• Korean Journal of Radiology
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• v.24 no.12
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• pp.1284-1292
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• 2023

Objective: We investigated the impacts of computed tomography (CT) added to ultrasound (US) for preoperative evaluation of patients with papillary thyroid carcinoma (PTC) on staging, surgical extent, and postsurgical survival. Materials and Methods: Consecutive patients who underwent surgery for PTC between January 2015 and December 2015 were retrospectively identified. Of them, 584 had undergone preoperative additional thyroid CT imaging (CT + US group), and 859 had not (US group). Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to adjust for 14 variables and balance the two groups. Changes in nodal staging and surgical extent caused by CT were recorded. The recurrence-free survival and distant metastasis-free survival after surgery were compared between the two groups. Results: In the CT + US group, discordant nodal staging results between CT and US were observed in 94 of 584 patients (16.1%). Of them, CT accurately diagnosed nodal staging in 54 patients (57.4%), while the US provided incorrect nodal staging. Ten patients (1.7%) had a change in the extent of surgery based on CT findings. Postsurgical recurrence developed in 3.6% (31 of 859) of the CT + US group and 2.9% (17 of 584) of the US group during the median follow-up of 59 months. After adjustment using IPTW (580 vs. 861 patients), the CT + US group showed significantly higher recurrence-free survival rates than the US group (hazard ratio [HR], 0.52 [95% confidence interval {CI}, 0.29-0.96]; P = 0.037). PSM analysis (535 patients in each group) showed similar HR without statistical significance (HR, 0.60 [95% CI, 0.31-1.17]; P = 0.134). For distant metastasis-free survival, HRs after IPTW and PSM were 0.75 (95% CI, 0.17-3.36; P = 0.71) and 0.87 (95% CI, 0.20-3.80; P = 0.851), respectively. Conclusion: The addition of CT imaging for preoperative evaluation changed nodal staging and surgical extent and might improve recurrence-free survival in patients with PTC.

• IMMUNE NETWORK
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• v.20 no.5
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• pp.40.1-40.15
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• 2020

The protein encoded by the Gene Associated with Retinoid-Interferon-Induced Mortality-19 (GRIM-19) is located in the mitochondrial inner membrane and is homologous to the NADH dehydrogenase 1-alpha subcomplex subunit 13 of the electron transport chain. Multiple sclerosis (MS) is a demyelinating disease that damages the brain and spinal cord. Although both the cause and mechanism of MS progression remain unclear, it is accepted that an immune disorder is involved. We explored whether GRIM-19 ameliorated MS by increasing the levels of inflammatory cytokines and immune cells; we used a mouse model of experimental autoimmune encephalomyelitis (EAE) to this end. Six-to-eight-week-old male C57BL/6, IFNγ-knockout (KO), and GRIM-19 transgenic mice were used; EAE was induced in all strains. A GRIM-19 overexpression vector (GRIM19 OVN) was electrophoretically injected intravenously. The levels of Th1 and Th17 cells were measured via flow cytometry, immunofluorescence, and immunohistochemical analysis. IL-17A and IFNγ expression levels were assessed via ELISA and quantitative PCR. IL-17A expression decreased and IFNγ expression increased in EAE mice that received injections of the GRIM-19 OVN. GRIM19 transgenic mice expressed more IFNγ than did wild-type mice; this inhibited EAE development. However, the effect of GRIM-19 overexpression on the EAE of IFNγ-KO mice did not differ from that of the empty vector. GRIM-19 expression was therapeutic for EAE mice, elevating the IFNγ level. GRIM-19 regulated the Th17/Treg cell balance.

• The Journal of Bigdata
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• v.8 no.2
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• pp.165-175
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• 2023

LNG is a representative imported cargo at Incheon Port and has a relatively high contribution to the increase/decrease in overall cargo volume at Incheon Port. In addition, in the view point of nationwide, LNG is the one of the most important key resource to supply the gas and generate electricity. Thus, it is very essential to identify the factors that have impact on the demand fluctuation and build the appropriate forecasting model, which present the basic information to make balance between supply and demand of LNG and establish the plan for power generation. In this study, different to previous research based on macroscopic annual data, the weekly demand of LNG is converted from the cargo volume unloaded by LNG carriers. We have identified the periodicity and correlations among internal and external factors of demand variability. We have identified the input factors for predicting the LNG demand such as seasonality of weekly cargo volume, the peak power demand, and the reserved capacity of power supply. In addition, in order to predict LNG demand, considering the characteristics of the data, time series prediction with weekly LNG cargo volume as a dependent variable and prediction through an artificial neural network model were made, the suitability of the predictions was verified, and the optimal model was established through error comparison between performance and estimates.

