• Radiation Oncology Journal
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• v.16 no.1
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• pp.43-49
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• 1998

Purpose : Carcinomas arising in the gall bladder(GB) or extrahepatic biliary ducts are uncommon and generally have a poor prognosis. The overall 5-year survival rates are less than $10\%$. Early experiences with the external radiation therapy demonstrated a good palliation with occasional long-term survival. The present report describes our experience over the past decade with irradiation of primary carcinomas of the gallbladder and extrahepatic biliary duct. Materials and Methods : From Feb. 1984 to Nov. 1995, thirty-three patients with carcinoma of the GB and extrahepatic biliary duct were treated with external beam radiotherapy with curative intent at our institution. All patients were treated with 4-MV linear accelerator and radiation dose ranged from 31.44Gy to 54.87Gy(median 44.25Gy), and three Patients received additional intraluminal brachytherapy(range, 25Gy to 30Gy). Twenty-seven Patients received postoperative radiation. Among 27 patients, Sixteen patients underwent radical operation with curative aim and the rest of the patients either had bypass surgery or biopsy alone. In seventeen patients, adjuvant chemotherapy was used and eleven patients were treated with 5-FU, mitomycin and leucovorin. Results : Median follow up period was 8.5 months(range 2-97 months). The overall 2-year and 5-year survival rates in all patients were $29.9\%$ and $13.3\%$ respectively. In patients with GB and extrahepatic biliary duct carcinomas, the 2-year survival rates were $34.5\%$ and $27.8\%$ respectively. Patients who underwent radical operation showed better 2-year survival rates than those who underwent palliative operation($43.8\%\;vs.\;20.7\%$), albeit statistically insignificant(p>0.05). The 2-year survival rates in Stage I and II were higher than in Stage III and IV with statistical significance(p<0.05). Patients with good performance status in the beginning showed significantly better survival rates than those with worse status(p<0.05). The 2-year survival rates in combined chemotherapy group and radiation group were $40.5\%$ and $22.0\%$ respectively. There was no statistical differences in two groups (p>0.05). Conclusion : The survival of patients with relatively lower stage and/or initial good performance was significantly superior to that of others. We found an statistically insignificant trend toward better survival in patients with radical operation and/or chemotherapy, More radical treatment strategies, such as total resection with intensive radiation and/or chemotherapy may offer a better chance for cure in selective patients with carcinoma of gall bladder and extrahepatic biliary ducts.

• The Journal of Korean Academic Society of Nursing Education
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• v.1 no.1
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• pp.17-23
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• 1995

