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Multi-classification of Osteoporosis Grading Stages Using Abdominal Computed Tomography with Clinical Variables : Application of Deep Learning with a Convolutional Neural Network (멀티 모달리티 데이터 활용을 통한 골다공증 단계 다중 분류 시스템 개발: 합성곱 신경망 기반의 딥러닝 적용)

  • Tae Jun Ha;Hee Sang Kim;Seong Uk Kang;DooHee Lee;Woo Jin Kim;Ki Won Moon;Hyun-Soo Choi;Jeong Hyun Kim;Yoon Kim;So Hyeon Bak;Sang Won Park
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.187-201
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    • 2024
  • Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

Design and Implementation of MongoDB-based Unstructured Log Processing System over Cloud Computing Environment (클라우드 환경에서 MongoDB 기반의 비정형 로그 처리 시스템 설계 및 구현)

  • Kim, Myoungjin;Han, Seungho;Cui, Yun;Lee, Hanku
    • Journal of Internet Computing and Services
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    • v.14 no.6
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    • pp.71-84
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    • 2013
  • Log data, which record the multitude of information created when operating computer systems, are utilized in many processes, from carrying out computer system inspection and process optimization to providing customized user optimization. In this paper, we propose a MongoDB-based unstructured log processing system in a cloud environment for processing the massive amount of log data of banks. Most of the log data generated during banking operations come from handling a client's business. Therefore, in order to gather, store, categorize, and analyze the log data generated while processing the client's business, a separate log data processing system needs to be established. However, the realization of flexible storage expansion functions for processing a massive amount of unstructured log data and executing a considerable number of functions to categorize and analyze the stored unstructured log data is difficult in existing computer environments. Thus, in this study, we use cloud computing technology to realize a cloud-based log data processing system for processing unstructured log data that are difficult to process using the existing computing infrastructure's analysis tools and management system. The proposed system uses the IaaS (Infrastructure as a Service) cloud environment to provide a flexible expansion of computing resources and includes the ability to flexibly expand resources such as storage space and memory under conditions such as extended storage or rapid increase in log data. Moreover, to overcome the processing limits of the existing analysis tool when a real-time analysis of the aggregated unstructured log data is required, the proposed system includes a Hadoop-based analysis module for quick and reliable parallel-distributed processing of the massive amount of log data. Furthermore, because the HDFS (Hadoop Distributed File System) stores data by generating copies of the block units of the aggregated log data, the proposed system offers automatic restore functions for the system to continually operate after it recovers from a malfunction. Finally, by establishing a distributed database using the NoSQL-based Mongo DB, the proposed system provides methods of effectively processing unstructured log data. Relational databases such as the MySQL databases have complex schemas that are inappropriate for processing unstructured log data. Further, strict schemas like those of relational databases cannot expand nodes in the case wherein the stored data are distributed to various nodes when the amount of data rapidly increases. NoSQL does not provide the complex computations that relational databases may provide but can easily expand the database through node dispersion when the amount of data increases rapidly; it is a non-relational database with an appropriate structure for processing unstructured data. The data models of the NoSQL are usually classified as Key-Value, column-oriented, and document-oriented types. Of these, the representative document-oriented data model, MongoDB, which has a free schema structure, is used in the proposed system. MongoDB is introduced to the proposed system because it makes it easy to process unstructured log data through a flexible schema structure, facilitates flexible node expansion when the amount of data is rapidly increasing, and provides an Auto-Sharding function that automatically expands storage. The proposed system is composed of a log collector module, a log graph generator module, a MongoDB module, a Hadoop-based analysis module, and a MySQL module. When the log data generated over the entire client business process of each bank are sent to the cloud server, the log collector module collects and classifies data according to the type of log data and distributes it to the MongoDB module and the MySQL module. The log graph generator module generates the results of the log analysis of the MongoDB module, Hadoop-based analysis module, and the MySQL module per analysis time and type of the aggregated log data, and provides them to the user through a web interface. Log data that require a real-time log data analysis are stored in the MySQL module and provided real-time by the log graph generator module. The aggregated log data per unit time are stored in the MongoDB module and plotted in a graph according to the user's various analysis conditions. The aggregated log data in the MongoDB module are parallel-distributed and processed by the Hadoop-based analysis module. A comparative evaluation is carried out against a log data processing system that uses only MySQL for inserting log data and estimating query performance; this evaluation proves the proposed system's superiority. Moreover, an optimal chunk size is confirmed through the log data insert performance evaluation of MongoDB for various chunk sizes.

