• Environmental and Resource Economics Review
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• v.18 no.4
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• pp.587-635
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• 2009

The purpose of this study is to develop the Global Dynamic Computable General Equilibrium Model (Global CGE Model) in order to produce an economic impact analysis, including prospective obligations for the Post-2012 regime. This model explores the impact of an international emissions trading market and macroeconomic variables such as GNP, consumption, investment, imports and exports, in accordance with potential increased obligations on the Republic of Korea. Distinguishing it from existing studies, this Global CGE Model divides the global community into major economic groups, and in the capacity of the analyzed global model, reflecting the principle nations' macroeconomic indicators through the theoretical approach of endogenous growth theory. Policies such as an emissions trading scheme and carbon tax are reflected in the model. Also, in particular, the model reflects exogenous technological advances. According to this analysis, the stronger the greenhouse gas reductions, the greater the adverse effects on the economy; among macroeconomic indicators that appear, a significant decline is realized in the balance of trade, along with a significant decrease in investment and consumption. Energy dependence, in particular, plays a large role-varying in degree by industry type-, as greenhouse gas reductions would have a greater impact on energy-intensive industries. Furthermore, if Korea, currently recognized as a developing country, is given the obligation to reduce greenhouse gas emissions, competing countries such as China and other developing countries will be given an advantage.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.64-71
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• 2017

A damage estimation method is presented for jacket-type support structure of offshore wind turbine using a change of modal properties due to damage and committee of neural networks for effective structural health monitoring. For more practical monitoring, it is necessary to monitor the critical and prospective damaged members with a limited number of measurement locations. That is, many data channels and sensors are needed to identify all the members appropriately because the jacket-type support structure has many members. This is inappropriate considering economical and practical health monitoring. Therefore, intensive damage estimation for the critical members using a limited number of the measurement locations is carried out in this study. An analytical model for a jacket-type support structure which can be applied for a 5 MW offshore wind turbine is established, and a training pattern is generated using the numerical simulations. Twenty damage cases are estimated using the proposed method. The identified damage locations and severities agree reasonably well with the exact values and the accuracy of the estimation can be improved by applying the committee of neural networks. A verification experiment is carried out, and the damage arising in 3 damage cases is reasonably identified.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.627-635
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• 2011

Purpose: Advanced breast cancer traditionally has been perceived as a contraindication to immediate breast reconstruction, because of concerns regarding adjuvant treatment delays and the cosmetic effects of radiotherapy to breast reconstruction, so delayed reconstruction is usually preferred in advanced breast cancer patients undergoing mastectomy. However, with the improved outcome using multimodality therapy, consisting of perioperative chemotherapy and radiotherapy, immediate breast reconstruction is now being performed as surgical option for selected advanced breast cancer patients. Additionally, advanced breast cancer patients may be needed soft tissue coverage of an extensive skin and soft tussue defect after mastectomy. Current authors have experienced several types of immediate breast and chest wall reconstruction for advanced breast cancer. Methods: From December of 2007 to June of 2009, 14 women performed for immediate breast and chest wall reconstruction for advanced breast cancer. They had been treated with neoadjuvant chemotherapy or chemoradiotherapy followed by modified radical mastectomy or radical mastectomy. Four different techniques were used immediate breast and chest wall reconstruction, which are pedicled TRAM flap (4 cases), extended LD flap with STSG (3 cases), thoracoabdominal flap (4 cases) and thoracoepigastric flap (3 cases). Results: The mean age was 53 years and mean follow up period was 9 months. Patients' oncologic status ranged stage IIIa to stage IV. Two patients had major complications: partial flap necrosis of TRAM flap and one distal necrosis of thoracoabdominal flap. Three patients with stage IV disease died from metastases. Conclusion: The result of this study suggests that immediate breast and chest wall reconstruction can be considered as surgical option for advanced breast cancer. But we need long term follow up and large prospective studies for recurrence and survival.

• Journal of the Korean Society of Radiology
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• v.10 no.3
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• pp.187-193
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• 2016

In this study, we performed the carotid artery ultrasound targeting 140 subjects who have conducted to evaluate the changes in intima-media thickness(IMT) and plaque correlated with the presence or absence of a hematological test of the carotid artery. Considering that the IMT thickness more than 1mm is abnormal based on the carotid artery ultrasound to assess the presence or absence of plaque, and examined the correlation by classifying the blood lipid value and the fasting blood glucose level through the serum test. Consequently, the fasting blood glucose level is being analyzed as independent predictors of causing dental plaque(p=0.033), cut off value was determined as 126 mg/dL(sensitivity 56.25%, specificity 68.38%) in ROC curve analysis. Furthermore, the odds ratio appeared 1.01 times the value in the Logistic regression. Therefore, it seemed that the necessity to prospective studies in a number of subjects are considered, and also taking into account a number of blood test values along with the sonography of the carotid artery as a valuable part for effective primary prevention and follow-up observation of the cardiac and brain vascular disease is highly recommended.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2001.04a
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• pp.115-126
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• 2001

