• Radiation Oncology Journal
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• v.10 no.1
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• pp.7-14
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• 1992

Between August 1988 and December 1991, 24 patients with intracranial tumors were treated with stereotactic radiosurgery(RS) using a 10 MV linear accelerator at Severance Hospital, Yonsei University College of Medicine. There were 5 meningiomas, 3 craniopharyngiomas, 9 glial tumors, 2 solitary metastases, 2 acoustic neurinomas, 2 pineal tumors, and 1 non-Hodgkin's lymphoma. Ten patients were treated as primary treatment after diagnosis with stereotactic biopsy or neuroimaging study. Nine patients underwent RS for post-op. residual tumors and three patients as a salvage treatment for recurrence after external irradiation. Two patients received RS as a boost followed by fractionated conventional radiotherapy. Among sixteen patients who were followed more than 6 months with neuroimage, seven patients (2 meningiomas, 4 benign glial tumors, one non-Hodgkin's lymphoma) showed complete response on neuroimage after RS and nine patients showed decreased tumor size. There was no acute treatment related side reaction. Late complications include three patients with symptomatic peritumoral brain edema and one craniopharyngioma with optic chiasmal injury. Through this early experience, we conclude that stereotactically directed single high doses of irradiation to the small intracranial tumors is effective for tumor control. However, in order to define the role of radiosurgery in the management of intracraniai tumors, we should get the long-term results available to demonstrate the benefits versus potential complications of this therapeutic modality.

• CRM연구
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• v.3 no.2
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• pp.21-41
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• 2010

The current research was conducted to examine the factors that affect outsourcing performances, and further investigate whether a discrepancy in performance exists between the medical institutions and hotel service institutions. The study surveyed both medical and hotel administrators for approximately two months, who managed outsourcing tasks. Total of 325 responses out of 350 distributed were collected. However, due to inadequate responses, six responses were excluded, amounting to total of 319 (155 medical institutions, 164 hotels) valid responses included in the final analysis. First, the informal outsourcing relationships between representatives of outsourcing service seekers and providers did not appear to have significant effects in terms of the levels of trust in neither medical institutions nor hotel industries. However, the relationships affected outsourcing degrees exclusively in medical institutions, showing the disparity between the two service institutions. This was explained due to the continuing long term efforts required to establish an informal relationship in medical institutions. Second, communication was shown to have positive effects on levels of trust in both medical institutions and hotel industries. This indicates a prominent outsourcing trait that emphasizes the significance of mutual cordial communication that contributes to establishing positive relationships. Third, opportunistic behavior of the outsourcing service providers appeared to negatively affect the levels of trust as well as outsourcing degrees for both medical and hotel industries. Therefore, opportunistic behaviors were found to have more tendencies to causing tension and discomfort rather than creating a relationship based on mutual credibility or conviviality. Fourth, the effect of service infrastructures on the level of trust did not appear to be significant on medical institutions, while showing positive influence on hotel industries. Additionally, service infrastructures were found to positively influence the outsourcing performance levels for both sectors. Fifth, trust between outsourcing service seekers and providers did not appear to have noticeable impact on the outsourcing degrees for either institution. On the contrary, trust appeared to have positive impacts on performance for both institutions. This further indicates that, when engaging in outsourcing, strengthening relationships through mutual partnership with outsourcing entities rather than establishing contractual relationships leads to improving the reciprocal trust, which in turn improves work results. Lastly the outsourcing degree of service seekers appeared to have positive impact on the outsourcing performance for both medical institutions and hotel industries, indicating the causal relationship between the affectability of outsourcing degrees and the following performance results.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.13 no.2
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• pp.159-175
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• 2018

The purpose of this study was to identify the factors that could overcome the crisis and adversity of the nursing care provider through understanding the effect of job adaptation on the turnover intention of the nursing care provider and to contribute to the various problems of the nursing care provider in the long term. In order to confirm this as an empirical research task, risk factors and protection factors, general characteristics of the survey subjects, job adaptation and turnover intention were selected, and the risk factors and protective factors of caregivers' As a mediator. So Seoul. The results of the questionnaire survey were as follows: 291 caregivers in the elderly medical welfare facilities in Gyeonggi area. First, as the relationship between the risk factors and protective factors of occupational caregivers and occupational adaptation were more severe, the higher the maladjustment of the workplace culture, the more the job satisfaction and organizational commitment were adversely affected. The emotional support, The higher the information support, the more satisfied and satisfied the job. Second, the relationship between the risk factors of the caregiver and the protective factors and the turnover intention, the higher the conflict of caregivers, the more unstable the workplace, the more difficult it is to adapt to work culture, Respectively. Finally, as a result of verifying the mediating effect of occupational adaptation on the relationship between risk factors and protective factors and turnover intention of caregivers, job satisfaction, which is a sub-factor of job adaptation, It is shown that they play mediating roles only in the relationship between stress and turnover intention, and do not play a mediating role in the relationship between protective factor self - efficacy and social support and turnover intention. In other words, if caregivers feel satisfaction about their job, they can be less stressed on their jobs, improve their self-efficacy, and have a positive attitude toward social support. Also, it was found that the more the caregiver 's immersion into the organization, the less job stress and turnover intention decreased, but the self - efficacy and social support perception were not influenced. Based on this, the director of the facility should strive to stabilize the operation of the facility and provide high-quality services by seeking ways to improve conflict resolution and adaptation to the workplace culture so that nursing care workers can adapt to their work. And it is required to develop active management strategies and institutional support for improving job satisfaction and organizational commitment of caregivers.

