• Korean Journal of Radiology
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• v.21 no.7
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• pp.880-890
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• 2020

Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (D_Thorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. D_Thorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between D_Thorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. D_Thorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. D_Thorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV₁) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DL_CO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower D_Thorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower D_Thorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV₁, and lower DL_CO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

• Journal of Distribution Research
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• v.17 no.4
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• pp.55-80
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• 2012

I. Introduction Developing the relationships between companies is very important issue to ensure a competitive advantage in today's business environment (Bleeke & Ernst 1991; Mohr & Spekman 1994; Powell 1990). Partnerships between companies are based on having same goals, pursuing mutual understanding, and having a professional level of interdependence. By having such a partnerships and cooperative efforts between companies, they will achieve efficiency and effectiveness of their business (Mohr and Spekman, 1994). However, it is difficult to expect these ideal results only in the B2B corporate transaction. According to agency theory which is the well-accepted theory in various fields of business strategy, organization, and marketing, the two independent companies have fundamentally different corporate purposes. Also there is a higher chance of developing opportunism and conflict due to natures of human(organization), such as self-interest, bounded rationality, risk aversion, and environment factor as imbalance of information (Eisenhardt 1989). That is, especially partnerships between principal(or buyer) and agent(or supplier) of companies within supply chain, the business contract itself will not provide competitive advantage. But managing partnership between companies is the key to success. Therefore, managing partnership between manufacturer and supplier, and finding causes of conflict are essential to improve B2B performance. In conclusion, based on prior researches and Agency theory, this study will clarify how business hazards cause conflicts on supply chain and then identify how developed conflicts have been managed by two control mechanisms. II. Research model III. Method In order to validate our research model, this study gathered questionnaires from small and medium sized enterprises(SMEs). In Korea, SMEs mean the firms whose employee is under 300 and capital is under 8 billion won(about 7.2 million dollar). We asked the manufacturer's perception about the relationship with the biggest supplier, and our key informants are denied to a person responsible for buying(ex)CEO, executives, managers of purchasing department, and so on). In detail, we contact by telephone to our initial sample(about 1,200 firms) and introduce our research motivation and send our questionnaires by e-mail, mail, and direct survey. Finally we received 361 data and eliminate 32 inappropriate questionnaires. We use 329 manufactures' data on analysis. The purpose of this study is to identify the anticipant role of business hazard (environmental dynamism, asset specificity) and investigate the moderating effect of control mechanism(formal control, social control) on conflict-performance relationship. To find out moderating effect of control methods, we need to compare the regression weight between low versus. high group(about level of exercised control methods). Therefore we choose the structural equation modeling method that is proper to do multi-group analysis. The data analysis is performed by AMOS 17.0 software, and model fits are good statically (CMIN/DF=1.982, p<.000, CFI=.936, IFI=.937, RMSEA=.056). IV. Result V. Discussion Results show that the higher environmental dynamism and asset specificity(on particular supplier) buyer(manufacturer) has, the more B2B conflict exists. And this conflict affect relationship quality and financial outcomes negatively. In addition, social control and formal control could weaken the negative effect of conflict on relationship quality significantly. However, unlikely to assure conflict resolution effect of control mechanisms on relationship quality, financial outcomes are changed by neither social control nor formal control. We could explain this results with the characteristics of our sample, SMEs(Small and Medium sized Enterprises). Financial outcomes of these SMEs(manufacturer or principal) are affected by their customer(usually major company) more easily than their supplier(or agent). And, in recent few years, most of companies have suffered from financial problems because of global economic recession. It means that it is hard to evaluate the contribution of supplier(agent). Therefore we also support the suggestion of Gladstein(1984), Poppo & Zenger(2002) that relational performance variable can capture the focal outcomes of relationship(exchange) better than financial performance variable. This study has some implications that it tests the sources of conflict and investigates the effect of resolution methods of B2B conflict empirically. And, especially, it finds out the significant moderating effect of formal control which past B2B management studies have ignored in Korea.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.91-99
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• 1999

