• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.17-25
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• 2006

Twelve cases in eleven patients with segmental bone defects were treated with contralateral fibula free flap and ipsilateral island fibula flap in an antegrade, retrograde or bidirectional flow fashion. Five cases were managed with free flaps and seven were with ipsilateral fibula island transfer. Among seven cases, antegrade fashion was three, retrograde was three, and bidirectional was one. All patients were related with open tibial fractures and its sequelae except one who had open foot bone fracture. According to Gustilo's classification, ten patients were type IIIb and one was type IIIc. Basically, antegrade-flow flaps based on the peroneal vessels as in the conventional free flap were used for the proximal or middle one-third tibial defects. On the contrary, retrograde-flow flaps based on the communicating branch between the peroneal and posterior tibial vessels were used for the middle or distal one-third of the tibia. Bidirection-flow flap based on intact peroneal vessels were used for the middle portion of the tibia. The patients who have undergone ipsilateral fibula island flap had one of the following problems: a previously failed free flap, below-knee amputation of the opposite leg because of open tibial fracture, refusal to use the contralateral sound leg, or poor general condition to stand a lengthy operation. Six of the patients who have got ipsilateral fibula island flap also had an associated fibula fracture on the same leg, which was ultimately used as one of the osteotomy sites. The follow-up period was from 1 to 10 years. Two cases of free flap were failed: one patient had below-knee amputation and the other patient had ipsilateral fibula transfer. Other cases were successful and excellent hypertophy of the transferred fibula was achieved. Time to bone union ranged from 4 to 11 months. Time to full weight bearing was from 5 to 13 months after surgery. All of the transferred fibulas showed hypertrophy after weight bearing. In one case, stress fracture was developed during ambulation, which was healed conservatively. Nonunion occurred in two cases, which were treated with a long leg cast and cancellous bone graft, respectively. Length discrepancy of the legs was noted. The limb was shorter by an average 0.5 cm in three cases, longer by 1.1 cm in one case. In the case of island fibula transfer, limited arc of rotation was not a problem. Other disabling complications were not seen. We believe that these diverse modalities using a vascularized fibula will make us more comfortable to handle major bone defects.

• The Korean Journal of Applied Statistics
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• v.32 no.5
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• pp.693-702
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• 2019

Deep learning has gained popularity for the classification and prediction task. Neural network layers become deeper as more data becomes available. Saturation is the phenomenon that the gradient of an activation function gets closer to 0 and can happen when the value of weight is too big. Increased importance has been placed on the issue of saturation which limits the ability of weight to learn. To resolve this problem, Glorot and Bengio (Proceedings of the Thirteenth International Conference on Artificial Intelligence and Statistics, 249-256, 2010) claimed that efficient neural network training is possible when data flows variously between layers. They argued that variance over the output of each layer and variance over input of each layer are equal. They proposed a method of initialization that the variance of the output of each layer and the variance of the input should be the same. In this paper, we propose a new method of establishing initialization by adopting truncated normal distribution and truncated cauchy distribution. We decide where to truncate the distribution while adapting the initialization method by Glorot and Bengio (2010). Variances are made over output and input equal that are then accomplished by setting variances equal to the variance of truncated distribution. It manipulates the distribution so that the initial values of weights would not grow so large and with values that simultaneously get close to zero. To compare the performance of our proposed method with existing methods, we conducted experiments on MNIST and CIFAR-10 data using DNN and CNN. Our proposed method outperformed existing methods in terms of accuracy.

• Journal of the Korea Convergence Society
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• v.9 no.9
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• pp.209-215
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• 2018

The purpose of this study is to grasp the overall policy decision system of sex crime prevention policy and analyze the interaction and pattern of actors in policy formation process. This is a useful way to identify the causes and ways to improve the policy if the sex crime prevention policy fails. As a research method, we used a model of advocacy through case analysis and language network analysis. In the external environment, low reporting of sex offenses, technical improvement and supplement for preventive management, consciousness of victims of sexual crimes, amendment of legislation, and support of the president. The conflicts between the advocacy coalition opposed the strong regulation, the prevention of recidivism, the expansion of the range of objects to be worn, the temporary effect of the system and the retrospective of the bill. As a problem-solving strategy, it was confirmed that the opposing positions of pros and cons of lack of manpower and negligence of management through the extension of the system were acutely opposed. In the context of media reports, this tendency is more likely to be understood as the concern of prevention and management at the central government level to prevent sex crimes. Therefore, although the methods of prevention of sex crimes have been insufficient in the past, it is hoped that this study will be helpful in breaking the link of negative policy vicious cycle.

