• The Korean Journal of Emergency Medical Services
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• v.5 no.1
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• pp.199-212
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• 2001

This research, aiming at analyzing the Emergency Medical Technicians' duties prior to establishing a baseline for question development in the national exams to qualify for the EMTs, investigated the importance and frequency per unit specified in the description with the EMTs to be subjects working on the task spot by means of questionnaires. The EMT duties were classified into 9 items like 1) the notification and response, 2) the scene size-up, 3) the patient assessment, 4) the emergency care, 5) the patient transport, 6) the duties at hospital clinics, 7) the operational management, 8) the receiving and responding to a call, 9) the self-development, and put the functional tasks into 52 items, describing the task elements into 177 items, and then questioned 112 EMTs working on the spot from July 21 through August 30, 2000, which showed the following results. 1) The distribution of subjects' career showed the highest rate with 33.9% for those who careered "less than a year", only 13.4% for those with more than 4 years and the highest rate with 43.8% for those who aged at 20-25. And 70.5% of all those who were questioned was the junior college graduates, 58.9% for those working at fire station and 29.5% working at hospital clinics. 2) Looking at the distribution of frequency and importance for each task element, questioning 'the patients main symptoms', 'accidental type', 'place of the patients identification' showed the highest rate in both frequency and importance in the field of "notification and response". 3) In the "scene size-up", identifying the patients showed the highest rate of frequency and importance, compared to other field of tasks, among which "identifying the patients' state" showed the highest rate of frequency (2.66) and importance (2.81). 4) In the "patient assessment", "identifying the patients" showed the high rate of frequency and importance in most elements of task, especially the importance showed the highest rate with 2.83 for the task of airway management and the cervical immobilization during "the primary assessment", and the frequency showed the highest rate for questioning the past case of the task of grasping the patients' history. 5) In the "emergency care", "the management of the heart attacked patients" and "the advanced cardiac life support" showed a high rate in the importance, whereas the frequency showed a very low rate. The high rate of frequency during the emergent task was the management of "musculoskeletal system injury patients" and of "the gastro-intestinal and urinary genital system injury patient support." In care of the patients with heart attack, the management of the airway showed the highest rate with 2.95, whereas the management of alcoholic abused patients and of dying patients, showed comparatively lower rate of assessment in the importance. The frequency of tasks showed the highest rate with 2.69 in the control of bleeding and the lowest with 0.47 in the management of abnormal delivery of child. 6) As to the patient transport, "the emergency transport" showed the highest rate with 2.74 and the unemergent transport with 2.55 in the importance, and the task importance at hospital showed the highest rate with 2.89 in managing the cardio-pulmonary resuscitation and with 2.60 in identifying the patient state. 7) Of all the tasks related with "operational task", the high importance was to "educate for the management of the first responder", but the frequency of tasks mostly showed a low rate and "receiving and responding to a call" showed relatively a high rate of importance and frequency. And related with "the self-development", "the health care management" and "the stress control" on working spot showed a high rate, but the frequency mostly showed a low rate.

• Journal of Distribution Science
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• v.9 no.1
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• pp.39-48
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• 2011