One of the biggest problems of Nursing Education in Korea is the division among nursing education programs of the last 3 and 4 years. To solve this problem, Nursing community must do variable trials to achieve the unity of a 4-year educational program. With this, we need to observe the phenomena and reality of the present 4-year nursing educational program that we have. The object of this study is to analyse and discuss that we have. The object of this study is to analyse and discuss the problems and future strategies of 4-year Nursing Baccalaureate program. 1. Problems as nursing department in Medical School. 1) Many 4-year nursing baccalaureate programs are operating under the medical school as nursing department. So the academic development in nursing department is unprogressive and is not approved as unique discipline. 2) The operating system between nursing and medical department are different even though they are in the same school. 3) Inequality between nursing and medical department : In many case, the nursing professor can not attend administraion committees to discuss the medical school's operation because of many differences between nursing and medical organization. 4) Weakness of the leadership and the student activities in nursing student : The nursing student involvement is usually passive because of the difference of curriculum, less number than medical students and the difference between 4-year and 6-year education program. 5) There is the obscurity of the relationship between department of nursing and other departments in whole university. 2. Problems in nursing itself 1) We need to reconstruct nursing discipline. We must change from the disease centered model to health centered model and life cycle centered model so that we can be distinguished from medicine. We also must change from hospital centered nursing to all population centered nursing, 2) The improvement of curriculum ; When the independent framework of nursing discipline become established, we need to improve the curriculum. 3) The education of clinical practice ; Most nursing school programs are divided into professors who are lecturing the theory and clinical teachers who are teaching the nursing technique in the clinic. So, what is needed in nursing discipline is that the professors have a dual position. In America, The professor is required to be a clinical specialist and to have his or her clinic so that the professor become a good role model, teach the clinical practice effectively, and give the student the practice field. 4) To extend fields of nursing : At first, the school nurse must become the school health educator, a real teacher. The nurse must establish and operate a childern's wellbeing center or nursery school, a disabled people's house or senile's wellbeing center, a mental health center, and a health promotion clinic for healthy people. 5) The name 'nursing department' need to be considered. When the focus is to be changed from the disease model to health improvement model, we take into consideration change 'nursing college', 'nursing department' and 'nursing profession' to 'health science college' or 'health wellbeing college'. 6) We must have highly qualified academic students. Each Nursing educational faculties must have the high qualified students through the development of nursing educational program and the increment of scholarship. The Korean Nurses Association and The Korean Clinical Nurses Association need to make an endeavor for the improvement of work condition and payment of clinical nurses of hospitals who consist of 70% of all nursing manpower. 3. Improvement Strategy 1) All nursing educational program must be changed 4-year program gradually. 2) Nursing department need to try to become nursing college. 3) We need to study many researches for improvement of the problem in nursing discipline and nursing education. We need more interdisciplinary researches, and we need to be granted for that research. 4) We need to have many seminars and workshops thoughout the whole country to expand a sense of nursing education. 5) Drawing up a policies plan for the nursing educational improvement : The Korean Nurses Association, The Korean Academic Nursing Association, Korea Nursing College and department President's Committee, and Korea Academic Society of Nursing Education must try for the development of nursing educational improvement and ask for government frame the policy to develop nursing education.

• The Korean Journal of Elementary Counseling
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• v.11 no.2
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• pp.299-320
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• 2012

We have information through a variety of media such as language, pictures and internet. Since we get information through texts mostly, we can say that reading ability which enables a person to read a text and understand its meaning basically is the most essential for people to possess. Taking the advantage of the fact that a school is a place where learning and daily-life guidance can be made at the same time, we need to try encouraging students to involve in learning process and feel a sense of accomplishment by adding consultation between a teacher and a student or between a student and a student in Korean subject. This study selected two fifth grade classes of an elementary school of small and medium-sized city as an experimental group and a control group respectively and applied reading strategy program by using interaction of complementary lesson as the number of ten times during five weeks. It focused on making students interested in complementary class and encouraging them to become active participants. This study's goal is to see if the reading strategy program affects students' reading comprehension, metacognition and a sense of self-efficacy The results of the study are as in the following: first, the reading strategy program of complementary lesson is effective in students' reading comprehension and a range of factual understanding and sentimental understanding. Second, the reading strategy program of complementary lesson is effective in adjustment area as a subordinate factor of metacognition. Third, the reading strategy program of complementary lessonis effective in students' sense of self-efficacy. It is shown that experience of using new reading strategy and successful experience and help in peer-group members have a positive effects on a student's sense of self-efficacy. Forth, as the result of satisfaction evaluation over the program with the students' activity report and researchers' observation results, the study shows that the organization and operation of the program influences on students' effort and participation to reach the goal together positively. Through the results as above, we can say that the reading strategy program of complementary lesson have a positive effect on a student's reading comprehension, metacognition and a sense of self-efficacy.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.3 no.3
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• pp.45-76
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• 2000

