• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• Journal of Korean Elementary Science Education
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• v.43 no.2
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• pp.301-321
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• 2024

This study aims to elucidate the historical origins of the long-term demand for the integration of "science subject classes" and "science-related events" within the context of science education for teachers. During the 1970s, science education in elementary schools faced a dual challenge marked by the tension between implementing the third curriculum, which emphasized fundamental science, and the "Pan-National Scientification Movement," which focused on technology education. The Ministry of Education was compelled to integrate the sudden demands of the Yushin regime into the ongoing third curriculum. As these demands emerged from dual policy directives, activities related to elementary science education were subsequently categorized into formal science subject classes and extracurricular science-related events. Although the movement did not directly alter the curriculum, it instigated modifications in personnel structure, activity spaces, and evaluation systems within schools. The introduction of the Pan-National Scientification Movement in elementary schools resulted in changes including the establishment of a new "science lead teacher system," the creation of a dedicated "science corner," and the implementation of a "science badge system." Although the movement was abruptly introduced, it ostensibly contributed to the advancement of the inquiry-oriented approach promoted by the third curriculum. Paradoxically, this advancement was facilitated by the integration of the consequences of the movement into schools' autonomous, extracurricular activities spearheaded by frontline education offices and schools. Although the movement represented a government-driven policy at a particular juncture in time, the manner in which science education practitioners responded to urgent governmental mandates, while preserving the integrity of the long-established third curriculum framework, involved dividing education activities into subject-specific classes and extracurricular science activities. Examining how science education practitioners in the 1970s proactively addressed these challenges offers valuable insights for the science education community in adapting to the current rapidly evolving educational landscape.

• Korean Journal of Remote Sensing
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• v.40 no.4
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• pp.351-361
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• 2024

Satellite imagery contains various elements such as clouds, cloud shadows, and terrain shadows. Accurately identifying and eliminating these factors that complicate satellite image analysis is essential for maintaining the reliability of remote sensing imagery. For this reason, satellites such as Landsat-8, Sentinel-2, and Compact Advanced Satellite 500-1 (CAS500-1) provide Usable Data Masks(UDMs)with images as part of their Analysis Ready Data (ARD) product. Precise detection of clouds and their shadows is crucial for the accurate construction of these UDMs. Existing cloud and their shadow detection methods are categorized into threshold-based methods and Artificial Intelligence (AI)-based methods. Recently, AI-based methods, particularly deep learning networks, have been preferred due to their advantage in handling large datasets. This study aims to analyze the applicability of constructing UDMs for high-resolution satellite images through deep learning-based cloud and their shadow detection using open-source datasets. To validate the performance of the deep learning network, we compared the detection results generated by the network with pre-existing UDMs from Landsat-8, Sentinel-2, and CAS500-1 satellite images. The results demonstrated that high accuracy in the detection outcomes produced by the deep learning network. Additionally, we applied the network to detect cloud and their shadow in KOMPSAT-3/3A images, which do not provide UDMs. The experiment confirmed that the deep learning network effectively detected cloud and their shadow in high-resolution satellite images. Through this, we could demonstrate the applicability that UDM data for high-resolution satellite imagery can be constructed using the deep learning network.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.401-410
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• 2009

