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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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The Improvement Measurement on Dispute Resolution System for Air Service Customer (항공서비스 소비자 분쟁해결제도의 개선방안)

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.225-266
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    • 2018
  • In 2017, 1,252 cases of damages relief related to air passenger transport service were received by the Korea Consumer Agency, a 0.8% drop from 1,262 cases in 2016, the first decline since 2013. In 2017, 444 cases (35.4%) out of received cases of damages relief in the field of air passenger service received by the Korea Consumer Agency were agreed on, and out of cases that were not agreed on, the most number of 588 cases (47.0%) were concluded due to information provision and counseling, and 186 cases (14.9%) were applied to the mediation of the Consumer Dispute Mediation Committee. Major legislations that contain regulations for the damages relief and disputes resolution of air service consumers include the Aviation Business Act and the Consumer Fundamental Act, etc. The Aviation Business Act provides the establishment and implementation of damage relief procedure and handling plan, and the receiving and handling of request of damage relief by air transport businessman, and the notice of protection standard for air traffic users. The Consumer Fundamental Act provides the establishment and management of the consumer counseling organization, the damage relief by the Korea Consumer Agency, the consumer dispute mediation, and the enactment of the criteria for resolving consumer disputes. The procedures for damages relief of air service consumers include the receiving and handling of damages relief by air transport businessman, the counseling, and receiving and handling of damages relief by the Consumer Counseling Center, the advice of mutual agreement by the Korea Consumer Agency, and the dispute mediation system by the Consumer Dispute Mediation Committee. The current system of damage relief and dispute mediation for air service consumer have the problem in the exemption from obligation of establishment and implementation of damage relief plan by air transport businessman under the Aviation Business Act, the problem in the exemption from liability in case of nonfulfillment and delay of transport by aviation businessman under the criteria for resolving consumer disputes in the aviation sector, and the uppermost limit in procedure progress and completion of consumer dispute mediation under the Consumer Fundamental Act. Therefore, the improvement measurements of the relevant system for proper damage relief and smooth dispute mediation for air service consumer are to be suggested as follows: First is the maintenance of the relevant laws for damage relief of air service consumer. The exemption regulation from obligation of establishment and implementation of damage relief plan by air transport businessman under the Aviation Business Act shall be revised. To enhance the structualization and expertise of the relevant regulation for protection and damage relief of air service consumer, it will be necessary to prepare the separate legislation similar to the US Federal Regulation 14 CFR and EU Regulation EC Regulation 261/2004. Second is the improvement of criteria for resolving air service consumer disputes. For this, it will be necessary to investigate whether the cause of occurrence of exemption reason was force majeure, and distinguish the exemption from liability in case of nonfulfillment and delay of transport by aviation businessman under the criteria for resolving consumer disputes in the aviation sector, and revise the same as exemption reasons regulated under the air transport chapter of the Commercial Act and Montreal Convention 1999, and unify the compensation criteria for the nonfulfillment of transport that the substitute flight was provided and the delay of transport. Third is the reinforcement of information provision for damage relief of air service consumer. Aviation-related government agencies and concerned agencies should cooperate with airlines and airports to provide rapidly and clearly diverse information to the air traffic users, including laws and policies for damages relief of air service consumers. Fourth is the supplement to the effectiveness, etc. of consumer dispute mediation. If there is no sign of acceptance for dispute mediation, it is not fair to regard it as acceptance, therefore it will be necessary to add objection system. And if a dispute resolution is requested to another dispute settlement agency in addition to the Consumer Dispute Mediation Committee, it is excluded from the damage relief package, but it should be allowed for the party to choose a mediation agency. It will be necessary to devise the institutional measures to increase the completion rate of mediation so that the consumer dispute can be resolved efficiently through the mediation. Fifth is the introduction of the air service consumer arbitration system. A measure to supplement the limitations of the consumer dispute mediation system is to introduce the consumer arbitration system, but there are two measurements which are the introduction of the consumer arbitration under the Consumer Fundamental Act and the introduction of the consumer arbitration under the Arbitration Act. The latter measurement is considered to be appropriate. In conclusion, as a policy task, the government should prepare laws and system to enhance the prevention and relief of damages and protection of the rights and interests of air service consumers, and establish and implement the consumer-centric policy for the advancement of air service.

