• 대한간호학회지
• /
• 제42권2호
• /
• pp.149-160
• /
• 2012

Purpose: The purpose of this study was to explain the role transition process to nurse case managers (NCMs) for Medical-aid beneficiaries in Korea. Methods: Fourteen NCMs were interviewed regarding their experiences of becoming proficient in the new role of case manger. Data were analyzed through the application of grounded theory. Results: 'Taking root in a barren land' was the core category explaining the role transition process of NCMs. They engaged in four stages: launching, trial and error, proficiency, and wait-and-see stages. NCMs showed not only fear but also passion for case management practice. Despite their passion and effort, NCMs went through a period of trial and error. After becoming skilled, NCMs went through a stage of wait-and-see often because of job insecurity related to temporary position or few opportunities for promotion. Factors influencing NCMs' role transition process included their understanding of client characteristics, belief in case management, and support from their colleagues and families. Conclusion: NCMs experience many challenges in the process of becoming proficient NCMs. To help with their role transition, there is a need for education programs, preceptorship programs, research on their roles and functions, and regulation for securing NCMs' employment and career stability.

• 한국경영과학회지
• /
• 제27권3호
• /
• pp.145-156
• /
• 2002

Business managers are often required to use LP problems to deal with uncertainty inherent in decision making due to rapid changes in today＇s business environments. Uncertain parameters can be easily formulated in the two-stage stochastic LP problems. However, since solution methods are complex and time-consuming, a common approach has been to use modified formulations to provide upper and lower bounds on the two-stage stochastic LP problem. One approach is to use an expected value problem, which provides upper and lower bounds. Another approach is to use “walt-and-see” problem to provide upper and lower bounds. The objective of this paper is to propose a modified approach of “wait-and-see” problem to provide an upper bound and to compare the relative error of optimal value with various upper and lower bounds. A computing experiment is implemented to show the relative error of optimal value with various upper and lower bounds and computing times.

• Korean Journal of Radiology
• /
• 제21권7호
• /
• pp.812-828
• /
• 2020

Objective: To provide an evidence-based guide for the MRI interpretation of complete tumor response after neoadjuvant chemoradiation therapy (CRT) for rectal cancer using visual assessment on T2-weighted imaging (T2) and diffusion-weighted imaging (DWI). Materials and Methods: PubMed MEDLINE, EMBASE, and Cochrane Library were searched on November 28, 2019 to identify articles on the following issues: 1) sensitivity and specificity of T2 or DWI for diagnosing pathologic complete response (pCR) and the criteria for MRI diagnosis; 2) MRI alone vs. MRI combined with other test(s) in sensitivity and specificity for pCR; and 3) tests to select patients for the watch-and-wait management. Eligible articles were selected according to meticulous criteria and were synthesized. Results: Of 1615 article candidates, 55 eligible articles (for all three issues combined) were identified. Combined T2 and DWI performed better than T2 alone, with a meta-analytic summary sensitivity of 0.62 (95% confidence interval [CI], 0.43-0.77; I² = 80.60) and summary specificity of 0.89 (95% CI, 0.80-0.94; I² = 92.61) for diagnosing pCR. The criteria for the complete response on T2 in most studies had the commonality of remarkable tumor decrease to the absence of mass-like or nodular intermediate signal, although somewhat varied, as follows: (near) normalization of the wall; regular, thin, hypointense scar in the luminal side with (near) normal-appearance or homogeneous intermediate signal in the underlying wall; and hypointense thickening of the wall. The criteria on DWI were the absence of a hyperintense signal at high b-value (≥ 800 sec/mm²) in most studies. The specific algorithm to combine T2 and DWI was obscure in half of the studies. MRI combined with endoscopy was the most utilized means to select patients for the watch-and-wait management despite a lack of strong evidence to guide and support a multi-test approach. Conclusion: This systematic review and meta-analysis provide an evidence-based practical guide for MRI assessment of complete tumor response after CRT for rectal cancer.