• Korean Journal of Ecology and Environment
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• v.43 no.3
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• pp.385-399
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• 2010

The objective of this study was to analyze long term temporal trends of water chemistry and spatial heterogeneity for 83 sampling sites of Geum-River watershed using water quality dataset during 2003~2007 (obtained from the Ministry of Environment, Korea). The water quality, based on multi-parameters of temperature, dissolved oxygen (DO), biochemical oxygen demand (BOD), chemical oxygen demand (COD), suspended solids (SS), total nitrogen (TN), total phosphorus (TP), and electric conductivity (EC), largely varied depending on the landuse patterns, years and seasons. The watershed was classified into three different landuse types: forest stream (Fo), agricultural stream (Ag), and urban stream (Ur). Largest seasonal variabilities in most parameters occurred during the two months of July to August and these were closely associated with large spate of summer monsoon rain. Conductivity, used as a key indicator for an ionic dilution during rainy season, and nutrients of TN and TP had inverse functions of precipitation. BOD, COD decrease during the rainy season. Minimum values in the conductivity, TN, and TP were observed during the summer monsoon, indicating an ionic and nutrient dilution of river water by the rainwater. In contrast, major inputs of suspended solids (SS) occurred during the period of summer monsoon. The landuse patterns analyses, based on the variables of BOD, COD, TN, TP and SS, showed that the values were greater in the agricultural stream (Ag) than in the forest stream (Fo) and urban stream (Ur) and that water quality was worst in the urban stream (Ur). The overall dataset suggest that efficient water quality management, especially in Gap-Stream and Miho-Stream, which showed worst water quality is required along with some of urban stream (Ur), based on the analysis of landuse patterns.

• Journal of Food Hygiene and Safety
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• v.33 no.1
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• pp.1-11
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• 2018

It is ten years since the Good Agricultural Practices (GAP) certification system was implemented in Korea, and the government aims to acquire GAP certification up to 25% of the total agricultural areas by 2022. As of the end of 2017, 6.3% of the total cultivated area and 8.1% of the total farm households were certified, which is slower than expected. The purpose of this study was to investigate the causes of the GAP accreditation through the surveys and on site inspections of the GAP certified farmers and to propose the development plans according to the problems analysis of the current system in order to expand the GAP certification. Certified farmers recognized the need for agricultural safety and hygiene, but there were a lot of nonconformities regarding practical practices. This is due to the ambiguity of the certification standards and the wrong ways in the training method for the producers. GAP certification is slow to expand to farmers and low consumer awareness is considered a structural problem of GAP certification system, and improvement measures are needed accordingly. It is necessary to convert the state-led GAP certification system into a state-led private certification system. It is necessary for the government to focus on policy, research and follow-up management. In addition, it is necessary to establish a separate organization in the form of a contribution organization for the certification, education, and public relations. In addition, long-term plan must be established and systematically carried out. It is necessary to integrate too many certification agencies compared to the farming scale of Korea, and it is necessary to realize the application fee for realizing the financial independence of the certification body and correct certification work. In addition, inspector qualification standards should be strengthened and training system should be improved to nurture high quality inspectors. Simplified certification standards based on statutes need to be subdivided into practical action plans. In order to improve the GAP certification system, it is necessary to have a discussion through a committee composed of specialists from industry and academia, and it will be possible to contribute to the safety of the food of the people through the production of safe by drawing concrete development plans.

