• Journal of Environmental Policy
• /
• v.8 no.2
• /
• pp.83-118
• /
• 2009

Clean Development Mechanism(CDM) projects under the Kyoto Protocol have two objectives. One is to assist the Parties included in Annex I in achieving compliance with their quantified emission limitation and reduction commitments in cost-effective ways by allowing them to implement emission reduction projects in Non-Annex I countries and receive CERs, which will offset their reduction commitments. The other is to assist Parties not included in Annex I in achieving sustainable development and technology transfers through investments by Annex I countries. However, in reality, it is said that the former objective is achievable but the latter is not. In this light, this article suggests sustainability appraisal criteria applicable for Korea. Among various methodologies, we used the 'multi-attributes utility theory(MAUT)'; one of the 'multi-criteria analysis (MCA)' methodologies judged to be the most practical and relevant. Based on the guidelines of the MAUT methodology, we identified sustainability criteria that meet the guidelines. We took two tracks, the first to find the preferences of Korean experts, and the other to check foreign cases. In all, 37 preliminary criteria were suggested to Korean experts and each criterion was scored, from between 1 and 3, in terms of relevance, possibility of real improvement, easiness of data collection, and preferences. We combined foreign cases and the results of a survey conducted in Korea and selected 12 core criteria and 10 additional criteria. After that, all the criteria were converted into indicators. The indicators were applied to a CDM project for case study. We chose the "Sihwa Tidal Power Project", which is currently the biggest tidal power plant in the world. Twelve core indicators and 3 additional indicators were applied. In order to weight each indicator, the 'analytical hierarchy process (AHP)' was used. A total of 30 experts were asked to suggest weights and 21 answered. Among them, only 14 respondents were proven to meet the consistency ratio. We analyzed the 14 responses through Expert Choice and the CDM project was scored (+)53.082. In addition, sensitivity analysis was undertaken with the result of (+)44.667 to (+)65.522. As a result of this study, it was proven that this project would contribute to the sustainable development of Korea.

• Investigative Magnetic Resonance Imaging
• /
• v.9 no.2
• /
• pp.109-116
• /
• 2005

Purpose : To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. Materials and Methods : Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm<, 1-2 cm, and >2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. Results : In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p=0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm<, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28%, p=0.023). Conclusion : Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (<2 cm) and could improve detection of the small hepatic metastases (<1 cm) from colorectal carcinoma.

• Journal of Hospice and Palliative Care
• /
• v.14 no.1
• /
• pp.28-33
• /
• 2011

Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.1
• /
• pp.26-35
• /
• 1994

Background: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. Methods: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, and survival retrospectively. Results: No correlation was found between patients' age, sex and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage IIIa diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of conclusion of this study. Conclusion: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.

• The KIPS Transactions:PartB
• /
• v.19B no.2
• /
• pp.123-126
• /
• 2012

This paper proposed a method to separate a liver into left and right liver lobes for simple and exact volumetry of the river graft at abdominal MDCT(Multi-Detector Computed Tomography) image before the living donor liver transplantation. A medical team can evaluate an accurate river graft with minimized interaction between the team and a system using this algorithm for ensuring donor's and recipient's safe. On the image of segmented liver, 2 points(PMHV: a point in Middle Hepatic Vein and PPV: a point at the beginning of right branch of Portal Vein) are selected to separate a liver into left and right liver lobes. Middle hepatic vein is automatically segmented using PMHV, and the cutting line is decided on the basis of segmented Middle Hepatic Vein. A liver is separated on connecting the cutting line and PPV. The volume and ratio of the river graft are estimated. The volume estimated using 2 points are compared with a manual volume that diagnostic radiologist processed and estimated and the weight measured during surgery to support proof of exact volume. The mean ${\pm}$ standard deviation of the differences between the actual weights and the estimated volumes was $162.38cm^3{\pm}124.39$ in the case of manual segmentation and $107.69cm^3{\pm}97.24$ in the case of 2 points method. The correlation coefficient between the actual weight and the manually estimated volume is 0.79, and the correlation coefficient between the actual weight and the volume estimated using 2 points is 0.87. After selection the 2 points, the time involved in separation a liver into left and right river lobe and volumetry of them is measured for confirmation that the algorithm can be used on real time during surgery. The mean ${\pm}$ standard deviation of the process time is $57.28sec{\pm}32.81$ per 1 data set ($149.17pages{\pm}55.92$).

