• Journal of Korean Society of Forest Science
• /
• v.52 no.1
• /
• pp.37-49
• /
• 1981

The purpose of the study is to find out the objective method of valuation on the forest stands through the analysis of logging costs that is positively related to timber production. The two forest (Amgog, Whangryoung), located nereby, but forest type, logging and skidding conditions being slightly different, were slected to carry out the study. The objective timber stumpage value were determined by investigating the appropriate timber production costs and profits of logging operations. The main result obtained in this study are as follows: 1. The rate of logging cost in consisting of timber market price is 13.15% in the area of Amgog logging place and 19.48% in Whangryoung. 2. The rate of the other production cost excluding logging cost is 15.36% in the area of Amgog logging place and 28.85% in Whangryoung. 3. The total rate of timber production cost in consisting of the market price is more than 28.51% in the area of Amgog logging place and 48.33% in Whangryoung, 4. Though the productivity of forest land is affected by the selection of tree species, tending, treatments and effective management of forest land, the more important problem is improvement of logging condition. 5. The rate of production cost in timber price is so high that we should endeavore to improve the productivity of labour and its quality, and minimize the difference of piece work per day in accordance to the various site condition. 6. Although the profit of forest industry is related to the period of recapturing investment, it is more closely related to the working condition, risk of investment and continuous change of social investment interest. 7. If the right variables which are related to the timber market, are objectively obtained, the stumpage value of mature forests can be objectively caculated by applying straight line discounting method or compound discounting method in caculating the stump to market price.

• Journal of Chest Surgery
• /
• v.41 no.3
• /
• pp.329-334
• /
• 2008

Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

• Radiation Oncology Journal
• /
• v.17 no.2
• /
• pp.113-119
• /
• 1999

Purpose : To evaluate possible acute toxicity and early response of concurrent radiation therapy and low dose daily cisplatin as a radiosensitizer in patients with locally advanced uterine cervical carcinomas. Materials and Method : From December 1996 to January 1999, 38 previously untreated Patients with locally advanced squamous cell carcinoma of the uterine cervix (from stage IIB to stage IIIB) were treated at Inha University Hospital. All patients underwent standard pretreatment staging Procedures after the initial evaluation by gynecologists and radiation oncologists. Sixteen Patients with huge cervical mass (>4 cm) were submitted to the group treated with concurrent radiation therapy and low dose daily cisplatin while the remainder was treated with radiation therapy alone. Radiation therapy consisted of 4500 cGy external beam irradiation to whole pelvis (midline block after 3000 cGy), 900$\~$1000 cGy boost to involved parametrium, and high dose-rate intracavitary brachytherapy (a total dose of 3000$\~$3500 cGy/500 cGy per fraction to point A, twice per week). In the group treated with low dose cisplatin concurrently, 10 mg of daily intravenous cisplatin was given from the 1st day of radiation therapy to the 20th day of radiation therapy. Acute toxicity was measured according to expanded common toxicity criteria of the NCI (C) Clinical Trials. Early response data were analyzed at minimum 4 weeks' follow-up after completion of the treatment protocol. Results: Hematolgic toxici쇼 was more prominent in patients treated with radiation therapy and cisplatin. Six of 16 patients (37.5$\~$) treated with radiation therapy and cisplatin and one of 22 patients (4.5$\~$) treated with radiation therapy alone experienced grade 3 leukopenia. In Fisher's exact test, there was statistically significant difference between two groups regarding leukopenia (P=0.030). There was no apparent difference in the frequency of gastrointestinal and genitourinary toxicity between two groups (P=0.066). Three of 16 patients (18.7$\~$) treated with radiation therapy and cisplatin and two of 22 patients (9.1$\~$) treated with radiation therapy alone experienced more than 5 kg weight loss during the treatment. There was no statistically significant difference on weight loss between two groups (P=0.63). Two patients on each group were not evaluable for the early response because of incomplete treatment. The complete response rate at four weeks' follow-up was 80$\~$(16/20) for the radiation therapy alone group and 78$\~$ (11/14) for the radiation therapy and cisplatin group. There was no statistically significant difference in early response between two treatment groups (P=0.126). Conclusion : This study led to the conclusion that the hematologic toxicity from the treatment with concurrent radiation therapy and low dose daily cisplatin seems to be more prominent than that from the treatment of radiation therapy alone. There was no grade 4 hematologic toxicity or mortality in both groups. The hematologic toxicity in both treatment groups seems to be well managable modically. Since the risk factors were not balanced between two treatment groups, the direct comparison of early response of both groups was not possible. However, preliminary results regarding early response for patients with bulky cervical tumor mass treated with radiation therapy and low dose daily cisplatin was encouraging. Longer follow-up is necessary to evaluate the survival data. A phase III study is needed to evaluate the efficacy of concurrent daily low dose cisplatin with radiation therapy in bulky cervical cancer.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.2
• /
• pp.201-209
• /
• 1996