Purpose : Pelvis and lumbar spine radiography, among various types of diagnostic radiography, include gonads of the human body and give patients high radiation dose. Nevertheless, diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography has not yet been established in Korea. Therefore, the radiation dose that patients receive from pelvis and lumbar radiography is measured and the diagnostic reference level on patient radiation dose for the optimization of radiation protection of patients in pelvis and lumbar spine radiography was established. Methods : The conditions and diagnostic imaging information acquired during the time of the postero-anterior view of the pelvis and the postero-anterior and lateral view of the lumbar spine at 125 medical institutions throughout Korea are collected for analysis and the entrance surface dose received by patients is measured using a glass dosimeter. The diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography to be recommended to the medical institutes is arranged by establishing the dose from the patient radiation dose that corresponds to the 3rd quartile values as the appropriate diagnostic reference level for patient radiation dose. Results : According to the results of the assessment of diagnostic imaging information acquired from pelvis and lumbar spine radiography and the measurement of patient entrance surface dose taken at the 125 medical institutes throughout Korea, the tube voltage ranged between 60~97 kVp, with the average use being 75 kVp, and the tube current ranged between 8~123 mAs, with the average use being 30 mAs. In the posteroanterior and lateral views of lumbar spine radiography, the tube voltage of each view ranged between 65~100 kVp (average use: 78 kVp) and 70~109 kVp (average use: 87 kVp), respectively, and the tube current of each view ranged between 10~100 mAs(average use: 35 mAs) and between 8.9~300 mAs(average use: 64 mAs), respectively. The measurements of entrance surface dose that patients receive during the pelvis and lumbar spine radiography show the following results: in the posteroanterior view of pelvis radiography, the minimum value is 0.59 mGy, the maximum value is 12.69 mGy and the average value is 2.88 mGy with the 1st quartile value being 1.91 mGy, the median being 0.59 mGy, and the 3rd quartile value being 3.43 mGy. Also, in the posteroanterior view of lumbar spine radiography, the minimum value is 0.64 mGy, the maximum value is 23.84 mGy, and the average value is 3.68 mGy with the 1st quartile value being 2.41 mGy, the median being 3.40 mGy, and the 3rd quartile value being 4.08 mGy. In the lateral view of lumbar spine radiography, the minimum value is 1.90 mGy, the maximum value is 45.42 mGy, and the average value is 10.08 mGy with the 1st quartile value being 6.03 mGy, the median being 9.09 mGy and the 3rd quartile value being 12.65 mGy. Conclusions : The diagnostic reference levels for patient radiation dose to be recommended to the medical institutes in Korea is 3.42 mGy for the posteroanterior view of pelvis radiography, 4.08 mGy for the posteroanterior view of lumbar spine radiography, and 12.65 mGy for the lateral view of lumbar spine radiography. Such values are all lower than the values recommended by 6 international organizations including World Health Organization, where the recommended values are 10 mGy for the posteroanterior view of pelvis radiography, 10 mGy for the posteroanterior view of lumbar spine radiography and 30 mGy for the lateral view of lumbar spine radiography.

• Sijohaknonchong
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• v.23
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• pp.161-188
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• 2005

The purpose of this study was to delve into the morphological types of Sijo in an effort to determine the morphological structure of Sasul-sijo, and it's also attempted to present standard about how to discriminate Pyong-si, Eos-sijo and Sasul-sijo from one another from a morphological standpoint. It's suggested that Si with tee Jangs, six verses and 12 stanzas or more, with three Jangs, seven verses and 14 stanzas or more, and with three Jangs, eight verses and 16 stanzas or more should respectively be called Pyong-sijo, Eos-sijo and Sasul-sijo. After what Sijo was and what's not were discussed, how to distinguish Eos-sijo from Sasul-sijo was described, and finally, the structure of Sasul-sijo was presented. As for Sijo and non-Sijo, the types of works that consisted of tee Jangs, like Sijo, yet didn't suit its framework and Yuljo and were written in Chinese characters were regarded as non-Sijo. Concerning discrimination between Eos-si and Sasul-sijo, the type of Sijo that included one more or higher number of verse(s) and two more or higher number of stanzas in one of three Jangs was defined as Eos-sijo, and the type of Sijo that involved two more or higher number of verses and four more or higher number of stanzas in one of three Jangs was called Sasul-sijo. In other words, Eos-sijo contained one more verse in one of tee Jangs, and Sasul-sijo included one more Jang in one tee Jangs. The sort of Sijo that contained one more Jang in one of three Jangs could be viewed as Sasul-sijo. Regarding the structure of Sasul-si, there should be three Jangs, eight verses and 16 stanzas in one piece of Sasul-sijo. Any type of Sijo that contained two more or higher number of verses and four more or higher number of stanzas could be called Sasul-sijo. Such an addition of verse and stanza could done in various ways. The examples were (1) adding stanzas the first Jang, 2) adding stanzas to the second Jang, (3) adding stanzas to the final Jang, (4) adding stanzas to both the first and Second Jangs, (5) adding stanzas to th the second and final Jangs, and (6) adding stanzas to all the first, second and third Jangs at the same time. Besides, there was an extremely broad gap between the numbers of verse and stanza in Sasul-sijo, which ranged from a low of eight stanzas to a high of 87 ones in one of three Jangs.

