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Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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Characteristics of Particulate Carbon in the Ambient Air in the Korean Peninsula (한반도 권역별 대기 중 입자상 탄소 특성 연구)

  • Lee, Yeong-jae;Park, Mi-kyung;Jung, Sun-a;Kim, Sun-jung;Jo, Mi-ra;Song, In-ho;Lyu, Young-sook;Lim, Yong-jae;Kim, Jung-hoon;Jung, Hae-jin;Lee, Sang-uk;Choi, Won-Jun;Ahn, Joon-young;Lee, Min-hee;Kang, Hyun-jung;Park, Seung-myeong;Seo, Seok-jun;Jung, Dong-hee;Hyun, Joo-kyeong;Park, Jong-sung;Hwang, Tae-kyung;Hong, You-deog;Hong, Ji-hyung;Shin, Hye-jung
    • Journal of Korean Society for Atmospheric Environment
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    • v.31 no.4
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    • pp.330-344
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    • 2015
  • Semi-continuous measurements of $PM_{2.5}$ mass, organic and elemental carbon were made for the period of January to October 2014, at six national air monitoring stations in Korea. OC and EC concentrations showed a clear seasonal variation with the highest in winter (January) and the lowest in summer (August). In winter, the high carbonaceous concentrations were likely influenced by increased fuel combustion from residential heating. OC and EC concentrations varied by monitoring stations with 5.9 and $1.7{\mu}g/m^3$ in Joongbu area, 4.2 and $1.2{\mu}g/m^3$ in Honam area, 4.0 and $1.3{\mu}g/m^3$ in Yeongnam area, 3.7 and $1.6{\mu}g/m^3$ in Seoul Metropolitan area, 3.0 and $0.8{\mu}g/m^3$ in Jeju Island, 2.9 and $0.7{\mu}g/m^3$ in Baengnyeong Island respectively. The concentrations of OC and EC comprised 9.6~ 15.5% and 2.4~ 4.7% of $PM_{2.5}$. Urban Joongbu area located adjacent to the intersection of several main roads showed the highest carbon concentration among six national air monitoring station. On the other hand, background Baengnyeong Island showed the lowest carbon concentration and the highest OC/EC ratio (4.5). During the haze episode, OC and EC were enhanced with increase in $PM_{2.5}$ about 1.3~ 3 and 1.3~ 4.0 times respectively. The concentrations of OC, EC in the Asian dust case are about 1~ 2.4 times greater than in the nondust case. The origins of air mass pathways arriving at Seoul, using the backward trajectory analysis, can be mostly classified into 6 groups (Sector I Northern Korea including the sea of Okhotsk, Sector II Northern China including Mongolia, Sector III Southern China, Sector IV South Pacific area, Sector V Japan, Sector VI Southern Korea area). When an air mass originating from northern China and Mongolia, the OC concentrations were the most elevated, with a higher OC/EC ratio (2.4~ 3.3), and accounting for 17% of $PM_{2.5}$ mass on average.

Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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The Impact of Conflict and Influence Strategies Between Local Korean-Products-Selling Retailers and Wholesalers on Performance in Chinese Electronics Distribution Channels: On Moderating Effects of Relational Quality (중국 가전유통경로에서 한국제품 현지 판매업체와 도매업체간 갈등 및 영향전략이 성과에 미치는 영향: 관계 질의 조절효과)