Diagnostic Accuracy and Safety of Medical Thoracoscopy (내과적 흉강경 검사의 진단적 유용성과 안전성)

  • Yang, Jung Kyung;Lee, Jung-Ho;Kwon, Mi-Hye;Jeong, Ji Hyun;Lee, Go Eun;Cho, Hyun Min;Kim, Young Jin;Jung, Sung Mee;Choi, Eu Gene;Son, Ji Woong;Na, Moon Jun
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.3
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    • pp.261-267
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    • 2007
  • Background: The causes of the pleural effusion are remained unclear in a the substantial number of patients with exudative effusions determined by an examination of the fluid obtained via thoracentesis. Among the various tools for diagnosing exudative pleural effusions, thoracoscopy has a high diagnostic yield for cancer and tuberculosis. Medical thoracoscopy can also be carried out under local anesthesia with mild sedation. The aim of this study was to determine diagnostic accuracy and safety of medical thoracoscopy. Methods: Twenty-five patients with exudative pleural effusions of an unknown cause underwent medical thoracoscopy between October 2005 and September 2006 in Konyang University Hospital. The clinical data such as age, gender, preoperative pulmonary function, amounts of pleural effusion on lateral decubitus radiography were collected. The vital signs were recorded, and arterial blood gas analyses were performed five times during medical thoracoscopy in order to evaluate the cardiopulmonary status and acid-base changes. Results: The mean age of the patients was 56.8 years (range 22-79). The mean depth of the effusion on lateral decubitus radiography (LDR) was 27.49 mm. The medical thoracoscopic pleural biopsy was diagnostic in 24 patients (96.0%), with a diagnosis of tuberculosis pleurisy in 9 patients (36%), malignant effusions in 8 patients (32%), and parapneumonic effusions in 7 patients (28%). Medical thoracoscopy failed to confirm the cause of the pleural effusion in one patient, who was diagnosed with tuberculosis by a pericardial biopsy. There were no significant changes in blood pressure, heart rate, acid-base and no major complications in all cases during medical thoracoscopy (p>0.05). Conclusions: Medical thoracoscopy is a safe method for patients with unknown pleural effusions with a relatively high diagnostic accuracy.

Current Status and Success Strategies of Crowdfunding for Start-up in Korea (국내 창업분야 크라우드펀딩(Crowdfunding) 현황과 성공전략)

  • Yoo, Younggeul;Jang, Ikhoon;Choe, Youngchan
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.4
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    • pp.1-12
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    • 2014
  • It is essential factor for business operation to raise funds effectively. However, in Korea, many start-ups and small businesses have difficulties in fund-raising. In recent years, crowdfunding, a new method for funding a project of individuals or organizations by raising monetary contributions from a large number of people, has been growing up simultaneously with diffusion of social media. Crowdfunding is on early stage in Korea, and the majority of projects are focused on cultural or art categories. There is high proportion of projects that have social value in start-up sector. Crowdfunding in Korea has great potential because success rate of it is much higher than its of advanced countries, although market size is much smaller than them. The purpose of this paper is to propose success strategies of crowdfunding for start-up through case study. 5 crowdfunding platforms of Korea and Kickstarter, the platform of United States were investigated. Then we checked the figures related to the operation of the whole Korean projects on start-up. Finally, we made comparison between the cases of success and failure by analyzing 8 project characteristics. The study shows that it were the differences in trustworthiness and activeness of project creator, value of reward and efforts for interactivity that have great effects on success of the project. Whereas there was no significant influence of societal contribution and sponsor engagement. The thesis provides success strategies of crowdfunding for start-up as follows. Firstly, creator of the project should make support base by enthusiastic activites before launching funding project. Secondly, there should be contents that can easily show the process of business development in the project information. Thirdly, there must be appropriate design of rewards for each amounts of support money. Finally, efforts for interactivity, such as frequent updates, response for comments and SNS posting, should be followed after the launch of the project.