Background : Auto-PEEP which develops when expiratory lung emptying is not finished until the beginning of next inspiration is frequently found in patients on mechanical ventilation. Its presence imposes increased risk of barotrauma and hypotension, as well as increased work of breathing (WOB) by adding inspiratory threshold load and/or adversely affecting to inspiratory trigger sensitivity. The aim of this study is to evaluate the relationship of auto-PEEP with WOB and to evaluate the effect of PEEP applied by ventilator (external PEEP) on WOB in patients with auto-PEEP. Method : 15 patients, who required mechanical ventilation for management of acute respiratory failure, were studied. First, the differences in WOB and other indices of respiratory mechanics were examined between 7 patients with auto-PEEP and 8 patients without auto-PEEP. Then, we applied the 3 cm $H_2O$ of external PEEP to patients with auto-PEEP and evaluated its effects on lung mechanics as well as WOB. Indices of respiratory mechanics including tidal volume ($V_T$), repiratory rate, minute ventilation ($V_E$), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), peak inspiratory pressure (PIP), $T_I/T_{TOT}$, auto-PEEP, dynamic compliance of lung (Cdyn), expiratory airway resistance (RAWe), mean airway resistance (RAWm), $p_{0.1}$, work of breathing performed by patient (WOB), and pressure-time product (PTP) were obtained by CP-100 Pulmonary Monitor (Bicore, USA). The values were expressed as mean $\pm$ SEM (standard error of mean). Results : 1) Comparison of WOB and other indices of respiratory mechanics in patients with and without auto-PEEP : There was significant increase in WOB ($l.71{\pm}0.24$ vs $0.50{\pm}0.19\;J/L$, p=0.007), PTP ($317{\pm}70$ vs $98{\pm}36\;cm$ $H_2O{\cdot}sec/min$, p=0.023), RAWe ($35.6{\pm}5.7$ vs $18.2{\pm}2.3\;cm$ H2O/L/sec, p=0.023), RAWm ($28.8{\pm}2.5$ vs $11.9{\pm}2.0cm$ H2O/L/sec, p=0.001) and $P_{0.1}$ ($6.2{\pm}1.0$ vs 2.9+0.6 cm H2O, p=0.021) in patients with auto-PEEP compared to patients without auto-PEEP. The differences of other indices including $V_T$, PEFR, $V_E$ and $T_I/T_{TOT}$ showed no significance. 2) Effect of 3 cm $H_2O$ external PEEP on respiratory mechanics in patients with auto-PEEP : When 3 cm $H_2O$ of external PEEP was applied, there were significant decrease in WOB ($1.71{\pm}0.24$ vs $1.20{\pm}0.21\;J/L$, p=0.021) and PTP ($317{\pm}70$ vs $231{\pm}55\;cm$ $H_2O{\cdot}sec/min$, p=0.038). RAWm showed a tendency to decrease ($28.8{\pm}2.5$ vs $23.9{\pm}2.1\;cm$ $H_2O$, p=0.051). But PIP was increased with application of 3 cm $H_2O$ of external PEEP ($16{\pm}2$ vs $22{\pm}3\;cm$ $H_2O$, p=0.008). $V_T$, $V_E$, PEFR, $T_I/T_{TOT}$ and Cdyn did not change significantly. Conclusion : The presence of auto-PEEP in mechanically ventilated patients was accompanied with increased WOB performed by patient, and this WOB was decreased by 3 cm $H_2O$ of externally applied PEEP. But, with 3 cm $H_2O$ of external PEEP, increased PIP was noted, implying the importance of close monitoring of the airway pressure during application of external PEEP.

