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A Study on Implementation of Primary Health Care Delivery System meet to Rural Area in Korea -Village Health Voluntary Worker Development- (우리 나라 농촌지역(農村地域)에 부합하는 1차(次) 보건의료전달체계(保健醫療傳達體系) 정착구현(定着具現)에 관한 연구(硏究) -마을 보건임원(保健任員) 개발(開發)-)

  • Koo, Y.C.;Wie, J.H.;Hwang, S.J.;Choi, S.S.
    • Journal of Preventive Medicine and Public Health
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    • v.12 no.1
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    • pp.13-23
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    • 1979
  • A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

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A Study on the Relationship of Learning, Innovation Capability and Innovation Outcome (학습, 혁신역량과 혁신성과 간의 관계에 관한 연구)

  • Kim, Kui-Won
    • Journal of Korea Technology Innovation Society
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    • v.17 no.2
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    • pp.380-420
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    • 2014
  • We increasingly see the importance of employees acquiring enough expert capability or innovation capability to prepare for ever growing uncertainties in their operation domains. However, despite the above circumstances, there have not been an enough number of researches on how operational input components for employees' innovation outcome, innovation activities such as acquisition, exercise and promotion effort of employee's innovation capability, and their resulting innovation outcome interact with each other. This trend is believed to have been resulted because most of the current researches on innovation focus on the units of country, industry and corporate entity levels but not on an individual corporation's innovation input components, innovation outcome and innovation activities themselves. Therefore, this study intends to avoid the currently prevalent study frames and views on innovation and focus more on the strategic policies required for the enhancement of an organization's innovation capabilities by quantitatively analyzing employees' innovation outcomes and their most suggested relevant innovation activities. The research model that this study deploys offers both linear and structural model on the trio of learning, innovation capability and innovation outcome, and then suggests the 4 relevant hypotheses which are quantitatively tested and analyzed as follows: Hypothesis 1] The different levels of innovation capability produce different innovation outcomes (accepted, p-value = 0.000<0.05). Hypothesis 2] The different amounts of learning time produce different innovation capabilities (rejected, p-value = 0.199, 0.220>0.05). Hypothesis 3] The different amounts of learning time produce different innovation outcomes. (accepted, p-value = 0.000<0.05). Hypothesis 4] the innovation capability acts as a significant parameter in the relationship of the amount of learning time and innovation outcome (structural modeling test). This structural model after the t-tests on Hypotheses 1 through 4 proves that irregular on-the-job training and e-learning directly affects the learning time factor while job experience level, employment period and capability level measurement also directly impacts on the innovation capability factor. Also this hypothesis gets further supported by the fact that the patent time absolutely and directly affects the innovation capability factor rather than the learning time factor. Through the 4 hypotheses, this study proposes as measures to maximize an organization's innovation outcome. firstly, frequent irregular on-the-job training that is based on an e-learning system, secondly, efficient innovation management of employment period, job skill levels, etc through active sponsorship and energization community of practice (CoP) as a form of irregular learning, and thirdly a model of Yί=f(e, i, s, t, w)+${\varepsilon}$ as an innovation outcome function that is soundly based on a smart system of capability level measurement. The innovation outcome function is what this study considers the most appropriate and important reference model.

Impact of Allogenic and Autologous Transfusion on Immune Function in Patients with Tumors

