• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.95-100
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• 2013

Purpose: Since 2008, hepatitis A patients was rapidly increasing. So, Most of the health checkup examinees were interested in whether hepatitis A antibody was a lot. thereby The number of tests was increasing. In recent years, Antibody test results in the range of cut-off values were increased. According to the cause analysis, most examinees had a hepatitis A vaccine. This study was conducted to classify hepatitis A antibody as natural antibody and antibody after vaccination and compared the titer for seroconversion rate based on cut-off values. Materials and Methods: For a month in August 2012, First, We surveyed 185 health examinees and classified 119 health examinees who had acquired natural antibody. Second, for employees who were inoculated against hepatitis at our hospital, We classified into 53 primary inoculators and 59 secondary inculators. when the standard of cut-off value was 1, The seroconversion rate was compared the titer divided by 0.90-1.10 (${\pm}$), 0.60-0,89 (1+), 0.30-0.59 (2+), 0.01-0.29 (3+) and we compared the titer for seroconversion rate by each manufacturer after vaccination. Results: When the standard of cut-off value was 1, the titer of 119 health examinees who had acquired natural antibody was 0.90-1.10 (${\pm}$): 0%, 0.60-0.89 (1+): 0%, 0.30-0.59 (2+): 4.2%, 0.01-0.29 (3+): 96% and the titer of <0.60 ($${\geq_-}2+$$) was 100%. The titer of 53 primary inoculators was 0.90-1.10 (${\pm}:59.1%$), 0.60-0.89 (1+): 18.1%, 0.30-0.59 (2+): 18.1%, 0.01-0.29 (3+): 4.6% and the seroconversion rate was 45.3%. The titer of $${\geq_-}0.60$$ ($${\leq_-}1+$$) was 77.3%. The titer of 59 secondary inoculators was 0.90-1.10 (${\pm}:1.9%$), 0.60-0.89 (1+): 15.4%, 0.30-0.59 (2+): 36.54%, 0.01-0.29 (3+): 46.2% and the seroconversion rate was 88.1%. The titer of <0.60 ($${\geq_-}2+$$) was 82.7%. When we compared the titer for seroconversion rate by each manufacturer after vaccination, the seroconversion rate of 53 primary inoculators was BNIBT: 20.8% (${\pm}:24.5%$), GB: 15.7% (${\pm}:7.8%$), RIAKEY: 94.3% (${\pm}:3.8%$), ROCHE: 83% (${\pm}:0%$), ABBOTT: 73.1% (${\pm}:5.8%$) and the seroconversion rate of 59 secondary inoculators was BNIBT : 86.4% (${\pm}:1.7%$), GB: 88.5% (${\pm}:1.9%$), RIAKEY: 100% (${\pm}:0%$), ROCHE: 98.3% (${\pm}:0%$), ABBOTT: 98.2% (${\pm}:0%$). Conclusion: The study show that the titer of natural immune antibodies is higher than the titer of vaccination and the titer of secondary inoculation is mainly higher than the titer of primary inoculation. Consequently, if we know the titer of hepatitis A antibodies, it will help to give resullt reports. And then, when we compared the titer and the seroconversion rate by each manufacturer, There was a very distinct difference. As the test subjects inoculate against hepatitis A (HAV), it is considered BNIBT, GB will occur false negative rate and RIAKEY, ROCHE, ABOTT will occur false positive rate.

• Journal of Agricultural Extension & Community Development
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• v.7 no.1
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• pp.155-166
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• 2000

