• Journal of Global Scholars of Marketing Science
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• v.20 no.2
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• pp.135-148
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• 2010

Arab boycotts of Danish products, Australian boycotts of French products and Chinese consumer aversion toward Japanese products are all examples of how adverse actions at the country level might impact consumers' behavior. The animosity literature has examined how consumers react to the adverse actions of other countries, and how such animosity impacts consumers' attitudes and preferences for products from the transgressing country. For example, Chinese consumers are less likely to buy Japanese products because of Japanese atrocities during World War II and the unjust economic dealings of the Japanese (Klein, Ettenson and Morris 1998). The marketing literature, however, has not examined how consumers react to adverse actions committed by their own country against other countries, and whether such actions affect their attitudes towards purchasing products that originated from the adversely affected country. The social psychology literature argues that consumers will experience a feeling called collective guilt, in response to such adverse actions. Collective guilt stems from the distress experienced by group members when they accept that their group is responsible for actions that have harmed another group (Branscombe, Slugoski, and Kappenn 2004). Examples include Americans feeling guilty about the atrocities committed by the U.S. military at Abu Ghraib prison (Iyer, Schamder and Lickel 2007), and the Dutch about their occupation of Indonesia in the past (Doosje et al. 1998). The primary aim of this study is to examine consumers' perceptions of adverse actions by members of one's own country against another country and whether such perceptions affected their attitudes towards products originating from the country transgressed against. More specifically, one objective of this study is to examine the perceptual antecedents of collective guilt, an emotional reaction to adverse actions performed by members of one's country against another country. Another objective is to examine the impact of collective guilt on consumers' perceptions of, and preference for, products originating from the country transgressed against by the consumers' own country. If collective guilt emerges as a significant predictor, companies originating from countries that have been transgressed against might be able to capitalize on such unfortunate events. This research utilizes the animosity model introduced by Klein, Ettenson and Morris (1998) and later expanded on by Klein (2002). Klein finds that U.S. consumers harbor animosity toward the Japanese. This animosity is experienced in response to events that occurred during World War II (i.e., the bombing of Pearl Harbor) and more recently the perceived economic threat from Japan. Thus this study argues that the events of Word War II (i.e., bombing of Hiroshima and Nagasaki) might lead U.S. consumers to experience collective guilt. A series of three hypotheses were introduced. The first hypothesis deals with the antecedents of collective guilt. Previous research argues that collective guilt is experienced when consumers perceive that the harm following a transgression is illegitimate and that the country from which the transgressors originate should be responsible for the adverse actions. (Wohl, Branscombe, and Klar 2006). Therefore the following hypothesis was offered: H1a. Higher levels of perceived illegitimacy for the harm committed will result in higher levels of collective guilt. H1b. Higher levels of responsibility will be positively associated with higher levels of collective guilt. The second and third hypotheses deal with the impact of collective guilt on the preferences for Japanese products. Klein (2002) found that higher levels of animosity toward Japan resulted in a lower preference for a Japanese product relative to a South Korean product but not a lower preference for a Japanese product relative to a U.S. product. These results therefore indicate that the experience of collective guilt will lead to a higher preference for a Japanese product if consumers are contemplating a choice that inv olves a decision to buy Japanese versus South Korean product but not if the choice involves a decision to buy a Japanese versus a U.S. product. H2. Collective guilt will be positively related to the preference for a Japanese product over a South Korean product, but will not be related to the preference for a Japanese product over a U.S. product. H3. Collective guilt will be positively related to the preference for a Japanese product over a South Korean product, holding constant product judgments and animosity. An experiment was conducted to test the hypotheses. The illegitimacy of the harm and responsibility were manipulated by exposing respondents to a description of adverse events occurring during World War II. Data were collected using an online consumer panel in the United States. Subjects were randomly assigned to either the low levels of responsibility and illegitimacy condition (n=259) or the high levels of responsibility and illigitemacy (n=268) condition. Latent Variable Structural Equation Modeling (LVSEM) was used to test the hypothesized relationships. The first hypothesis is supported as both the illegitimacy of the harm and responsibility assigned to the Americans for the harm committed against the Japanese during WWII have a positive impact on collective guilt. The second hypothesis is also supported as collective guilt is positively related to preference for a Japanese product over a South Korean product but is not related to preference for a Japanese product over a U.S. product. Finally there is support for the third hypothesis, since collective guilt is positively related to the preference for a Japanese product over a South Korean product while controlling for the effect of product judgments about Japanese products and animosity. The results of these studies lead to several conclusions. First, the illegitimacy of harm and responsibility can be manipulated and that they are antecedents of collective guilt. Second, collective guilt has an impact on a consumers' decision when they face a choice set that includes a product from the country that was the target of the adverse action and a product from another foreign country. This impact however disappears from a consumers' decision when they face a choice set that includes a product from the country that was the target of the adverse action and a domestic product. This result suggests that collective guilt might be a viable factor for company originating from the country transgressed against if its competitors are foreign but not if they are local.