  • Chun, Dal-Young;Kwon, Joo-Hyung;Lee, Guo-Ming
    • Journal of Distribution Research
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    • v.16 no.3
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    • pp.1-32
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    • 2011
  • I. Introduction: In Chinese electronics industry, the local wholesalers are still dominant but power is rapidly swifting from wholesalers to retailers because in recent foreign big retailers and local mass merchandisers are growing fast. During such transient period, conflicts among channel members emerge important issues. For example, when wholesalers who have more power exercise influence strategies to maintain status, conflicts among manufacturer, wholesaler, and retailer will be intensified. Korean electronics companies in China need differentiated channel strategies by dealing with wholesalers and retailers simultaneously to sell more Korean products in competition with foreign firms. For example, Korean electronics firms should utilize 'guanxi' or relational quality to form long-term relationships with whloesalers instead of power and conflict issues. The major purpose of this study is to investigate the impact of conflict, dependency, and influence strategies between local Korean-products-selling retailers and wholesalers on performance in Chinese electronics distribution channels. In particular, this paper proposes effective distribution strategies for Korean electronics companies in China by analyzing moderating effects of 'Guanxi'. II. Literature Review and Hypotheses: The specific purposes of this study are as follows. First, causes of conflicts between local Korean-products-selling retailers and wholesalers are examined from the perspectives of goal incongruence and role ambiguity and then effects of these causes are found out on perceived conflicts of local retailers. Second, the effects of dependency of local retailers upon wholesalers are investigated on local retailers' perceived conflicts. Third, the effects of non-coercive influence strategies such as information exchange and recommendation and coercive strategies such as threats and legalistic pleas exercised by wholesalers are explored on perceived conflicts by local retailers. Fourth, the effects of level of conflicts perceived by local retailers are verified on local retailers' financial performance and satisfaction. Fifth, moderating effects of relational qualities, say, 'quanxi' between wholesalers and retailers are analyzed on the impact of wholesalers' influence strategies on retailers' performances. Finally, moderating effects of relational qualities are examined on the relationship between conflicts and performance. To accomplish above-mentioned research objectives, Figure 1 and the following research hypotheses are proposed and verified. III. Measurement and Data Analysis: To verify the proposed research model and hypotheses, data were collected from 97 retailers who are selling Korean electronic products located around Central and Southern regions in China. Covariance analysis and moderated regression analysis were employed to validate hypotheses. IV. Conclusion: The following results were drawn using structural equation modeling and hierarchical moderated regression. First, goal incongruence perceived by local retailers significantly affected conflict but role ambiguity did not. Second, consistent with conflict spiral theory, the level of conflict decreased when retailers' dependency increased toward wholesalers. Third, noncoercive influence strategies such as information exchange and recommendation implemented by wholesalers had significant effects on retailers' performance such as sales and satisfaction without conflict. On the other hand, coercive influence strategies such as threat and legalistic plea had insignificant effects on performance in spite of increasing the level of conflict. Fourth, 'guanxi', namely, relational quality between local retailers and wholesalers showed unique effects on performance. In case of noncoercive influence strategies, 'guanxi' did not play a role of moderator. Rather, relational quality and noncoercive influence strategies can serve as independent variables to enhance performance. On the other hand, when 'guanxi' was well built due to mutual trust and commitment, relational quality as a moderator can positively function to improve performance even though hostile, coercive influence strategies were implemented. Fifth, 'guanxi' significantly moderated the effects of conflict on performance. Even if conflict arises, local retailers who form solid relational quality can increase performance by dealing with dysfunctional conflict synergistically compared with low 'quanxi' retailers. In conclusion, this study verified the importance of relational quality via 'quanxi' between local retailers and wholesalers in Chinese electronic industry because relational quality could cross out the adverse effects of coercive influence strategies and conflict on performance.

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The Effect of the Simple Fogarty Thromboembolectomy (단순 Fogarty 혈전색전 제거술의 효과)

  • Oh, Joong-Hwan;Park, Il-Hwan;Lee, Chong-Kookk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.480-486
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    • 2009
  • Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

The Mediating Effect of Experiential Value on Customers' Perceived Value of Digital Content: China's Anti-virus Program Market (경험개치대소비자대전자내용적인지개치적중개영향(经验价值对消费者对电子内容的认知价值的中介影响): 중국살독연건시장(中国杀毒软件市场))

