• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 1993.06a
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• pp.1051-1054
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• 1993

The International Atomic Energy Agency's Statute in Article III.A.5 allows it“to establish and administer safeguards designed to ensure that special fissionable and other materials, services, equipment, facilities and information made available by the Agency or at its request or under its supervision or control are not used in such a way as to further any military purpose; and to apply safeguards, at the request of the parties, to any bilateral or multilateral arrangement, or at the request of a State, to any of that State's activities in the field of atomic energy”. Safeguards are essentially a technical means of verifying the fulfilment of political obligations undertaken by States and given a legal force in international agreements relating to the peaceful uses of nuclear energy. The main political objectives are: to assure the international community that States are complying with their non-proliferation and other peaceful undertakings; and to deter (a) the diversion of afeguarded nuclear materials to the production of nuclear explosives or for military purposes and (b) the misuse of safeguarded facilities with the aim of producing unsafeguarded nuclear material. It is clear that no international safeguards system can physically prevent diversion. The IAEA safeguards system is basically a verification measure designed to provide assurance in those cases in which diversion has not occurred. Verification is accomplished by two basic means: material accountancy and containment and surveillance measures. Nuclear material accountancy is the fundamental IAEA safeguards mechanism, while containment and surveillance serve as important complementary measures. Material accountancy refers to a collection of measurements and other determinations which enable the State and the Agency to maintain a current picture of the location and movement of nuclear material into and out of material balance areas, i. e. areas where all material entering or leaving is measurab e. A containment measure is one that is designed by taking advantage of structural characteristics, such as containers, tanks or pipes, etc. To establish the physical integrity of an area or item by preventing the undetected movement of nuclear material or equipment. Such measures involve the application of tamper-indicating or surveillance devices. Surveillance refers to both human and instrumental observation aimed at indicating the movement of nuclear material. The verification process consists of three over-lapping elements: (a) Provision by the State of information such as - design information describing nuclear installations; - accounting reports listing nuclear material inventories, receipts and shipments; - documents amplifying and clarifying reports, as applicable; - notification of international transfers of nuclear material. (b) Collection by the IAEA of information through inspection activities such as - verification of design information - examination of records and repo ts - measurement of nuclear material - examination of containment and surveillance measures - follow-up activities in case of unusual findings. (c) Evaluation of the information provided by the State and of that collected by inspectors to determine the completeness, accuracy and validity of the information provided by the State and to resolve any anomalies and discrepancies. To design an effective verification system, one must identify possible ways and means by which nuclear material could be diverted from peaceful uses, including means to conceal such diversions. These theoretical ways and means, which have become known as diversion strategies, are used as one of the basic inputs for the development of safeguards procedures, equipment and instrumentation. For analysis of implementation strategy purposes, it is assumed that non-compliance cannot be excluded a priori and that consequently there is a low but non-zero probability that a diversion could be attempted in all safeguards ituations. An important element of diversion strategies is the identification of various possible diversion paths; the amount, type and location of nuclear material involved, the physical route and conversion of the material that may take place, rate of removal and concealment methods, as appropriate. With regard to the physical route and conversion of nuclear material the following main categories may be considered: - unreported removal of nuclear material from an installation or during transit - unreported introduction of nuclear material into an installation - unreported transfer of nuclear material from one material balance area to another - unreported production of nuclear material, e. g. enrichment of uranium or production of plutonium - undeclared uses of the material within the installation. With respect to the amount of nuclear material that might be diverted in a given time (the diversion rate), the continuum between the following two limiting cases is cons dered: - one significant quantity or more in a short time, often known as abrupt diversion; and - one significant quantity or more per year, for example, by accumulation of smaller amounts each time to add up to a significant quantity over a period of one year, often called protracted diversion. Concealment methods may include: - restriction of access of inspectors - falsification of records, reports and other material balance areas - replacement of nuclear material, e. g. use of dummy objects - falsification of measurements or of their evaluation - interference with IAEA installed equipment.As a result of diversion and its concealment or other actions, anomalies will occur. All reasonable diversion routes, scenarios/strategies and concealment methods have to be taken into account in designing safeguards implementation strategies so as to provide sufficient opportunities for the IAEA to observe such anomalies. The safeguards approach for each facility will make a different use of these procedures, equipment and instrumentation according to the various diversion strategies which could be applicable to that facility and according to the detection and inspection goals which are applied. Postulated pathways sets of scenarios comprise those elements of diversion strategies which might be carried out at a facility or across a State's fuel cycle with declared or undeclared activities. All such factors, however, contain a degree of fuzziness that need a human judgment to make the ultimate conclusion that all material is being used for peaceful purposes. Safeguards has been traditionally based on verification of declared material and facilities using material accountancy as a fundamental measure. The strength of material accountancy is based on the fact that it allows to detect any diversion independent of the diversion route taken. Material accountancy detects a diversion after it actually happened and thus is powerless to physically prevent it and can only deter by the risk of early detection any contemplation by State authorities to carry out a diversion. Recently the IAEA has been faced with new challenges. To deal with these, various measures are being reconsidered to strengthen the safeguards system such as enhanced assessment of the completeness of the State's initial declaration of nuclear material and installations under its jurisdiction enhanced monitoring and analysis of open information and analysis of open information that may indicate inconsistencies with the State's safeguards obligations. Precise information vital for such enhanced assessments and analyses is normally not available or, if available, difficult and expensive collection of information would be necessary. Above all, realistic appraisal of truth needs sound human judgment.

• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 1993.06a
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• pp.1041-1043
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• 1993

Fuzzy logic based Control Theory has gained much interest in the industrial world, thanks to its ability to formalize and solve in a very natural way many problems that are very difficult to quantify at an analytical level. This paper shows a solution for treating membership function inside hardware circuits. The proposed hardware structure optimizes the memoried size by using particular form of the vectorial representation. The process of memorizing fuzzy sets, i.e. their membership function, has always been one of the more problematic issues for the hardware implementation, due to the quite large memory space that is needed. To simplify such an implementation, it is commonly [1,2,8,9,10,11] used to limit the membership functions either to those having triangular or trapezoidal shape, or pre-definite shape. These kinds of functions are able to cover a large spectrum of applications with a limited usage of memory, since they can be memorized by specifying very few parameters ( ight, base, critical points, etc.). This however results in a loss of computational power due to computation on the medium points. A solution to this problem is obtained by discretizing the universe of discourse U, i.e. by fixing a finite number of points and memorizing the value of the membership functions on such points [3,10,14,15]. Such a solution provides a satisfying computational speed, a very high precision of definitions and gives the users the opportunity to choose membership functions of any shape. However, a significant memory waste can as well be registered. It is indeed possible that for each of the given fuzzy sets many elements of the universe of discourse have a membership value equal to zero. It has also been noticed that almost in all cases common points among fuzzy sets, i.e. points with non null membership values are very few. More specifically, in many applications, for each element u of U, there exists at most three fuzzy sets for which the membership value is ot null [3,5,6,7,12,13]. Our proposal is based on such hypotheses. Moreover, we use a technique that even though it does not restrict the shapes of membership functions, it reduces strongly the computational time for the membership values and optimizes the function memorization. In figure 1 it is represented a term set whose characteristics are common for fuzzy controllers and to which we will refer in the following. The above term set has a universe of discourse with 128 elements (so to have a good resolution), 8 fuzzy sets that describe the term set, 32 levels of discretization for the membership values. Clearly, the number of bits necessary for the given specifications are 5 for 32 truth levels, 3 for 8 membership functions and 7 for 128 levels of resolution. The memory depth is given by the dimension of the universe of the discourse (128 in our case) and it will be represented by the memory rows. The length of a world of memory is defined by: Length = nem (dm(m)＋dm(fm) Where: fm is the maximum number of non null values in every element of the universe of the discourse, dm(m) is the dimension of the values of the membership function m, dm(fm) is the dimension of the word to represent the index of the highest membership function. In our case then Length=24. The memory dimension is therefore 128*24 bits. If we had chosen to memorize all values of the membership functions we would have needed to memorize on each memory row the membership value of each element. Fuzzy sets word dimension is 8*5 bits. Therefore, the dimension of the memory would have been 128*40 bits. Coherently with our hypothesis, in fig. 1 each element of universe of the discourse has a non null membership value on at most three fuzzy sets. Focusing on the elements 32,64,96 of the universe of discourse, they will be memorized as follows: The computation of the rule weights is done by comparing those bits that represent the index of the membership function, with the word of the program memor . The output bus of the Program Memory (μCOD), is given as input a comparator (Combinatory Net). If the index is equal to the bus value then one of the non null weight derives from the rule and it is produced as output, otherwise the output is zero (fig. 2). It is clear, that the memory dimension of the antecedent is in this way reduced since only non null values are memorized. Moreover, the time performance of the system is equivalent to the performance of a system using vectorial memorization of all weights. The dimensioning of the word is influenced by some parameters of the input variable. The most important parameter is the maximum number membership functions (nfm) having a non null value in each element of the universe of discourse. From our study in the field of fuzzy system, we see that typically nfm 3 and there are at most 16 membership function. At any rate, such a value can be increased up to the physical dimensional limit of the antecedent memory. A less important role n the optimization process of the word dimension is played by the number of membership functions defined for each linguistic term. The table below shows the request word dimension as a function of such parameters and compares our proposed method with the method of vectorial memorization[10]. Summing up, the characteristics of our method are: Users are not restricted to membership functions with specific shapes. The number of the fuzzy sets and the resolution of the vertical axis have a very small influence in increasing memory space. Weight computations are done by combinatorial network and therefore the time performance of the system is equivalent to the one of the vectorial method. The number of non null membership values on any element of the universe of discourse is limited. Such a constraint is usually non very restrictive since many controllers obtain a good precision with only three non null weights. The method here briefly described has been adopted by our group in the design of an optimized version of the coprocessor described in [10].

