• Tuberculosis and Respiratory Diseases
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• 제59권3호
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• pp.286-297
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• 2005

Background : Non-small cell lung cancer (NSCLC) is a common cause of cancer-related death in North America and Korea, with an overall 5-year survival rate of between 4 and 14%. The TNM staging system is the best prognostic index for operable NSCLC . However, epidermal growth factor receptor (EGFR), matrix metalloproteinase-9(MMP-9), and C-erbB-2 have all been implicated in the pathogenesis of NSCLC and might provide prognostic information. Methods : Immunohistochemical staining of 81 specimens from a resected primary non-small cell lung cancer was evaluated in order to determine the role of the biological markers on NSCLC . Immunohistochemical staining for EGFR, MMP-9, and C-erbB-2 was performed on paraffin-embedded tissue sections to observe the expression pattern according to the pathologic type and surgical staging. The correlations between the expression of each biological marker and the survival time was determined. Results : When positive immunohistochemical staining was defined as the extent area>20%(more than Grade 2), the positive rates for EGFR, MMP-9, and C-erbB-2 staining were 71.6%, 44.3%, and 24.1% of the 81 patients, respectively. The positive rates of EGFR and MMP-9 stain for NSCLC according to the surgical stages I, II, and IIIa were 75.0% and 41.7%, 66.7% and 47.6%, and 76.9% and 46.2%, respectively. The median survival time of the EGFR(-) group, 71.8 months, was significantly longer than that of the EGFR(+) group, 33.5 months.(p=0.018, Kaplan-Meier Method, log-rank test).. The MMP-9(+) group had a shorter median survival time than the MMP-9(-) group, 35.0 and 65.3 months, respectively (p=0.2). The co-expression of EGFR and MMP-9 was associated with a worse prognosis with a median survival time of 26.9 months, when compared with the 77 months for both negative-expression groups (p=0.0023). There were no significant differences between the C-erbB-2(+) and C-erbB-2 (-) groups. Conclusion : In NSCLC, the expression of EGFR might be a prognostic factor, and the co-expression of EGFR and MMP-9 was found to be associated with a poor prognosis. However, C-erbB-2 expression had no prognostic significance.

• Radiation Oncology Journal
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• 제22권2호
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• pp.115-123
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• 2004

Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

• Radiation Oncology Journal
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• 제17권2호
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• pp.100-107
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• 1999

Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.

• Journal of Preventive Medicine and Public Health
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• 제6권1호
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• pp.51-63
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• 1973

This paper illustrate residual hearing and socio-medical background on the hearing impaired children, 207 comming to Deaf School. attached to Hankuk Social Work College, Taegu, Korea. The survey was performed through interview with their parents and testing by diagnostic audio-meter (TRIO, AS 105 type) at soundproof room from March 10, to November 28, 1973. The results obtained were as follows. 1) The attendance rate of the compulsory primary school was markedly lower tendency in female than male according to directly proportional to prevalence rate of deafness among them. If was showed the deeper gap in the more superior school (middle and high school). 2) Who entered at the suitable age to each school (six years old to primary school, 12 years to middle and 15 years to high) was 11.3%. And who were enrolled in school age to each school (6-11 years for primary. 12-14 years for middle and 15-17 years for high) was 45.9% (43.7% in male, 50.0% in female). 3) As causative disease, congenital case, were 23.6% included of 13.5% of heredity and 10.1% of troubles during pregnancy; the total acquired cases were 47.9%, it was classified as 11.6% of convulsion from any other diseases, 7.7% of measles, 7.7% of other febrile diseases, 3.4% of drug (the most of streptomycin) intoxication, 2.4% of meningitis, 1.5% of epidemic encephalitis and 31.3% of other diseases; and unknown cases were 28.5%. 4) 31.4% of who included congenital cases lost their hearing within six months old, 11.6% in 6-11 months. 9.7% in 1-2 years old and 14.0% in 2-3years old. Consequently we obtained that the most cases 90.0% were lost their hearing within 3 years after birth. 5) According to qualities of hearing leases the most of cases were perceptive, 197(97.5%), only two cases were conductive, and eight cases were mixed. 6) The status of residual hearing according to average grade of hearing loss. $B(=\frac{a+2b+c}{4}$ as table 13) were as follows. Two cases were normal (one was mute and another was severe speach disorder). Ten cases, moderate. Moderately severe cases were 40 (19.3%). Severe cases, 38(18.4%). Scale out, profound cases, 48 (23.3%). And impossible testing cases because that were infantile or had some mental disorder were 69 (33.3%). 7) The using rate of hearing aides was only 12.0%. Among them who had some more residual hearing and could showed hearing effect with hearing aide have used more many proportionary but who were difficult to expect that effect were rare.

