• Journal of the Korean Society of School Health
• /
• v.9 no.1
• /
• pp.77-98
• /
• 1996

This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiosity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", "avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging, "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "information availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporating the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthiness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthiness. 6. The older the victims, The weaker the senses of being taken aback and filthiness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 13. The more closed the personality of tile subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more lilely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuses, the more likely response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping. 17. The less available information concerning sexual abuses, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 21. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping. 22. The more likely the response to 'being taken aback' and 'filthiness' is 'informing and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypotheses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined with weak sexual curiosity and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness', further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 3) In case the level of violence is strong and 'being taken abuse' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protective and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despite the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong and 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequency is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohesion is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

• Journal of Intelligence and Information Systems
• /
• v.27 no.3
• /
• pp.231-252
• /
• 2021

Artificial intelligence (AI) is a key technology that will change the future the most. It affects the industry as a whole and daily life in various ways. As data availability increases, artificial intelligence finds an optimal solution and infers/predicts through self-learning. Research and investment related to automation that discovers and solves problems on its own are ongoing continuously. Automation of artificial intelligence has benefits such as cost reduction, minimization of human intervention and the difference of human capability. However, there are side effects, such as limiting the artificial intelligence's autonomy and erroneous results due to algorithmic bias. In the labor market, it raises the fear of job replacement. Prior studies on the utilization of artificial intelligence have shown that individuals do not necessarily use the information (or advice) it provides. Algorithm error is more sensitive than human error; so, people avoid algorithms after seeing errors, which is called "algorithm aversion." Recently, artificial intelligence has begun to be understood from the perspective of the augmentation of human intelligence. We have started to be interested in Human-AI collaboration rather than AI alone without human. A study of 1500 companies in various industries found that human-AI collaboration outperformed AI alone. In the medicine area, pathologist-deep learning collaboration dropped the pathologist cancer diagnosis error rate by 85%. Leading AI companies, such as IBM and Microsoft, are starting to adopt the direction of AI as augmented intelligence. Human-AI collaboration is emphasized in the decision-making process, because artificial intelligence is superior in analysis ability based on information. Intuition is a unique human capability so that human-AI collaboration can make optimal decisions. In an environment where change is getting faster and uncertainty increases, the need for artificial intelligence in decision-making will increase. In addition, active discussions are expected on approaches that utilize artificial intelligence for rational decision-making. This study investigates the impact of artificial intelligence on decision-making focuses on human-AI collaboration and the interaction between the decision maker personal traits and advisor type. The advisors were classified into three types: human, artificial intelligence, and human-AI collaboration. We investigated perceived usefulness of advice and the utilization of advice in decision making and whether the decision-maker's personal traits are influencing factors. Three hundred and eleven adult male and female experimenters conducted a task that predicts the age of faces in photos and the results showed that the advisor type does not directly affect the utilization of advice. The decision-maker utilizes it only when they believed advice can improve prediction performance. In the case of human-AI collaboration, decision-makers higher evaluated the perceived usefulness of advice, regardless of the decision maker's personal traits and the advice was more actively utilized. If the type of advisor was artificial intelligence alone, decision-makers who scored high in conscientiousness, high in extroversion, or low in neuroticism, high evaluated the perceived usefulness of the advice so they utilized advice actively. This study has academic significance in that it focuses on human-AI collaboration that the recent growing interest in artificial intelligence roles. It has expanded the relevant research area by considering the role of artificial intelligence as an advisor of decision-making and judgment research, and in aspects of practical significance, suggested views that companies should consider in order to enhance AI capability. To improve the effectiveness of AI-based systems, companies not only must introduce high-performance systems, but also need employees who properly understand digital information presented by AI, and can add non-digital information to make decisions. Moreover, to increase utilization in AI-based systems, task-oriented competencies, such as analytical skills and information technology capabilities, are important. in addition, it is expected that greater performance will be achieved if employee's personal traits are considered.

