The term 'fourth industrial revolution' was mentioned at the World Economic Forum (WEF) in 2016 and has become a term representing a new industrial era based on information and communication technology (ICT). In the environment of the 4th industrial revolution, ESG management activities are becoming a very important factor in business activities. With the emergence of a new paradigm of organizational operation in the post Covid19 era, the demands for ESG (Environment, Social, Governance) investment related to the environment, social responsibility are increasing. This study examines the role that can support ESG management by utilizing the expertise of appraisers. Real estate is one of the fields of high public interest, and since most ESGs have been conducted centered on the role of private companies, the role of the expert group or the role of public corporations and public institutions is relatively insufficient. If a company or general company engaged in the real estate investment business establishes the role of the Korea Appraisers Association to revitalize ESG management using appraisers, such as ESG appraisers, when investing in real estate, it is believed that it will be possible to promote efficient and sound development of the real estate industry. It was judged that a study on a group of experts was also necessary. In addition, even if the impact of Covid-19 is excluded, it is necessary to gradually introduce an appraisal using non-face-to-face or various advanced technologies (the 4th industry). This study differs from previous studies in that it focused on the role of ESG by the Korea Association of Property Appraisers while research on the role of ESG in public institutions or expert groups is being actively conducted in recent years.
Kwang Hyun Chung;Jin Myung Park;Jae Min Lee;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
Journal of Digestive Cancer Research
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v.1
no.2
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pp.104-107
/
2013
Gallbladder (GB) cancer is highly malignant neoplasm found in advanced stage and chemotherapy commonly plays a palliative role in GB cancer. We report a case of unresectable GB cancer treated with chemotherapy followed by extended cholecystectomy. Fifty-six-year-old male visited our hospital with weight loss and dyspnea on exertion. Computed tomography detected pulmonary embolism and diffuse GB wall thickening with para-aortic lymph node enlargement. The length of common channel was 23mm at magnetic resonance cholangiopancreatography which stands for anomalous union of the pancreaticobiliary duct. Anticoagulation was started for pulmonary embolism. GB wall mass was regarded as unresectable GB cancer with distant lymph node metastasis. Gemcitabine and cisplatin combination chemotherapy was carried out for 6 cycles. Primary tumor was stationary but multiple enlarged lymphnodes were almost completely disappeared. Extended cholecystectomy with hepaticojejunostomy was performed. Post-operative tumor stage was T3N1 (stage IIIB) and R0 resection was achieved. After operation he has no evidence of disease recurrence for 6 months.
Mi Kyung Kang;Hana Park;Sunju Park;Hae Sik Jeong;Woon Sang Yoon;Jeonghwan Lee
Economic and Environmental Geology
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v.56
no.6
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pp.887-897
/
2023
Leading waste disposal countries, such as Sweden, Switzerland, and the United Kingdom, conduct safety assessments across all stages of High-Level Radioactive Waste Deep Geological Disposal Facilities-from planning and site selection to construction, operation, closure, and post-closure management. As safety assessments are repeatedly performed at each stage, generating vast amounts of diverse data over extended periods, it is essential to construct a database for safety assessment and establish a data management system. In this study, the safety assessment data management systems of leading countries, were analyzed, categorizing them into 1) input and reference data for safety assessments, 2) guidelines for data management, 3) organizational structures for data management, and 4) computer systems for data management. While each country exhibited differences in specific aspects, commonalities included the classification of safety assessment input data based on disposal system components, the establishment of organizations to supply, use, and manage this data, and the implementation of quality management systems guided by instructions and manuals. These cases highlight the importance of data management systems and document management systems for securing the safety and enhancing the reliability of High-Level Radioactive Waste Disposal Facilities. To achieve this, the classification of input data that can be flexibly and effectively utilized, ensuring the consistency and traceability of input data, and establishing a quality management system for input data and document management are necessary.
