In recent years, frequent terror or military attacks by explosion or impact accidents have occurred. Examplary case of these attacks were World Trade Center collapse and US Department of Defense Pentagon attack on Sept. 11 of 2001. These attacks of the civil infrastructure have induced numerous casualties and property damage, which raised public concerns and anxiety of potential terrorist attacks. However, a existing design procedure for civil infrastructures do not consider a protective design for extreme loading scenario. Also, the extreme loading researches of prestressed concrete (PSC) member, which widely used for nuclear containment vessel, gas tank, bridges, and tunnel, are insufficient due to experimental limitations of loading characteristics. To protect concrete structures against extreme loading such as explosion and impact with high strain rate, understanding of the effect, characteristic, and propagation mechanism of extreme loadings on structures is needed. Therefore, in this paper, to evaluate the impact resistance capacity and its protective performance of bi-directional unbonded prestressed concrete member, impact tests were carried out on
This study demonstrates the changes in the spatial organization of Korea by the construction of Seoul-Pusan railroad. This Seoul-Pusan line, which is the most important one in Korea was constructed in 1905. The original plan of the line was selected to cross the main traditional roads to control the entire Korean peninsular and to mobilize the Korean commercial potentials. It was the line to exploit the staples and to expand the Japanese market in Korea. In accordance with the contracts between Japan and Korean government, Korean government had to supply the lands for railroad, office, and service facilities. That was one of the important reasons that Korean government had been broken down. The main findings of this study are as follows: 1. The Seoul-Pusan railroad line was constructed Japanese colonial policy which emphasized three main purposes; the first was to reorganize the economic space and to collapse the traditional Korean markets for Japanese ruling, and the second was to find out the military supply routes, and the third was to search for the transcontinental line for China and Siberia. As the results, the old Korean pedestrian routes, which were the Eastern, the mid, the westren, and the Samnam route lost their functions. 2. Japanese requested for Korean government usually ten times of wider space for the site of stations than the needed one. The land was expropriated, and constructed the new centers aparted from the original Korean towns. In this process Japanese got the most developmental and windfall profits. The newly constructed centers were for Japanese immigration and the town service facilities which would be used to control the Korean financial market. At last, they easily converted the Korean spatial economy into Japanese colonial one, which made to reinforce the sphere of Seoul-Pusan line. 3. Japanese planned the stations as the central points in Korea. So the railroad stations were located apart from the centers of towns, to avoid the Korean resistances, and to maximize their profits. The mean distance from staiton to 'the town center is about 1km while the Japanese case is 0.6km. 4. The pattern of present Korean railroads is not the 'X type'. Because the Honam line is not the trunk one. So, we could call the Korean railroad pattern as the 'Ip(Chinese character 入) type' . The operational effects of Seoul-Pusan line brought out the concentration of the national economy to this line as Japanese planned. And the polorization had occurred between this line and the other parts of Korea. For twenty years (1910-1930), the transported freights were increased about 5 times. In 1930, the total freight of Seoul-Pusan line became 2, 010, 444 metric tons. If we examine this process, the underconstructing Seoul-Pusan express electric railroad should avoid adjacent this line to reduce the regional and ecological imbalance. 5. The forms of centers on the Seoul-Pusan line were classified into six types in relation to station, town center, and built-up area; the compact (integrated) type, the elongated one, the splited (independent) one, the absorbed one, the consolidated one, and the declined one. All types of these towns might be developed in accordance with the centrality, railroad function, and the other transportational functions. 6. The Seoul-Pusan line plays the most important role among Korean railroads but the ratio of passenger and freight become lower because the effiects of other inaugurated railoads the different transportation modes such as trucks and cars would be got more merits in competition. 7. The results of cluster analyses on the cities of railroad stations showed the rudimentary urban systems in 1910 and 1930. In 1930, the cities were classified into three groups; the group of small cites, the intermediate (developing) city-group, and the special city-group. In 1930s the spatial organization and urban system of Korea were similar to the present ones. We call appreciate that these were the effects of the Seoul-Pusan line.