One of the major reasons for fierce competition among firms is that they strive to increase their own market shares in the same market with similar and apparently undifferentiated products in terms of quality and perceived benefit. Due to such changes in the marketing environment, differentiated after-sales service and diversified promotion strategies have become more important in the race to gain a competitive advantage. Price discount is one of the popular promotion strategies that most retailers use, especially to increase sales, but offering a price discount does not always lead to the expected result. If marketers apply an identical price-promotion strategy without considering the characteristic differences in products and consumer preferences, the discounted price itself may make people skeptical about the quality of the product. Moreover, the changes in perceived value may appear differently depending on factors such as consumer involvement. This implies that variables such as the level of consumer involvement, brand loyalty, and external reference prices, in reality, would have different effects on how consumers perceive the value of price discounts. The variables that affect consumers' perceived values and buying decisions are diverse and complicated. Several studies have examined the effects of such variables as external reference price, selling price, and brand on consumers' perceived value of products. Results have not shown consistent patterns. Therefore, we must note that the factors affecting consumers' value perceptions and buying behaviors are diverse and that the results of studies on the same dependent variable come out differently depending on what that variable is. This study focused on the level of consumer involvement as a salient variable that supposedly affects the perceived value of a product, willingness to buy, and search intentions. We tried to examine whether a price discount affects the perceived value-such as perceived acquisition value and perceived transaction value-in different ways depending on the level of consumer involvement. In addition, we proposed managerial implications that marketers need to consider as a whole, for instance, product attributes, brand loyalty, and involvement and then established a differentiated pricing strategy, case by case, in order to effectively enhance consumers' perceived values. As a result, we found that perceived transaction value positively affects perceived acquisition value and when discounting the price of a high-involvement product enhances the consumer's willingness to buy, but perceived acquisition value does not affect the search intentions significantly. In the case of discounting prices of low-involvement products, on the other hand, the perceived transaction value has a positive effect on the willingness to buy, but the negative effect of perceived acquisition value on the search intentions was not significant. We suppose that people doubt a product's quality because of a declined perceived quality derived from a price discount. Even though the price discount enhanced the transaction value, people eventually increased their level of searching for additional product information. From the results of this study, we suggest that marketers ought to establish an appropriate value-enhancing strategy based on the understanding of which perceived value consumers rely on more when they conduct purchasing behavior because consumers perceive the degree of importance of acquisition value or transaction value differently, depending on their level of involvement.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.60 no.1
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• pp.91-96
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• 2015

Stable production of green manure crop is one of the critical factor for successful implementation of environmental-friendly agriculture in South Korea. Most green manure crops including hairy vetch cultivated in South Korea must be passed cold winter season. This study was conducted to establishment of cultivation zones on green manure crops under paddy field in South Korea using on minimum temperature and drainage class. In order to build the spatial distribution map, hairy vetch, triticale, barley, rye, and clover as green manure crop were selected and mean of daily minimum temperature and drainage class in paddy field were considered as limiting factor for stable growth of green manure crop. And cultivation zone on green manure crops was divided into two categories; 'Availability area' and 'Safety area'. Low limit temperature on green manure crops in this study was the following. Temperature on 'Availability area' was $-10^{\circ}C$, $-8^{\circ}C$, $-6^{\circ}C$, and $-20^{\circ}C$ for hairy vetch (including triticale), barley, clover, and rye respectively. And temperature on 'Safety area' was lower $-2^{\circ}C$ compared to that of 'Availability area' exception rye which was the same degree. Rye was expected to safely cultivated the almost whole paddy field (99.71%) of South Korea. 'Safety area' among the whole paddy field for hairy vetch, barley, and clover were 86.58, 53.06, and 15.76% respectively. The spatial distribution map of green manure crops reestablished in this study could be used the policy and agricultural management for environmental-friendly agriculture using green manure crops in South Korea.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.1-5
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• 2006

Purpose: IMRT quality assurance(Q.A) is consist of the absolute dosimetry using ionization chamber and relative dosimetry using the film. We have in general used 0.015 cc ionization chamber, because small size and measure the point dose. But this ionization chamber is too small to give an accurate measurement value. In this study, we have examined the degree of calculated to measured dose difference in intensity modulated radiotherapy(IMRT) based on the observed/expected ratio using various kinds of ion chambers, which were used for absolute dosimetry. Materials and Methods: we peformed the 6 cases of IMRT sliding-window method for head and neck cases. Radiation was delivered by using a Clinac 21EX unit(Varian, USA) generating a 6 MV x-ray beam, which is equipped with an integrated multileaf collimator. The dose rate for IMRT treatment is set to 300 MU/min. The ion chamber was located 5cm below the surface of phantom giving 100cm as a source-axis distance(SAD). The various types of ion chambers were used including 0.015cc(pin point type 31014, PTW. Germany), 0.125 cc(micro type 31002, PTW, Germany) and 0.6 cc(famer type 30002, PTW, Germany). The measurement point was carefully chosen to be located at low-gradient area. Results: The experimental results show that the average differences between plan value and measured value are ${\pm}0.91%$ for 0.015 cc pin point chamber, ${\pm}0.52%$ for 0.125 cc micro type chamber and ${\pm}0.76%$ for farmer type 0.6cc chamber. The 0.125 cc micro type chamber is appropriate size for dose measure in IMRT. Conclusion: IMRT Q.A is the important procedure. Based on the various types of ion chamber measurements, we have demonstrated that the dose discrepancy between calculated dose distribution and measured dose distribution for IMRT plans is dependent on the size of ion chambers. The reason is small size ionization chamber have the high signal-to-noise ratio and big size ionization chamber is not located accurate measurement point. Therefore our results suggest the 0.125 cc farmer type chamber is appropriate size for dose measure in IMRT.