• Korean Journal of Organic Agriculture
• /
• v.13 no.4
• /
• pp.401-412
• /
• 2005

This study was conducted to examine the effects of dietary Mogchotan(the mixture of charcoal and pyroligneous acid, 80:20, w/w) supplementation on fattening performance, fatty acid composition and the physico-chemical characteristics of meat in pigs. The present study was also stressed to investigate the possibility of industrial utilization of charcoal and pyroligneous acid as a livestock feed additive. Weight gain and feed conversion in pigs fed the Mogchotan supplemented diet were higher than those of the control group. In fatty acids composition, palmitic acid(C16:0) contents of Mogchotan treatment groups were lower than that of control group. However, Mogchotan supplementation increased C16:1, C18:0, C18:1, C18:2 and C18:3 contents when compared with control group pigs. Also, Mogchotan supplementation groups decreased saturated fatty acids level than control group. On the other hand, Mogchotan supplementation showed higher unsaturated fatty acids value, especially polyunsaturated fatty acids value compared to control group. The carcass pH of pigs fed the Mogchotan tended to be higher than control, but was not significantly different. The water holding capacity was significantly higher in pigs fed the 3.0% Mogchotan-supplemented diet than those of other treatment groups(p<0.05). Altogether, it has been suggested that dietary $1{\sim}3%$ of Mogchotan supplementation improved the fattening performance and meat quality in pigs.

• Journal of Hospice and Palliative Care
• /
• v.16 no.2
• /
• pp.90-97
• /
• 2013

Purpose: Ten years have passed since the Korean government announced its plan to institutionally support hospice and palliative care in 2002. In line with that, this study aims to suggest future directions for Korea's hospice and palliative care policy. Methods: We conducted a survey on people's perception and acceptance of well-dying. Data were collected from 1,000 participants aged 19~69 years between June 1 and June 11, 2012 via computer-assisted telephone interviews. Results: The most important factor for well-dying was placing no burden of care on others (36.7%) and the second most important factor was staying with their family and loved ones (19.1%). Among nine suggestions of policy support for well-dying, the most popular was the promotion of voluntary care sharing (88.3%), followed by the palliative care training support for healthcare providers (83.7%) and the support for palliative care facilities instead of funeral halls (81.7%). The idea of formulating a five-year national plan for end-of-life care drew strong support (91%). According to the survey, the plan should be implemented by the central government (47.5%), the National Assembly (20.2%) or civic groups (10%). Conclusion: This study demonstrated the public consensus and their consistent direction toward policy support for well-dying. Results of this study may serve as a foundation for the establishment of policy support for people's well-dying and palliative care at the national-level.

• Korean Journal of Environmental Biology
• /
• v.37 no.4
• /
• pp.749-758
• /
• 2019

The aim of this study is to provide a scientific basis for decision making regarding environmental damage in case of future chemical accidents by evaluating the ecotoxicity of 4 substances requiring preparation for accidents. For this purpose, acute and chronic toxicities of nitric acid, sulfuric acid, hydrogen peroxide, and ammonia solution, which can change the physical and chemical properties of soil to Paronychiurus kimi(Collembola) were investigated. The pH of artificial soil spiked with a series of test chemical concentrations was also measured. The pH of soil spiked with 10,000 mg kg^-1 of soil nitric acid, sulfuric acid, hydrogen peroxide, and ammonia solution were 2.86, 2.72, 7.18 and 9.69, respectively. The 28-d LC₅₀ of nitric acid, sulfuric acid, hydrogen peroxide and ammonia solution were 2,703, 5,414, 3,158 and 859 mg kg^-1 soil dry wt., respectively and 28-d EC₅₀ were 587, 2,148, 1,300 and 216 mg kg^-1 soil dry wt., respectively. These results indicated that the mortality and juvenile production of P. kimi were influenced by not only the soil pH but also by the reduced organic content and products produced by the reaction of soil with the tested chemicals. Given the fact that most substances requiring preparation for accidents can change soil characteristics, assessment and restoration methods that take into account changes in soil properties are needed for accurate decision making after chemical accidents.

• Journal of Hospice and Palliative Care
• /
• v.13 no.3
• /
• pp.181-189
• /
• 2010

Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

• Journal of Hospice and Palliative Care
• /
• v.7 no.2
• /
• pp.214-220
• /
• 2004

Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.