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The Role of Radiation Therapy in the Treatment of Adenoid Cystic Carcinoma of the Head and Neck (두경부에 생긴 선양 낭포암의 치료에 있어서 방사선치료의 역할)

  • Kim, Won-Dong;Park, Charn-Ii;Kim, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.35-41
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    • 1992
  • Forty eight patients with adenoid cystic carcinoma (ACC) in the head and neck treated between 1979 and 1990 were reviewed according to treatment modalities and clinical courses. The common site of origin was minor salivary gland ($69\%$), mostly hard palate and maxillary sinus. 11 patients received radiation therapy (RT) alone and 37 patients received combined surgery and radiation therapy. The follow-up period of the survivors ranged from 4 to 118 months (median 49.5 months). The 5 year local control rate was $69.3\%$, $67.3\%$ and 83.9$\%$ in RT alone, conservative operation (OP)+RT and radical OP+RT group, respectively (p>0.05). The control of local disease was best achieved with radical OP+RT. In postoperative RT, high dose ($\ge$60 Gy) and generous field size($\ge$64 cm$^2$) yielded a better local control rate. Actuarial overall survival rate was $79.0\%$, at 5 years and $19.2\%$ at 10 years. Distant metastases (DM) developed in $40\%$ of patients, mostly in the lung. Disease-free (NED) survival rate was $45.8\%$ at 5 years and significant differences did not exist according to primary sites and treatment options. Survival rate after the onset of DM was $19.5\%$ at 5 years. Occurrence of DM tends to lower survival significantly. In an effort to find the role of RT in the treatment of ACC, our data suggest that a well-planned postoperative RT employing a high dose and generous field size can produce high local control rate and remaining urgent problem of distant metastasis demands more effective chemotherapy for the purpose of improving survival of ACC patients.

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The Effect of Entrepreneurship Education on the Career Path of University Students (창업교육이 대학생의 진로에 미치는 효과성 연구)

  • Ahn, Tae-Uk;Park, Jae-Whan
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.2
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    • pp.177-192
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    • 2018
  • The mission of the university is to grow young people who will be responsible for the next generation nation to mature society. In particular, the role of universities in the 4th Industrial Revolution era is to foster creative talents. Therefore, innovative changes are required for existing infusion education and employment-oriented college education contents and teaching methodology. In the high youth unemployment rate, entrepreneurship education is spreading to universities to innovate existing organizations and create new jobs. Until now, however, the effects of university entrepreneurship education have been studied mainly in the field of start-up. Therefore, it is very difficult to study various effects on entrepreneurship education. In this study, empirical analysis of the effect of entrepreneurship training on career preparation behaviors of university students who are about to enter the society is verified. The sample of this study was surveyed from August, 2016, and the questionnaire was applied to 393 university students who selected 5 universities and entrepreneurship education. As a result of the analysis, the ability of communicative communication and creative problem solving cultivated through entrepreneurship education had a positive effect on entrepreneurship and self - efficacy, Entrepreneurship and self - efficacy had a positive (+) positive effect on career preparation behavior. However, cooperative communication ability, creative problem solving ability, and effective work behavior ability by entrepreneurship education were not directly related to career preparation behavior. On the other hand, in verifying the mediating effect of entrepreneurship and self - efficacy, it proved that mediating role of positive communication between collaborative communication ability, creative problem solving ability and career preparation behavior. The implications of this study are as follows This study examines the effects of university entrepreneurship education on career preparedness behaviors.In other words, the university proved the direct effect and the mediating effect that affects positively (+) effect on career preparation behaviors by encouraging entrepreneurship and self - efficacy, rather than quantitative extension based on competency. Also, the implication of the parameters (entrepreneurship, self - efficacy) as a key variable for the effect and performance of career preparation behavior was derived.It also suggests that it is necessary to improve the creativity ability of entrepreneurship education so that it can have a direct and meaningful influence on career preparation behavior. First of all, it is urgent to develop a qualitative evaluation index for entrepreneurship education in order to measure these effects. Therefore, further study is required to verify the various implications for future entrepreneurship education, as well as the implications that entrepreneurship education is indispensable for the preparation of university students' careers.