Diagnostic Reference Levels for Patient Radiation Doses in Pelvis and Lumbar spine Radiography in Korea (우리나라의 골반 및 요추 엑스선검사에서의 환자선량 권고량)

  • Lee, Kwang-Yong;Lee, Byung-Young;Lee, Jung-Eun;Lee, Hyun-Koo;Jung, Seung-Hwan;Kim, Byung-Woo;Kim, Hyeog-Ju;Kim, Dong-Sup
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.401-410
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    • 2009
  • Purpose : Pelvis and lumbar spine radiography, among various types of diagnostic radiography, include gonads of the human body and give patients high radiation dose. Nevertheless, diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography has not yet been established in Korea. Therefore, the radiation dose that patients receive from pelvis and lumbar radiography is measured and the diagnostic reference level on patient radiation dose for the optimization of radiation protection of patients in pelvis and lumbar spine radiography was established. Methods : The conditions and diagnostic imaging information acquired during the time of the postero-anterior view of the pelvis and the postero-anterior and lateral view of the lumbar spine at 125 medical institutions throughout Korea are collected for analysis and the entrance surface dose received by patients is measured using a glass dosimeter. The diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography to be recommended to the medical institutes is arranged by establishing the dose from the patient radiation dose that corresponds to the 3rd quartile values as the appropriate diagnostic reference level for patient radiation dose. Results : According to the results of the assessment of diagnostic imaging information acquired from pelvis and lumbar spine radiography and the measurement of patient entrance surface dose taken at the 125 medical institutes throughout Korea, the tube voltage ranged between 60~97 kVp, with the average use being 75 kVp, and the tube current ranged between 8~123 mAs, with the average use being 30 mAs. In the posteroanterior and lateral views of lumbar spine radiography, the tube voltage of each view ranged between 65~100 kVp (average use: 78 kVp) and 70~109 kVp (average use: 87 kVp), respectively, and the tube current of each view ranged between 10~100 mAs(average use: 35 mAs) and between 8.9~300 mAs(average use: 64 mAs), respectively. The measurements of entrance surface dose that patients receive during the pelvis and lumbar spine radiography show the following results: in the posteroanterior view of pelvis radiography, the minimum value is 0.59 mGy, the maximum value is 12.69 mGy and the average value is 2.88 mGy with the 1st quartile value being 1.91 mGy, the median being 0.59 mGy, and the 3rd quartile value being 3.43 mGy. Also, in the posteroanterior view of lumbar spine radiography, the minimum value is 0.64 mGy, the maximum value is 23.84 mGy, and the average value is 3.68 mGy with the 1st quartile value being 2.41 mGy, the median being 3.40 mGy, and the 3rd quartile value being 4.08 mGy. In the lateral view of lumbar spine radiography, the minimum value is 1.90 mGy, the maximum value is 45.42 mGy, and the average value is 10.08 mGy with the 1st quartile value being 6.03 mGy, the median being 9.09 mGy and the 3rd quartile value being 12.65 mGy. Conclusions : The diagnostic reference levels for patient radiation dose to be recommended to the medical institutes in Korea is 3.42 mGy for the posteroanterior view of pelvis radiography, 4.08 mGy for the posteroanterior view of lumbar spine radiography, and 12.65 mGy for the lateral view of lumbar spine radiography. Such values are all lower than the values recommended by 6 international organizations including World Health Organization, where the recommended values are 10 mGy for the posteroanterior view of pelvis radiography, 10 mGy for the posteroanterior view of lumbar spine radiography and 30 mGy for the lateral view of lumbar spine radiography.

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Usefulness of Stomach Extension after Drinking Orange Juice in PET/CT Whole Body Scan (PET/CT 전신 영상에서 오렌지 주스(Orange Juice)를 이용한 위장 확장 영상의 유용성)

