• Title/Summary/Keyword: Long-Term care

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Compilation of 104 Experimental Theses on the Antitumor and Immuno-activating therapies of Oriental Medicine (한의학의 항종양 면역치료에 관한 연구 -1990년 이후 발표된 실험논문을 중심으로-)

  • Kang Yeon Yee;Kim Tai Im;Park Jong Ho;Kim Sung Hoon;Park Jong Dai;Kim Dong Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.1
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    • pp.1-24
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    • 2003
  • This study was done to compile 104 experimental theses which are related to the antitumor and immuno-activating therapies between February 1990 through February 2002. Master's and doctoral theses were dassified by schools, degrees, materials, effects, experimental methods of antitumor and immunoactivity, and results. The following results were obtained from this study : 1. Classifying the theses by the school, 34.6% were presented by Daejeon University, 29.8% by Kyung-hee University and 11.5% by Won-kwang University. Of all theses, 51.0% were aimed for the doctoral degree and 43.3% were for the master's degree. All of three universities have their own cancer centers. 2. Classifying the theses by herb materials, complex prescription accounted for 60.3%, single herb accounted for 24.8% and herbal acupuncture accounted for 14.2%. Considering the key principles of the traditional medicine, complex prescription was much more thoroughly studied than single herb prescription. The results showed that the complex prescription had both antitumor activity and immuno-activating activity, which might reflects on multi-activation mechanisms by complex components. 3. Classifying the theses by the efficacy of herbs examined, in single herb, invigorating spleen and supplementing was 35.5%, expelling toxin and cooling was 29.0%, activating blood flow and removing blood stasis was 12.9%. In herbal acupuncture, invigorating spleen and supplementing was 52.9%, expelling toxin and cooling was 29.4%. In complex prescription, pathogen-free status was 41.9%, strengthening healthy qi to eliminate pathogen was 35.5%, strengthening healthy qi was 22.6%. It is presumed that the antitumor and immunoactivating therapy based on syndrome differentiation is the best way to develop oriental oncology. 4. Classifying the theses by antitumor experiments, cytotoxic effect was 48.1 %, survival time was 48.1 % and change of tumor size was 42.3%. Survival rate was not necessarily correlated with cytotoxicity. These data reflect the characteristic, wholistic nature of the oriental medicine which is based on BRM (biological response modifier). 5. Classifying the theses by immunoactivating experiments, hemolysin titer was 51.0%, hemagglutinin titer was 46.2% and NK cell's activity was 44.2%. In the future studies, an effort to elucidate specific molecular and cellular mechanisms of cytokine production in the body would be crucial. 6. Classifying the theses according to the data in terms of antitumor activity, 50% was evaluated good, 24.0% was excellent, and 15.5% have no effect. In an evaluation of immuno-activating activity, 35.9% was excellent and 18.0% showed a little effect. The index point, as described here, may helps to use experimental data for clinical trials. Changes in index points by varying dosage implicate the importance of oriental medical theory for prescription. 7. In 167 materials, IIP (immunoactivating index point, mean : 3.12±0.07) was significantly higher than AIP(antitumor index point, mean : 2.83±0.07). These data demonstrate that the effect of herb medicine on tumor activity depends more on immunoactivating activity than antitumor activity. This further implies that the development of herbal antitumor drugs must be preceded by the mechanistic understanding of immunoactivating effect. 8. After medline-searching tumor and herb-related articles from NCBI web site, we conclude that most of the studies are primarily focused on biomolecular mechanisms and/or pathways. Henceforth, we need to define the biomolecular mechanisms and/or pathways affected by herbs or complicated prescriptions. 9. Therefore, the most important point of oriental medical oncology is to conned between experimental results and clinical trials. For the public application of herbal therapy to cancer, it is critical to present the data to mass media. 10. To develop the relationship of experimental results and clinical trials, university's cancer clinic must have a long-range plan related to the university laboratories and, at the same time, a regular consortium for this relationship is imperative. 11. After all these efforts, a new type herbal medicine for cancer therapy which is to take care of the long-term administering and safety problem must be developed. Then, it would be expected that anti-tumor herbal acupuncture can improve clinical symptoms and quality of life (QOL) for cancer patients. 12. Finally, oriental medical cancer center must be constructed in NCC (National Cancer Center) or government agency for the development of oriental medical oncology which has international competitive power.