• Journal of Korea Water Resources Association
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• v.45 no.10
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• pp.969-981
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• 2012

In this study, we analysed hydrologic variability in quantity and onset of annual maximum flow and low flow by impacts of the different phases of ENSO (El Ni$\tilde{n}$o Southern Oscillation) over the Han River Basin. The results show that annual maximum flow has increased statistically significant about 48.3% of all over the watershed. The onset of annual maximum flow was delayed in the west of the Han River basins and in the east of the basins was likely to be rapid onset. Also, this study shows that 7-day low flow was deceased statistically significant about 26.0% of the total area in the Han River Basin, and onset of 7-day low flow tends to be faster in the upper-middle basins of the Han River. The onset of annual maximum flow shows similar pattern during the CT (Cold tongue)/WP (Warm-pool) El Ni$\tilde{n}$o years, but annual maximum flow appeared less in 89.0% of all basins during the CT El Ni$\tilde{n}$o years. In addition, the onset of 7-day low flow tended to be faster about 17 days on average during the WP El Ni$\tilde{n}$o years, and 72.7% of the basins show significant increase during the CT El Ni$\tilde{n}$o years. Consequently, it was found that the different phases of CT/WP El Ni$\tilde{n}$o have effects on sensitivity to variability in quantity and onset of water resources over the Han River Basin. We expect that the present diagnostic study on hydrological variability during different phases of ENSO will provide useful information for long-term prediction and water resources management.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.274-282
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• 2002

Background: Paravalvular leakage or false aneurysm developed after isolated aortic valve replacement(AVR) for aortic regurgitation(AR) associated with Behcet's disease is one of the most serious complications, and requires subsequent reoperations. We describe the surgical result of homograft aortic root replacement(ARR) for AR associated with Behcet's disease. Material and Method: From January 1992 to December 2001, 6 patients with AR associated with Behcet's disease underwent 7 ARR with homograft and 1 Ross operation. Five patients were male and one was female. The grafts used for ARR were 5 aortic and 2 pulmonic homografts. Ages at operation ranged from 27 to 51 years(mean, 37$\pm$9 years). Two patients underwent ARR with aortic homograft at the first operation. In the remaining 4 patients, ARR using a homograft was performed for paravalvular leakage that developed after AVR, and the mean interval from AVR to ARR was 21 $\pm$29 months(range, 5 to 73.3 moths, median, 7.6 months). Result: There was no early death. All patients were followed up for an average of 18.9$\pm$24.0 months(range, 1.9 to 68.9 months, median, 8.4 months). Two of 4patients who had undergone ARR after AVR required subsequent reoperations for false aneurysm of the ascending aorta and failure of pulmonary homograft. One patient underwent re-replacement of the aortic root, ascending aorta and partial aortic arch with an aortic homograft, the other underwent Ross operation. Conclusion: This study suggests that aortic root replacement using a homograft in aortic regurgitation with Behcet's disease may provide good clinical results and decrease the incidence of paravalvular leakage or false aneurysm after aortic valve replacement. However, the adequate perioperative management and complete removal of the inflarrunatory tissue at operation were also important for the good long-term results.

• Korean Journal of Ecology and Environment
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• v.39 no.1 s.115
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• pp.73-84
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• 2006

The objective of this study was to analyze long-term temporal trends of water chemistry and spatial heterogeneity for 10 sampling sites of the Yeongsan River watershed using water quality dataset during 1995 to 2004 (obtained from the Ministry of Environment, Korea). The water quality, based on multi-parameters of biological oxygen demand (BOD), chemical oxygen demand (COD), conductivity, dissolved oxygen (Do), total phosphorus (TP), total nitrogen (TN) and total suspended solids (TSS), largely varied depending on the sampling sites, seasons and years. Largest seasonal variabilities in most parameters occurred during the two months of July to August and these were closely associated with large spate of summmer monsoon rain. Conductivity, used as a key indicator for a ionic dilution during rainy season, and nutrients of TN and TP had an inverse function of precipitation (absolute r values> 0.32, P< 0.01, n= 119), whereas BOD and COD had no significant relations(P> 0.05, n= 119) with rainfall. Minimum values in conductivity, TN, and TP were observed during the summer monsoon, indicating an ionic and nutrient dilution of river water by the rainwater. In contrast, major inputs of total suspended solids (TSS) occurred during the period of summer monsoon. BOD values varied with seasons and the values was closely associated (r=0.592: P< 0.01) with COD, while variations of TN were had high correlations (r=0.529 : P< 0.01) with TP. Seasonal fluctuations of DO showed that maximum values were in the cold winter season and minimum values were in the summer seasons, indicating an inverse relation with water temperature. The spatial trend analyses of TP, TN, BOD, COD and TSS, except for conductivity, showed that the values were greater in the mid-river reach than in the headwater and down-river reaches. Conductivity was greater in the down-river sites than any other sites. Overall data of BOD, COD, and nutrients (TN, TP) showed that water quality was worst in the Site 4, compared to those of others sites. This was due to continuous effluents from the wastewater treatment plants within the urban area of Gwangju city. Based on the overall dataset, efficient water quality management is required in the urban area for better water quality.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.715-721
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• 1999

