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Variability in Drug Interaction According to Genetic Polymorph isms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • Environmental Mutagens and Carcinogens
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    • v.23 no.4
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    • pp.131-134
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    • 2003
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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A Model based Vocational Evaluation for People with Psychiatric Disabilities (정신장애인 직업재활모델과 직업평가 - 직업기능척도 개발을 위한 예비연구 -)

  • Lee, Seong-Gyu;Kim, Sang-Hee
    • Korean Journal of Social Welfare
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    • v.54
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    • pp.123-147
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    • 2003
  • It is well known that one of essential features of psychiatric disability is vocational impairment. Since the year of 2000 when psychiatric disability was declared as one of disability categories in Korea, vocational rehabilitation programs have been actively administered. At this point, it is compelling that vocational evaluation serves as a means of screening out the most promising candidates, identifying their vocational deficits and strengths, designing the individualized vocational interventions, and evaluating vocational outcomes. Still, vocational evaluation for people with psychiatric disabilities has been more problematic than for any other group with disabilities. The authors argued that vocational evaluation for people with psychiatric disabilities should be based on a certain vocational rehabilitation model to address those problems. It is because there exists an indispensible relationship between the vocational rehabilitation model and vocational evaluation. In other words, the main purposes, measurement time points, and focus of vocational evaluation may depend on which of vocational rehabilitation models to make a choice of. In addition, the vocational rehab model(i.e., vocational readiness model or graduation model) underlying traditional vocational evaluation does not seem to work for people with psychiatric disabilities. Authors argued that accelerating model fits for psychiathric characteristics which are often unpredictable and turbulent. As a preliminary step of developing vocational functioning instrument incorporating the demand characteristics of the accelerating model, post-hoc analyses were done on data from a vocational functioning measure and the results were critically examined from viewpoints of accelerating model. For these purposes, discussions were made about a) general functioning of vocational evaluation, (b) relation between vocational rehabilitation model and vocational evaluation, (c) the reasons why the accelerating model is more appropriate to the characterstics of psychiatric clients than the graduation model, (d) post-hoc analytic results reviewed from viewpoints of accelerating model-based vocational evaluation This study is significant in that it attempted model-based, model-specific vocational evaluation as a preliminary step for developing vocational functioning assessment instruments ill future.

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Effect of Inhaled Fluticasone Propionate on Hypothalamic-Pituitary-Adrenal Axis in Bronchial Asthma Patient (기관지 천식환자에서 Fluticasone Propionate 흡입제가 Hypothalamic-Pituitary-Adrenal Axis에 미치는 영향)

  • Hwang, Jun-Kyu;Lee, Ho-Meong;No, Yang-Won;Park, Gye-Young;Park, Chong-Wung;Park, Jae-Kyung;Jeong, Seong-Hwan;Nam, Gui-Hyun;Kim, Hong-Kyu;Park, Hye-Young;Kang, Moon-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.25-34
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    • 2001
  • Background : Inhaled glucocorticoids are the medical treatment of choice in asthma patients. Fluticasone propionate is one of the most effective inhaled corticosteroids and has been reported to have minimal effect on the hypothalamic-pituitary-adrenal axis at the recommended dose. However, reports of long-term trials characterizing their systemic safety with chronic use are rare. This study was designed to evaluate the long-term safety of inhaled fluticasone propionate to the hypothalamic-pituitary-adrenal axis. Method : This study was conducted on 21 patients to evaluate the adrenal response to rapid ACTH stimulation test after 6 months of treatment with fluticasone propionate from $200\;{\mu}g$ to $750\;{\mu}g$ daily. The serum cortisol levels was measured to assess its effect on the hypothalamic-pituitary-adrenal axis just prior to the injection, at 30 minutes and 60 minutes after an intramuscular injection of synthetic ACTH. Result : The mean dose of inhaled fluticasone propionate was $355\;{\mu}g$ per day(SD=$174\;{\mu}g$, range=$200\;{\mu}g$ to $750\;{\mu}g$). The mean serum cortisol levels of the patients was $11.0\;{\mu}g/d{\ell}$(SD=$6.4\;{\mu}g/d{\ell}$) prior to the injection, $20.0\;{\mu}g/d{\ell}$ (SD=$7.7\;{\mu}g/d{\ell}$) after 30 minutes, and $23.0\;{\mu}g/d{\ell}$(SD=$6.3\;{\mu}g/d{\ell}$) after 60 minutes. Sixteen patients of the 21 patients had a normal response(> $18\;{\mu}g/d{\ell}$), and 5 out of the 21 patients had serum cortisol levels below the normal range after the rapid ACTH stimulation test. Conclusion: Adrenal suppression occurred in 5 out of 21 patients with 6 months treatment with inhaled fluticasone propionate.