Experiences with Emergency Percutaneous Cardiopulmonary Support in In-hospital Cardiac Arrest or Cardiogenic Shock due to the Ischemic Heart Disease (허혈성 심질환으로 인해 병원 내에서 발생한 심정지 혹은 심정지 혹은 심인성 쇼크에 있어서의 경피적 심폐 보조장치의 치료 경험)

  • Rhee Il;Kwon Sung-Uk;Cho Sung Woo;Gwon Hyeon-Cheol;Lee Young Tak;Park Pyo Won;Park Kay-Hyun;Lee Sang Hoon;Sung Kiick
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.201-207
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    • 2006
  • Background: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest re~ exploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. Material and Method: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP (Medtronic inc. Minneapolis, MN) or the RMI (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. Result: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCls under the cardiopulmonary support. The mean support time on the PCPS was 38$\pm$42 hours. Of the 20 patients implanted with PCPS, 11 patients ($55\%$) have had the PCPS removed successfully; overall, 8 of these patients ($40\%$) were discharged from the hospital in an average surviving time for 27$\pm$17 days after removing the PCPS and survived well with 31$\pm$30 months of follow-up after the procedure. Conclusion: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.

Characterization of Antidiabetic Compounds from Extract of Torreya nucifera (비자나무 추출물의 항당뇨 활성물질의 특성 연구)

  • Kim, Ji Won;Kim, Dong-Seob;Lee, Hwasin;Park, Bobae;Yu, Sun-Nyoung;Hwang, You-Lim;Kim, Sang Hun;Ahn, Soon-Cheol
    • Journal of Life Science
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    • v.32 no.1
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    • pp.1-10
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    • 2022
  • Natural products have gained increasing attention due to their advantage of long-term safety and low toxicity for a very long time. Torreya nucifera is widespread in southern Korea and Jeju Island and its seeds are commonly used as edible food. Oriental ingredients have often been reported for their insecticidal, antioxidant and antibacterial properties, but there have not yet been any studies on their antidiabetic effect. In this study, we investigated several biological activities of T. nucifera pericarp (TNP) and seeds (TNS) extracts and proceeded to characterize the antidiabetic compounds of TNS. The initial results suggested that TNS extract at 15 and 10 ㎍/ml concentration has inhibitory effects on α-glucosidase and protein tyrosine phosphatase 1B, that is 14.5 and 4.35 times higher than TNP, respectively. Thus, the stronger antidiabetic TNS was selected for the subsequent experiments to characterize its active compounds. Ultrafiltration was used to determine the apparent molecular weight of the active compounds, showing 300 kDa or more. Finally the mixture was then partially purified using Diaion HP-20 column chromatography by eluting with 50~100% methanol. Therefore we concluded that the active compounds of TNS have potential as therapeutic agents in functional food or supplemental treatment to improve diabetic diseases.

A Study on Forest Insurance (산림보험(山林保險)에 관한 연구(硏究))