Nowadays, major advanced countries in aviation technology are putting their effort to develop commercial and civil Unmanned Aircraft System(UAS) due to its highly promising market demand in the future. The market scale of commercial and civil UAS is expected to increase up to approximately 8.8 billon U.S. dollars by the year 2020. The usage of commercial and civil UAS covers various areas such as remote sensing, relaying communications, pollution monitoring, fire detection, aerial reconnaissance and photography, coastline monitoring, traffic monitoring and control, disaster control, search and rescue, etc. With the introduction of UAS, changes need to be made on current Air Traffic Management Systems which are focused mainly manned aircrafts to support the operation of UAS. Accordingly, the legislation for the UAS operation should be followed. Currently, ICAO's Unmanned Aircraft System Study Group(UASSG) is leading the standardization process of legislation for UAS operation internationally. However, some advanced countries such as United States, United Kingdom, Australia have adopted its own legislation. Among these countries, United States is most forth going with President Obama signing a bill to integrate UAS into U.S. national airspace by 2015. In case of Korea, legislation for the unmanned aircraft system is just in the beginning stage. There are no regulations regarding the operation of unmanned aircraft in Korea's domestic aviation law except some clauses regarding definition and permission of the unmanned aircraft flight. However, the unmanned aircrafts are currently being used in military and under development for commercial use. In addition, the Ministry of Land, Infrastructure and Transport has a ambitious plan to develop commercial and civil UAS as Korea's most competitive area in aircraft production and export. Thus, Korea is in need of the legislation for the UAS operation domestically. In this regards, I personally think that Korea's domestic legislation for UAS operation will be enacted focusing on following 12 areas : (1)use of airspace, (2)licenses of personnel, (3)certification of airworthiness, (4)definition, (5)classification, (6)equipments and documents, (7)communication, (8)rules of air, (9)training, (10)security, (11)insurance, (12)others. Im parallel with enacting domestic legislation, korea should contribute to the development of international standards for UAS operation by actively participating ICAO's UASSG.
The 10th constitution established in 1987 serves as the theoretical foundation of democracy in South Korea in the 21st century. Respect for human rights, resistance to injustice, and equality consciousness inherent in this constitution do not conflict with the content of Confucian philosophy. This means that the spirit of the constitution of South Korea in the 21st century was formed under the influence of the idea of democracy and Confucian philosophy. However, the 10th constitution attaches importance to the idea of the 'Basic free and democratic order', which was accepted in the Yushin constitution and inherited by the military forces. The Yushin constitution was affected by liberalism that prioritizes freedom over equality rather than supporting the compatibility between freedom and equality. Therefore, policies to expand the interests of the bourgeoisie rather than public welfare or the interests of the public have been implemented frequently. In particular, during the Lee Myeong-bak and Park Geun-hye regimes, many unequal phenomena were mass-produced. Confucian philosophy in the 21st century critically sees this unequal society. Confucian philosophy thinks that a sense of relative deprivation plays a role of alienating humans and emphasizes the importance of equal relationships. In addition, this constitution emphasizes the rule of law. However, the rule of law attaches importance to positive laws when the spirit of the constitution that contains natural law is applied to reality through systems. This rejects autonomous judgments and choices while inducing reliance on heteronomy. These heteronomous laws as such are accompanied by forcibleness. The positive laws as such can degrade humans into passive beings that indiscriminately adapt themselves to frames already set instead of active beings that think freely and creatively. Confucian philosophy regards and criticizes the rule of law as a system that makes humans into a means. Confucian philosophy regards humans as moral beings instead of tools. Confucian philosophy seeks to build a healthy society through morality accomplished through conscious realization of the principles of life. Confucian philosophy regards humans as originally free beings. Therefore, human beings are autonomous beings, not heteronomous beings. According to Confucian philosophy, humans beings that can realize the morality contained in their inner side by themselves to responsibly carry out their own judgments and choices. Therefore, Confucian philosophy, which considers human beings as beings to be trusted instead of beings to be distrusted, attaches importance to the realization of human decency through edification rather than by punishment through the law. This means that human values cannot be kept by the heteronomy termed positive laws but the identity of humans can be maintained by voluntary choices and judgments. As such, the comment of Confucian philosophy on the problems of liberal democracy and positive laws contained in the 10th constitution can be helpful in essentially solving the contradictions of modern South Korean society.