1988년 Reaven이 인슐린저항성증후군(insulin resistance syndrome)의 개념을 처음 소개한 후 전세계적으로 관심이 증가하고 있다. 인슐린저항성증후군은 대사성증후군 (metabolic syndrome), X 증후군(syndrome X)이라고도 하며, 인슐린 저항성에 따른 고인슐린혈증, 내당능장애(impaired glucose tolerance)와 2형 당뇨병(인슐린 비의존형 당뇨병), 이상지질혈증(dyslipidemia), 고혈압 등 일련의 질환은 동일인에서 흔히 병발하고, 이들은 모두 죽상경화증(atherosclerosis)의 위험인자라는 관점에서 상호연관성을 갖는 질환군이라는 개념이다. 2형 당뇨병은 인슐린에 대한 말초조직의 저항성과 상대적으로 감소된 인슐린 분비능의 결과라고 할 수 있다. 또한 상당수의 2형 당뇨병은 비만, 특히 복부비만을 동반하고 있으며, 비만은 그 자체로 인슐린 저항성을 유발한다. 결국 인슐린 저항성이 장기간 개선되지 못하게 되면 2형 당뇨병이 유발되게 된다. 따라서 2형 당뇨병에 대한 최선의 치료는 혈당조절 뿐만 아니라 인슐린 저항성과 관련된 심혈관계 위험인자를 개선시키는 것을 목표로 해야 한다. 그 증거로 당뇨병 조절과 관련한 대규모 전향적 연구인 UKPDS(United Kingdom Prospective Diabetes Study)의 결과를 보면, 2형 당뇨병에서 설폰요소제(sulfonylurea)나 인슐린으로 10년동안 혈당조절을 했을 때 미세혈관 합병증은 의미있게 감소시켰으나 대혈관 합병증의 발생률은 의미있는 감소를 보이지 못하였다. 반면 대혈관 합병증이 미세혈관 합병증보다 사망에 기여하는 비율이 70배 이상이라는 사실은 당뇨병의 치료가 혈당조절에만 초점이 맞추어져서는 안 되며 심혈관계 위험인자를 개선시키는 치료가 동시에 진행되어야 한다는 점을 시사한다.시료에서 매우 드물게 관찰된다. 음극선발광(cathodoluminescence) 영상의 해석을 통해 저어콘 결정의 성장사를 유추하였으며, 이를 바탕으로 이온현미분석 점(spot)을 정하였다. U-Pb-Th 자료는 퍼스(Perth) 저어콘 스탠다드 (CZ3, 564 Ma, $^{206}$Pb/$^{238}$U=0.0914)를 사용하였다. 아래에 기술하는 연대는 모두 $^{206}$Pb/$^{238}$U 연대에 해당된다. 두 개의 화강암질 편마암 시료로부터 구한 U-Pb 저어콘 연대는 각각 812 $\pm$ 14 Ma(1006-8)와 822 $\pm$ 17 Ma(1006-9)로 분석오차 내에서 서로 일치한다. 이 결과는 춘천 및 전곡 지역의 석류석 각섬암에서 보고된 Sm-Nd 전암연대(852 $\pm$ 24 Ma 및 824 $\pm$ 143 Ma; Lee and Cho, 1995; Ree et al., 1996)와 잘 부합한다. 따라서 후기 원생대 기간 중 화성활동이 한반도에서 광범위하게 일어났음을 시사한다. 한편, 1006-9 시료에서는 예외적으로 한 개의 저어콘 입자 주변부(rim)에서 매우 얇은 과성장띠가 관찰되었으며, 두 개의 점 분석으로부터 구한 U-Pb 저어콘 연대는 약 235 Ma이다. 이 띠는 또한 변성기원의 저어콘에서 흔히 관찰되는 작은 W (<0.05) 비를 보인다. 1006-5 시료는 위 두 시료로부터 수 km 떨어진 지점에서 채집하였으나, 저어콘 연대는 상이한 기록을 보여준다. 즉 매우 작은 Th/U (<0.01) 값을 갖는 저어콘의 주변부에서 223 $\pm$ 5 Ma의 연대가 잘 정의되며, 이는 1006-9 시료에서 관찰된 결과와

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.147-153
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• 2015