Background:The number of old patients receiving coronary artery bypass grafting(CABG) is increasing. With the more recent advances in operative techniques, the age at which CABG is indicated has also increased. This study evaluated the risk factors associated with the hospital mortality and the morbidity following CABG in elderly patients. Material and Method: Between March 1991 and June 1998, we retrospectively reviewed 45 consecutive patients aged 65 years or older who underwent CABG. We compared the data with the results of 179 patients under the age 65 years operated during the same period. Result: Mean age was 68${\pm}$1.41 years(range 65 to 74 years). Emergency surgery was required in 4, and elective surgery in 41 patients. The mean number of distal anastomosis per patient was 3.62 ${\pm}$0.81 and mean aortic cross-cramp time was 69.84${\pm}$18.5 minutes. Thirty patients had Canadian class III or IV preoperatively, but 43 patients had class I or II postoperatively. The left ventricular ejection fraction increased significantly from 54.23${\pm}$10.62% preoperatively to 58.14${\pm}$9.88% postoperatively(p<0.05). Postoperative complication was pneumonia in 2 patients, acute renal failure in 2 patients, sternal wound infection in 1 patient, and postoperative myocardial infarction in 1 patient. There were two postoperative deaths. The causes of deaths were low output syndrome in one patient, and sepsis due to pneumonia in the other patient. The hospital mortality was higher in the elderly group(4.4 versus 2.86%) but was not statistically significant(p>0.05). Incremental risk factors for hospital deaths in the elderly were emergent operation, preoperative PTCA, postoperative use of IABP and postoperative ARF(p<0.05). The duration of hospital stay after operation was significantly longer for the elderly group than the younger group(19.27${\pm}$12.51 vs 15.55${\pm}$6.99 days; p＜ 0.05). Follow-up was complete for 34 of the hospital survivors and ranged from 1 to 73 months(mean: 23.58${\pm}$19.56 months). There was no late mortality of cardiac origin. Conclusion: Age is an important factor in selecting optimal management for elderly patients with coronary compromise, but age alone should not dictate the choice of therapy. Coronary artery bypass surgery in the elderly is associated with acceptable early mortality and excellent long-term results.

• Korean Journal of Environmental Agriculture
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• v.24 no.2
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• pp.106-116
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• 2005

This experiment was conducted to investigate available extraction capacity and potential mobility of heavy metal according to the distribution property and contamination level of heavy metals in soils and to suggest a reform measure of soil environment assessment methodology applied with soil quality and the official soil heavy metal test methods in domestic and foreign countries. The soils were collected from the natural forest paddy with long-term application of same type fertilizer, and paddies near metal mine and industrial complex. The post-treatment methods of soil were partial extraction, acid digestion and sequential extraction methods. For the heavy metal contents with different soil properties, it was shown that their natural forest and paddy soil were slightly low and similar to the general paddy soil, while their paddies near metal mine and industrial complex were higher than the standard level of Soil Environment Protection Act. Heavy metal concentrations in the soils with different soil properties had difference between $HNO_3\;and\;HNO_3+HCl$ extractant by US-EPA 3051a method. There were highly significant positive relationships in both two methods. It was appeared that the higher extractable concentration ratio with 0.1N-HCl to total heavy metal content with $HNO_3+HCl$ extractant the greater total heavy metal content. There were highly significant positive correlationship between total heavy metal content and extractable content with 0.1N-HCl. For extractable capacity of soil extractable solution compared to the total heavy metal content it was appeared that it extractable method with 0.1N-HCl was higher than those with EDTA and DTPA. In extractable ratio with 0.1N-HCl in the contaminated paddy soils near mine and industrial complex, it was shown that the lower soil pH, the higher total heavy metal content. The order of a potential mobility coefficient by distribution of heavy metal content with ie different typies in the soil was Cd>Ni>Zn>Cu>Pb. It could be known that contamination characteristics of heavy metals with different types of soils were affected by different heavy metal components, contamination degree and soil chemical properties, and heavy metal concentration with different extractable methods had great variations with adjacent environment. To be compared with assessment methodology of soil environment impact at domestic and foreign countries with our results, it might be considered that there was necessary to make a single analysis method based on total heavy metal content with environmental overloading concept because of various analysis methods for total heavy metal content and present analysis method with great variation according to soil environment. In spite of showing higher concentration of heavy metal with acidic digestion than the extractable method, it might be considered that there is need to be adjusted the national standard of soil heavy metal contamination.