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Expression of TIMP1, TIMP2 Genes by Ionizing Radiation (이온화 방사선에 의한 TIMP1, TIMP2 유전자 발현 측정)

  • Park Kun-Koo;Jin Jung Sun;Park Ki Yong;Lee Yun Hee;Kim Sang Yoon;Noh Young Ju;Ahn Seung Do;Kim Jong Hoon;Choi Eun Kyung;Chang Hyesook
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.171-180
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    • 2001
  • Purpose : Expression of TIMP, intrinsic inhibitor of MMP, is regulated by signal transduction in response to genotoxins and is likely to be an important step in metastasis, angiogenesis and wound healing after ionizing radiation. Therefore, we studied radiation mediated TIMP expression and its mechanism in head and neck cancer cell lines. Materials and Methods : Human head and neck cancer cell lines established at Asan Medical Center were used and radiosensitivity $(D_0)$, radiation cytotoxicity and metastatic potential were measured by clonogenic assay, n assay and invasion assay, respectively. The conditioned medium was prepared at 24 hours and 48 hours after 2 Gy and 10 Gy irradiation and expression of TIMP protein was measured by Elisa assay with specific antibodies against human TIMP. hTIMP1 promoter region was cloned and TIMP1 luciferase reporter vector was constructed. The reporter vector was transfected to AMC-HN-1 and -HN-9 cells with or without expression vector Ras, then the cells were exposed to radiation or PMA, PKC activator. EMSA was peformed with oligonucleotide (-59/-53 element and SP1) of TIMP1 promoter. Results : $D_0$ of HN-1, -2, -3, -5 and -9 cell lines were 1.55 Gy, 1.8 Gy, 1.5 Gt, 1.55 Gy and 2.45 Gy respectively. n assay confirmed cell viability, over $94\%$ at 24hrs, 48hrs after 2 Gy irradiation and over 73% after 10 Gy irradiation. Elisa assay confirmed that cells secreted TIMP1, 2 proteins continuously. After 2 Gy irradiation, TIMP2 secretion was decreased at 24hrs in HN-1 and HN-9 cell lines but after 10 Gy irradiation, it was increased in all cell lines. At 48hrs after irradiation, it was increased in HN-1 but decreased in HN-9 cells. But the change in TIMP secretion by RT was mild. The transcription of TIMP1 gene in HN-1 was induced by PMA but in HN-9 cell lines, it was suppressed. Wild type Ras induced the TIMP-1 transcription by 20 fold and 4 fold in HN-1 and HN-9 respectively. The binding activity to -59/-53, AP1 motif was increased by RT, but not to SP1 motif in both cell lines. Conclusions : We observed the difference of expression and activity of TIMPs between radiosensitive and radioresistant cell line and the different signal transduction pathway between in these cell lines may contribute the different radiosensitivity. Further research to investigate the radiation response and its signal pathway of TIMPs is needed.

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A Study on Improvement on National Legislation for Sustainable Progress of Space Development Project (우주개발사업의 지속발전을 위한 국내입법의 개선방향에 관한 연구)