• Korean Journal of Agricultural Science
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• v.8 no.1
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• pp.97-107
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• 1981

This study was carried out in order to provide the basic data necessary to develop the effective and desirable cooking method on large scale for investigating the physical characteristics of cooked rices and studying optimum cooking conditions by pressure in kettle cooking rices. Milyang-15, local Japonica type and Milyang-23, high yielding Indica type major varieties cultivated in Korea were used as cooking sample after polishing 70% and 90% respectively, and the results obtained are summarized as follows. 1. The average moisture content of cooked rice by open kettle and pressure kettle method in typical households were 65.17% and 64.52%, respectively. 2. In water absorption capacity of rice grain Milyang-23 was 4.5% higher than Milyang-15, and maximum water content after absorption in Milyang-23 was 29.14%. 3. The expansion volume of cooked rice was changed proportionally by water absorption, heating temperature and time, and maximum expansion volume of cooked rice was 3.2 times greater than rice grain. 4. The gelatinization degree of cooked rice intensively concerning in hardness of rice grain was increased as water-to-rice ratio, heating temperature and time increased, and it was 0.44 in Milyang-23 and 0.64 in Milyang-15 under the optimum cooking conditions as 160% water-to-rice ratio, $0.2kg/cm^2$ cooking pressure and 25 minutes cooking time. 5. The hardness of cooked rice was decreased as water-to-rice ratio, heating temperature and time increased, and it showed 2.35kg/wt in 90% polished Milyang-23 and 2.0kg/wt in 90 polished Milyang-15 under optimum cooking conditions. For maintaining the same level of hardness of cooking rice Milyang-23 required 25% much more water than Milyang-15. 6. The elasticity of cooked rice was changed proportionally by water-to-rice ratio, heating temperature and time, and it appeared 19.2mm and 15.7mm in 90% polished Milyang-15 and Milyang-23 respectively. 7. The gumminess of cooked rice was decreased as water-to-rice ratio, heating temperature and time increased, and it showed 60 and 73 in 90% polished Milyang-23 and Milyang-15, respectively. 8. The optimum cooking time on differerent pressure in kettle took 25 minutes at $0.2kg/cm^2$, 20 minutes at $0.4kg/cm^2$, 15 minutes at $0.6kg/cm^2$, and 10 minutes at $0.8kg/cm^2$.