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Physiologic Changes During Bronchoscopy in Mechanically Ventilated Patients (기계환기중인 환자에서 기관지내시경 검사에 따른 생리적 변화)

  • Pyun, Yu Jang;Suh, Gee Young;Koh, Won-Jung;Yu, Chang-Min;Jeon, Kyeongman;Jeon, Ik Soo;Ham, Hyoung Suk;Kang, Eun Hae;Chung, Man Pyo;Kim, Hojoong;Kown, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.523-531
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    • 2004
  • Background : Bronchoscopy in patients on mechanical ventilation is being performed much more frequently. However, there is little data on the changes in physiologic parameters and no established mechanical ventilation protocol during bronchoscopy. A decreasing or the removal of positive end-expiratory pressure (PEEP) during bronchoscopy may precipitate severe hypoxemia and/or derecruitment. Methods : Our standardized mechanical ventilation protocol, without changing the PEEP level, was used during bronchoscopy. The physiological parameters were measured during the bronchoscopic procedure. Results : During bronchoscopy, respiratory acidosis, elevation of peak pressure, elevation of heart rate and auto-PEEP were developed, but were reversible changes. Procedure-related gross barotraumas or other severe complications did not developed. Conclusion : No serious complications developed during bronchoscopy under our standardized mechanical ventilation protocol when the PEEP level remained unchanged. The procedure time should be kept to a minimum to decrease the exposure time to undesirable physiological changes.

Development of $^{166}Ho$-Stent for the Treatment of Esophageal Cancer (식도암 치료용 $^{166}Ho$-Stent 개발)

  • Park, Kyung-Bae;Kim, Young-Mi;Kim, Kyung-Hwa;Shin, Byung-Chul;Park, Woong-Woo;Han, Kwang-Hee;Chung, Young-Ju;Choi, Sang-Mu;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.62-73
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    • 2000
  • Purpose: Esophageal cancer patients have a difficulty in the intake of meals through the blocked esophageal lumen, which is caused by an ingrowth of cancer cells and largely influences on the prognosis. It is reported that esophageal cancer has a very low survival rate due to the lack of nourishment and immunity as the result of this. In this study a new radioactive stent, which prevents tumor ingrowth and restenosis by additional radiation treatment, has been developed. Materials and Methods: Using ${\ulcorner}HANARO{\lrcorner}$ research reactor, the radioactive stent assembly ($^{166}Ho$-SA) was prepared by covering the metallic stent with a radioactive sleeve by means of a post-irradiation and pre-irradiation methods. Results: Scanning electron microscopy and autoradiography exhibited that the distribution of $^{165/166}Ho\;(NO_3)$ compounds in polyurethane matrix was homogeneous. A geometrical model of the esophagus considering its structural properties, was developed for the computer simulation of energy deposition to the esophageal wall. The dose distributions of $^{166}Ho$-stent were calculated by means of the EGS4 code system. The sources are considered to be distributed uniformly on the surface in the form of a cylinder with a diameter of 20 mm and length of 40 mm. As an animal experiment, when radioactive stent developed in this study was inserted into the esophagus of a Mongrel dog, tissue destruction and widening of the esophageal lumen were observed. Conclusion: We have developed a new radioactive stent comprising of a radioactive tubular sleeve covering the metallic stent, which emits homogeneous radiation. If it is inserted into the blocked or narrowed lumen, it can lead to local destruction of the tumor due to irradiation effect with dilatation resulting from self-expansion of the metallic property. Accordingly, it is expected that restenosis esophageal lumen by the continuous ingrowth and infiltration of cancer after insertion of our radioactive stent will be decreased remarkably.