  • Park, Tai Sik
    • Journal of Korean Society of Forest Science
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    • v.15 no.1
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    • pp.1-38
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    • 1972
  • 1. Objective of the Study The objective of the study was to make fundamental suggestions for drawing a forest insurance system applicable in Korea by investigating forest insurance systems undertaken in foreign countries, analyzing the forest hazards occurred in entire forests of Korea in the past, and hearing the opinions of people engaged in forestry. 2. Methods of the Study First, reference studies on insurance at large as well as on forest insurance were intensively made to draw the characteristics of forest insurance practiced in main forestry countries, Second, the investigations of forest hazards in Korea for the past ten years were made with the help of the Office of Forestry. Third, the questionnaires concerning forest insurance were prepared and delivered at random to 533 personnel who are working at different administrative offices of forestry, forest stations, forest cooperatives, colleges and universities, research institutes, and fire insurance companies. Fourth, fifty three representative forest owners in the area of three forest types (coniferous, hardwood, and mixed forest), a representative region in Kyonggi Province out of fourteen collective forest development programs in Korea, were directly interviewed with the writer. 3. Results of the Study The rate of response to the questionnaire was 74.40% as shown in the table 3, and the results of the questionaire were as follows: (% in the parenthes shows the rates of response; shortages in amount to 100% were due to the facts of excluding the rates of response of minor respondents). 1) Necessity of forest insurance The respondents expressed their opinions that forest insurance must be undertaken to assure forest financing (5.65%); for receiving the reimbursement of replanting costs in case of damages done (35.87%); and to protect silvicultural investments (46.74%). 2) Law of forest insurance Few respondents showed their views in favor of applying the general insurance regulations to forest insurance practice (9.35%), but the majority of respondents were in favor of passing a special forest insurance law in the light of forest characteristics (88.26%). 3) Sorts of institutes to undertake forest insurance A few respondents believed that insurance companies at large could take care of forest insurance (17.42%); forest owner's mutual associations would manage the forest insurance more effectively (23.53%); but the more than half of the respondents were in favor of establishing public or national forest insurance institutes (56.18%). 4) Kinds of risks to be undertaken in forest insurance It would be desirable that the risks to be undertaken in forest insurance be limited: To forest fire hazards only (23.38%); to forest fire hazards plus damages made by weather (14.32%); to forest fire hazards, weather damages, and insect damages (60.68%). 5) Objectives to be insured It was responded that the objectives to be included in forest insurance should be limited: (1) To artificial coniferous forest only (13.47%); (2) to both coniferous and broad-leaved artificial forests (23.74%); (3) but the more than half of the respondents showed their desire that all the forests regardless of species and the methods of establishment should be insured (61.64%). 6) Range of risks in age of trees to be included in forest insurance The opinions of the respondents showed that it might be enough to insure the trees less than ten years of age (15.23%); but it would be more desirous of taking up forest trees under twenty years of age (32.95%); nevertheless, a large number of respondents were in favor of underwriting all the forest trees less than fourty years of age (46.37%). 7) Term of a forest insurance contract Quite a few respondents favored a contract made on one year basis (31.74%), but the more than half of the respondents favored the contract made on five year bases (58.68%). 8) Limitation in a forest insurance contract The respondents indicated that it would be desirable in a forest insurance contract to exclude forests less than five hectars (20.78%), but more than half of the respondents expressed their opinions that forests above a minimum volume or number of trees per unit area should be included in a forest insurance contract regardless of the area of forest lands (63.77%). 9) Methods of contract Some responded that it would be good to let the forest owners choose their forests in making a forest insurance contract (32.13%); others inclined to think that it would be desirable to include all the forests that owners hold whenerver they decide to make a forest insurance contract (33.48%); the rest responded in favor of forcing the owners to buy insurance policy if they own the forests that were established with subsidy or own highly vauable growing stock (31.92%) 10) Rate of premium The responses were divided into three categories: (1) The rate of primium is to be decided according to the regional degree of risks(27.72%); (2) to be decided by taking consideration both regional degree of risks and insurable values(31.59%); (3) and to be decided according to the rate of risks for the entire country and the insurable values (39.55%). 11) Payment of Premium Although a few respondents wished to make a payment of premium at once for a short term forest insurance contract, and an annual payment for a long term contract (13.80%); the majority of the respondents wished to pay the premium annually regardless of the term of contract, by employing a high rate of premium on a short term contract, but a low rate on a long term contract (83.71%). 