  • Jia, Weiwei;Kim, Sae-Bum
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.219-230
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    • 2010
  • Digital content makes big changes to our daily lives while bringing opportunities and challenges for companies. Creative firms integrate pictures, texts, videos, audios, and data by digitalization to develop new products or services and create digital experiences to promote their brands. Most articles on digital content contribute to the basic concept or development of marketing it in literature. Actually, compared with traditional value chains for common products or services, the digital content industry seems to have more potential value. Because quite a bit of digital content is free to the consumer, price is not necessarily perceived as an indicator of the quality or value of information (Rowley 2008). It becomes evident that a current theme in digital content is the issue of "value," and research on customers' perceived value of digital content is a necessity. This article argues that experiential value has an advantage in customers' evaluations of digital content. Two different but related contributions to the understanding of "value" of digital content are made here. First, based on the comparison of digital content with products and services, the article proposes two key characteristics that make experiential strategy available for digital content: intangibility and near-zero reproduction cost. On top of that, based on the discussion of the gap between company's idealized value and customer's perceived value, this article emphasizes that digital content prices and pricing of digital content is different from products and services. As a result of intangibility, prices may not reflect customer value. Moreover, the cost of digital content in the development stage may be very high while reproduction costs shrink dramatically. Moreover, because of the value gap mentioned before, the pricing polices vary for different digital contents. For example, flat price policy is generally used for movies and music (Magiera 2001; Netherby 2002), while for continuous demand, digital content such as online games and anti-virus programs involves a more complicated matter of utility and competitive price levels. Digital content companies have to explore various kinds of strategies to overcome this gap. Rethinking marketing solutions such as advertisements, images, and word-of-mouth and their effect on customers' perceived value becomes essential. China's digital content industry is becoming more and more globalized and drawing special attention from different countries and regions that have respective competitive advantages. The 2008-2009 Annual Report on the Development of China's Digital Content Industry (CCIDConsulting 2009) indicates that, with the driven power of domestic demand and governmental policy support, the country's digital content industry maintained a fast growth of some 30 percent in 2008, obviously indicating the initial stage of industry expansion. In China, anti-virus programs and other software programs which need to be updated use a quarter-based pricing policy. Customers can download a trial version for free and use it for six months or a year. If they want to use it longer, continuous payment is needed. They examine the excellence of the digital content during this trial period and decide whether to pay for continued usage. For China’s music and movie industries, as a result of initial development, experiential strategy has not been much applied, even though firms in other countries find the trial experience and explore important strategies(such as customers listening to music for several seconds for free before downloading it). For the above reasons, anti-virus program may be a representative for digital content industry in China and an exploratory study of the advantage of experiential value in customer's perceived value of digital content is done in the anti-virus market of China. In order to enhance the reliability of the survey data, this study focused on people who were experienced users of anti-virus programs. The empirical results revealed that experiential value has a positive effect on customers' perceived value of digital content. In other words, because digital content is intangible and the reproduction costs are nearly zero, customers' evaluations are based heavily on their experience. Moreover, image and word-of-mouth do not have a positive effect on perceived value, only on experiential value. That is to say, a digital content value chain is different from that of a general product or service. Experiential value has a notable advantage and mediates the effect of image and word-of-mouth on perceived value. The results of this study help provide an understanding of why free digital content downloads exist in developing countries. Customers can perceive the value of digital content only by using and experiencing it. This is also why such governments support the development of digital content. Other developing countries whose digital content business is also in the beginning stage can make use of the suggestions here. Moreover, based on the advantage of experiential strategy, companies should make more of an effort to invest in customers' experience. As a result of the characteristics and value gap of digital content, customers perceive more value in the intangible digital content only by experiencing what they really want. Moreover, because of the near-zero reproduction costs, companies can perhaps use experiential strategy to enhance customer understanding of digital content.

Relationships on Magnitude and Frequency of Freshwater Discharge and Rainfall in the Altered Yeongsan Estuary (영산강 하구의 방류와 강우의 규모 및 빈도 상관성 분석)

  • Rhew, Ho-Sang;Lee, Guan-Hong
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.16 no.4
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    • pp.223-237
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    • 2011
  • The intermittent freshwater discharge has an critical influence upon the biophysical environments and the ecosystems of the Yeongsan Estuary where the estuary dam altered the continuous mixing of saltwater and freshwater. Though freshwater discharge is controlled by human, the extreme events are mainly driven by the heavy rainfall in the river basin, and provide various impacts, depending on its magnitude and frequency. This research aims to evaluate the magnitude and frequency of extreme freshwater discharges, and to establish the magnitude-frequency relationships between basin-wide rainfall and freshwater inflow. Daily discharge and daily basin-averaged rainfall from Jan 1, 1997 to Aug 31, 2010 were used to determine the relations between discharge and rainfall. Consecutive daily discharges were grouped into independent events using well-defined event-separation algorithm. Partial duration series were extracted to obtain the proper probability distribution function for extreme discharges and corresponding rainfall events. Extreme discharge events over the threshold 133,656,000 $m^3$ count up to 46 for 13.7y years, following the Weibull distribution with k=1.4. The 3-day accumulated rain-falls which occurred one day before peak discharges (1day-before-3day -sum rainfall), are determined as a control variable for discharge, because their magnitude is best correlated with that of the extreme discharge events. The minimum value of the corresponding 1day-before-3day-sum rainfall, 50.98mm is initially set to a threshold for the selection of discharge-inducing rainfall cases. The number of 1day-before-3day-sum rainfall groups after selection, however, exceeds that of the extreme discharge events. The canonical discriminant analysis indicates that water level over target level (-1.35 m EL.) can be useful to divide the 1day-before-3day-sum rainfall groups into discharge-induced and non-discharge ones. It also shows that the newly-set threshold, 104mm, can just separate these two cases without errors. The magnitude-frequency relationships between rainfall and discharge are established with the newly-selected lday-before-3day-sum rainfalls: $D=1.111{\times}10^8+1.677{\times}10^6{\overline{r_{3day}}$, (${\overline{r_{3day}}{\geqq}104$, $R^2=0.459$), $T_d=1.326T^{0.683}_{r3}$, $T_d=0.117{\exp}[0.0155{\overline{r_{3day}}]$, where D is the quantity of discharge, ${\overline{r_{3day}}$ the 1day-before-3day-sum rainfall, $T_{r3}$ and $T_d$, are respectively return periods of 1day-before-3day-sum rainfall and freshwater discharge. These relations provide the framework to evaluate the effect of freshwater discharge on estuarine flow structure, water quality, responses of ecosystems from the perspective of magnitude and frequency.