  • Guo, Jian-Rong;Xu, Feng;Jin, Xiao-Ju;Shen, Hua-Chun;Liu, Yang;Zhang, Yi-Wei;Shao, Yi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.467-474
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    • 2014
  • Objective: To observe the effects of allogeneic and autologous transfusion on cellular immunity, humoral immunity and secretion of serum inflammatory factors and perforin during the perioperative period in patients with malignant tumors. Methods: A total of 80 patients (age: 38-69 years; body weight: 40-78 kg; ASA I - II) receiving radical operation for gastro-intestinal cancer under general anesthesia were selected. All the patients were divided into four groups based on the methods of infusion and blood transfusion: blank control group (Group C), allogeneic transfusion group (group A), hemodiluted autotransfusion Group (Group H) and hemodiluted autotransfusion + allogenic transfusion Group (A+H group). Venous blood was collected when entering into the surgery room ($T_0$), immediately after surgery ($T_1$) and 24h ($T_2$), 3d ($T_3$) and 7d ($T_4$) after surgery, respectively. Moreover, flow cytometry was applied to assess changes of peripheral blood T cell subpopulations and NK cells. Enzyme linked immunosorbent assays were performed to determine levels of IL-2, IL-10, TNF-${\alpha}$ and perforin. Immune turbidimetry was employed to determine the changes in serum immunoglobulin. Results: Both CD3+ and NK cells showed a decrease at $T_1$ and $T_2$ in each group, among which, in group A, CD3+ decreased significantly at $T_2$ (P<0.05) compared with other groups, and CD3+ and NK cell reduced obviously only in group A at $T_3$ and $T_4$ (P<0.05). CD4+ cells and the ratio of D4+/CD8+ were decreased in groups A, C and A+H at $T_1$ and $T_2$ (P<0.05). No significant intra- and inter-group differences were observed in CD8+ of the four groups (P<0.05). IL-2 declined in group C at $T_1$ and $T_2$ (P<0.05) and showed a decrease in group A at each time point (P<0.05). Moreover, IL-2 decreased in group A + H only at $T_1$. No significant difference was found in each group at $T_1$ (P<0.05). More significant decrease in group ?? at $T_2$, $T_3$ and $T_4$ compared with group A (P<0.05), and there were no significant differences among other groups (P>0.05). IL-10 increased at $T_1$ and $T_2$ in each group (P<0.05), in which it had an obvious increase in group A, and increase of IL-10 occurred only in group A at $T_3$ and $T_4$ (P<0.05). TNF-${\alpha}$ level rose at $T_1$ (P<0.05), no inter- and intra-group difference was found in perforin in all groups (P<0.05). Compared with the preoperation, both IgG and IgA level decreased at $T_1$ in each group (P<0.05), and they declined only in Group A at $T_2$ and $T_3$ (P<0.05), and these parameters were back to the preoperative levels in other groups. No significant differences were observed between preoperative and postoperative IgG and IgA levels in each group at $T_4$ (P>0.05). No obvious inter- and intra-group changes were found in IgM in the four groups (P>0.05). Conclusions: Allogeneic transfusion during the perioperative period could obviously decrease the number of T cell subpopulations and NK cells and the secretion of stimulating cytokines and increase the secretion of inhibiting cytokines in patients with malignant tumors, thus causing a Th1/Th2 imbalance and transient decreasing in the content of plasma immune globulin. Autologous transfusion has little impact and may even bring about some improvement oo postoperative immune function in patients with tumors. Therefore, cancer patients should receive active autologous transfusion during the perioperative period in place of allogeneic transfusion.

The effects of Galgŭnhaegit'ang and Won's-Galgŭnhaegit'ang for Taeŭmin on the immune response (태음인(太陰人) 갈근해기탕(葛根解肌湯)과 원특상(元特上)의 갈근해기탕(葛根解肌湯)이 면역반응(免疫反應)에 미치는 영향(影響))