When the marcher visited Korea in fall 1994, he was shocked to see high rise apartment buildings around the capitol region including Seoul and Suwon, resulting from rising demand of housing because of urban migration followed by second and third industrial development. After 6 years in March 2000, the researcher witnessed more apartment buildings and vinyl house complexes, one of the evidences of continued economic progress in Korea. Korea had to receive the rescue finance from International Monetary Fund (IMF) because of financial crisis in 1997. However, the sign of recovery was seen in a year, and the growth rate of Gross Domestic Products (GDP) in 1999 recorded as high as 10.7 percent. During this period, the Korean government has been working on restructuring of banks, enterprises, labour and public sectors. The major directions of government were; localization, reducing administrative manpower, limiting agricultural budgets, privatization of public enterprises, integration of agricultural organization, and easing of various regulations. Thus, the power of central government shifted to local government resulting in a power increase for city mayors and county chiefs. Agricultural extension services was one of targets of government restructuring, transferred to local governments from central government. At the same time, the number of extension offices was reduced by 64 percent, extension personnel reduced by 24 percent, and extension budgets reduced. During the process of restructuring, the basic direction of extension services was set by central Rural Development Administration Personnel management, technology development and supports were transferred to provincial Rural Development Administrations, and operational responsibilities transferred to city/county governments. Agricultural extension services at the local levels changed the name to Agricultural Technology Extension Center, established under jurisdiction of city mayor or county chief. The function of technology development works were added, at the same time reducing the number of educators for agriculture and rural life. As a result of observations of rural areas and agricultural extension services at various levels, functional responsibilities of extension were not well recognized throughout the central, provincial, and local levels. Central agricultural extension services should be more concerned about effective rural development by monitoring provincial and local level extension activities more throughly. At county level extension services, it may be desirable to add a research function to reflect local agricultural technological needs. Sometimes, adding administrative tasks for extension educators may be helpful far farmers. However, tasks such as inspection and investigation should be avoided, since it may hinder the effectiveness of extension educational activities. It appeared that major contents of the agricultural extension service in Korea were focused on saving agricultural materials, developing new agricultural technology, enhancing agricultural export, increasing production and establishing market oriented farming. However these kinds of efforts may lead to non-sustainable agriculture. It would be better to put more emphasis on sustainable agriculture in the future. Agricultural extension methods in Korea may be better classified into two approaches or functions; consultation function for advanced farmers and technology transfer or educational function for small farmers. Advanced farmers were more interested in technology and management information, while small farmers were more concerned about information for farm management directions and timely diffusion of agricultural technology information. Agricultural extension service should put more emphasis on small farmer groups and active participation of farmers in these groups. Providing information and moderate advice in selecting alternatives should be the major activities for consultation for advanced farmers, while problem solving processes may be the major educational function for small farmers. Systems such as internet and e-mail should be utilized for functions of information exchange. These activities may not be an easy task for decreased numbers of extension educators along with increased administrative tasks. It may be difficult to practice a one-to-one approach However group guidance may improve the task to a certain degree.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.143-151
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• 2005

Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

• Journal of Distribution Research
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• v.15 no.1
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• pp.49-71
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• 2010

Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1210-1219
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• 2001

Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

• Journal of Global Scholars of Marketing Science
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• v.18 no.4
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• pp.157-194
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• 2008