• Journal of Acupuncture Research
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• v.21 no.4
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• pp.177-196
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• 2004

Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

• Journal of Gifted/Talented Education
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• v.21 no.1
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• pp.57-81
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• 2011

The purpose of this study was to explore the quality of life of musically talented students as measured by their external experiences (e.g., activities, companions) and internal experiences (e.g., flow, emotion). The participants in this study were 33 musically talented students (10 males, 23 females) aged 13 to 19. Study data were collected for 7 consecutive days using the Experience Sampling Method (ESM), which employs a cellular-phone as a signaling device. The results were as follows: First, in response to the 1625 random signals, musically talented students reported that 40.9% of their time was spent on productive activities. An additional 33.4% of time was used for maintenance activities and the rest of their time was spent on leisure/social activities. Also, musically talented students reported that 48.5% of their time was spent alone. When they were alone, they spent a lot of time engaging in productive activities (44.3%). Second, in order to measure the flow of their life, two methods were used. One used a 4-channel flow model (i.e. apathy, boredom, flow, anxiety) and the other used 8 dimensions and conditions of the flow experience (i.e. concentration, self-consciousness disappears, action and awareness merge, distorted sense of time, freedom from worry about failure, clear goals, immediate feedback, balance between challenges and skills). According to the former, when engaged in music-related activities, musically talented students usually reported flow (54.0%), while they felt apathy (41.3%) for daily routines activities. According to the latter method, musically talented students experienced flow for most productive activities, while they experienced flow least for maintenance activities. Emotional variables of ESF are comprised of 10 semantic scales (i.e. happy-sad, strong-weak, active-passive, sociablelonely, proud-ashamed, involved-detached, excited-bored, clear-confused, relaxed-worried, cooperative-competitive). Musically talented students reported experiencing the most positive emotion for social activities and experiencing the most negative emotion for maintenance activities. Results of this study assert that musically talented students had to trade off immediate enjoyment for developing their special gifts. They could not afford as much time for socializing with friends, and they had to spend more time alone compared to their peers without such gifts. Consequently, they were found to deprive themselves of the spontaneous good times that teenagers usually thrive on. They were helped in this respect by their autotelic personality traits, especially their strong need for achievement and endurance. The downside, however, is that the moment-to-moment quality of their moods suffered. The argument concerning musically talented students applies for all adolescents. The choices that talented students must make between immediate gratification and long-term development, and between solitude and companionship, are the same choices every young person must make, regardless of her or his level of talent. All of us have gifts that are potentially useful and worthy of being appreciated. But to develop these latent talents we must cultivate them, and this takes time and the investment of mental energy. The lifestyle that musically talented students develop can show us some of the choices all of us must make in order to cultivate our gifts.

• Journal of Biosystems Engineering
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• v.3 no.2
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• pp.35-61
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• 1978