• Economic and Environmental Geology
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• v.12 no.3
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• pp.147-176
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• 1979

The Yeonhwa II zinc-lead mine is characterized by a dozen of moderately dipping tabular orebodies of skarn and zinc-lead sulfides, developed in accordance with the ENE-trending bedding thrusts and bedding planes of the Pungchon Limestone and underlying Myobong Formation, mostly along the contacts of a ENE-trending sill and a NW-trending dike of quartz mononite porphyry. The orebodies occur in three groups: (1) the footwall Wolgok orebodies with respect to the sill, (2) the hangingwall Wolgok orebodies, and (3) the Seongok orebodies extended from dike contacts into carbonate beds. Mineral compositions of these orebodies are dominated by calc-silicates (skarn) associated with ore minerals of sphalerite, galena, and chalcopyrite, as well as sulfide gangue of pyrrhotite. A pair of exo- and endo-skerns in the Wolgok footwall contact aureole between the Pungchon Limestone and quartz monzonite porphyry on the -120 level represents a well-developed symmetrical pattern of mineral zoning: a garnet/quartz zone in the center of exoskarn, two zones of pyroxene with ore minerals on both sides of the garnet/quartz zone, further outwards-an epidote/chlorite-bearing hornfelsic zone in the Myobong slate beyond a zone of unaffected limestone, and an epidote-dominated zone of endo skarn on the opposite side toward fresh quartz monzonite porphyry. These features indicate a combination of two effects on the skarn formation: (1) differences in composition of the host rocks(sedimentary and ignous), and (2) progressive outward migration of inner zones on outer zones on the course of metasomatic replacement of the pre-existing minerals. Microprobe analyses of garnet, pyroxene, pyroxenoids, epidote, and chlorite for nine major elements on a total of 23 mineral grains revealed that: the pyroxenes are hedenbergitic, in most zones, with a gradual decrease of Fe- and Mn-contents toward the central zone, whereas the garnets are andraditic in outer zones, but are grossularitic in the central zone. This indicates a reverse relationship of Fe-contents between pyroxene and garnet across the exoskarn zones. Pyroxenoids are lacking in wollastonite but are dominated by pyroxmangite, rhodonite and bustamite, indicating a Mn-rich nature in bulk chemistry. Pseudomorphic fluorite after garnet occurs abundantly reflecting a fluorine-enhanced evidence of the skarn-forming fluids. Epidote contains 0.19-0.25mole fraction of pistacite, and chlorite is Mn-rich but is Mg-poor. Sulfide mineralization took place with the most Fe-rich pyroxene rather than with garnet as indicated by the fact that the highest value of hedenbergite mole fraction occurs in the ore-bearing pyroxene zone. The Yeonhwa II ores are characterized by high zinc and low lead in metal grade, with minor quantity of copper content in almost constant grade. The hangingwall Wolgok and Seongok orebodies, that formed in a more open environment with respect to their local configurations of geologic setting, are more variable in metal grades and ratios, than are the footwall Wolgok orebodies formed in a more closed condition in a narrow interval of sedimentary beds.

• Applied Biological Chemistry
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• v.26 no.2
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• pp.82-89
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• 1983

In order to develop a commercial storage method of onions by irradiation combined with natural low temperature, two local varieties of onions, precocious species and late ripening, were stored at natural low temperature storage room ($450{\times}650{\times}250cmH.$; year-round temperature change, $2{\sim}17^{\circ}C$; R.H., $80{\sim}85%$) on batch scale following irradiation with optimum dose level. Precocious and late varieties were all sprouted after five to seven months storage, whereas $10{\sim}15$ Krad irradiated precocious variety was $2{\sim}4%$ sprouted after nine months storage, but sprouting was completly inhibited at the same dose for late variety. The extent of loss due to rot attack after ten months storage were $23{\sim}49%$ in both control and irradiated group of precocious variety but those of late variety were only $4{\sim}10%$. The weight loss of irradiated precocious variety after ten months storage was $13{\sim}16$, while that of late variety was $5.3{\sim}5.9%$ after nine months storage. The moisture content, during whole storage period, of two varieties were $90{\sim}93$ with negligible changes. The total sugar content differed little with varieties and doses immediatly after irradiation, but decreased by the elapse of storage period. 33.6% of its content was decreased in control and 12.5% in irradiated group but $20{\sim}26$ decreased in both control and irradiated group of late variety after nine months storage. No appreciable change was observed immediately after irradiation irrespective of variety and dose, but decreased slightly with storage. Ascorbic acid content of precocious variety was increased slightly with dose immediately after irradiation, but those of late variety decreased slightly. Ascorbic acid content were generally decreased during whole storage period. An economical preservation method of onions appliable to late variety, would be to irradiate onion bulbs at dost range of $10{\sim}15$ Krad followed by storage at natural low temperature storage room.