The History and Culture Park and the Lee Kun-hee Donation Hall will be built in Songhyeon-dong, Seoul. Political games from the Joseon Dynasty to the present greatly influenced the historicity of Songhyeon-dong. However, place analysis was limited to changes in landowners and land uses rather than a historical context. Therefore, this study analyzed the context in which the placeness of Songhyeon-dong changed according to the emergence of cultural hegemony using the perspective of modern cultural geography and comparative history. As a result of the analysis, cultural hegemony in historical transitions, such as Sinocentrism, maritime expansion, civil revolutions, imperialism, nationalism, popular art, and neoliberalism, was found to have created new intellectuals in Bukchon, including Songhyeon-dong, and influenced social systems and spatial policies. In this social relations, the placeness of Songhyeon-dong changed as follows. First, the founding forces of Joseon created pine forests as Bibo Forests to invocate the permanence of the dynasty. In the late Joseon dynasty, it was an era of maritime expansion, and as Joseon's yeonhaeng increased, a garden for the Gyeonghwasejok, who enjoyed the culture of the Qing dynasty, was built. Although pine forests and gardens disappeared due to the development of housing complexes as the population soared during the Japanese colonial era, Cha Gyeong's landscape aesthetics, which harmonized artificial gardens and external nature, are worth reinterpreting in modern times. Second, the wave of modernization created a new school in Bukchon and a boarding house in Songhyeon-dong owned by a pro-Japanese faction. Angukdongcheon-gil, next to Songhyeon-dong, was where thinkers who promoted civil revolution and national self-determination exchanged ideas. Songhyeon-dong, the largest boarding house, served as a residence for students to participate in the March 1st Movement and was the cradle of the resulting culture of student movements. The appearance of the old road is preserved, so it is a significant part of the regeneration of walking in the historic city center, connecting Gwanghwamun-Bukchon-Insadong -Donhwamunro. Third, from the cultural rule of the Government General of Joseon to the Military Government, Songhyeon-dong acted as a passage to western culture with the Joseon Siksan Bank's cultural housing and staff accommodations at the U.S. Embassy. Ancient and contemporary art coexisted in the surrounding area, so the modern and contemporary art market was formed. The Lee Kun-hee Donation Hall is expected to form a cultural belt for citizens with the gallery, Bukchon Hanok Village, the Craft Museum, and the Modern Museum of Art. Discourses and challenges are needed to recreate the place in harmony with the forests, gardens, the street of citizens' birth, history and culture park, the art museum, and the surrounding walking network.
Land was originally communized by a community in the primitive society of Korea, and in the age of the ancient society SAM KUK-SILLA, KOKURYOE and PAEK JE-it was distributed under the principle of land-nationalization. But by the occupation of the lands which were permitted to transmit from generation to generation as Royal Grant Lands and newly cleared lands, the private occupation had already begun to be formed. Thus the private ownership of land originated by chiefs of the tribes had a trend to be gradually pervaded to the communal members. After the, SILLA Kingdom unified SAM KUK in 668 A.D., JEONG JEON System and KWAN RYO JEON System, which were the distribution systems of farmlands originated from the TANG Dynasty in China, were enforced to established the basis of an absolute monarchy. Even in this age the forest area was jointly controlled and commonly used by village communities because of the abundance of area and stocked volume, and the private ownership of the forest land was prohibited by law under the influence of the TANG Dynasty system. Toward the end of the SILLA Dynasty, however, as its centralism become weak, the tendency of the private occupancy of farmland by influential persons was expanded, and at the same time the occupancy of the forest land by the aristocrats and Buddhist temples began to come out. In the ensuing KORYO Dynasty (519 to 1391 A.D.) JEON SI KWA System under the principle of land-nationalization was strengthened and the privilege of tax collection was transferred to the bureaucrats and the aristocrats as a means of material compensation for them. Taking this opportunity the influential persons began to expand their lands for the tax collection on a large scale. Therefore, about in the middle of 11th century the farmlands and the forest lands were annexed not only around the vicinity of the capital but also in the border area by influential persons. Toward the end of the KORYO Dynasty the royal families, the bureaucrats and the local lords all possessed manors and occupied the forest lands on a large scale as a part of their farmlands. In the KORYO Dynasty, where national economic foundation was based upon the lands, the disorder of the land system threatened the fall of the Dynasty and so the land reform carried out by General YI SEONG-GYE had led to the creation of ensuing YI Dynasty. All systems of the YI Dynasty were substantially adopted from those of the KORYO Dynasty and thereby KWA JEON System was enforced under the principle of land-nationalization, while the occupancy or the forest land was strictly prohibited, except the national or royal uses, by the forbidden item in KYEONG JE YUK JEON SOK JEON, one of codes provided by the successive kings in the YI Dynasty. Thus the basis of the forest land system through the YI Dynasty had been established, while the private forest area