To find out the power tiller's travel and tractive characteristics on the general slope land, the tractive p:nver transmitting system was divided into the internal an,~ external power transmission systems. The performance of power tiller's engine which is the initial unit of internal transmission system was tested. In addition, the mathematical model for the tractive force of driving wheel which is the initial unit of external transmission system, was derived by energy and force balance. An analytical solution of performed for tractive forces was determined by use of the model through the digital computer programme. To justify the reliability of the theoretical value, the draft force was measured by the strain gauge system on the general slope land and compared with theoretical values. The results of the analytical and experimental performance of power tiller on the field may be summarized as follows; (1) The mathematical equation of rolIing resistance was derived as $$Rh=\frac {W_z-AC \[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\] sin\theta_1}} {tan\phi \[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\]+\frac{tan\theta_1}{1}$$ and angle of rolling resistance as $$\theta _1 - tan^1\[ \frac {2T(AcrS_0 - T)+\sqrt (T-AcrS_0)^2(2T)^2-4(T^2-W_2^2r^2)\times (T-AcrS_0)^2 W_z^2r^2S_0^2tan^2\phi} {2(T^2-W_z^2r^2)S_0tan\phi}\] $$and the equation of frft force was derived as$$P=(AC+Rtan\phi)\[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\]cos\phi_1 \ulcorner \frac {W_z \ulcorner{AC\[ [1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\]sin\phi_1 {tan\phi[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\]+ \frac {tan\phi_1} { 1} \ulcorner W_1sin\alpha $$The slip coefficient K in these equations was fitted to approximately 1. 5 on the level lands and 2 on the slope land. (2) The coefficient of rolling resistance Rn was increased with increasing slip percent 5 and did not influenced by the angle of slope land. The angle of rolling resistance Ol was increasing sinkage Z of driving wheel. The value of Ol was found to be within the limits of Ol =2\ulcorner "'16\ulcorner. (3) The vertical weight transfered to power tiller on general slope land can be estim ated by use of th~ derived equation: $$R_pz= \frac {\sum_{i=1}^{4}{W_i}} {l_T} { (l_T-l) cos\alpha cos\beta \ulcorner \bar(h) sin \alpha - W_1 cos\alpha cos\beta$$The vertical transfer weight $R_pz$ was decreased with increasing the angle of slope land. The ratio of weight difference of right and left driving wheel on slop eland,$\lambda= \frac { {W_L_Z} - {W_R_Z}} {W_Z} $, was increased from ,$\lambda$=0 to$\lambda$=0.4 with increasing the angle of side slope land ($\beta = 0^\circ~20^\circ) (4) In case of no draft resistance, the difference between the travelling velocities on the level and the slope land was very small to give 0.5m/sec, in which the travelling velocity on the general slope land was decreased in curvilinear trend as the draft load increased. The decreasing rate of travelling velocity by the increase of side slope angle was less than that by the increase of hill slope angle a, (5) Rate of side slip by the side slope angle was defined as $ S_r=\frac {S_s}{l_s} \times$ 100( %), and the rate of side slip of the low travelling velocity was larger than that of the high travelling velocity. (6) Draft forces of power tiller did not affect by the angular velocity of driving wheel, and maximum draft coefficient occurred at slip percent of S=60% and the maximum draft power efficiency occurred at slip percent of S=30%. The maximum draft coefficient occurred at slip percent of S=60% on the side slope land, and the draft coefficent was nearly constant regardless of the side slope angle on the hill slope land. The maximum draft coefficient occurred at slip perecent of S=65% and it was decreased with increasing hill slope angle $\alpha$. The maximum draft power efficiency occurred at S=30 % on the general slope land. Therefore, it would be reasonable to have the draft operation at slip percent of S=30% on the general slope land. (7) The portions of the power supplied by the engine of the power tiller which were used as the source of draft power were 46.7% on the concrete road, 26.7% on the level land, and 13~20%; on the general slope land ($\alpha = O~ 15^\circ ,\beta = 0 ~ 10^\circ$) , respectively. Therefore, it may be desirable to develope the new mechanism of the external pO'wer transmitting system for the general slope land to improved its performance.l slope land to improved its performance.

• Journal of Biosystems Engineering
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• v.3 no.2
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• pp.34-34
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• 1978