12) Institutes in charge of forest insurance business A few respondents showed their desire that forest insurance be taken care of at the government forest administrative offices (18.75%); others at insurance companies (35.76%); but the rest, the largest number of the respondents, favored forest associations in the county. They also wanted to pay a certain rate of premium to the forest associations that issue the insurance (44.22%). 13) Limitation on indemnity for damages done In limitation on indemnity for damages done, the respondents showed a quite different views. Some desired compesation to cover replanting costs when young stands suffered damages and to be paid at the rate of eighty percent to the losses received when matured timber stands suffered damages(29.70%); others desired to receive compensation of the actual total loss valued at present market prices (31.07%); but the rest responded in favor of compensation at the present value figured out by applying a certain rate of prolongation factors to the establishment costs(36.99%). 14) Raising of funds for forest insurance A few respondents hoped to raise the fund for forest insurance by setting aside certain amount of money from the indemnity paid (15.65%); others wished to raise the fund by levying new forest land taxes(33.79%); but the rest expressed their hope to raise the fund by reserving certain amount of money from the surplus money that was saved due to the non-risks (44.81%). 15) Causes of fires The main causes of forest fires 6gured out by the respondents experience turned out to be (1) an accidental fire, (2) cigarettes, (3) shifting cultivation. The reponses were coincided with the forest fire analysis made by the Office of Forestry. 16) Fire prevention The respondents suggested that the most important and practical three kinds of forest fire prevention measures would be (1) providing a fire-break, (2) keeping passers-by out during the drought seasons, (3) enlightenment through mass communication systems. 4. Suggestions The writer wishes to present some suggestions that seemed helpful in drawing up a forest insurance system by reviewing the findings in the questionaire analysis and the results of investigations on forest insurance undertaken in foreign countries. 1) A forest insurance system designed to compensate the loss figured out on the basis of replanting cost when young forest stands suffered damages, and to strengthen credit rating by relieving of risks of damages, must be put in practice as soon as possible with the enactment of a specifically drawn forest insurance law. And the committee of forest insurance should be organized to make a full study of forest insurance system. 2) Two kinds of forest insurance organizations furnishing forest insurance, publicly-owned insurance organizations and privately-owned, are desirable in order to handle forest risks properly. The privately-owned forest insurance organizations should take up forest fire insurance only, and the publicly-owned ought to write insurance for forest fires and insect damages. 3) The privately-owned organizations furnishing forest insurance are desired to take up all the forest stands older than twenty years; whereas, the publicly-owned should sell forest insurance on artificially planted stands younger than twenty years with emphasis on compensating replanting costs of forest stands when they suffer damages. 4) Small forest stands, less than one hectare holding volume or stocked at smaller than standard per unit area are not to be included in a forest insurance writing, and the minimum term of insuring should not be longer than one year in the privately-owned forest insurance organizations although insuring period could be extended more than one year; whereas, consecutive five year term of insurance periods should be set as a mimimum period of insuring forest in the publicly-owned forest insurance organizations. 5) The forest owners should be free in selecting their forests in insuring; whereas, forest owners of the stands that were established with subsidy should be required to insure their forests at publicly-owned forest insurance organizations. 6) Annual insurance premiums for both publicly-owned and privately-owned forest insurance organizations ought to be figured out in proportion to the amount of insurance in accordance with the degree of risks which are grouped into three categories on the basis of the rate of risks throughout the country. 7) Annual premium should be paid at the beginning of forest insurance contract, but reduction must be made if the insuring periods extend longer than a minimum period of forest insurance set by the law. 8) The compensation for damages, the reimbursement, should be figured out on the basis of the ratio between the amount of insurance and insurable value. In the publicly-owned forest insurance system, the standard amount of insurance should be set on the basis of establishment costs in order to prevent over-compensation. 9) Forest insurance business is to be taken care of at the window of insurance com pnies when forest owners buy the privately-owned forest insurance, but the business of writing the publicly-owned forest insurance should be done through the forest cooperatives and certain portions of the premium be reimbursed to the forest cooperatives. 10) Forest insurance funds ought to be reserved by levying a property tax on forest lands. 11) In order to prevent forest damages, the forest owners should be required to report forest hazards immediately to the forest insurance organizations and the latter should bear the responsibility of taking preventive measures.