possessed by influential persons since the previous KORYO Dynasty was preserved continuously under the influence of their authorities. Therefore, this principle of the prohibition was nothing but a legal fiction for the security of sovereign powers. Consequently the private occupancy of the forest area was gradually enlarged and finally toward the end of YI Dynasty the privately possessed forest lands were to be officially authorized. The forest administration systems in the YI Dynasty are summarized as follows: a) KEUM SAN and BONG SAN. Under the principle of land-nationalization by a powerful centralism KWA JEON System was established at the beginning of the YI Dynasty and its government expropriated all the forests and prohibited strictly the private occupation. In order to maintain the dignity of the royal capital, the forests surounding capital areas were instituted as KEUM SAN (the reserved forests) and the well-stocked natural forest lands were chosen throughout the nation by the government as BONG SAN(national forests for timber production), where the government nominated SAN JIK(forest rangers) and gave them duties to protect and afforest the forests. This forest reservation system exacted statute labors from the people of mountainious districts and yet their commons of the forest were restricted rigidly. This consequently aroused their strong aversion against such forest reservation, therefore those forest lands were radically spoiled by them. To settle this difficult problem successive kings emphasized the preservation of the forests repeatedly, and in KYEONG KUK DAI JOEN, the written constitution of the YI Dynasty, a regulation for the forest preservation was provided but the desired results could not be obtained. Subsequently the split of bureaucrats with incessant feuds among politicians and scholars weakened the centralism and moreover, the foreign invasions since 1592 made the national land devasted and the rural communities impoverished. It happned that many wandering peasants from rural areas moved into the deep forest lands, where they cultivated burnt fields recklessly in the reserved forest resulting in the severe damage of the national forests. And it was inevitable for the government to increase the number of BONG SAN in order to solve the problem of the timber shortage. The increase of its number accelerated illegal and reckless cutting inevitably by the people living mountainuos districts and so the government issued excessive laws and ordinances to reserve the forests. In the middle of the 18th century the severe feuds among the politicians being brought under control, the excessive laws and ordinances were put in good order and the political situation became temporarily stabilized. But in spite of those endeavors evil habitudes of forest devastation, which had been inveterate since the KORYO Dynasty, continued to become greater in degree. After the conclusion of "the Treaty of KANG WHA with Japan" in 1876 western administration system began to be adopted, and thereafter through the promulgation of the Forest Law in 1908 the Imperial Forests were separated from the National Forests and the modern forest ownership system was fixed. b) KANG MU JANG. After the reorganization of the military system, attaching importance to the Royal Guard Corps, the founder of the YI Dynasty, TAI JO (1392 to 1398 A.D.) instituted the royal preserves-KANG MU JANG-to attain the purposes for military training and royal hunting, prohibiting strictly private hunting, felling and clearing by the rural inhabitants. Moreover, the tyrant, YEON SAN (1495 to 1506 A.D.), expanded widely the preserves at random and strengthened its prohibition, so KANG MU JANG had become the focus of the public antipathy. Since the invasion of Japanese in 1592, however, the innovation of military training methods had to be made because of the changes of arms and tactics, and the royal preserves were laid aside consequently and finally they had become the private forests of influential persons since 17th century. c) Forests for official use. All the forests for official use occupied by government officies since the KORYO Dynasty were expropriated by the YI Dynasty in 1392, and afterwards the forests were allotted on a fixed standard area to the government officies in need of firewoods, and as the forest resources became exhausted due to the depredated forest yield, each office gradually enlarged the allotted area. In the 17th century the national land had been almost devastated by the Japanese invasion and therefore each office was in the difficulty with severe deficit in revenue, thereafter waste lands and forest lands were allotted to government offices inorder to promote the land clearing and the increase in the collections of taxes. And an abuse of wide occupation of the forests by them was derived and there appeared a cause of disorder in the forest land system. So a provision prohibiting to allot the forests newly official use was enacted in 1672, nevertheless the government offices were trying to enlarge their occupied area by encroaching the boundary and this abuse continued up to the end of the YI Dynasty. d) Private forests. The government, at the bigninning of the YI Dynasty, expropriated the forests all over the country under the principle of prohibition of private occupancy of forest lands except for the national uses, while it could not expropriate completely all of the forest lands privately occupied and inherited successively by bureaucrats, and even local governors could not control them because of their strong influences. Accordingly the King, TAI JONG (1401 to 1418 A.D.), legislated the prohibition of private forest occupancy in his code, KYEONG JE YUK JEON (1413), and furthermore he repeatedly