Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.
Journal of the Korea Academia-Industrial cooperation Society
/
v.19
no.4
/
pp.481-491
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2018
As the global business environment is dynamic, uncertain, and complex, supply chain management determines the performance of the supply chain in terms of the utilization of resources and capabilities of companies involved in the supply chain. Companies pursuing open innovation gain greater access to the external environment and accumulate knowledge flows and learning experiences, and may generate better business performance from dynamic capabilities. This study analyzed the effects of supply chain dynamic capabilities, open innovation, and supply uncertainty on supply chain performance. Through questionnaires on 178 companies listed on KOSDAQ, empirical results are as follows: First, integration and reactivity capabilities among supply chain dynamic capabilities have a positive effect on supply chain performance. Second, the moderating effect of open innovation showed a negative correlation in the case of information exchange, and a positive correlation in the cases of integration, cooperation and reactivity. Third, two of the 3-way interaction terms, "information exchange*open innovation*supply uncertainty" and "integration*open innovation*supply uncertainty" were statistically significant. The implications of this study are as follows: First, as the supply chain needs to achieve optimization of the whole process between supply chain components rather than individual companies, dynamic capabilities play an important role in improving performance. Second, for KOSDAQ companies featuring limited capital resources, open innovation that integrates external knowledge is valuable. In order to increase synergistic effects, it is necessary to develop dynamic capabilities accordingly. Third, since resources are constrained, managers must determine the type or level of capabilities and open innovation in accordance with supply uncertainty. Since this study has limitations in analyzing survey data, it is necessary to collect secondary data or longitudinal data. It is also necessary to further analyze the internal and external factors that have a significant impact on supply chain performance.
As the frequency and intensity of catastrophic disasters increase, there is widespread public sentiment that government capacity for disaster response and recovery is fundamentally limited, and that the involvement of civil society and the private sector is ever more vital. That is, in order to strengthen national disaster response capacity, governments need to build disaster systems that are more participatory and function through the channels of civil society, rather than continuing themselves to bear sole responsibility for these "wicked problems." With the advancement of smart mobile technology and social media, government and society as a whole have been called upon to apply these new information and communication technologies to address the current shortcomings of government-led disaster management. As illustrated in such catastrophic disasters as the 2011 Tohoku earthquake and tsunami in Japan, the 2010 Haitian earthquake, and Hurricane Katrina in the United States in 2005, the realization of participatory potential of smart technologies for better disaster response has enabled citizen participation via new smart technologies during disasters and resulted in positive impact on the management of such disasters. In this context, this study focuses on the South Korean context, and aims to analyze Korean government officials' readiness for public participation using smart technologies. On this basis, it aims to offer policy suggestions aimed at promoting smart technology-enabled citizen participation. For this purpose, it proposes a particular model, termed SMART (System, Motivation, Ability, Response, and Technology).
In some documentary films, there are interviews, but in some other ones, there aren't any. As for the documentaries with interviews, the director uses talking heads to suggest their own arguments and to have audience agree. It is evident that interviews play a key role since they lead the story of a human-related documentary. Some directors prefer interviews where directors' questions and interviewees' answers are both heard. On the other hand, there a re directors who carry out the story just by using the answers from the interviewees. Then, it becomes crucial that we understand both of these styles and have new perspectives when watching documentary films. Ethics has always been considered one of the most important factors in documentaries and since they are believed to be "true," the influence documentaries have on the society is enormous. However, possibilities of exaggerating or manipulating the "truth" always exist. Therefore, it is important for the audience to identify the intentions of the director. As a matter of fact, there have been countless researches being done, but it is difficult to find studies that discuss the ways interviews are used in documentary films. The two different styles mentioned above do have huge differences in terms of directing methods. Thus, taking a look at differences from diverse angles will help us better understand the essentials of documentary films. This study will take examples from the interviews in Michael Moore's (2002), (2007) and observe how the flow of interviews can change when the voice of the director gets involved. There will also be a close examination of interviews in Kim Ilran and Hong Ji Yoo's (2011), and (2005) directed by Jim Butterworth, Aeron Lubarsky, and Lisa Sleeth, as well as Sebastian Junger and Tim Hetherington's (2010). By a careful review, use of dissolve, cross-cutting, and flashback will be analyzed to show how different editing techniques have an impact on subjective views of the director.