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A Study on Food Service Franchise Location Factors and Quality of Service Factors, The Impact on Customer Satisfaction (외식 프랜차이즈 입지요건과 서비스 품질 요인이 고객만족에 미치는 영향)

  • Kim, Jo In Seog;Cho, Kyu Youn;An, Sang
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.5
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    • pp.77-90
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    • 2016
  • This study is to examine the importance of site selection and service quality in franchise business as food service franchise became one of the fastest-growing service industries today. The chief finding of this study is as follows: First, a survey in locational and service quality factors affecting food service franchise shows that responders are more concerned with hygiene and visibility of the store than proximity and transportation advantages which reflects low statistical significance, thus the distance did not seem to be a big problem for the responders in the context that they mostly visit nearby food franchise. Second, the examination of the influence by the service quality factors and customer satisfaction shows significant positive relation with customer response, speed and accuracy, and accuracy factors which reveals that the responders prefer prompt response and swift judgment toward the customer's needs and expectations, professional knowledge services to the credibility factors in which little correlation with the customer satisfaction were found. Third, the examination of the influence by the service quality factors, locational factors, and re-visit reveals that customer response and specialty showed statistically significant correlation with intention of WOM (Word of Mouth) and revisit, which suggests that swift judgment and response toward the customer's needs and expectations, professional knowledge services is of great importance to both customer satisfaction and revisit. The study on the aspects of locational and service quality factors affecting franchise industry's customer satisfaction was conducted as above, an investigation in both factors' influence on the customer satisfaction was made, and based on the results of the analysis, this research seeks an optimal operation strategy of a franchise business. Food service franchise are relatively very competent to business adminstration and reaction capability to consumption changes due to the already established market, and there are stores springing up everywhere inspired by the founders who are too confident of their success in the franchise business. However, it is necessary for the franchise beginners to figure out a zone oriented, regular customer oriented business strategy than just complying with the head office manual. Owing to an increasing trend of opening medium to large sized stores and investments in the wake of converting to multiple business type Korean food franchise, there is growing need to set up new concept of store development and operational management strategy in order to overcome the excessive competition and limited sales volume of the old-fashioned small sized, small capital franchise stores. Furthermore, as most business category of food service franchise serve very similar menus, from a product differentiation point of view, it is required to map out flexible sales concept including the adoption of competitive and low-price strategy. In conclusion, as is shown in the analytical research, the customers' optimal choice fluctuate over their preferences like customer convenience and circumstances rather than insisting on specific brand, thus it will be necessary for the franchise stores to draw up aggressive strategy and planning in running food service franchise to maximize their profits.

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Effects of Strength Recognition on the Intent of Start-up after Retirement: To the Office Workers (강점인식이 은퇴 후 창업의도에 미치는 영향: 직장인을 대상으로)

  • Park, Hye sung;Park, Woojin;Yun, Bae byung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.1
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    • pp.143-150
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    • 2020
  • This research is intended to identify how office worker's recognition of strength affects the intention of starting a business when it is used as a medium for utilizing strength. The survey period was conducted for two months from January 17, 2019 to March 8, 2019. In order to achieve the object of this study, a significant number of employees have been collected nationwide, and 287 office workers were analyzed after collecting 300 questionaires, excluding 13 office workers who were not sincere. The significant data were analyzed by utilizing the structural equation and technical statistics and by verifying the conformity of structural model and measurement model and by investigating the relationship between variables. The results of this study are summarized as follows: First, employee's perception of strength has been found to have a significant effect on the utilizing of strength. Second, the use of workers' strengths has been found to have a significant effect on the intention of starting a business. Third, it has been confirmed that in the relationship between the employee's perception of strength and intention to start a business, the recognition of strength has a significant effect on the intention of starting a business only through the use of strength. Most office workers are nervous about the future and make various plans. The time to live after retirement is getting longer and jobs and working hours are shrinking at an alarming rate. According to the analysis on the status of small business owners in the mid-term of 2017 data, the average monthly operating profit of small business owners across the country is decreasing over the years, and most start-ups are subsistence-type start-ups, and they decide to start their own businesses because they have no other choice than start-ups. As the number of small business owners suffering from financial difficulties has increased since the financial crisis and insecurity of job is pushing those with financial difficulties after retirement to the battleground of the start-up market, the result of this research suggest that the workers need to recognize their own strength and enhance the importance of utilizing the strength.