• Journal of Korean Neurosurgical Society
• /
• 제54권1호
• /
• pp.50-53
• /
• 2013

Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH. The present case of spinal SAH due to rupture of dissecting aneurysm of the Adamkiewicz artery underwent subsequent spontaneous resolution, indicating that the wait-and-see strategy may provide adequate treatment option.

• Asia pacific journal of information systems
• /
• 제11권2호
• /
• pp.57-78
• /
• 2001

This study examines which factors are urging Korean companies to participate in e-marketplaces. By adding interorganizational factors, we extended an innovation-theory-based research model that is often applied to study the information technology adoption. 71 questionnaires from 720 Korean manufacturing companies were collected. Independent variables of the research were environmental, organizational, innovation, and interorganizational characteristics. We found that the environmental characteristics, innovation characteristics, and interorganizational characteristics have insignificant effect on the participation of domestic companies in e-marketplaces whereas the organizational characteristics have significant relationship with the participation in e-marketplaces. The result implies that many Korean companies take wait-and-see strategy in the forming stage of e-marketplaces, However, IT infrastructure and the support of top management for IT play very important role in adopting e-marketplaces.

• 한국경영과학회:학술대회논문집
• /
• 대한산업공학회/한국경영과학회 1996년도 춘계공동학술대회논문집; 공군사관학교, 청주; 26-27 Apr. 1996
• /
• pp.689-692
• /
• 1996

The environment surrounded by industries is represented by the 3Cs : Customers, Competition, and Changes. The 3Cs drive industries to pursue external business targets such as customer's needs and marketplaces with BPR (Business Process Reengineering). BPR addresses core business process. One of these core business processes is product development. This product development process has been reengineered by the concept of CE (Concurrent Engineering). The aim of the paper is to build frameworks of CE to clarify the CE concept. This paper begins with investigating the product development process from the perspectives of three drivers: cost, quality and speed. CE frameworks are then followed. The first frmework is concerned with the CE definition and thus three keyphrases are extracted : from the outset, concurrent design and systematic approach. Concerned with the CE implementation, the second framework is composed of five components: generalist & specialist, cross-function team, enabling tools & techniques, success metrics, and total visibility. This paper concludes that the CE practice is hard to achieve because of the 'dont't-tell-them-early' attitude of upstream people, and the 'wait-and-see' attitude of downstream people. As resolution, a change management program is recommended that changes an employees mind-set. This paper also supposes computer systems which facilitate and keep automatic track of the CE process as engineered. Finally it gives a warning that computer systems alone do not guarantee success without being preceded by process re-engineering.

• Nuclear Engineering and Technology
• /
• 제40권1호
• /
• pp.9-20
• /
• 2008

Since plutonium accounts for 40-50% of the power produced by uranium fuels, spent fuel contains only residual plutonium. Management of this plutonium is one of the aspects influencing the choice of a fuel cycle back-end option: reprocessing, direct disposal or wait-and-see. Different grades and qualities of plutonium exist depending from their specific generation conditions; all are valuable fissile material. Safeguard authorities watch the inventories of civil plutonium, but access to those data is restricted. Independent evaluations have led to an estimated current inventory of 220t plutonium in total (spent fuel, separated civil plutonium and military plutonium). If used as MOX fuel, it would be sufficient to feed all the PWRs and BWRs worldwide during 7 years or to deploy a FBR park corresponding to 150% of today' s installed nuclear capacity worldwide, which could then be exploited for centuries with the current stockpile of depleted and spent uranium. The energy potential of plutonium deteriorates with storage time of spent fuel and of separated plutonium, due to the decay of $^{241}Pu$, the best fissile isotope, into americium, a neutron absorber. The loss of fissile value of plutonium is more pronounced for usage in LWRs than in FBR. However, keeping the current plutonium inventory for an expected future deployment of FBRs is counterproductive. Recycling plutonium reduce the required volume for final disposal in an underground repository and the cost of final disposal. However, the benefits of utilizing an energy resource and of reducing final disposal liabilities are not the only aspects that determine the choice of a back-end policy.