The Different View Point of Child Education Center Food Service Program between the Parents and the Teachers (유아교육기관에서의 급식관리 실태에 대한 교사 및 학부모의 인식 연구)

  • Lee, Young-Mee
    • Korean Journal of Community Nutrition
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    • v.10 no.5
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    • pp.654-667
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    • 2005
  • To survey the different view points about food service programs among parents and teachers, 2 types of questionnaires, which consisted of attitude, perception, satisfaction and demand of the food service program in child education centers, were used. The data was collected from 2450 parents and 450 teachers who attended a child education center in 16 provinces, nationwide. SPSS was used for descriptive analysis and ANOVA test and $X^2-test$. The frinding results were as follows. 1. The average serving size of meal (lunch) were 80 meals per day and 167 meals per day at large institutions. Mean cost of snacks was 14,709 won per month and mean costs of lunch were 29,319 won per month. The mean price was not significantly different according to the scale of institution. The numbers of servings of lunch, morning snack and afternoon snack were 5, 3.4 and 3.5 times per week each. $56.4\%$ of the institutions served meals to children in classrooms, but the national/public institutions, which were attending elementary school, served meals in a dining place in the elementary school. 2. Teacher controlled serving portion size of snacks $(79.6\%)$ and lunch $(88.8\%)\;and\;30.1\%$ of teacher did not allow leaving lunch food. The ratio of knowing about preserved meals of the teacher who worked at a small institution was significantly higher than the teacher who worked at large institutions (p<0.01). 3. Between parents and teachers, several different view points about school lunch programs were detected. Most parents and teachers wanted that the school lunch to be fully cooked and served at the child education institution itself, but $12.2\%$ of parents and $14.4\%$ of teachers wanted a catering service. The teachers group preferred 'lunch box from home' and 'home partially prepared lunch' as an ideal meal serving type than the parent groups (p<0.01). And there were significantly different view points about price factors in school meals, teachers group highly answered that operating expenses must be added in meal prices. 4. The teacher groups' priorities of education activities during meal time were a significantly lower score than parents group in overall education activities. Teacher and parent groups pointed out that individual sanitation activities were most important of the education activities during meal time, but promoting good eating habits was the lowest score in both groups. 5. 'Improving taste and food quality' was most urgent in food service at child education centers, but there were significantly different view points between parent groups $(64.5\%)$ and teacher groups $(43.8\%)\;(p<0.05)$. They answered at a lower percent in 'employee qualified person' and 'cost control' point to improve food service, but there were also different opinions between the two groups (p<0.01). 6. As to the matter of the advantages and disadvantages of catering services, two group answered that the advantages of a catering service were 'convenience' and 'to solve facilities and labor problems', disadvantages were 'lower in food freshness' and 'sanitation problems'. There were also several different view pionts in catering services, the parents groups were more anxious about food sanitation than teachers. This study found several different view points about school food services among parents and teachers. To improve food services at child education institutions, there is a need to adjust the differences between the two groups through interactive communication channels and education and to employ dietitians as taking charge of adjusting roles between the two groups.

Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

A Study Security Measures for Protection of VIP in the G20 Summit (G20 정상회의 시 주(主)행사장에서의 VIP 안전대책 방안에 관한 연구)

