• Journal of Environmental Policy
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• v.9 no.2
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• pp.185-205
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• 2010

Climate change vulnerability assessment based on local conditions is a prerequisite for establishment of climate change adaptation policies. While some studies have developed a methodology for vulnerability assessment at the national level using statistical data, few attempts, whether domestic or overseas, have been made to develop methods for local vulnerability assessments that are easily applicable to a single city. Accordingly, the objective of this study was to develop a conceptual framework for climate change vulnerability, and then develop a general methodology for assessment at the regional level applied to a single coastal city, Mokpo, in Jeolla province, Korea. We followed the conceptual framework of climate change vulnerability proposed by the IPCC (1996) which consists of "climate exposure," "systemic sensitivity," and "systemic adaptive capacity." "Climate exposure" was designated as sea level rises of 1, 2, 3, 4, and 5 meter(s), allowing for a simple scenario for sea level rises. Should more complex forecasts of sea level rises be required later, the methodology developed herein can be easily scaled and transferred to other projects. Mokpo was chosen as a seaside city on the southwest coast of Korea, where all cities have experienced rising sea levels. Mokpo has experienced the largest sea level increases of all, and is a region where abnormal high tide events have become a significant threat; especially subsequent to the construction of an estuary dam and breakwaters. Sensitivity to sea level rises was measured by the percentage of flooded area for each administrative region within Mokpo evaluated via simulations using GIS techniques. Population density, particularly that of senior citizens, was also factored in. Adaptive capacity was considered from both the "hardware" and "software" aspects. "Hardware" adaptive capacity was incorporated by considering the presence (or lack thereof) of breakwaters and seawalls, as well as their height. "Software" adaptive capacity was measured using a survey method. The survey questionnaire included economic status, awareness of climate change impact and adaptation, governance, and policy, and was distributed to 75 governmental officials working for Mokpo. Vulnerability to sea level rises was assessed by subtracting adaptive capacity from the sensitivity index. Application of the methodology to Mokpo indicated vulnerability was high for seven out of 20 administrative districts. The results of our methodology provides significant policy implications for the development of climate change adaptation policy as follows: 1) regions with high priority for climate change adaptation measures can be selected through a correlation diagram between vulnerabilities and records of previous flood damage, and 2) after review of existing short, mid, and long-term plans or projects in high priority areas, appropriate adaptation measures can be taken as per this study. Future studies should focus on expanding analysis of climate change exposure from sea level rises to other adverse climate related events, including heat waves, torrential rain, and drought etc.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.611-618
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• 2006

Background: There have been controversies whether mitral valvular surgery is necessary in the patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting. The purpose of this study is to evaluate the long term clinical results of patients with moderate ischemic mitral regurgitation. Material and Method: Between January 1992 and February 2005, 44 patients with moderate ischemic mitral regurgitation underwent coronary artery bypass grafting. Concomitant mitral valvular procedure was performed in 20 patients (group 1) and isolated coronary artery bypass grafting was performed in 24 patients (group 2). There were no significant difference between groups except cardiopulmonary bypass time (p<0.01). Postoperative follow up duration was $30.1{\pm}29.6$ months and last follow up echocardiographic examination was performed at $21.2{\pm}28.0$ months. Result: There was no difference in operative mortality between groups (group 1 vs group 2, 15.0% vs 8.3%, p=0.493). Grade of mitral regurgitation ${(0.81{\pm}0.91\;vs\;1.50{\pm}0.05,\;p=0.046)}$ and reduction in regurgitation grade ${(1.75{\pm}0.93\;vs\;0.70{\pm}1.26,\;p=0.009)}$ were different between two groups. But there were no significant differences in left ventricular ejection fraction ${(34.1{\pm}11.4%\;vs\;41.6{\pm}12.9%)}$, left ventricular end systolic volume ${(118.2{\pm}63.9\;ml%\;vs\;85.6{\pm}281\;ml)}$, New York Heart Association functional class ${(2.1{\pm}0.2\;vs\;2.4{\pm}1.2)}$ and 5 year survival rate ${(85{\pm}8%\;vs\;82{\pm}8%)}$. There was no risk factor for operative mortality and the only risk factor for late death was preoperative atrial fibrillation (p=0.042). There was no significant correlation between mitral valvular surgery and late death. Conclusion: Concomitant mitral valvular procedure in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting had no significant positive effect on survival and ventricular function compared with isolated coronary artery bypass grafting. Prospective randomized study may be needed to evaluate the necessity of concomitant mitral procedure and to find more effective method for the improvement of ventricular function.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.905-911
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• 2007