• KOREAN JOURNAL OF CROP SCIENCE
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• v.18
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• pp.1-27
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• 1975

Experiment I: A field experiment was conducted in an attempt to find the effect of top-dressing at heading time in different levels of nitrogen application and of different positioned leaf blades formed by the treatment of leaf defoliation at heading time on the ripening and the yield of rice. The results obtained are as follows: 1. Average number of ears per hill and average number of grains per ear in different levels of nitrogen application were increased as the amount of nitrogen applied was increased. while the rate of ripened grains the yield of rough rice and the weight of 1, 000 kernels of brown rice were decreased respectively as the amount of nitrogen applied was increased. 2. The rate of ripened grains and the weight of 1.000 kernels of brown rice in different levels of nitrogen, top-dressing at heading time were larger than those in control and increased. The yield of rough rice although statistically significant differences were not recognized, were numerically increased. 3. The rate of ripened grains, the yield of rough rice, the weight of 1, 000 kernels of brown rice and the rate of hulling in different treatments of leaf defoliation were remarkably decreased as the degree of leaf-defoliation became larger. 4. The rate of ripened grains, the yield of rough rice, the weight of 1, 000 kernels of brown rice and the rate of hulling in different combinations of number of remained leaves positioned differently, formed the order of $L_1(flag leaf)>L_2>L_3>L_4$ when only one leaf blade was remained, and were increased as the positions of leaves were higher when two leaf blades. were, remained. 5. In case of decrease in the number of leaf blades positioned differently, by the treatment of leaf. defoliation, rate of ripened grains, the yield of rough rice, the weight of 1, 000 kernels of brown rice and the rate of hulling were increased as the area of remained leaves became larger and the nitrogen content of a leaf blade was increased. 6. There was a tendency that the increase in the amount of fertilizer application made the rate of ripened grains and the weight of 1, 000 kernels of brown rice reduced in any number of remained leaf blades, but the application of top-dressing at heading. time resulted in the reverse tendency. The yield of rough rice showed a tendency to be increased as the amount of basal dressing and top-dressing increased and for the application of top-dressing at heading time, the yield of rough rice was less at the smaller number of those. 7. The productivity effect of the rate of ripened grains and the yield of brown rice covered by leaf blades was more than 50 per cent and that of the. weight of 1, 000 kernels of brown rice was not more than 1.0 percent. As the amount of nitrogen application increased the. effect of leaf blades on the rate of ripened. grains and the weight of 1, 000 kernels of brown rice was increased. The effect of leaf blades on the weight of brown rice was increased as the amount of basal dressing-application, but the effect was decreased as the amount of top-dressing at heading time increased, 8. The productivity effects of different positioned leaf blades on the rate of ripened grains, the yield of rough rice and the weight of 1, 000 kernels of brown rice were in order of $L_1(flag leaf)>L_2>L_3>L_4$ the productivity effects of $L_1$ and $L_2$ had a tendency to be increased as the amount of nitrogen applied was increased. Experiment II: A field experiment was done in order to disclose the effect of the time of nitrogen application on yield component and the effect of different positioned leaves formed by leaf defoliation at heading time on the rate of ripened grains and the yield of rice. The results obtained are as follows: 1. Average number of ears per hill was increased in the treatment of nitrogen application from basal dressing to 22 days before heading and in the treatment of application distributed weekly. Number of grains was increased in the treatment of nitrogen application from 36 days to 15 days before heading. The rate of ripened grains was, lower in the treatment of nitrogen application from top-dressing to 15 days before heading than in that of non-application, was higher in the treatment of nitrogen application within 8 days before heading, and was the lowest in that of application 29 days before heading. The yield of rough rice was the highest in the treatment of nitrogen application from 29 days to 22 days before heading. The weight of 1, 000 kernels of brown rice was a little high in the treatment of application from 29 days to 8 days before heading. 2. The rate of ripened grains the yield of rough rice, the weight of 1, 000 kernels of brown rice and the rate of hulling in different treatments of leaf defoliation were remarkably decreased as the degree of leaf defoliation got larger and there were highly significant differences among treatments. There was also a recognized interaction between the time of nitrogen application and leaf defoliation. 3. In relation to the rate of ripened grains, the weight of 1. 