To find out the power tiller's travel and tractive characteristics on the general slope land, the tractive p:nver transmitting system was divided into the internal an,~ external power transmission systems. The performance of power tiller's engine which is the initial unit of internal transmission system was tested. In addition, the mathematical model for the tractive force of driving wheel which is the initial unit of external transmission system, was derived by energy and force balance. An analytical solution of performed for tractive forces was determined by use of the model through the digital computer programme. To justify the reliability of the theoretical value, the draft force was measured by the strain gauge system on the general slope land and compared with theoretical values. The results of the analytical and experimental performance of power tiller on the field may be summarized as follows; (1) The mathematical equation of rolIing resistance was derived as $$Rh=\frac {W_z-AC \[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\] sin\theta_1}} {tan\phi \[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\]+\frac{tan\theta_1}{1}$$ and angle of rolling resistance as $$\theta _1 - tan^1\[ \frac {2T(AcrS_0 - T)+\sqrt (T-AcrS_0)^2(2T)^2-4(T^2-W_2^2r^2)\times (T-AcrS_0)^2 W_z^2r^2S_0^2tan^2\phi} {2(T^2-W_z^2r^2)S_0tan\phi}\] $$and the equation of frft force was derived as$$P=(AC+Rtan\phi)\[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\]cos\phi_1 ? \frac {W_z ?{AC\[ [1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\)\]sin\phi_1 {tan\phi[1+ \frac{sl}{K} \(\varrho ^{-\frac{sl}{K}-1\]+ \frac {tan\phi_1} { 1} ? W_1sin\alpha $$The slip coefficient K in these equations was fitted to approximately 1. 5 on the level lands and 2 on the slope land. (2) The coefficient of rolling resistance Rn was increased with increasing slip percent 5 and did not influenced by the angle of slope land. The angle of rolling resistance Ol was increasing sinkage Z of driving wheel. The value of Ol was found to be within the limits of Ol =2? "'16?. (3) The vertical weight transfered to power tiller on general slope land can be estim ated by use of th~ derived equation: $$R_pz= \frac {\sum_{i=1}^{4}{W_i}} {l_T} { (l_T-l) cos\alpha cos\beta ? \bar(h) sin \alpha - W_1 cos\alpha cos\beta$$The vertical transfer weight $R_pz$ was decreased with increasing the angle of slope land. The ratio of weight difference of right and left driving wheel on slop eland,$\lambda= \frac { {W_L_Z} - {W_R_Z}} {W_Z} $, was increased from ,$\lambda$=0 to$\lambda$=0.4 with increasing the angle of side slope land ($\beta = 0^\circ~20^\circ) (4) In case of no draft resistance, the difference between the travelling velocities on the level and the slope land was very small to give 0.5m/sec, in which the travelling velocity on the general slope land was decreased in curvilinear trend as the draft load increased. The decreasing rate of travelling velocity by the increase of side slope angle was less than that by the increase of hill slope angle a, (5) Rate of side slip by the side slope angle was defined as $ S_r=\frac {S_s}{l_s} \times$ 100( %), and the rate of side slip of the low travelling velocity was larger than that of the high travelling velocity. (6) Draft forces of power tiller did not affect by the angular velocity of driving wheel, and maximum draft coefficient occurred at slip percent of S=60% and the maximum draft power efficiency occurred at slip percent of S=30%. The maximum draft coefficient occurred at slip percent of S=60% on the side slope land, and the draft coefficent was nearly constant regardless of the side slope angle on the hill slope land. The maximum draft coefficient occurred at slip perecent of S=65% and it was decreased with increasing hill slope angle $\alpha$. The maximum draft power efficiency occurred at S=30 % on the general slope land. Therefore, it would be reasonable to have the draft operation at slip percent of S=30% on the general slope land. (7) The portions of the power supplied by the engine of the power tiller which were used as the source of draft power were 46.7% on the concrete road, 26.7% on the level land, and 13~20%; on the general slope land ($\alpha = O~ 15^\circ ,\beta = 0 ~ 10^\circ$) , respectively. Therefore, it may be desirable to develope the new mechanism of the external pO'wer transmitting system for the general slope land to improved its performance.

• Journal of the Korean Geographical Society
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• v.38
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• pp.15-36
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• 1988

