• Title/Summary/Keyword: Treatment Plan

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Clinical Evaluation of Guided Bone Regeneration Using 3D-titanium Membrane and Advanced Platelet-Rich Fibrin on the Maxillary Anterior Area (상악 전치부 3D-티타늄 차폐막과 혈소판농축섬유소를 적용한 골유도재생술의 임상적 평가)

  • Lee, Na-Yeon;Goh, Mi-Seon;Jung, Yang-Hun;Lee, Jung-Jin;Seo, Jae-Min;Yun, Jeong-Ho
    • Implantology
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    • v.22 no.4
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    • pp.242-254
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    • 2018
  • The aim of the current study was to evaluate the results of horizontal guided bone regeneration (GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-year-old female patient presented with discomfort due to mobility and pus discharge on tooth #11. Three months after extracting tooth #11, diagnostic software (R2 GATE diagnostic software, Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane ($i-Gen^{(R)}$, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen $membrane^{(R)}$, Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placement. Five months after placing the implant, the second stage of implant surgery was performed, and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$), 3D-titanium membrane ($i-Gen^{(R)}$), resorbable collagen membrane (Ossix $plus^{(R)}$, Datum, Telrad, Israel), and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage of implant surgery six months after implant placement, healing abutment was connected after removing the 3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term follow-up evaluation should be performed.

A Study on the Selection of Base Port and Establishment of International Cooperation System for Seafarer Rotation In case of Emergency - Focusing on the Service Network of HMM - (비상 시 선원교대를 위한 거점항만 선정과 국제협력 방안 - HMM 정기선을 중심으로 -)

  • Kim, Bo-ram;Lee, Hye-jin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.27 no.2
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    • pp.275-285
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    • 2021
  • COVID-19 is threatening the safety of ships and seafarers by delaying seafarer rotation. Shipping companies and governments have a blindspot in case of the onboard environment of seafarers. An effective, alternative plan should be devised to eliminate the possibility of human accidents in an emergency that threatens the safety of seafarers. According to the survey of former and current seafarers, the most important factor in boarding life was safety, and the most necessary thing during emergencies was to secure smooth seafarer rotation rather than improve wages and welfare. By analyzing the major routes of national shipping companies by continent, ports with a large number of calls and a high Air Connectivity Index were selected as the base port. In addition, the route was designed for effective, domestic seafarer rotation during international shipping. Other countries must be consulted to establish a travel route linking ships, ports, and airports for the safe return of sailors to their home countries during an emergency. In addition, it is necessary to work together for the seafarers who are in trouble of seafarer rotation through cooperation with the International Maritime Organization(IMO). Starting with this, the government should have a monitoring system for the return and non-return routes as well as the number of seafarers on board. If such a system is established, it will be able to determine the response direction of our country's policy in case of an emergency. Along with the shipping company's ef orts to improve the treatment of seafarers, national and social attention will be needed to review domestic laws and improve awareness about seafarers.

Prevalence and Patterns of Congenitally Missing Teeth among Pediatric Patients Aged 8 - 16 in Pusan National University Dental Hospital (부산대학교 치과병원에 내원한 8 - 16세 환자의 선천성 치아 결손 유병률 및 유형 평가)