• Applied Biological Chemistry
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• v.17 no.3
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• pp.149-176
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• 1974

Eight substituted diphenyl ether herbicides and some of their photoproducts were studied in terms of solution phase photolysis under simulated environmental conditions by using a Rayonet photochemical reactor. The test compounds absorbed sufficient light energy at the wavelength of 300 nm to undergo various photoreactions. All the photoproducts were confirmed by means of tlc, glc, ir, ms, and/or nmr spectrometry. The results obtained are summarized as follows: Solution phase photolysis of C-6989: An exceedingly large amount of p-nitrophenol formed strongly indicates the readiness of the ether linkage cleavage of this compound as the main reaction in all solvents used. Photoreduction of nitro to amino group(s) and photooxidation of trifluoromethyl to carboxyl group were recognized as minor reactions. Aqueous photolysis of p-nitrophenol: Quinone(0.28%), hydroquinone (0.66%), and p-aminophenol (0.42%) were confirmed as photoproducts, in addition to a relatively small amount of an unknown compound. The mechanisms of formation of these products were proposed to be the nitro-nitrite rearrangement via $n{\rightarrow}{\pi}^*$ excitation and the photoreduction through hydrogen abstractions by radicals, respectively. Solution phase photolysis of Nitrofen: Photochemical reduction leading to the p-amino derivative was the main reaction in n-hexane. In aqueous solution, the photoreduction of nitro to amino group and hydroxylation predominated over the ether linkage cleavage. Nucleophilic displacement of the nitro group by hydroxide ion and replacement of chlorine substituents by hydroxyl group or, to a lesser extent, hydrogen were also observed as minor reactoins. Solution phase photolysis of MO-338: Photoreduction of the nitro to amino group was marked in the n-hexane solution photolysis. In the aqueous solution, photoreduction of the nitro substituent and hydroxylation were the main reactions with replacement of chlorine substituents by the hydroxyl group and hydrogen, and cleavage of the ether linkage as minor reactions. Photolyses of MC-4379, MC-3761, MC-5127, MC-6063, and MC-7181 in n-hexane and cyclohexane: Photoreduction of the nitro group leading to the corresponding amino derivative and replacement of one of the halogen substituents by hydrogen from the solvent used were the key reactions in each compound. Aqueous photolysis of MC-4379: Cleavage of the ether linkage, replacement of the carboxymethyl by hydroxyl group, hydroxylation, and replacement of the nitro by hydroxy group were prominent with photoreduction and dechlorination as minor reactions. Aqueous photolysis of MC-3761: Cleavage of the ether linkage, replacement of the carboxymethyl by hydroxyl group, and photoreduction followed by hydroxylation were the main reactions. Aqueous photolysis of MC-5127: Replacement of carboxyethyl by hydrogen was predominant with ether linkage cleavage, photoreduction, and dechlorination as minor reactions. It was obvious that the decarboxyethylation proceeded more readily than decarboxymethylation occurring in the other compounds. Aqueous photolysis of MC-6063: Cleavage of the ether linkage and photodechlorination were the main reactions. Aqueous photolysis of MC-7181: Replacement of the carboxymethyl group by hydrogen and monodechlorination were the remarkable reactions. Cleavage of the ether linkage and hydroxylation were thought to be the minor reactions. Aqueous photolysis of 3-carboxymethyl-4-nitrophenol: The photo-induced Fries rearrangement common to aromatic esters did not appear to occur in the carboxymethyl group of this type of compound. Conversion of nitro to nitroso group was the main reaction.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.131-143
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• 2015