In this paper, I consider the development of methods in contemporary human geography in terms of a dialectical relation of action and structure, and try to draw a new horizon of method toward which geographical research and spatial theory would develop. The positivist geography which was dominent during 1960s has been faced both with serious internal reflections and strong external criticisms in the 1970s. The internal reflections that pointed out its ignorance of spatial behavior of decision-makers and its simplication of complex spatial relations have developed behavioural geography and systems-theoretical approach. Yet this kinds of alternatives have still standed on the positivist, geography, even though they have seemed to be more real and complicate than the previous one, The external criticisms that have argued against the positivist method as phenomenalism and instrumentalism suggest some alternatives: humanistic geography which emphasizes intention and action of human subject and meaning-understanding, and structuralist geography which stresses on social structure as a totality which would produce spatial phenomena, and a theoretical formulation. Human geography today can be characterized by a strain and conflict between these methods, and hence rezuires a synthetic integration between them. Philosophy and social theory in general are in the same in which theories of action and structural analysis have been complementary or conflict with each other. Human geography has fallen into a further problematic with the introduction of a method based on so-called political ecnomy. This method has been suggested not merely as analternative to the positivist geography, but also as a theoretical foundation for critical analysis of space. The political economy of space with has analyzed the capitalist space and tried to theorize its transformation may be seen either as following humanistic(or Hegelian) Marxism, such as represented in Lefebvre's work, or as following structuralist Marxism, such as developed in Castelles's or Harvey's work. The spatial theory following humanistic Marxism has argued for a dialectic relation between 'the spatial' and 'the social', and given more attention to practicing human agents than to explaining social structures. on the contray, that based on structuralist Marxism has argued for social structures producing spatial phenomena, and focused on theorising the totality of structures, Even though these two perspectives tend more recently to be convergent in a way that structuralist-Marxist. geographers relate the domain of economic and political structures with that of action in their studies of urban culture and experience under capitalism, the political ecnomy of space needs an integrated method with which one can overcome difficulties of orthhodox Marxism. Some novel works in philosophy and social theory have been developed since the end of 1970s which have oriented towards an integrated method relating a series of concepts of action and structure, and reconstructing historical materialism. They include Giddens's theory of structuration, foucault's geneological analysis of power-knowledge, and Habermas's theory of communicative action. Ther are, of course, some fundamental differences between these works. Giddens develops a theory which relates explicitly the domain of action and that of structure in terms of what he calls the 'duality of structure', and wants to bring time-space relations into the core of social theory. Foucault writes a history in which strategically intentional but nonsubjective power relations have emerged and operated by virtue of multiple forms of constrainst wihthin specific spaces, while refusing to elaborate any theory which would underlie a political rationalization. Habermas analyzes how the Western rationalization of ecnomic and political systems has colonized the lifeworld in which we communicate each other, and wants to formulate a new normative foundation for critical theory of society which highlights communicatie reason (without any consideration of spatial concepts). On the basis of the above consideration, this paper draws a new norizon of method in human geography and spatial theory, some essential ideas of which can be summarized as follows: (1) the concept of space especially in terms of its relation to sociery. Space is not an ontological entity whch is independent of society and has its own laws of constitution and transformation, but it can be produced and reproduced only by virtue of its relation to society. Yet space is not merlely a material product of society, but also a place and medium in and through which socety can be maintained or transformed.(2) the constitution of space in terms of the relation between action and structure. Spatial actors who are always knowledgeable under conditions of socio-spatial structure produce and reproduce their context of action, that is, structure; and spatial structures as results of human action enable as well as constrain it. Spatial actions can be distinguished between instrumental-strategicaction oriented to success and communicative action oriented to understanding, which (re)produce respectively two different spheres of spatial structure in different ways: the material structure of economic and political systems-space in an unknowledged and unitended way, and the symbolic structure of social and cultural life-space in an acknowledged and intended way. (3) the capitalist space in terms of its rationalization. The ideal development of space would balance the rationalizations of system space and life-space in a way that system space providers material conditions for the maintainance of the life-space, and the life-space for its further development. But the development of capitalist space in reality is paradoxical and hence crisis-ridden. The economic and poltical system-space, propelled with the steering media like money, and power, has outstriped the significance of communicative action, and colonized the life-space. That is, we no longer live in a space mediated communicative action, but one created for and by money and power. But no matter how seriously our everyday life-space has been monetalrized and bureaucratised, here lies nevertheless the practical potential which would rehabilitate the meaning of space, the meaning of our life on the Earth.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1214-1222
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• 1998

Background : The intrapleural hypofibrinolysis is caused by mainly excessive concentration of pleural plasminogen activator inhibitor-1 antigen(PAI-1 Ag), which binds tissue type plasminogen activator. In pleural inflammation induced by sclerosing agents for pleurodesis, levels of pleural PAI-1 antigen increase in relation to decreasing D-dimer levels. It has been known that the pleural mesothelial cells have the capability of secreting PAI-1 Ag in response to inflammation in vivo. Therefore, we estimated whether pleural inflammation changes the balance between fibrinolytic and coagulative properties in exudative pleural effusions. Method : The thirty cases was included in our study. We determined the pleural levels of glucose, lactic dehydrogenase(LDH), pH and the counts of white blood cell(WBC), polymorpho leukocyte(PMN), lymphocyte as the parameters of pleural inflammation and cellular components of pleural fluid. The plasma level of fibrinogen in fluid and the neutrophil count in blood were determined. The levels of D-dimer, PAI-1 Ag and thrombinantithrombin III complex(TAT) were determined by ELISA(Behring, Marburg, Germany). Result : The causes of pleural effusion were as following : tuberculous in 14 cases, malignant in 10 cases and parapneumonic in 6 cases. The levels of pleural D-dimer, PAI-1 Ag and TAT was significantly higher than that of plasma(p<0..001). The severity of pleural inflammation did not correlated with pleural D-dimer, PAI-1 Ag, TAT and their plasma levels. But the level of pleural TAT correlated with pleural WBC and lymphocyte count. Conclusion : We found that the severity of pleural inflammations did not correlated with pleural D-dimer, PAI-1 Ag, TAT and the possibility of local production of PAI-1 antigen is present.

• 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.