Actor-Network Theory 관점에서 본 한국 전자정부 서비스의 진화

학위논문 (석사)-- 서울대학교 대학원 : 경영학과, 2015. 2. 안중호.ABSTRACT The Evolution of Korean e-Government in the Perspective of Actor-Network Theory Sulim Kim College of Business Administration Seoul National University In these days, as technologies has developed, it has changed our lives in everywhere. There is no exception for a nation. Since Information Technology (IT) was a criterion for deciding the national competiveness, it has been considered as a catalyst for the rapid growth in the knowledge information society. As a result, a government uses IT as a tool for accomplishing the national goal. E-Government is an effective tool to improve effectiveness, to elevate the quality of public service, and to promote active public participation in governance. (The Korean Association for Policy Studies, 2011) In order to accomplish the intended goal of e-Government, the Korean government has evolved its services and made considerable efforts. In this study, it shows the evolution of Korean e-Government services in details by using the lens of Actor-Network Theory. ANT considers that human and non-human actors are same and equal factors in its analytical view (Lee & Oh, 2006). Thus, this study focuses on the network between human actors (i.e. president and administrations) and non-human actors (i.e. law, standard and relay system). However, due to the strategy of top-down in the assimilation of Korean e-Government system, it caused the inequality between the central agencies. That is, ANT has the limitation in explaining the public sector cases in terms of the imbalance between actors. According to Naidoo (2009), Walsham (2001) made a valuable contribution by combining ANT and ST theories in the same cases, using ST to guide broader social analysis, and ANT to describe the detailed socio-technical processes that took place. Thus, this study decides to adopt Structuration Theory to overcome the shortage of ANT. This study involved six in-depth interviews with the key actors in the case of Korean e-Government. These interviews were conducted in face-to-face with audio recording from October 22, 2014 to November 20, 2014, and they progressed with specific and open-ended questions. The interviews with the key actors provided the overview of the evolution of Korean e-Government services process and meaningful insights on the success of e-Government in Korea. This case demonstrates that cases in public sector can adopt not only Actor-Network Theory, but also Structuration Theory to explain in both micro and macro contexts. Practical implications are given especially for developing countries in pursuing the rapid development process of Korean e-Government services. Keywords: Korean e-Government, Actor-Network Theory, Structuration Theory, Law, Standard, Relay system. Student ID Number: 2013-20463TABLE OF CONTENTS TABLE OF CONTENTS III LIST OF TABLES III LIST OF FIGURES IV CHAPTER 1 INTRODUCTION 1 CHAPTER 2 THEORETICAL BACKGROUND 5 2.1. Actor Network Theory 5 2.2 Limitations of Actor Network Theory 9 2.3. Structuration Theory 13 2.4 Standard 17 2.5 Technology Standard in Information System 19 CHAPTER 3 METHODOLOGY 23 CHAPTER 4 CASE: THE EVOLUTION OF KOREAN E-GOVERNMENT 25 4.1 Problematization (Establishment Stage: 1987 ~ 1996) 25 4.2 Domination (Promotion Stage: 1997 ~ 2002) 30 4.3 Enrollment (Advanced Stage: 2003 ~ 2009) 38 4.4 Moblization (Advanced Stage: 2010 ~ 2014) 46 CHAPTER 5 CONCLUSION 50 5.1 Findings 50 5.2 Implications and Limitations 52 REFERENCES 54 APPENDIX: PROCEDURE STANDARD IN KOREAN E-GOVERNMENT 65Maste

Comparison of midurethral sling outcomes with and without concomitant prolapse repair

Objective : We compared the outcomes of the midurethral sling (MUS) with and without concomitant prolapse repair. Methods : We retrospectively reviewed the outcomes of 203 women who underwent MUS at Severance Hospital from January 2009 to April 2012 with and without concomitant prolapse repair. Patients completed the urogenital distress inventory questionnaire preoperatively and postoperatively. The outcomes were assessed by using validated questionnaires and reviewing medical records. McNemar's test, t-test, and multiple logistic regression were used for analysis. Results : We noted that women who underwent MUS alone were more likely to experience urinary frequency (12% vs. 25%, P = 0.045), urgency (6% vs. 24%, P < 0.001), and bladder emptying difficulty (2% vs. 10%, P = 0.029) compared to those who underwent concomitant repair. Women who only MUS were more likely to experience discomfort in the lower abdominal or genital region compared to those who than those who underwent concomitant repair; however, the difference was not significant (5% vs. 11%, P = 0.181). In the MUS only group, maximal cystometric capacity (MCC) was a significant parameter of preoperative and postoperative urinary frequency (P = 0.042; odds ratio, 0.994; P = 0.020; odds ratio, 0.993), whereas the Valsalva leak point pressure (VLPP) was a significant factor of postoperative bladder emptying difficulty (P = 0.047; odds ratio, 0.970). Conclusion : The outcomes did not differ between patients who underwent MUS alone and those with concomitant repair. In the MUS only group, MCC and VLPP were significant urodynamics study parameters related to urinary outcome.ope