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Prediction of Isothermal and Reacting Flows in Widely-Spaced Coaxial Jet, Diffusion-Flame Combustor (큰 지름비를 가지는 동축제트 확산화염 연소기내의 등온 및 연소 유동장의 예측)

  • O, Gun-Seop;An, Guk-Yeong;Kim, Yong-Mo;Lee, Chang-Sik
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.20 no.7
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    • pp.2386-2396
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    • 1996
  • A numerical simulation has been performed for isothermal and reacting flows in an exisymmetric, bluff-body research combustor. The present formulation is based on the density-weighted averaged Navier-Stokes equations together with a k-epsilon. turbulence model and a modified eddy-breakup combustion model. The PISO algorithm is employed for solution of thel Navier-Stokes system. Comparison between measurements and predictions are made for a centerline axial velocities, location of stagnation points, strength of recirculation zone, and temperature profile. Even though the numerical simulation gives acceptable agreement with experimental data in many respects, the present model is defictient in predicting the recoveryt rate of a central near-wake region, the non-isotropic turbulence effects, and variation of turbulent Schmidt number. Several possible explanations for these discrepancies have been discussed.

A Comparative Study on Hydrolase Activities in Acanthamoeba culbeytconi and A. roureba (Acanthamoebaculbertsoni와 A. royreba의 가수분해 효소 활성도의 비교 연구)

  • 김용규;김태우
    • Parasites, Hosts and Diseases
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    • v.26 no.2
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    • pp.95-106
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    • 1988
  • Specific or non-specific cytolytic processes of free-living amoebae causing meningoencephalitls have been emphasized and the cytolytic ability related to hydrolases in Entantoeba sp. and Naegleria sp. has also been reported since the latter half of 1970's. However, no information on hydrolase activities in Acanthamoeba sp. is available. Hydrolases in Acanthamoeba culbertsoni, a pathogenic species of free-living amoebae, were assayed and compared with those in a non-pathogenic species, A. royreba. Pathogenicity of these two species was confirmed through experimental infection to BALB/c mice. Hydrolase activities and cytotoxic effects between pathogenic and non.pathogenic species were compared in the trophozoites cultured in CGV media and in CHO cell line, respectively. The results are summarized as follows: 1. The mice infected with A. culbertseni were all dead 15 days after nasal inoculation, and the mean survival time was 8.5 days. Also the mice infected with this pathogenic species manifested typical meningoencephalitis, whereas the mice infected with A. royreba did not. 2. Hydrolases detected both in the cell extracts and culture media were acid phosphatase, ${\beta}-N-acetyl$ galactosaminidase, ${\beta}-N-acetyl$ glucosaminidase, ${\alpha}-mannosidase$, neutral proteinase and acid proteinase, all of which were detected with remarkably higher rate in A. culbertsoni than in A. royreba. 3. A. cuzbertsoni revealed strong cytotoxicity for the target CHO cells, whereas A. royreba did not show any specific cytotoxicity. About 80% of the target cells mixed with A. culbertsoni were dead 48 hours after cultivation, and more than 95% of the target cells were dead 72 hours after cultivation. 4. Hydrolase activities in A. culbertsoni cultured with the target cell line were assayed according to the culture time. The activities of acid phosphatase, ${\beta}-N-acetyl$ galactosaminidase, ${\beta}-N-acetyl$ glucosaminidase, ${\alpha}-mannosidase$ and acid proteinase in this pathogenic amoeba were detected higher in amoeba extracts than in culture media up to 120 hours after cultivation, but after 120 hours of cultivation those activities were detected higher in culture media than in the amoeba Iysates. Neutral proteinase activity in A. culbertsoni increased more in EBSS medium than in the Iysate specimens although the activity in the extracts was generally steady according to the cultivation time. Summarizing the above results, it is concluded that there were differences in hydrolase activities between Pathogenic A. culbertsoni and non-pathogenic A. royreba, and that some hydrolase activities were detected remarkably higher in A. culbertsoni which revealed strong cytotoxicity to the target CHO cell line.

