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Acute Respiratory Distress Syndrome in Respiratory Intensive Care Unit (호흡기계 중환자실에서 치료 관리된 급성호흡곤란증후군의 임상특성)

  • Moon, Seung-Hyug;Song, Sang-Hoon;Jung, Ho-Seuk;Yeun, Dong-Jin;Uh, Su-Tack;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1252-1264
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    • 1998
  • Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

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Proliferative Properties and Cytokine Secretion of Lung Fibroblast Cell Lines of the Patients with Idiopathic Pulmonary Fibrosis (정상인 및 간질성 폐섬유증 환자들의 폐 병변내 섬유모세포주의 증식양상 및 Cytokine분비능에 관한 연구)

  • Kim, Dong-Soon;Paik, Sang-Hoon;Kong, Kyung-Yup;Kim, Dong-Kwan;Park, Seong-Il;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.128-139
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    • 1998
  • Background: It is well known that various cytokines and growth factors secreted mainly from alveolar macrophages do the key role in the pathogenesis of IPF. But recently it has been known that structural cells like fibroblast can also release cytokines. So the phenotypic changes in fibroblasts of IPF may do a role in continuous progression of fibrosis. The aim of this study is to find out whether there is a change in the biologic properties of the lung fibroblasts of IPF. Subjects and Method: The study was done on 13 patients with IPF diagnosed by open or thoracoscopic lung biopsy and 7 control patients who underwent resectional surgery for lung cancer. Lung fibroblast cell lines (FB) were established by explant culture technique from the biopsy or resected specimen Result: Basal proliferation of the fibroblast of IPF(IFB) measured by BrdU uptake tended to be highter than control fibroblast(NFB) (0.212 0.107 vs $0.319{\pm}0.143$, p=0.0922), also there was no significant difference in proliferation after the stimulation with PDGF or 10% serum. On the contrary, the degree of inhibition in proliferation by PGE2 was significantly lower($33.0{\pm}13.1%$) in IFB than control($46.7{\pm}10.0%$, p=0.0429). The IFB secreted significantly higher amount of MCP-l($l574{\pm}1283$ pg/ml) spontaneously than NFB($243{\pm}100$ pg/ml) and also after the stimulation with TGF-$\beta$($3.23{\pm}1.31$ ng/ml vs $0.552{\pm}0.236$ ng/ml, p=0.0012). Similarly IL-8 and IL-6 seretion of IFB was significantly higher than NFB at basal state and with TGF-$beta$ stimulation. But after the maximal stimulation with IL-1,8, no significant difference in cytokine secretion was found between IFB and NFB. Conclusion : Above data suggest that the fibroblasts of IPF were phenotypically changed and these change may do a role in the pathogenesis of IPF.

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A Study on the Various Attributes of E-Sport Influencing Flow and Identification (e-스포츠의 다양한 속성이 유동(flow)과 동일시에 미치는 영향에 관한 연구)