  • Park, Seong-Sik;Ko, Byung-Hee;Song, Il-Byung
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.1
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    • pp.315-337
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    • 1997
  • In order to compare the dffects of $Galg{\breve{u}}nhaegit'ang$(葛根解肌湯) of "Dongeuisusebowon(東醫壽世保元)and Won's(元)-$Galg{\breve{u}}nhaegit'ang$(葛根解肌湯) of "Dongeuisasansinpyun(東醫四象新編)" on the immune respone, Sprague-Dawley male rats were used and randomly divided into four groups. Normal group was under normal condition, Control group was injected i.v. with 2mg/kg Methotrexate(MTX) on the 9th day and 11th day after sensitization with SRBC on the 5th day, $Galg{\breve{u}}nhaegit'ang$ group was fed with 1ml of $Galg{\breve{u}}nhaegit'ang$ and Won's-$Galg{\breve{u}}nhaegit'ang$ group was fed with 1ml of Won's-$Galg{\breve{u}}nhaegit'ang$ by oral during eighteen days. In the 9th day and the 11th day after oral feeding with medication, MTX was injected in tail of rats in order to reduce immune function. Leukocyte count, lymphocyte ratio, lymphocyte count of spleen, lymphocyte count of bone marrow, contact hypersensitivity to DNFB, morphologic change of thymus cell, and electropherogram of serum protein were estimated and compared according to the group. The results are as follows : 1. Before and after MTX injection, leukocyte(WBC) count was increased signigicantly in Won's-$Galg{\breve{u}}nhaegit'ang$ group compared to control group. $Galg{\breve{u}}nhaegit'ang$ group had no significant difference compared to control group. 2. Before and after MTX injection, lymphocyte ratio was not significantly different in Won's-$Galg{\breve{u}}nhaegit'ang$ group and in $Galg{\breve{u}}nhaegit'ang$ group compared to control group. 3. The lymphocyte count of spleen was increased significantly in $Galg{\breve{u}}nhaegit'ang$ group compared to control group and Won's-$Galg{\breve{u}}nhaegit'ang$ group. Won's-$Galg{\breve{u}}nhaegit'ang$ group had no significant difference compared to control group. 4. The lymphocyte count of bone marrow was increased significantly in Won's-$Galg{\breve{u}}nhaegit'ang$ group compared to control group and $Galg{\breve{u}}nhaegit'ang$ group. $Galg{\breve{u}}nhaegit'ang$ group had no significant difference compared to control group. 5. Contact hypersensitivity was increased significantly in Won's-$Galg{\breve{u}}nhaegit'ang$ group compared to other group. $Galg{\breve{u}}nhaegit'ang$ group had no significant difference compared to control groups. 6. In the morphologic change of thymus cell, control group compared to normal group had a indistinct boundary between cortex and medulla and lymphocyte cell density of thymus was low. $Galg{\breve{u}}nhaegit'ang$ group and Won's-$Galg{\breve{u}}nhaegit'ang$ group compared to control group had a definite boundary between cortex and medulla and lymphocyte cell density of thymus was high. 7. In the SDS-PAGE electropherogram of serum protein, Won's-$Galg{\breve{u}}nhaegit'ang$ group had a wide band of nearby 25,000 Dalton, and which meant IgG generated more actively. Considering this results, $Galg{\breve{u}}nhaegit'ang$ group and Won's-$Galg{\breve{u}}nhaegit'ang$ group have an effect on the depression of immune function induced by MTX, and especially Won's-$Galg{\breve{u}}nhaegit'ang$ group has an significant effect than $Galg{\breve{u}}nhaegit'ang$ group.

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Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia (근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가)

  • Bahk, Won-Jong;Sohn, Jong-Min;Chung, Yang-Guk;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.139-143
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    • 2001
  • Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

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THE LUMINOSITY-LINEWIDTH RELATION AS A PROBE OF THE EVOLUTION OF FIELD GALAXIES