Purpose : Ghrelin, being secreted from the stomach, stimulates growth hormone secretion and controls energy homeostasis by increasing appetite. Leptin, being secreted from the adipocytes, controls weight and energy homeostasis by decreasing appetite. Leptin concentration is reported to increase after childhood cancer therapy. This study was aimed to compare ghrelin and leptin concentrations in normal children and children who received cancer therapy. Methods : We enrolled forty-three patients who were diagnosed with cancer and received radiotherapy or chemotherapy during Dec. 2004 through Dec. 2005 in St. Marys hospital and Kangnam St. Marys hospital. Forty-five healthy children were selected as a control group whose age, gender, weight and height were similar to those of cancer group. The serum leptin and ghrelin concentrations were also measured by radioimmunoassay. Results : The cancer group showed higher BMI and leptin concentrations. The control group showed higher concentrations of ghrelin. Both control and cancer groups revealed positive correlations between leptin concentrations and BMI. Ghrelin concentrations in the control group showed negative correlations with age, height, weight and BMI but no significant correlation was found in the cancer group. All the parameters in the group treated with chemotherapy only were not different from those in the group treated with chemotherapy and irradiation. But the level of ghrelin in the acute myeloid leukemia group was much higher than those in the acute lymphoblastic leukemia group. Conclusion : Patients with pediatric cancer treatment have presented higher BMI and leptin concentrations but lower ghrelin concentrations than those in healthy children. Because of the relatively short duration and cross sectional method of the study, however, further long term and prospective study will be required in the future.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.315-322
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• 2008

Purpose : Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by the deletion of the paternally derived 15q11-13 region or the maternal uniparental disomy of chromosome 15 (mUPD(15)). In this study, we compared phenotypic differences between those patients whose disease was caused by microdeletion and those caused by mUPD(15). In addition, a comparison of the efficacy of growth hormone (GH) therapy between these two PWS genotypes was analyzed. Methods : Fifty-three patients were diagnosed as having PWS based on molecular and cytogenetic analyses and clinical features. Data that included maternal age, birth weight, a feeding problem in the neonatal period, cryptorchidism, developmental delay or mental retardation, short stature, hypopigmentation, changes in height, weight, and body mass indexes (BMI) before and after GH treatment were obtained by a retrospective review of medical records. The data from the patients with microdeletion were compared with those from the patients with mUPD(15). Results : Of the 53 patients with genetically confirmed PWS, 39 cases had microdeletion and 14 mUPD(15). Maternal ages were significantly higher in the mUPD(15) group, and hypopigmentation and a feeding problem in the neonatal period were more frequent in the microdeletion group. Growth hormone was administered to 20 patients [14 with microdeletion, 6 with mUPD(15)]. There were no differences between the two groups in height velocity, weight and height SDS, and BMI after GH therapy. Conclusion : Phenotype and genotype correlations were observed in Korean PWS patients, such as more advanced maternal ages in the mUPD(15) group and more feeding problems and hypopigmentations in the microdeletion group. Further long-term prospective studies are needed to correlate other aspects of the phenotypes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.18-28
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• 2005

Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

• The Journal of Industrial Distribution & Business
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• v.8 no.6
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• pp.51-60
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• 2017

Purpose - This study aimed to investigate the correlation between the social activity of the elderly and recognition of family cohesion of the elderly who are exposed to the current aging society. In addition, the study has delved into the method of family cohesion improvement through the differences between groups based on the mediator effect of how the results have effects on the elderly's self-control capabilities. Research design, data, and methodology - This study has targeted the elderly who are attending the elderly university among users in seven community centers located in Seoul and Gyeonggi-do area. The study has also conducted a survey by the format of a half-structured questionnaire. It is aiming to investigate the elderly's family cohesion with children and their self-control capability, and understand their satisfaction of social activity to help successful elderly life. The study has suggested the following as mentioned. First, the study analyzed that the perceptual factor of family cohesion with children would be deducted based on advanced researches. Second, the influencing relationship would be analyzed through the relational analysis between the elderly's family cohesion and social activity. Results - The family cohesion with children has a significant effect on psychological happiness and it showed the influencing relationship with improvement of the elderly's self-control capability. Therefore, creating fellowship through meaningful conversation with children would be needed. In addition, various programs and consultant service would be offered to build healthy relationship between aged parents and their children. Through this, the elderly will be able to have not only better relationships with their family, but also increased psychological health and well-being as well. Conclusions - It is needed that not only supporting policies for children who take care of aged parents but also that the elderly who need long-term care could meet their children whenever they want through increased numbers of sanatoriums operated by cities and countries. In addition, the nation would offer financial and administrative support continuously so that people receive the benefits from sanatoriums located in the locality of children's residence beyond the elderly's residence. Moreover, social infra would be established as well.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.50-57
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• 1995