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Effects of Market Orientation and Relationship Orientation with Suppliers on Business Performance in Animal Clinic Industry: Moderating Effects of Entrepreneur's Characteristics and Clinic Location (동물병원의 시장지향성과 공급업체와의 관계지향성이 동물병원 성과에 미치는 영향: 경영자의 특성과 동물병원 입지에 따른 조절효과)

  • Yoo, Dong-Keun;Suh, Seung-Won;Lee, Yong-Ki
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.189-222
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    • 2008
  • This study developed a model to empirically investigate the effects of market orientation and relationship orientation with suppliers on business performance and examine the moderating effects of entrepreneur's characteristics (working tenure) and clinic's location. The data was collected from 200 animal clinics which belong to Korean Animal Hospital Association (KAHA)'s national conference in April, 2007. Descriptive statistic, factor analysis, reliability analysis, and regression analysis were conducted to analyze the data using SPSS/PC+ 12.0. The findings are as follows. First, the market orientation of animal clinics influences significantly both financial and non-financial performance. When the moderating effect of entrepreneur's working tenure is considered, market orientation has significant effect on animal clinic's financial and non-financial performance. However, when the moderating effect of animal clinic's location is considered, market orientation has not significant effect on animal clinic's financial and non-financial performance. Second, animal clinic's relationship orientation with suppliers mostly affects the financial and non-financial performance significantly. When entrepreneur's working tenure in the clinic is longer (above 4 years group), relationship orientation with suppliers significantly affects both financial and non-financial performance. Meanwhile, when the entrepreneur's working tenure in the clinic is shorter (less than 3 years group), relationship orientation with suppliers doesn't affect clinic's financial performance but affect non-financial performance partially. In other words, when entrepreneur's working tenure is shorter (less than 3 years group), market orientation more influences on clinic's financial and non-financial performance while relationship orientation with suppliers does less. It is thought that their relation with suppliers and relationship orientation activities with suppliers are less strongly established and maintained yet. So, they primarily focus on market orientation strategy when entrepreneur's working tenure is shorter. Third, when animal clinics are located in non-metropolitan area, relationship orientation with suppliers significantly affects financial and non-financial performance. However, when animal clinics are located in metropolitan area, it doesn't affect financial and non-financial performance either. It is thought that animal clinics which are located in non-metropolitan area need stronger relationship with suppliers and need support more from them as most of suppliers actively work in metropolitan area not in the non-metropolitan area and animal clinics in metropolitan area can easily get better market information than animal clinics in non-metropolitan area. Lastly, while the effect of the market orientation significantly influences animal clinic's business performance continuously, the effect of the relationship orientation differently influences business performance as it is moderated by entrepreneur's working tenure and animal clinic's location. So, relationship orientation with suppliers can be selectively applied to improve the clinic's financial and no-financial performance. In summary, both of animal clinic's marketing orientation and animal clinic's relationship orientation with suppliers positively influence their business performance. However, entrepreneur's working tenure and animal clinic location moderate the relationship between market orientation and relationship orientation and their business performance differently. This study is quite meaningful to empirically investigate the effects of both of market orientation and relationship orientation with suppliers on business performance and examine the moderating effects of entrepreneur's characteristics (working tenure) and clinic's location. And, as this kind of study has been very few in the context of animal clinic industry, it helps practically understand the effects of market orientation and relationship orientation with suppliers on the financial and non-financial performance in animal clinic industry. Furthermore, as the market conditions in animal clinic industry have been in difficulty for a few years, this study can help improve animal clinic's financial and non-financial business performance together with their suppliers as business partners. Lastly, this study can help find mid-term and long-term cooperation between animal clinics and their suppliers. This study has some limitations. So, care should be taken when generalizing the results of the study. First, our samples were collected from only the animal clinics industry. However, a comparison of the results presented here with those form other marketing contexts (e.g., general hospitals) would be worthwhile. Future comparative research will enhance the generality of our contingency theory cross industry context. Second, this study found that market orientation and relationship orientation affect business performance. However, there may be other antecedents, such as internal market orientation and relationship orientation with customers. Also, this research did not consider other moderators, such as overall market conditions, competitive situations, and power/conflict between suppliers and buyers in the relationship between market and relationship orientation and business performance.