The Comparison of Absolute Dose due to Differences of Measurement Condition and Calibration Protocols for Photon Beams (6MV 광자선에서 측정 조건의 변화와 측정법의 차이에 의한 절대 선량값의 비교)

  • 김회남;박성용;서태석;권수일;윤세철
    • Progress in Medical Physics
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    • v.8 no.2
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    • pp.87-102
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    • 1997
  • The absolute absorbed dose can be determined according to the measurement conditions; measurement material, detector, energy and calibration protocols. The purpose of this study is to compare the absolute absorbed dose due to the differences of measurement condition and calibration protocols for photon beams. Dosimetric measurements were performed with a farmer type PTW and NEL ionization chambers in water, solid water, and polystyrene phantoms using 6MV photon beams from Siemens linear accelerator. Measurements were made along the central axis of 10cm $\times$ 10cm field size for constant target to surface distance of 100cm for water, solid water and polystyrene phantom. Theoretical absorbed dose intercomparisons between TG21 and IAEA protocol were performed for various measurement combinations of phantom, ion chamber, and electrometer. There were no significant differences of absorbed dose value between TG21 and IAEA protocol. The differences between two protocols are within 1% while the average value of IAEA protocol was 0.5% smaller than TG21 protocol. For the purpose of comparison, all the relative absorbed dose were nomalized to NEL ion chamber with Keithley electrometer and water phantom, The average differences are within 1%, but individual discrepancies are in the range of - 2.5% to 1.2% depending upon the choice of measurement combination. The largest discrepancy of - 2.5% was observed when NEL ion chamber with Keithley electrometer is used in solid water phantom. The main cause for this discrepancy is due to the use of same parameters of stopping power, absorption coeficient, etc. as used in water phantom. It should be mentioned that the solid water phantom is not recommended for absolute dose calibration as the alternative of water, since absorbed dose show some dependency on phantom material other than water. In conclusion, the trend of variation was not much dependent on calibration protocol. However, it shows that absorbed dose could be affected by phantom material other than water.

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A Study on the State of Health Functional Foods & Herbal Medicine Consumed by Elementary School Students (초등학생의 건강기능식품 및 한약 복용 실태에 대한 연구)

  • Kim, Mi-Ki;Jung, Ji-Ho;Ahn, Jae-Sun;Yim, Jung-Hoon;An, Min-Seop;Park, Jin-Su;Lee, Hai-Ja;Park, Eun-Jung
    • The Journal of Pediatrics of Korean Medicine
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    • v.23 no.3
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    • pp.143-153
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    • 2009
  • Objectives The purpose of this study is to get the basic information from patients how much they understood about their medication and also to know whether patients are making reasonable drug choice between Health Functional Foods and Herbal medicine. Methods 500 questionnaires were handed out to the parents of students in two elementary schools located in OO, Junlabukdo province. 421 questionnaires were completed to be evaluated. Results Among 421 subjects, 53.0% were female, and 47.0% were male. The percentages of the subjects consuming Health Functional Foods and herbal medicine were67.7% and 67.8%, respectively. Among those people who consumed Health Functional Food, 44.1% were using nutritional supplements, red ginseng or ginseng products (26.9%), chlorella products (11.5%), and plum extract products (7.7%). As for the reason to consume Health Functional Foods were varied, but 'in order to be healthy, although currently displaying no illness.'(43.0%) were the most responses among the given choices. On the other hand, the reason for consuming herbal medicine was 'In order to grow taller'(26.1%), 'In order to cure weak physical state frequently displaying common illnesses',(25.9%), and 'In order to cure diseases.'(23.3%). For the questions about effectiveness after consumption,the 69.9% subjects said that it seemed to be effected, and that % was slightly higher than that of subjects with consuming Health Functional Foods(64.4%). For question concerning preferences between Health Functional Foods and herbal medicine, 57.5% chose herbal medicine, and this percentage was higher than that of Health Functional Foods(42.5%).As for the reasons of additional consumption of the Health Functional Foods, subject answered as 'Easy to consume.'(41,6%), which was the most common among the subjects consuming Health Functional Foods. On other hand, the subjects of herbal medicine answered as that herbal medicine is 'more effective'(45.7%), and 'more trustworthy in preventing side-effects.'(40.3%). After consumption of the herbal medication, only 3.9% of the subjects consuming either Health Functional Foods or herbal medicine had side-effects. The most common side-effects were 'dermal reaction' which is normally caused by Health Functional Foods and 'indigestion' problems caused by herbal consumption. Conclusions According to the 421 subjects those involved in study, the percentages of consuming Health Functional Foods(67.7%) and herbal medicine(67.8%) were similar. The most commonly consumed products were a type of Health Functional Foods which were the nutrition-supplying products. Ginseng or red ginseng products were the next commonly used products. Health Functional Foods were commonly consumed for preventing illness and maintaining health rather than any other purpose. In contrary, herbal medicines were more commonly consumed for purposes such as for growth or treating certain type of disease. As a result of consumption, more than half of both subject replied as 'satisfied'. As for the side effects, dermal reaction was the most common problem for those with consuming Health Functional Foods, while indigestion was the most common side effect from the subjects with consuming herbal medicine.