• Korean Journal of Breeding Science
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• v.41 no.4
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• pp.607-611
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• 2009

"Jongnambyeo", a new japonica rice cultivar(Oryza sativa L.), is a mid-late maturing ecotype developed by the rice breeding team of National Yeongnam Agricultural Experiment Station(NYAES) in 2001 and released in 2002. This variety originated from the cross of Milyang96/YR12734-B-B-22-2(in 1991/1992 winter) and was selected by means of a mixed method of bulk and pedigree breeding. The pedigree of Junambyeo, Milyang 169 designated in 1999, was YR15161-B-B-B-57-2-3. It has about 79cm in culm length and tolerant to lodging. And this variety is resistant to bacterial leaf blight($K_1$), stripe virus and moderately resistant to leaf blast disease. Milled rice kernels of "Jongnambyeo" is translucent with non-glutinous endosperm and clear in chalkness and good at eating quality in pannel test. The yield potential of "Jongambyeo" in milled rice is about 5.60MT/ha at ordinary fertilizer level of local adaptability test. This cultivar would be adaptable to the Yeongnam plain and southern coastal of Korea.

• The Korean Journal of Archival Studies
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• no.22
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• pp.157-199
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• 2009

The organization for managing records and archives did not emerge together with the founding of the Chinese Communist Party. Such management became active with the establishment of the Department of Documents (文書科) and its affiliated offices overseeing reading and safekeeping of official papers, after the formation of the Central Secretariat(中央秘書處) in 1926. Improving the work of the Secretariat's organization became the focus of critical discussions in the early 1930s. The main criticism was that the Secretariat had failed to be cognizant of its political role and degenerated into a mere "functional organization." The solution to this was the "politicization of the Secretariat's work." Moreover, influenced by the "Rectification Movement" in the 1940s, the party emphasized the responsibility of the Resources Department (材料科) that extended beyond managing documents to collecting, organizing and providing various kinds of important information data. In the mean time, maintaining security with regard to composing documents continued to be emphasized through such methods as using different names for figures and organizations or employing special inks for document production. In addition, communications between the central political organs and regional offices were emphasized through regular reports on work activities and situations of the local areas. The General Secretary not only composed the drafts of the major official documents but also handled the reading and examination of all documents, and thus played a central role in record processing. The records, called archives after undergoing document processing, were placed in safekeeping. This function was handled by the "Document Safekeeping Office(文件保管處)" of the Central Secretariat's Department of Documents. Although the Document Safekeeping Office, also called the "Central Repository(中央文庫)", could no longer accept, beginning in the early 1930s, additional archive transfers, the Resources Department continued to strengthen throughout the 1940s its role of safekeeping and providing documents and publication materials. In particular, collections of materials for research and study were carried out, and with the recovery of regions which had been under the Japanese rule, massive amounts of archive and document materials were collected. After being stipulated by rules in 1931, the archive classification and cataloguing methods became actively systematized, especially in the 1940s. Basically, "subject" classification methods and fundamental cataloguing techniques were adopted. The principle of assuming "importance" and "confidentiality" as the criteria of management emerged from a relatively early period, but the concept or process of evaluation that differentiated preservation and discarding of documents was not clear. While implementing a system of secure management and restricted access for confidential information, the critical view on providing use of archive materials was very strong, as can be seen in the slogan, "the unification of preservation and use." Even during the revolutionary movement and wars, the Chinese Communist Party continued their efforts to strengthen management and preservation of records & archives. The results were not always desirable nor were there any reasons for such experiences to lead to stable development. The historical conditions in which the Chinese Communist Party found itself probably made it inevitable. The most pronounced characteristics of this process can be found in the fact that they not only pursued efficiency of records & archives management at the functional level but, while strengthening their self-awareness of the political significance impacting the Chinese Communist Party's revolution movement, they also paid attention to the value possessed by archive materials as actual evidence for revolutionary policy research and as historical evidence of the Chinese Communist Party.

