• Journal of The Geomorphological Association of Korea
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• v.27 no.3
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• pp.53-73
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• 2020

Morphology and grain size distribution of coastal dunes should be well documented because they are critical to dune's buffering capacity and resilience against storm surges. The nationwide coastal dune survey produced the dataset, including beach-dune topographic profiles and grain size parameters for frontal beaches, foredunes, and inland dunes. This research investigated the dataset to describe geomorphic and textural properties of coastal dunes: foredune slopes, dune heights above approximately highest high water, mean size, and sorting, together with associated variables of coastal setting that influence coastal dunes. It also explores the possibility of a dune type scheme based on gran size trends. The results are as follows. First, the coast in which dunes are developed is the primary control on foredune morphology and sediment texture. Coastal dunes on the east coast were developed more alongshore rather than inland, with gentler slopes on the higher ground and out of coarser sand. The shore aspect contributes to this pattern because the east coast cannot benefit from prevailing northwesterly. Second, grain size trends from beaches through foredunes to inland dunes were little identified. Third, 12 dune types were identified from 69 dunes, showing the indicative capability for the status of beaches and dunes. We confirmed that the dataset could increase our understanding of the overall characteristics of coastal dune morphology and texture, though there is something to be improved, for example, establishing the refined and comprehensive field survey protocol.

• The Journal of Korean Medicine
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• v.44 no.2
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• pp.201-201
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• 2023

Objectives: Cupping therapy (CT) has been widely used in traditional medicine worldwide for various indications, including stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• Health Policy and Management
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• v.33 no.4
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• pp.457-478
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• 2023

Background: This study aims to contribute to the adjustment of the appropriate doctor manpower by analyzing the distribution, supply and demand, and estimation of the doctor manpower. Methods: This study utilized the medical personnel data of the Ministry of Health and Welfare, population trend data of the National Statistical Office, and health insurance benefit performance data of the National Health Insurance Service. Based on 2021, we compared the number of doctors in actual supply and the number of doctors in demand according to the amount of medical use by gender and age for 250 regions. Logistic regression analysis and scenario analysis were performed to estimate the future medical workforce by considering the demand for doctors according to the future demographic structure, the size of the quota in medical schools, and the retirement rate. Results: There were 186 regions in which the supply of doctors was below average, and the average ratio of the number of doctors in supply to demand in the region was 62.1%. Conclusion: In order to increase the number of active doctors nationwide to at least 80%, 7,756 people must be allocated. The number of doctors in demand is estimated to decrease after increasing to 1.492 times in 2059. The future projected number of doctors is expected to increase to 1.349 times in 2050 and then decrease taking into account the doctor quota and the retirement rate.

• Child Health Nursing Research
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• v.29 no.4
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• pp.271-279
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• 2023

Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

• Journal of Gastric Cancer
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• v.24 no.2
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• pp.220-230
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• 2024

Purpose: Prevention of pancreas-related complications after gastric cancer surgery is critical. Polyglycolic acid (PGA) mesh reduces postoperative pancreatic fistula formation following pancreatic resection. However, the clinical efficacy of PGA mesh in gastric cancer surgery has not been adequately investigated. Materials and Methods: This retrospective study compared the short-term outcomes between two groups: patients who underwent minimally invasive R0 gastrectomy for gastric cancer with the use of a PGA mesh (PGA group) and those without the use of a PGA mesh (non-PGA group) at the Cancer Institute Hospital, Tokyo, between January 2019 and May 2023. Propensity score matching (PSM) was performed to adjust for the possible confounding factors. Results: A total of 834 patients were initially included, of whom 614 (307 in each group) remained after PSM. The amylase levels in the drained abdominal fluid on postoperative days 1 and 3 were similar between the PGA and non-PGA groups. The PGA group had a significantly lower incidence of pancreas-related complications of Clavien-Dindo grade ≥2 than that in the non-PGA group (6.8% vs. 2.9%, P=0.025). In subgroup analyses, the odds ratio for pancreas-related complications appeared to be better in the PGA group than in the non-PGA group in patients with American Society of Anesthesiologists Physical Status Classification score of 2 or 3, those operated via a laparoscopic approach, and those undergoing procedures other than proximal gastrectomy. Conclusions: The use of PGA mesh significantly reduced pancreas-related complications after minimally invasive surgery for gastric cancer and might thus benefit patients at risk of such complications.

