• Atmosphere
• /
• v.34 no.2
• /
• pp.107-121
• /
• 2024

In this study, we empirically analyzed the impact of physical risks due to climate change on the soundness and operational performance of the financial industry by combining economics and climatology. Particularly, unlike previous studies, we employed the Seasonal-Trend decomposition using LOESS (STL) method to extract trends of climate-related risk variables and economic-financial variables, conducting a two-stage empirical analysis. In the first stage estimation, we found that the delinquency rate and the Bank for International Settlement (BIS) ratio of commercial banks have significant negative effects on the damage caused by natural disasters, frequency of heavy rainfall, average temperature, and number of typhoons. On the other hand, for insurance companies, the damage from natural disasters, frequency of heavy rainfall, frequency of heavy snowfall, and annual average temperature have significant negative effects on return on assets (ROA) and the risk-based capital ratio (RBC). In the second stage estimation, based on the first stage results, we predicted the soundness and operational performance indicators of commercial banks and insurance companies until 2035. According to the forecast results, the delinquency rate of commercial banks is expected to increase steadily until 2035 under assumption that recent years' trend continues until 2035. It indicates that banks' managerial risk can be seriously worsened from climate change. Also the BIS ratio is expected to decrease which also indicates weakening safety buffer against climate risks over time. Additionally, the ROA of insurance companies is expected to decrease, followed by an increase in the RBC, and then a subsequent decrease.

• Journal of Korean Neurosurgical Society
• /
• v.59 no.2
• /
• pp.117-121
• /
• 2016

Objective : Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. Methods : This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. Results : Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate $5.8{\pm}1.4%/year$). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). Conclusion : Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.

• The Korean Journal of Nuclear Medicine
• /
• v.35 no.3
• /
• pp.117-124
• /
• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• Clinical and Experimental Pediatrics
• /
• v.63 no.7
• /
• pp.272-277
• /
• 2020

Background: The optimal management of perianal abscess in children is controversial. Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001-2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary surgery group). Conservative treatment was initiated in 49 patients (primary conservative group) but was stopped because of inefficiency in 25 patients, who were referred for surgery after a median 7.03 days (range, 2 to 16 days). The other 24 patients (48%) initially achieved complete remission after conservative treatment, but 10 were readmitted after a median 34 months (range, 3 to 145 months) with recurrent disease. There were no significant differences in permanent success after conservative treatment between infants (10 of 29, 34%) and older children (4 of 20 [20%], P=0.122). Overall, conservative treatment alone was effective in only 14 of 113 patients. Recurrence after surgery occurred in 16 patients (25%) in the primary surgery group and 11 patients (22%) in the primary conservative group (P=0.75). Univariate analysis of predictors for conservative treatment failure revealed inflammatory values (C-reactive protein and white blood count, P=0.017) and abscess size (P=0.001) as significant parameters, whereas multivariate analysis demonstrated that only abscess size (odds ratio, 3.37; P=0.023) was significant. Conclusion: Conservative treatment of perianal abscess is permanently efficient in only a minority of children but is not associated with a higher recurrence rate after subsequent surgery. Abscess size is a predictor for therapy failure.

• Archives of Plastic Surgery
• /
• v.33 no.6
• /
• pp.711-714
• /
• 2006

Purpose: Contralateral reduction mammaplasty at the time of breast reconstruction using autogenous tissue gives aesthetically improved results in the patients with mammary hypertrophy or ptosis. It also reduces required flap size for reconstruction and permits discarding zones of poor perfusion, decreasing flap size-related problems such as partial flap loss or fat necrosis. Considering the high rate of bilaterality of breast cancer, it also provides a good opportunity for exploration and occult cancer diagnosis in such high risk group patients. Methods: We retrospectively reviewed 45 consecutive patients who underwent simultaneous breast reconstruction and contralateral reduction mammaplasty was performed about surgical technique, pathologic diagnosis, and subsequent treatment. Results: Three occult breast cancers were found in 45 patients(6.7%); one was microinvasive, and the other two were invasive carcinomas and their mean diameter was 1.2 cm. One patient underwent subsequent breast conserving mastectomy, adjuvant radiation and chemotherapy. The others underwent only radiation and hormone therapy. They were followed up for 10 to 42 months without evidence of recurrence or metastasis. Conclusion: Occult breast cancer diagnosed in reduction mammaplasty specimen will lead to good prognosis due to its early detection. Treatment options depend on pathologic finding, stage, marginal status, and the timing of diagnosis. We recommend adequate markings for orientation and margins, excision with sufficient margin, and confirmation by frozen biopsy for suspected lesions.

• Quality Improvement in Health Care
• /
• v.12 no.1
• /
• pp.78-90
• /
• 2006

Background : The concept of 'service' in a hospital is based on the quality of medical staffs who serve as customer-satisfying media, and this is what distinguishes general hospitals from other business corporations in which customer satisfaction is achieved through commercial products. Thus, the internal employee satisfaction is essential in the improvement of the 'service' and subsequent 'competitiveness' of a hospital. The purpose of this study is to establish internal marketing strategies for a general hospital through regular surveys on employee satisfaction. Method : Surveys on employee satisfaction in radiology department were conducted regularly twice a year in a university hospital with 800 beds 2001 in 2004. The subjects of this study were 35 employees who work in radiology department. The authors developed the questionnaires and the surveys were conducted initially during the first 6 months of the year. After necessary improvements were made by applying 6 Sigma techniques, subsequent surveys were conducted during the latter 6 months of the year and the degree of employee satisfaction was compared. Results : Overall satisfaction increased with a constant rate and the authors were able to assess that the hospital is being gradually stabilized. The degree of satisfaction assessed by multiple choices showed only minor changes. However, as a result of focusing on the demands put forth by the employees through the open questions, the degree of satisfaction increased gradually year after year. Conclusions : It is important to heighten the internal employee satisfaction systematically and harmoniously through the assessment on the demands of the internal customers and feedback-based communications between the management officers and the staffs. Continuous surveys on the internal employee satisfaction will serve to be valuable materials in the establishment of internal marketing strategies for a general hospital.

