• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.1-8
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• 2015

Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

• The Journal of the Korean life insurance medical association
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• v.27 no.2
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• pp.68-74
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• 2008

Medical verification of cancer diagnosis in insurance claims is a very important procedure in insurance administrations. Claims staffs are in need of medical experts' opinions about claim administration. This procedure is called medical claim review (MCR) and is composed of verification and advice. MCR verification evaluates the insured’s physical condition by medical records and compares it with product coverage. It is divided into assessment of living assurance benefit, verification of cancer, and assessment of the cause of death. Actually cancer verification of MCR is applicable to coding because the risk ratio in product development is usually coded data. There are some confusing neoplastic diseases in assessing the verification of cancer. This article reviews gastrointestinal stromal tumors (GIST) and mucosa-associated lymphoid tissue tumors (MALToma) of the stomach. The second most common group of stromal or mesenchymal neoplasms affecting the gastrointestinal tract is GIST. Nowadays there are many articles about the pathophysiology of GIST. However there are few confirmative theories except molecular cell biology of KIT mutation and some tyrosine kinase. Therefore, coding the GIST, which has previously been classified as an intermediate risk group according to NIH2001 criteria, for cancer verification of MCR is suitable for D37.1; neoplasm of uncertain or unknown behavior of digestive organs and the stomach. The gastrointestinal tract is the predominant site of extranodal non-Hodgkin's lymphomas. B-cell lymphomas of the MALT type, now called extranodal marginal zone B-cell lymphoma of MALT type in the REAL/WHO classification, are the most common primary gastric lymphomas worldwide. Its characteristics are as follows. First, it is different from traditional stomach cancers such as gastric adenocarcinoma. Second, the primary therapy of MALToma is the eradication of H. pylori by antibiotics and the remission rate is over 80%. Third, it has a different clinical course compared to traditional malignant lymphoma. Someone insisted that cancer verification is not possible for the above reasons. However, there have been findings on pathologic mechanism, and according to WHO classification, MALToma is classified into malignant B-cell lymphoma and it must be verified as malignancy in MCR.

• Health Policy and Management
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• v.10 no.4
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• pp.116-143
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• 2000

Considerable attention has been devoted in the accounting literature to identify the factors that cause or drive the costs of overhead activities. This paper extends recent cost driver research to the health care provider. In various case studies, it has been suggested that overhead costs are driven by volume and complexity variables. This paper investigates the significance of these variables in determining hospital overhead costs, how they are structurally related and how the cost impacts of these variables can be estimated in practice. This paper analyzes the determinants of hospital costs using the sample of South Korea hospitals for seven year during the period 1952－1997. The paper focuses on the extent to which hospital overhead costs depend on complexity, efficiency in addition to depending on more conventional volume based measures of hospital activity. The results of regression analysis suggest that volume and complexity factors positively and significantly affect overhead costs in the hospital industry. The results show that the complexity-related cost drivers strongly affected on the overhead costs in tile health care provider industry more than manufacturing industry which is mainly affected by volume-related cost drivers. That means each Industry may have different cost structures. Therefore it Is Important to find their proper cost structures and cost drivers and use them. Futhermore identification of overhead or indirect cost drivers is likely to be particularly useful in heath care. The identification of cost drivers can be of benefit to all health care stakeholders because these facilitates more efficient management of the national resources devoted to health care. While this study has documented that the level of service complexity is a significant determinant of hospital overhead costs, caution should be exercised in interpreting this as supportive of the cost accounting procedures associated with ABC. It is an open question whether even a well-designed ABC system will provide suitable proxies for marginal costs for decision making purposes.

• Journal of Korea Water Resources Association
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• v.46 no.10
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• pp.997-1004
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• 2013

There is imminent need to find a way to measure the recreational benefits of water so that appropriate actions can be taken to make a multi-purpose reservoir. Therefore, this study attempts to apply a choice experiment to quantifying the recreational benefits of a multi-purpose reservoir, using a specific case study of Sangkwan multi-purpose reservoir. We consider the trade-offs between price and attributes of recreational attributes for selecting a preferred alternative and derive the marginal willingness to pay (MWTP) estimate for each attribute. The results show that the MWTP for providing additional 10,000 ton of water is estimated to be 3 won per household per year. The MWTP for improving 1 level of water quality is computed to be 645.5 won per household per year. Moreover, the MWTP for providing recreation facilities is calculated to be 1,518.6 won per household per year. This study allows us to provide policy-makers with useful quantitative information that can reduce uncertainty in the decision-making process related to a multi-purpose reservoir construction projects.