• Korean Journal of Heritage: History & Science
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• v.45 no.3
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• pp.60-79
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• 2012

Environment of ancient Chinese Buddhist temple can be classified to three types such as regional society(鄕村), famous mountain(名山), and urban areas(都市). This made differences in environment where a temple existed and in turn, affected development of Buddhism. And this made another type in relationship between Buddhist temple and a society. This study explains influences which regional society gave on not only Buddhist temple and a monk but also existence and development of Buddhism. When temples are placed in different environmental position, that is, urban areas and regional society, among a social structure, they eventually should adapt to a different society externally and internally. As told in above, ancient Chinese Buddhist temple was located in regional society, famous mountain, and urban areas. Since Eastern Jin and Sixteen Kingdoms, as number of temple much increased, and temples and monks were concentrated on famous mountain, temples in famous mountains and urban areas had developed showing similar aspects each other. But because temples in regional society were influenced a little differently, this study focused on the point. There are four kinds of influences between temples and monks in regional areas. Monks in regional areas had a comparatively close relationship with a society because they came from same area or surrounding areas. Therefore,powers of regional areas restrict influences made by monk group in temple. Second, temples in regional areas shared their joys and sorrows depending on regional economy. Temples in regional areas became a public place for the society and often a market place. In fact, construction and existence of a temple originally became a driving force in regional economy. This is because construction of temple needs artisans and materials and some temples had visitors and included market economy like consumption of incense and candles, though the economic size was large or small. And when regional areas experienced natural disaster or man-made disaster or had poor harvest or economy was in depression, monks left temples and then, temples themselves could not exist. Third, the relationship between temples in regional areas and Buddhists was distinguished from the temples in urban areas and famous mountains. This is because temples in China were places where monks practiced and at the same time, places where general Buddhists worshipped. So there were always a number of Buddhists around the temples. Forth, Buddhism in resional areas was connected to regional Folk beliefs. As a result, Buddhism was spread across the nation, worship with local color often was changed to Buddhist belief or was tinged with Buddhism. While temples in regional areas maintained a close relationship with regional society.they were influenced by the region or gave influences. As a representative example, temples in regional areas showed model behaviors instead of roles of facilities related to various cultures with comparatively advanced level - for example, school, hospital etc. The temples highly affected funerary rites in regional areas. Chinese tombs were mainlymade in regional areas. After death,people living in urban areas were buried in hometown or at least, they were buried in suburbs not urban areas. Temples in regional areas generally participated in funerary rites. Above shows that though most of famous Buddhist temples were located in urban areas not in famous mountains,majority of temples were located in vast regional areas. Through mutual interaction between temples and regional society, the temples in the regional areas were related to Chinese people of over 90% and regional areas became the most important foundation for Buddhism in China. Mutual influences between temples in regional areas and the general public in regions were omnidirectional and spreaded to every aspects of social life in small or large degree. Thus Tombs in temple were widely spreaded across regional areas over time and space. This is enough to explain a close relationship between Buddhist temples and rural society in ancient China.

• Korean Journal of Breeding Science
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• v.51 no.3
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• pp.263-276
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• 2019