The Reserch on Actual Condition of Crime of Arson Which Occurs in Korea and Its Countermeasures (방화범죄의 실태와 그 대책 - 관심도와 동기의 다양화에 대한 대응 -)

  • Choi, Jong-Tae
    • Korean Security Journal
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    • no.1
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    • pp.371-408
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    • 1997
  • This article is the reserch on actual condition of crime of arson which occurs in Korea and its countermeasures. The the presented problem in this article are that (1) we have generally very low rate concern about the crime of arson contrary to realistic problems of rapid increase of crime of arson (2) as such criminal motives became so diverse as to the economic or criminal purpose unlike characteristic and mental deficiency of old days, and to countermeasure these problems effectively it presentation the necessity of systemantic research. Based on analysis of reality of arson, the tendency of this arson in Korea in the ratio of increase is said to be higher than those in violence crime or general fire rate. and further its rate is far more greater than those of the U.S.A. and Japan. Arson is considered to be a method of using fire as crime and in case of presently residence to be the abject, it is a public offense crime which aqccompany fatality in human life. This is the well It now fact to all of us. And further in order to presentation to the crime of arson, strictness of criminal law (criminal law No, 164 and 169, and fire protection law No. 110 and 111) and classification of arsonist as felony are institutionary reinforced to punish with certainty of possibility, Therefore, as tendency of arson has been increased compared to other nations, it is necessary to supplement strategical policy to bring out overall concerns of the seriousness of risk and damage of arson, which have been resulted from the lack of understanding. In characteristics analysis of crime of arson, (1) It is now reveald that, in the past such crime rate appeared far more within the boundary of town or city areas in the past, presently increased rate of arsons in rural areas are far more than in the town or small city areas, thereby showing characteristics of crime of arson extending nation wide. (2) general timetable of arson shows that night more than day time rate, and reveald that is trait behavior in secrecy.(3) arsonists are usually arrested at site or by victim or report of third person(82,9%).Investigation activities or self surrenders rate only 11.2%. The time span of arrest is normally the same day of arson and at times it takes more than one year to arrest. This reveals its necessity to prepare for long period of time for arrest, (4) age rate of arson is in their thirties mostly as compared to homicide, robbery and adultery, and considerable numbers of arsons are in old age of over fifties. It reveals age rate is increased (5) Over half of the arsonists are below the junior high school (6) the rate of convicts by thier records is based on first offenders primarily and secondly more than 4 time convicts. This apparently shows necessity of effective correctional education policy for their social assimilation together with re-investigation of human education at the primary and secondary education system in thier life. The examples of motivation for arosnits, such as personal animosity, fury, monetary swindle, luscious purpose and other aims of destroying of proof, and other social resistance, violence including ways of threatening, beside the motives of individual defects, are diverse and arsonic suicide and specifically suicidal accompany together keenly manifested. When we take this fact with the criminal theory, it really reveals arsons of crime are increasing and its casualities are serious and a point as a way of suicide is the anomie theory of Durkheim and comensurate with the theory of that of Merton, Specifically in the arson of industrial complex, it is revealed that one with revolutionary motive or revolting motive would do the arsonic act. For the policy of prevention of arsons, professional research work in organizational cooperation for preventive activities is conducted in municipal or city wise functions in the name of Parson Taskforces and beside a variety of research institutes in federal government have been operating effectively to countermeasure in many fields of research. Franch and Sweden beside the U.S. set up a overall operation of fire prevention research funtions and have obtained very successful result. Japan also put their research likewise for countermeasure. In this research as a way of preventive fire policy, first, it is necessary to accomodate the legal preventitive activities for fire prevention in judicial side and as an administrative side, (1) precise statistic management of crime of arson (2) establishment of professional research functions or a corporate (3) improvement of system for cooperative structural team for investigation of fires and menpower organization of professional members. Secondly, social mentality in individual prospect, recognition of fires by arson and youth education of such effect, educational program for development and practical promotion. Thirdly, in view of environmental side, the ways of actual performance by programming with the establishment of cooperative advancement in local social function elements with administrative office, habitants, school facilities and newspapers measures (2) establishment of personal protection where weak menpowers are displayed in special fire prevention measures. These measures are presented for prevention of crime of arson. The control of crime and prevention shall be prepared as a means of self defence by the principle of self responsibility Specifically arsonists usually aims at the comparatively weak control of fire prevention is prevalent and it is therefore necessary to prepare individual facilities with their spontaneous management of fire prevention instead of public municipal funtures of local geverment. As Clifford L. Karchmer asserted instead of concerns about who would commit arson, what portion of area would be the target of the arson. It is effective to minister spontaveously the fire prevention measure in his facility with the consideration of characteristics of arson. On the other hand, it is necessary for the concerned personnel of local goverment and groups to distribute to the local society in timely manner for new information about the fire prevention, thus contribute to effective result of fire prevention result. In consideration of these factors, it is inevitable to never let coincide with the phemonemon of arsons in similar or mimic features as recognized that these could prevail just an epedemic as a strong imitational attitude. In processing of policy to encounter these problems, it is necessary to place priority of city policy to enhancement of overall concerns toward the definitive essense of crime of arson.