• Environmental and Resource Economics Review
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• v.23 no.4
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• pp.719-746
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• 2014

This study attempts to estimate the value of the water quality improvement by deriving the equilibrium price of the water pollutant emission permit for the imaginary water pollutant emission trading market. It is reasonable to say that there is already an implicit social agreement for the unit value of water pollutant, when the government set the Total Water Pollutant Loading System for the major river basin as a part of the Comprehensive Measures for Water Management, particularly for the Nakdong River Basin. Therefore, we can derive the unit value of water pollutant emission, which is already implied in the pollution allowance for each city or county by the Total Water Pollutant Loading System. Once estimated, it will be useful to the economic assessment of the water quality related projects. An imaginary water pollutant emission trading system for the Nakdong River Basin, where Total Water Pollutant Loading System is already effective, is constructed for the estimation of the equilibrium price of water pollutant permit. By estimating marginal abatement cost curve or each city or county, we can compute the equilibrium price of the permit and then it is regarded as the economic value of the water pollutant. The marginal net benefit function results from the relationship between the emission and the benefit, and then the equilibrium price of permit comes from constructing the excess demand function of the permit by using the total allowable permit of the local government entity. The equilibrium price of the permit would be estimated to be $1,409.3won/kg{\cdot}BOD$. This is within reasonable boundary compared for the permit price compared to foreign example. This permit price would be applied to calculate for the economic value of the water quality pollutants, and also be expected to use directly for the B/C analysis of the business involved with water quality change.

• Korean Journal of Agricultural Science
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• v.35 no.1
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• pp.85-100
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• 2008

The United States Department of Agriculture (USDA) funded collaborative project on The Economic Feasibility Analysis of Crop Cultivation Practice Project in Pirganj and Kurigram Districts in Bangladesh will started during 2008-2012, for 4 years with total project cost of US$ 571,270. The project will be implemented in 6 villages; has 1,097 hectares areas which is divided into 948 hectares of agricultural land, 52 hectares of forest land and 345 hectares of other land, covered 1,059 households equal to 5,305 persons in Pirganj and Kurigram districts The project has proposed to be implemented in joint collaboration by Bangladesh Agricultural Research Council (BARC), Bangladesh Agricultural Research Institute (BARI) and Rangpur Dinajpur Rural Service (RDRS) Bangladesh with full participation of the farmers' groups of respective project site. The specific objectives of the project are: (1) to estimate the productivity of paddy, wheat, maize, tobacco and sugarcane (2) to determine the cost of production and returns to the above mentioned crops (3) to study the interrelationship between inputs and output of the above mentioned crops and (4) to examine the resource utilization patterns at farm level. In this project analysis, the net incremental profit is US$33,028. The expected incremental project benefit and incremented production cost are estimated as US$ 219,959 and US$ 186,931 respectively. The financial decision making criteria would be followed in this crop cultivation practice project. After the project implementation, the expected project benefits are assumed to be continued for 15 years. The benefit cost ratio (B/C) of the project is estimated at 1.077 (table 11) when using discount rate of 10% as an opportunity cost of capital in Bangladesh. FIRR of project is estimated at 26.15% which is bigger than the opportunity cost by more than double. So this project is financially feasible and acceptable. Therefore, this project should be extended to other areas to increase the farm income and economic growth of marginal poor farmers in Bangladesh.

• Journal of Korean Society of Transportation
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• v.22 no.5
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• pp.139-149
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• 2004

As the expansion of road capacity has become impractical in many urban areas, congestion pricing has been widely considered as an effective method to reduce urban traffic congestion in recent years. The principal reason is that the congestion pricing may lead the user equilibrium (UE) flow pattern to system optimum (SO) pattern in road network. In the context of network equilibrium, the link tolls according to the marginal cost pricing principle can user an UE flow to a SO pattern. Thus, the pricing method offers an efficient tool for moving toward system optimal traffic conditions on the network. This paper proposes a continuous network design program (CNDP) in network equilibrium condition, in order to find optimal congestion toll for maximizing net economic benefit (NEB). The model could be formulated as a bi-level program with continuous variable(congestion toll) such that the upper level problem is for maximizing the NEB in elastic demand, while the lower level is for describing route choice of road users. The bi-level CNDP is intrinsically nonlinear, non-convex, and hence it might be difficult to solve. So, we suggest a heuristic solution algorithm, which adopt derivative information of link flow with respect to design parameter, or congestion toll. Two example networks are used for test of the model proposed in the paper.