The purposes of this study were to investigate and understand the present status of various types of "deserts", such as sand desert, gravel desert, rock desert, earth desert, salt desert, desert, rocky desert, gobi desert, sandy desert, clay desert, etc., and the general countermeasures for the combating "desertification" "desertization", and to develop the technologies on the revegetation and restoration for the combating desertification in China. The methods of this study were mainly composed of field surveys on the several experimental sites and research institutes related to combating desertification in China, and examinations on the various technologies for the combating desertification at the Daxing Experimental Station of Beijing Forestry University. The conclusion from this study may be summarized as follows; 1. Status and tendency of desertification in China : China is one of the countries seriously threatened by desertification. Desertification affected areas in China are mainly distributed in arid, semi-arid and dry sub-humid areas in China, covering the most regions of the Northeast China (eastern region of Inner-Mongolia), the northern part of the North China (middle and western region of Inner-Mongolia, Shaanxi, Ningsha, Gansu) and the western part of the Northwest China (Xinzang, Qinghai, Xizang). The total area affected by desertification in China is approximately 2.622 million $km^2$. It covers 27.3% of the total territory of China. Until recently, it is estimated that the annual spreading ratio of desertification in China is 2,460 $km^2$. Therefore, desertification is mostly serious problems facing to the Chinese people. 2. The causes and environmental effect of desertification : The desertification in China is mainly caused by compound factors, including natural condition and human activities. In China, the desertification is started by the decrease of precipitation, continuous dry and drought, strong wind, wind and water erosion, land degradation and loss of natural vegetation caused by climate variation, and accelerated by the human activities, such as over-cultivating, over-grazing, over-cutting of woods, irrational use of water resources. Because desertification has affected the geographical features, soil nutrients contents, salinity, vegetation coverage and the functions of ecosystem, the environmental deteriorations in the desertification affected areas are very seriously. 3. The fundamental strategies of combating desertification in China are the increase of education and awareness of people through various mass media, the revision of laws to guarantee operation of Desertification Combating Law and to improve many relating laws and regulations, the application of advanced technologies and training of experts, the establishment of discriminative policies, and increasing arrangement of budget-investment, and so on. China, as a signed country in UNCCD, has made efforts for the combating desertification. Korea is also signed country in UNCCD, so we should play an important role in the desertification combating projects of China for the northest asia and global environmental conservation as well as environmental conservation of Korea.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.6
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• pp.13-25
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• 2016

This study aims to analyze the change process in order to set the improvement strategies for the zoo in the Seoul Children's Grand Park. The zoo can be reviewed through three significant time periods with noticeable changes. As a framework to analyze the major changes that happened in the zoo, this study looks at the changes in terms of the planning aspect as well as the animal welfare and program operation aspect. The findings are as follows: first, the era of general theme park turned out to have focused on exhibiting animals to meet visitor demands by expanding the zoo area of the zoo without enlarging stockyards for the animals. Second, the environmental park era created a zoo having entertaining and educational functions by arranging animal houses with the concept of zoological taxonomy and introducing animal behavioral enrichment, animal welfare programs and visitor participatory programs. The era of the zoo as an Urban Cultural Park improved old animal houses and facilities for the welfare of the animals and increased educational programs to preserve species and provide environmental education. The current status of the zoo turns out not to meet the conditions for creating an ecological zoo, which is the overall goal for contemporary zoos. The improvement strategies based on the analysis through three different eras are three-fold. First, the zoo needs to improve the boundary conditions of the animals to showcase animal wildness through landscape immersion. Second, the zoo should provide a shared environment for animals from the same habitats by changing the classification methods from the existing polyphyletic taxon to a classification that considers ecological habitat. Third, the zoo needs to develop various ecological education programs by supplementing specialists in professional education.

• Korean Chemical Engineering Research
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• v.52 no.5
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• pp.592-602
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• 2014

In the Integrated Gasification Combined Cycle (IGCC), the stability of the gasifier has strong influences on the rest of the plant as it supplies the feed to the rest of the power generation system. In order to ensure a safe and stable operation of the entrained-flow gasifier and for protection of the gasifier wall from the high internal temperature, the solid slag layer thickness should be regulated tightly but its control is hampered by the lack of on-line measurement for it. In this study, a previously published dynamic simulation model of a Shell-type gasifier is reproduced and two different linear model predictive control strategies are simulated and compared for multivariable control of the entrained-flow gasifier. The first approach is to control a measured secondary variable as a surrogate to the unmeasured slag thickness. The control results of this approach depended strongly on the unmeasured disturbance type. In other words, the slag thickness could not be controlled tightly for a certain type of unmeasured disturbance. The second approach is to estimate the unmeasured slag thickness through the Kalman filter and to use the estimate to predict and control the slag thickness directly. Using the second approach, the slag thickness could be controlled well regardless of the type of unmeasured disturbances.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.805-812
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• 2001