  • GUHATHAKURTA PURAGRA;ING KRISTINE;RIX HANS-WALTER;COLLESS MATTHEW;WILLIAMS TED
    • Journal of The Korean Astronomical Society
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    • v.29 no.spc1
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    • pp.63-64
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    • 1996
  • The nature of distant faint blue field galaxies remains a mystery, despite the fact that much attention has been devoted to this subject in the last decade. Galaxy counts, particularly those in the optical and near ultraviolet bandpasses, have been demonstrated to be well in excess of those expected in the 'no-evolution' scenario. This has usually been taken to imply that galaxies were brighter in the past, presumably due to a higher rate of star formation. More recently, redshift surveys of galaxies as faint as B$\~$24 have shown that the mean redshift of faint blue galaxies is lower than that predicted by standard evolutionary models (de-signed to fit the galaxy counts). The galaxy number count data and redshift data suggest that evolutionary effects are most prominent at the faint end of the galaxy luminosity function. While these data constrain the form of evolution of the overall luminosity function, they do not constrain evolution in individual galaxies. We are carrying out a series of observations as part of a long-term program aimed at a better understanding of the nature and amount of luminosity evolution in individual galaxies. Our study uses the luminosity-linewidth relation (Tully-Fisher relation) for disk galaxies as a tool to study luminosity evolution. Several studies of a related nature are being carried out by other groups. A specific experiment to test a 'no-evolution' hypothesis is presented here. We have used the AUTOFIB multifibre spectro-graph on the 4-metre Anglo-Australian Telescope (AAT) and the Rutgers Fabry-Perot imager on the Cerro Tolalo lnteramerican Observatory (CTIO) 4-metre tele-scope to measure the internal kinematics of a representative sample of faint blue field galaxies in the red-shift range z = 0.15-0.4. The emission line profiles of [OII] and [OIII] in a typical sample galaxy are significantly broader than the instrumental resolution (100-120 km $s^{-l}$), and it is possible to make a reliable de-termination of the linewidth. Detailed and realistic simulations based on the properties of nearby, low-luminosity spirals are used to convert the measured linewidth into an estimate of the characteristic rotation speed, making statistical corrections for the effects of inclination, non-uniform distribution of ionized gas, rotation curve shape, finite fibre aperture, etc.. The (corrected) mean characteristic rotation speed for our distant galaxy sample is compared to the mean rotation speed of local galaxies of comparable blue luminosity and colour. The typical galaxy in our distant sample has a B-band luminosity of about 0.25 L$\ast$ and a colour that corresponds to the Sb-Sd/Im range of Hub-ble types. Details of the AUTOFIB fibre spectroscopic study are described by Rix et al. (1996). Follow-up deep near infrared imaging with the 10-metre Keck tele-scope+ NIRC combination and high angular resolution imaging with the Hubble Space Telescope's WFPC2 are being used to determine the structural and orientation parameters of galaxies on an individual basis. This information is being combined with the spatially resolved CTIO Fabry-Perot data to study the internal kinematics of distant galaxies (Ing et al. 1996). The two main questions addressed by these (preliminary studies) are: 1. Do galaxies of a given luminosity and colour have the same characteristic rotation speed in the distant and local Universe? The distant galaxies in our AUTOFIB sample have a mean characteristic rotation speed of $\~$70 km $s^{-l}$ after correction for measurement bias (Fig. 1); this is inconsistent with the characteristic rotation speed of local galaxies of comparable photometric proper-ties (105 km $s^{-l}$) at the > $99\%$ significance level (Fig. 2). A straightforward explanation for this discrepancy is that faint blue galaxies were about 1-1.5 mag brighter (in the B band) at z $\~$ 0.25 than their present-day counterparts. 2. What is the nature of the internal kinematics of faint field galaxies? The linewidths of these faint galaxies appear to be dominated by the global disk rotation. The larger galaxies in our sample are about 2"-.5" in diameter so one can get direct insight into the nature of their internal velocity field from the $\~$ I" seeing CTIO Fabry-Perot data. A montage of Fabry-Perot data is shown in Fig. 3. The linewidths are too large (by. $5\sigma$) to be caused by turbulence in giant HII regions.

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The Effect of Growth Hormone and the Factors Influencing Growth in Pediatric Chronic Peritoneal Dialysis Patients (만성 복막투석 환자에서 성장호르몬 치료의 효과와 성장에 영향을 주는 요인에 대한 연구)

  • Kim, Su-Jin;Park, Sung-Won;Sohn, Young-Bae;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.38-46
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    • 2008
  • Purpose: Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients. Methods: Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total $CO_2$, calcium, phosphate and iPTH during GH treatment were compared between the growth group (increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=l1) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6). Results: The mean age at the start of dialysis was 7.7${\pm}$5.2 years and the mean age at the start of GH treatment was 8.5${\pm}$4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72${\pm}$1.00 vs. -0.77${\pm}$0.88, P=0.048) and residual renal Kt/Vurea was better (1.54${\pm}$0.51 vs. 0.15${\pm}$0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group. Conclusion: GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.