  • Suh, Mun-Shik;Ahn, Jin-Woo;Kim, Eun-Young;Um, Seong-Won
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.59-80
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    • 2008
  • Recently, e-sports are growing with potentiality as a new industry with conspicuous profit model. But studies that dealing with e-sports are not enough. Hence, proposes of this paper are both to establish basic model that is for the design of e-sport marketing strategy and to contribute toward future studies which are related to e-sports. Recently, the researches to explain sports-sponsorship through the identification theory have been discovered. Many researches say that somewhat proper identification is a requirement for most sponsors to improve the their images which is essential to sponsorship activity. Consequently, the research for sponsorship associated with identification in the e-sports, not in the physical sports is the core sector of this study. We extracted the variables from online's major characteristics and existing sport sponsorship researches. First, because e-sports mean the tournaments or leagues in the use of online game, the main event of the game is likely to call it online game. Online media's attributes are distinguished from those of offline. Especially, interactivity, anonymity, and expandibility as a e-sport game attributes are able to be mentioned. So, these inherent online attributes are examined on the relationship with flow. Second, in physical sports games, Fisher(1998) revealed that team similarity and team attractivity were positively related to team identification. Wann(1996) said that the result of former game influenced the evaluation of the next game, then in turn has an effect on the identification of team supporters. Considering these results in the e-sports side, e-sports gamer' attractivity, similarity, and match result seem to be important precedent variables of the identification with a gamer. So, these e-sport gamer attributes are examined on the relationship with both flow and identification with a gamer. Csikszentmihalyi(1988) defined the term flow as feeling status for him to be making current positive experience optimally. Hoffman and Novak(1996) also said that if a user experienced the flow he would visit a website without any reward. Therefore flow might be positively associated with user's identification with a gamer. And, Swanson(2003) disclosed that team identification influenced the positive results of sponsorship, which included attitude toward sponsors, sponsor patronage, and satisfaction with sponsors. That is, identification with a gamer expect to be connected with corporation identification significantly. According to the above, we can design the following research model. All variables used in this study(interactivity, anonymity, expandibility, attractivity, similarity, match result, flow, identification with a gamer, and identification with a sponsor) definitely were defined operationally underlying precedent researches. Sample collection was carried out to the person who has an experience to have enjoyed e-sports during June 2006. Much portion of samples is men because much more men than women enjoy e-sports in general. Two-step approach was used to test the hypotheses. First, confirmatory factor analysis was committed to guarantee the validity and reliability of variables. The results showed that all variables had not only intensive and discriminant validity, but also reliability. Then, research model was examined with fully structural equation using LISREL 8.3 version. The fitness of the suggested model mostly was at the acceptable level. Shortly speaking about the results, first of all, in e-sports game attributes, only interactivity which is called a basic feature in online situation affected flow positively. Secondly, in e-sports gamer's attributes, similarity with a gamer and match result influenced flow positively, but there was no significant effect in the relationship between the attractivity of a gamer and flow. And as expected, similarity had an effect on identification with a gamer significantly. But unexpectedly attractivity and match result did not influence identification with a gamer significantly. Just the same as the fact verified in the many precedent researches, flow greatly influenced identification with a gamer, and identification with a gamer continually had an influence on the identification with a sponsor significantly. There are some implications in these results. If the sponsor of e-sports supports the pro-game player who absolutely should have the superior ability to others and is similar to the user enjoying e-sports, many amateur gamers will feel much of the flow and identification with a pro-gamer, and then after all, feel the identification with a sponsor. Such identification with a sponsor leads people enjoying e-sports to have purchasing intention for products produced by the sponsor and to make a positive word-of-mouth for those products or the sponsor. For the future studies, we recommend a few ideas. Based on the results of this study, it is necessary to find new variables relating to the e-sports, which is not mentioned in this study. For this work to be possible, qualitative research seems to be needed to consider the inherent e-sport attributes. Finally, to generalize the results related to e-sports, a wide range of generations not a specific generation should be researched.

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Requirement and Perception of Parents on the Subject of Home Economics in Middle School (중학교 가정교과에 대한 학부모의 인식 및 요구도)

  • Shin Hyo-Shick;Park Mi-Soog
    • Journal of Korean Home Economics Education Association
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    • v.18 no.3 s.41
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    • pp.1-22
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    • 2006
  • The purpose of this study is that I should look for a desirous directions about home economics by studying the requirements and perception of the high school parents who have finished the course of home economics. It was about 600 parents whom I have searched Seoul-Pusan, Ganwon. Ghynggi province, Choongcheong-Gyungsang province, Cheonla and Jeju province of 600, I chose only 560 as apparently suitable research. The questions include 61 requirements about home economics and one which we never fail to keep among the contents, whenever possible and one about the perception of home economics aims 11 about the perception of home economics courses and management. The collections were analyzed frequency, percent, mean. standard deviation t-test by using SAS program. The followings is the summary result of studying of it. 1. All the boys and girls learning together about the Idea of healthy lives and desirous human formulation and knowledge together are higher. 2. Among the teaching purposes of home economics, the item of the scientific principle and knowledge for improvements of home life shows 15.7% below average value. 3. The recognition degree about the quality of home economics is highly related with the real life, and about the system. we recognize lacking in periods and contents of home economics field and about guiding content, accomplishment and application qualities are higher regardless of sex. 4. The important term which we should emphasize in the subject of home economics is family part. 5. Among the needs of home economic requirement in freshman, in the middle unit, their growth and development are higher than anything else, representing 4.11, and by contrast the basic principle and actuality is 3.70, which is lowest among them. 6. In the case of second grade requirement of home economics content for parents in the middle unit young man and consuming life is 4.09 highest. 7. In the case of 3rd grade requirement of economics contents in the middle unit the choice of coming direction and job ethics is highest 4.16, and preparing meals and evaluation is lowest 3.50.