• Radiation Oncology Journal
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• v.14 no.1
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• pp.77-85
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• 1996

Purpose : Multileaf collimator(MLC) is very suitable tool for conformal radio-therapy and commissioning measurements for a multileaf collimator installed on a dual energy accelerator with 6 and 10MV photons are required, For modeling the collimator with treament planning software, detailed dosimetric characterization of the multileaf collimator including the penumbra width, leaf transmission between leaf leakage and localization of the leaf ends and sides is an essential requirement. materials and Methods : Measurement of characteristic data of the MLC with 26 pair block leaves installed on CLINAC 2100C linear accelerator was performed. Low sensitive radiographic film(X-omatV) was used for the penumbra measurement and separate experiments using radiographic film and thermoluminescent dosimeters were performed to verify the dose distribution, Measured films were analized with a photodensitometer of WP700i scanner. Results : For 6 & 10 MV x-ray energies, approximately $2.0\%$ of photons incident on the multileaf collimator were transmitted and an additional $0.5\%$ leakage occurs between the leaves. Localizing the physical end of the leaves showed less than 1mm deviation from the $50\%$ decrement line and this difference is attributed to the curved shaped end on the leaves One side of a sin히e leaf corresponded to the $50\%$ decrement line, but the opposite face was aligned with a lower value. This difference is due to the tongue and groove used to decrease between leaf leakage. Alignment of the leaves to form a straight edge resulted larger penumbra at far position from isocenter as compare with divergent alloy blocks. When the MLC edge is stepped by sloping field, the isodose lines follow the leaf pattern and Produce scalloping isodose curves in tissue. The effective penumbra by 45 degree stepped MLC is about 10mm at 10cm depth for 6MV x-ray. The difference of effective penumbra in deep tissue between MLC and divergent alloy blocks is small (5mm). Conclusion : Using the characteristic data of MLC, the MLC has the clinlical acceptability and suitability for 3-D conformal radiotherapy except small field size.

• Radiation Oncology Journal
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• v.13 no.4
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• pp.403-409
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• 1995

Purpose : Authors tried to enhance the safety and accuracy of radiosurgery by verifying stereotacitc target point in actual treatment position prior to irradiation. Materials and Methods : Before the actual treatment, several sections of anthropomorphic head phantom were used to create a condition of unknown coordinates of the target point. A film was sandwitched between the phantom sections and punctured by sharp needle tip. The tip of the needle represented the target point. The head phantom was fixed to the stereotactic ring and CT scan was done with CT localizer attached to the ring. After the CT scanning, the stereotactic coordinates of the target point were determined. The head phantom was secured to accelerator's treatment couch and the movement of laser isocenter to the stereotactic coordinates determined by CT scanning was performed using target positioner. Accelerator's anteroposterior and lateral portal films were taken using angiographic localizers. The stereotactic coordinates determined by analysis of portal films were compared with the stereotactic coordinates previously determined by CT scanning. Following the correction of discrepancy the head phantom was irradiated using a stereotactic technique of several arcs. After the irradiation, the film which was sandwitched between the phantom sections was developed and the degree of coincidence between the center of the radiation distribution with the target point represented by the hole in the film was measured. In the treatment of the actual patients, the way of determining the stereotactic coordinates with CT localizers and angiograuhic localizers was the same as the phantom study. After the correction of the discrepancy between two sets of coordinates, we proceeded to the irradiation of the actual patient. Results : In the phantom study, the agreement between the center of the radiation distribution and the localized target point was very good. By measuring optical density profiles of the sandwitched film along axes that intersected the target point, authors could confirm the discrepancy was 0.3 mm. In the treatment of an actual patient, the discrepancy between the stereotactic coordinates with CT localizers and angiographic localizers was 0.6 mm. Conclusion : By verifying stereotactic target point in actual treatment position prior to irradiation, the accuracy and safety of streotactic radiosurgery procedure were established.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.214-222
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• 1988

