• Title/Summary/Keyword: Disadvantages

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Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries -Comparison between the different surgical approaches- (폐동맥폐쇄와 주대동맥폐동맥혈관부행지를 동반한 활로씨사징증 -다양한 외과적 치료접근의 비교-)

  • 이정렬;양지혁;김용진;노준량
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.471-479
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    • 1999
  • Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

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The Concentration of Economic Power in Korea (경제력집중(經濟力集中) : 기본시각(基本視角)과 정책방향(政策方向))

  • Lee, Kyu-uck
    • KDI Journal of Economic Policy
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    • v.12 no.1
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    • pp.31-68
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    • 1990
  • The concentration of economic power takes the form of one or a few firms controlling a substantial portion of the economic resources and means in a certain economic area. At the same time, to the extent that these firms are owned by a few individuals, resource allocation can be manipulated by them rather than by the impersonal market mechanism. This will impair allocative efficiency, run counter to a decentralized market system and hamper the equitable distribution of wealth. Viewed from the historical evolution of Western capitalism in general, the concentration of economic power is a paradox in that it is a product of the free market system itself. The economic principle of natural discrimination works so that a few big firms preempt scarce resources and market opportunities. Prominent historical examples include trusts in America, Konzern in Germany and Zaibatsu in Japan in the early twentieth century. In other words, the concentration of economic power is the outcome as well as the antithesis of free competition. As long as judgment of the economic system at large depends upon the value systems of individuals, therefore, the issue of how to evaluate the concentration of economic power will inevitably be tinged with ideology. We have witnessed several different approaches to this problem such as communism, fascism and revised capitalism, and the last one seems to be the only surviving alternative. The concentration of economic power in Korea can be summarily represented by the "jaebol," namely, the conglomerate business group, the majority of whose member firms are monopolistic or oligopolistic in their respective markets and are owned by particular individuals. The jaebol has many dimensions in its size, but to sketch its magnitude, the share of the jaebol in the manufacturing sector reached 37.3% in shipment and 17.6% in employment as of 1989. The concentration of economic power can be ascribed to a number of causes. In the early stages of economic development, when the market system is immature, entrepreneurship must fill the gap inherent in the market in addition to performing its customary managerial function. Entrepreneurship of this sort is a scarce resource and becomes even more valuable as the target rate of economic growth gets higher. Entrepreneurship can neither be readily obtained in the market nor exhausted despite repeated use. Because of these peculiarities, economic power is bound to be concentrated in the hands of a few entrepreneurs and their business groups. It goes without saying, however, that the issue of whether the full exercise of money-making entrepreneurship is compatible with social mores is a different matter entirely. The rapidity of the concentration of economic power can also be traced to the diversification of business groups. The transplantation of advanced technology oriented toward mass production tends to saturate the small domestic market quite early and allows a firm to expand into new markets by making use of excess capacity and of monopoly profits. One of the reasons why the jaebol issue has become so acute in Korea lies in the nature of the government-business relationship. The Korean government has set economic development as its foremost national goal and, since then, has intervened profoundly in the private sector. Since most strategic industries promoted by the government required a huge capacity in technology, capital and manpower, big firms were favored over smaller firms, and the benefits of industrial policy naturally accrued to large business groups. The concentration of economic power which occured along the way was, therefore, not necessarily a product of the market system. At the same time, the concentration of ownership in business groups has been left largely intact as they have customarily met capital requirements by means of debt. The real advantage enjoyed by large business groups lies in synergy due to multiplant and multiproduct production. Even these effects, however, cannot always be considered socially optimal, as they offer disadvantages to other independent firms-for example, by foreclosing their markets. Moreover their fictitious or artificial advantages only aggravate the popular perception that most business groups have accumulated their wealth at the expense of the general public and under the behest of the government. Since Korea stands now at the threshold of establishing a full-fledged market economy along with political democracy, the phenomenon called the concentration of economic power must be correctly understood and the roles of business groups must be accordingly redefined. In doing so, we would do better to take a closer look at Japan which has experienced a demise of family-controlled Zaibatsu and a success with business groups(Kigyoshudan) whose ownership is dispersed among many firms and ultimately among the general public. The Japanese case cannot be an ideal model, but at least it gives us a good point of departure in that the issue of ownership is at the heart of the matter. In setting the basic direction of public policy aimed at controlling the concentration of economic power, one must harmonize efficiency and equity. Firm size in itself is not a problem, if it is dictated by efficiency considerations and if the firm behaves competitively in the market. As long as entrepreneurship is required for continuous economic growth and there is a discrepancy in entrepreneurial capacity among individuals, a concentration of economic power is bound to take place to some degree. Hence, the most effective way of reducing the inefficiency of business groups may be to impose competitive pressure on their activities. Concurrently, unless the concentration of ownership in business groups is scaled down, the seed of social discontent will still remain. Nevertheless, the dispersion of ownership requires a number of preconditions and, consequently, we must make consistent, long-term efforts on many fronts. We can suggest a long list of policy measures specifically designed to control the concentration of economic power. Whatever the policy may be, however, its intended effects will not be fully realized unless business groups abide by the moral code expected of socially responsible entrepreneurs. This is especially true, since the root of the problem of the excessive concentration of economic power lies outside the issue of efficiency, in problems concerning distribution, equity, and social justice.