  • Eunjin Kim;Soyoung Park;Eungyung Lee;Taesung Jeong;Jonghyun Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.179-191
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    • 2023
  • The purpose of this study was to investigate the prevalence and patterns of congenitally missing teeth in permanent teeth excluding third molars, in patients aged 8 to 16 years who visited Pusan National University Dental Hospital from January 2010 to February 2021. This retrospective study evaluated tooth agenesis and the pattern of missing teeth represented by the tooth agenesis code by reviewing panoramic radiographs and electronic medical records of 11,759 patients, including 5,548 females and 6,211 males. The prevalence of congenitally missing teeth was 10.74% (females 11.95%, males 9.66%, p < 0.0001). Patients with tooth agenesis had an average of 2.22 missing teeth, and congenitally missing teeth occurred more frequently in the mandible (8.39%) than in the maxilla (4.52%, p < 0.0001). The mandibular second premolar (58.19%) was the most frequently missing tooth. The second premolar was the most frequently missing tooth in all quadrants (30.10%, 31.67%, 43.14%, and 35.59%) when a single tooth was absent, while the first and second premolars were the most commonly absent teeth (11.69%, 11.47%, 5.94%, and 5.24%) when two or more teeth were missing. In the relationship between maxillary-mandibular antagonistic quadrants and full mouth, the 1st to 4th place of the missing patterns were all involved with the 1st and 2nd premolars. This study can be clinically helpful in establishing a treatment plan for patients with missing teeth. In addition, it can be used as basic data for molecular biological research to find out the relationship between tooth agenesis and specific genes.

Characteristics of User's Behavior across Generations for space planing in General Hospital (종합병원 환경계획을 위한 세대별 종합병원 이용행태 특성분석)

  • Park, Hey Kyung;Oh, Ji Young
    • Korea Science and Art Forum
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    • v.28
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    • pp.105-116
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    • 2017
  • This study is a basic research to suggest user-centered general hospital environmental design guidelines, which aims to analyze user's behavior characteristics across generation in general hospital. For this purpose, this study constructed an analysis tool through the literature review with regard to generation and behavior characteristics in general hospital. Besides, an online survey regarding user's behavior in general hospital was conducted targeting from 20s to 60s, 300 persons for each group, total 1,500 persons for about 3 weeks since September 1, 2016. The results of this study are as follows: (1) Based on the generation, there were significant differences in relevant categories of their visiting frequency, visiting purpose, visiting hour, transportation, companion, behavior during the wait and selection of a general hospital. (2) In all generation, they responded that they have visited once or twice per year. People in 20s and 30s responded that their visit for the hospital is to receive specific treatment, while other people in 40s, 50s and 60s visit the hospital majorly for routine check-ups. Therefore, it is imperative for a health check-up center to design an environmental plan that reflects the characteristics of elders in 40s, 50s and 60s. (3) People in 40s, 50s and 60s usually visit a general hospital in the mornings of weekdays, while generations in 20s and 30s responded that they mostly visit the hospital in the mornings of weekend. (4) When they visit a general hospital, people in their 20s are usually using public transportations, while people in their 30s to 60s are using their own vehicle. (5) People in their 20s majorly visited 'lobby'. In older generations, they tend to visit 'outpatient clinic'. Therefore, it is necessary to build an outpatient clinic environment that considers the elderly. (6) Patients majorly responded that they are using their cell phone, while waiting for their clinic call. In elder generations, they responded that they are more likely watching TVs, reading books/magazines or doing nothing. Therefore, it is essential to provide cell-phone related services and environmental supports. Visually attractive media can be utilized for this purpose.

A Study on the Material Characteristics and Weathering Aspects of Sculpture Stone Around the World Cultural Heritage Joseon Dynasty Royal Tombs - Focused on the East Nine Royal Tombs - (세계문화유산 조선왕릉 석조문화재의 재질특성 및 풍화양상 연구 - 구리 동구릉을 중심으로 -)

