• 한국노년학
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• v.41 no.2
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• pp.217-240
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• 2021

The purpose of this study is to examine the effect of care workers' employment characteristics and perception of facility directors' transformational leadership on quality of service through a hierarchical linear model. For this aim, survey data were collected amongst 240 older adults and 200 care workers who are affiliated within 45 long-term care facilities in Seoul, and analyzed using SPSS 26.0 and HLM 8.0. As a result, one's perception of transformational leadership had a positive effect, whereas, among employment characteristics, employment type and working hours had negative effects on quality of service. Regular workers with fewer working hours and higher awareness of transformational leadership toward the director provided higher quality of service. But wage, total experience and tenure didn't meaningfully affect it. Therefore, the following suggestions were presented. First, it is necessary to reorganize incentive, salary systems and budgets, changing the status of temporary workers' hourly wage system into that of regular workers' monthly one in order to strengthen employment security with acknowledging fundamental professional values through reinforcement of expertise. Reinforcement of long-term care's publicness and establishment of base facilities are also suggested. Second, maintaining appropriate hours of work and rest including annual leave under the Labor Standards Act is needed. Also, increasing the salary of and decreasing working hours for night shift workers are required. Third, education and intervention for inspiring transformational leadership of directors and strengthening qualification standards of them are required.

• Journal of Teachers' Pension
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• v.3
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• pp.69-105
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• 2018

저출산과 고령화 이슈는 우리사회의 경제적 문제뿐만 아니라 공적연금의 재정지속가능성 여부와도 맞물려 있다. 실제로 우리나라 모든 공적연금은 사회보험역설(social insurance paradox)이 지속되기 힘든 새로운 도전에 직면하였다. 즉, 재정지속가능성은 제도 내적 연금개혁 혹은 제도 외적 재정지원이 없다면 항시적 수지불균형 상태가 누적될 것으로 예측된다. 이에 정부는 직접 고용과 관련된 공무원연금과 군인연금에 대해서만 연금충당부채를 산출하도록 규정하고 있다. 발생주의회계를 채택한 국제회계기준(종업원급여)을 참조하여 연금충당부채 산출을 위한 연금회계준칙(2011.8.3. 제정; 2011.1.1. 시행) 그리고 '연금회계 평가 및 공시 지침(2011.8.3. 고시 : 이하 편의상 연금회계지침이라 함)'을 신설하였다. 사학연금에 적용성 여부 논의에 앞서, 이들의 산출방법상의 문제점을 먼저 살펴보았다. 첫째, 공적연금은 공통적으로 세대 간 합의에 의해 운영되는 사회계약에 해당하므로 제도의 연속성을 전제로 한다. 하지만 연금회계준칙 및 지침은 제도의 청산을 전제로 현재 가입자(연금 미수령자, 연금 수령자)에 대해서 연금충당부채를 산출하는 폐쇄형측정(closed group valuation)을 채택하고 있다. 즉, 폐쇄형은 제도의 연속성 속성을 반영하고 있지 못하고 있어 기본 전제와 모순된다. 둘째, 공무원연금과 군인연금은 이미 기금 소진(최소한의 유동성기금만 보유함)이 되었고 정부의 보전금에 의해 수지 균형이 유지되는 순수부과방식 체계로 전환되었다. 따라서 연금충당부채는 해당 적립기금의 과소 여부를 판정하는 재정상태 기준 값에 해당하므로 기금소진이 진행된 현 상황에서는 산출의 목적, 필요성을 찾기가 힘들다. 부언하면, 제도 외적 재정지원(보전금)에 의한 수지균형방식이라면 발생주의회계보다는 현금주의회계가 회계의 목적적합성이 높다. 마지막으로 연금충당부채 산출에 있어 가장 민감한 할인율 설정 권한을 기재부장관에게 위임한 내용은 산출의 객관성, 일관성을 확보하기 힘들다고 판단된다. 이를 해소하기 위한 방안으로 본 연구에서는 5년마다 실시하고 있는 장기재정계산에서 예측된 명목 기금투자수익률을 연도별로 적용할 것을 권고하고 있다. 현행 정부회계기준을 사학연금제도에 그대로 적용하기에는 상당한 무리가 있다. 그 이유와 공시방안에 대해 살펴본다. 현재 사학연금은 기금소진 이슈로부터 상당부분 벗어나기 위해 2015년 연금개혁을 단행한 바가 있고 이를 통해 상당기간 부분적립방식 체계가 유지될 것이다. 물론 제도 외적 재정지원은 사학연금법 제53조의7에서 정부지원의 가능성만을 열어 놓은 상태이므로 미래기금소진의 가능성은 상존한다고 볼 수 있다. 먼 미래에는 순수부과방식 체계로 전환될 개연성이 높다. 이러한 재정의 양면성을 본 연구에서는 이중재정방식(dual financing system)이라고 한다. 이러한 속성을 고려하여 연금충당부채(연금채무라는 표현이 적합할 것으로 사료됨)를 산출하고 공시하여야 한다. 그 주요 연구 결과는 다음과 같이 요약된다. 먼저 현행 부분적립방식의 재정상태 검증을 위해 연금채무를 산정할 필요성이 있다. 이를 위해 본 연구에서는 기발생주의(예측단위방식 적용)에 근거한 폐쇄형 측정I(제도 종료를 전제로 현 가입자의 잠재연금채무(IPD) 산출에 초점을 둠) 그리고 미래발생주의(가입연령방식 적용)에 근거한 폐쇄형 측정II(추가적으로 현 가입자의 일정기간 급여 및 기여 발생 허용)을 제안하고 있다. 이를 통해 미적립채무의 규모 그리고 이를 해소하기 위한 상각부담률을 산출할 수 있다. 최종적으로 미래 가입자들까지 포함하고 기금소진 가능성까지 고려하는 개방형측정(open group valuation)을 다루고 있다. 단, 본 연구에서는 공무원연금처럼 기금부족분에 대해서 향후 정부보전금이 있다는 가정 하에 공시 방법을 제시하고 있다. 요약하면, 현행 사학연금제도는 현재와 미래의 재정 양면성을 모두 고려하여 연금채무 및 미적립채무를 공시하여야 한다. 부언하면, 현재 부분적립방식 재정상태를 반영하는 연금채무는 발생주의회계를 적용하고 미래에 도래할 순수부과방식 재정상태는 현금주의회계를 적용할 것을 최종 결론으로 도출하고 있다. 마지막으로 본 연구의 한계는 정부보전금의 가능성에 대한 법률적 해석과 병행하여 책임준비금 범위의 안정적 확대를 전제로 한 공시 논의 그리고 보전금의 책임한도 범위에 따른 공시 논의 등은 다루고 있지 않다는 점이다. 이러한 논의 사항은 향후 연구과제로 두고자 한다.