• Journal of Korean Academy of Nursing
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• 제15권1호
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• pp.59-75
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• 1985

Accepting the health as the fundamental human right, the nation and society came to admit the duty to give it to all the people. Korean government is expanding the Primary Health Care as one of the policies for developing the people's health by the lead of community. Like this current situation the School Health Service which is the center of community Health Service schould be active to keep, promote and maintain the health of students and teachers. This investigation was attempted to help to establish the basis of the Health Education Program which would perform the health education efficiently and bring the reforming of student's health control, by measuring the degree of junior high school student's practice concerning health care and con-firming the relationship of knowledge, concern and level of health. The subjects for this study were made up 296 boys at the third grade in a school, located in Seoul. The tool for this study was questionaire. Data were collected for five days, September 22∼26, 1983. The investigators explained the students how to answer the questions of the survey questionaire and then collected the survey cards immediately. The data were analyzed by means of percentages, Pearson Correlation Coefficient and Stepwise Multiple Regression. The results of this study are as follows. 1. The subjects' reaction to the practice concerning Health Care; According to the average proportion of practice concerning health care, subjects' practice in the aspect of Infectious Disease Care is the highest 82.4％ and they showed their practice in the aspect of the accident prevention by 77.5% and in the aspect of mental health by 74.8%. Their practice in the aspect of personal hygiene and daily lifehabit is the lowest 71.2%. 2. Health Knowledge; The whole mark distribution of health knowledge is ranged from the lowest 4 point to the highest, 30 point, therefore point range is 26.0. The Average point is 16.58. 11.2% of students solved more than two thirds of personal knowledge levels. 81.4% of students did more than one third of them. 7.415 of students did less than one third of them. 3. Health Concern; The Students of the average 3.99 point respond positively to the question about the health concern, ‘They think health is more important than money’, this is the highest rate. The students of the average 2.78 respond“when they are sick, they enter the appointed hospital where they own choose”, while it is the lowest. 4. Subjects' response to the health level are at follow: Very healthy 26.0%, healthy 47.0%, less healthy 10.5%, 34.9% of them have ever been sick within two weeks, the number of symptoms they reported amount to 114 and the number of cases poi one person is 0.35. 5. The hypotheses test about the practice concerning health care and the factor which effect on it. 1) The main first hypothesis:“The more knowledge of health the subjects have, the better they practice health care.”was accepted. (r=0.1582, p <0.05) 2) The minor first hypothesis:“The more interest in health subjects have, the better they practice”was accepted. (r=0.4354, p ＜0.001) 3) The minor second hypothesis;“The healthier subjects are, the better they practice health care”was accepted. (r=0.1069, p＜0.05) As other test, partical correlation test is performed in other refine whether health knowledge, a fact influencing the students practice concerning health care, is associated with the practice after controlling the third variables. First, after controlling health concern, the correlation of health knowledge and practice concerning health care was kept. (r=0.1347, p <0.005) Second, after controlling health level, the correlation of health knowledge and practice concerning health care was kept. (r=0.1526, p <0.005) And finally, after controlling economic state, the correlation of health knowledge and practice concern-ing health care was kept. (r=0.1413, p <0.05) Additionally Stepwise Multiple Regression between practice concerning health care and variables. 1.6591 of compliance was explained with the know-ledge (F=5.584, p <0.05), 20.0% of compliance was explained with the health concern added to knowledge. (F=63,213, p <0.005) As the above, health knowledge obviously have effects on the practice about the health care. But, contrary to researcher's expectation, health concern has more affects than health knowledge. Therefore, we must grope the plan to enhance health concern through the regular curriculum and systematic health education for students. Besides, we must study further on, to find the factors which have affect on the practice concerning health care.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권3호
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• pp.182-191
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• 2011

Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

• Nuclear Medicine and Molecular Imaging
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• 제40권1호
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• pp.9-15
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• 2006

Purpose: Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyroid disease. Materials and Methods: Total patients were 119 cases (Men 15, $48{\pm}13$ yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was stored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. Results: ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of malignant thyroid diseases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution of NIS expression, which was not correlated with that of primary lesion. Conclusion: In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.

• Journal of Science Education
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• 제37권1호
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• pp.52-67
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• 2013

The purpose of this study was to examine the effect of educational science magic program on creative problem solving ability, inquiry skill, and scientific attitude in elementary school science. For this, two classes of 3th grade were chosen in the J elementary school located in Suwon city as the experimental class(30 students) and the comparative class(30 students). The two groups were selected through a diagnostic examining program. Instruction using educational science magic program was applied to the experimental class. The results of this study were as follows. 1. the creative problem solving ability of the experimental class has statistically meaningful differences and improved, compared with the comparative class(p<.05). 2. the scientific inquiry skill was improved, but it has no meaningful difference statistically. However, science tasks applied educational science magic program had valuable significance to ability of measure(p<.05). 3. the scientific attitude score also was improved, but it has no meaningful difference statistically. However, science tasks applied educational science magic program had valuable significance to endurance(p<.05). 4. the results of survey showed that educational science magic program influence students' interests and concerns in science, class participation, pleasure in class, and comprehension of what is said in class positively. Therefore, a educational science magic program applied in this study might be useful to improve the creative problem solving ability, interests and concerns in science, class participation, pleasure in class, and comprehension of what is said in class.