The popularity of communities on the internet has captured the attention of marketing scholars and practitioners. By adapting to the culture of the internet, however, and providing consumer with the ability to interact with one another in addition to the company, businesses can build new and deeper relationships with customers. The economic potential of online communities has been discussed with much hope in the many popular papers. In contrast to this enthusiastic prognostications, empirical and practical evidence regarding the economic potential of the online community has shown a little different conclusion. To date, even communities with high levels of membership and vibrant social arenas have failed to build financial viability. In this perspective, this study investigates the role of various kinds of influencing factors to online community loyalty and basically suggests the framework that explains the process of building purchase loyalty. Even though the importance of building loyalty in an online environment has been emphasized from the marketing theorists and practitioners, there is no sufficient research conclusion about what is the process of building purchase loyalty and the most powerful factors that influence to it. In this study, the process of building purchase loyalty is divided into three levels; characteristics of community site such as content superiority, site vividness, navigation easiness, and customerization, the mediating variables such as self congruency, consumer experience, and consumer to consumer interactivity, and finally various factors about online community loyalty such as visit loyalty, affect, trust, and purchase loyalty are those things. And the findings of this research are as follows. First, consumer-to-consumer interactivity is an important factor to online community purchase loyalty and other loyalty factors. This means, in order to interact with other people more actively, many participants in online community have the willingness to buy some kinds of products such as music, content, avatar, and etc. From this perspective, marketers of online community have to create some online environments in order that consumers can easily interact with other consumers and make some site environments in order that consumer can feel experience in this site is interesting and self congruency is higher than at other community sites. It has been argued that giving consumers a good experience is vital in cyber space, and websites create an active (rather than passive) customer by their nature. Some researchers have tried to pin down the positive experience, with limited success and less empirical support. Web sites can provide a cognitively stimulating experience for the user. We define the online community experience as playfulness based on the past studies. Playfulness is created by the excitement generated through a website's content and measured using three descriptors Marketers can promote using and visiting online communities, which deliver a superior web experience, to influence their customers' attitudes and actions, encouraging high involvement with those communities. Specially, we suggest that transcendent customer experiences(TCEs) which have aspects of flow and/or peak experience, can generate lasting shifts in beliefs and attitudes including subjective self-transformation and facilitate strong consumer's ties to a online community. And we find that website success is closely related to positive website experiences: consumers will spend more time on the site, interacting with other users. As we can see figure 2, visit loyalty and consumer affect toward the online community site didn't directly influence to purchase loyalty. This implies that there may be a little different situations here in online community site compared to online shopping mall studies that shows close relations between revisit intention and purchase intention. There are so many alternative sites on web, consumers do not want to spend money to buy content and etc. In this sense, marketers of community websites must know consumers' affect toward online community site is not a last goal and important factor to influnece consumers' purchase. Third, building good content environment can be a really important marketing tool to create a competitive advantage in cyberspace. For example, Cyworld, Korea's number one community site shows distinctive superiority in the consumer evaluations of content characteristics such as content superiority, site vividness, and customerization. Particularly, comsumer evaluation about customerization was remarkably higher than the other sites. In this point, we can conclude that providing comsumers with good, unique and highly customized content will be urgent and important task directly and indirectly impacting to self congruency, consumer experience, c-to-c interactivity, and various loyalty factors of online community. By creating enjoyable, useful, and unique online community environments, online community portals such as Daum, Naver, and Cyworld are able to build customer loyalty to a degree that many of today's online marketer can only dream of these loyalty, in turn, generates strong economic returns. Another way to build good online community site is to provide consumers with an interactive, fun, experience-oriented or experiential Web site. Elements that can make a dot.com's Web site experiential include graphics, 3-D images, animation, video and audio capabilities. In addition, chat rooms and real-time customer service applications (which link site visitors directly to other visitors, or with company support personnel, respectively) are also being used to make web sites more interactive. Researchers note that online communities are increasingly incorporating such applications in their Web sites, in order to make consumers' online shopping experience more similar to that of an offline store. That is, if consumers are able to experience sensory stimulation (e.g. via 3-D images and audio sound), interact with other consumers (e.g., via chat rooms), and interact with sales or support people (e.g. via a real-time chat interface or e-mail), then they are likely to have a more positive dot.com experience, and develop a more positive image toward the online company itself). Analysts caution, however, that, while high quality graphics, animation and the like may create a fun experience for consumers, when heavily used, they can slow site navigation, resulting in frustrated consumers, who may never return to a site. Consequently, some analysts suggest that, at least with current technology, the rule-of-thumb is that less is more. That is, while graphics etc. can draw consumers to a site, they should be kept to a minimum, so as not to impact negatively on consumers' overall site experience.

• Journal of the Korean association of regional geographers
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• v.3 no.2
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• pp.163-193
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• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

• Journal of Korean Society of Forest Science
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• v.33 no.1
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• pp.33-58
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• 1977