• KIPS Transactions on Computer and Communication Systems
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• v.12 no.5
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• pp.171-180
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• 2023

The three major sleep disorders in Korea are snoring, sleep apnea, and insomnia. Lack of sleep is the root of all diseases. Some of the most serious potential problems associated with sleep deprivation are cardiovascular problems, cognitive impairment, obesity, diabetes, colitis, prostate cancer, etc. To solve these problems, the Korean government provided low-cost national health insurance benefits for polysomnography tests in July 2018. However, insomnia patients still have problems getting treated in terms of time, space, and economic perspectives. Therefore, it would be better for insomnia patients to be allowed to test at home. The measuring device can measure six biosignals (eye movement, tossing and turning, body temperature, oxygen saturation, heart rate, and audio). A gyroscope sensor (MPU9250, InvenSense, USA) was used for eye movement, tossing, and turning. The input range of the sensor was in 258°/sec to 460°/sec, and the data range was in the input range. Body temperature, oxygen saturation range, and heart rate were measured by a sensor (MAX30102, Analog Devices, USA). The body temperature was measured in 30 ℃ to 45 ℃, and the oxygen saturation range was 0% for the unused state and 20 % to 90 % for the used state. The heart rate measurement range was in 40 bpm to 180 bpm. The measurement of audio signal was performed by an audio sensor (AMM2742-T-R, PUIaudio, USA). The was -42 dB ±1 dB frequency range was 20 Hz to 20 kHz. The measured data was successfully received in wireless network conditions. The system configuration was consisted of a PC and a mobile app for bio-signal measurement and data collection. The measured data was collected by mobile phones and desktops. The data collected can be used as preliminary data to determine the stage of sleep and perform the screening function for sleep induction and sleep disturbances. In the future, this convenient sleep measurement device could be beneficial for treating insomnia.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Journal of Intelligence and Information Systems
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• v.21 no.4
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• pp.37-51
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• 2015