• Journal of Global Scholars of Marketing Science
• /
• v.19 no.3
• /
• pp.17-27
• /
• 2009

Price promotion typically reduces the price for a given quantity or increases the quantity available at the same price, thereby enhancing value and creating an economic incentive to purchase. It often is used to encourage product or service trial among nonusers of products or services. Thus, it is important to understand the effects of price promotions on quality perception made by consumer who do not have prior experience with the promoted brand. However, if consumers associate a price promotion itself with inferior brand quality, the promotion may not achieve the sales increase the economic incentives otherwise might have produced. More specifically, low qualitative perception through price promotion will undercut the economic and psychological incentives and reduce the likelihood of purchase. Thus, it is important for marketers to understand how price promotional informations about a brand have impact on consumer's unfavorable quality perception of the brand. Previous literatures on the effects of price promotions on quality perception reveal inconsistent explanations. Some focused on the unfavorable effect of price promotion on consumer's perception. But others showed that price promotions didn't raise unfavorable perception on the brand. Prior researches found these inconsistent results related to the timing of the price promotion's exposure and quality evaluation relative to trial. And, whether the consumer has been experienced with the product promotions in the past or not may moderate the effects. A few studies considered differences among product categories as fundamental factors. The purpose of this research is to investigate the effect of price promotional informations on consumer's unfavorable quality perception under the different conditions. The author controlled the timing of the promotional exposure and varied past promotional patterns and information presenting patterns. Unlike previous researches, the author examined the effects of price promotions setting limit to pretrial situation by controlling potentially moderating effects of prior personal experience with the brand. This manipulations enable to resolve possible controversies in relation to this issue. And this manipulation is meaningful for the work sector. Price promotion is not only used to target existing consumers but also to encourage product or service trial among nonusers of products or services. Thus, it is important for marketers to understand how price promotional informations about a brand have impact on consumer's unfavorable quality perception of the brand. If consumers associate a price promotion itself with inferior quality about unused brand, the promotion may not achieve the sales increase the economic incentives otherwise might have produced. In addition, if the price promotion ends, the consumer that have purchased that certain brand will likely to display sharply decreased repurchasing behavior. Through a literature review, hypothesis 1 was set as follows to investigate the adjustive effect of past price promotion on quality perception made by consumers; The influence that price promotion of unused brand have on quality perception made by consumers will be adjusted by past price promotion activity of the brand. In other words, a price promotion of an unused brand that have not done a price promotion in the past will have a unfavorable effect on quality perception made by consumer. Hypothesis 2-1 was set as follows : When an unused brand undertakes price promotion for the first time, the information presenting pattern of price promotion will have an effect on the consumer's attribution for the cause of the price promotion. Hypothesis 2-2 was set as follows : The more consumer dispositionally attribute the cause of price promotion, the more unfavorable the quality perception made by consumer will be. Through test 1, the subjects were given a brief explanation of the product and the brand before they were provided with a $2{\times}2$ factorial design that has 4 patterns of price promotion (presence or absence of past price promotion * presence or absence of current price promotion) and the explanation describing the price promotion pattern of each cell. Then the perceived quality of imaginary brand WAVEX was evaluated in the scale of 7. The reason tennis racket was chosen is because the selected product group must have had almost no past price promotions to eliminate the influence of average frequency of promotion on the value of price promotional information as Raghubir and Corfman (1999) pointed out. Test 2 was also carried out on students of the same management faculty of test 1 with tennis racket as the product group. As with test 1, subjects with average familiarity for the product group and low familiarity for the brand was selected. Each subjects were assigned to one of the two cells representing two different information presenting patterns of price promotion of WAVEX (case where the reason behind price promotion was provided/case where the reason behind price promotion was not provided). Subjects looked at each promotional information before evaluating the perceived quality of the brand WAVEX in the scale of 7. The effect of price promotion for unfamiliar pretrial brand on consumer's perceived quality was proved to be moderated with the presence or absence of past price promotion. The consistency with past promotional behavior is important variable that makes unfavorable effect on brand evaluations get worse. If the price promotion for the brand has never been carried out before, price promotion activity may have more unfavorable effects on consumer's quality perception. Second, when the price promotion of unfamiliar pretrial brand was executed for the first time, presenting method of informations has impact on consumer's attribution for the cause of firm's promotion. And the unfavorable effect of quality perception is higher when the consumer does dispositional attribution comparing with situational attribution. Unlike the previous studies where the main focus was the absence or presence of favorable or unfavorable motivation from situational/dispositional attribution, the focus of this study was exaus ing the fact that a situational attribution can be inferred even if the consumer employs a dispositional attribution on the price promotional behavior, if the company provides a persuasive reason. Such approach, in academic perspectih sis a large significance in that it explained the anchoring and adjng ch approcedures by applying it to a non-mathematical problem unlike the previous studies where it wis ionaly explained by applying it to a mathematical problem. In other wordn, there is a highrspedency tmatispositionally attribute other's behaviors according to the fuedach aal attribution errors and when this is applied to the situation of price promotions, we can infer that consumers are likely tmatispositionally attribute the company's price promotion behaviors. Ha ever, even ueder these circumstances, the company can adjng the consumer's anchoring tmareduce the po wibiliute thdispositional attribution. Furthermore, unlike majority of previous researches on short/long-term effects of price promotion that only considered the effect of price promotions on consumer's purchasing behaviors, this research measured the effect on perceived quality, one of man elements that affects the purchasing behavior of consumers. These results carry useful implications for the work sector. A guideline of effectively providing promotional informations for a new brand can be suggested through the outcomes of this research. If the brand is to avoid false implications such as inferior quality while implementing a price promotion strategy, it must provide a clear and acceptable reasons behind the promotion. Especially it is more important for the company with no past price promotion to provide a clear reason. An inconsistent behavior can be the cause of consumer's distrust and anxiety. This is also one of the most important factor of risk of endless price wars. Price promotions without prior notice can buy doubt from consumers not market share.