Purpose: This study was aimed to investigate the contamination rates of blood culture in a neonatal intensive care unit (NICU) and to examine the clinical characteristics related to the contamination. Methods: Eight hundred thirty cases of blood culture performed from March 2013 to February 2014 were analyzed. We evaluated the contamination rates of blood culture by blood sampling sites and compared the clinical characteristics such as real name system and body weights of the contaminated cases and those of non-contaminated ones. The clinical characteristics were retrospectively reviewed by medical records. Results: The overall contamination rate was 3.6% (30/830). The contamination rates by blood sampling sites were as follows: peripheral vein 15.6% (10/64), peripheral artery 2.6% (20/759), and umbilical arterial catheter 0% (0/7). There was no difference in the contamination rates between cases with and without real name system (P=0.484). However, there were significant differences in the contamination rates by the physicians who performed the culture (P=0.038) and body weight (<1,000 g vs. ${\geq}1,000g$) at the time of blood culture (P<0.001). Conclusions: These results suggest that neonates with a body weight less than 1,000 g have more risks of the contamination of blood culture. Furthermore, there is a necessity to provide blood culture performers with active feedbacks and individualized education plans that can help diminish blood culture contamination rates. Prospective studies in a systematic manner that can be applied in actual clinical settings are needed in order to figure out factors that can diminish the contamination rates of blood culture in NICU.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.331-336
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• 2001

Objectives : To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. Methods : Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). Results : The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.03) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). Conclusions : Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.

• Health Policy and Management
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• v.25 no.3
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• pp.185-196
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• 2015

Background: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. Methods: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. Results: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. Conclusion: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2941-2946
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• 2016

Background: The limitations of total serum PSA values remain problematic, especially after an initial negative prostate biopsy. In this prospective study of Chilean men with a continued suspicion of prostate cancer due to a persistently elevated total serum PSA, abnormal digital rectal examination and initial negative prostate biopsy were compared with the use of the on-line Chun nomagram, detection of primary malignant circulating prostate cells (CPCs) and free percent PSA to predict a positive second prostate biopsy. We hypothesized that men negative for circulating prostate cells have a small risk of clinically significant prostate cancer and thus may be conservatively observed. Men positive for circulating prostate cells should undergo biopsy to confirm prostate cancer. Materials and Methods: Consecutive men with a continued suspicion of prostate cancer underwent 12 core TRUS prostate biopsy; age, total serum PSA and percentage free PSA and Chun nomagram scores were registered. Immediately before biopsy an 8ml blood simple was taken to detect primary mCPCs. Mononuclear cells were obtained by differential gel centrifugation and identified using double immunostaining with anti-PSA and anti-P504S. Biopsies were classifed as cancer/no-cancer, mCPC detecton test as negative/positive and the total number of cells/8ml registered. Areas under the curve (AUC) for percentage free PSA, Chun score and CPCs were calculated and compared. Diagnostic yields were calculated with reference to the number of possible biopsies that could be avoided and the number of clinically significant cancers that would be missed. Results: A total of 164 men underwent a second biopsy; 41 (25%) had cancer; the AUCs were 0.65 for free PSA, 0.76 for the Chun score and 0.87 for CPC detection, the last having a significantly superior prediction value (p=0.01). Using cut off values of free PSA <10%, Chun score >50% and ${\geq}1$ CPC detected, CPC detection had a higher diagnostic yield. Some 4/41 cancers complied with the criteria for active surveillance, free PSA and the Chun score missed a higher number of significant cancers when compared with CPC detection. Conclusions: Primary CPC detection outperformed the use of free PSA and the Chun nomagram in predicting clinically significant prostate cancer at repeat prostate biopsy.

• Endocrinology and Metabolism
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• v.33 no.4
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• pp.466-472
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• 2018

Background: Thyroid dysfunction is associated with negative neonatal and obstetric outcomes. Large differences in thyroid function reference intervals exist across different populations. These differences can be explained by population-specific factors, such as iodine status. Many countries in Latin America report iodine sufficiency, but relatively few countries have published up-to-date data on iodine levels and thyroid function in the overall population, and especially in pregnant women. We evaluated the iodine status of pregnant women in Chile and determined thyroid hormone reference ranges in this population. Methods: This was a prospective observational study of healthy Chilean women at their first prenatal visit before week 14. Thyroid-stimulating hormone (TSH), total thyroxine ($T_4$), free $T_4$, antithyroid peroxidase antibody (TPOAb), and iodine levels from spot urine samples were measured. Iodine status and the reference ranges for TSH were calculated. Results: A total of 1,022 pregnant women in the first trimester were selected. Urinary iodine levels were measured in 302 randomly-selected women. The median urinary iodine concentration was $173.45{\mu}g/L$ (interquartile range, 108.11 to 249.35).The reference ranges of TSH were calculated in 670 patients selected according to the National Academy of Clinical Biochemistry guidelines. The median TSH level was $1.88{\mu}IU/mL$ (2.5th percentile: 0.13 to 97.5th percentile: 5.37). Using the reference range in the 1,022 women, the prevalence of clinical hypothyroidism was 1.76%, and that of subclinical hypothyroidism was 3.92%. TPOAb positivity was more common in women with TSH levels above $3.5{\mu}IU/mL$. Conclusion: We found adequate iodine intake and a right-shifted distribution of serum TSH levels in pregnant women in Chile. The prevalence of hypothyroidism in our sample of pregnant women was higher than has been described in the literature.