The significance and factors related to bladder outlet obstruction in pelvic floor dysfunction in preoperative urodynamic studies: A retrospective cohort study

Objective : To demonstrate the significance of bladder outlet obstruction (BOO) in preoperative urodynamic studies (UDS) in women who have been diagnosed with pelvic floor dysfunction including pelvic organ prolapsed (POP) and stress urinary incontinence (SUI). Methods : The medical records of 150 patients with pelvic floor dysfunction who underwent preoperative UDS at Yonsei University Health System from 2006 to 2012 were reviewed. Under the criteria of BOO, as a maximal flow rate in free-flow study (Qmax) less than 12 mL/sec and a detrusor pressure at Qmax in pressure-flow study (PdetQmax) higher than 20 cmH2O in UDS, they were divided into two groups: a group of 50 patients with BOO and a group of 100 patients without BOO. Comparisons were made between the patients with and without BOO in preoperative UDS. Results : In the POP-with-SUI group, 25 patients with BOO had lower mean Qmax (10.0 vs. 25.4 mL/sec, P < 0.001), higher PdetQmax (49.6 vs. 21.5 cmH2O, P < 0.001), lower maximum cystometric capacity (422.7 vs. 454.0 mL, P = 0.007), and higher postvoidal residual volume (44.3 vs. 21.1 mL, P = 0.021) than the patients without BOO. In the SUI-only group, the mean Qmax was significantly lower in the 25 patients with BOO (9.4 vs. 25.4 mL/sec, P < 0.001). The mean PdetQmax was significantly higher with BOO (39.6 vs. 25.4 cmH2O, P = 0.004). In the univariate analyses, menopause, maximum cystometric capacity, and cystoscopic bladder trabeculation were associated with BOO. Conclusion : In the univariate analysis, menopause, MCC and cystoscopic bladder trabeculation were associated with BOO. In the multivariate model, however, no significant association with BOO was found.ope

Comparison of perioperative, long-term complications and recurrence rates after vaginal prolapse surgery by considering ICS POP-Q stage.

OBJECTIVE: The aim of this study was to report subjective and objective outcomes and to compare complication and recurrence rate in patients undergoing surgery for International Continence Society (ICS) stage 4 prolapse compared to ICS stage 2 or 3 prolapse. METHODS: We retrospectively reviewed the records of all patients having had surgical treatment for ICS Pelvic Organ Prolapse Quantification (POP-Q) stage 2-4 prolapse between January 2007 and December 2010 at the Yonsei University Severance Hospital. Only patients with ICS POP-Q stage 2-4 prolpase undergoing obliterative procedures or anti-incontinence surgery only were excluded. RESULTS: Three hundred ninety nine patients met inclusion criteria, including 23 with stage 2, 239 with stage 3 and 137 with stage 4 prolapse. The postoperative recurrence rate of preoperative stage IV was 2.4 times higher than that of stage III. There was a significantly higher incidence rates of perioperative and long-term complications, compared to women with other stage prolapse. The mean operative time was significantly greater in the stage 4 group compared to the stage 2, 3 group. CONCLUSION: The overall perioperative complication and recurrence rates in women undergoing surgery for pelvic organ prolapse are low. Women undergoing surgery for ICS POP-Q stage 4 prolapse were found to have a significantly greater blood loss and higher incidence rates of perioperative complications and recurrence, compared with women of other stage.ope

Changes in sexual function and comparison of questionnaires following surgery for pelvic oran prolapse

PURPOSE: The aim of this study was to evaluate the effect of surgical repair of pelvic organ prolapse on female sexual function and to assess correlations between the two using two current standardized questionnaires. MATERIALS AND METHODS: From October 2009 to September 2010, 143 patients with posterior compartment or combined vaginal prolapse were included. We assessed surgical outcomes according to anatomical change in the vagina and results of the Female Sexual Function Index (FSFI) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12) both pre- and postoperatively. RESULTS: Among the 143 preoperative patients, 99 and 84 patients responded to the PISQ-12 and FSFI, respectively. The mean PISQ-12 score increased after surgery (p<0.001). Specifically, postoperative scores for questions 8 and 12 were higher than their respective preoperative scores (p<0.001). Postoperatively, mean FSFI score changed only slightly (p=0.76), and only the score for the satisfaction domain was improved (p=0.023). In regards to vaginal anatomy, vaginal length was significantly greater postoperatively (6.99±0.18 vs. 7.56±1.08, p<0.001), and postoperative vaginal caliber was narrowed to a two-finger width. CONCLUSION: In this study, surgery for pelvic organ prolapse was shown to affect female sexual function. Moreover, menopause was associated with a change in postoperative sexual function.ope