emphasized to observe the law. But The private occupancy of forest lands was not yet ceased up at the age of the King, SE JO (1455 to 1468 A.D.), so he prescribed the provision in KYEONG KUK DAI JEON (1474), an immutable law as a written constitution in the YI Dynasty: "Anyone who privately occupy the forest land shall be inflicted 80 floggings" and he prohibited the private possession of forest area even by princes and princesses. But, it seemed to be almost impossible for only one provsion in a code to obstruct the historical growing tendecy of private forest occupancy, for example, the King, SEONG JONG (1470 to 1494 A.D.), himself granted the forests to his royal families in defiance of the prohibition and thereafter such precedents were successively expanded, and besides, taking advantage of these facts, the influential persons openly acquired their private forest lands. After tyrannical rule of the King, YEON SAN (1945 to 1506 A.D.), the political disorder due to the splits to bureaucrats with successional feuds and the usurpations of thrones accelerated the private forest occupancy in all parts of the country, thus the forbidden clause on the private forest occupancy in the law had become merely a legal fiction since the establishment of the Dynasty. As above mentioned, after the invasion of Japanese in 1592, the courts of princes (KUNG BANGG) fell into the financial difficulties, and successive kings transferred the right of tax collection from fisherys and saltfarms to each KUNG BANG and at the same time they allotted the forest areas in attempt to promote the clearing. Availing themselves of this opportunity, royal families and bureaucrats intended to occupy the forests on large scale. Besides a privilege of free selection of grave yard, which had been conventionalized from the era of the KORYO Dynasty, created an abuse of occuping too wide area for grave yards in any forest at their random, so the King, TAI JONG, restricted the area of grave yard and homestead of each family. Under the policy of suppresion of Buddhism in the YI Dynasty a privilege of taxexemption for Buddhist temples was deprived and temple forests had to follow the same course as private forests did. In the middle of 18th century the King, YEONG JO (1725 to 1776 A.D.), took an impartial policy for political parties and promoted the spirit of observing laws by putting royal orders and regulations in good order excessively issued before, thus the confused political situation was saved, meanwhile the government officially permittd the private forest ownership which substantially had already been permitted tacitly and at the same time the private afforestation areas around the grave yards was authorized as private forests at least within YONG HO (a boundary of grave yard). Consequently by the enforcement of above mentioned policies the forbidden clause of private forest ownership which had been a basic principle of forest system in the YI Dynasty entireely remained as only a historical document. Under the rule of the King, SUN JO (1801 to 1834 A.D.), the political situation again got into confusion and as the result of the exploitation from farmers by bureaucrats, the extremely impoverished rural communities created successively wandering peasants who cleared burnt fields and deforested recklessly. In this way the devastation of forests come to the peak regardless of being private forests or national forests, moreover, the influential persons extorted private forests or reserved forests and their expansion of grave yards became also excessive. In 1894 a regulation was issued that the extorted private forests shall be returned to the initial propriators and besides taking wide area of the grave yards was prohibited. And after a reform of the administrative structure following western style, a modern forest possession system was prepared in 1908 by the forest law including a regulation of the return system of forest land ownership. At this point a forbidden clause of private occupancy of forest land got abolished which had been kept even in fictitious state since the foundation of the YI Dynasty. e) Common forests. As above mentioned, the forest system in the YI Dynasty was on the ground of public ownership principle but there was a high restriction to the forest profits of farmers according to the progressive private possession of forest area. And the farmers realized the necessity of possessing common forest. They organized village associations, SONGE or KEUM SONGE, to take the ownerless forests remained around the village as the common forest in opposition to influential persons and on the other hand, they prepared the self-punishment system for the common management of their forests. They made a contribution to the forest protection by preserving the common forests in the late YI Dynasty. It is generally known that the absolute monarchy expr opriates the widespread common forests all over the country in the process of chainging from thefeudal society to the capitalistic one. At this turning point in Korea, Japanese colonialists made public that the ratio of national and private forest lands was 8 to 2 in the late YI Dynasty, but this was merely a distorted statistics with the intention of rationalizing of their dispossession of forests from Korean owners, and they took advantage of dead forbidden clause on the private occupancy of forests for their colonization. They were pretending as if all forests had been in ownerless state, but, in truth, almost all the forest lands in the late YI Dynasty except national forests were in the state of private ownership or private occupancy regardless of their lawfulness.
The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.
Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.