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A Comparative Study on Awareness of Middle School Students, School Parents, and Human Resources Directors in Industrial Institutions about Admission into Specialized High Schools and Career after Graduating from Specialized High Schools (특성화고 진학 및 졸업 후 진로에 대한 중학생, 학부모, 산업체 인사 담당자의 인식 비교 연구)

  • Lee, Byung-Wook;Ahn, Jae-Yeong;Lee, Chan-Joo;Lee, Sang-Hyun
    • 대한공업교육학회지
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    • v.38 no.2
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    • pp.48-67
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    • 2013
  • This study tried to suggest implications about operation direction of specialized high schools (SHS) by researching awareness of middle school students (MSS), school parents (SP), human resources directors in industrial institutions (HRDII) who will be the main users of SHS education, about entering SHS and career after graduating from SHS. Seniors of middle school, SP and HRDII in Asan, Chungnam were the subject of this survey research. The summary of the result of this study is as follow: First, MSS and SP usually hoped to enter general high schools rather than vocational education schools such as SHS, meister high schools, and MSS considered school records and SP considered aptitude and talent for the factors to choose high school. Second, MSS, SP, and HRDII recognized purposes of SHS as improvement of talent and aptitude, and getting a job. As for positive images of SHS, they recognized it as applying talent and aptitude to life early, getting good jobs easily, fast independence after graduation, and learning excellent technologies, and as for negative images of SHS, they recognized it as social prejudices and discrimination, students with bad school records enter them, disadvantages about promotion and wages, and being unfavorable for entering universities. They also recognized education of SHS as being effective for improvement of basic and executive ability and key competency, development of creative human resources, and improvement of right personality and courteous manners. Third, many MSS and SP showed intention to enter SHS if it is established in Asan. They wished to enter SHS because they would like to apply their aptitude and talent to life early, learn excellent skill, and hope for early employment, on the other hand, they did not wish to enter SHS because it was not suited for their aptitude and talent, awareness about SHS is low, it is unfavorable to enter universities, and there were social prejudices and discrimination. They also similarly hoped for getting jobs and entering universities after graduating from SHS. And the reason they wanted to get a job was usually because they want to be successful by advancing into society early, or because it is still hard to get a job even after graduate from the university, on the other hand, the reason they want to enter university is because is usually in-depth education about major and social discrimination about level of education. The ability to perform duties forms the greatest part of the employment standard that MSS, SP, and HRDII aware. MSS and SP usually hoped for industrial, home economics and housework and commercial majors in SHS, and considered aptitude and talent, the promising future, and being favorable for employment for choosing major. The reason HRDII hire SHS student was to develop student into talent of industrial institution, ability of student, and need for manpower with high school graduation level, and there were also partial answer that they can hire SHS student if they have ability to perform duties. The proposals about operation direction of SHS according to the results above are as follow: SHS should diversify major and curriculum to meet various requirements of student and parents, establish SHS admission system based on career guidance, and improve student's ability to perform duties by establishing work-based learning. The Government should organize work-to-school policy to enable practical career development of students from SHS, and promote relevant policy to reinforcing SHS education rather than quantitative evaluation such as employment rate, and cooperative support from each government departments is required to make manpower with skill related to SHS to get proper evaluation and treatment.