  • CHO Hajin ;CHAE Seunga ;SONG Jinuk;LEE Myeongseong ;LEE Taejong
    • Korean Journal of Heritage: History & Science
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    • v.55 no.4
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    • pp.180-193
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    • 2022
  • The East Nine Royal Tombs is a representative place in the Royal Tombs of Joseon (a World Heritage Site). It consists of 1,289 stone artifacts including 979 related stone structures, 310 stone statues, and objects. Most of the stone structures in the East Nine Royal Tombs are composed of biotite granite, but some tombs are composed of light red granite. As a result of magnetic susceptibility measurement, the average data from Geonwolleung to Mongneung, excluding Hyeolleung, were similar, so it is estimated that stones were obtained from the same quarry. In the case of Sungneung, Sureung, and Gyeongneung, the range of susceptibility measurement is widely distributed. It assumed that the newly produced stones were mixed in the moving and construction process. Also, stones might be gathered from different quarries. As a result of a conservation status investigation, both the mound member and the ridge stone had the highest damage rate due to peeling and granular decomposition according to surface weathering. In the case of surface discoloration, yellowing and soils were found in the burial mound members. Yellowing, blackening, and soil were identified in the ridge stone structures. Bio-degradation is the major factor of deterioration of the East Nine Royal Tombs and the conservation status of the tombs were detected as grades 4 to 5. It seems that it is easy for the environment of the royal tombs to form soil for the microorganisms and fine conditions for continuous moisture. In the case of structures, they are in relatively good condition. As a result of a comprehensive damage rating for each tomb, the overall condition is good, but the Geonwolleung Royal Tomb and Hyeolleung Tomb, which were created in the early period, had relatively high weathering ratings. Stone objects in East Nine Royal Tombs have lost many pieces and gateway members due to surface deterioration. Also, secondary damage is ongoing. Each damage factor of the stone artifacts of the East Nine Royal Tombs combines to cause various and continuous damages. Therefore, it is necessary to establish regular conservation status data of the stone artifacts for efficient management after processing as well as conservation treatment of the royal tombs, and specific management manuals and systems. This study investigated the conservation status of stone structures in the East Nine Royal Tombs, a World Heritage Site, and systematically classified them to provide priority and necessity for conservation processing. We look forward to establishing a plan for the conservation and management of the East Nine Royal Tombs with this database in the future.

An Economic Analysis Study of Recycling PET·OPP Laminated Film Waste Generated during DECO Film Manufacturing (DECO 필름 제조시 발생하는 PET·OPP 합성 폐필름 재활용의 경제성 분석 연구)

  • Mi Sook Park;Da Yeon Kim;Soo Jin Yang;Seong You Lee;Chun San Kim;Ok Jin Joung;Yong Woo Hwang
    • Resources Recycling
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    • v.32 no.3
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    • pp.57-67
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    • 2023
  • The treatment of waste plastic has primarily been entrusted to small companies, which has resulted in challenges in obtaining an accurate overview of the current state of affairs and ensuring profitability. Consequently, despite the presence of recycling technology, their practical application has proven to be challenging. In this study, as part of the waste plastic material recycling plan, it is assumed that the PET/OPP laminated waste film is peeled off at the waste film generation site for the second use. The recycling rate of PET/OPP delaminated waste film is assumed to be 2%, 10%, and 30% referring to the figures suggested by "Life-cycle Post Plastic Measures" from the Korean government. In this study, a physical separation method was developed as a recycling approach for waste PET. A result of cost-benefit analysis was conducted to evaluate the economic viability of the recycling process based on changes in the recycling rate. The findings indicated that a recycling rate of waste PET was 30% or higher resulted in a cost-benefit ratio (Benefit-cost ratio, BCR) of 1.32, exceeding the threshold of BCR ≥1, which is considered to meet the minimum requirement for cost-benefit balance. As the government's allocation ratio and unit price are expected to increase in the future, the cost-benefit ratio is expected to increase further. This case is expected to serve as a pilot initiative for waste PET recycling and foster profit creation for businesses in similar industries.

The effect of university students' participation in the entrepreneurship planning course on the enhancement of core competencies of entrepreneurship: Focusing on the case of S women's university (대학생의 창업계획 교육과정 참여가 창업가정신 핵심역량 증진에 미치는 효과: S여대 사례를 중심으로)