  • Lee, Sun-Ki;Lee, Choong-Soo
    • Korean Security Journal
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    • no.24
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    • pp.91-123
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    • 2010
  • The threat factors available for occurrence given G20 Summit Meeting are expected leader terrorism, hostage terrorism, bomb terrorism, public facilities terrorism, and aircraft terrorism. As for the threat groups, which are expected in Korea, the North Korea, Islam extremist group, and the group such as NGO organization of being opposed to international meeting are regarded as having possibility of causing hazard. Thus, the purpose of this study is to suggest VIP Security-measure plans in the main site in preparation for G20 Summit Meeting. Accordingly, each country in the world is adopting 'the principle of Triple Ring' in common. Thus, it elicited a coping plan by 1st line(inner ring) 2nd line(middle ring) 3rd line(outer ring) based on this principle, and proposed even an opinion together that will need to be reflected in light of policy for the VIP security measures. In conclusion, as for the VIP Security-measure plans in the main site in preparation for G20 Summit Meeting, In the inner ring(safety sector), first, an intercepting measure needs to be devised for a spot of getting into and out of vehicles given the Straight Street. Second, the Walking Formation needs to be reinforced boldly in the exposed area. In the middle ring(security sector), first, the control plan needs to be devised by considering particularity of the main site. Second, there is necessity for adopting the efficient security badge operation plan that is included RFID function within security badge. In the outer ring(aid protective sector), first, there is necessity of preparing for several VIP terrorisms, of collecting information and intelligence, and of reinforcing the information collection system against terrorism under the cooperation with the overseas information agency. Second, the urgent measure training in time of emergency needs to be carried out toward security agent event manpower. Third, to maintain the certain pace in VIP motorcade, the efficient traffic control system needs to be operated. Finally, as for what will need to be reflected in light of policy for VIP security measures, first, there is necessity for allowing VIP residence to be efficiently dispersed to be distributed and controlled. Second, there is necessity for allowing impure element to misjudge or attack to be failed by utilizing diverse deception operations. Third, according to the reorganization in North Korea's Organization of the South Directed Operations, the powerful 'military-support measure' needs to be driven from this G20 Summit Meeting. For this, the necessity was proposed for further reinforcing the front back defense posture under the supervision of the Ministry of National Defense and for positively coping even with detecting and removing poison in preparation for CBR (chemical, biological, and radio-logical) terrorism.

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Application of LCA Methodology on Lettuce Cropping Systems in Protected Cultivation (시설재배 상추에 대한 전과정평가 (LCA) 방법론 적용)

  • Ryu, Jong-Hee;Kim, Kye-Hoon
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.5
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    • pp.705-715
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    • 2010
  • The adoption of carbon foot print system is being activated mostly in the developed countries as one of the long-term response towards tightened up regulations and standards on carbon emission in the agricultural sector. The Korean Ministry of Environment excluded the primary agricultural products from the carbon foot print system due to lack of LCI (life cycle inventory) database in agriculture. Therefore, the research on and establishment of LCI database in the agriculture for adoption of carbon foot print system is urgent. Development of LCA (life cycle assessment) methodology for application of LCA to agricultural environment in Korea is also very important. Application of LCA methodology to agricultural environment in Korea is an early stage. Therefore, this study was carried out to find out the effect of lettuce cultivation on agricultural environment by establishing LCA methodology. Data collection of agricultural input and output for establishing LCI was carried out by collecting statistical data and documents on income from agro and livestock products prepared by RDA. LCA methodology for agriculture was reviewed by investigating LCA methodology and LCA applications of foreign countries. Results based on 1 kg of lettuce production showed that inputs including N, P, organic fertilizers, compound fertilizers and crop protectants were the main sources of major emission factor during lettuce cropping process. The amount of inputs considering the amount of active ingredients was required to estimate the actual quantity of the inputs used. Major emissions due to agricultural activities were $N_2O$ (emission to air) and ${NO_3}^-$/${PO_4}^-$ (emission to water) from fertilizers, organic compounds from pesticides and air pollutants from fossil fuel combustion in using agricultural machines. The softwares for LCIA (life cycle impact assessment) and LCA used in Korea are 'PASS' and 'TOTAL' which have been developed by the Ministry of Knowledge Economy and the Ministry of Environment. However, the models used for the softwares are the ones developed in foreign countries. In the future, development of models and optimization of factors for characterization, normalization and weighting suitable to Korean agricultural environment need to be done for more precise LCA analysis in the agricultural area.