  • Cho, Seok-Won;Chung, Seok;Oh, Shin-Hyun;Park, Hoon-Hee;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.86-92
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    • 2009
  • Purpose: The PET/CT has a clear distinction on the lesion of the functional image by adding anatomical information. It also could reduce the examination time using CT data as the attenuation-correction. When the stomach was contracted from a fast, it could bring a misinterpretation of the cancer of the lesion with a presence of physiological $^{18}F$-FDG uptake in stomach and it occasionally would bring an additional scan to confirm. To complement this shortcoming, the method that the patients had water before the examination to extend the stomach had been attempted. However, a short excretion time of the stomach did not give sufficiently extended image of the stomach. Then the patients had additional water and had the examination again. Therefore, the noticed fact is that the stomach excretion time depends on calories, protein content, and the level of carbohydrate. In this study, we use an orange juice to evaluate the extension of the stomach and usefulness of it. Materials and Methods: PET/CT scan were obtained on total 150 of patient from February 2008 to October2008, There were 3 groups in this study and each group had 50 patients. First group drank nothing, Second group drank water and third group drank orange juice. The patients (man 25, female 25) not drinking are the age of 30~71 years old (average: 54), the patients (man: 25, female: 25) drinking water (400 cc) are the age of 28~71 years old (average: 54) and the patients (man: 25, female: 25) drinking orange juice (400 cc) are the age of 32~74 years old (average: 56). The patients were fasted in 6-8 hours before the test, the patients were not diabetic. $^{18}F$-FDG 370~555 MBq were injected intravenously. The patients were in stable position for 1 hour, than the image was obtained. The patients drank water and other patients drank orange juice before Whole body scan. The image scan started from mid-femur to skull base. The emission scan acquired for three minutes per bed and the images were reconstructed. Stomach extension analysis is measured from vertical and horizontal length. Results: Stomach Extension was described as the vertical length of the Non Drink Group was $1.20{\pm}0.50\;cm$, horizontal length was $1.4{\pm}0.53\;cm$, the vertical length of the Water Drink Group was $1.67{\pm}0.63\;cm$, horizontal length was $1.65{\pm}0.77\;cm$, the vertical length of Orange juice Drink Group was $3.48{\pm}0.77\;cm$, horizontal length was $3.66{\pm}0.77\;cm$ in coronal image. Stomach Extension was described the vertical length of the Non Drink Group was $2.03{\pm}0.62\;cm$, horizontal length was $1.69{\pm}0.68\;cm$, the vertical length of Water Drink Group was $5.34{\pm}1.62\;cm$, horizontal length was $2.45{\pm}0.72\;cm$, the vertical length of Orange juice Drink Group was $7.74{\pm}1.62\;cm$, horizontal length was $3.57{\pm}0.77\;cm$ in transverse image. The Stomach Extension has specific differences (p<0.001). The SUVs shows the Non Drink Group were measured as Liver $2.52{\pm}0.42$, Lung $0.51{\pm}0.14$, the Water Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$, Orange juice Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$. The SUVs did not have specific differences (p>0.759). Conclusions: There was not a large difference of SUV in three groups. When the patients drank Orange juice and water, the range extension of stomach was higher than without drinking nothing and it was possible to acquire fully extended images. Therefore, it will be possible that unnecessary additional stomach scans will be reduced by drinking orange juice before the examination so that the patients' claim from uncomfortable and long period of fast will be minimized.

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Environmental Changes after Timber Harvesting in (Mt.) Paekunsan (백운산(白雲山) 성숙활엽수림(成熟闊葉樹林) 개벌수확지(皆伐收穫地)에서 벌출직후(伐出直後)의 환경변화(環境變化))