000 kernels of brown rice and the rate of hulling in different numbers of remained leaves positioned differently and their combinations, the yield components were in order of $L_1(flag leaf)>L_2>L_3>L_4$ when only one leaf was remained, which indicated that the components were increased as the leaf position got higher. When two laves were remained, the rate of ripened grains, the yield of rough rice and rate of hulling were high in case of the combinations of upper positioned leaves, and the increase in the weight of 1, 000 kernels of brown rice appeared to be affected most]y by flag leaf. When three leaf blades were remained similarly the components were increased with the combination of upper positioned leaf blades. 4. In case of decreased different positioned leaf blades by treatment of leaf defoliation, there was a significant positive regression between the leaf area, the dry matter weight of leaf blades and the nitrogen contents of leaf blades, and rate of ripened grains and the yield of rough rice, but there was no constant tendency between the former components and the weight of 1. 000 kernels of brown rice. 5. The closer the time of fertilizer application to heading time, the more the rate of ripened grains and the weight of 1, 000 kernels was decreased by defoliation, and the less were the remained leaf blades, the more remarkable was the tendency. The rate of ripened grains and the weight of 1. 000 kernels was increased by the top-dressing after heading time as the number of remained leaf blades. When the number of remained leaf blades was small the yield of rough rice was increased as the time of fertilizer application was closer to heading time. 6. Discussing the productivity effects of different organs in different times of nitrogen application, the productivity effect of a leaf blade on the rate of ripened grains was higher as the time of nitrogen application got later, and in the treatment of non-fertilization the productivity effect of a leaf blade and that of culm were the same. In the productivity effect on the yield of brown rice, the effect of culm covered more than 50 percent independently on the time of nitrogen application, and the tendency was larger in the treatment of non-fertilizer. The productivity effect of culm on the weight of 1. 000 kernels of brown rice was more than 90 percent, and the productivity effect of a leaf blade was increased as the time of application got later. 7. The productivity effect of a leaf blade in different positions on the rate of ripened grains, the yield of rough rice and the weight of 1, 000 kernels of brown rice had a tendency to be increased as the time of application got later and as the position of leaf blades got higher. In the treatment of weekly application through the entire growing period, the rate of ripened grains and the yield of rough rice were affected by flag leaf and the second leaf at the same level, the but the weight of 1, 000 kernels of brown rice was affected by flag leaf with more than 60 percent of the yield of total leaves.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.16-25
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• 2007

[ $\underline{Purpose}$ ]: Breast conserving surgery (BCS) followed by chemotherapy (CTx.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. $\underline{Materials\;and\;Methods}$: From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, $27{\sim}76$ years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection. BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An aditional dose of $9{\sim}16\;Gy$ was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CTx. with $4{\sim}6$ cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: $17{\sim}93$ months). $\underline{Results}$: The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five patients developed distant metastases as the first sign of recurrence at $6{\sim}33$ months (mean 21 months). Sites of distant metastatic sites were bone in 3 patients, liver in 1 patient and systemic lesions in 1 patient. Among the patients with distant metastatic sites, two patients died at 17 and 25 months during the follow-up period. According to stage, the 5Y-OSR was 95.5%, 100%, 84.6%, and 100% for stage I, IIa, IIb, and III respectively. The 5Y-DFSR was 96.8%, 92.7%, 76.9%, and 100% for stage I, IIa, IIb, and III respectively. Stage was the only risk factor for local recurrence based on univariate analysis. Ten stage III patients included in this analysis had a primary tumor size of less than 3 cm and had more than 4 axillary lymph node metastases. The 10 stage III patients received not only breast RT but also received posterior axillary boost RT to the supraclavicular node. During the median 53.3 months follow-up period, no any local or distant failure was found. Complications were asymptomatic radiation pneumonitis in 10 patients, symptomatic pneumonitis in 1 patient and lymphedema in 8 patients. $\underline{Conclusion}$: Although our follow up period is short, we had excellent local control and survival results and reaffirmed that BCS followed by RT and CTx. appears to be an adequate treatment method. These results also provide evidence that distant failure occurs earlier and more frequent as compared with local failure. Further studies and a longer follow-up period are needed to assess the effectiveness of BCS followed by RT for the patients with less than a 3 cm primary tumor and more than 4 axillary node metastases.