• The Korean Journal of Pain
• /
• v.27 no.1
• /
• pp.35-42
• /
• 2014

Background: Epidural steroid injection (ESI) is one of the most common procedures for patients presenting low back pain and radiculopathy. However, there is no clear consensus on what constitutes appropriate steroid use for ESIs. To investigate optimal steroid injection methods for ESIs, surveys were sent to all academic pain centers and selected private practices in Korea via e-mail. Methods: Among 173 pain centers which requested the public health insurance reimbursements for their ESIs and were enrolled in the Korean Pain Society, 122 completed questionnaires were returned, for a rate of 70.5%; also returned were surveys from 39 academic programs and 85 private practices with response rates of 83.0% and 65.9%, respectively. Results: More than half (55%) of Korean pain physicians used dexamethasone for ESIs. The minimum interval of subsequent ESIs at the academic institutions (3.1 weeks) and the private practices (2.1 weeks) were statistically different (P = 0.01). Conclusions: Although there was a wide range of variation, there were no significant differences between the academic institutions and the private practices in terms of the types and single doses of steroids for ESIs, the annual dose of steroids, or the limitations of doses in the event of diabetes, with the exception of the minimum interval before the subsequent ESI.

• Environmental Engineering Research
• /
• v.19 no.1
• /
• pp.83-89
• /
• 2014

The effects of initial solid concentration and microwave irradiation (MWI) time on the hydrolysis of waste activated sludge (WAS) were investigated. MWI time strongly influenced WAS hydrolysis for all initial solid concentrations of 8.20, 31.51, and 52.88 g VSS/L. For all WAS, the volatile suspended solids (VSS) solubilization degree ranged from 35.6% to 38.4% during a total MWI time of 10 min. Soluble chemical oxygen demand (SCOD) concentration increased at a rate proportional to the decrease of VSS during the MWI. However, the clearly different VSS solubilization patterns that were observed during the MWI were explained by the 2-step hydrolysis of WAS, consisting of the initial disintegration of the easily degradable part of the sludge, followed by the subsequent disintegration of the hardly degradable part of the sludge. WAS hydrolysis rates for 3 to 6 min of MWI were significantly lower than those for less than 3 min, or more than 6 min. From these results, 3 min MWI time and WAS of 31.51 g VSS/L (centrifugal thickener WAS) showed the most efficient hydrolysis of WAS at 36.0%. The profiles of total nitrogen (T-N) concentrations corresponded well to the SCOD increases in terms of the empirical formula of bacterial cell mass ($C_5H_7O_2N$). The negligible T-N increase and pH decrease during WAS hydrolysis by MWI will allow the application of this process to subsequent biological processes, such as anaerobic digestion.

• Proceedings of the IEEK Conference
• /
• 2001.10a
• /
• pp.106-110
• /
• 2001

Formation of stoichiometric lithium-, nickel-, and zinc- ferrites by calcining organo-metallic precursors a temperature below 40$0^{\circ}C$ is examined using DTA/TG, and XRD techniques. It attempts to simulate th immobilization of metal ions in industrial liquid influents (waste) through the synthesis of stoichiometric spinel ferrites (SSF). Two steps of the SSF formation during thermal treatments are noted. The transformation of magnetite to ${\gamma}$ - Fe$_2$O$_3$and subsequent first formation of SSF were observed at temperatures ranging from 200 to 45$0^{\circ}C$. Th formation of cation-containing ${\gamma}$-Fe$_2$O$_3$and subsequent second formation of the ferrite occurred at temperature ranges of < 45$0^{\circ}C$ and 500 to $650^{\circ}C$, depending on the heating rate used. Then the temperature range of 200t 45$0^{\circ}C$ is critical to the performance of the technique, because a calcination at the range would lead to a complete formation of SSF, avoiding the occurrences of ${\gamma}$-Fe$_2$O$_3$and ion-containing ${\gamma}$-Fe$_2$O$_3$. If not, so $\alpha$-Fe$_2$O$_3$would occur. And annealing at temperature above $650^{\circ}C$ must be employed by which solid-state reactio of $\alpha$-Fe$_2$O$_3$with metal ions (possibly metal oxides) to form SSF can be conducted.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.14
• /
• pp.5853-5858
• /
• 2015

Background: The survival rate reflecting prognosis of breast cancer patients is usually estimated based on crude survival methods such as observed and cause-specific. In situations where data are based on population-cancer registries, this method may produce biased estimations. This study therefore aimed to estimate the net survival of breast cancer based on relative survival. Materials and Methods: Data for 622 breast cancer patients diagnosed at the Iran Cancer Institute during 1990-95 and tracked till the end of 2000 were analyzed. For estimation of relative survival, Ederer's second method and SAS (9.1) and STATA (11) software were used. Results: Threeyear relative survivals of 85%, 90%, 80% and 67% were observed for age groups 15-44, 55-59, 60-74, and 75+years-old, respectively. A relative survival of approximately one was observed for two subsequent years for age-group 45-59 years-old. A value greater than one for two subsequent years of follow-up was observed in the age-group 60-74 years-old. Conclusions: Tracking the diagnosis of breast cancer, the relative survival decreases as we go to higher age-groups. It is also perceived that through follow-up, relative survival first decreased and then increased a little. The statistical cure point is acceptable for age group 45-59 years-old while for age-groups 15-44 and 60-74 years old is a sign of low quality data for some follow-up intervals.