Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)
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- Tuberculosis and Respiratory Diseases
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- v.44 no.2
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- pp.241-250
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- 1997
Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.
It has been diversified and serious attempt to establish the identity of Changgeuk, but it is still independent dramaturgy or the current unformed progressive art. In this situation, exploring works of the identity of changgeuk that is base on the performed individual and specific works in the title of Changgeuk is needed. The 80s and 90s Heo, Gyu was leading an active life as a director who was responsible for directing of Changgeuk. He dramatized Siljeon Pansori -which is a group of Pansori missing text- as well as 5-remained Songs in Pansori and he presented a number of creative Changgeuk works on stage. Especially, the completion of dramatizing 5-remained Songs in Pansori under the name of 'Wanpan Changgeuk -which means full version performance without omit-' is the one of his big achievement by performing "Heungbojeon" on the stage 1982 and "Jeokbyeokga" 1985. The purposes of this research are confirmation of Heo's direction of the formulation and considering its characteristics & significance through 'Wanpan Changgeuk' which written by Heo. Heo was a practical play who was interested in the subjective formulation of national culture and creative transmission for Korean traditional performance. He tried to formulate Changgeuk to a representative performance of Korea. In the process he pointed out those problems, (1) interpretation of a work problem, (2) actor's creative problems, (3) structure problem of theater for Changgeuk. He indicated that the other challenges are to use of the stage & device, to overcome sentimentalism, to stylize acting, to improve own quality, to control the speed and length of the song, to choose the suitable musical accompaniment, to create new repertories problems, and etc. Changgeuk is classified in 3 group by origin, (1)dramatizing of 5-remained Songs, (2)dramatizing of 7-missing Songs, (3)creative dramatizing. It contains all of 3 types that Heo's work. The dramatizing of remained 5 Songs are the great importance among those works. Heo hoped that Chaggeuk has become the most representative art work of Korea by performing 'Wanpan Changgeuk' compiled heritage of Korea's outstanding artistic achievement. The characteristics of 'Wanpan Changgeuk' can be summarized following four. (1) Directing attitudes that emphasizes tradition, (2) Accepting the elements of traditional performance actively, (3) Valuing the classy and ethic, (4) Emphasizing humor and active utilizing of the secondary characters. Heo's 'Wanpan Changgeuk' shows a peak of the artistic level which Changgeuk can be reached. He want to make Changgeuk a Korean representative artistic performance by compiling Pansori heritage and accommodating Korean traditional performance. Heo continued his effort to present Pansori's authenticity and to dramatize from beginning to end without missing. It shows very well that 'Wanpan Changgeuk' takes 4~5 hours for playing. It looks Heo's achievement in the 'Wanpan Changgeuk' influenced Changgeuk significantly since then. Heo's 'Wanpan Changgeuk' is matrix of 'Wanpan JangMak Changgeuk' attempted in the 1990s. Especially, their intent is consistent to synthesize texts and to show all the virtue of Pansori. But 90's 'Wanpan JangMak Changgeuk' aim for large stage, fancy device & costume and variety contents compared with 'Wanpan Changgeuk'. Recently, producers have tried not to make a impressive Changgeuk but to make a interesting one. They usually organize performance within 2 hours and prefer orchestral music to its unique sound. In those point of view, it seems that Heo's idle in 'Wanpan Changgeuk' has become one of target to conquer in these days.