Performance analysis of Frequent Itemset Mining Technique based on Transaction Weight Constraints (트랜잭션 가중치 기반의 빈발 아이템셋 마이닝 기법의 성능분석)

  • Yun, Unil;Pyun, Gwangbum
    • Journal of Internet Computing and Services
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    • v.16 no.1
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    • pp.67-74
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    • 2015
  • In recent years, frequent itemset mining for considering the importance of each item has been intensively studied as one of important issues in the data mining field. According to strategies utilizing the item importance, itemset mining approaches for discovering itemsets based on the item importance are classified as follows: weighted frequent itemset mining, frequent itemset mining using transactional weights, and utility itemset mining. In this paper, we perform empirical analysis with respect to frequent itemset mining algorithms based on transactional weights. The mining algorithms compute transactional weights by utilizing the weight for each item in large databases. In addition, these algorithms discover weighted frequent itemsets on the basis of the item frequency and weight of each transaction. Consequently, we can see the importance of a certain transaction through the database analysis because the weight for the transaction has higher value if it contains many items with high values. We not only analyze the advantages and disadvantages but also compare the performance of the most famous algorithms in the frequent itemset mining field based on the transactional weights. As a representative of the frequent itemset mining using transactional weights, WIS introduces the concept and strategies of transactional weights. In addition, there are various other state-of-the-art algorithms, WIT-FWIs, WIT-FWIs-MODIFY, and WIT-FWIs-DIFF, for extracting itemsets with the weight information. To efficiently conduct processes for mining weighted frequent itemsets, three algorithms use the special Lattice-like data structure, called WIT-tree. The algorithms do not need to an additional database scanning operation after the construction of WIT-tree is finished since each node of WIT-tree has item information such as item and transaction IDs. In particular, the traditional algorithms conduct a number of database scanning operations to mine weighted itemsets, whereas the algorithms based on WIT-tree solve the overhead problem that can occur in the mining processes by reading databases only one time. Additionally, the algorithms use the technique for generating each new itemset of length N+1 on the basis of two different itemsets of length N. To discover new weighted itemsets, WIT-FWIs performs the itemset combination processes by using the information of transactions that contain all the itemsets. WIT-FWIs-MODIFY has a unique feature decreasing operations for calculating the frequency of the new itemset. WIT-FWIs-DIFF utilizes a technique using the difference of two itemsets. To compare and analyze the performance of the algorithms in various environments, we use real datasets of two types (i.e., dense and sparse) in terms of the runtime and maximum memory usage. Moreover, a scalability test is conducted to evaluate the stability for each algorithm when the size of a database is changed. As a result, WIT-FWIs and WIT-FWIs-MODIFY show the best performance in the dense dataset, and in sparse dataset, WIT-FWI-DIFF has mining efficiency better than the other algorithms. Compared to the algorithms using WIT-tree, WIS based on the Apriori technique has the worst efficiency because it requires a large number of computations more than the others on average.