  • Kyun, Suna;Seo, Heejeon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.5
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    • pp.81-94
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    • 2022
  • This study analyzed the effect of the entrepreneurship planning course provided by an women's university in Seoul on the enhancement of the core competencies of entrepreneurship of university students. To this end, pre- and post-test of core entrepreneurship competency were conducted on 63 female university students (32 in experimental group, 31 in control group) and then the results were analyzed. The course in which the experimental group participated was a team-based project learning course and it required a team of three people to draw an entrepreneurship plan containing social problem solving as the final result. The course was operated for a total of 8 weeks. To measure the level of entrepreneurship core competency in the pre- and post- test, the survey tool that was developed by the Ministry of Education and Korea Entrepreneurship Foundation (2020) was used. This tool composed by 'value creation', 'challenge', 'self-directed', and 'group creativity' competencies. As analyses methods, i) covariance analysis was performed using the pretest as a covariate, and then a two-way ANOVA was performed with treatment (experimental group, control group) and time point (pre test, post test) as two independent variables. Results show while there was no significant difference between the experimental group and the control group in the value creation competency, it significantly contributed to the enhancement of challenge, self-directed, and collective creativity competencies. Based on these results, implications and limitations were discussed, followed by future research direction.

Evaluation of the Usefulness of MapPHAN for the Verification of Volumetric Modulated Arc Therapy Planning (용적세기조절회전치료 치료계획 확인에 사용되는 MapPHAN의 유용성 평가)

  • Woo, Heon;Park, Jang Pil;Min, Jae Soon;Lee, Jae Hee;Yoo, Suk Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.115-121
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    • 2013
  • Purpose: Latest linear accelerator and the introduction of new measurement equipment to the agency that the introduction of this equipment in the future, by analyzing the process of confirming the usefulness of the preparation process for applying it in the clinical causes some problems, should be helpful. Materials and Methods: All measurements TrueBEAM STX (Varian, USA) was used, and a file specific to each energy, irradiation conditions, the dose distribution was calculated using a computerized treatment planning equipment (Eclipse ver 10.0.39, Varian, USA). Measuring performance and cause errors in MapCHECK 2 were analyzed and measured against. In order to verify the performance of the MapCHECK 2, 6X, 6X-FFF, 10X, 10X-FFF, 15X field size $10{\times}10$ cm, gantry $0^{\circ}$, $180^{\circ}$ direction was measured by the energy. IGRT couch of the CT values affect the measurements in order to confirm, CT number values : -800 (Carbon) & -950 (COUCH in the air), -100 & 6X-950 in the state for FFF, 15X of the energy field sizes $10{\times}10$, gantry $180^{\circ}$, $135^{\circ}$, $275^{\circ}$ directionwas measured at, MapPHAN allocated to confirm the value of HU were compared, using the treatment planning computer for, Measurement error problem by the sharp edges MapPHAN Learn gantry direction MapPHAN of dependence was measured in three ways. GANTRY $90^{\circ}$, $270^{\circ}$ in the direction of the vertically erected settings 6X-FFF, 15X respectively, and Setting the state established as a horizontal field sizes $10{\times}10$, $90^{\circ}$, $45^{\circ}$, $315^{\circ}$, $270^{\circ}$ of in the direction of the energy-6X-FFF, 15X, respectively, were measured. Without intensity modulated beam of the third open arc were investigated. Results: Of basic performance MapCHECK confirm the attenuation measured by Couch, measured from the measured HU values that are assigned to the MAP-PHAN, check for calculation accuracy for the angled edge of the MapPHAN all come in a range of valid measurement errors do not affect the could see. three ways for the Gantry direction dependence, the first of the meter built into the value of the Gantry $270^{\circ}$ (relative $0^{\circ}$), $90^{\circ}$ (relative $180^{\circ}$), 6X-FFF, 15X from each -1.51, 0.83% and -0.63, -0.22% was not affected by the AP/PA direction represented. Setting the meter horizontally Gantry $90^{\circ}$, $270^{\circ}$ from the couch, Energy 6X-FFF 4.37, 2.84%, 15X, -9.63, -13.32% the difference. By-side direction measurements MapPHAN in value is not within the valid range can not, because that could be confirmed as gamma pass rate 3% of the value is greater than the value shown. You can check the Open Arc 6X-FFF, 15X energy, field size $10{\times}10$ cm $360^{\circ}$ rotation of the dose distribution in the state to look at nearly 90% pass rate to emerge. Conclusion: Based on the above results, the MapPHAN gantry direction dependence by side in the direction of the beam relative dose distribution suitable for measuring the gamma value, but accurate measurement of the absolute dose can not be considered is. this paper, a more accurate treatment plan in order to confirm, Reduce the tolerance for VMAT, such as lateral rotation investigation in order to measure accurate absolute isodose using a combination of IMF (Isocentric Mounting Fixture) MapCHEK 2, will be able to minimize the impact due to the angular dependence.

