$), divided by tidal ravinement surface, have been formed in Yosu Strait, whereas in Gwangyang Bay backstepping delta deposits ($LH_1$) without tidal ravinement surface have been formed during Holocene sea-level rise. These characteristics indicate that different stacking patterns could be formed in these two areas according to different increasing rate of accommodation space caused by different geomorphology, sediment supply and tidal-current patterns even in the same period of Holocene sea-level rise.

• Journal of Bio-Environment Control
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• v.9 no.3
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• pp.166-170
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• 2000

Three methods for heat collection, which were the flat solar collector, two fan with radiator, and square pipe method, were studied to sue efficiently solar energy in the three different glasshouses for two years. The flat plate solar collector method was made use of the commercial solar collector with collection area of 24$m^2$, the method of two fans with radiators collected solar energy at the top of the glasshouse. An thermal storage tank was constructed underneath in teach glasshouses. When an area of 1,000$m^2$ was heated to the minimum temperature of 9$^{\circ}C$, the decrease rate of heating fuel for the flat plate solar collector, the fan attached radiator and the square pipe methods were 7%, 19% and 28% respectively. The flat plate solar collector method, which could be heated approximately 40-50$m^2$, was currently used by most of the farmer. Under the condition, the decrease rate of annual heating fuel was 14% which was not better for an economic annual heating fuel. If the fan with radiator method was operated, the use of installation and maintenance were required. So, it could not be good economic efficiency of solar heating. The heating efficiency of the square pipe method was relatively better thant those of the flat plate solar collector or the fan attached radiator. Since the cost of materials and its installation of the use of square pipe method was lower than any other method. However, corrosion of the pipe, greater shade in the greenhouse and strength against the square pipe were problems that should be overcome in the square pipe method.

• Journal of Engineering Education Research
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• v.12 no.1
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• pp.3-16
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• 2009

The purpose of this study is to prepare diverse measures to enhance the utilization of national authorized qualification. The detail objectives of this study are first, to re-establish the utilization scope and range of national authorized qualification through analysis of advance research and theory in various fields of learning on the function of qualification; and second, to set the direction to strengthen the utilization of national authorized qualification. Based on discussions on the various fields of learning on the function of qualification, this study divided the utilization scope of qualification into personal utilization for the benefit of the qualification acquirer him or herself and public utilization for the social and economic benefits. And according to this distinction, we prepared measures to strengthen the utilization of national authorized qualification. First of all, as a way to strengthen personal utilization of the national authorized qualification, we prepared measures to enhance accessibility and facilitate further improvement. As a means to enhance accessibility, we proposed restriction on setting the application condition, diversification of qualification authorization method, facilitation of partial qualification system and minimization of expense required to acquire qualification. Also for the further improvement, we proposed creation of job-level centered grade system and development of job-level centered qualification item by stage. For strengthening the public utilization of national authorized qualification, we come up with ways of strengthening flexibility, transparency, public trust and compatibility. As a way to strengthen flexibility, we proposed establishment of qualification demand monitoring system, expansion of direct participation of users on qualification management, establishment of qualification expiration period and its renewal. For the strengthening of transparency, we proposed to build general qualification information system and to utilize qualification recommendation system. To strengthen public trust, we proposed to strengthen the management of qualification management regulation, secure independency, establish internal audit system and strengthen post management of national authorized qualification. And lastly, we suggested that compatibility comparison standard between qualification and qualification level standard be developed for the strengthening of compatibility.

• Korean Journal of Agricultural and Forest Meteorology
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• v.17 no.1
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• pp.25-34
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• 2015

In this research, we applied a procedure of quality control (QC) to the agro-meteorological data measured at the Suwon weather station of Korea Meteorological Administration (KMA). The QC was conducted through six steps based on the KMA Real-time Quality control system for Meteorological Observation Data (RQMOD) and four steps based on the International Soil Moisture Network (ISMN) QC modules. In addition, we set up our own empirical method to remove erroneous data which could not be filtered by the RQMOD and ISMN methods. After all these QC procedures, a well-refined agro-meteorological dataset was complied at both air and soil temperatures. Our research suggests that soil moisture requires more detailed and reliable grounds to remove doubtful data, especially in winter with its abnormal variations. The raw data and the data after QC are now available at the NCAM website (http://ncam.kr/page/req/agri_weather.php).