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An Examination of Knowledge Sourcing Strategies Effects on Corporate Performance in Small Enterprises (소규모 기업에 있어서 지식소싱 전략이 기업성과에 미치는 영향 고찰)

  • Choi, Byoung-Gu
    • Asia pacific journal of information systems
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    • v.18 no.4
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    • pp.57-81
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    • 2008
  • Knowledge is an essential strategic weapon for sustaining competitive advantage and is the key determinant for organizational growth. When knowledge is shared and disseminated throughout the organization, it increases an organization's value by providing the ability to respond to new and unusual situations. The growing importance of knowledge as a critical resource has forced executives to pay attention to their organizational knowledge. Organizations are increasingly undertaking knowledge management initiatives and making significant investments. Knowledge sourcing is considered as the first important step in effective knowledge management. Most firms continue to make an effort to realize the benefits of knowledge management by using various knowledge sources effectively. Appropriate knowledge sourcing strategies enable organizations to create, acquire, and access knowledge in a timely manner by reducing search and transfer costs, which result in better firm performance. In response, the knowledge management literature has devoted substantial attention to the analysis of knowledge sourcing strategies. Many studies have categorized knowledge sourcing strategies into intemal- and external-oriented. Internal-oriented sourcing strategy attempts to increase firm performance by integrating knowledge within the boundary of the firm. On the contrary, external-oriented strategy attempts to bring knowledge in from outside sources via either acquisition or imitation, and then to transfer that knowledge across to the organization. However, the extant literature on knowledge sourcing strategies focuses primarily on large organizations. Although many studies have clearly highlighted major differences between large and small firms and the need to adopt different strategies for different firm sizes, scant attention has been given to analyzing how knowledge sourcing strategies affect firm performance in small firms and what are the differences between small and large firms in the patterns of knowledge sourcing strategies adoption. This study attempts to advance the current literature by examining the impact of knowledge sourcing strategies on small firm performance from a holistic perspective. By drawing on knowledge based theory from organization science and complementarity theory from the economics literature, this paper is motivated by the following questions: (1) what are the adoption patterns of different knowledge sourcing strategies in small firms (i,e., what sourcing strategies should be adopted and which sourcing strategies work well together in small firms)?; and (2) what are the performance implications of these adoption patterns? In order to answer the questions, this study developed three hypotheses. First hypothesis based on knowledge based theory is that internal-oriented knowledge sourcing is positively associated with small firm performance. Second hypothesis developed on the basis of knowledge based theory is that external-oriented knowledge sourcing is positively associated with small firm performance. The third one based on complementarity theory is that pursuing both internal- and external-oriented knowledge sourcing simultaneously is negatively or less positively associated with small firm performance. As a sampling frame, 700 firms were identified from the Annual Corporation Report in Korea. Survey questionnaires were mailed to owners or executives who were most erudite about the firm s knowledge sourcing strategies and performance. A total of 188 companies replied, yielding a response rate of 26.8%. Due to incomplete data, 12 responses were eliminated, leaving 176 responses for the final analysis. Since all independent variables were measured using continuous variables, supermodularity function was used to test the hypotheses based on the cross partial derivative of payoff function. The results indicated no significant impact of internal-oriented sourcing strategies while positive impact of external-oriented sourcing strategy on small firm performance. This intriguing result could be explained on the basis of various resource and capital constraints of small firms. Small firms typically have restricted financial and human resources. They do not have enough assets to always develop knowledge internally. Another possible explanation is competency traps or core rigidities. Building up a knowledge base based on internal knowledge creates core competences, but at the same time, excessive internal focused knowledge exploration leads to behaviors blind to other knowledge. Interestingly, this study found that Internal- and external-oriented knowledge sourcing strategies had a substitutive relationship, which was inconsistent with previous studies that suggested complementary relationship between them. This result might be explained using organizational identification theory. Internal organizational members may perceive external knowledge as a threat, and tend to ignore knowledge from external sources because they prefer to maintain their own knowledge, legitimacy, and homogeneous attitudes. Therefore, integrating knowledge from internal and external sources might not be effective, resulting in failure of improvements of firm performance. Another possible explanation is small firms resource and capital constraints and lack of management expertise and absorptive capacity. Although the integration of different knowledge sources is critical, high levels of knowledge sourcing in many areas are quite expensive and so are often unrealistic for small enterprises. This study provides several implications for research as well as practice. First this study extends the existing knowledge by examining the substitutability (and complementarity) of knowledge sourcing strategies. Most prior studies have tended to investigate the independent effects of these strategies on performance without considering their combined impacts. Furthermore, this study tests complementarity based on the productivity approach that has been considered as a definitive test method for complementarity. Second, this study sheds new light on knowledge management research by identifying the relationship between knowledge sourcing strategies and small firm performance. Most current literature has insisted complementary relationship between knowledge sourcing strategies on the basis of data from large firms. Contrary to the conventional wisdom, this study identifies substitutive relationship between knowledge sourcing strategies using data from small firms. Third, implications for practice highlight that managers of small firms should focus on knowledge sourcing from external-oriented strategies. Moreover, adoption of both sourcing strategies simultaneousiy impedes small firm performance.