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Chlamydia trachomatis respiratory infection in Korean young infants (국내 영유아에서의 Chlamydia trachomatis 호흡기 감염)

  • Hong, Ki Bae;Shin, Youn Shim;Roh, Eui-Jung;Chung, Eun Hee
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.729-735
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    • 2008
  • Purpose : Chlamydia trachomatis is one of the most common sexually transmitted diseases and is also a cause of pneumonia in infants. Respiratory infections by respiratory viruses are also common for infants. The objectives of this study were to identify the clinical manifestations and to determine the prevalence of C. trachomatis respiratory infections and coinfections by respiratory viruses in infants younger than 6 months of age. Methods : For this study, we enrolled 6 months or younger infants who were admitted to the Dankook University Hospital between January 2002 and July 2007, with respiratory symptoms. Nasopharyngeal aspirates or throat swabs were collected within s d of hospitalization and C. trachomatis was detected using polymerase chain reaction (PCR). Patients who tested positive underwent multiplex PCR for respiratory viruses. Results : A total of 690 patients underwent chlamydial PCR testing and 36 (5.2%) had positive results. Of the 36, 28 (78%) were male; 30 were vaginally delivered. From the 36 patients positive for C. trachomatis, 26 underwent multiplex respiratory viral PCR; 12 were coinfected with viruses. Respiratory syncytial virus (RSV) was the most frequent pathogen that was detected in 6 patients. Increased C-reactive protein and fever were significant in patients coinfected with respiratory viruses. Conclusion : C. trachomatis can infected in infants delivered by cesarean section as well as in 6 months old or younger infants. Infant with C. trachomatis respiratory infections can also be coinfected with respiratory infection also coinfected with respiratory viruses. Further studies are needed to better understand the prevalence rates of the this infection and its coinfection rate with respiratory viruses.

The Effect of Individual Characteristics and Economic Environment on Entrepreneurship (개인의 계획된 행위와 국가경제환경이 기업가정신에 미치는 영향 분석: OECD국가를 대상으로)

  • Han, Sangyun
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.4
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    • pp.149-165
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    • 2016
  • The objectives of this study is to assess the influence of individual characteristics and economic environment on the entrepreneurship such as entrepreneurial Intention and behavior based on the theory of Planned behaviors. This study used a country-level merged data set composed of GEM(Global Entrepreneurship Monitor) data and the OECD Statistics data. And this used the fixed effect model to analyze the panel data of 31 OECD countries during the period from 2005 to 2014. Our findings show that subjective norm has a significantly positive effect on entrepreneurial intention. In individual characteristics, the perceived opportunities has a significantly positive effect on early-stage entrepreneurial activity(TEA) and improvement-driven opportunity entrepreneurial activity. We identify the differences of between necessity-driven and improvement-driven opportunity entrepreneurial activity. For example, the effect on necessity-driven entrepreneurial activity is significantly negative. We also find the differences of between necessity-driven and improvement-driven opportunity entrepreneurial activity in economic environment variables. While real GDP growth as a demand variable has a significantly positive effect on necessity-driven entrepreneurial activity, unemployment rate as a supply variable has a significantly negative effect on early-stage entrepreneurial activity(TEA) and improvement-driven opportunity entrepreneurial activity. And GDP per capita as a supply variable has a significantly positive effect on early-stage entrepreneurial activity(TEA) and improvement-driven opportunity entrepreneurial activity. But the effect on necessity-driven entrepreneurial activity is significantly negative. We provide an interpretation of these empirical findings, emphasizing the importance of considering individual characteristics and economic environment simultaneously in promoting entrepreneurship.

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