Background: Transcather arterial embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function such as postpneumonectomy patients and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization and analysed the correlation of the clinical and angiographic characteristics and investigated the clinical course and outcome after arterial embolization in the patients with significant hemoptysis. Method: 58 patients with massive or recurrent hemoptysis underwent transcatheter arterial embolization for the treatment of hemoptysis from April 1992 to Sept. 1993. Results: Most common cause of hemoptysis was pulmonary tuberculosis(34 cases, 58.3%). Embolized vessels responsible for hemoptysis were 56 bronchial arteries and 32 nonbronchial systemic arteries. Initial most common angiographic findings were hypervascularity and shunt. Initial success rate of hemoptysis control revealed 81.1%. However, 15 of 58 patients(25.9%) showed recurrence of hemoptysis after transcatheter arterial embolization. The complications(18 cases, 31%) such as chest pain, fever, voiding difficulty, atelectasis, paralytic ileus and unwanted embolization were occured. Conclusion: Transcatheter arterial embolization is useful and relatively safe treatment modality for immediate bleeding control of patients with massive hemoptysis or inoperable cases. The further evaluation of the long term results according to the embolized material and underlying pulmonary disease will be required.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.631-637
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• 2005

Background : Transcriptional factors of the CREB(cAMP Response Element Binding Protein) are involved in the regulation of gene expression in response to a variety of signaling pathways. Proteins produced by the CREB genes play key roles in many physiological processes, including memory and long-term potentiation. The retinoic acid receptor (RAR) axis mediates epithelial cell differentiation and proliferation in many tissues including the lung. Material and method : The RAR and CREB expression levels were examined in 60 adenocarcinomas and 60 squamous cell carcinomas of the lung using immunohistochemical staining. Results : 1) RAR protein expression was found in 58.3%(35/60) of adenocarcinomas and 36.7%(22/60) of squamous cell carcinomas(P<0.05). 2) RAR protein expression was found in 80%(16/20) of well differentiated adenocarcinomas, 60%(12/20) of moderately differentiated adenocarcinomas, and 35%(7/20) of poorly differentiated adenocarcinomas (P<0.01). 3) RAR protein expression was found in 45%(9/20) of well differentiated squamous cell carcinomas, 35%(7/20) of moderately differentiated squamous cell carcinomas, and 30%(6/20) of poorly differentiated squamous cell carcinomas (P>0.05). 4) CREB expression was found in 61.7%(37/60) of adenocarcinomas and 40%(24/60) of squamous cell carcinomas( P<0.05). 5) CREB expression was found in 85%(17/20) of well differentiated adenocarcinomas, 60%(12/20) of moderately differentiated adenocarcinomas, and 40%(8/20) of poorly differentiated adenocarcinomas (P<0.01). 6) CREB expression was found in 45%(9/20) of well differentiated squamous cell carcinomas, 35%(7/20) of moderately differentiated squamous cell carcinomas, and 35%(8/20) of poorly differentiated squamous cell carcinomas(P>0.05). 7) RAR and CREB expression was found in 68.5% of lung cancers, and there was a significant correlation between them(P<0.05). Conclusion : RAR and CREB expression can be used to indirectly determine the malignant potentiality of a cell.

• KDI Journal of Economic Policy
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• v.12 no.1
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• pp.111-125
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• 1990

For the last several years, considerable criticism has been leveled against Korea's exchange rate management. While Korea was designated a currency manipulator by the U.S., domestically it is often complained that the won/dollar rate did not adequately reflect changes in Korea's export competitiveness and fluctuations in the exchange rates of major currencies. In view of this situation, Korea changed its exchange regime at the beginning of March this year from the dual currency basket system to a more flexible one, called a "market average rate regime". Under this new regime, the won rate is determined in the exchange market based upon the supply of and demand for foreign exchange and is allowed to freely fluctuate each day within a + 0.4 % range. This paper, first, seeks to evaluate Korea's exchange rate management under the dual basket regime of the 1980s, and then to construct an optimal currency basket for the won which could provide a proper indicator for exchange market intervention under the new market average rate regime. The analysis of fluctuations in the real effective exchange rate (REER) of the won indicates that the won rates in the 1980s failed not only to offset changes in relative prices between home and trading partner countries, but also to properly respond to variations in major exchange rates as further evidenced by sizable fluctuations in the nominal effective rates of the won. In other words, the currency basket regime which was adopted in 1980 for the stabilization of the REER of the won has not been operated properly, mainly because authorities often resorted to policy considerations in determining the won's rate. In the second part of the paper, an optimal currency basket for Korea is constructed, designed to minimize the fluctuations in the REER of the won without including policy considerations as a factor. It is recognized, however, that both domestic and foreign price data are not available immediately for the calculation of the REER. For this problem, the approach suggested by Lipschitz (1980) is followed, in which optimal weights for currencies in the basket are determined based upon the past correlation between price and exchange rates. When the optimal basket is applied to Korea since the mid-80s, it is found that the REER of the won could have been much more stable than it actually was. We also argue for the use of variable weights rather than fixed ones, which would be determined by the changing relationship between exchange rates and relative prices. The optimal basket, and the optimal basket exchange rate based on that basket, could provide an important medium- or long-term reference for proper exchange market intervention under the market average rate regime, together with other factors, such as developments in the current account balance and changes in productivity.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.506-525
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• 1992

Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.