Jin Eun;Stephen Ahn;Min Ho Lee;Jin-Gyu Choi;Jae-Sung Park;Chul Bum Cho;Young Il Kim
Journal of Korean Neurosurgical Society
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v.66
no.6
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pp.726-734
/
2023
Objective : Chronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. The authors aimed to analyze the factors influencing outcome by targeting patients using AT and to establish a desirable treatment strategy. Methods : A retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. Outcomes included incidence of postoperative acute bleeding, recurrence rate, and morbidity or mortality rate. Patients were divided into the following four groups based on their history of AT use : no AT. Only antiplatelet agents (AP), only anticoagulants (AC), both of AP and AC. In addition, a concurrent literature review was conducted alongside our cohort study. Results : Of 462 patients, 119 (119/462, 25.76%) were using AT. AP prescription did not significantly delay surgery (p=0.318), but AC prescription led to a significant increase in the time interval from admission to operation (p=0.048). After BHT, AP or AC intake significantly increased the period required for an in-dwelling drain (p=0.026 and p=0.037). The use of AC was significantly related to acute bleeding (p=0.044), while the use of AP was not (p=0.808). Use of AP or AC had no significant effect on CSDH recurrence (p=0.517 and p=1.000) or reoperation (p=0.924 and p=1.000). Morbidity was not statistically correlated with use of either AP or AC (p=0.795 and p=0.557, respectively), and there was no significant correlation with mortality for use of these medications (p=0.470 and p=1.000). Conclusion : Elderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. However, the use of AC necessitates individualized due to potential postoperative bleeding. Careful post-operative monitoring could mitigate prognosis and recurrence impacts.
Hae Min Shin;Joongyub Lee;Dong Hyeon Lee;Seung Hyup Kim
Journal of the Korean Society of Radiology
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v.84
no.2
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pp.409-417
/
2023
Purpose Patients with bladder cancer may show hematuria after radical cystectomy with ileal neobladder formation, causing anxiety regarding tumor recurrence. Here, we aim to show that the nutcracker syndrome (NCS) can be a cause of hematuria post-operation, and is a common, rather than a rare syndrome. Materials and Methods A retrospective review of contrast-enhanced abdominopelvic CT (CE-APCT) and urine analysis (UA) findings of 255 patients with bladder cancer who underwent radical cystectomy and ileal neobladder formation between 2011 and 2016 was performed. In the CE-APCT review, the left renal vein flow patterns were evaluated to determine the presence of NCS findings. In the UA review, patients were classified according to the percentage of UA tests with positive hematuria among the total number of UA tests. Results CT findings of NCS were present in 31.9% of the 135 patients. In the positive hematuria group, there were 26% more patients with NCS findings than those without. Conclusion NCS findings are prevalent even for bladder cancer patients after surgery, and there is a strong correlation between NCS findings and hematuria. Furthermore, the prevalence of NCS findings is much higher than urinary tract recurrence after the surgery.
The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.
Journal of the Korean Society of Food Science and Nutrition
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v.42
no.3
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pp.389-396
/
2013
Epidermal hydration is mainly maintained by natural moisturizing factors (NMFs). Of these various NMFs, free amino acids (AAs) are major constituents generated by filaggrin degradation. The reduction of these AAs has been reported in aging skin induced during menopause. In this study, we examined whether the dietary supplementation of royal jelly (RJ) during the pre- and post-menopausal period alters epidermal levels of filaggrins, free AAs, and peptidylarginine deiminase-3 (PAD-3) (an enzyme involved in filaggrin degradation processes). Sprague Dawley rats were divided into five groups: groups fed a control diet for 12 weeks, in which an ovariectomy (OVX) or sham operation (SHAM) were underwent at week 4; groups fed a diet with 1% RJ harvested in different area of Korea (RJ1 and RJ2); and a group fed a diet with isoflavone (IF), the typical functional food for menopause prevention, for 4 weeks before and 8 weeks after an ovariectomy operation. In the epidermis of group OVX, total filaggrins (including profilaggrin and filaggrin) were reduced; these levels in groups RJ1 and IF were similar or less than in group OVX. However, total AAs, which showed no apparent difference between groups SHAM and OVX, were highly increased in groups RJ1 and IF. Specifically, aspartate (Asp) and proline (Pro), the major AAs in functioning NMF, were highly increased in group RJ1. Although total filaggrins, profilaggrin, filaggrin and PAD3 increased, total AAs (including Asp and Pro) in group RJ2 were modest or less than in group RJ1. The PAD3 alteration was not apparent among the four other groups. Taken together, we demonstrate that the diet supplementation of RJ1 enhanced filaggrin degradation (but not through the increased protein expression of PAD3), and increased total AAs, Asp and Pro. RJ1 could be a dietary supplementation for preventing the skin aging induced during menopause.