Propose : This study was performed to find out the prognostic factors affecting local control, survival and disease free survival rate in nasopharyngeal carcinomas treated with chemotherapy and radiation therapy. Materials and Methods : We analysed 47 patients of nasopharyngeal carcinomas, histologically confirmed and treated at Chonnam University Hospital between July 1986 and June 1996, retrospectively. Range of patients' age were from 16 to 80 years (median; 52 years). Thirty three (70$\%$) patients was male. Histological types were composed of 3 (6$\%$) keratinizing, 30 (64$\%$) nonkeratinizing squamous cell carcinoma and 13 (28$\%$) undifferentiated carcinoma. Histoiogicai type was not known in 1 patient (2$\%$). We restaged according to the staging system of 1997 American Joint Committee on Cancer Forty seven patients were recorded as follows: 71: 11 (23$\%$), T2a; 6 (13$\%$), T2b; 9 (19$\%$), 73; 7 (15$\%$), 74: 14 (30$\%$), and NO; 7 (15$\%$), Nl: 14 (30$\%$), N2; 21 (45%), N3: 5 (10%). Clinical staging was grouped as follows: Stage 1; 2 (4$\%$), IIA: 2 (4$\%$), IIB; 10 (21$\%$), III; 14 (30$\%$), IVA; 14 (30$\%$) and IVB; 5 (11$\%$). Radiation therapy was done using 6 MV and 10 MV X- ray of linear accelerator. Electron beam was used for the Iymph nodes of posterior neck after 4500 cGy. The range of total radiation dose delivered to the primary tumor was from 6120 to 7920 cGy (median; 7020 cGy). Neoadjuvant chemotherapy was performed with cisplatin +5-fluorouracil (25 patients) or cisplatin+pepleomycin (17 patients) with one to three cycles. Five patients did not received chemotherapy. Local control rate, survival and disease free suwival rate were calculated by Kaplan-Meier method. Generalized Wilcoxon test was used to evaluate the difference of survival rates between groups. multivariate analysis using Cox proportional hazard model was done for finding prognostic factors. Results: Local control rate was 81$\%$ in 5 year. Five year survival rate was 60$\%$ (median survival; 100 months). We included age, sex, cranial nerve deflicit, histologic type, stage group, chemotherapy, elapsed days between chemotherapy and radiotherapy, total radiation dose, period of radiotherapy as potential prognostic factors in multivariate analysis. As a result, cranial none deficit (P=0.004) had statistical significance in local control rate. Stage group and total radiation dose were significant prognostic factors in survival (P=0.000, P=0.012), and in disease free survival rates (P=0.003, P=0.008), respectively. Common complications were xerostomia, tooth and ear problems. Hypothyroidism was developed in 2 patients. Conclusion : In our study, cranial none deficit was a significant prognostic factor in local control rate, and stage group and total radiation dose were significant factors in both survival and disease free survival of nasopharyngeal carcinoma. We have concluded that chemotherapy and radiotherapy used in our patients were effective without any serious complication.

• Journal of Soil and Groundwater Environment
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• v.14 no.2
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• pp.1-9
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• 2009

This study was objected to identify the effect on water quality and contamination by non-agricultural facilities in 'A' reservoir watershed located in OO city, Kyounggi-do, Korea. Ground- and stream water samples showed (Na+K)-Cl, Ca(Cl, SO$_4$) and Ca-Cl type in an illegally discharging area of sewage and a densely industrial area indicating water contamination. Stream water of an illegally discharging area of sewage had high COD, T-N and T-P. In this area, direct incoming of sewage into stream water was induced ground water system by well pumping, and it made a progress of ground water contaminations with those components. Groundwater of a densely industrial area showed high concentrations of T-N, NO$_3$N. From a nitrogen isotope analysis, stream water of an illegally discharging area of sewage has ${\delta}^{15}N-NO_3$values of 0.7%0 was strongly affected by nitrogen originated from agrochemicals, and a densely industrial area of 19.7%0 from septic system. Ground- and stream water of a livestock fanning area were contaminated with NH$_3$-N and Mn, which was affected by intensive livestock facilities. SAR-conductivity plot indicates the water does not pose either alkalinity or salinity hazard for irrigation. COD, T-N, T-P, NO$3$-N, NH$_3$N and Mn concentrations from contaminated areas were diminished by mixing with 'A' reservoir water. There were no water contaminations in silver towns, vacationlands around reservoir and golf links. Consequently, it should be made a plan of systematic managements for past and- present possible contaminants and sewage systems in preventing water contamination by non-agricultural facilities.