Objectives : The goal of the surgical management of large and giant aneurysm is complete extirpation of the aneurysms with preservation or reconstruction of the parent artery. To improve the surgical management results of those aneurysms in the future, we review our experience and discuss technical maneuvers and strategies used to avoid potential complications of those aneurysm surgery. Material and Methods : During the past 12 years, thirty six cases of large and giant aneurysms(diameter>19mm) were managed by surgery. The clinical characteristics, treatment methods, surgical complications and outcome of those cases were analyzed and, based on the review of the literatures, the preventive methods of surgical complication related to the clipping of those aneurysms were discussed. Results : The locations of those aneurysms were anterior circulation in 34 cases and posterior circulation in 2 cases. The most frequent site of aneurysmal location was a paraclinoidal region of the anterior circulation. The aneurysms were managed surgically by direct clipping of aneurysmal neck in 31 cases, aneurysmal trapping followed by extracranial-intracranial bypass in 2 cases, proximal clipping of parent artery, aneurysmorrhaphy, and excision of aneurysm followed by end to end anastomosis of parent artery in each one case. Surgical complications occurred in 13 cases. A parent vessel occlusion by thrombus formation and parent vessel stenosis after clipping of aneurysm were the main complications. We obtained good outcome in 27, fair 5, poor 1 and dead in 3 case(s). Conclusion : We conclude that selection of suitable management method for each case, high quality of surgical technique and prevention of complication during operation are important key points for the successful treatment of large and giant aneurysm. The heparinization prior to application of temporary clip on parent vessels, aneurysmal decompression during dissection and clipping of aneurysm, complete closing of the aneurysmal neck and avoiding the narrowing of parent vessel after clipping of aneurysm were the main technical maneuvers used to avoid complications of those aneurysm surgery.

• Journal of the Korean Society of Marine Environment & Safety
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• v.19 no.4
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• pp.366-374
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• 2013

Maritime transportation circumstance is changing rapidly in accordance with the increase of cargo volume between countries and increase of marine leisure activities by improvement of quality of life. And the circumstance for ship operation is also changing due to aging of seafarers and increasing of foreign seafarers. To cope with such changes in maritime environment well, it requires higher safety management skills from shipping companies, the main subject in charge of the safety matter. In this paper, we analyzed domestic and foreign similar system, and then applied imitation strategies for introduction of an unific evaluation and management system that was consist of marine accidents, port state control, ISM Code and so on from shipping companies. We defined that the imitation industry and system are converted accident ration of construction industry and traffic safety excellence company of road transportation, and then extracted relevant law, evaluation index, incentive system as a imitation subject. We also proposed scheme that introduction of basis law, and evaluation tool with marine accidents ratio, port state control & ism code result, and incentives such as immunity of safety inspection or reduction of commission for introduction of company's safety management level evaluation system. Finally, we proposed the imitation timing and plan in stages for system's sustainable development through the prompt introduction and continuous enforcement.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• Journal of agricultural medicine and community health
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• v.35 no.4
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• pp.350-360
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• 2010

Objectives: This study was conducted to identify factors that affect medical service performance in rural health sub-centers and to develop a method to improve health sub-center performance that takes advantage of these insights. Methods: This study included 1,242 South Korean health sub-centers that had been in operation at least since December 31, 2009 as units of analysis. After adjusting for population differences between areas, the performance of medical service among health sub-centers was analyzed according to medical services performed per person. We performed t-tests, ANOVA, Scheffe's tests and multiple regression analyses. Results: The following were significant variables affecting the medical service performance of rural health sub-centers: number of hospitals and clinics, presence of community health practitioner posts, distance from health sub-centers to main public health centers, distance from health sub-centers to the nearest emergency medical facilities, and proportion of the local population aged 65 and over. In contrast, the proportion of the local population between ages 0-4 and the placement of public health doctors that had already completed their internship were not significant variables. Conclusions: The medical service performance of health sub-centers located in rural areas is significantly affected by local population and health care environment characteristics, and therefore, it is imperative to develop strategies to provide differentiated service based on these factors.