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Study for Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Diseases (폐 비결핵향산균종의 임상적 특징에 관한 연구)

  • Pae, H.H.;Lee, J.H.;Yoo, C.G.;Lee, C.T.;Chung, H.S.;Kim, Y.W.;Shim, Y.S.;Han, S.K.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.735-746
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    • 1999
  • Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

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A Comparative Study of Korean Home Economic Curriculum and American Practical Problem Focused Family & Consumer Sciences Curricula (우리나라 가정과 교육과정과 미국의 실천적 문제 중심 교육과정과의 비교고찰)

  • Kim, Hyun-Sook;Yoo, Tae-Myung
    • Journal of Korean Home Economics Education Association
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    • v.19 no.4
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    • pp.91-117
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    • 2007
  • This study was to compare the contents and practical problems addressed, the process of teaching-learning method, and evaluation method of Korean Home Economics curriculum and of the Oregon and Ohio's Practical Problem Focused Family & Consumer Sciences Curricula. The results are as follows. First, contents of Korean curriculum are organized by major sub-concepts of Home Economics academic discipline whereas curricular of both Oregon and Ohio states are organized by practical problems. Oregon uses the practical problems which integrate multi-subjects and Ohio uses ones which are good for the contents of the module by integrating concerns or interests which are lower or detailed level (related interests). Since it differentiates interest and module and used them based on the basic concept of Family and Consumer Science, Ohio's approach could be easier for Korean teachers and students to adopt. Second, the teaching-learning process in Korean home economics classroom is mostly teacher-centered which hinders students to develop higher order thinking skills. It is recommended to use student-centered learning activities. State of Oregon and Ohio's teaching-learning process brings up the ability of problem-solving by letting students clearly analyze practical problems proposed, solve problems by themselves through group discussions and various activities, and apply what they learn to other problems. Third, Korean evaluation system is heavily rely on summative evaluation such as written tests. It is highly recommended to facilitate various performance assessment tools. Since state of Oregon and Ohio both use practical problems, they evaluate students mainly based on their activity rather than written tests. The tools for evaluation include project documents, reports of learning activity, self-evaluation, evaluation of discussion activity, peer evaluation in a group for each students for their performance, assessment about module, and written tests as well.

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Middle School Home Economics Teachers' Performance Conditions of Self Supervision Related to the Home Economics (중학교 가정과 교사의 교과 관련 자기장학에 대한 수행 실태)

  • Nam, Yun-Jin;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.19 no.2
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    • pp.61-75
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    • 2007
  • The method used in this descriptive study is the survey. The purpose of the study is to investigate performances of middle school home economics(HE) teachers regarding the HE subject. Respondents in this study were 177 HE teachers. Questionnaires from HE teachers were collected through e-mails. With the operation of the SPSS/Win (ver10.1) program, the analyses such as mean, standard deviation, frequencies, percents, t-test and ANOVA are done to see the relations between the related variables. The results of this study were as follows. First, the middle school HE teachers performed well above the standards in terms of planning, execution, and evaluation about self supervision related to HE. Second, the HE teachers collected materials for instruction by using literary (books) survey, Internet and mass media. They mainly focused on improving ways of "teaching and learning" and deepening the studies related to contents of textbooks. Third, the HE teachers used various ways to improve self supervision in the following order: mass media, literary (books) survey, participation in societies for researches, meetings, various training and field trip More than half of the middle school HE teachers proceeded to graduate schools, joined meetings for researches and had experiences of taking classes in private institutes. They also made a field trip once or twice a year and depended much on TV programs and education broadcasting programs as ways of improving their performances related to self supervision. While they were actively sharing information with their peer group, they made little effort at analyzing and evaluating their classes and utilizing expert group for their classes. The main problems as to self supervision were that only the half of the HE teachers responded that they were performing self supervision related to their classes well above the standards and the area where they heavily focused on has been "teaching and learning" and "the studies related to contents of textbooks". Therefore, to motivate incentives of the HE teachers for self supervision, meetings for researches should be activated and various training programs should be developed. In addition, government should give administrative and institutional support through a publication of books introducing detailed ways of self supervision and an establishment of centers and institutions for supporting self supervision.