• 농촌계획
• /
• 제15권3호
• /
• pp.99-106
• /
• 2009

In the rural communities in less-favored areas (mainly hilly and mountainous areas) in Japan, the number of settlements which cannot maintain the community functions by themselves has been increasing because of the progress of depopulation and aging, so the necessity for achieving mutual supplementation of the community function by the settlement reorganization has been increasing. This paper consists of the following three points. 1) General view of settlement reorganization policy in Japan. 2) Case study of the T district in Japan. 3) Possibility of the settlement reorganization by the policy measures which obligate community members to work together. Main results are as follows. 1) There are several settlement reorganization policy measures, but many are still the model project stage, and not yet spread, so it is necessary to wait and see how these measures will develop. 2) The number of the residents of small-scale aging settlements who do not hope for the reorganization, nor feel the necessity of reorganization shall not be few. This will make great difficulty in the settlement reorganization process. 3) A local area activity promotion conference which derives from a former administrative unit like a former village has many functions to the settlement reorganization. 4) In the rural communities in less-favored areas, the policy measures which obligate community members to work together have widely spread. These are expected to play the supplemental role for the settlement reorganization. It is necessary to discuss among residents the activation plan and the future vision of the community, as well as to discuss the settlement reorganization.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제29권3호
• /
• pp.255-261
• /
• 2007

Preface: Dental implant is important method that may solve the mastication, occlusion, esthetic, temporomandibular joint, and psychologic problem in oral and maxillofacial surgery. It is ideal that all of the implant are well positioned by adequate technique. By the way it‘s not always possible because of some anatomic, physiologic factor. In this case, If the implant can be moved to adequate position, it may be possible more esthetically and implanted patients more satisfied, but the majority of Implantists and orthodontists have thought that it is not possible. However, Implant, in fact, can be moved. and thus we can overcome the limit of implantation more. The aim of the present study was to evaluate the possibility of implant movement after corticotomy. Case report: Patient missed the upper right first molar. and implantation was done after completion of socket healing. We wait six months for osseointegration. Then, corticotomy was done under local anesthesia and close coil was used for orthodontic force. After traction during 3 weeks, we find the change of implant position at horizontal plane. we can not see the degenerative change on adjacent structure and tracted implant. there is a clinical mobility on upper right second premolar that used for anchorage but it subside spontaneously at the timing of prosthetic restoration without additional treatment. Discussion: As we could have some knowledge with this experiment, we report the case of implant movement after corticotomy and suggest a method about more esthetic implant treatment with a review of literature.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권9호
• /
• pp.4619-4622
• /
• 2012

Whether it is beneficial to dissect level V in papillary thyroid cancer (PTC) patients with positive lateral neck lymph nodes at levels II-IV is still controversial, especially for low risk cases. In this study, we reviewed the medical records of 47 patients who underwent 47 ipsilateral selective lateral neck dissections (levels II-IV) for previously untreated papillary thyroid carcinomas between October 2006 and October 2008 to assist in establishing the optimal strategy for lateral neck dissection in low risk PTC patients with clinically negative level V nodes. All 47 patients were confirmed to have positive lymph nodes pathologically. Seventeen (36.12%), 36 (76.6%), and 34 (72.34%) patients had positive lymph nodes in levels II, III, and IV, respectively. The mean number of pathologically positive lymph nodes was 1.7 in level II, 2.9 in level III, 2.8 in level IV. No death and distant metastasis were recorded during follow up period. Just 2 patients exhibited recurrence to lymph nodes, and only one showed nodal recurrence in ipsilateral level V, who had positive lymph nodes in all of levels II, III, and IV at initial neck surgery. In conclusion, for PTC low risk patients with clinically negative lymph nodes in level V, non-performance of level V dissection would still achieve good survival results as traditional modified radical neck dissection, with a "wait and see" strategy to be recommended.