Most people prefer to choose zero-cost products they may get without paying any money. The 'zero-cost effect' can be explained with a 'zero-cost model' where consumers attach special values to zero-cost products in a different way from general economic models (Shampanier, Mazar and Ariely 2007). If 2 different products at the regular prices of ￦200 and ￦400 simultaneously offer ￦200 discounts, the prices will be changed to ￦0 and ￦200, respectively. In spite of the same price gap of the two products after the ￦200 discounts, people are much more likely to select the free alternative than the same product at the price of ￦200. Although prior studies have focused on the 'zero-cost effect' in isolation of other factors, this study investigates the moderating effects of a self-regulatory resource and a construal level on the selection of free products. Self-regulatory resources induce people to control or regulate their behavior. However, since self-regulatory resources are limited, they are to be easily depleted when exerted (Muraven, Tice, and Baumeister 1998). Without the resources, consumers tend to become less sensitive to price changes and to spend money more extravagantly (Vohs and Faber 2007). Under this condition, they are also likely to invest less effort on their information processing and to make more intuitive decisions (Pocheptsova, Amir, Dhar, and Baumeister 2009). Therefore, context effects such as price changes and zero cost effects are less likely in the circumstances of resource depletion. In addition, construal levels have profound effects on the ways of information processing (Trope and Liberman 2003, 2010). In a high construal level, people tend to attune their minds to core features and desirability aspects, whereas, in a low construal level, they are more likely to process information based on secondary features and feasibility aspects (Khan, Zhu, and Kalra 2010). A perceived value of a product is more related to desirability whereas a zero cost or a price level is more associated with feasibility. Thus, context effects or reliance on feasibility (for instance, the zero cost effect) will be diminished in a high level construal while those effects may remain in a low level construal. When people make decisions, these 2 factors can influence the magnitude of the 'zero-cost effect'. This study ran two experiments to investigate the effects of self-regulatory resources and construal levels on the selection of a free product. Kisses and Ferrero-Rocher, which were adopted in the prior study (Shampanier et al. 2007) were also used as alternatives in Experiments 1 and 2. We designed Experiment 1 in order to test whether self-regulatory resource depletion will moderate the zero-cost effect. The level of self-regulatory resources was manipulated with two different tasks, a Sudoku task in the depletion condition and a task of drawing diagrams in the non-depletion condition. Upon completion of the manipulation task, subjects were randomly assigned to one of a decision set with a zero-cost option (i.e., Kisses ￦0, and Ferrero-Rocher ￦200) or a set without a zero-cost option (i.e., Kisses ￦200, and Ferrero-Rocher ￦400). A pair of alternatives in the two decision sets have the same price gap of ￦200 between a low-priced Kisses and a high-priced Ferrero-Rocher. Subjects in the no-depletion condition selected Kisses more often (71.88%) over Ferrero-Rocher when Kisses was free than when it was priced at ￦200 (34.88%). However, the zero-cost effect disappeared when people do not have self-regulatory resources. Experiment 2 was conducted to investigate whether constual levels influence the magnitude of the 'zero-cost effect'. To manipulate construal levels, 4 different 'why (in the high construal level condition)' or 'how (in the low construal level condition)' questions about health management were asked. They were presented with 4 boxes connected with downward arrows. In a box at the top, there was one question, 'Why do I maintain good physical health?' or 'How do I maintain good physical health?' Subjects inserted a response to the question of why or how they would maintain good physical health. Similar tasks were repeated for the 2nd, 3rd, and 4th responses. After the manipulation task, subjects were randomly assigned either to a decision set with a zero-cost option, or to a set without it, as in Experiment 1. When a low construal level is primed with 'how', subjects chose free Kisses (60.66%) more often over Ferrero-Rocher than they chose ￦200 Kisses (42.19%) over ￦400 FerreroRocher. On contrast, the zero-cost effect could not be observed any longer when a high construal level is primed with 'why'.