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.1
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    • pp.97-158
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    • 2010
  • The purpose of this paper is to research on the contents and improvement of national legislations relating to space development in Korea to make the sustainable progress of space development project in Korea. Korea has launched its first satellite KITST-1 in 1992. The National Space Committee has established "The Space Development Promotion Basic Plan" in 2007. The plan addressed the development of total 13 satellites by 2010 and the space launch vehicle by 2020, and the launch of moon exploration spaceship by 2021. Korea has built the space center at Oinarodo, Goheng Province in June 2009. In Korea the first small launch vehicle KSLV-1 was launched at the Naro Space Center in August 2009, and its second launch was made in June 2010. The United Nations has adopted five treaties relating to the development of outer space as follows : The Outer Space Treaty of 1967, the Rescue and Return Agreement of 1968, the Liability Convention of 1972, the Registration Convention of 1974, and the Moon Treaty of 1979. All five treaties has come into force. Korea has ratified the Outer Space Treaty, the Rescue and Return Agreement, the Liability Convention and the Registration Convention excepting the Moon Treaty. Most of development countries have enacted the national legislation relating to the development of our space as follows : The National Aeronautic and Space Act of 1958 and the Commercial Space Act of 1998 in the United States, Outer Space Act of 1986 in England, Establishment Act of National Space Center of 1961 in France, Canadian Space Agency Act of 1990 in Canada, Space Basic Act of 2008 in Japan, and Law on Space Activity of 1993 in Russia. There are currently three national legislations relating to space development in Korea as follows : Aerospace Industry Development Promotion Act of 1987, Outer Space Development Promotion Act of 2005, Outer Space Damage Compensation Act of 2008. The Ministry of Knowledge Economy of Korea has announced the Full Amendment Draft of Aerospace Industry Development Promotion Act in December 2009, and it's main contents are as follows : (1) Changing the title of Act into Aerospace Industry Promotion Act, (2) Newly regulating the definition of air flight test place, etc., (3) Establishment of aerospace industry basic plan, establishment of aerospace industry committee, (4) Project for promoting aerospace industry, (5) Exploration development, international joint development, (6) Cooperative research development, (7) Mutual benefit project, (8) Project for furthering basis of aerospace industry, (9) Activating cluster of aerospace industry, (10) Designation of air flight test place, etc., (11) Abolishing the designation and assistance of specific enterprise, (12) Abolishing the inspection of performance and quality. The Outer Space Development Promotion Act should be revised with regard to the following matters : (1) Overlapping problem in legal system between the Outer Space Development Promotion Act and the Aerospace industry Development promotion Act, (2) Distribution and adjustment problem of the national research development budget for space development between National Space Committee and National Science Technology Committee, (3) Consideration and preservation of environment in space development, (4) Taking the legal action and maintaining the legal system for policy and regulation relating to space development. The Outer Space Damage Compensation Act should be revised with regard to the following matters : (1) Definition of space damage and indirect damage, (2) Currency unit of limit of compensation liability, (3) Joint liability and compensation claim right of launching person of space object, (4) Establishment of Space Damage Compensation Council. In Korea, it will be possible to make a space tourism in 2013, and it is planned to introduce and operate a manned spaceship in 2013. Therefore, it is necessary to develop the policy relating to the promotion of commercial space transportation industry. Also it is necessary to make the proper maintenance of the current Aviation Law and space development-related laws and regulations for the promotion of space transportation industry in Korea.

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Principles of Space Resources Exploitation under International Law (국제법상 우주자원개발원칙)