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Outdoor Landscape Design Proposal for a Resort using the Baekje Traditional Garden as a Theme (백제정원을 주제로 한 리조트 외부 공간 계획)

  • Kim, Yun-Geum;Kim, Hai-Gyoung;Kim, Young-Mo;Chin, Yang-Kyo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.2
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    • pp.1-9
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    • 2011
  • This study concerns the Baekje Traditional Garden, one of the open spaces in the Lotte Resort in the Baekje Historical Reappearance Complex, which is part of the comprehensive plan for specific areas in the Baekje cultural area. The Baekje Traditional Garden has historic value, and its excellent garden style influenced the ancient Japanese gardens. This study dealt with three issues: (1) The context in which Lotte Buyeo Resort accepted the Baekje Traditional Garden, particularly the background and process of such; (2) The original form of the Baekje Traditional Garden; and (3) How the Baekje Traditional Garden should be represented in the open space of the resort. Representation is accomplished in two ways: using the structure of the original garden and in the borrowing of elements. For representation using the structure of the original garden, Imrugak was used as the main entrance space, and Wolsunjung was represented from the Ganbuklee remains. In the rear garden are wave watercourses and other garden facilities of the Wanggungri site in Iksan. Borrowing of elements, on the other hand, was accomplished in the plant plan and detailed development. In addition, mountaintops (three mountains and five mountain summits), a clean stream between mountains, and a pine forest are visualized in the garden. This is the representative landscape of the Taoist hermit world that appeared in the Baekje Gilt Bronze Incense Burner and Landscape pattern. The significance of this study is twofold. First, the Baekje Traditional Garden is a fresh trail because there has been no previous research concerning it. Second, while past research concerning traditional spaces focused on the results of representation, this study focused on the process of representation. This means that this research work tried to extend the study concerning the representation of traditional spaces from the conceptual to the practical approach. This study, however, also has its limitations. The authenticity of the representation suggested in this study may be questioned later because efforts have been made to preserve the original Baekje Traditional Garden. In addition, this study should seek a balance between authenticity on one hand and amusement and diversity of experience on the other, because the site is a resort.

S-MADP : Service based Development Process for Mobile Applications of Medium-Large Scale Project (S-MADP : 중대형 프로젝트의 모바일 애플리케이션을 위한 서비스 기반 개발 프로세스)

  • Kang, Tae Deok;Kim, Kyung Baek;Cheng, Ki Ju
    • KIPS Transactions on Software and Data Engineering
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    • v.2 no.8
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    • pp.555-564
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    • 2013
  • Innovative evolution in mobile devices along with recent spread of Tablet PCs and Smart Phones makes a new change not only in individual life but also in enterprise applications. Especially, in the case of medium-large mobile applications for large enterprises which generally takes more than 3 months of development periods, importance and complexity increase significantly. Generally Agile-methodology is used for a development process for the medium-large scale mobile applications, but some issues arise such as high dependency on skilled developers and lack of detail development directives. In this paper, S-MADP (Smart Mobile Application Development Process) is proposed to mitigate these issues. S-MADP is a service oriented development process extending a object-oriented development process, for medium-large scale mobile applications. S-MADP provides detail development directives for each activities during the entire process for defining services as server-based or client-based and providing the way of reuse of services. Also, in order to support various user interfaces, S-MADP provides detail UI development directives. To evaluate the performance of S-MADP, three mobile application development projects were conducted and the results were analyzed. The projects are 'TBS(TB Mobile Service) 3.0' in TB company, mobile app-store in TS company, and mobile groupware in TG group. As a result of the projects, S-MADP accounts for more detailed design information about 'Minimizing the use of resources', 'Service-based designing' and 'User interface optimized for mobile devices' which are needed to be largely considered for mobile application development environment when we compare with existing Agile-methodology. Therefore, it improves the usability, maintainability, efficiency of developed mobile applications. Through field tests, it is observed that S-MADP outperforms about 25% than a Agile-methodology in the aspect of the required man-month for developing a medium-large mobile application.

Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.99-128
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    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

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Dynamic Behavior of Reactor Internals under Safe Shutdown Earthquake (안전정기지진하의 원자로내부구조물 거동분석)

  • 김일곤
    • Computational Structural Engineering
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    • v.7 no.3
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    • pp.95-103
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    • 1994
  • The safety related components in the nuclear power plant should be designed to withstand the seismic load. Among these components the integrity of reactor internals under earthquake load is important in stand points of safety and economics, because these are classified to Seismic Class I components. So far the modelling methods of reactor internals have been investigated by many authors. In this paper, the dynamic behaviour of reactor internals of Yong Gwang 1&2 nuclear power plants under SSE(Safe Shutdown Earthquake) load is analyzed by using of the simpled Global Beam Model. For this, as a first step, the characteristic analysis of reactor internal components are performed by using of the finite element code ANSYS. And the Global Beam Model for reactor internals which includes beam elements, nonlinear impact springs which have gaps in upper and lower positions, and hydrodynamical couplings which simulate the fluid-filled cylinders of reactor vessel and core barrel structures is established. And for the exciting external force the response spectrum which is applied to reactor support is converted to the time history input. With this excitation and the model the dynamic behaviour of reactor internals is obtained. As the results, the structural integrity of reactor internal components under seismic excitation is verified and the input for the detailed duel assembly series model could be obtained. And the simplicity and effectiveness of Global Beam Model and the economics of the explicit Runge-Kutta-Gills algorithm in impact problem of high frequency interface components are confirmed.

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Ecological Characteristics and Management Program for Buffer Greens at Sinhyeon-Eup, Geoje-Si (거제시 신현읍 완충녹지의 생태적 특성 및 관리방안)

  • SaGong, Young-Bo;Lee, Soo-Dong
    • Korean Journal of Environment and Ecology
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    • v.21 no.3
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    • pp.243-256
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    • 2007
  • The purpose of this paper is aimed at identifying the planting condition of greenbelt axis covering forests located at Sinhyeon-eup, Geoje-si and also establishing improvement plans for the ecological organization. The study was executed with buffer green space designed to mitigate noise, which is located at a halfway point linking Mt. Yukkyo(altitude of 50m) and Mt. Jungmae(altitude of 131m). The number of the biotope patterns was classified into 17 in total: the two are urbanized districts such as a townified district and streets and another 15 are greenbelts and open space such as forest biotope, inland water biotope, and landscaping tree plantations biotope. According to the analysis of biotope types, it was estimated that the making use of already established buffer greens as a linking medium with a foothold of Mt. Yukkyo and Jungmae, whose natural eco-system is well suited for habitation of living organism, is the one and only way to the influx of living organism into the downtown area. The green coverage rate of the base green area, sub-base green area and linkage green area was 160.29%, 128.37% and 44.37% respectively; the green capacity coefficient(i.e. GVZ[$Gr{\ddot{u}}nvolumezahl$]) for base green area, sub-base green area and linkage green area was $4.04m^3/m^2,\;3.95m^3/m^2\;and\;0.65m^3/m^2$ respectively. The base green area has constituted multi-layered vegetation structure and thus played a role as habitats for living organism and supply centre of species, whereas the sub-base green area has destroyed lower layer vegetation, and the linkage green area was in bad shape due to the lack of planting volume and damage of the shrub layer. Accordingly, this research paper intended to suggest detailed implementation plans for the improvement in landscape for city dwellers' use and relaxation; in other words, this paper focused on ecological build-up for the Influx of wild birds into the downtown area for the promotion of bio-diversity of species through the linkage of base green areas and the fostering of nature observing trails for citizens as well as the connecting of green areas through the build-up of roadside greens to make these green areas to be efficiently used as corridors for the influx of wild birds and bio-organism habitation and for citizens' using space.