Just before the Korean War, the total number of the North Korean troops was 198,380, while that of the ROK(Republic of Korea) army troops 105,752. That is, the total number of the ROK army troops at that time was 53.3% of the total number of the North Korean army. As of December 2008, the total number of the North Korean troops is estimated to be 1,190,000, while that of the ROK troops is 655,000, so the ROK army maintains 55.04% of the total number of the North Korean troops. If the ROK army continues to reduce its troops according to [Military Reform Plan 2020], the total number of its troops will be 517,000 m 2020. If North Korea maintains the current status(l,190,000 troops), the number of the ROK troops will be 43.4% of the North Korean army. In terms of units, just before the Korean War, the number of the ROK army divisions and regiments was 80% and 44.8% of North Korean army. As of December 2008, North Korea maintains 86 divisions and 69 regiments. Compared to the North Korean army, the ROK army maintains 46 Divisions (53.4% of North Korean army) and 15 regiments (21.3% of North Korean army). If the ROK army continue to reduce the military units according to [Military Reform Plan 2020], the number of ROK army divisions will be 28(13 Active Division, 4 Mobilization Divisions and 11 Local Reserve Divisions), while that of the North Korean army will be 86 in 2020. In that case, the number of divisions of the ROK army will be 32.5% of North Korean army. During the Korean war, North Korea suddenly invaded the Republic of Korea and occupied its capital 3 days after the war began. At that time, the ROK army maintained 80% of army divisions, compared to the North Korean army. The lesson to be learned from this is that, if the ROK army is forced to disperse its divisions because of the simultaneous invasion of North Korea and attack of guerrillas in home front areas, the Republic of Korea can be in a serious military danger, even though it maintains 80% of military divisions of North Korea. If the ROK army promotes the plans in [Military Reform Plan 2020], the number of military units of the ROK army will be 32.5% of that of the North Korean army. This ratio is 2.4 times lower than that of the time when the Korean war began, and in this case, 90% of total military power should be placed in the DMZ area. If 90% of military power is placed in the DMZ area, few troops will be left for the defense of home front. In addition, if the ROK army continues to reduce the troops, it can allow North Korea to have asymmetrical superiority in military force and it will eventually exert negative influence on the stability and peace of the Korean peninsular. On the other hand, it should be reminded that, during the Korean War, the Republic of Korea was attacked by North Korea, though it kept 53.3% of troops, compared to North Korea. It should also be reminded that, as of 2008, the ROK army is defending its territory with the troops 55.04% of North Korea. Moreover, the national defense is assisted by 25,120 troops of the US Forces in Korea. In case the total number of the ROK troops falls below 43.4% of the North Korean army, it may cause social unrest about the national security and may lead North Korea's misjudgement. Besides, according to Lanchester strategy, the party with weaker military power (60% compared to the party with stronger military power) has the 4.1% of winning possibility. Therefore, if we consider the fact that the total number of the ROK army troops is 55.04% of that of the North Korean army, the winning possibility of the ROK army is not higher than 4.1%. If the total number of ROK troops is reduced to 43.4% of that of North Korea, the winning possibility will be lower and the military operations will be in critically difficult situation. [Military Reform Plan 2020] rums at the reduction of troops and units of the ground forces under the policy of 'select few'. However, the problem is that the financial support to achieve this goal is not secured. Therefore, the promotion of [Military Reform Plan 2020] may cause the weakening of military defence power in 2020. Some advanced countries such as Japan, UK, Germany, and France have promoted the policy of 'select few'. However, what is to be noted is that the national security situation of those countries is much different from that of Korea. With the collapse of the Soviet Unions and European communist countries, the military threat of those European advanced countries has almost disappeared. In addition, the threats those advanced countries are facing are not wars in national level, but terrorism in international level. To cope with the threats like terrorism, large scaled army trops would not be necessary. So those advanced European countries can promote the policy of 'select few'. In line with this, those European countries put their focuses on the development of military sections that deal with non-military operations and protection from unspecified enemies. That is, those countries are promoting the policy of 'select few', because they found that the policy is suitable for their national security environment. Moreover, since they are pursuing common interest under the European Union(EU) and they can form an allied force under NATO, it is natural that they are pursing the 'select few' policy. At present, NATO maintains the larger number of troops(2,446,000) than Russia(l,027,000) to prepare for the potential threat of Russia. The situation of japan is also much different from that of Korea. As a country composed of islands, its prime military focus is put on the maritime defense. Accordingly, the development of ground force is given secondary focus. The japanese government promotes the policy to develop technology-concentrated small size navy and air-forces, instead of maintaining large-scaled ground force. In addition, because of the 'Peace Constitution' that was enacted just after the end of World War II, japan cannot maintain troops more than 240,000. With the limited number of troops (240,000), japan has no choice but to promote the policy of 'select few'. However, the situation of Korea is much different from the situations of those countries. The Republic of Korea is facing the threat of the North Korean Army that aims at keeping a large-scale military force. In addition, the countries surrounding Korea are also super powers containing