• The Korean Journal of Pain
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• v.37 no.2
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• pp.119-131
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• 2024

There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

• Korean Journal of Agricultural Science
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• v.31 no.1
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• pp.53-75
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• 2004

This study is aimed at identifying the national economic value of the irrigation facilities by reviewing the existing papers on economic values of the irrigation facilities and presenting current status of dual O & M problems of the irrigation facilities. This study suggested the unified O & M system rather than continuing the existing dual O & M system of irrigation facilities based on the surveyed results of the activities of irrigation fraternities in Chungnam Province. The findings and proposals for the successful unified and mono O & M system of the irrigation facilities are as follows: (1) Total number of irrigation facilities in the nation accounts for 67,582, while the total length of irrigation and drainage canals amounted to about 174,259km. On account of the total length of structural canals was estimated at 31%, much losses of water and much O & M costs have been inevitable for the full irrigation rice culture. In spite of the past heavy investment for irrigation facilities, the ratio of rain-fed and partially irrigated paddy fields accounts for 23% in 2003. Both Korea Agricultural and Rural Infrastructure Corporation (KARICO) and the city and Gun Governments have managed the irrigation facilities separately by irrigation fraternities. The KARICO have commanded 59% of irrigation paddy area with 18% of the total irrigation facilities, while the city and Gun governments covered 41% of irrigation paddy area with 82% of the existing number of irrigation facilities representing small and medium scale. (2) The 1999 demand prices of irrigation water per ton expressed in 2000 constant market price was estimated at 388 won, the supply price was amounted to 184 won per ton. Considering the supply and demand curve of the irrigation water, the existing irrigation facilities could not satisfy the demand of irrigation water. (3) In 1999, total present added value of the irrigation facilities during the economic life accounted for 48 trillion won, while total supply cost was 44.7 trillion won. The marginal benefit and cost ratio of irrigation water was 1.08. (4) The total O & M cost per year amounting to 681.1 billion won have been required to maintain and repair the existing irrigation facilities in Korea. For the successful unified O & M of irrigation facilities covering whole irrigated paddy field in Korea, 950 billion won of O & M costs are required to keep up the marginal benefit of irrigation water as 2,800 billion won per year. The total O & M cost as 950 billion won should be allocated 40%, 380 billion won for O & M costs of irrigation facilities and 60%, 570 billion won for improvement of irrigation facilities. (5) The study investigated and reviewed the present O & M status of the irrigation facilities by small and medium irrigation fraternities. Most of the farmers belong to the irrigation fraternities preferred not only unified O & M but also KARICO take-over of the whole O & M activities of the irrigation facilities. The prevailing O & M cost per 10a expended by the Corporation was amounted to 104,890 won, while that of city and Gun governments was only amounted to 4,600 won per 10a. regarding the small amount of O & M cost expended by city and Gun governments, it is evident that the existing irrigation system have been managed ineffectively and deteriorated the facilities comparing that of KARICO. In conclusion, the Government could not satisfied the demand of irrigation water by suppling water with existing irrigation facilities. Therefore new additional investment and financial support for irrigation water development should be made to convert rain-fed and partially irrigated paddy fields into fully irrigated ones. The operation and maintenance cost should be supported to keep the marginal values of rice production of existing irrigation facilities in the national economy and to modernize the obsolete irrigation facilities. By unifying the existing dual O & M systems, all the farmers belong to the irrigated paddy fields have to be equally benefited and could be increased their farm income and be stabilized their rural lives.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.156-163
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• 1998

Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

• Journal of Korean Society of Transportation
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• v.30 no.1
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• pp.59-72
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• 2012

In aspects of traffic operation, a climbing lane may cause traffic congestion if the volume of traffic (v/c) grows and the ratio of heavy vehicle increases. Conversely, it would be effective, if the climbing lane is dynamically operated according to changes in traffic flow. However, there are no guideline to effectively control this climbing lane in aspects of traffic operation. In this study, we examine the necessity of flexible traffic operation criteria and its process for dynamic traffic management and also establish and analyze the effect of flexible traffic operation criteria in accordance with traffic properties using an example of climbing lane. We selected the operation criteria (critical travel speed), which decides whether to operate or close the climbing lane when the average travel speed of climbing lane is 50km/h based on VISSM (microscopic traffic simulation) analysis of Nakdong junction towards Masan with the volume of traffic (v/c), ratio of heavy vehicle as the traffic operation parameters. Based on the simulation result in accordance with the volume of traffic by the operation mode of climbing lane, the analysis on the effect of dynamic traffic management of climbing lane showed that the dynamic traffic management provides more convenience compare to the operation and close of climbing lane. Thereby, we proved that the dynamic traffic management of climbing lane is more effective.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.34 no.1
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• pp.235-241
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• 2014

There are many traffic problems in a city such as parking, traffic jam caused by traffic induction facility. Therefore it is essential to demand for traffic demand management to building's owner whose building location causes traffic induction. According to the 90s traffic policy, government collects fee for traffic induction facility through traffic policy management and they encourage the building owner to join reduction of traffic jam program by reduction of traffic induction fee. However there are not many buildings owner joined this program because the program is not ghat beneficial. For example, if government set out parking guidance system (part of parking demanding system) in a city, it will reduce to 20% of traffic induced contributions but t can be used only once a year, so it is not efficient to used even it is valuable for about 10 years. In particular, according to the economic efficiency analysis, evaluate economically as net present value (NPV) to 2,160.44 million won, ratio of benefit/cost (B / C) to 2.44 during 10 years. Therefore this research will find out what is necessary for parking guidance system.