Cardiac Injury due to Thoracic Trauma (흉부외상에 의한 심장손상)

  • Kim, Han-Yong;Kim, Myoung-Young;Park, Jae-Hong;Chei, Chang-Seck;Hwang, Sang-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.831-836
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    • 2007
  • Background: Cardiac injuries are the most commonly overlooked injuries in patients who die from trauma. Patients who survive blunt cardiac rupture or penetrating injuries are rare and the incidence is not well defined. Many patients require urgent or emergency operations and operative mortality is very high. Material and Method: A retrospective review of 26 patients with cardiac injuries due to thoracic trauma undergoing emergency thoracotomy from January 1997 to December 2005. Result: There were 17 male and 9 female patients, with a mean age of $45.3{\pm}16.2\;(range:\;17{\sim}80)$. Thirteen patients (50%) were injured in motor vehicle accidents, and five patients (19%) in motorcycle accidents. Six patients (23%) were injured by knives, and two patients (8%) were injured by falling. Anatomic injuries included right atrium (12 [46%]), left atrium (1 [4%]), right ventricle (5 [19%]), left ventricle (5 [19%]), and cardiac chambers (2 [7%]). Diagnosis was made by computer tomography in 12 patients and sonography in 14 patients. The average times from admission to operating room was $89.2{\pm}86.7\;min\;(range:\;10{\sim}335)$. The average time for diagnosis was $51.3{\pm}13.6\;min\;(range:\;5{\sim}280)$. The mean Revised Trauma Score (RTS) was $6.7{\pm}0.8$, and the Glasgow Coma Scale (GCS), was $12.8{\pm}2.8$. The overall mortality rate was 12% (3 out of 26 patients). Conclusion: The mortality rate from cardiac injury is very high. The survival rate can be increased only by a high index of suspicion, aggressive expeditious diagnostic evaluation, and prompt appropriate surgical management.

A Survey of the Current Information Activities in the Advanced Developing Countries (중진국의 정보유통체제 연구)

  • Choi Sung-jin
    • Journal of the Korean Society for Library and Information Science
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    • v.7
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    • pp.89-195
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    • 1980
  • The advanced developing countries including Korea are assumed to have reached a developmental stage which necessitates them to formulate and implement a plan for a national information network. Most of the governments in the advanced developing countries are well aware of the necessity for such a plan and some of them have actually commenced their studies on the feasibility of a national network of their own hoping to achieve maximum utility of their limited information resources. Two urgent problems facing planners in the design of a national information network are identified. One is lack of an optimum organisational model to enable them to meet their own situations, and the other is lack of a guideline to help designers evaluate the alternative structures and models when they are available. In resolving these two problems, network planners in the advanced developing countries would benefit from the achievement of the objectives of the present study. The major objective is to elicit and describe common information needs, desires and value of the people using information, and other common factors which are responsible for the present information services in the advanced developing countries and which have implications for the basic structure of the national information network. The value of this study is to aid administrators in Korea and those in the other advanced developing countries who are responsible for making national policies and who are now beginning to recognise the need for information services with the planning of economic and social development so as to enable all the groups in the community to have access to the information which are essential for decision making, research work, studies and even for recreational reading. This recognition will hopefully give them a rational basis for formulating right policies on information services. The methodology utlised for collecting the required data in this study falls under the category of observation and largely consists of the two techniques: literature review and postal questionnaire. Background information on the individual advanced developing: countries was gathered from monographic and periodical literature. and country reports presented at the various international conferences were analysed for other relevant data. For most of the data needed for the present study, a questionnaire on 'Library and Information Services as They Are Available in the Selected Countries' was formulated. This questionnaire was designed to be completed without help, by an expert who was well informed of the library and information services in his or her country. The questionnaire was intended to look in details at what information services in the advanced developing countries were doing-whom they were serving, in what way, and how well and establish to what extent they were meeting the nation's information requirements. It was also intended to ascertain the respondents' ideas on possible future developments in information provision in their countries, that is, in the advanced devanced developing countries. The questionnaire was posted to a total of 63 natinal librarians, directors of national information centres and those of other major libraries or information centres in 21 selected countries. Complete usable responses were received from 34 persons in 14 countries. In order to identify common characteristics of the information needs and desires in the advanced developing countries and the present situation of the information services to meet them, and the requirements and constraints peculiar to those countries which bought to be considered in the design of a national information network for advanced developing countries, an individual report on the current status of information activities for each of the fourteen countries chosen for this study, was presented. The procedure used was to arrange the data acquired in the questionnaire responses and other sources, in the form of fifteen country reports to be summarised by cross-section characteristics later.