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Relationships between inbreeding coefficient and economic traits in inbred line of Duroc pigs (두록 계통조성 집단의 근교수준이 경제형질에 미치는 영향)

  • song, Na-Rae;Kim, Yong-Min;Kim, Doo-Wan;Sa, Soo-Jin;Kim, Ki-Hyun;Kim, Young-Hwa;Cho, Kyu-Ho;Do, Chang-hee;Hong, Joon-Ki
    • Korean Journal of Agricultural Science
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    • v.42 no.2
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    • pp.141-149
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    • 2015
  • The data of Duroc swine species that were born from 2000 to 2014 excluding missing ones collected by Korea National Institute of Animal Science were used in the present study. After removing missing data we used 9756 of productions data and 1728 of reproductive reference of breeding research to study the level of inbreeding and to investigate the impact on the reproductive traits, production traits. The correlation of reproductive traits and inbreeding coefficient are -0.07, -0.08 for total number pigs born, number of pigs born alive respectively and birth weight per litter is -0.10, number of pigs born alive per litter to 21days is -0.06 and body weight per litter to 21days is -0.09. The correlation coefficients of the inbreeding coefficients of reproductive traits are shown within 10% with negative correlation (P < 0.05). Days of 90kg and Backfat in the correlation coefficient and inbreeding coefficient production traits were not observed significant correlations, Average daily gain was investigated by the positive correlation of 0.05. According to the above results, the inbreeding level gave a negative effect on the improvement of the breed traits, investigating a relatively high compared to a negative effect on other traits. But overall correlation degree is less than 10% was observed. This inbreeding coefficient has not been clearly observed due to degeneration of the average inbreeding coefficients of these generations was maintained within 10% of the population. The scale of the experimental group was about 150 degree pig husbandry is very small compared to the advanced countries. However, the level of inbreeding in the population group with the appropriate mating combinations is maintained below 10% of population is thought to be small and can minimize the effects of inbreeding degeneration. further testing utilizing this selection is constantly considered to be necessary.

Effect of Cassia tora L. Powder Added-Diets on the Accumulation of Cadmium in Rat (결명자 첨가식이가 흰쥐의 체내 카드뮴 축적에 미치는 영향)

  • 김성조;백승화;허종욱;김운성;이주돈;강경원;박성혜;한종현;정성윤
    • Journal of the East Asian Society of Dietary Life
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    • v.12 no.6
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    • pp.554-565
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    • 2002
  • The purpose of this study is to investigate the effect of raw Cassia tora L. powder added-diets on reducing cadmium accumulation in rats. The experimental animals were Sprague-Dawley family(♂, 4 weeks) which was classified into normal group CN, compared group CS, Cd-added group Cl and groups C2, C3, C4 in which 0.5, 1.0 and 1.5% of the Cassia tora L. powder are added, respectively. The growth rate and food efficiency ratio, and the amounts of accumulated cadmium in rats for S weeks were measured and analyzed. The results are as follows; 1. The rates of weight gain decreased in the order of C3>C2>C4>Cn>Cs>Cl groups, and Cl group to which only cadmium water had been fed was the lowest among them. The correlation between groups Cl and C3 was significantly different at the 1% level. 2. Food efficiency ratio(FER) decreased in the order of C3>C2>Cs>Cn>C4>Cl, and the FERs of C3, C2, CS, CN and C4 are greater than that of Cl by 22.87, 19.59, 18.54, 14.20 and 13.17%, respectively. 3. As for the Cassia tora L. powder-added groups, the amounts of cadmium accumulated in organs and tissues, that is, the brain, heart, spleen, liver, lungs, testicles. kidney, femoral muscle and leg bones were 0.45 $\pm$ 0.04 to 0.83$\pm$0.04, 1.68$\pm$0.02 to 2.16$\pm$0.02, 3.26$\pm$0.05 to 4.62$\pm$0.27, 37.52$\pm$0.09 to 47.71$\pm$0.73, 1.07$\pm$0.10 to 1.66$\pm$0.04, 1.04$\pm$0.06 to 1.24$\pm$0.08, 36.79$\pm$0.20 to 39.61 $\pm$0.53, 0.87$\pm$0.02 to 1.00$\pm$0.02 and 0.65$\pm$0.17 to 1.27 $\pm$ 0.06 $\mu\textrm{g}$/g, respectively. 4. The accumulated Cd content for C4 was the lowest among Cassia tora L. powder-added groups. When the results for C4 are compared with those for Cl, it is observed that each cadmium content accumulated in the brain, heart spleen, liver, lungs, testicles, kidney. femoral muscle and leg bones is dropped by 49.03, 22.56, 36.02, 35.75, 41.75, 36.20, 37.00, 22.77 and 56.67 %, respectively. On the other hand. the accumulated Cd content increased in the order of brain