With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

• Applied Microscopy
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• v.38 no.4
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• pp.307-314
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• 2008

Hydrophytes such as Spirodela polyrhiza form dormant turions to withstand cold winters. The turion is an anatomically distinct structure from which a vegetative frond arises later during germination. The turions sink to the bottom of the pond when temperatures drop and remain there throughout the winter. In the spring, they float to the surface and germinate into a new frond from the turion primordium. Unlike fronds, turions are known to possess small aerenchyma, starch grains, and relatively dense cytoplasm. These features allow the turions to survive the cold winter season at the bottom of the pond. Spirodela polyrhiza has been investigated previously to a great extent, especially in its physiological, biochemical and ecological attributes. However, a little is known about the structural features of the frond and turion during turion development. Thus, the aim of the present study was to reveal the structural characteristics of the frond and turion with regard to tissue differentiation, aerenchyma development, starch distribution, and ultrastructure, with the use of electron microscopy. A moderate degree of mesophyll tissue differentiation was found in the frond, whereas the turion did not exhibit such differentiation. Within the frond tissue, approximately $37{\sim}45%$ of the cellular volume was occupied by a large aerenchyma, but only $9{\sim}15%$ was taken up by the aerenchyma in the turion. The turion cells, especially those of the turion primordium, were derived from frond cells, and contained cytoplasm. Their cytoplasm was densely packed with plastids, mitochondria, endoplasmic reticulum, Golgi bodies, and microtubules. Plasmodesmata were also well developed within these cells. The most striking feature observed was the distribution of starch grains within the plastids of turion cells. Before the turion sank to the bottom of the pond, a considerable amount of starch accumulated in the plastid stroma. The starch grains dissolved when temperatures rose in the spring, and this promptly provided the nutrients which the primordium needed for turion germination. The turion therefore, was an appropriate dormant structure for free-floating, reduced hydrophytes like Spirodela polyhriza due to its small aerenchyma and large starch grains that aided in the purpose of sinking below the surface of the water to survive cold winters. The new fronds that arose from such turions grew rapidly in the spring, beginning the new life cycle.

• Korean Journal of Environment and Ecology
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• v.32 no.2
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• pp.165-175
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• 2018

The purpose of this study is to provide the basic data such as distribution status, growth characteristics, and the structural characteristics of forest stands for the systematic conservation and management of relict forest trees (stem girth of 300cm or larger) established naturally in Gangwon Province, Korea. The survey showed that 434 individuals of 19 species (conifers: 228 individuals of 4 species, broad-leaved trees: 206 individuals of 15 species) were distributed in Gangwon Province, and Taxus cuspidata was the most abundant among them with 203 individuals or about 46.7 % of the total. The stem girth was average of 404cm (conifers: 373cm, broad-leaves: 421cm), and Tilia amurensis with multi-stemmed growing on Sorak mountain range had the largest stem girth at 1,113cm. The average height and the crown width of relict forest trees were 15.4m and 10.0m, respectively. Although the environments of relict forest trees showed a slight difference by species, the relative appearance frequencies of most trees were high in the environments where the altitude was higher than 1,000 m, slope degree was greater than $25^{\circ}$, the slope faced north, and microtopography was at the upper of slopes. Regarding the stand characteristics of relict forest trees per unit area ($/100m^2$), the average total coverage was 294% (max. 475%), the total average number of species was 36 species (max. 60 species), the average species diversity index (H') was 2.560 (max. 3.593), the average canopy closure was 84.8% (max. 94.6%), and the average basal area (/ha) was $52.7m^2$ (max. $116.4m^2$, relict trees $30.0m^2$, and other trees $22.7m^2$). The analysis of the dynamics of the forest stands where relict forest trees were growing showed four types of the maintenance mechanisms of relict forest trees depending on the supply pattern of succeeding trees: "Low-density but persistent type (Quercus mongolica, Abies holophylla, Tilia amurensis, and Pyrus ussuriensis)," "Long ago stopped type (Pinus densiflora)," "Recently stopped type (Abies nephrolepis, Quercus variabilis, and Betula schmidtii)," and "Periodically repeated types of supply and stop (Salix caprea and Quercus serrata).".

• Progress in Medical Physics
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• v.23 no.4
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• pp.269-278
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• 2012

Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.