Background: Patients with cardiac diseases who have structural defects in their heart bring about metabolic insult such as preoperative acid-base imbalance. Cardiac operation requires many nonphysiologic procedures such as extracorporeal circulation, hypothermia, and hemodilution. We studied the acid-base status of surgical heart diseases pre-operatively, during extracorporeal circulation, and post-operatively and researched the treatment indications of acid-base disturbances. Material and Method: From January 1997 to May 1999, fifty two cases of open heart surgery were carried out under extracorporeal circulation, which divided into a set of pediatric and adult groups, congenital and acquired groups, non-cyanotic and cyanotic groups, The $\alpha$ -stat arterial blood gas analysis was done in each group during the preoperative period, during the operation with extracorporeal circulation, and during the postoperative period. Result: Before surgery, all patients present metabolic acidosis, PaO2 was low in adult group and acquired group and compensatory respiratory alkalosis was noted in cyanotic group. During extracorporeal circulation, adult group revealed alkalosis and normal in acquired group. Pediatric group presents low Pa$CO_2$, metabolic acidosis and respiratory alkalosis. Congenital group and non-cyanotic group showed non-compensatory alkalosis trend and non-compensatory respiratory acidosis were observed in cyanotic group during extracorporeal circulation. Postoperative acid-base status of adult group was recovered to normal and the standard bicarbonate was increased in the acquired group. All of the pediatric, congenital non-cyanotic, and cyanotic groups revealed the lack of buffer base.
Background: Thoracoscopic T2 sympathicotomy is an effective method for the treatment of palmar hyperhidrosis. Not only are the symptoms of hyperhidrosis abolished but also the temperature of the ipsilateral palm is elevated due to the sympatholytic vasodilation after the completion of the sympathicotomy on the first side. However little is known about the temperature changes in the contralateral palm. This study was performed to evaluate the changes in both palmar temperatures during the thoracoscopic T2 sympathicotomy for palmar hyperhidrosis. Material and Method: Thoracoscopic T2 sympathicotomy was performed in 15 patients with primary palmar hyperhidrosis. Surface temperatures of both palms were monitored continuously and were recorded simultaneously during the 7 different stages of the operation. Result: When T2 sympathicotomy was performed on the first(left) side, an ipsilateral increase with a contralateral decrease of temperature was observed. The difference in the temperature of both palms was greatest just before the sympathicotomy on the contralateral(right) side(Lt. 34.6$\pm$0.9$^{\circ}C$ vs. Rt. 31.6$\pm$1.3$^{\circ}C$, P<0.0001). After the sympathicotomy on the second(right) side, temperature of the right palm was elevated. The difference in the temperature of both palms was abolished at the end of the operation(Lt.34.7$\pm$0.9$^{\circ}C$ vs. Rt.34.4$\pm$1.$0^{\circ}C$, P=0.415). Conclusion: When T2 sympathicotomy was performed on the first side, an ipsilateral palmar temperature increased due to the sympatholytic vasodilation. However contralateral palmar temperature decreased due to a vasoconstriction. Although the mechanism of vasoconstriction is still unknown, it is postulated that there may be a cross- inhibitory effect by the post-ganglionic neurons innervating blood vessels of the palm.
Kim, Jong Sun;Choi, Won-Jung;Chang, Hang-Seok;Lee, Yong Sang;Oh, Young-Ja;Seok, Jeong-Ho
Korean Journal of Psychosomatic Medicine
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v.20
no.2
/
pp.75-81
/
2012
Objectives : Thyroid cancer patients may experience emotional distress during cancer treatment including surgical operation and radioactive iodine treatment. The aims of this prospective study were to investigate changes of anxiety and depressive symptoms in patients with differentiated thyroid cancer(DTC) under preoperative, postoperative and short-term hypothyroidism state. Methods : Using the Hospital Anxiety and Depression scale(HAD) and the Distress Thermometer, we sequentially assessed the levels of anxiety, depression and distress in 41 DTC patients at 3 time points such as preoperative state, postoperative state and short-term hypothyroidism state. Results : The HAD-anxiety score was significantly higher in preoperative state($6.93{\pm}3.97$) than postoperative state($4.22{\pm}2.92$) and short-term hypothyroidism state($4.93{\pm}3.64$). Any other significant change in depression or distress thermometer score was not observed. Especially, difference of HADS score between the distress and none-distress groups was significant in preoperative state and post-operative state, but the difference become not significant in the short-term hypothyroidism state. Conclusions : Induced thyroid hormone deficiency during cancer treatment does not significantly affect emotional distress in patient with DTC. Anxiety and depression in these patients may be associated with distress of the patient before active cancer treatment.
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