• Radiation Oncology Journal
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• 제17권1호
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• pp.43-51
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• 1999

Purpose : To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy Materials and Methods : Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1 ~l.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery, Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. Results : All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOGIEORTC grade 3 or 4). Conclusion : The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.

• The Korean Journal of Elementary Counseling
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• 제5권1호
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• pp.159-184
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• 2006

Lately, the rapid social and family system change, the entrance examination-centered circumstance in education have a negative influence not only on making up the affirmative self-esteem but also on building up the personal relationship through mutual communication with friends of the same age. Making children adapt well to school life and develop a good relationship in the class is an important subject in educational field. Thus, various school activities should offer lots of opportunities to increase their affirmative self-esteem and more specified performance-centered programs are required toform a harmonious relationship among parties of students. The purpose of this study is to improve an affirmative self-esteern and a desirable personal relationship of children through developing friend-praise program and adapting it to children. Based on the above purpose, the following subjects for this study 'are suggested. Firstly, is the friend-praise program effective in forming an affirmative self-esteem of elementary students? Secondly, is the friend-praise program successful in improving a desirable personal relationship in an elementary school? In addition, two hypotheses of study are decided on the basis of theoretical background and the former study. Hypothesis 1. The friend-praise program will have a meaningful effect on improving an affirmative self-esteem. Hypothesis 2. The friend-praise program will have a meaningful effect on improving a desirable personal relationship. In order to improve the above hypotheses, the experiment was carried out with two classes on the fourth grade in M elementary school in Wonju with being divided into one experimental group and the other comparative group. The friend-praise program which was adapted to the experimental group was composed with four steps as 'introduction', 'preparation', 'operation' and 'closing'. This program which has twelve categories was executed once or twice in a week and each class was continued for forty or sixty minutes. Contrastively, comparative group had no application of the main program. For the purpose of proving the hypotheses after adapting the program to students, I have executed both self-esteem test and personal relationship test. The tests were performed with using SPSS/Windows V10.0 and the statistic was conducted through independant sample t-test for the difference between groups and contrastive sample t-test for the individual difference in each group. The results of this study can be summarized like the followings: Firstly, from the result of previous and after tests, there was no meaningful change in the comparative group, but the experimental group showed meaningful difference in all categories of self-esteem(t=-4.496, p=.000). Especially, the general self-esteem(t=-3.216, p=.003), social self-esteem(t=-2.680, p=.012), homely self-esteem(t=-3.732, p=.001), and school self-esteem(t=-3.902, p=.000) showed a meaningful difference. At the same time, the experimental group also showed meaningful difference with the comparative group in self-esteem(t=-4.758, p=.000). Especially, the general self-esteem(t=2.581, p=.017), social self-esteem(t=3.160, p=.003), homely self-esteem(t=4.283, p=.000), and school self-esteem(t=4.110, p=.000) showed a meaningful difference. As a result of this experiment, the friend-praise program will have a meaningful effect on improving an affirmative self-esteem was proved. Secondly, there was no meaningful change in the comparative group, but the experimental group showed meaningful difference in all categories of personal relationship(t=-4.131, p=.000). Specifically, satisfaction(t=-2.113, p=.045), communication(t=-3.381, p=.002), confidence(t=-3.517, p=.001), intimacy(t=-3.958, p=.000), sensibility(t=-2.955, p=.006), openness(t=-4.318, p=.000) and interest(t=-2.941, p=.000) showed a meaningful difference. In the same instant, the experimental group also showed meaningful difference with the comparative group in all categories of personal relationship(t=3.897, p=.000). Especially, satisfaction(t=2.257, p=.003), communication(t=3.527, p=.001), confidence(t=3.704, p=.001), intimacy(t=3.904, p=.000), sensibility (t=4.382, p=.000), openness(t=2.648, p=.013) and interest(t=2.944, p=.006) showed a meaningful difference. Accordingly, the friend-praise program will have a meaningful effect on improving a desirable personal relationship was proved. Judging from all these results, we should provide primary students with various opportunities to take part in active programs which help them to set up their righteous sense of value, to solve their own problems and to develop their potentials. Consequently, many kinds of practice-centered program like the friend-praise program should be developed more systematically and teachers should apply all those programs to students according to their individual level and developmental stage.