A bark comprises about 10 to 20 percents of a typical log by volume, and is generally considered as an unwanted residue rather than a potentially valuable resourses. As the world has been confronted with decreasing forest resources, natural resources pressure dictate that a bark should be a raw material instead of a waste. The utilization of the largely wasted bark of genus Pinus, Quercus, and Populus grown in Korea can be enhanced by learning its physical and mechanical properties. However, the study of tree bark grown in Korea have never been undertaken. In the present paper, an investigative study is carried out on the bark of three genus, eleven species representing not only the major bark trees but major species currently grown in Korea. For each species 20 trees were selected, at Suweon and Kwang-neung areas, on the same basis of the diameter class at the proper harvesting age. One $200cm^2$ segment of bark was obtained from each tree at brest height. Physical properties of bark studied are: bark density, moisture content of green bark (inner-, outer-, and total-bark), fiber saturation point, hysteresis loop, shrinkage, water absorption, specific heat, heat of wetting, thermal conductivity, thermal diffusivity, heat of combustion, and differential thermal analysis. The mechanical properties are studied on bending and compression strength (radial, longitudinal, and tangential). The results may be summarized as follows: 1. The oven-dry specific gravities differ between wood and bark, further more even for a given bark sample, the difference is obersved between inner and outer bark. 2. The oven-dry specific gravity of bark is higher than that of wood. This fact is attributed to the anatomical structure whose characters are manifested by higher content of sieve fiber and sclereids. 3. Except Pinus koraiensis, the oven-dry specific gravity of inner bark is higher than that of outer bark, which results from higher shrinkage of inner bark. 4. The moisture content of bark increases with direct proportion to the composition ratio of sieve components and decreases with higher percent of sclerenchyma and periderm tissues. 5. The possibility of determining fiber saturation point is suggested by the measuring the heat of wetting. With the proposed method, the fiber saturation point of Pinus densiflora lies between 26 and 28%, that of Quercus accutissima ranges from 24 to 28%. These results need be further examined by other methods. 6. Contrary to the behavior of wood, the bark shrinkage is the highest in radial direction and the lowest in longitudinal direction. Quercus serrata and Q. variabilis do not fall in this category. 7. Bark shows the same specific heat as wood, but the heat of wetting of bark is higher than that of wood. In heat conductivity, bark is lower than wood. From the measures of oven-dry specific gravity (${\rho}d$) and moisture fraction specific gravity (${\rho}m$) is devised the following regression equation upon which heat conductivity can be calculated. The calculated heat conductivity of bark is between $0.8{\times}10^{-4}$ and $1.6{\times}10^{-4}cal/cm-sec-deg$. $$K=4.631+11.408{\rho}d+7.628{\rho}m$$ 8. The bark heat diffusivity varies from $8.03{\times}10^{-4}$ to $4.46{\times}10^{-4}cm^2/sec$. From differential thermal analysis, wood shows a higher thermogram than bark under ignition point, but the tendency is reversed above ignition point. 9. The modulus of rupture for static bending strength of bark is proportional to the density of bark which in turn gives the following regression equation. M=243.78X-12.02 The compressive strength of bark is the highest in radial direction, contrary to the behavior of wood, and the compressive strength of longitudinal direction follows the tangential one in decreasing order.

• Sleep Medicine and Psychophysiology
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• v.17 no.2
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• pp.100-108
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• 2010

Objectives: "Internet-addiction" came into common use not only in clinical setting but also in everyday life. But, pathophysiology and diagnostic criteria of the internet addiction remain unknown. Because adolescents are in developing period, they might be vulnerable to the internet addiction, depression and sleep-related problem. The objectives of this study were to investigate the characteristics of internet addiction and its association with sleep pattern and depression in Korean adolescence. Methods: Subjects were 799 middle and high school students in Seoul, Korea. We administered a self-reported questionnaire including socio-demographic data, Korean versions of Young's Internet Addiction Scale (YIAS), Pittsburgh Sleep Quality Index (PS-QI), the Center for Epidemiologic Studies for Depression Scale (CES-D) and questions about internet using patterns. Data of 696 subjects were included in analysis. Chi-square tests were used to analyze proportional differences, and ANOVA with post-hoc tests were used to analyze differences among groups. Partial correlation analyses were performed to analyze the correlation of internet addiction with other variables (two-tailed, p<0.05). Results: Of the 696 participants (grade 2 of middle school; M2 135 vs. grade 1 of high school; H1 238 vs. grade 2 of high school; H2 323), 2.0% (n=14) were internet-addicted (IA), 27.7% (n=193) were over-using (OU) and 70.3% (n=489) were not-addicted (NA). The mean scores of YIAS, PSQI and CES-D scores were 35.24${\pm}$12.78, 5.53${\pm}$3.04 and 16.72${\pm}$8.69, respectively. In higher grade students, average total sleep time was shorter (M2 426.20${\pm}$67.68 min. vs. H1 380.47${\pm}$62.57 min. vs. H2 354.67${\pm}$73.37 min., F=51.909, p<0.001), and PSQI (4.69${\pm}$3.14 vs. 5.42${\pm}$3.15 vs. 5.97${\pm}$2.83, F=8.871, p<0.001) CES-D (13.53${\pm}$8.37 vs. 16.96${\pm}$8.24 vs. 17.87${\pm}$8.84, F=12.373, p<0.001) scores were higher than those of lower grade students. Comparing variables among IA, OU and NA groups, computer using time not for study (96.36${\pm}$63.31 min. vs. 134.92${\pm}$86.79 min. vs. 213.57${\pm}$136.87 min., F=34.287, p<0.001) and portable device using time not for study (84.22${\pm}$79.11 min. vs. 96.97${\pm}$91.89 min. vs. 152.31${\pm}$93.64 min., F= 5.400, p=0.005) were different among groups. PSQI (5.26${\pm}$2.97 vs. 6.08${\pm}$2.97 vs. 7.50${\pm}$4.41, F=8.218, p<0.001) and CES-D scores (15.40${\pm}$8.08 vs. 19.05${\pm}$8.42 vs. 30.43${\pm}$13.69, F=32.692, p<0.001) were also different among groups. YIAS score were correlated with computer using time not for study (r=0.356, p<0.001) and portable device using time not for study (r= 0.136, p<0.001). PSQI score (r=0.237, p<0.001) and CES-D score (r=0.332, p<0.001). YIAS score and PSQI score (r=0.131, p= 0.001), YIAS and CES-D score (r=0.265, p<0.001), PSQI score and CES-D score (r=0.357, p<0.001) were correlated each other. Conclusion: These results suggested that adolescents' internet-addiction was correlated with not only computer and portable device using time not for study but also depression and sleep-related problems. We should pay attention to depression and sleep-related problems, when evaluating internet-addiction in adolescents.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1236-1251
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• 1998