Due to the development of internet technology and the rapid increase of internet data, various studies are actively conducted on how to use and analyze internet data for various purposes. In particular, in recent years, a number of studies have been performed on the applications of text mining techniques in order to overcome the limitations of the current application of structured data. Especially, there are various studies on sentimental analysis to score opinions based on the distribution of polarity such as positivity or negativity of vocabularies or sentences of the texts in documents. As a part of such studies, this study tries to predict ups and downs of stock prices of companies by performing sentimental analysis on news contexts of the particular companies in the Internet. A variety of news on companies is produced online by different economic agents, and it is diffused quickly and accessed easily in the Internet. So, based on inefficient market hypothesis, we can expect that news information of an individual company can be used to predict the fluctuations of stock prices of the company if we apply proper data analysis techniques. However, as the areas of corporate management activity are different, an analysis considering characteristics of each company is required in the analysis of text data based on machine-learning. In addition, since the news including positive or negative information on certain companies have various impacts on other companies or industry fields, an analysis for the prediction of the stock price of each company is necessary. Therefore, this study attempted to predict changes in the stock prices of the individual companies that applied a sentimental analysis of the online news data. Accordingly, this study chose top company in KOSPI 200 as the subjects of the analysis, and collected and analyzed online news data by each company produced for two years on a representative domestic search portal service, Naver. In addition, considering the differences in the meanings of vocabularies for each of the certain economic subjects, it aims to improve performance by building up a lexicon for each individual company and applying that to an analysis. As a result of the analysis, the accuracy of the prediction by each company are different, and the prediction accurate rate turned out to be 56% on average. Comparing the accuracy of the prediction of stock prices on industry sectors, 'energy/chemical', 'consumer goods for living' and 'consumer discretionary' showed a relatively higher accuracy of the prediction of stock prices than other industries, while it was found that the sectors such as 'information technology' and 'shipbuilding/transportation' industry had lower accuracy of prediction. The number of the representative companies in each industry collected was five each, so it is somewhat difficult to generalize, but it could be confirmed that there was a difference in the accuracy of the prediction of stock prices depending on industry sectors. In addition, at the individual company level, the companies such as 'Kangwon Land', 'KT & G' and 'SK Innovation' showed a relatively higher prediction accuracy as compared to other companies, while it showed that the companies such as 'Young Poong', 'LG', 'Samsung Life Insurance', and 'Doosan' had a low prediction accuracy of less than 50%. In this paper, we performed an analysis of the share price performance relative to the prediction of individual companies through the vocabulary of pre-built company to take advantage of the online news information. In this paper, we aim to improve performance of the stock prices prediction, applying online news information, through the stock price prediction of individual companies. Based on this, in the future, it will be possible to find ways to increase the stock price prediction accuracy by complementing the problem of unnecessary words that are added to the sentiment dictionary.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.7-15
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• 2007

[ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.138-155
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• 2000

Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.2
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• pp.37-81
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• 2015

AirAsia QZ8501 Jet departed from Juanda International Airport in, Surabaya, Indonesia at 05:35 on Dec. 28, 2014 and was scheduled to arrive at Changi International Airport in Singapore at 08:30 the same day. The aircraft, an Airbus A320-200 crashed into the Java Sea on Dec. 28, 2014 carrying 162 passengers and crew off the coast of Indonesia's second largest city Surabaya on its way to Singapore. Indonesia's AirAsia jet carrying 162 people lost contact with ground control on Dec. 28, 2014. The aircraft's debris was found about 66 miles from the plane's last detected position. The 155 passengers and seven crew members aboard Flight QZ 8501, which vanished from radar 42 minutes after having departed Indonesia's second largest city of Surabaya bound for Singapore early Dec. 28, 2014. AirAsia QZ8501 had on board 137 adult passengers, 17 children and one infant, along with two pilots and five crew members in the aircraft, a majority of them Indonesian nationals. On board Flight QZ8501 were 155 Indonesian, three South Koreans, and one person each from Singapore, Malaysia and the UK. The Malaysia Airlines Flight 370 departed from Kuala Lumpur International Airport on March 8, 2014 at 00:41 local time and was scheduled to land at Beijing's Capital International Airport at 06:30 local time. Malaysia Airlines also marketed as China Southern Airlines Flight 748 (CZ748) through a code-share agreement, was a scheduled international passenger flight that disappeared on 8 March 2014 en route from Kuala Lumpur International Airport to Beijing's Capital International Airport (a distance of 2,743 miles: 4,414 km). The aircraft, a Boeing 777-200ER, last made contact with air traffic control less than an hour after takeoff. Operated by Malaysia Airlines (MAS), the aircraft carried 12 crew members and 227 passengers from 15 nations. There were 227 passengers, including 153 Chinese and 38 Malaysians, according to records. Nearly two-thirds of the passengers on Flight 370 were from China. On April 5, 2014 what could be the wreckage of the ill-fated Malaysia Airlines was found. What appeared to be the remnants of flight MH370 have been spotted drifting in a remote section of the Indian Ocean. Compensation for loss of life is vastly different between US. passengers and non-U.S. passengers. "If the claim is brought in the US. court, it's of significantly more value than if it's brought into any other court." Some victims and survivors of the Indonesian and Malaysia airline's air crash case would like to sue the lawsuit to the United States court in order to receive a larger compensation package for damage caused by an accident that occurred in the sea of Java sea and the Indian ocean and rather than taking it to the Indonesian or Malaysian court. Though each victim and survivor of the Indonesian and Malaysia airline's air crash case will receive an unconditional 113,100 Unit of Account (SDR) as an amount of compensation for damage from Indonesia's AirAsia and Malaysia Airlines in accordance with Article 21, 1 (absolute, strict, no-fault liability system) of the 1999 Montreal Convention. But if Indonesia AirAsia airlines and Malaysia Airlines cannot prove as to the following two points without fault based on Article 21, 2 (presumed faulty system) of the 1999 Montreal Convention, AirAsia of Indonesiaand Malaysia Airlines will be burdened the unlimited liability to the each victim and survivor of the Indonesian and Malaysia airline's air crash case such as (1) such damage was not due to the negligence or other wrongful act or omission of the air carrier or its servants or agents, or (2) such damage was solely due to the negligence or other wrongful act or omission of a third party. In this researcher's view for the aforementioned reasons, and under the laws of China, Indonesia, Malaysia and Korea the Chinese, Indonesian, Malaysia and Korean, some victims and survivors of the crash of the two flights are entitled to receive possibly from more than 113,100 SDR to 5 million US$ from the two airlines or from the Aviation Insurance Company based on decision of the American court. It could also be argued that it is reasonable and necessary to revise the clause referring to bodily injury to a clause mentioning personal injury based on Article 17 of the 1999 Montreal Convention so as to be included the mental injury and condolence in the near future.