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Bacteremia in pediatric cancer patients : A single center study (소아 암 환아에서 발생한 균혈증의 분석 : 단일기관 연구)

  • Park, Sun Mi;Choe, Byung Kyu;Kim, Chun Soo;Kim, Joon Sik;Kim, Heung Sik;Ryoo, Nam-Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.882-888
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    • 2006
  • Purpose : Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. Methods : We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. Results : There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), ${\alpha}$-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. Conclusion : Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.

The consideration for methods of statistical analysis about the thesis published in the journal of korean oriental medical Ophthalmology & Otolaryngology & Dermatology from 2003 to 2005 (2003년부터 2005년까지 안이비인후피부과 학회지에 게재된 논문들의 통계적 분석 방법에 대한 고찰)

  • Kim, Keoo-Seok;Nam, Hae-Jung;Park, Owe-Suk;Kim, Hee-Jeong;Cha, Jae-Hoon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.3 s.31
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    • pp.134-145
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    • 2006
  • Objective : This study was carried out to investigate what type of assumption and conditions are needed for the application of various statistical techniques such as descriptive statistics, t-test, analysis of variance, correlation analysis, regression analysis and chi-square test and to evaluate that they are used correctly in the research process. Methods : One more methods of statistical analysis were used in 91 papers among 162 papers selected from the journal of Korean oriental medical Ophthalmology & Otolaryngology & Dermatology from April 2003 to December 2005. So we analysed the type of statistical analysis method in 91 papers(clinical and experimental study) and assessed the their validity of statistical techniques by the check list consisting of 34 items(3 items for validity assessment of descriptive statistics, 6 items for t-test, 7 items for analysis of variance, correlation analysis and regression analysis, respectively, 4 items for chi-square test) Results : 1. The type of 65(40%) cases is experimental trial, the type of 55(34%) cases is case report, the type of 26(16%) cases is clinical trial and the type of 16(10%) cases is review, in 91 papers using statistical techniques among 162 papers selected from the journal of Korean oriental medical Ophthalmology & Otolaryngology & Dermatol-ogy from April 2003 to December 2005. 2. One more methods of statistical analysis were used in the experimental and clinical study. When we classified 125 units using statistical analysis methods in 91 papers according to statistical techniques such as descriptive statistics, t-test, analysis of variance, correlation analysis, regression analysis and chi-square test, the number of independent sample t-test is 33(26%), the number of only descriptive statistics is 28(22%), the number of independent sample t-test is 33(26%), the number of only descriptive statistics is 28(22%), the number of one way ANOVA is 15(12%), the number of non-parametric test 10(8%). 3. After carrying out one way ANOVA, the number of using multiple comparison methods is 15(Scheffe:6(26%), Duncan:4(17%), Dunnett:3(13%), Tukey:2(9%)) out of 23 (total case carrying out one way ANOVA). 8(35%) out of 23 did not enforce multiple comparison methods after carrying out one way ANOVA. 4. From the assessment of validity about 63 cases using statistical techniques(except descriptive statistics), 5(8%) cases are proper, the other 58(92%) are improper, so we recognized a serious misuse of statistical application in our journal. 5. The number of case below 10 sample size in experimental and clinical study(except descriptive statistics) is 31(34%) and frequent. Also the number of case containing no mention of sample size is 41(45%, including culture study). 6. For example of statistical error, there are wrong choice of statistical technique, lack of check on standard assumption(such as standard distribution, equivariance, independence), and so on. Conclusions : We investigated the validity of statistical analysis methods in our journal by check list consisting of 34 items and suggested correct statistical analysis methods. We should practice the spread of education about statistical analysis methods and precis application, enhance objectivity and reliability of our thesis and further correspond with purpose of scientific study.