strong military forces. Therefore, to cope with the actual threat of present and unspecified threat of future, the importance of maintaining a carefully calculated large-scale military force cannot be denied. Furthermore, when considering the fact that Korea is in a peninsular, the Republic of Korea must take it into consideration the tradition of continental countries' to maintain large-scale military powers. Since the Korean War, the ROK army has developed the technology-force combined military system, maintaining proper number of troops and units and pursuing 'select few' policy at the same time. This has been promoted with the consideration of military situation in the Koran peninsular and the cooperation of ROK-US combined forces. This kind of unique military system that cannot be found in other countries can be said to be an insightful one for the preparation for the actual threat of North Korea and the conflicts between continental countries and maritime countries. In addition, this kind of technology-force combined military system has enabled us to keep peace in Korea. Therefore, it would be desirable to maintain this technology-force combined military system until the reunification of the Korean peninsular. Furthermore, it is to be pointed out that blindly following the 'select few' policy of advanced countries is not a good option, because it is ignoring the military strategic situation of the Korean peninsular. If the Republic of Korea pursues the reduction of troops and units radically without consideration of the threat of North Korea and surrounding countries, it could be a significant strategic mistake. In addition, the ROK army should keep an eye on the fact the European advanced countries and Japan that are not facing direct military threats are spending more defense expenditures than Korea. If the ROK army reduces military power without proper alternatives, it would exert a negative effect on the stable economic development of Korea and peaceful reunification of the Korean peninsular. Therefore, the desirable option would be to focus on the development of quality of forces, maintaining proper size and number of troops and units under the technology-force combined military system. The tableau above shows that the advanced countries like the UK, Germany, Italy, and Austria spend more defense expenditure per person than the Republic of Korea, although they do not face actual military threats, and that they keep achieving better economic progress than the countries that spend less defense expenditure. Therefore, it would be necessary to adopt the merits of the defense systems of those advanced countries. As we have examined, it would be desirable to maintain the current size and number of troops and units, to promote 'select few' policy with increased defense expenditure, and to strengthen the technology-force combined military system. On the basis of firm national security, the Republic of Korea can develop efficient policies for reunification and prosperity, and jump into the status of advanced countries. Therefore, the plans to reduce troops and units in [Military Reform Plan 2020] should be reexamined. If it is difficult for the ROK army to maintain its size of 655,000 troops because of low birth rate, the plans to establish the prompt mobilization force or to adopt drafting system should be considered for the maintenance of proper number of troops and units. From now on, the Republic of Korean government should develop plans to keep peace as well as to prepare unexpected changes in the Korean peninsular. For the achievement of these missions, some options can be considered. The first one is to maintain the same size of military troops and units as North Korea. The second one is to maintain the same level of military power as North Korea in terms of military force index. The third one is to maintain the same level of military power as North Korea, with the combination of the prompt mobilization force and the troops in active service under the system of technology-force combined military system. At present, it would be not possible for the ROK army to maintain such a large-size military force as North Korea (1,190,000 troops and 86 units). So it would be rational to maintain almost the same level of military force as North Korea with the combination of the troops on the active list and the prompt mobilization forces. In other words, with the combination of the troops in active service (60%) and the prompt mobilization force (40%), the ROK army should develop the strategies to harmonize technology and forces. The Korean government should also be prepared for the strategic flexibility of USFK, the possibility of American policy change about the location of foreign army, radical unexpected changes in North Korea, the emergence of potential threat, surrounding countries' demand for Korean force for the maintenance of regional stability, and demand for international cooperation against terrorism. For this, it is necessary to develop new approaches toward the proper number and size of troops and units. For instance, to prepare for radical unexpected political or military changes in North Korea, the Republic of Korea should have plans to protect a large number of refugees, to control arms and people, to maintain social security, and to keep orders in North Korea. From the experiences of other countries, it is estimated that 115,000 to 230,000 troops, plus ten thousands of police are required to stabilize the North Korean society, in the case radical unexpected military or political change happens in North Korea. In addition, if the Republic of Korea should perform the release of hostages, control of mass destruction weapons, and suppress the internal wars in North Korea, it should send 460,000 troops to North Korea. Moreover, if the Republic of Korea wants to stop the attack of North Korea and flow of refugees in DMZ area, at least 600,000 troops would be required. In sum, even if the ROK army maintains 600,000 troops, it may need additional 460,000 troops to prepare for unexpected radical changes in North Korea. For this, it is necessary to establish the prompt mobilization force whose size and number are almost the same as the troops in active service. In case the ROK army keeps 650,000 troops, the proper number of the prompt mobilization force would be 460,000 to 500,000.