Differential Effects of Recovery Efforts on Products Attitudes (제품태도에 대한 회복노력의 차별적 효과)

  • Kim, Cheon-GIl;Choi, Jung-Mi
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.33-58
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    • 2008
  • Previous research has presupposed that the evaluation of consumer who received any recovery after experiencing product failure should be better than the evaluation of consumer who did not receive any recovery. The major purposes of this article are to examine impacts of product defect failures rather than service failures, and to explore effects of recovery on postrecovery product attitudes. First, this article deals with the occurrence of severe and unsevere failure and corresponding service recovery toward tangible products rather than intangible services. Contrary to intangible services, purchase and usage are separable for tangible products. This difference makes it clear that executing an recovery strategy toward tangible products is not plausible right after consumers find out product failures. The consumers may think about backgrounds and causes for the unpleasant events during the time gap between product failure and recovery. The deliberation may dilutes positive effects of recovery efforts. The recovery strategies which are provided to consumers experiencing product failures can be classified into three types. A recovery strategy can be implemented to provide consumers with a new product replacing the old defective product, a complimentary product for free, a discount at the time of the failure incident, or a coupon that can be used on the next visit. This strategy is defined as "a rewarding effort." Meanwhile a product failure may arise in exchange for its benefit. Then the product provider can suggest a detail explanation that the defect is hard to escape since it relates highly to the specific advantage to the product. The strategy may be called as "a strengthening effort." Another possible strategy is to recover negative attitude toward own brand by giving prominence to the disadvantages of a competing brand rather than the advantages of its own brand. The strategy is reflected as "a weakening effort." This paper emphasizes that, in order to confirm its effectiveness, a recovery strategy should be compared to being nothing done in response to the product failure. So the three types of recovery efforts is discussed in comparison to the situation involving no recovery effort. The strengthening strategy is to claim high relatedness of the product failure with another advantage, and expects the two-sidedness to ease consumers' complaints. The weakening strategy is to emphasize non-aversiveness of product failure, even if consumers choose another competitive brand. The two strategies can be effective in restoring to the original state, by providing plausible motives to accept the condition of product failure or by informing consumers of non-responsibility in the failure case. However the two may be less effective strategies than the rewarding strategy, since it tries to take care of the rehabilitation needs of consumers. Especially, the relative effect between the strengthening effort and the weakening effort may differ in terms of the severity of the product failure. A consumer who realizes a highly severe failure is likely to attach importance to the property which caused the failure. This implies that the strengthening effort would be less effective under the condition of high product severity. Meanwhile, the failing property is not diagnostic information in the condition of low failure severity. Consumers would not pay attention to non-diagnostic information, and with which they are not likely to change their attitudes. This implies that the strengthening effort would be more effective under the condition of low product severity. A 2 (product failure severity: high or low) X 4 (recovery strategies: rewarding, strengthening, weakening, or doing nothing) between-subjects design was employed. The particular levels of product failure severity and the types of recovery strategies were determined after a series of expert interviews. The dependent variable was product attitude after the recovery effort was provided. Subjects were 284 consumers who had an experience of cosmetics. Subjects were first given a product failure scenario and were asked to rate the comprehensibility of the failure scenario, the probability of raising complaints against the failure, and the subjective severity of the failure. After a recovery scenario was presented, its comprehensibility and overall evaluation were measured. The subjects assigned to the condition of no recovery effort were exposed to a short news article on the cosmetic industry. Next, subjects answered filler questions: 42 items of the need for cognitive closure and 16 items of need-to-evaluate. In the succeeding page a subject's product attitude was measured on an five-item, six-point scale, and a subject's repurchase intention on an three-item, six-point scale. After demographic variables of age and sex were asked, ten items of the subject's objective knowledge was checked. The results showed that the subjects formed more favorable evaluations after receiving rewarding efforts than after receiving either strengthening or weakening efforts. This is consistent with Hoffman, Kelley, and Rotalsky (1995) in that a tangible service recovery could be more effective that intangible efforts. Strengthening and weakening efforts also were effective compared to no recovery effort. So we found that generally any recovery increased products attitudes. The results hint us that a recovery strategy such as strengthening or weakening efforts, although it does not contain a specific reward, may have an effect on consumers experiencing severe unsatisfaction and strong complaint. Meanwhile, strengthening and weakening efforts were not expected to increase product attitudes under the condition of low severity of product failure. We can conclude that only a physical recovery effort may be recognized favorably as a firm's willingness to recover its fault by consumers experiencing low involvements. Results of the present experiment are explained in terms of the attribution theory. This article has a limitation that it utilized fictitious scenarios. Future research deserves to test a realistic effect of recovery for actual consumers. Recovery involves a direct, firsthand experience of ex-users. Recovery does not apply to non-users. The experience of receiving recovery efforts can be relatively more salient and accessible for the ex-users than for non-users. A recovery effort might be more likely to improve product attitude for the ex-users than for non-users. Also the present experiment did not include consumers who did not have an experience of the products and who did not perceive the occurrence of product failure. For the non-users and the ignorant consumers, the recovery efforts might lead to decreased product attitude and purchase intention. This is because the recovery trials may give an opportunity for them to notice the product failure.