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Analysis of Vision Statements in 6th Community Health Plan of Local Government in Korea (우리나라 시·군·구 지역보건의료계획의 비전(Vision) 문구 분석)

  • Ahn, Chi-Young;Kim, Hyun-Soo;Kim, Won-bin;Oh, Chang-hoon;Hong, Jee-Young;Kim, Eun-Young;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.42 no.1
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    • pp.1-12
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    • 2017
  • Objectives: In this study, we analyzed vision statements of the 6th community health plan of local government in Korea. Methods: We examined vision statements letters, missions and strategy plans, and long-term missions of 6th community health plans of 229 local government in Korea. We also analyzed the numbers of vision letters, sentence examination, word frequency, each vision statement with frequency analysis, chi-square test, and one-way ANOVA. Results: Among 229 local government, 172(75.1%) of local government had the number of letters (Korean) less than 17 of vision statements, and there were a significant differences according to type of community health centers (p<0.05). Figuration (37.1%) were the most used in an expression of vision statement sentence, and special characters (43.2%) were the most used language except Korean. The most commonly used words of vision statement in order of frequency were 'health', 'happiness', 'with', 'citizen', 'city', '100 years old' etc. Chungcheong provinces and Daejeon metropolitan city had a highest score in directionality on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Gyeongsang provinces, Ulsan, Daegu, and Busan metropolitan cities had a highest score in future orientation and sharing possibilities on phrase evaluation, and there were a significant differences according to regional classes of local government (p<0.01). Conclusions: Vision is one of the most important component of community health plan. We need more detailed 'vision statement guideline' and the community health care centers of local government should effort to make more clear and complete their vision.

A Study on Organizational Effectiveness of Administrative Personnel in Hospitals (병원 행정직원의 조직효과성 수준)

  • Lee, Duk-Gu;Park, Eun-Cheol;Yu, Seung-Hum;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.7 no.2
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    • pp.52-79
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    • 2002
  • The hospital is characterized by it's remarkable labor industry and human resources input by unit. Recently, the administrative personnel are recognized as an important staff to provide a hospital guidance to consumer and also easiness for consumer's visit to hospital. The purpose of this study is to find the organizational effectiveness of the administrative personnel in hospitals. The survey data involved in the study was derived from 229 personnels working in 3 medium and small sized hospitals and 1 university hospital in Inchon area. The major finding are as follows; 1. The organizational efficiency in accordance with the general characteristics of subjects in order of over 31 years of age, university graduates, long-term tenure and high position is higher, whereas, in as much as wage and well trained personnels in are higher, general hospital's organizational efficiency is higher in comparison with those of university hospital. 2. The organizational efficiency in accordance with satisfaction and the psychological motive contributional factors is higher as much as the high satisfactory level in every hospitals in general. 3. The organizational efficiency in accordance with the factors of job characteristics is higher in as much as difficulty of the jobs is lesser, however there was not statically significance. In as much as job standard level is higher and the more job responsibility the higher organizational efficiency. It was obvious that the higher professional expertise as well as the training and application level are improving the organizational efficiency. 4. The organizational efficiency in accordance with the factors of structural characteristics was higher in as much as the intercommunication was smooth and the structural formalization level are higher, however there was not statically significance between the participation level of decision making and the organizational efficiency. 5. In as much as older age, management of organization and the job level are satisfied, the higher structural formalization level, the smooth intercommunication have affected as major influence factors of organizational efficiency. 6. In the university hospitals is satisfied in the management and job level of hospital organization as there are no difficult jobs while the level of hospital's organizational formality is high and the intercommunication is smooth, which are improving the organizational efficiency. In the general hospitals is also satisfied the management and job level of hospital organization and psychological motive contributional factors is higher, it was apparent that the organizational efficiency is higher in as much as the level of job standardization is high and the intercommunication is smooth. As a result of this study, in order for improving the organizational efficiency of administrative personnel in hospitals, the management and job level as well as personal relation are preferably satisfied, whereas formalization of organization, intercommunication and etc. should be satisfied, and, therefore, it is advisable to buildup discriminated organizational management and environment for different division on the basis above factors. Since this study is carried on four hospitals in Inchon area, there is a certain limit to generalize its result to all domestic hospitals, nevertheless the gallop poll was made by developing the questionnaires with reasonability and reliability. Especially. as the study was carried by analyzing the comparison of influence factors' difference of organizational efficiency in accordance with the divisional characteristics of the university and general hospitals.