• Asia Marketing Journal
• /
• v.14 no.2
• /
• pp.157-176
• /
• 2012

Brand switching data frequently used in market structure analysis is adequate to analyze non- durable goods, because it can capture competition between specific two brands. But brand switching data sometimes can not be used to analyze goods like automobiles having long term duration because one of main assumptions that consumer preference toward brand attributes is not changed against time can be violated. Therefore a new type of data which can precisely capture competition among durable goods is needed. Another problem of using brand switching data collected from actual purchase behavior is short of explanation why consumers consider different set of brands. Considering above problems, main purpose of this study is to analyze market structure for durable goods with consideration set. The author uses exploratory approach and latent class clustering to identify market structure based on heterogeneous consideration set among consumers. Then the relationship between some factors and consideration set formation is analyzed. Some benefits and two demographic variables - age and income - are selected as factors based on consumer behavior theory. The author analyzed USA automotive market with top 11 brands using exploratory approach and latent class clustering. 2,500 respondents are randomly selected from the total sample and used for analysis. Six models concerning market structure are established to test. Model 1 means non-structured market and model 6 means market structure composed of six sub-markets. It is exploratory approach because any hypothetical market structure is not defined. The result showed that model 1 is insufficient to fit data. It implies that USA automotive market is a structured market. Model 3 with three market structures is significant and identified as the optimal market structure in USA automotive market. Three sub markets are named as USA brands, Asian Brands, and European Brands. And it implies that country of origin effect may exist in USA automotive market. Comparison between modal classification by derived market structures and probabilistic classification by research model was conducted to test how model 3 can correctly classify respondents. The model classify 97% of respondents exactly. The result of this study is different from those of previous research. Previous research used confirmatory approach. Car type and price were chosen as criteria for market structuring and car type-price structure was revealed as the optimal structure for USA automotive market. But this research used exploratory approach without hypothetical market structures. It is not concluded yet which approach is superior. For confirmatory approach, hypothetical market structures should be established exhaustively, because the optimal market structure is selected among hypothetical structures. On the other hand, exploratory approach has a potential problem that validity for derived optimal market structure is somewhat difficult to verify. There also exist market boundary difference between this research and previous research. While previous research analyzed seven car brands, this research analyzed eleven car brands. Both researches seemed to represent entire car market, because cumulative market shares for analyzed brands exceeds 50%. But market boundary difference might affect the different results. Though both researches showed different results, it is obvious that country of origin effect among brands should be considered as important criteria to analyze USA automotive market structure. This research tried to explain heterogeneity of consideration sets among consumers using benefits and two demographic factors, sex and income. Benefit works as a key variable for consumer decision process, and also works as an important criterion in market segmentation. Three factors - trust/safety, image/fun to drive, and economy - are identified among nine benefit related measure. Then the relationship between market structures and independent variables is analyzed using multinomial regression. Independent variables are three benefit factors and two demographic factors. The result showed that all independent variables can be used to explain why there exist different market structures in USA automotive market. For example, a male consumer who perceives all benefits important and has lower income tends to consider domestic brands more than European brands. And the result also showed benefits, sex, and income have an effect to consideration set formation. Though it is generally perceived that a consumer who has higher income is likely to purchase a high priced car, it is notable that American consumers perceived benefits of domestic brands much positive regardless of income. Male consumers especially showed higher loyalty for domestic brands. Managerial implications of this research are as follow. Though implication may be confined to the USA automotive market, the effect of sex on automotive buying behavior should be analyzed. The automotive market is traditionally conceived as male consumers oriented market. But the proportion of female consumers has grown over the years in the automotive market. It is natural outcome that Volvo and Hyundai motors recently developed new cars which are targeted for women market. Secondly, the model used in this research can be applied easier than that of previous researches. Exploratory approach has many advantages except difficulty to apply for practice, because it tends to accompany with complicated model and to require various types of data. The data needed for the model in this research are a few items such as purchased brands, consideration set, some benefits, and some demographic factors and easy to collect from consumers.

