• 한국지형학회지
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• 제27권3호
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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.

• 대한한의학회지
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• 제44권2호
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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.

• 보건행정학회지
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• 제33권4호
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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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• 제29권4호
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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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• 제24권2호
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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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• 제37권2호
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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.

• 농업과학연구
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• 제31권1호
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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.

• 대한두경부종양학회지
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• 제14권2호
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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.

• 대한교통학회지
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• 제30권1호
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• pp.59-72
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• 2012

교통소통을 개선하기 위해 설치된 오르막차로의 운영효율은 교통상태에 따라 달라지는 것이 관측된다. 교통운영측면에서 교통량(v/c)이 증가하고 중차량 구성비가 증가할 경우, 오르막차로는 오히려 교통혼잡의 요인으로 작용하기도 한다. 이는 교통류 상태에 따라 오르막차로를 동적으로 운영하면 효과가 있다는 것을 시사하지만, 교통운영측면에서 이를 효과적으로 제어할 계량적인 기준은 없는 실정이다. 본 연구에서는 오르막구간에서의 동적차로운영기준의 필요성을 제시하고, 교통특성에 맞는 기준을 수립하여 이에 대한 효과를 분석하고자 하였다. 낙동분기점 마산방향의 오르막구간을 선정하여 교통량비(v/c), 중차량 구성비 등을 교통운영변수로 VISSIM 분석을 시행하였다. 시뮬레이션 결과, 오르막구간의 평균통행속도가 50km/h일 때 오르막차로의 개방과 폐쇄를 결정하는 운영기준(임계통행속도)으로 적절한 것으로 나타났다. 또한 오르막차로 동적운영에 따른 효과를 분석한 결과, 동적운영의 경우 일반적인 개방과 폐쇄보다 편익이 높은 것으로 나타났다.

• 대한토목학회논문집
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• 제34권1호
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• pp.235-241
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• 2014

도심지내 대규모 교통유발시설로 인한 인구 및 차량 집중화로 주차, 혼잡 등의 교통문제가 지속적으로 대두되고 있다. 이를 해결하기 위해 정책적인 교통수요관리 외에 교통유발의 원인이 되는 건물 소유주에게 자발적인 교통수요제도 참여를 유도하는 것이 필수적인 부분이다. 이러한 맥락으로 이미 '90년부터 정책적으로 교통유발부담금제도를 운영하여 교통유발시설에 대해서 부담금을 징수 해왔고, 건물 소유주의 참여 유도를 위해 교통량감축 프로그램을 이행할 시 교통유발부담금을 감면해주고 있다. 그러나 전체적인 부담금 감면 혜택의 약화 등으로 참여 유도가 미흡한 실정이다. 특히, 본 연구에서 다루고자하는 주차수요관리의 일환인 주차유도시스템은 실제 설치 시 최대 20%까지 부담금을 감면해 주지만 해당연도 1회에 불과하여 약 10년 정도의 효용가치가 있음에도 효율적으로 활용되지 못하고 있다. 또한 경제적 분석 기법을 활용한 결과, 주차유도시스템 내구연한을 10년 정도 가정해 볼 때, 사회적 할인율을 감안하면, 현재 기준 약 3,662,390,000원의 경제적 효과가 발생할 것으로 추정되었고, 순현재가치(NPV)는 2,160,440,000원와 비용-편익비(B/C Ratio)는 2.44로 나타났다. 따라서 본 연구에서는 주차유도시스템을 실제로 설치하여 조사한 자료를 바탕으로 설치전후를 비교한 사례를 제시하고 효과를 분석하여 교통유발부담금 경감을 위한 주차유도시스템의 활용에 필요한 정책적 시사점을 제시하는데 목적이 있다.