Background : TNF-$\alpha$ appears to be a central mediator of the host response to sepsis. While TNF-$\alpha$ is mainly considered a proinflammatory cytokine, it can also act as a direct cytotoxic cytokine. However, there are not so many studies about the relationship bet ween TNF-$\alpha$ level and lung injury severity in ALI, particularly regarding the case of ALI caused by direct lung injury such as diffuse pulmonary infection. Recently, a natural defense mechanism, known as the stress response or the heat shock response, has been reported in cellular or tissue injury reaction. There are a number of reports examining the protective role of pre-induced heat stress proteins on subsequent LPS-induced TNF-$\alpha$ release from monocyte or macrophage and also on subsequent LPS-induced ALI in animals. However it is not well established whether the stress protein synthesis such as HSP can be induced from rat alveolar macrophages by in vitro or in vivo LPS stimulation. Methods : We measured the level of TNF-$\alpha$, the percentage of inflammatory cells in bronchoalveolar lavage fluid, protein synthesis in alveolar macrophages isolated from rats at 1, 2, 3, 4, 6, 12, and 24 hours after intratracheal LPS instillation. We performed histologic examination and also obtained histologic lung injury index score in lungs from other rats at 1, 2, 3, 4, 6, 12, 24 h after intratracheal LPS instillation. Isolated non-stimulated macrophages were incubated for 2 h with different concentration of LPS (0, 1, 10, 100 ng/ml, 1, or 10 ${\mu}g/ml$). Other non-stimulated macrophages were exposed at $43^{\circ}C$ for 15 min, then returned to at $37^{\circ}C$ in 5% CO2-95% for 1 hour, and then incubated for 2 h with LPS (0, 1, 10, 100ng/ml, 1, or 10 ${\mu}g/ml$). Results : TNF-$\alpha$ levels began to increase significantly at 1 h, reached a peak at 3 h (P<0.0001), began to decrease at 6 h, and returned to control level at 12 h after LPS instillation. The percentage of inflammatory cells (neutrophils and alveolar macrophages) began to change significantly at 2 h, reached a peak at 6 h, began to recover but still showed significant change at 12 h, and showed insignificant change at 24 h after LPS instillation compared with the normal control. After LPS instillation, the score of histologic lung injury index reached a maximum value at 6 h and remained steady for 24 hours. 35 kDa protein band was newly synthesized in alveolar macrophage from 1 hour on for 24 hours after LPS instillation. Inducible heat stress protein 72 was not found in any alveolar macrophages obtained from rats after LPS instillation. TNF-$\alpha$ levels in supernatants of LPS-stimulated macro phages were significantly higher than those of non-stimulated macrophages(p<0.05). Following LPS stimulation, TNF-$\alpha$ levels in supernatants were significantly lower after heat treatment than in those without heat treatment (p<0.05). The inducible heat stress protein 72 was not found at any concentrations of LPS stimulation. Whereas the 35 kDa protein band was exclusively found at dose of LPS of 10 ${\mu}g/ml$. Conclusion : TNF-$\alpha$ has a direct or indirect close relationship with lung injury severity in acute lung injury or acute respiratory distress syndrome. In vivo and in vitro LPS stimulation dose not induce heat stress protein 72 in alveolar macrophages. It is likely that 35 kDa protein, synthesized by alveolar macrophage after LPS instillation, does not have a defense role in acute lung injury.