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Review of Policy Direction and Coupled Model Development between Groundwater Recharge Quantity and Climate Change (기후변화 연동 지하수 함양량 산정 모델 개발 및 정책방향 고찰)

  • Lee, Moung-Jin;Lee, Joung-Ho;Jeon, Seong-Woo;Houng, Hyun-Jung
    • Journal of Environmental Policy
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    • v.9 no.2
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    • pp.157-184
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    • 2010
  • Global climate change is destroying the water circulation balance by changing rates of precipitation, recharge and discharge, and evapotranspiration. The Intergovernmental Panel on Climate Change (IPCC 2007) makes "changes in rainfall pattern due to climate system changes and consequent shortage of available water resource" a high priority as the weakest part among the effects of human environment caused by future climate changes. Groundwater, which occupies a considerable portion of the world's water resources, is related to climate change via surface water such as rivers, lakes, and marshes, and "direct" interactions, being indirectly affected through recharge. Therefore, in order to quantify the effects of climate change on groundwater resources, it is necessary to not only predict the main variables of climate change but to also accurately predict the underground rainfall recharge quantity. In this paper, the authors selected a relevant climate change scenario, In this context, the authors selected A1B from the Special Report on Emission Scenario (SRES) which is distributed at Korea Meteorological Administration. By using data on temperature, rainfall, soil, and land use, the groundwater recharge rate for the research area was estimated by period and embodied as geographic information system (GIS). In order to calculate the groundwater recharge quantity, Visual HELP3 was used as main model for groundwater recharge, and the physical properties of weather, temperature, and soil layers were used as main input data. General changes to water circulation due to climate change have already been predicted. In order to systematically solve problems associated with how the groundwater resource circulation system should be reflected in future policies pertaining to groundwater resources, it may be urgent to recalculate the groundwater recharge quantity and consequent quantity for using via prediction of climate change in Korea in the future and then reflection of the results. The space-time calculation of changes to the groundwater recharge quantity in the study area may serve as a foundation to present additional measures for the improved management of domestic groundwater resources.

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Potential Effects of Gaming Disorder Classification on Gamers' Attitude and Gaming Intention (게임이용장애 질병분류가 게임이용자의 태도와 게임의향에 미치는 효과)

  • Kim, Suk Hwan;Han, Sang Hoon;Kim, Bora;Kang, Hyoung Goo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.4
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    • pp.277-301
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    • 2020
  • This study surveyed 503 adults to examine the effect of gaming disorder classification, recently announced by World Health Organization(WHO), when it is applied to Korean game market. Considering the difference in respondents' background knowledge on gaming disorder, half of the respondents were randomly assigned to read an informative news article describing WHO's decision and its expected effect on domestic game industry. Based on previous literature of gaming disorder, we categorized respondents into a normal-use group and a potentially problematic-use group. As a result of analyses, it was found that the gaming disorder classification would yield overall reduction of game-related consumption in terms of gaming time(24%), game cost(28%), the number of games(22%), etc. The potentially problematic group showed higher willingness to pay for gaming than the normal group did, even if the game cost presumably increases due to the gaming disorder classification. A similar outcome was observed in those with high stress levels. This implies that the policy to solve game addiction problems may ironically lead to unexpected cost increases to the target group of the policy. Hence, problematic groups, especially, highly stressful people and the people with the lack of self-control, need to be considered when the gaming disorder classification policy is established. Furthermore, the informative news article had the preventive effect on the attitude and the intention of the people with moderate or high self-control capacity, but not to the people with gaming-additive tendencies, Again, this finding confirms the necessity of the tweezers policy to refine target groups by their characteristics and prepare for differentiated policies. When the gaming disorder classification is simply adopted with no consideration of domestic circumstances, irreversible loss could affect Korean game users, game industries, and related companies. This calls for urgent cooperation between academia, government, and industry to set up appropriate measures to deal with the gaming disorder classification.