• Journal of Wetlands Research
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• v.18 no.4
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• pp.474-480
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• 2016

In this study, formation background of biodiversity and its changes in the process of geologic history, and effects of climate change on biodiversity and human were discussed and the alternatives to reduce the effects of climate change were suggested. Biodiversity is 'the variety of life' and refers collectively to variation at all levels of biological organization. That is, biodiversity encompasses the genes, species and ecosystems and their interactions. It provides the basis for ecosystems and the services on which all people fundamentally depend. Nevertheless, today, biodiversity is increasingly threatened, usually as the result of human activity. Diverse organisms on earth, which are estimated as 10 to 30 million species, are the result of adaptation and evolution to various environments through long history of four billion years since the birth of life. Countlessly many organisms composing biodiversity have specific characteristics, respectively and are interrelated with each other through diverse relationship. Environment of the earth, on which we live, has also created for long years through extensive relationship and interaction of those organisms. We mankind also live through interrelationship with the other organisms as an organism. The man cannot lives without the other organisms around him. Even though so, human beings accelerate mean extinction rate about 1,000 times compared with that of the past for recent several years. We have to conserve biodiversity for plentiful life of our future generation and are responsible for sustainable use of biodiversity. Korea has achieved faster economic growth than any other countries in the world. On the other hand, Korea had hold originally rich biodiversity as it is not only a peninsula country stretched lengthily from north to south but also three sides are surrounded by sea. But they disappeared increasingly in the process of fast economic growth. Korean people have created specific Korean culture by coexistence with nature through a long history of agriculture, forestry, and fishery. But in recent years, the relationship between Korean and nature became far in the processes of introduction of western culture and development of science and technology and specific natural feature born from harmonious combination between nature and culture disappears more and more. Population of Korea is expected to be reduced as contrasted with world population growing continuously. At this time, we need to restore biodiversity damaged in the processes of rapid population growth and economic development in concert with recovery of natural ecosystem due to population decrease. There were grand extinction events of five times since the birth of life on the earth. Modern extinction is very rapid and human activity is major causal factor. In these respects, it is distinguished from the past one. Climate change is real. Biodiversity is very vulnerable to climate change. If organisms did not find a survival method such as 'adaptation through evolution', 'movement to the other place where they can exist', and so on in the changed environment, they would extinct. In this respect, if climate change is continued, biodiversity should be damaged greatly. Furthermore, climate change would also influence on human life and socio-economic environment through change of biodiversity. Therefore, we need to grasp the effects that climate change influences on biodiversity more actively and further to prepare the alternatives to reduce the damage. Change of phenology, change of distribution range including vegetation shift, disharmony of interaction among organisms, reduction of reproduction and growth rates due to odd food chain, degradation of coral reef, and so on are emerged as the effects of climate change on biodiversity. Expansion of infectious disease, reduction of food production, change of cultivation range of crops, change of fishing ground and time, and so on appear as the effects on human. To solve climate change problem, first of all, we need to mitigate climate change by reducing discharge of warming gases. But even though we now stop discharge of warming gases, climate change is expected to be continued for the time being. In this respect, preparing adaptive strategy of climate change can be more realistic. Continuous monitoring to observe the effects of climate change on biodiversity and establishment of monitoring system have to be preceded over all others. Insurance of diverse ecological spaces where biodiversity can establish, assisted migration, and establishment of horizontal network from south to north and vertical one from lowland to upland ecological networks could be recommended as the alternatives to aid adaptation of biodiversity to the changing climate.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.192-199
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• 2004

Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.