골반저 질환을 가진 환자군에서 HOXA 11 과 HOXA 13 유전자의 발현 차이

Dept. of Medicine/박사Pelvic floor dysfunction (PFD), including stress urinary incontinence (SUI) and pelvic organ prolapse (POP), is a major health problem for elderly women. Although PFD is a highly prevalent disease, the underlying mechanism and basic pathophysiology are poorly understood. Uterosacral ligaments (USLs) are the key structures of the uterus and vagina and are fragile in patients with PFD. Endopelvic fascias in the vagina compose the supportive tissue of the pelvic floor and often are diminished in PFD.Homeobox (HOX) genes are transcriptional regulators that orchestrate embryonic development. The HOXA11 gene controls the development of the lower uterine cervix and vagina. The HOXA13 gene is also responsible for the development of the vagina and regulates extracellular matrix constituents. We hypothesized that expressions of HOXA11 in USLs and HOXA13 in the vagina might be decreased in women with PFD. In addition, we investigated quantitative mRNA expression of matrix metalloproteinases (MMPs), collagen І, and collagen Ш, from PFD and non-PFD patients.Sixty-eight subjects were enrolled for the experimental procedure. Biopsy specimens were obtained from the anterior and posterior apex of the vagina and bilateral USLs from women with no PFD, SUI combined with POP, and POP; from patients with SUI, we took only anterior vaginal specimens by biopsies. Specimens were divided in half. One section was prepared for real-time polymerase chain reaction (RT-PCR), and the other half was saved for western blot analysis. RT-PCR and western blots were used to determine HOXA11 and HOXA13 expression and the protein levels. In addition, we performed RT-PCR to compare the expression of MMP2, MMP9, collagen І, and collagen Ш genes in the vaginal wall and USLs of all enrolled patients. Quantitative data are expressed as mean + SEM and as percentages. The results of relative mRNA expression analysis were compared using the Kruskal–Wallis test for independent ‘k’ samples, complemented when necessary by Dunnett’s multiple comparisons test, to evaluate possible differences between patient groups, for both vaginal wall and USL samples. Statistical analyses were performed with SPSS 19 (SPSS Inc. Chicago, IL, USA) and Graph-Pad Prism 5.0 (GraphPad Software Inc., San Diego, CA, USA). A P value less than 0.05 was considered statistically significant for all data analyzed.We found that the relative HOXA13 mRNA expression in the anterior vaginal wall of SUI patients was 4.3-fold lower compared with that of controls (P = 0.006). In addition, the anterior vaginal wall specimens from patients in the SUI combined POP and POP groups had lower expression of HOXA13 compared with the controls (4.3-fold, P = 0.007; 6.3-fold, P < 0.001, respectively). In the posterior vaginal wall, the relative mRNA expression of HOXA13 of SUI combined POP and POP patients was lower (3.1-fold, P < 0.001; 2.7-fold, P < 0.001, respectively) than that of control patients. There were no differences in vaginal expression of HOXA13 between SUI and POP specimens or between specimens obtained from patients with SUI combined POP and patients with only POP. Expression of HOXA11 was 2.3-fold lower in women with POP compared with controls (P = 0.004). HOXA 11 expression in USLs was also 2.7-fold lower in SUI combined POP patients compared with controls (P = 0.004); however, there was no statistically significant difference between POP patients and women with SUI combined POP (P = 0.08). Western blot analysis demonstrated the presence of HOXA11 and 13 in the USLs and vagina, although the levels were lower in the POP and/or SUI group compared with controls (P < 0.001). Collagen І and collagen Ш expressions were lower in groups of PFD patients than controls. The expression of MMP 2 mRNA in USLs was elevated in POP patients with/without SUI compared to controls, although this alteration was not statistically significant for women with POP. In addition, the change in expression detected for both MMP2 and MMP9 was not statistically significant in samples from the anterior and posterior vaginal wall.Expression of HOXA13 and both collagens in the vagina was reduced in women with SUI, SUI combined POP, and POP compared with control women. Expression of HOXA11 and both collagens in USLs was also reduced in all PFD patients. These reduced levels may contribute to alterations in the biomechanical strength of the pelvic supportive tissue, leading to prolapse or incontinence. A better understanding of the influence of these genes may prove beneficial in defining the underlying etiologies of PFD development and aid in the development of new treatment optionsope