• Economic and Environmental Geology
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• v.45 no.3
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• pp.217-235
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• 2012

We evaluated the geochemical characteristics and their potential pollution of Asian Dusts in Daejeon, Korea during spring 2007. Compared with the chemical compositions of soils in source area of Asian Dust, those of aerosols in Daejeon were enriched with trace elements (ten to hundred fold), inferring that pollutants from China have affected on local environment in adjoining country such as Korea. Chemical analysis of aerosols during Asian dust showed that fine particles ($PM_{2.5}$) contained high contents of trace elements such as Cr, Cu, Pb, Zn, V, S, As, Cd, Co, Ni, Mo, Sb, Cs, Rb, Th, Sc and Y. In the case of TSP (Total Suspended Particle), Zr, Sr, Ba, Li, Th and U were contained much more than other trace elements. The contents of some elements (i.e. Li, Cs, Co, U, Cr, Ni, Rb, V, Th, Y, Sr and Sc) in aerosols collected in Asian Dust period, which are not likely enriched by air pollutants, were higher (2 - 4.2 fold) than those in Non Asian Dust period, indicating that these elements could be used as indicator elements for determining the occurrence of Asian Dust phenomena (especially, Sr, V, Cr & Li). In the case of Asian Dust coming through the big cities and/or industrial areas of China, the domestic aerosols had higher contents of trace elements (such as S, Cd, Zn, Pb, Cu, Mo and As) than those from Northeastern China via North Korea, indicating that the transportation courses of air mass are very important to determine the pollution degrees. Using the enrichment factors of trace elements in aerosols during Asian Dust and Non Asian Dust, we identified that some elements (i.e. S, Zn, Cu, Pb, As, Mo and Cd) were most problematic in terms of environmental hazard aspects, and these elements could affect adverse effects on human health as well as ecosystem and surface environment (soil and water) through long-lived precipitation.

• Journal of Gastric Cancer
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• v.20 no.2
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• pp.152-164
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• 2020

Purpose: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). Materials and Methods: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. Results: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693-4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664-1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595-85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502-5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618-3.028; P<0.001) were determined as independent prognostic factors for DFS. Conclusions: S-1 and CAPOX AC regimens did not show significant difference in over-5yr DFS after curative gastrectomy in patients with stage II or III GC. The pT, pN stage, and completion of planned chemotherapy were prognostic factors for GC recurrence.

• Korean Journal of Occupational Health Nursing
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• v.6 no.2
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• pp.144-155
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• 1997

In December 1990, Occupational Safety and Health Law was amended to reinforce employer's responsibilities on employees' health and safety. Among the amended law it was important to expand the role of an occupational health nurse to the role of an occupational health manager. An occupational health manager should take charge of coordinating periodic health examination and environmental hazard evaluation, providing primary care, monitoring employees' health status, giving the workplace walk-through, selecting safe protection equipment, providing health information, counseling and health education, independently. This position of occupational health nurse is equivalent to the role of doctors or occupational hygienists. In 1991, government made a master plan to prevent occupational disease and injury. Under the plan, Korea Industrial Nursing Association (KINA) was established in 1994 with the purpose of improving health services and upgrading career opportunities for members. Therefore, this study was designed to analyze the transition of occupational health nursing education with the changes of law and policy in Korea between 1991 and 1996. In details, it was to analyze the rate of school providing occupational health nursing practice based lecture, lecture hours, lecture contents in undergraduate curriculum, program contents of graduate school, kinds of continuing education, etc. For this purpose, we conducted survey two times. In February 1991, baseline study was conducted with all nursing programs in Korea (19 BSN programs and 43 nursing departments of junior college). From April to May in 1996, the second survey was conducted with all nursing programs (38 BSN programs and 69 junior colleges). The first response rate was 66.1% and the second was 40.6%. Structured questionnaires were mailed to the deans or the community health nursing faculties. In the case of graduate school, telephone survey was conducted with 10 school of public health or environmental health area. Data from the yearbook of Industrial Safety Training Institute (ISTI), the history of Korea Industrial Health Association, and the journals of KINA were also included in the analysis. As the results, we found that there were remarkable improvement in undergraduate and graduate programs, obligatory as well as voluntary continuing education in terms of occupational health nursing expertise between 1991 and 1996. 1) The number of school providing occupational health nursing practice-based lecture was increased with the rate from 7.3% to 25.6%. The rate of school giving over 15 class-hours was increased from 33.3% to 46.6%. 2) Content areas were composed of introduction of occupational health, occupational epidemiology, industrial hygiene, occupational disease and injury, law and policy, health education, concept of occupational health nursing, role of occupational health nurse, occupational health nursing process, etc. Of content areas, occupational health nursing process was more emphasized with the increased rate from 43.9% to 88.4%. 3) In the case of graduate school, occupational health programs were increased from 4 to 10. One of them has developed occupational health nursing program as an independent course since 1991. 4) The law increased educational hours from 28 hours to 36 hours for introductory course at the time of appointment, and from 14 hours to 24 hours every 2 years for continuing education. Course contents were Occupational safety and health law, introduction of occupational health, health education methodology, planning and evaluation, periodic health exam, occupational disease care, primary care, emergency care, management, industrial environment evaluation, etc. In 1996, Korea Industrial Nursing Association has begun to provide continuing education after Industrial Safety Training Institute. 5) Various educational programs in voluntary base were developed such as monthly seminar, CE articles, annual academic symposium, etc. It was shown that changes of law and policy led rapid growth of occupational health nursing education in various levels. From this trend, it is expected that occupational health nurse expertise be continuously to be enhanced in Korea. Legal and political supports should proceed for the development of occupational health nursing in early stage.