'Sinjinbaek' is a bacterial blight (BB)-resistant, mid-late maturing rice cultivar with high grain quality. To diversify the resistance genes and enhance the resistance of Korean rice cultivars against BB, 'Sinjinbaek' was developed from a cross between 'Iksan493' (cultivar name 'Jinbaek') and the F₁ cross between 'Hopum' and 'HR24670-9-2-1' ('HR24670'). 'Jinbaek' is a BB-resistant cultivar with two BB resistance genes, Xa3 and xa5. 'Hopum' is a high grain quality cultivar with the Xa3 resistance gene. 'HR24670' is a near-isogenic line that carries the Xa21 gene, a resistance gene inherited from a wild rice species O. longistaminata, in the genetic background of japonica elite rice line 'Suweon345'. 'Sinjinbaek' was selected through the pedigree method, yield trials, and local adaptability tests. Using bioassay for BB races and DNA markers for resistance genes, three resistance genes, Xa3, xa5, and Xa21, were pyramided in the 'Sinjinbaek' cultivar. 'Sinjinbaek' exhibited high-level and broad-spectrum resistance against BB, including the K3a race, the most virulent race in Korea. 'Sinjinbaek' is a mid-late maturing rice cultivar tolerant to lodging. It has multiple disease resistance against BB, rice blast, and stripe virus. The yield of 'Sinjinbaek' was similar to that of 'Nampyeong'. 'Sinjinbaek' showed excellent grain appearance, good taste of cooked rice, and enhanced milling performance, and we concluded that it could contribute to improving the quality of BB-resistant cultivars. 'Sinjinbaek' was successfully introgressed with the Xa21 gene without the linkage drag negatively affecting its agronomic characteristics. 'Sinjinbaek' improved the resistance of Korean rice cultivars against BB by introgression of a new resistance gene, Xa21, as well as by pyramiding three resistance genes, Xa3, xa5, and Xa21. 'Sinjinbaek' would be suitable for the cultivation in BB-prone areas since it has been used in breeding programs for enhancing plants' resistance to BB (Registration No. 7273).

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

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

• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.39-46
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• 1989