그물편(mesh)을 이용한 골반 저 질환의 수술적 교정술

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Relative influence of donation amount and percentage on donation evaluation

학위논문 (석사) -- 서울대학교 대학원 : 사회과학대학 심리학과, 2021. 2. 최인철.사람들은 적은 금액이지만 자신이 가진 큰 부분을 낸 기부자와 많은 금액이지만 가진 것 중 일부만을 낸 기부자를 어떻게 평가할까? 둘 중 어떤 기부자가 더 이타적이며, 어떤 기부가 더 의미 있고 가치 있다고 평가할까? 만일 두 기부에 대한 평가가 다르다면 그 평가에 영향을 미치는 요인은 무엇일까? 위 질문에 대해 기존 연구들은 일관된 답을 내리고 있지 않은 듯 보인다. 기부 평가에 관한 기존 연구들에서는 절대적인 돈의 크기를 의미하는 기부 금액과 가진 것 중 기부한 돈이 차지하는 비중을 의미하는 기부 비율이 명확히 구분되지 않았기 때문이다. 이에 본 연구는 기부 금액과 기부 비율을 명확히 구분하고 그것이 기부자의 이타성을 평가하는 데에 미치는 영향력을 비교하였다. 또, 기부 금액과 비율의 영향력이 사람에 따라 더 커지거나 작아지도록 조절하는 요인에 대해 탐구하였다. 마지막으로 기부 정보에 따라 기부자의 이타성 평가가 달라진다면, 이 평가가 기부의 의미와 가치 평가를 예측할 수 있는지 확인하였다. 본 연구는 각 150명의 참여자를 대상으로 수행한 두 번의 실험을 통해 사람들이 기부자의 이타성을 평가하는 데에는 기부 금액보다 기부 비율이 더 큰 영향을 미친다는 것을 밝혀내었다. 이때 개인의 순수 이타성 신념에 따라 기부 비율의 영향력이 조절되었다. 또한 기부 비율에 따라 달라지는 기부자의 이타성 평가가 기부의 의미와 가치 평가의 변화를 매개할 수 있음을 보였다. 종합 논의에서는 연구 결과의 이론적, 실천적 함의와 한계를 다루고 후속 연구를 제안하였다.Imagine there are two donors: one donating a small amount but a large portion of his or her own, and the other donating a large amount but only a small portion of what he or she has. Which of the two donors would people evaluate as more altruistic? Which of the two donations do people think is more meaningful and valuable? What makes the evaluation of the two donations different? There has been no consistent answers to the above questions. One possible reason for explaining the inconsistent results is that in the previous studies on donation evaluation, the donation amount and the donation percentage were not clearly distinguished. The present study patently defined the donation amount as the absolute value of money and the donation percentage as the ratio of the donated amount to surplus income. Two studies examined the relative influence the donation amount and percentage have on evaluating donors’altruism. In addition, the moderating factor controlling the influence of the donation amount and percentage was explored. Finally, if the donor's altruism evaluation varies according to the donation information, it was checked whether this evaluation can predict the meaning and value of donation. The donation percentage had a greater influence on the donors’altruism than the donation amount. The influence of the donation percentage was moderated by the pure altruism beliefs. In addition, altruism evaluation on donors mediated changes in the meaning and value of donation. In the general discussion, the theoretical and practical implications were addressed, and limitations and ideas for future research were proposed.서 론 1 기부자의 이타성 평가 5 기부 금액과 비율이 기부자 이타성 평가에 미치는 영향 6 순수 이타성 신념이 기부자 이타성 평가에 미치는 영향 11 기부자 이타성 평가가 기부의 의미 및 가치 평가에 미치는 영향 13 연구 개요 14 연구 1: 기부 금액과 비율의 영향력 비교 및 순수 이타성 신념의 조절 효과 18 방법 18 결과 21 논의 28 연구 2: 기부 비율과 기부 평가 간 관계에 미치는 이타성 평가의 조절된 매개 효과 31 방법 32 결과 34 논의 47 종합논의 48 참고문헌 54 부 록 59 Abstract 61Maste

과민성 방광 증후군 환자와 복압성 요실금 환자에서 체질량 지수 및 위험 요인에 대한 고찰

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