  • Park, Jae-Hyeon
    • Journal of Korean Society of Forest Science
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    • v.84 no.4
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    • pp.465-478
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    • 1995
  • The objective of this study was to investigate the impacts of large-scale timber harvesting on the environment of a mature hardwood forest. To achieve the objective, the effects of harvesting on forest environmental factors were analyzed quantitatively using the field data measured in the study sites of Seoul National University Research Forests [(Mt.) Paekunsan] for two years(1993-1994) following timber harvesting. The field data include information on vegetation, soil mesofauna, physicochemical characteristics of soil, surface water runoff, water quality in the stream, and hillslope erosion. For comparison, field data for each environmental factor were collected in forest areas disturbed by logging and undisturbed, separately. The results of this study were as follows : The diversity of vegetational species increased in the harvested sites. However, the similarity index value of species between harvested and non-harvested sites was close to each other. Soil bulk density and soil hardness were increased after timber harvesting, respectively. The level of organic matter, total-N, avail $P_2O_5$, CEC($K^+$, $Na^+$, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$) in the harvested area were found decreased. While the population of Colembola spp., and Acari spp. among soil mesofauna in harvested sites increased by two to seven times compared to those of non-harvested sites during the first year, the rates of increment decreased in the second year. However, those members of soil mesofauna in harvested sites were still higher than those of non-harvested sites in the second year. The results of statistical analysis using the stepwise regression method indicated that the diversity of soil mesofauna were significantly affected by soil moisture, soil bulk density, $Mg^{{+}{+}}$, CEC, and soil temperature at soil depth of 5(0~10)cm in the order of importance. The amount of surface water runoff on harvested sites was larger than that of non-harvested sites by 28% in the first year and 24.5% in the second year after timber harvesting. The level of BOD, COD, and pH in the stream water on the harvested sites reached at the level of the domestic use for drinking in the first and second year after timber harvesting. Such heavy metals as Cd, Pb, Cu, and organic P were not found. Moreover, the level of eight factors of domestic use for drinking water designated by the Ministry of Health and Welfare of Korea were within the level of the first class in the quality of drinking water standard. The study also showed that the amount of hillslope erosion in harvested sites was 4.77 ton/ha/yr in the first year after timber harvesting. In the second year, the amount decreased rapidly to 1.0 ton/ha/yr. The impact of logging on hillslope erosion in the harvested sites was larger than that in non-harvested sites by seven times in the first year and two times in the second year. The above results indicate that the large-scale timber harvesting cause significant changes in the environmental factors. However, the results are based on only two-year field observation. We should take more field observation and analyses to increase understandings on the impacts of timber harvesting on environmental changes. With the understandings, we might be able to improve the technology of timber harvesting operations to reduce the environmental impacts of large-scale timber harvesting.

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Study on In Vitro Aggregation and Culture of Mouse Embryos by Phytohemagglutinin-P (Phytohemagglutinin-P 첨가(添加)에 따른 생쥐배(胚)의 시험관내(試驗管內) 응집(凝集)과 배양(培養)에 관하여)

  • Park, Hang Kyun;Ryou, Zae Yoong
    • Current Research on Agriculture and Life Sciences
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    • v.7
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    • pp.83-97
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    • 1989
  • This study was carried out to obtain basic information necessary for aggregation and in-vitro culture of mouse embryos by treating phytohemagglutinin-p (PHA-P). The 4-, 8-cell and morula embryos were obtained from female mice of albino BALE/C, CBA and C57BL strains, those were injected 5 i.u pregenant mare serum gonadotrophin and 5 i.u human chorionic gonadotrophin to superovulation. The zona pellucidia was removed by placing the embryos in Acidic Tyrode solution containing 1.0% protease or/and 5 ug/ml PHA-P. The pairs of zona free embryos were subjected to aggregation by glassneedle in BMOC-3 containing 5 ug/ml PHA-P. The aggregation embryos were cultured in Brinster's mouse ova culture-3(BMOC-3) medium under the gas phase of 5% $CO_2$ in air $37^{\circ}C$ for 13 to 50 hours. The results obtained in this study are summarised as follows : 1. When 4-, 8-cell and morula embryos were zona-freed in acidic Tyrode solution containing 1.0% protease or/and 5 ug/ml PHA-P, and cultured in vitro to blastocysts, the 4- and 8-cell embryos showed slightly less development rates than the morula one did, and solution of 5 ug/ml PHA-P brought some higher development rate than negative control. 2. As 2, 5 or 10 ug/ml PHA-P was added to the solution to aggregate 4-, 8-cell or morula embryos, 2 ug/ml solution represented slightly lower aggregation rate than the higher levels solutions, and 4- and 8-cell embryos showed higher rates than morula one did (P<.05). 3. In respect to the development rates of aggregated embryos to morula no significant difference was found among PHA-P levels and between 4-and 8-cell embryos. With respect to those of aggregated embryos to blastocysts the different levels of PHA-P showed similar results, however, the 4- and 8-cell embryos represented higher rates than the morula one did (P<.05). 4. The mean time necessary for development of aggregated 4-, 8-cell and morula embryos to blastocysts were 38.5-40, 26-27 and 19-20hrs. Respectively in solution for aggregation. 5. The aggregation rates of embryos were 34-94%, when treated protease or/and PHA-P. Supplementation of 5 ug/ml PHA-P to the solution for aggregation showed a trend demonstrating higher aggregation rate compared to negative control, although no significance was found. However, 4- and 8-cell embryos represented significantly higher aggregation rates than the morula one did (P<.05). 6. The development rates of 4- and 8-cell embryos to morula were 52.7-84.7 and 73.8-87.2%, respectively, showing no significant difference between two cell stages. However, the aggregation rates of embryos treated with solution containing PHA-P were higher than negative control (P<.05). 7. The development rates of 4- and 8-cell and morula embryos to blastocysts were 41.7-77.7 78.7-83.0 and 0-19.2%, respectively. The rates of 4-cell embryos treated with PHA-P were significant higher than the negative control (P<.05). The 8-cell and morula embryos also showed more rates when treated PHA-P.