The purpose of this study was to examine the relationship between the lifestyle of dental consumers and their hospital satisfaction level in an attempt to lay the foundation for successful dental marketing strategy setting. The subjects in this study were 720 medical consumers who visited dental institutions in Jeolla buk-do province. A survey was conducted from October 1 to December 1, 2006, with self-administered questionnaires. The collected data were analyzed with SPSS(Statistical Package for the Social Science) 12.0 program to find out their lifestyle and hospital satisfaction level. Concerning the impact of lifestyle on satisfaction with dental institutions, lifestyle made a difference to the satisfaction level of the hospital users with promptness and economicality(p < 0.001). As to connections between hospital-reuse intention and satisfaction level, those who were willing to reuse the dental institutions they had visited expressed better satisfaction with promptness(p < 0.05). As for links between health-related lifestyle and hospital satisfaction level, health conscious style, health promoting style health unconscious styles had a statistically significantly positive relationship to hospital satisfaction level, which showed a significant relationship between the three lifestyles and hospital satisfaction level. As for factors affecting reuse of dental institutions, it's found that their intention to reuse the same dental institution they had visited was linked to their satisfaction level with it, what made them choose it and their health-related lifestyle. In the future, more precise and in-depth questionnaires should be developed to analyze the health-related lifestyle of medical consumers.
The factors contributing to the formation of an important scientific concept in South Korea and its circulation in the society are the scientific knowledge that had been already formed, matured, and established in the U.S.A, Europe and Japan and has been introduced into Korea, and the institutions that have been formed during the recent modernization in South Korea. The concept of 'genetic information' cannot be an exception in this context. The concept of genetic information is the one that has been extended and intensified by the genomics and bioinformatics formed and matured through the Human Genome Projects from the former concept of inheritance or heredity within the framework of classical and molecular genetics. The purpose of this study was to find out 'how the production structure of genetic information in South Korea has been formed', under the perspective of the conceptual, epistemic, and institutional holisticity or integratedness in the concept and knowledge production structure idealized in Western advanced nations. The discourse of genetic engineering popular in the mid 1980's in South Korea has catalyzed the development of molecular biology. However, the institutional balance that had been established for the biochemistry departments in Natural Science College and Medical College was not formed between the genetic engineering and genetics departments in South Korea. Therefore, they were unable to achieve the more integrative and macro-level disciplinary impact on life sciences, largely due to institutional lack of the capable (human) genetics departments in some leading Korean colleges of Medicine. In genomics, the cutting-edge reprogramming and restructuring of the traditional genetics in the West, South Korea has not invested, even meagerly, in the infrastructure, fund, and research and development (R & D) for the Basic or First Phase of the research trajectory in the Human Genome Project. Without a minimal Basic Phase, the genomics research and development in Korea has been running more or less for the Advanced or Second Phase. Bioinformatics has started developing in Korea under a narrow perspective which regards it as a mere sub-discipline of information technology (IT). Having developed itself in parallel with genomics, bioinformatics contains its own unique logics and contents that can be both directly and indirectly connected to the information science and technology. As a result, bioinformatics reveals a defect in respect of being synergistically integrated into genetics and life sciences in Korea. Owing to the structural problem in the production, genetic information appears to be produced in a fragmented pattern in the Korean society since its fundamental base is weak and thin. A good example of the conceptual and institutional fragmentedness is that 'the genetics of individual identification' is not a normal integrated part of the Korean genetics, but a scientific practice exercised in the departments of legal medicine in a few Medical Colleges. And the environment contributing to the production structure of genetic information in South Korea today comprises 'sangmyung gonghak'(or life engineering) discourse and non-governmental organization movement.
Background : Smoke inhalation injury is an important determinant of mortality in burn patients. The early detection of inhalation injury in burn patients is important because the incidence of respiratory failure after inhalation injury was known to be high, with hypoxemia, pneumonia, and prolonged ventilatory support being commonplace. Acute carbon monoxide poisoning was one feature of smoke inhalation. The purpose of our study were to investigate the clinical characteristics of burn patients whose initial arterial carboxyhemoglobin (COHb) level had been elevated, to assess the clinical impact of COHb for smoke inhalation injury. Methods : Among 1,416 burn patients had been admitted at our institution from August 1, 2001 to July 31, 2002, 39 patients whose initial arterial COHb level have been more than 5% were included. We compared clinical scoring system for inhalation injury, percent total body surface area (%TBSA) burn, initial chest X-ray findings, APACHE II scores and SAPS II scores between survivors (n=27) and non-survivors (n=12) retrospectively. Results : COHb level were 9.7(5.71% and 10.3(8.81% in survivors and in non-survivors (p>0.05). Mean %TBSA burn of survivors and non-survivors were $16.6{\pm}17.8%$ and $60.7{\pm}28.8%$ (p<0.001). We did not find any difference in clinical scoring system, initial chest X-ray findings in survivors and in non-survivors. But %TBSA burn, APACHE II and SAPS II scores were high in non-survivors than in survivors significantly. Important factors associated with death were %TBSA burn, APACHE II scores, SAPS II scores, and the most important factor in predicting mortality was %TBSA burn. Conclusion : Burn patients with elevated initial arterial COHb level showed poor prognosis, but further study may be performed to know that the effect of COHb on prognosis in burn patients accompanying smoke inhalation.
Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.
Using data from the Korean Labor & Income Panel Study (KLIPS), this study investigates private income transfers in Korea, where adult children have undertaken the most responsibility of supporting their elderly parents without well-established social safety net for the elderly. According to the KLIPS data, three out of five households provided some type of support for their aged parents and two out of five households of the elderly received financial support from their adult children on a regular base. However, the private income transfers in Korea are not enough to alleviate the impact of the fall in the earned income of those who retired and are approaching an age of needing financial assistance from external source. The monthly income of those at least the age of 75, even with the earning of their spouses, is below the staggering amount of 450,000 won, which indicates that the elderly in Korea are at high risk of poverty. In order to analyze microeconomic factors affecting the private income transfers to the elderly parents, the following three samples extracted from the KLIPS data are used: a sample of respondents of age 50 or older with detailed information on their financial status; a five-year household panel sample in which their unobserved family-specific and time-invariant characteristics can be controlled by the fixed-effects model; and a sample of the younger split-off household in which characteristics of both the elderly household and their adult children household can be controlled simultaneously. The results of estimating private income transfer models using these samples can be summarized as follows. First, the dominant motive lies on the children-to-parent altruistic relationship. Additionally, another is based on exchange motive, which is paid to the elderly parents who take care of their grandchildren. Second, the amount of private income transfers has negative correlation with the income of the elderly parents, while being positively correlated with the income of the adult children. However, its income elasticity is not that high. Third, the amount of private income transfers shows a pattern of reaching the highest level when the elderly parents are in the age of 75 years old, following a decreasing pattern thereafter. Fourth, public assistance, such as the National Basic Livelihood Security benefit, appears to crowd out private transfers. Private transfers have fared better than public transfers in alleviating elderly poverty, but the role of public transfers has been increasing rapidly since the welfare expansion after the financial crisis in the late 1990s, so that one of four elderly people depends on public transfers as their main income source in 2003. As of the same year, however, there existed and occupied 12% of the elderly households those who seemed eligible for the National Basic Livelihood benefit but did not receive any public assistance. To remove elderly poverty, government may need to improve welfare delivery system as well as to increase welfare budget for the poor. In the face of persistent elderly poverty and increasing demand for public support for the elderly, which will lead to increasing government debt, welfare policy needs targeting toward the neediest rather than expanding universal benefits that have less effect of income redistribution and heavier cost. Identifying every disadvantaged elderly in dire need for economic support and providing them with the basic livelihood security would be the most important and imminent responsibility that we all should assume to prepare for the growing aged population, and this also should accompany measures to utilize the elderly workforce with enough capability and strong will to work.
The purpose of this experiment lies in finding the most appropriate cutting condition of Taxus cuspidata Sieb. et Zucc. which has been considered valuable tree species in gardening. Statistical analysis was focused on the comparison of the average ratios of rooting between greenhouses and fields, based on the observation rooted autogenis. To conduct this survey, hardwood cutting of Taxus cuspidata Sieb. et Zucc. were performed at both places of experiment above on April 20, 1982 with rooting results calculated on October 31, 1982. After formation of cuttings, it was soaked in IBA 200 ppm for 12 hours and than put in a bed. A summary of the result is presented as follows; 1) Cutting at the greenhouse showed higher average rate of rooting than at fields. Same tendency was found regardless of the differences in treatment. 2) It was clear that IBA-treatment contributed remarkably to causing higher average rooting rate. As an evidence, when twenty centimeter cuttings were inserted sandy media, IBA-treated area resulted in eighty six percent of average rooting rate, as compared with only twenty three percent in nontreatment case. In case of field cutting, IBA-treatment brought about fifty three percent of rooting in comparison with eleven percent nontreatment. 3) When sandy soil, loam and brown soil were separately used as cutting media, the highest rooting rate was found in case of sandy soil, without any difference between the two experimental places above. 4) As a result of the analysis to seek the impact of the length of cuttings on rooting, the range of length form fifteen to twenty centimeter was apparently most appropriate. It was also found that the rate of rooting declined beyond twenty five centimeter. 5) Two kinds of rooting pattern were observed. One was the case that callus cell lump was created on the lower cut side of cuttings. Importantly, root radical were formed inside the lump to influence the germination of root system. The other relates to the case that adventitious root which look like lateral roots appeared at the stem region. In abstract, first, sandy soil was effectively recommended in case of hardwood cutting in April. Second, the most appropriate length of cuttings ranged between fifteen and twenty centimeters. Third, high density IBA treatment was clearly effective. Forth, for proper environmental management, both pre-disinfection of sail by sterilizer and maintenance of high relative humidity were essentially required.
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