• Health Policy and Management
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• v.27 no.4
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• pp.273-275
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• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• Journal of Food Hygiene and Safety
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• v.21 no.1
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• pp.41-46
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• 2006

This study was carried out to survey the prevalence of foodborne pathogens in Sangshik products and their raw materials far the purpose of ensuring safety of those products in market, and establishing microbial regulatory standard. From 2002 to 2004, a total of 191 Sangshik products were purchased from market or mail-order sales, and major foodborne pathogens; E. coli, Salmonella, Staphylococcus aureus, Bacillus cereus, Clostridium perfringens, Listeria monocytogenes, Campylobacter jejuni, Yersinia enterocolitica, E. coli O157:H7, Vibrio parahaemolyticus were tested. B. cereus, C. perfringens and E. coli were detected from 29 samples (15.2%), 21 samples (11.0%) and 1 sample (0.5%), respectively. But other tested bacteria were not detected. For the identification of contamination source, 53 Sangshik ingredients were collected from 9 different manufacture factories. The results were similar with the Sangshik products. Aerobic plate counts were ranging from $1.0X10^3cfu/g\;to\;1.5X10^8cfu/g$. B. cereus was detected from 13 samples (24.5%), and counted as less than 100 cfu/g. C. perfringens were detected from 2 samples (3.8%), and counted as less than 100 cfu/g. Other foodborne pathogens were not detected except for B. cereus and C. perfringens. From the results, it was revealed that potential of microbial hazard by Sangshik was relatively low. However, it would be suggested that hygienic management and controling be needed for the prevention of growing contaminated pathogens and cross contamination during process and sale due to improper storage and management.

• Journal of Food Hygiene and Safety
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• v.29 no.3
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• pp.202-206
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• 2014

In this study, the bacteriological survey was examined on ice creams at manufacturing factories in Korea during the summer season of 2011. The nineteen selected among 166 samples by preliminary test were collected from 11 different manufacturing factories in four major manufacturers in May 2011. Samples from ice milk, ice creams, sherbets, and non milk fat ice creams were tested for the total aerobic bacteria, coliform bacteria, and five food borne pathogens, respectively. The results showed that the coliforms including E. coli O157:H7, Salmonella spp., Staphylococcus aureus, Clostridium perfringens, and Listeria monocytogenes were not detected on all the ice creams. The total aerobic bacteria of the packed samples examined ranged between $2.5{\times}10^3$ and $5.5{\times}10^5cfu/g$. One ice cream, two sherbets, and four ice milk samples exceeded the acceptable limits of total aerobic bacteria according to the Korean standards for ice cream ($1.0{\times}10^5cfu/g$) and others ($5.0{\times}10^4cfu/g$). The levels of these microorganisms from ice creams were higher in three original equipment manufacturers than seven self-manufacturers. Three of ten ice creams (30.0%), three of six ice milks (50.0%), and one of two sherbets (50%) exceeded the acceptable limits of total aerobic bacteria, respectively. The personnel hygiene procedures with chocolate and vanilla chip addition from the manufacturing process were the main sources of the microbial contamination of stick-bar type ice creams when being produced in a factory. Improvement of the hazard analysis critical control points (HACCP) system should be introduced into the ice cream factory to improve the microbial quality of the ice cream products in Korea.