Kimura's Disease is a chronic inflammatory and proliferative condition producing subcutaneous masses especially in the head and neck area. This report of our experience with 5 patients with this disease is the first in the Korean surgical literature. Kimura's Disease is thought to be part of the larger spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). It is characterized pathologically by hyperplastic lymphoid follicles, eosinophilic infiltration, and vase 비 ar proliferation. It produces masses which are most common in the area of the parotid, submandibular gland and upper neck. These masses occupy the subcutaneous tissues but also extend into salivary tissue and into upper neck nodes. One of our patients had masses in the groin. The tumors are extremely vascular due to the presence of new proliferative vessels and sinusoids. The average age of our 5 patients was 35, but all but one case were younger than 38 years of age. The male: female ratio was 3 : 2, and the average duration of symptoms was 5,2years. All patients had peripheral blood eosinophilia. All had multiple masses, sometimes symmetrical. The management was surgery alone in one case, surgery and steroids in one case, surgery and radiotherapy in two cases, and all three modalities in one case. The relationship of this entity to ALHE and our experience in the management of this disease are presented. A clinicopathological discrepancy alerted us to the existence of Kimura's Disease. A nineteen-year old male presented with subcutaneous masses over both mastoid areas present for 3 years (Case III). When biopsy on each side was reported as 'eosinophilic granuloma' we submitted the slides to an internationally expert pathologist. Symmetrically occurring tumors in the peri-parotid subcutaneous areas did not fit any category of neoplasm or granuloma known to us. The diagnosis, made by Dr. Gist Fan at the Ochsner Clinic, was Kimura's Disease. We found two additional cases in a review of soft tissue eosinophilic granuloma previously reported at Presbyterian Medical Center, and since then have diagnosed two new cases. These five cases constitute the basis for this, the largest series to be reported in Korea. These vascular, tumor-like lesions of the skin, subcutaneous areas and subjacent structures of the head and neck have been a variety of names, such as angiolymphoid hyperplasia with eosinophilia, eosinophilic hyperplastic lymphogranuloma, angioblastic lymphoid hyperplasia with eosinophilia, histioid hemangioma, and epithelioid hemangioma. The history of this disease spectrum dates back to 1937 when Kimm and Szeto (1) reported 7 cases of 'eosinophilic hyperplastic lymphogranuloma' in the Proceedings of the Chinese Medical Journal. In 1948 Kimura and his associates(2) reported additional cases in Japan under the title 'On the unusual granulation combined with hyperplastic changes of lymphatic tissue.' From then until 1966 several hundred cases were reported in China and Japan. The first report from the West was by Wells and Whimster(3) in the British Journal of Dermatology, in 1969. These authors coined the term, angiolymphoid hyperplasia with eosinophilia (ALHE). Since that time a debate has ensued as to whether Kimura's Disease and ALHE are distinct entities, or whether Kimura's is part of the larger spectrum of ALHE, perhaps a later or advanced phase. From the clinical perspective, surgeons should be aware of the diagnosis of Kimura's Disease not only as part of the differential diagnosis of head and neck tumors but also because these lesions are indolent, and generally require conservative surgical removal as part of the management program. CASE I. A 37-year-old female company employee presented in August 1982 with submental swelling of 12 years' duration and with inguinal swelling of 7 years' duration. The submental mass measured 5x5cm. and the inguinal mass was 8x4cm. in size. Peripheral eosinophilia varying from 14% to 40% was found. On August 20, 1982, the submental mass was removed and a superficial groin dissection was done. In May 1983 an intraoral lesion of the palate was removed. The patient is free of disease. CASE II. A 23-year-old unemployed man visited this hospital for the first time in July, 1984, with swelling of the right cheek present for 6 years. The mass was soft and ill-defined but measured 10x20cm. and extended from the submandibular upper neck to the zygomatic arch, and from the mastoid to the cheek, over the parotid gland. Eosinophilia varying from 27% to 29% was noted in the peripheral blood. On March 21, 1986, the lesion was resected. The procedure comprised an extended superficial parotidectomy from the temporalis fascia to the upper neck. Post-operatively radiotherapy 3000 rad tissue dose was administered using the 6 MeV linear accelerator. The patient remains free of disease. CASE III. A 19-year-old student came to the clinic with masses over both mastoid areas, present 3 years. On the right there were two adjacent lesions, one over the mastoid, the other in the upper jugular level of the neck. On the left it was a single mass over the mastoid. Eosinophilia varied from 13 to 32% in the peripheral blood, and 11.6% in the bone marrow. Incisional biopsy revealed 'eosinophilic granuloma' and a trial of predisolone was employed. The mass increased in size so a small dose of radiation (600 rads) was used, with substantial regression,. The lesion on the left was excised and follwed by 1000 rads radiotherapy. Finally recurrent tumor on the right side was removed on November 5, 1985. The patient remains free of disease. CASE N. A 29-year-old local merchant had had swelling of both upper necks since childhood. At the time of his first visit on March 17, 1986, the right submandibular mass measured 5x3.5cm. and the ,right upper neck and parotid tail mass measured 2.5cm. On the left there were masses in the upper neck, the largest of which measured 2.5cm, and of the parotid tail, 2.0cm. in size.(See Fig. 1) Peripheral eosinophilia of 39% was recorded. Left side partial parotidectomy and resection of the upper neck and subdigstric mases was done on May 2, 1986. The mass involving the right parotid tail and upper neck nodes was removed on Angust 7,1986. Postoperatively the patient was placed on prednisolone 30 mg. per day. No definite masses are palpable. CASE V. A 66-year-old housewife informed us, at the time of her first visit in May, 1986, that she had had multiple neck masses since 10 years ago. On the right side there was a 2.5cm. subcutaneous mass of the upper neck, over the upper jugular chain. On the left there was a 9x4.5cm. mass involving the entire parotid, the post-auricular area and the upper neck. A third mass presented in the submental area and measured 3.5cm. (See Fig. 2) Eosinophilia of 51% was noted in the peripheral blood. partial excision of the left upper neck lesion and complete excision of the submental mass were performed on june 6, 1986. post-operatively she was placed on 20 mg. of prednisolone daily, but when the mass re-grew after two months she was referred to Radiation Therapy for a 2500 rad course of treatment. A barely palpable thickening remains.