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A Study on Teaching-Learning and Evaluation Methods of Environmental Studies in the Middle School (중학교 "환경" 교과의 교수.학습 및 평가 방법 연구)

  • 남상준
    • Hwankyungkyoyuk
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    • v.7 no.1
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    • pp.1-17
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    • 1994
  • This study was performed to determine appropriate teaching-learning and evaluation methods for Environmental Studies. To promote the relevance of our study to the needs of the schools and concerned educational communities of environmental education, we reviewed related literature, conducted questionnaire surveys, interviewed related teachers and administrator, held meetings with experts, and field-tested our findings. For selecting and developing teaching-learning methods of Environmental Studies, findings of educational research in general are considered. moreover, principles of environmental education, general aim of environmental education, orientations of environmental education, and developmental stages of middle school students in educational psychology were attended. In addition, relevance to the purpose of the Environmental Studies curriculum, appropriateness for value inquiry as well as knowledge inquiry, small group centered class organization, social interaction centered teaching-learning process, regional environmental situation, significance of personal environment, evaluation methods of Environmental Studies, multi- and inter-disciplinary contents of the Environmental Studies textbook, suitability to the evaluation methods of Environmental Studies, and emphasis on the social interaction in teaching-learning process were regarded. It was learned the Environmental Studies can be taught most effectively in via of holding discussion sessions, conducting actual investigation, doing experiment-practice, doing games and plate, role-playing and carrying out simulation activities, and doing inquiry. These teaching-learning methods were field-tested and proved appropriate methods for the subject. For selecting and developing evaluation method of Environmental Studies, such principles and characteristics of Environmental Studies as objective domains stated in the Environmental Studies curriculum, diversity of teaching-learning organization, were appreciated. We categorized nine evaluation methods: the teacher may conduct questionnaire surveys, testings, interviews, non-participatory observations; they may evaluate student's experiment-practice performances, reports preparation ability, ability to establish a research project, the teacher may ask the students to conduct a self-evaluation, or reciprocal evaluation. To maximize the effect of these methods, we further developed an application system. It considered three variables, that is, evaluates, evaluation objectives domains, and evaluation agent, and showed how to choose the most appropriate methods and, when necessary, how to combine uses of different methods depending on these variables. A sample evaluation instrument made on the basis of this application system was developed and tested in the classes. The system proved effective. Pilot applications of the teaching-learning methods and evaluation method were made simultaneously; and the results and their implications are as follows. Discussion program was applied in a lesson dealing with the problems of waste disposal, in which students showed active participation and creative thinking. The evaluation method used in this lesson was a multiple-choice written test for knowledge and skills. It was shown that this evaluation method and device are effective in helping students' revision of the lesson and in stimulating their creative interpretations and responces. Pupils showed great interests in the actual investigation program, and this programme was proved to be effective in enhancing students' participation. However, it was also turned out that there must be pre-arranged plans for the objects, contents and procedures of survey if this program is to effective. In this lesson, non-participatory observation methods were used with a focus on the attitudes of students. A scaled reported in general description rather than in grade. Experiment-practice programme was adopted in a lesson for purifying contaminated water and in this lesson, instruction objectives were properly established, the teaching-learning process was clearly specified and students were highly motivated. On the other hand, however, it was difficult to control the class when some groups of students require more times to complete their experiment, and sometimes different results. As regards to evaluation, performance observation test were used for assessing skills and attitudes. If teachers use well-prepared Likert scale, evaluation of all groups within a reasonablely short period of time will be possible. The most effective and successful programme in therms of students' participation and enjoyment, was the 'ah-nah-bah-dah-market' program, which is kind of game of the flea market. For better organized program of this kind, however, are essential, In this program, students appraise their own attitudes and behavior by responding to a written questionnaire. In addition, students were asked to record any anecdotes relating to self-appraisal of changes on one's own attitudes and behaviours. Even after the lesson, students keep recording those changes on letters to herself. Role-playing and simulation game programme was applied to a case of 'NIMBY', in which students should decide where to located a refuse dumping ground. For this kind of programme to e successful, concepts and words used in the script should be appropriate for students' intellectual levels, and students should by adequately introduced into the objective and the procedures of the lessons. Written questionnaire was used to assess individual students' attitudes after the lesson, but in order to acquire information on the changes of students' attitudes and skills, pre-test may have to be made. Doing inquiry programme, in which advantages in which students actually investigated the environmental influence of the areas where school os located, had advantages in developing students' ability to study the environmental problems and to present the results of their studies. For this programme to be more efficient, areas of investigation should be clearly divided and alloted to each group so that repetition or overlap in areas of study and presentation be avoided, and complementary wok between groups bee enhanced. In this programme, teacher assessed students' knowledge and attitudes on the basis of reports prepared by each group. However, there were found some difficults in assessing students' attitudes and behaviours solely on the grounds of written report. Perhaps, using a scaled checklist assessing students' attitudes while their presentation could help to relieve the difficulties.

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