• Journal of Chest Surgery
• /
• v.38 no.1 s.246
• /
• pp.44-49
• /
• 2005

Although thymomas are relatively common mediastinal tumors, to date not only has a universal system of pathologic classification not been established but neither has a clearly defined predictable relationship between treatment and prognosis been made. Recently, a new guideline for classification was reported by WHO, and efforts, based on this work, have been made to better define the relationship between treatment and pro­gnostic outcome. In the present study a comparative analysis between the WHO classification and Masaoka stage system with the clinical disease pattern was conducted. Material and Method: A total of 98 patients undergoing complete resection for mediastinal thymoma between Juanuary 1993 and June 2003 were included in the present study. The male female ratio was 48 : 50 and the mean age at operation was $49.6{\pm}13.9\;years.$ A retrospective analytic comparison studying the relationship between the WHO classification and the Masaoka stage system with the clinical disease pattern of thymoma was conducted. Pathologic slide specimens were carefully examined, details of postoperative treatment were documented, and a relationship with the prognostic outcome and recurrence was studied. Result: There were 7 patients in type A according to the WHO system of classification, 14 in AB, 28 in B 1, 23 in B2, 18 in B3, and 9 in type C. The study of the relationship between the Masaoka stage and WHO classification system showed 4 patients to be in WHO system type A, 7 in type AB, 22 in B 1, 17 in B2, and 3 in type B3 among 53 $(54{\%})$ patients shown to be in Masaoka stage I. Among 28 $(28.5{\%})$ patients in Masaoka stage II system, there were 2 patients in type A, 7 in AB, 4 in B 1, 2 in B2, 8 in B3, and 5 in type C. Among 15 $(15.3{\%})$ in Masaoka stage III, there were 1 patient in type B1, 3 in B2, 7 in B3, and 4 in type C. Finally, among 2 $(2{\%})$ patients found to be in Masaoka stage IV there was 1 patient in type B1, and 1 in type B2. The mean follow up duration was $28{\pm}6.8$ months. There were 3 deaths in the entire series of which 2 were in type B2 (Masaoka stages III and IV), and 1 was in type C (Masaoka stage II). Of the patients that experienced relapse, 6 patients remain alive of which 2 were in type B2 (Masaoka III), 2 in type B3 (Masaoka I and III) and 2 in type C (Masaoka stage II). The 5 year survival rate by the Kaplan-Meier method was $90{\%}$ for those in type B2 WHO classification system, $87.5{\%}$ for type C. The 5 year freedom from recurrence rate was $80.7{\%}$ for those in WHO type B2, $81.6{\%}$ for those in type B3, and $50{\%}$ for those in type C. By the Log-Rank method, a statistically significant correlation between survival and recurrence was found with the WHO system of classification (p<0.05). An analysis of the relationship between the WHO classification and Masaoka stage system using the Spearman correction method, showed a slope=0.401 (p=0.023), showing a close correlation. Conclusion: As type C of the WHO classification system is associated with a high postoperative mortality and recurrence rate, aggressive treatment postoperatively and meticulous follow up are warranted. The WHO classification and Masaoka stage system were found to have a close relationship with each other and either the WHO classification method or the Masaoka stage system may be used as a predict prognostic outcome of Thymoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.3 no.1
• /
• pp.30-40
• /
• 2000

Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.1
• /
• pp.1-10
• /
• 1994

Background: Patients with mitral stenosis(MS) have been demonstrated to have a variable degree of pulmonary dysfunction and exercise impairment. The hemodynamic changes of MS can be reversed after percutaneous mitral balloon valvuloplasty(PMV), but the extent and time course of the imporvement in pulmonary function and exercise capacity are not defined. Methods: In order to investigate the early(3 weeks or less)and late(3 months or more) effects of PMV on pulmonary function and determine if the pulmonary dysfunction is reversible even in patients with moderate to severe pulmonary hypertension, we performed the spirometry, measurements of diffusing capacity and lung volumes, and incremental exercise tests in patients with MS before and after PMV. Results: In 46 patients with MS(age: $40{\pm}12$years, male to female ratio: 1:2, mitral valve area: $0.8{\pm}0.2cm^2$) there was a significant increase in FVC(P<0.0025), $FEV_1$(P<0.001), $FEF_{25-75%}$(P<0.001, $FEF_{50%}$(P<0.001), PEF(P<0.0005), MVV(P<0.005), $\dot{V}O_2$max (P<0.0001), and AT(P<0.0001) after average 10 days of PMV. Also there was a significant decrease in DLco(P<0.0001) and DL/VA(P<0.0001). At later($5{\pm}2$months) follow-up in 11 patients, there was no further improvement in any parameters of pulmonary function and exercise test. Twenty nine patients with sinus rhythm were divided into 16 patients with pulmonary arterial pressure(PAP) more than 35mmHg and/or tricuspid regurgitation grade n or more(group A) and 13 patients with PAP less than 35mmHg(group B). Group A Patients had significantly lower FVC(P<0.001), $FEV_1$(P<0.001), DLco(P<0.05), $\dot{V}O_2$ max(P<0.025) and mitral valve area(P<0.025) than group B patients. Group A patients after PMV, showed significant increase in FVC(P<0.001), maximum $O_2$ pulse(P<0.00001) and $\dot{V}O_2$ max(P<0.00025). Both group showed an increase in AT(P<0.0001, P<0.005), but group A showed greater decrease in $\dot{V}E/\dot{V}O_2$ and $\dot{V}E/\dot{V}CO_2$ both at AT(P<0.001, P<0.001) and $\dot{V}O_2$ max(P<0.0001, P<0.0001) after PMV compared with group B. Conclusion: These data suggest that patients with MS can show increased pulmonary function and exercise performance within 1 month after PMV. Patients with moderate to severe pulmonary hypertension had a significant increase in exercise performance compared with those with mild to no pulmonary hypertension and it is thought to be related to a significat decrease of ventilation for a given oxygen consumption at maximum exercise.

• Radiation Oncology Journal
• /
• v.17 no.2
• /
• pp.100-107
• /
• 1999

Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.

• Radiation Oncology Journal
• /
• v.25 no.2
• /
• pp.79-92
• /
• 2007

[ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

• Health Policy and Management
• /
• v.10 no.3
• /
• pp.19-49
• /
• 2000

This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.6
• /
• pp.1308-1317
• /
• 1997

Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.