• Journal of The Korean Association For Science Education
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• v.32 no.2
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• pp.236-264
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• 2012

The purpose of this study is to provide teachers with sub-components of inquiry skills and help them to give direct instructions on the skills to their students. Inquiry skills and strategies are considered by-products of science and inquiry instruction by most of the science teachers. On the other hand, much research shows that many students are not familiar with the way that they can use inquiry skills therefore direct instruction on the inquiry skills is needed. The lack of guidance on the sub-components for the inquiry skills, however, results in science teachers' ignorance of the inquiry skills. As shown in the previous studies which suggest that without teachers' guidance, students cannot acquire the intended skills, and it is necessary to inform science teachers of the necessity for direct instruction on the inquiry skills and strategy as well as give them the sub-components of the inquiry skills. On the basis of the results from the previous research on the inquiry skills, this study presents the sub-components of basic inquiry skills (observation, classification, measure, prediction, and reasoning) and integrated inquiry skills (problem recognition, hypothesis formulation, control of variables, data transformation, data interpretation, drawing conclusion, and generalization).

• The KIPS Transactions:PartA
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• v.13A no.5 s.102
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• pp.465-472
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• 2006

Recently, many suggestions have been made in image segmentation methods for extracting human organs or disease affected area from huge amounts of medical image datasets. However, images from some areas, such as brain, which have multiple structures with ambiruous structural borders, have limitations in their structural segmentation. To address this problem, clustering technique which classifies voxels into finite number of clusters is often employed. This, however, has its drawback, the influence from noise, which is caused from voxel by voxel operations. Therefore, applying image enhancing method to minimize the influence from noise and to make clearer image borders would allow more robust structural segmentation. This research proposes an efficient structural segmentation method by filtering based clustering to extract detail structures such as white matter, gray matter and cerebrospinal fluid from brain MR. First, coherence enhancing diffusion filtering is adopted to make clearer borders between structures and to reduce the noises in them. To the enhanced images from this process, fuzzy c-means clustering method was applied, conducting structural segmentation by assigning corresponding cluster index to the structure containing each voxel. The suggested structural segmentation method, in comparison with existing ones with clustering using Gaussian or general anisotropic diffusion filtering, showed enhanced accuracy which was determined by how much it agreed with the manual segmentation results. Moreover, by suggesting fine segmentation method on the border area with reproducible results and minimized manual task, it provides efficient diagnostic support for morphological abnormalities in brain.

• Korean Journal of Construction Engineering and Management
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• v.16 no.3
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• pp.68-77
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• 2015

One of recent concerns for super-tall buildings is how to manage hoisting plans and equipment efficiently. Disasters are frequently occurred in relation to electromotive hoists and cranes which are commonly used in construction sites. For construction lifts, particularly, it is highly important to conduct regular inspections or prepare against breakdown in terms of safety. However, unfortunately the reality is that regular inspections are only flatly conducted according to operating hours only. A lift, whose life span is subject to the complicated considerations such as operating hours, loading condition, and the like of each component, is far too invalid as a means of maintenance. As a way to resolve this problem and improve its convenience and safety for users, this study intends to calculate individual inspection interval for the main components of lifts by measuring their actual operating hours with sensing technology and analyzing their historical data. The findings of study include calculation of inspection intervals for the main components of lifts and classification of components to check by the actual operating hours of lift (40, 90, 130, 400 hours), which are drawn up into tables. This will make an opportunity to suggest efficient maintenance measures by enabling prevention of safety accidents and enhancement of safety for workers. Also, it will lead to increasing productivity of works by eliminating sources of delaying the term due to the breakdown of lifts.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.6
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• pp.458-466
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• 2015