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Clinical Manifestation and Treatment Outcome of Lupus Nephritis in Children (소아 루프스 신염의 임상양상 및 치료결과)

  • Park Jee-Min;Shin Jae-Il;Kim Pyung-Kil;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.155-168
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    • 2002
  • Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

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How to Reflect Sustainable Development, exemplified by the Equator Principles, in Overseas Investment (해외투자(海外投資)와 지속가능발전 원칙 - 프로젝트 파이낸스의 적도원칙(赤道原則)을 중심으로 -)

  • Park, Whon-Il
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.31
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    • pp.27-56
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    • 2006
  • Today's financial institutions usually take environmental issues seriously into consideration as they could not evade lender liability in an increasing number of cases. On the international scene, a brand-new concept of the "Equator Principles" in the New Millenium has driven more and more international banks to adopt these Principles in project financing. Sustainable development has been a key word in understanding new trends of the governments, financial institutions, corporations and civic groups in the 21st century. The Equator Principles are a set of voluntary environmental and social guidelines for sustainable finance. These Principles commit bank officers to avoid financial support to projects that fail to meet these guidelines. The Principles were conceived in 2002 on an initiative of the International Finance Corporation(IFC), and launched in June 2003. Since then, dozens of major banks, accounting for up to 80 percent of project loan market, have adopted the Principles. Accordingly, the Principles have become the de facto standard for all banks and investors on how to deal with potential social and environmental issues of projects to be financed. Compliance with the Equator Principles facilitates for endorsing banks to participate in the syndicated loan and help them to manage the risks associated with large-scale projects. The Equator Principles call for financial institutions to provide loans to projects under the following circumstances: - The risk of the project is categorized in accordance with internal guidelines based upon the environmental and social screening criteria of the IFC. - For Category A and B projects, borrowers or sponsors are required to conduct a Social and Environmental Assessment, the preparation of which must meet certain requirements and satisfactorily address key social and environmental issues. - The Social and Environmental Assessment report should address baseline social and environmental conditions, requirements under host country laws and regulations, sustainable development, and, as appropriate, IFC's Environmental, Health and Safety Guidelines, etc. - Based on the Social and Environmental Assessment, Equator banks then make agreements with borrowers on how they mitigate, monitor and manage the risks through a Social and Environmental Management System. Compliance with the plan is included in the covenant clause of loan agreements. If the borrower doesn't comply with the agreed terms, the bank will take corrective actions. The Equator Principles are not a mere declaration of cautious banks but a full commitment of lenders. A violation of the Principles in the process of project financing, which led to an unexpected damage to the affected community, would not give rise to any specific legal remedies other than ordinary lawsuits. So it is more effective for banks to ensure consistent implementation of the Principles and to have them take responsible measures to solve social and environmental issues. Public interests have recently mounted up with respect to environmental issues on the occasion of the Supreme Court's decision (2006Du330) on the fiercely debated reclamation project at Saemangeum. The majority Justices said that the expected environmental damages like probable pollution of water and soil were not believed so serious and that the Administration should continue to implement the project seeking ways to make it more environment friendly. In this case, though the Category A Saemangeum Project was carried out by a government agency, the Supreme Court behaved itself as a signal giver to approve or stop the environment-related project like an Equator bank in project financing. At present, there is no Equator bank in Korea in contrast to three big banks in Japan. Also Korean contractors, which are aggressively bidding for Category A-type projects in South East Asia and Mideast, might find themselves in a disadvantageous position because they are generally ignorant of the environmental assessment associated with project financing. In this regard, Korean banks and overseas project contractors should care for the revised Equator Principles and the latest developments in project financing more seriously. It's because its scope has expanded to the capital cost of US$10 million or more across all industry sectors regardless of developing countries or not. It should be noted that, for a Korean bank, being an Equator bank is more or less burdensome in a short-term period, but it must be conducive to minimizing risks and building up good reputation in the long run.

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Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.