Purpose : By comparing a CT fusion plan based on MRI with a plan based on only MRI without CT, we intended to study usefulness of a plan based on only MRI. And furthermore, we intended to realize a realtime MR-IGRT by MRI image without CT scan during the course of simulation, treatment planning, and radiation treatment. Materials and Methods : BBB CT (Brilliance Big Bore CT, 16slice, Philips), Viewray MRIdian system (Viewray, USA) were used for CT & MR simulation and Treatment plan of 11 patients (1 Head and Neck, 5 Breast, 1 Lung, 3 Liver, 1 Prostate). When scanning for treatment, Free Breathing was enacted for Head&Neck, Breast, Prostate and Inhalation Breathing Holding for Lung and Liver. Considering the difference of size between CT and Viewray, the patient's position and devices were in the same condition. Using Viewray MRIdian system, two treatment plans were established. The one was CT fusion treatment plan based on MR image. Another was MR treatment plan including electron density that [ICRU 46] recommend for Lung, Air and Bone. For Head&Neck, Breast and Prostate, IMRT was established and for Lung and Liver, Gating treatment plan was established. PTV's Homogeneity Index(HI) and Conformity Index(CI) were use to estimate the treatment plan. And DVH and dose difference of each PTV and OAR were compared to estimate the treatment plan. Results : Between the two treatment plan, each difference of PTV's HI value is 0.089% (Head&Neck), 0.26% (Breast), 0.67% (Lung), 0.2% (Liver), 0.4% (Prostate) and in case of CI, 0.043% (Head&Neck), 0.84% (Breast), 0.68% (Lung), 0.46% (Liver), 0.3% (Prostate). As showed above, it is on Head&Neck that HI and CI's difference value is smallest. Each difference of average dose on PTV is 0.07 Gy (Head&Neck), 0.29 Gy (Breast), 0.18 Gy (Lung), 0.3 Gy (Liver), 0.18 Gy (Prostate). And by percentage, it is 0.06% (Head&Neck), 0.7% (Breast), 0.29% (Lung), 0.69% (Liver), 0.44% (Prostate). Likewise, All is under 1%. In Head&Neck, average dose difference of each OAR is 0.01~0.12 Gy, 0.04~0.06 Gy in Breast, 0.01~0.21 Gy in Lung, 0.06~0.27 Gy in Liver and 0.02~0.23 Gy in Prostate. Conclusion : PTV's HI, CI dose difference on the Treatment plan using MR image is under 1% and OAR's dose difference is maximum 0.89 Gy as heterogeneous tissue increases when comparing with that fused CT image. Besides, It characterizes excellent contrast in soft tissue. So, radiation therapy using only MR image without CT scan is useful in the part like Head&Neck, partial breast and prostate cancer which has a little difference of heterogeneity.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.99-106
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• 2007

Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.2
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• pp.43-49
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• 2019

Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

• Journal of the East Asian Society of Dietary Life
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• v.19 no.2
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• pp.287-294
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• 2009

This study was conducted to evaluate the perception and satisfaction of undergraduates majoring in culinary arts and food service with working and internship abroad. The responses of the participants to 10 questions regarding perception and 13 questions regarding the importance and satisfaction with working and internship abroad were measured on a 5 point Likert scale. The primary results were as follows : 1) The subjects were composed of 50.9% male and 49.1% female students, of which 42.1% were employed and 57.9% experienced an internship abroad. 2) Most students went abroad to gain experience with respect to various foreign cultures in response to recommendations by the western cuisine department. 3) The items "I wish to conduct my affairs continuously"(M=4.21) and "I have good relationships with my colleagues at work"(M=4.11) received the highest points from male and female respondents, respectively. 4) Male students considered "cooperation among divisions"(M=4.11), "language skills"(M=4.38), and "kitchen environment"(M=4.34) to be very important. However, female students believed that "language skills"(M=4.36),"social relationships"(M=4.21), and "wage income"(M=4.18) were most important. Furthermore, male students were most satisfied with "company size" (M=4.28), "kitchen environment"(M=4.21), and "business hours"(M=4.10), while female students were most satisfied with "kitchen environment","incentive"(M=4.14) and "social relationships"(M=4.11).