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Annual Analysis on Quality Attributes and Customer Satisfaction in School Foodservice (연차별 학교급식 품질 속성 및 전반적인 만족도 분석)

  • Yi, Bo-Sook;Yang, Il-Sun;Park, Moon-Kyung
    • Journal of Nutrition and Health
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    • v.42 no.8
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    • pp.770-783
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    • 2009
  • The school foodservice was quantitatively extended by policy of government all the while. There was carried out the survey of customer satisfaction about school foodservice by the ministry of education, science, and technology since 2006 years. Therefore, the purpose of this study was to grasp an improvement of the scores of school foodservice' quality attributes and satisfaction as compared with the preceding year by respondents and school type (elementary school, middle school, and high school). An annual survey was practiced to respondents (students, parents, and faculty) on september 2007 years and 2008 years in 16 cities and provinces. The statistics was analyzed to descriptive analysis and t-test for SPSS 12.0. The scores of school foodservice' quality attributes and overall customer satisfaction were almost increased to students, parents, and faculty and especially, big elevation in middle school. There was big increased the quality attributes such as 'providing information on foodservice', 'pleasant foodservice environment', 'kindness offered by employee' in elementary school, middle school, and high school to total respondents. An overall satisfaction in school foodservice was improved from 69.2 score to 71.9 score. On students, scores of overall satisfaction was increased from 72.9 to 74.0 as students of elementary school and from 61.5 to 65.8 as students of middle school (p < .001). Therefore, for improvement and development of school foodservice, there should be a necessary for an operator of school foodservice and an office of education to make an effort.

Development of Root Media Containing Pine Bark for Cultivation of Horticultural Crops (소나무 수피를 포함한 원예작물 재배용 혼합상토의 개발)

  • Park, Eun Young;Choi, Jong Myung
    • Horticultural Science & Technology
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    • v.32 no.4
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    • pp.499-506
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    • 2014
  • This research was conducted to develop root media containing ground and aged pine bark (GAPB) and ground and raw pine bark (GRPB). After analysis of physico chemical properties, the pine barks were blended with peat moss (PM) or coir dust (CD) in various ratios to formulate 12 root media. Then, two out of 12 root media were chosen based on the physical properties for further experiments. The pre-planting nutrient charge fertilizers (PNCF) were incorporated into two root media and chemical properties were analysed again. The total porosity (TP), container capacity (CC), and air-filled porosity (AFP) of GAPB were 78.7%. 39.4%, and 38.3%, respectively, while those of GRPB were 74.7%, 41.2%, and 33.4%, respectively. The percentage of easily available water (EAW, from CC to 4.90 kPa tension) and buffering water (BW, 4.91-9.81 kPa tension) in GAPB were 12.7% and 8.5%, respectively, which were a little lower than the 13.5% and 8.8% in GRPB. The pH and EC were not different significantly, but cation exchange capacity was different between the two pine barks (GAPB: pH 5.26, EC $0.61dS{\cdot}m^{-1}$, CEC $15.7meq{\cdot}100g^{-1}$; GRPB: pH 5.19, EC $0.32dS{\cdot}m^{-1}$, CEC $9.32meq{\cdot}100g^{-1}$). The concentrations of exchangeable cations in GAPB were Ca 0.32, K 0.05, Mg 0.27 and $0.12cmol+{\cdot}kg^{-1}$, whereas those in GRPB were Ca 0.28, K 0.08, Mg 0.25 and $0.09cmol+{\cdot}kg^{-1}$. The concentrations of $PO_4$-P, $NH_4$-N and $NO_3$-N were 485.8, 0.62 and $0.91mg{\cdot}L^{-1}$ in GAPB and 578, 1.00 and $0.82mg{\cdot}L^{-1}$ in GRPB, respectively, when those were analyzed in the solution of the saturated paste. The TP, CC and AFP in the two selected media were 89.3 and 76.3, and 13.0% in PM+GAPB (8:2, v/v) and 88.2, 68.2 and 20.0% in CD+GRPB (8:2), respectively. The pHs and ECs were 3.8 and $0.24dS{\cdot}m^{-1}$ in PM+GAPB which were a little lower than 5.8 and $0.65dS{\cdot}m^{-1}$ in CD+GRPB. However, the pHs analysed before and after incorporation of PNCF in the two root media did not show large differences. This is because the solubility of dolomitic lime is very low, and the pH it is expected to rise gradually when crops are cultivated int he root media. The information obtained in this study should facilitate effective formulation of root media containing pine bark.