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An Exploratory Study of Hospice Care to Patients with Advanced Cancer (암환자를 위한 호스피스 케어에 관한 탐색적 연구)

  • Park, Hye-Ja
    • The Korean Nurse
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    • v.28 no.3
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    • pp.52-67
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    • 1989
  • True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

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A Study on BRCA1/2 Mutations, Hormone Status and HER-2 Status in Korean Women with Early-onset Breast Cancer (젊은 한국인 유방암 환자에서 BRCA1/2 돌연변이와 호르몬 수용체, HER-2 상태에 관한 연구)

  • Choi, Doo-Ho;Jin, So-Young;Lee, Dong-Wha;Kim, Eun-Seog;Kim, Yong-Ho
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.65-73
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    • 2008
  • Purpose: Women with breast cancer diagnosed at an age of 40 years or younger have a greater prevalence of germline BRCA1 and BRCA2 mutations than the prevalence of women with breast cancer diagnosed at older ages. Several immunohistochemical characteristics have been identified in breast cancers from studies of Caucasian women with BRCA1/2 mutations having familial or early-onset breast cancers. The aim of this study is to determine whether early-onset breast cancer in BRCA1 or BRCA2 mutation carriers, who were not selected from a family history, could be distinguished by the use of immunohistochemical methods and could be distinguished from breast cancer in women of a similar age without a germline BRCA1 or BRCA2 mutation. We also analyzed the prognostic difference between BRCA1/2 related and BRCA1/2 non-related patients by the use of univariate and multivariate analysis. Materials and Methods: Breast cancer tissue specimens from Korean women with early-onset breast cancers were studied using a tumor tissue microarray. Immunohistochemical staining of estrogen receptor(ER), progesterone receptor(PR) and HER-2, as well as the histology and grade of these specimens, were compared. The prognostic impact of immunohistochemical and histological factors as well as the BRCA1/2 mutation status was investigated separately. Results: There were 14 cases and 16 deleterious BRCA1/2 mutations among 101 patients tested. A family history(4/14) and bilateral breast cancers(3/9) were high risk factors for BRCA1/2 mutations. BRCA1/2-associated cancers demonstrated more expression of ER-negative(19.4% versus 5.1%, p=0.038) and HER-2 negative than BRCA1/2 negative tumors, especially for tumors with BRCA1 tumors The BRCA1/2 mutation rate for patients with triple negative tumors(negative expression of ER, PR and HER-2) was 24.2%. Tumor size, nodal status, and HER-2 expression status were significantly associated with disease free survival, as determined by univariate and multivariate analysis, but the BRCA1/2 status was not a prognostic factor. Conclusion: Breast cancer that occurs in women with a germline BRCA1 or BRCA2 mutations have recognizable immunohistochemical features, which may be useful in identifying individuals that are more likely to carry germline mutations. Although the BRCA1/2 mutation status was not a prognostic factor in Korean women with early-onset breast cancer, more cases with a longer follow-up period are needed for further study.