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A Study on the Effects of Support Service of Gyeonggi-do Cultural Contents Area Business Incubating Center on Corporate Performance: Focusing on the Business Validity of Business Start-Up Items (경기도 문화콘텐츠분야 창업보육센터 지원서비스가 입주기업 성과에 미치는 영향에 관한 연구: 창업아이템의 사업타당성을 중심으로)

  • Hong, Dae Ung;Lee, Il han;Son, Jong Seo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.4
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    • pp.47-60
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    • 2017
  • As the recent cultural contents area start-ups are creating remarkable outcomes such as investment attraction together with the reinforced institutional supports from the government, this study aimed to reverify the significance of researches related to correlation analysis between service of Business Incubating Center of Small & Medium Business Administration operated with no separation of business type, and corporate performance, in the aspect of Business Incubating Center in cultural contents area, and also to suggest the importance of establishing the business incubating system in the systematic and rational cultural contents area through the differentiated business incubating service by verifying the significant effects of the business validity of items on corporate performance, and then discovering services suitable for business incubating in cultural contents area, targeting Gyeonggi-do cultural contents area Business Incubating Center recently showing the biggest growth. Especially, contrary to the existing researches, in order to verify the characteristics of Gyeonggi-do Cultural Contents Business Incubating Center, the personal support service and marketing support service were included. It also aimed to understand the effects of the business validity of start-up items on corporate performance. Summarizing the results of this study, contrary to the results of the existing researches saying that spatial & additional support service, management support service, technical support service, personal support service, and marketing support service had significant effects on corporate performance, among the support service of Gyeonggi-do cultural contents area Business Incubating Center, the spatial & additional support service, personal support service, and marketing support service had significantly positive(+) effects on corporate performance while the management support service and technical support service had no significant effects on it. Comparing with the results of the researches on the support service of Business Incubating Center(BI) of Small & Medium Business Administration, the effects of the management support service and technical support service of Gyeonggi-do cultural contents area Business Incubating Center on corporate financial/non-financial performance were not huge. Also, in the results of analyzing the business validity of star-up items, the spatial & additional support service, management support service, and technical support service did not have significant effects on the business validity of start-up items while the personal support service and marketing support service had significantly positive(+) effects on it. In case when selecting companies, Gyeonggi-do Business Incubating Center emphasized the business validity of start-up items. However, the support service provided after the selection did not have huge effects on the business validity of start-up items. Lastly, in the results of analyzing the effects of the business validity of start-up items in Gyeonggi-do cultural contents area on corporate performance, among the success factors of business start-up, the business validity of start-up items was an important element having effects on corporate performance(financial/non-financial) in the cultural contents area.

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A Study of Knowledge, Attitude, and Practice Relative to Maternal and Child Health Among Women Residing in Apartments at Yonsei Community Health Area (연세지역 아파트 주민의 모자보건에 관한 실태조사)