A Clinicopathologipal Study on the Prognosis of IgA Nephropathy in Children (소아 IgA 신병증의 예후와 관련한 임상병리학적 고찰)

  • Kwon Jae-Hun;Choi Eun-Na;Park Jee-Min;Jeung Hyeun-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.23-29
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    • 2003
  • Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

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Determining the Locations of Washland Candidates in the Four Major River Basins Using Spatial Analysis and Site Evaluation (공간분석 및 현장조사 평가 기법을 활용한 4대강 강변저류지 조성 후보지 선정)

  • Jeong, Kwang-Seuk;Shin, Hae-Su;Jung, Ju-Chul;Kim, Ik-Jae;Choi, Jong-Yun;Jung, In-Chul;Joo, Gea-Jae
    • Korean Journal of Ecology and Environment
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    • v.43 no.1
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    • pp.44-54
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    • 2010
  • In this study, a comprehensive exploration and evaluation of washland candidate locations by means of field monitoring as well as spatial analysis in six major river system (Han, Nakdong, Nam, Geum, Youngsan, and Seomjin Rivers). Washland(in other words, river detention basin) is an artificial wetland system which is connected to streams or rivers likely to riverine wetlands. Major purpose of washland creation is to control floodings, water supply and purification, providence of eco-cultural space to human and natural populations. Characteristics and functions of riverine wetlands can be expected as well, thus it is believed to be an efficient multi-purpose water body that is artificially created, in terms of hydrology and ecology. Geographical information and field monitoring results for the washland candidate locations were evaluated in 2009, with respect to optimal location exploration, ecosystem connectivity and educational-cultural circumstances. A total of $269\;km^2$ washland candidate locations were found from spatial analysis (main channel of Rivers South Han, 71.5; Nakdong 54.1; Nam, 2.3; Geum, 79.0; Youngsan 46.4; Seomjin 15.7), and they tended to be distributed in mid- to lower part of the rivers to which tributaries are confluent. Field monitoring at 106 sites revealed that some sites located in the Rivers Nam and Geum is appropriate for restoration or artificial creation as riverine wetlands. Several sites in the Nakdong and Seomjin Rivers were close to riverine wetlands (e.g., Upo), habitats of endangered species (e.g., otters), or adjacent to educational facility (e.g., museums) or cultural heritages (e.g., temples). Those sites can be utilized in hydrological, ecological, educational, and cultural ways when evidence of detailed hydrological evaluation is provided. In conclusion, determination of washland locations in the major river basins has to consider habitat expansion as well as hydrological function (i.e. flood control) basically, and further utility (e.g. educational function) will increase the values of washland establishment.