Differences in the Soundscape Characteristics of a Natural Park and an Urban Park (자연공원과 도시공원의 Soundscape 특성 차이)

  • Gim, Ji-youn;Lee, Jae-Yoon;Ki, Kyong-Seok
    • Korean Journal of Environment and Ecology
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    • v.31 no.1
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    • pp.112-118
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    • 2017
  • The purpose of this study is to clarify the characteristics of the soundscape in a natural park and an urban park. The study sites were a natural park (Chiaksan Nationalpark) and an urban park (Rose Park) in Wonju City, Gangwon Province. Soundscape recording was conducted using Digital Recorder from April 2015 to January 2016. The analysis period was 8 days per season, with a total of 64 days (2 places). Analysis items were soundscape's daily cycle, soundscape type, and seasonal variation. According to the result of the daily cycle analysis of the soundscape, the natural park was dominated by the biophony in accordance with the cycle of the sun, and the airplane sound was observed in the daytime. Meanwhile, anthrophony was consistently produced in the urban park 24 hours a day. As a result of the detailed type analysis of the soundscape, the sources of biophony were classified into wild birds, mammals, insects and amphibians, and the sources of geophony were classified into rain and wind. The anthrophony was mostly airplane sound. In the urban park, wild birds appeared to most influence the biophonic sounds while rain and the wind were the most frequent sounds that contribute to geophony. The most influential components of anthrophony in the urban park were in the order of automobiles, people, music, construction, cleaning, and airplane sound. As a result of the seasonal difference analysis of the soundscape, it was statistically significant that the natural park shows higher biophony in spring, summer, and autumn compared to the urban park. Anthrophony in the urban park appeared to be higher than the natural park in all seasons. The significance of this study is that it is the first study to identify the characteristics of the soundscape of a natural park and an urban park emanating from different landscapes in South Korea.

Quantitative Analysis of Digital Radiography Pixel Values to absorbed Energy of Detector based on the X-Ray Energy Spectrum Model (X선 스펙트럼 모델을 이용한 DR 화소값과 디텍터 흡수에너지의 관계에 대한 정량적 분석)

  • Kim Do-Il;Kim Sung-Hyun;Ho Dong-Su;Choe Bo-young;Suh Tae-Suk;Lee Jae-Mun;Lee Hyoung-Koo
    • Progress in Medical Physics
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    • v.15 no.4
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    • pp.202-209
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    • 2004
  • Flat panel based digital radiography (DR) systems have recently become useful and important in the field of diagnostic radiology. For DRs with amorphous silicon photosensors, CsI(TI) is normally used as the scintillator, which produces visible light corresponding to the absorbed radiation energy. The visible light photons are converted into electric signal in the amorphous silicon photodiodes which constitute a two dimensional array. In order to produce good quality images, detailed behaviors of DR detectors to radiation must be studied. The relationship between air exposure and the DR outputs has been investigated in many studies. But this relationship was investigated under the condition of the fixed tube voltage. In this study, we investigated the relationship between the DR outputs and X-ray in terms of the absorbed energy in the detector rather than the air exposure using SPEC-l8, an X-ray energy spectrum model. Measured exposure was compared with calculated exposure for obtaining the inherent filtration that is a important input variable of SPEC-l8. The absorbed energy in the detector was calculated using algorithm of calculating the absorbed energy in the material and pixel values of real images under various conditions was obtained. The characteristic curve was obtained using the relationship of two parameter and the results were verified using phantoms made of water and aluminum. The pixel values of the phantom image were estimated and compared with the characteristic curve under various conditions. It was found that the relationship between the DR outputs and the absorbed energy in the detector was almost linear. In a experiment using the phantoms, the estimated pixel values agreed with the characteristic curve, although the effect of scattered photons introduced some errors. However, effect of a scattered X-ray must be studied because it was not included in the calculation algorithm. The result of this study can provide useful information about a pre-processing of digital radiography.

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