• KIPS Transactions on Software and Data Engineering
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• v.7 no.9
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• pp.325-334
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• 2018

Requirement traceability should be continuously maintained in software development and evolution. However, it is usually updated in practice in the quality assurance phase. The gap between "is" and "should" exists due to the fact that developers must invest considerable effort to update requirement traceability while being able to obtain only marginal benefit from the updated traceability. To close this gap, we propose a spreadsheet application that enables developers to flexibly change mappings in a requirement traceability matrix. In this way, developers can reduce their effort in updating the requirement traceability matrix, but still obtain the common form of a requirement traceability matrix on a spreadsheet. The proposed application maintains the mappings between two artifacts on each sheet so that, whenever an artifact item changes, developers can instantly insert the relevant mapping changes. Then, when developers desire the common form of a requirement traceability matrix, the proposed application calculates the mappings among several artifacts and creates the matrix. The application also checks traceability errors and calculates the metrics so that developers can understand the completeness of the matrix. To understand the applicability of the proposed approach, we conducted a case study, which shows that the proposed application can be applied to the real project and easily incorporate the mapping changes.

• Journal of Gastric Cancer
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• v.18 no.1
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• pp.69-81
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• 2018

Purpose: It has been reported that the survival of patients with locally advanced gastric cancer (LAGC) is better in East Asia countries than in developed western countries; however, the prognosis of LAGC remains poor. This study aimed to evaluate the effects of perioperative chemotherapy on the long-term survival of East Asia patients with LAGC. Materials and Methods: From October 2006 through August 2008, 43 patients with LAGC received perioperative S-1 combined with weekly docetaxel in a phase II study (neoadjuvant group). These patients were matched using propensity scores to patients who underwent surgery without neoadjuvant chemotherapy during the same period (surgery group). The surgical outcomes and long-term survivals were compared between the 2 groups. Results: After matching, 43 and 86 patients were included in the neoadjuvant and surgery groups, respectively, and there was no significant difference in their baseline characteristics. Although the operating time was longer in the neoadjuvant group, there was no significant difference in postoperative complications between the 2 groups. The neoadjuvant group had a significantly higher 5-year overall survival (OS) rate (73.3% vs. 51.1%, P=0.005) and a trend towards higher 5-year progression-free survival (PFS) (62.8% vs. 49.9%, P=0.145). In the multivariate analysis, perioperative chemotherapy was an independent factor for OS, with a hazard ratio of 0.4 (P=0.005) and a marginal effect on the PFS (P=0.054). Conclusions: Perioperative chemotherapy was associated with better long-term survival without increasing postoperative complications in the setting of D2 surgery for patients with LAGC, suggesting that perioperative chemotherapy can be a therapeutic option in East Asia countries.

• Land and Housing Review
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• v.7 no.4
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• pp.191-205
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• 2016

North Korea(NK) has designated the special economic zones(SEZs) since the first one in Rason. But, why have the SEZs in NK still not been developed successfully? This study comparatively evaluated the SEZs in China, Vietnam and NK, with respect to 'context/purpose', 'development/management system', and 'location/infrastructure.' NK's strategies for the SEZs were different from those of China and Vietnam in terms of historical context and development purpose. China and Vietnam chose the market opening policy aiming to reform their national economy, while NK tried the opening policy without the economic reform. This difference made NK's decentralization and location strategies marginal. In spite of the positive land system and tax benefit of NK, the strategies couldn't make a successful result. The implications of this comparative study are as follows. Firstly, NK needs to establish a strategy for the SEZs in accord with the comprehensive and long-term plan for economic development and 'trustworthy and substantial market-systems' being compatible with outside world. For that, NK has to secure the regime stability in political and diplomatic dimensions. Secondly, NK has to carry out policies of decentralization and location of the SEZs more positively. Thirdly, in order to solve the problem related to lack of infrastructure capital, NK needs to utilize a BOT scheme.