Structural Adjustment of Domestic Firms in the Era of Market Liberalization (시장개방(市場開放)과 국내기업(國內企業)의 구조조정(構造調整))

  • Seong, So-mi
    • KDI Journal of Economic Policy
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    • v.13 no.4
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    • pp.91-116
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    • 1991
  • Market liberalization progressing simultaneously with high and rapidly rising domestic wages has created an adverse business environment for domestic firms. Korean firms are losing their international competitiveness in comparison to firms from LDC(Less Developed Countries) in low-tech industries. In high-tech industries, domestic firms without government protection (which is impossible due to the liberalization policy and the current international status of the Korean economy) are in a disadvantaged position relative to firms from advanced countries. This paper examines the division of roles between the private sector and the government in order to achieve a successful structural adjustment, which has become the impending industrial policy issue caused by high domestic wages, on the one hand, and the opening of domestic markets, on the other. The micro foundation of the economy-wide structural adjustment is actually the restructuring of business portfolios at the firm level. The firm-level business restructuring means that firms in low-value-added businesses or with declining market niches establish new major businesses in higher value-added segments or growing market niches. The adjustment of the business structure at the firm level can only be accomplished by accumulating firm-specific managerial assets necessary to establish a new business structure. This can be done through learning-by-doing in the whole system of management, including research and development, manufacturing, and marketing. Therefore, the voluntary cooperation among the people in the company is essential for making the cost of the learning process lower than that at the competing companies. Hence, firms that attempt to restructure their major businesses need to induce corporate-wide participation through innovations in organization and management, encourage innovative corporate culture, and maintain cooperative labor unions. Policy discussions on structural adjustments usually regard firms as a black box behind a few macro variables. But in reality, firm activities are not flows of materials but relationships among human resources. The growth potential of companies are embodied in the human resources of the firm; the balance of interest among stockholders, managers, and workers of the company' brings the accumulation of the company's core competencies. Therefore, policymakers and economists shoud change their old concept of the firm as a technological black box which produces a marketable commodities. Firms should be regarded as coalitions of interest groups such as stockholders, managers, and workers. Consequently the discussion on the structural adjustment both at the macroeconomic level and the firm level should be based on this new paradigm of understanding firms. The government's role in reducing the cost of structural adjustment and supporting should the creation of new industries emphasize the following: First, government must promote the competition in domestic markets by revising laws related to antitrust policy, bankruptcy, and the promotion of small and medium-sized companies. General consensus on the limitations of government intervention and the merit of deregulation should be sought among policymakers and people in the business world. In the age of internationalization, nation-specific competitive advantages cannot be exclusively in favor of domestic firms. The international competitiveness of a domestic firm derives from the firm-specific core competencies which can be accumulated by internal investment and organization of the firm. Second, government must build up a solid infrastructure of production factors including capital, technology, manpower, and information. Structural adjustment often entails bankruptcies and partial waste of resources. However, it is desirable for the government not to try to sustain marginal businesses, but to support the diversification or restructuring of businesses by assisting in factor creation. Institutional support for venture businesses needs to be improved, especially in the financing system since many investment projects in venture businesses are highly risky, even though they are very promising. The proportion of low-value added production processes and declining industries should be reduced by promoting foreign direct investment and factory automation. Moreover, one cannot over-emphasize the importance of future-oriented labor policies to be based on the new paradigm of understanding firm activities. The old laws and instititutions related to labor unions need to be reformed. Third, government must improve the regimes related to money, banking, and the tax system to change business practices dependent on government protection or undesirable in view of the evolution of the Korean economy as a whole. To prevent rational business decisions from contradicting to the interest of the economy as a whole, government should influence the business environment, not the business itself.

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Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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