  • Kim, Han-Teak
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.35-59
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    • 2018
  • Professor Bin Cheng said that outer space was res extra commercium, while the moon and the other celestial bodies were res nullius before the 1967 Outer Space Treaty(OST). However, Article 2 of the OST made the moon and other celestial bodies have the legal status as res extra commmercium, not appropriated by any country or private enterprises or individual person, but the resources there can be freely available, as those on the high seas. The non-appropriation principle was introduced to corpus juris spatialis internationalis. Whether or not the non-appropriation principle is binding for the non-parties of the OST, many scholars see this principle as an international customary law, even developing into jus cogens. Article 11(2) of the Moon Agreement(MA) reconfirms the nonappropriation principle of Article 2 of the OST, but it has much less effect than the OST because the MA binds only the 18 parties involved. The MA applies only to the moon and celestial bodies other than the Earth in the Solar System, the OST's application scope extends to the Galaxy because the OST has no such substantive enactment. As referred to in the 2015 CSLCA of USA or Luxembourg's Law of Space Resources, allowing individuals and enterprises run by other countries to commercially explore and utilize the space resources, the question may arise whether this violates the non-appropriation principle under Article 2 of the OST and Article 11 of the MA. In the case of the CSLCA, the law explicitly specifies that sovereignty, possessory rights, and judiciary rights to a specific celestial body cannot be claimed, let alone ownership. This author believes that this law respects the legal status of outer space and the celestial bodies as res extra commmercium. As long as any countries or private enterprises or individuals respect the non-appropriation principle of outer space and the celestial bodies, they could use, exploit it. Another question might be raised in the difference between res extra commercium on the high seas and res extra commercium in outer space and the celestial bodies. Collecting resources on the high seas and exploiting space resources should be interpreted differently. On the high seas, resources can be collected without any obstacles like fishing, whereas, in the case of the deep sea-bed area, the Common Heritage of Mankind principles under the UNCLOS should be operated by the International Seabed Authority as an international regime. The nature or form of the sea resources found on the high seas are thus different from that of space resources, which are fixed on the moon and the celestial bodies without water. Thus, if individuals or private enterprises collect these resources from outer space and the celestial bodies, they might secure a certain section and continue collecting or mining works without any limitation. If an American enterprise receives an approval from the U.S. government, secures the best location and collects resources on the moon, can other countries' enterprises access to this area? How large the exploiting place can be allotted on the moon? How long should such a exploiting activity be lasted? Under the current international space law, these matters might be handled according to the principle of "first come, first served." As a consequence, the international community should provide a guideline or a proposal for the settlement of any foreseeable disputes during the space activity to solve plausible space legal questions in the near future.

Active Inferential Processing During Comprehension in Poor Readers (미숙 독자들에 있어 이해 도중의 능동적 추리의 처리)

  • Zoh Myeong-Han;Ahn Jeung-Chan
    • Korean Journal of Cognitive Science
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    • v.17 no.2
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    • pp.75-102
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    • 2006
  • Three experiments were conducted using a verification task to examine good and poor readers' generation of causal inferences(with because sentences) and contrastive inferences(with although sentences). The unfamiliar, critical verification statement was either explicitly mentioned or was implied. In Experiment 1, both good and poor readers responded accurately to the critical statement, suggesting that both groups had the linguistic knowledge necessary to the required inferences. Differences were found, however, in the groups' verification latencies. Poor, but not good, readers responded faster to explicit than to implicit verification statements for both because and although sentences. In Experiment 2, poor readers were induced to generate causal inferences for the because experimental sentences by including fillers that were apparently counterfactual unless a causal inference was made. In Experiment 3, poor readers were induced to generate contrastive inferences for the although sentences by including fillers that could only be resolved by making a contrastive inference. Verification latencies for the critical statements showed that poor readers made causal inferences in Experiment 2 and contrastive inferences in Experiment 3 doting comprehension. These results were discussed in terms of context effect: Specific encoding operations performed on anomaly backgrounded in another passage would form part of the context that guides the ongoing activity in processing potentially relevant subsequent text.

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Detection of Serum Hepatitis B Virus DNA According to HBV Markers in Chronic Hepatitis B Liver Disease (만성 B형 간질환에서 간염 B virus 표식자 발현에 따른 DNA의 검출)