The purpose of this study was to review the research on treating depression in Traditional Chinese Medicine(TCM) over the last 5 years to set the foundation for further studies. We searched for and analyzed articles about depression in CNKI(China National Knowledge Infrastructure) from January 2010 to December 2014. The results were as follows : The most frequently used diagnostic criteria was CCMD-3(The Chinese Classification of Mental Disorders-3), and the most used evaluation criteria was HAMD(Hamilton Depression Rating Scale). Prescription of decoction of medical herbs was most frequently used as a therapeutic method. Acupuncture, traditional Chinese psychotherapy, and music therapy were also used for some studies. The most frequent TCM Syndrome Differentiation Type was stagnation of liver-QI. For decoction of Chinese herbs, Soyo-san(Xiaoyao-san) and Sihosogan-san(Chaihushugan-san) were most often prescribed, and Bupleuri Radix, Paeoniae Radix Alba, Curcumae Radix, Poria cocos wolf, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba were mainly used for medical herbs. BaekHoi(GV20) and Yindang(Ex-HN3) were often used as acupuncture sites. Post-Stroke Depression was the most common case of intercurrent or secondary depression. According to the Jadad Quality Assessment Scale, the quality of the reports was not high as most of the reports had a score of 3 or below. Most systematic reviews on depression were conducted by Chinese researchers. The problem with Clinical research on depression, according to those reviews, was that there were no standardized criteria for the diagnosis and treatment and the trials were usually not randomized nor controlled. We found out there are various clinical methods for treating depression in TCM, and hope that this research could provide the preliminary data for designing and conducting clinical trials for depression.

• Molecular & Cellular Toxicology
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• v.4 no.4
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• pp.318-322
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• 2008

Obesity is an increasing worldwide health problem that is strongly related to the imbalance of food intake and energy metabolism. It was well-known that several substances in the hypothalamus regulate food intake and energy metabolism. We planned an integrative study to elucidate the mechanism of the development of obesity. Firstly, to find candidate genes with the marvelous effect, the different expression in the hypothalamus between ob/ob and 48-h fasting mice was investigated by using DNA microarray technology. As a result, we found 3 genes [peroxisome proliferator activated receptor, gamma, coactivator 1 alpha (Ppargc1a), calmodulin 1 (Calm1), and complexin 2 (Cplx2)] showing the different hypothalamic expression between ob/ob and 48-h fasting mice. Secondly, a genetic approach on PPARGC1A gene was performed, because PPARGC1A acts as a transcriptional coactivator and a metabolic regulator. Two hundred forty three obese female patients with body mass index (BMI)${\geq}$25 and 285 control female subjects with BMI 18 to<23 were recruited according to the Classification of Korean Society for the Study of Obesity. Among the coding single nucleotide polymorphisms (cSNPs) of PPARGC1A, 2 missense SNPs (rs8192678, Gly482Ser; rs3736265, Thr612Met) and 1 synonymous SNP (rs3755863, Thr528Thr) were selected, and analyzed by PCR-RFLP and pyrosequencing. For the analysis of genetic data, chi-square ($X^2$) test and EH program were used. The rs8192678 was significantly associated with obese women (P<0.0006; odds ratio, 1.5327; 95% confidence interval, 1.2006-1.9568). Haplotypes also showed significant association with obese women ($X^2$=33.28, P<0.0008). These results suggest that PPARGC1A might be related to the development of obesity.

• Ecology and Resilient Infrastructure
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• v.7 no.2
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• pp.114-125
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• 2020

Despite the various artificial neural networks that have been developed, most of the discharge models in previous studies have been developed using deep neural networks. This study aimed to develop a discharge model using a convolution neural network (CNN), which was used to solve classification problems. Furthermore, the applicability of CNN was evaluated. The photographs (pictures or images) for input data to CNN could not clearly show the characteristics of the study area as well as precipitation. Hence, the model employed in this study had to use numerical images. To solve the problem, the CN of NRCS was used to generate images as input data for the model. The generated images showed a good possibility of applicability as input data. Moreover, a new application of CN, which had been used only for discharge prediction, was proposed in this study. As a result of CNN training, the model was trained and generalized stably. Comparison between the actual and predicted values had an R² of 0.79, which was relatively high. The model showed good performance in terms of the Pearson correlation coefficient (0.84), the Nash-Sutcliffe efficiency (NSE) (0.63), and the root mean square error (24.54 ㎥/s).