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Experimental investigation of the photoneutron production out of the high-energy photon fields at linear accelerator (고에너지 방사선치료 시 치료변수에 따른 광중성자 선량 변화 연구)

  • Kim, Yeon Su;Yoon, In Ha;Bae, Sun Myeong;Kang, Tae Young;Baek, Geum Mun;Kim, Sung Hwan;Nam, Uk Won;Lee, Jae Jin;Park, Yeong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.257-264
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    • 2014
  • Purpose : Photoneutron dose in high-energy photon radiotherapy at linear accelerator increase the risk for secondary cancer. The purpose of this investigation is to evaluate the dose variation of photoneutron with different treatment method, flattening filter, dose rate and gantry angle in radiation therapy with high-energy photon beam ($E{\geq}8MeV$). Materials and Methods : TrueBeam $ST{\time}TM$(Ver1.5, Varian, USA) and Korea Tissue Equivalent Proportional Counter (KTEPC) were used to detect the photoneutron dose out of the high-energy photon field. Complex Patient plans using Eclipse planning system (Version 10.0, Varian, USA) was used to experiment with different treatment technique(IMRT, VMAT), condition of flattening filter and three different dose rate. Scattered photoneutron dose was measured at eight different gantry angles with open field (Field size : $5{\time}5cm$). Results : The mean values of the detected photoneutron dose from IMRT and VMAT were $449.7{\mu}Sv$, $2940.7{\mu}Sv$. The mean values of the detected photoneutron dose with Flattening Filter(FF) and Flattening Filter Free(FFF) were measured as $2940.7{\mu}Sv$, $232.0{\mu}Sv$. The mean values of the photoneutron dose for each test plan (case 1, case 2 and case 3) with FFF at the three different dose rate (400, 1200, 2400 MU/min) were $3242.5{\mu}Sv$, $3189.4{\mu}Sv$, $3191.2{\mu}Sv$ with case 1, $3493.2{\mu}Sv$, $3482.6{\mu}Sv$, $3477.2{\mu}Sv$ with case 2 and $4592.2{\mu}Sv$, $4580.0{\mu}Sv$, $4542.3{\mu}Sv$ with case 3, respectively. The mean values of the photoneutron dose at eight different gantry angles ($0^{\circ}$, $45^{\circ}$, $90^{\circ}$, $135^{\circ}$, $180^{\circ}$, $225^{\circ}$, $270^{\circ}$, $315^{\circ}$) were measured as $3.2{\mu}Sv$, $4.3{\mu}Sv$, $5.3{\mu}Sv$, $11.3{\mu}Sv$, $14.7{\mu}Sv$, $11.2{\mu}Sv$, $3.7{\mu}Sv$, $3.0{\mu}Sv$ at 10MV and as $373.7{\mu}Sv$, $369.6{\mu}Sv$, $384.4{\mu}Sv$, $423.6{\mu}Sv$, $447.1{\mu}Sv$, $448.0{\mu}Sv$, $384.5{\mu}Sv$, $377.3{\mu}Sv$ at 15MV. Conclusion : As a result, it is possible to reduce photoneutron dose using FFF mode and VMAT method with TrueBeam $ST{\time}TM$. The risk for secondary cancer of the patients will be decreased with continuous evaluation of the photoneutron dose.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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