  • Lee, Dong-Jun;Choi, Jin-Su;Kim, Joon-Hwan;Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.155-167
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    • 1997
  • The identification of serum HBV DNA is very important for the assessment of the disease activity in persistent infection, for the evaluation of the infectivity of an individuals blood. The dot blot, however, has limited sensitivity and sometimes inconsistent with other serological markers and clinical settings. Using the most important recent advance in molecular biology, the polymerase chain reaction(PCR), specific DNA sequences can be amplified more than a million-fold in a few hours and with this technique the detection of the extreme low level of DNA is possible. This study was to determine sensitivity of the PCR for the detection of serum HBV DNA in comparison with dot blot analysis and to investigate the serum HBV DNA status and clinical significance of PCR in patients with chronic HBsAg positive liver disease. The subjects of this study were 17 patients with asymptomatic HBsAg carriers(9 HBeAg positive patients, 8 anti-HBe positive patients), 91 chronic hepatitis B(50 HBeAg positive patients, 41 anti-HBe positive patients), 57 liver cirrhosis(21 HBeAg positive patients, 36 anti-HBe positive patients), 27 hepatocellular carcinoma(10 HBeAg positive patients, 17 anti-HBe positive patients). The results were summerized as following; The detection rates of HBV DNA by dot blot, PCR were 58.9%, 72.2% in HBeAg positive patients, 34.3%, 53.9% in anti-HBe positive patients. The detection rates of HBV DNA by PCR in HBeAg negative patients were 25.0% in asymptomatic HBsAg carriers, 61.0% in chronic hepatitis B, 52.8% in liver cirrhosis, 52.9% in hepatocellular carcinoma. The positive rate for HBV DNA is a significant difference between HBeAg positive and negative asymptomatic HBsAg carriers, but not significantly difference in other groups. In conclusions, this study confirmed that the PCR is much more sensitive than the dot blot analysis in detecting the HBV DNA in the sera of patients with chronic liver disease. The presence of HBV DNA in the serum was detected by PCR with higher sensitivity and it suggested that active viral replication is still going on in most patients with chronic HBsAg positive liver disease irrespective of HBeAg/anti-HBe status, and PCR may be used as a prognostic factor in asymptomatic HBsAg carriers.

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Effects of Endocrine Disruptors (NP, DBP and BPA) on Sperm Characteristics and Development of IVF Embryos in Pig

  • Yuh, In Suh;Cheong, Hee Tae;Kim, Jong Taek;Park, In Chul;Park, Choon Keun;Yang, Boo Keun
    • Journal of Animal Science and Technology
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    • v.55 no.4
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    • pp.237-247
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    • 2013
  • This study was to examine single or combined in vitro effects of environmental endocrine disruptors on boar sperm characteristics, oxidative stress damage in sperm and development of porcine IVF embryos. Addition of various concentration of NP (10, 20, $30{\mu}M$), DBP (10, 50, $100{\mu}M$) and BPA (1, 5 or $10{\mu}g/ml$) on boar sperm characteristics such as percentages of sperm motility, viability, membrane integrity and mitochondrial activity were dose-dependently decreased within 3, 6 or 9 hr incubation period (p<0.05). The overall detrimental effects increased with incubation time increasement. NP, DBP and BPA showed the detrimental effects on sperm membrane and mitochondria of energy production organelles affecting cell viability with the dependancy of dose and incubation time. In combination effects, NP ($10{\mu}M$) + DBP ($10{\mu}M$) significantly decreased boar general sperm characteristics for 3 or 6 hr incubation period compared with control (p<0.05). When both of NP and DBP concentrations (NP; $30{\mu}M$, DBP; $100{\mu}M$) increase, the detrimental effects on sperm characteristics were larger than those of low concentration combination (p<0.05). The inhibitory effects of NP ($30{\mu}M$) + BPA ($10{\mu}g/ml$) on sperm characteristics were larger than those of NP ($10{\mu}M$) + BPA ($1{\mu}g/ml$) (p<0.05). DBP ($100{\mu}M$) + BPA ($10{\mu}g/ml$) decreased sperm characteristics compared with the low concentration combination (DBP $10{\mu}M$ + BPA $1{\mu}g/ml$, p<0.05). This result indicates the detrimental effects of both chemicals on sperm characteristics were dose dependent. Addition of NP ($30{\mu}M$) + DBP ($100{\mu}M$), NP ($30{\mu}M$) + BPA ($10{\mu}g/ml$), DBP ($10{\mu}M$) + BPA ($1{\mu}g/ml$) or DBP ($100{\mu}M$) + BPA ($10{\mu}g/ml$) significantly increased lipid peroxidation for 3 or 6 hr incubation period (p<0.05) compared with no addition control. NP (${\geq}20{\mu}M$) decreased the percentages of IVF embryo development from morulae and blastocyst stages (p<0.05) and its detrimental effects were dose-dependant. BPA 0, 1, 5 or $10{\mu}g/ml$ decreased significantly and dose-dependently the percentage of morulae plus and blastocysts (p<0.05). Combinations of DBP ($100{\mu}M$) plus NP ($30{\mu}M$) and DBP ($100{\mu}M$) plus BPA ($10{\mu}g/ml$) did not affect on morulae and blastocyst development, but NP ($30{\mu}M$) plus BPA ($10{\mu}g/ml$) has significant detrimental effect on embryo development at these stages (p<0.05). These overall results indicate that the partial detrimental effects on boar sperm characteristics and embryo development by NP, DBP, BPA or the combination of these chemicals might be due to the increasement of lipid peroxidation and free radical formation in the cell and there were no specific interaction effects on boar sperm and embryo degeneration among the combined treatments.