  • Yu, Seung-Hum;Chung, Young-Sook;Lee, Kyung-Ja;Kim, Kwang-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.4 no.1
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    • pp.77-87
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    • 1971
  • A study of the knowledge, attitude and practices about the maternal and child health of 305 married women residing in apartments at the Yonsei Community Health area was conducted during the period from November to December 1970 using designed questionnaire with well trained interviewers. The results and findings obtained from the study are summarized as follows: A. Pregnancy and Birth Questions were asked about their last child. 1. 16.4% of the women were pregnant. 2. Among 281 women who had experienced delivery, 48.0% were assisted by doctor or midwisves for their last delivery, while the rest of women delivered their last baby at home without any professional's assistance. The higher the level of education or the greater exposure to mass communication, the more the deliveries were assisted by doctors or midwives. Those women who were born and raised in cities had more deliveries assisted by doctors and midwives than those who were not. 3. Kinds of delivery sheets used. Among 141 cases of home delivery 68% used cement bag paper or vinyl sheets. Three% used nothing and remained used unsterile materials. 4. Among 141 cases of home delivery, 70.2% used scissors. The rest of them used other methods. 5. 47.3% of the women had a rest for one month or more after birth. The higher the level of education, the longer the period of rest was observed. 6. 52.4% of the women fed the colostrum to their babies. This was not related to the mother's education. 7 About half(42.9%) of the women had poor knowledge about a proper diet for the pre and post natal period. B. Child Health 1. Knowledge and practice regarding to the immunization for their children: Most of the women (93.2%) could name at least one kind of immunization. 20.3% could name 6 kinds of immunization. Mothers education level did not influence their ability to name immunizations. 85.2% of children had been immunized at least once. 2. Morbidity of last born children: 48.1% of their last born children were found to have been sick during the last year. Less than half(41.5%) of the sick children were seen by doctor. 3. Counselling at well baby clinic: Most of the women(76.5%) had no counselling for their children. Registration rate at the well baby clinic at the Severance Hospital was 13.2%. 45.9% wanted to visit to the well baby clinic at the Severance Hospital. 4. Weaning Period: 44.6% said that the beginning of the weaning for their last born children was from 6 months to twelve months of age. The most important reason of weaning was the health of both mothers and children. 5. Knowledge and Practice regarding birth and death Registration: 64.6% of the women could name correctly the Ku-office as the place for the registration. Only 29.2% registered the birth of their last born children within 14 days. C. Knowledge, Attitude and Practice regarding to family planning Most: of the women accepted the idea of family planning. 97.7% could name at least one contraceptive method. 35.4% were found to be current users of contraceptive methods. The ideal number of children was 3.1 in average.

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Performance of Korean State-owned Enterprises Following Executive Turnover and Executive Resignation During the Term of Office (공기업의 임원교체와 중도퇴임이 경영성과에 미치는 영향)

  • Yu, Seungwon;Kim, Suhee
    • KDI Journal of Economic Policy
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    • v.34 no.3
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    • pp.95-131
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    • 2012
  • This study examines whether the executive turnover and the executive resignation during the term of office affect the performance of Korean state-owned enterprises. The executive turnover in the paper means the comprehensive change of the executives which includes the change after the term of office, the change after consecutive terms and the change during the term of office. The 'resignation' was named for the executive change during the term of office to distinguish from the executive turnover. The study scope of the paper is restrained to the comprehensive executive change itself irrespective of the term of office and the resignation during the term of office. Therefore the natural change of the executive after the term of office or the change after consecutive terms is not included in the study. Spontaneous resignation and forced resignation are not distinguished in the paper as the distinction between the two is not easy. The paper uses both the margin of return on asset and the margin of return on asset adjusted by industry as proxies of the performance of state-owned enterprises. The business nature of state-owned enterprise is considered in the study, the public nature not in it. The paper uses the five year (2004 to 2008) samples of 24 firms designated as public enterprises by Korean government. The analysis results are as follows. First, 45.1% of CEOs were changed a year during the sample period on the average. The average tenure period of CEOs was 2 years and 3 months and 49.9% among the changed CEOs resigned during the term of office. 41.6% of internal auditors were changed a year on the average. The average tenure period of internal auditors was 2 years and 2 months and 51.0% among the changed internal auditors resigned during the term of office. In case of outside directors, on average, 38.2% were changed a year. The average tenure period was 2 years and 7 months and 25.4% among the changed internal directors resigned during the term of office. These statistics show that numerous CEOs resigned before the finish of the three year term in office. Also, considering the tenure of an internal auditor and an outside director which diminished from 3 years to 2 years by an Act on the Management of Public Institutions (applied to the executives appointed since April 2007), it seems most internal auditors resigned during the term of office but most outside directors resigned after the end of the term. Secondly, There was no evidence that the executives were changed during the term of office because of the bad performance of prior year. On the other hand, contrary to the normal expectation, the performance of prior year of the state-owned enterprise where an outside director resigned during the term of office was significantly higher than that of other state-owned enterprises. It means that the clauses in related laws on the executive dismissal on grounds of bad performance did not work normally. Instead it can be said that the executive change was made by non-economic reasons such as a political motivation. Thirdly, the results from a fixed effect model show there were evidences that performance turned negatively when CEOs or outside directors resigned during the term of office. CEO's resignation during the term of office gave a significantly negative effect on the margin of return on asset. Outside director's resignation during the term of office lowered significantly the margin of return on asset adjusted by industry. These results suggest that the executive's change in Korean state-owned enterprises was not made by objective or economic standards such as management performance assessment and the negative effect on performance of the enterprises was had by the unfaithful obeyance of the legal executive term.

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Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.