• Korean Journal of Animal Reproduction
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• v.24 no.1
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• pp.1-18
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• 2000

Eighty dairy farms in Palmers ton North area in New Zealand were surveyed on 1) general characteristics (10 Questions), 2) milk yield and feed supplementary (7 questions), 3) reproductive efficiencies (12 questions) and 4) reproductive disorders (12 questions) by mail questions from February to July, 1998. Among those 4 items from 38 dairy farms (47.5%), especially in items 1) and 2), overall dairy farming situation, supplementary feeding and milk yields were surveyed and analyzed for Korean dairy farmers (especially in Cheju island) to have better understanding or higher economical gains. The results were as follows. 1. In dairy experience, 21 (45%) among 38 dairy farms surveyed were answered that farming less than 15 years, 15~19 year, 20~25 years and over 26 years experience were 3 (7.9%), 7 (18.4%), 6 (15.8%) and 5 (13.2%) which generally showed longer experience compare to Korean dairy farming situation. In survey of labour input and business goal of dairy farming, self-managing farms, sharemilkers, unpaid family manpowering farms, manager running farms, farms with hired worker, farms with part time helper and other type was 21 (55.3%), 10 (26.3%), 2 (3.5%), 3 (5.3%), 18 (31.6%), 2 (3.5%), and 1 (1.8%), respectively. 2. Analyzing pasture and tillable land, pasture according to feeding scale (200, 300 and 400 heads) were 56, 90 and 165.3 ha, and tillable lands were 51, 78 and 165 ha which showed some differences among feeding scale. In recording methods in 38 farms replied, 36 (95%) dairy handbook and 23 (70%) dual methods taking farms were higher than that of 10 (26.3%) computer and 15(39.5%) well-recorder methods. 3. Dairy waste processing facilities in environmental field were almost perfect except of metropolitan area, and so no problem was developed in its control so far. Hence, 26 farm (68.4%) of pond system was higher rather than those in 8 (21.2%) of using as organic manure after storing feces of dairy cattle, 1(2.6%) bunker system and 3 (7.9%) other type farms. 4. In milking facilities, 33 farms (86.9%) of Harringbone types were higher than those in 3 (7.9%) of Walkthrough types, 1 (2.6%) of Rotary system and other types. Although the construction facilities was not enough, this system show the world-leveled dairy country to attempted to elevate economic gains using the advantage of climatic condition. 5. In milking day and yearly yield per head, average 275 milking days and 87 drying days were longer than that of 228 average milking days in New Zealand. Annual total milk yield per head and milk solid (ms) was 3,990 kg and approximately 319 kg. Dairy milk solid (ms) per head, milk yield, fat percentage was 1.2 kg, 15.5 kg and average 4.83% which was much higher than in other country, and milk protein was average 3.75%. 6. In coclusion, Palmerstone North has been a center of dairy farming in New Zealand for the last 21 years. Their dairy farming history is 6~9 year longer than ours and the average number of milking cows per farm is 355, which is much greater than that (35) of Korea. They do not have dairy barn, but only milking parlors. Cows are taken care of by family 0.5 persons), are on a planned calving schedule in spring (93%) and milked for 240~280 days a year, avoiding winter. Cows are dried according to milk yield and body condition score. This management system is quite different from that of Korean dairy farms. Cows are not fed concentrates, relying entirely on pasture forages and the average milk yield per cow is 3,500 kg, which is about 1/2 milk yield of Korean dairy farms. They were bred to produce high fat milk with an average of 4.5%. Their milk production cost is the lowest in the world and the country's economy relies heavily on milk production. We Korean farmers may try to increase farming size, decreasing labor and management costs.

• 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.