Forsythiae Fructus Induces VEGF Production via p38 MAPK Activation in Human Keratinocytes (각질형성세포에서 p38 MAPK 활성을 통한 연교의 VEGF 생성 효과)

  • Kim, Mi-Sun;Choi, Yun Ho;Park, Sun Gyoo;Lee, Cheon Koo;Lee, Sang Hwa
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.4
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    • pp.329-336
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    • 2016
  • Cutaneous microvasculature plays a critical role in age-associated skin changes. A considerable reduction of number and size of vessels has been observed in the upper dermis of elderly skin. Forsythiae fructus (FF), the dried fruit of plant Forsythia suspensa (F. suspensa), has been traditionally used as an herbal medicine to treat inflammatory diseases and bacterial diseases. However, its regulatory effect on angiogenic responses has not been elucidated in skin. Therefore, we analyzed secretory profiles upon treatment of FF extract using array designed to detect angiogenesis-associated mediators in human keratinocytes. Because keratinocyte-derived VEGF (vascular endothelial growth factor) has been regarded as a potent factor for new microvasculature under the epidermis, we further investigated the effect of FF extract on VEGF production. We observed that the VEGF expression of mRNA and protein level was increased by about 2 folds in a dose-dependent manner after FF extract treatment. In signaling experiments, FF extract induced rapid p38 MAPK activation within 5 min, and the activation was totally abrogated by pretreatment with a p38 MAPK specific inhibitor. The FF-induced VEGF upregulation was also significantly attenuated by a p38 MAPK inhibition. Taken together, FF extract induces VEGF production via p38 MAPK activation in human epidermal keratinocytes. These novel findings suggest that FF is useful as a potential agent with pro-angiogenic activity and may help to improve age-dependent reduction of the microvasculature in aged skin or to heal skin wound.

The effect of chitosan/ACS on bone regeneration in rat calvarial defects (백서두개골 결손부에서 키토산/흡수성 콜라겐 전달체의 골재생)