• Journal of The Korean Association For Science Education
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• v.24 no.5
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• pp.851-868
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• 2004

The main purposes of this study is to develop a web-based STS biology instruction program (WB-STS) for the scientifically gifted students. The specific main research questions were as follows; 1. How can the WB-STS for biology education be developed and what are the primary components involved in it? 2. Is there any proper validity for developed the WB-STS in biology education? To solve the above mentioned problems, several procedures were applied. First, in order to develop WB-STS for the scientifically gifted students, NCISE, Renzulli' s Enrichment Triad Model and the Iowa Chautauqua program's main characteristics were analyzed systematically and the principles and general process for constructing WB-STS were examined. Additionally, the needs of students and the goals of Biology education were identified thoroughly. And then all these ideas were embodied in an agenda for constructing WB-STS. Second, to analyse the validity and utility of developing WB-STS, a questionnaire was developed and submitted to seven specialists and a group of twenty students who would participate in the experiment later. The main results of study are summarized below: First, WB-STS appeared to be successfully constructed based on Renzulli' s Enrichment Triad Model and the Iowa Chautauqua program. Its main features are that it was made emphasizing a learner-centered approach and constructive learning. It is composed of five steps: Scientific theme selection -${\rightarrow}$Exploration ${\rightarrow}$ Concept & Principle Check ${\rightarrow}$ Finding Solution ${\rightarrow}$ Action. Second, seven specialists and a group of students assessed the developed WB-STS's validity and utility with a questionnaire, the results appeared satisfactory. Students showed high interest in WB-STS and gave a positive evaluation of WB-STS.

• The Korean Journal of Air & Space Law and Policy
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• v.33 no.1
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• pp.81-120
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• 2018

To promote the aviation safety reporting system that is operated to enhance aviation safety and to utilize related information, it should first be preceded by standards for non-punishment and data protection. It is because the purpose of collection and analysis of aviation safety related data through the aviation safety reporting system is to prevent recurrence of accidents by investigating their causes through collection and analysis of diverse types of information related to aviation safety. Both mandatory and voluntary reporting systems are in operation for aviation safety under the current Aviation Safety Act. It is said that they were introduced to survey causes for accidents and to prevent recurrences. In fact, however, it is hard to expect active implementation of the reporting system for aviation safety unless the reporters are firstly exempted from punishment. Therefore, the system should be improved so that it can satisfy its purpose and the purposes of data collection concerning aviation safety through examination of the purposes of the reporting system. One of the matters that needs to be considered to promote the reporting system should be the scope of aviation safety hindrances presupposed under the current institution. The voluntary aviation safety reporting system differs from the systems of ICAO or the key advanced countries, including the USA and the UK as it limits the target accidents subject to reporting to minor aviation safety hindrances only. That being said, improvements should be made by requiring mandatory reporting of aviation safety hindrances based on their severity while recognizing a greater variety of aviation safety concerns like international standards. Safety actions and sharing of information based on collection and analysis of diverse data related to aviation safety will greatly contribute to enhance aviation safety as the purposes of the reporting system are to explore causes for accidents and to prevent their recurrences. What is most important in this regard is strict data protection and non-punishment principles; compliance with them should be secured. We can hardly expect the successful operation of the system unless the reporter is exempted from punishment and the relevant data is protected as promotion of voluntary reporting is an essential factor for enhancing the safety culture. Otherwise, the current system may induce hiding of relevant facts or data to evade punishment. It is true that the regulation for enhancing safety tends to have limitations or blind spots; nevertheless, it should still be enforced strictly and completely. Technological progresses and mistakes of operators appear in different forms based on individual cases. The consequential damages may amount to a truly severe level. Therefore, we have studied and suggested to the methods of activiation and amendments on the aviation safety reporting system, which is referred for one of the proactive safety management systems. The proposed improvement of the reporting system and introduction of non-punishment for collection of aviation safety data for deploying a preemptive prevention system would serve as the backbone for enhancing aviation safety in Korea.