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Radiation Therapy Using M3 Wax Bolus in Patients with Malignant Scalp Tumors (악성 두피 종양(Scalp) 환자의 M3 Wax Bolus를 이용한 방사선치료)

  • Kwon, Da Eun;Hwang, Ji Hye;Park, In Seo;Yang, Jun Cheol;Kim, Su Jin;You, Ah Young;Won, Young Jinn;Kwon, Kyung Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.75-81
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    • 2019
  • Purpose: Helmet type bolus for 3D printer is being manufactured because of the disadvantages of Bolus materials when photon beam is used for the treatment of scalp malignancy. However, PLA, which is a used material, has a higher density than a tissue equivalent material and inconveniences occur when the patient wears PLA. In this study, we try to treat malignant scalp tumors by using M3 wax helmet with 3D printer. Methods and materials: For the modeling of the helmet type M3 wax, the head phantom was photographed by CT, which was acquired with a DICOM file. The part for helmet on the scalp was made with Helmet contour. The M3 Wax helmet was made by dissolving paraffin wax, mixing magnesium oxide and calcium carbonate, solidifying it in a PLA 3D helmet, and then eliminated PLA 3D Helmet of the surface. The treatment plan was based on Intensity-Modulated Radiation Therapy (IMRT) of 10 Portals, and the therapeutic dose was 200 cGy, using Analytical Anisotropic Algorithm (AAA) of Eclipse. Then, the dose was verified by using EBT3 film and Mosfet (Metal Oxide Semiconductor Field Effect Transistor: USA), and the IMRT plan was measured 3 times in 3 parts by reproducing the phantom of the head human model under the same condition with the CT simulation room. Results: The Hounsfield unit (HU) of the bolus measured by CT was $52{\pm}37.1$. The dose of TPS was 186.6 cGy, 193.2 cGy and 190.6 cGy at the M3 Wax bolus measurement points of A, B and C, and the dose measured three times at Mostet was $179.66{\pm}2.62cGy$, $184.33{\pm}1.24cGy$ and $195.33{\pm}1.69cGy$. And the error rates were -3.71 %, -4.59 %, and 2.48 %. The dose measured with EBT3 film was $182.00{\pm}1.63cGy$, $193.66{\pm}2.05cGy$ and $196{\pm}2.16cGy$. The error rates were -2.46 %, 0.23 % and 2.83 %. Conclusions: The thickness of the M3 wax bolus was 2 cm, which could help the treatment plan to be established by easily lowering the dose of the brain part. The maximum error rate of the scalp surface dose was measured within 5 % and generally within 3 %, even in the A, B, C measurements of dosimeters of EBT3 film and Mosfet in the treatment dose verification. The making period of M3 wax bolus is shorter, cheaper than that of 3D printer, can be reused and is very useful for the treatment of scalp malignancies as human tissue equivalent material. Therefore, we think that the use of casting type M3 wax bolus, which will complement the making period and cost of high capacity Bolus and Compensator in 3D printer, will increase later.