  • Kim, Soo-Kyoung;Suk, Hun-Joo;Kim, Chang-Sung;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.33 no.3
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    • pp.457-474
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    • 2003
  • The ultimate objective of periodontal treatment is to get rid of an on-going periodontal disease and further regenerate the supporting tissue, which is already destroyed, functionally. Currently, the bone grafting operation using various kinds of bone grafting materials and the operation for induced regeneration of periodontal tissue using the blocking membrane are performed for regeneration of the destroyed periodontal tissue. However, there are respective limitations Galenical preparations, which are used for regeneration of periodontal of tissue, has less risk of rejective reaction or toxicity that may be incidental to degradation and their effect is sustainable. Thus, in case they are applicable to a clinic, they can he used economically. Chitosan has such compatibility, biological actions including antibacterial activity, acceleration of wound treatment, etc., and excellent mechanical characteristics, which has recently aroused more interest in it. Also, it has been reported that it promotes osteogenesis directly or indirectly by functioning as a matrix to promote migration and differentiation of a specific precussor cell (for example, osteoblast) and further inhibiting the function of such a cell as fibroblast to prevent osteogenesis. In this study, the pure chitosan solution, which was obtained by purifying chitosan, was used. However, since this chitosan is of a liquiform, it is difficult to sustain it in a defective region. It is, therefore, essential to use a carrier for delivering chitosan to, and sustaining it gradually in the defective region. In the calvarial defect model of the Sprague-Dawley rat, it is relatively easy to maintain a space. Therefore, in this study, the chitosan solution with which ACS was wetted was grafted onto the defective region, For an experimental model, a calvarial defect of rat m s selected, and a critical size of the defective region was a circular defect with a diameter of 8 mm. A group in which no treatment was conducted for the calvarial defect was set as a negative control group. Another group in which treatment was conducted with ACS only was set as a positive control group (ACS group). And another group in which treatment was conducted was conducted with by grafting the pure chitosan solution onto the defective region through ACS which was wetted with the chitosan solution was set an experimental group (Chitosan/ACS group). Chitosan was applied to the Sprague-Dawley rat's calvarial bone by applying ACS which was wetted with the chitosan solution, and each Sprague-Dawley rat was sacrificed respectively 2 weeks and 8 weeks after the operation for such application. Then, the treatment results were compared and observed histologically and his tometrically. Thereby, the following conclusions were obtained. 1. In the experimental group, a pattern was shown that from 2 weeks after the operation, vascular proliferation proceeded and osteogenesis proceeded through osteoblast infiltration, and at 8 week after the operation, ACS was almost absorbed, the amount of osteogensis was increased and many osteoid tissue layers were observed. 2. At 2 weeks after the operation, each amount of osteogenesis appeared to be 8.70.8 %, 13.62.3 % and 4.80.7 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be higher in the Experimental group and the positive control group than in the negative control group, but there was no significant difference statistically (p<0.01). 3. At 8 weeks after the operation, each amount of osteogenesis appeared to be 62.26.1%, 17.42.5 % and 8.21.4 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be substantially higher in the experimental group than in the positive control group and the negative control group, and there was a significant difference statistically (p<0.01). As a result of conducting the experiment, when ACS was used as a carrier for chitosan, chitosan showed effective osteogenesis in the perforated defective region of the Sprague-Dawley rat's calvarial bone.

Autometallography for Zinc Detection in the Central Nervous System (중추신경계통내 분포하는 Zinc의 조직화학적 동정)

  • Jo, Seung-Mook;Gorm, Danscher;Kim, Sung-Jun;Park, Seung-Kook;Kang, Tae-Cheon;Won, Moo-Ho
    • Applied Microscopy
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    • v.30 no.4
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    • pp.347-355
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    • 2000
  • Zinc is one of the most abundant oligoelements in the living cell. It appears tightly bound to some metalloproteins and nucleic acids, loosely bound to some metallothioneins or even as free ion. Small amounts of zinc ions (in the nanomolar range) regulate a plentitude of enzymatic proteins, receptors and transcription factors, thus rolls need accurate homeostasis of zinc ions. Zinc is an essential catalytic or structural element of many proteins, and a signaling messenger that is released by neural activity at many central excitatory synapses. Growing evidences suggest that zinc may also be a key mediator and modulator of the neuronal death associated with transient global ischemia and sustained seizures, as well as perhaps other neurological disease stoles. Some neurons have developed mechanisms to accumulate zinc in specific membrane compartment ('vesicular zinc') which can be evidenced using histochemical techniques. Substances giving a bright colour or emitting fluorescence when in contact with divalent metal ions are currently used to detect them inside cells; their use leads to the so called 'direct' methods. The fixation and precipitation of metal ions as insoluble salt precipitates, their maintenance along the histological process and, finally, their demonstration after autometallographic development are essential steps for other methods, the so called 'indirect methods'. This study is a short report on the autometallograhical approaches for zinc detection in the central nervous system (CNS) by means of a modified selenium method.

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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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