• Journal of Korean Society of Forest Science
• /
• v.45 no.1
• /
• pp.11-25
• /
• 1979

There was much mass movement at many different mountain side of Peong Chang area in Kwangwon province by the influence of heavy rainfall through August/4 5, 1979. This study have done with the fact observed through the field survey and the information of the former researchers. The results are as follows; 1. Heavy rainfall area with more than 200mm per day and more than 60mm per hour as maximum rainfall during past 6 years, are distributed in the western side of the connecting line through Hoeng Seong, Weonju, Yeongdong, Muju, Namweon and Suncheon, and of the southern sea side of KeongsangNam-do. The heavy rain fan reason in the above area seems to be influenced by the mouktam range and moving direction of depression. 2. Peak point of heavy rainfall distribution always happen during the night time and seems to cause directly mass movement and serious damage. 3. Soil mass movement in Peongchang break out from the course sandy loam soil of granite group and the clay soil of lime stone and shale. Earth have moved along the surface of both bedrock or also the hardpan in case of the lime stone area. 4. Infiltration seems to be rapid on the both bedrock soil, the former is by the soil texture and the latter is by the crumb structure, high humus content and dense root system in surface soil. 5. Topographic pattern of mass movement spot is mostly the concave slope at the valley head or at the upper part of middle slope which run-off can easily come together from the surrounding slope. Soil profile of mass movement spot has wet soil in the lime stone area and loose or deep soil in the granite area. 6. Dominant slope degree of the soil mass movement site has steep slope, mostly, more than 25 degree and slope position that start mass movement is mostly in the range of the middle slope line to ridge line. 7. Vegetation status of soil mass movement area are mostly fire field agriculture area, it's abandoned grass land, young plantation made on the fire field poor forest of the erosion control site and non forest land composed mainly grass and shrubs. Very rare earth sliding can be found in the big tree stands but mostly from the thin soil site on the un-weatherd bed rock. 8. Dangerous condition of soil mass movement and land sliding seems to be estimated by the several environmental factors, namely, vegetation cover, slope degree, slope shape and position, bed rock and soil profile characteristics etc. 9. House break down are mostly happen on the following site, namely, colluvial cone and fan, talus, foot area of concave slope and small terrace or colluvial soil between valley and at the small river side Dangerous house from mass movement could be interpreted by the aerial photo with reference of the surrounding site condition of house and village in the mountain area 10. As a counter plan for the prevention of mass movement damage the technics of it's risk diagnosis and the field survey should be done, and the mass movement control of prevention should be started with the goverment support as soon as possible. The precautionary measures of house and village protection from mass movement damage should be made and executed and considered the protecting forest making around the house and village. 11. Dangerous or safety of house and village from mass movement and flood damage will be indentified and informed to the village people of mountain area through the forest extension work. 12. Clear cutting activity on the steep granite site, fire field making on the steep slope, house or village construction on the dangerous site and fuel collection in the eroded forest or the steep forest land should be surely prohibited When making the management plan the mass movement, soil erosion and flood problem will be concidered and also included the prevention method of disaster.

• Journal of Preventive Medicine and Public Health
• /
• v.20 no.1 s.21
• /
• pp.165-203
• /
• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.