• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

• Childhood Kidney Diseases
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• v.2 no.1
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• pp.77-81
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• 1998

The author exprienced a case of glycogen storage disease type Ia(GSD-I) in an 18-year-old male patient who was admitted to our hospital due to proteinuria and hypertension. he was suspected to have GSD when 12 years old because of his family history of short stature and hepatomegaly. On admission, physical examination revealed short stature, heparomegaly, and The diagnosis of GSD-I was confirmed by compatible liver biopsy finding and enzyme assay which erealeddeficiency of glcose-6-phosphatase if hepatocyte. Sympromatic treatment was done using antihypertensive drugs and allopurinol with diet control. The authors report a case of glycogen storage disease type Ia completely confirmed by typical clinical manifestation, pathologic findings of the liver and the kidney, and the result of enzyme assay which revealed deficiency of glucose-6-phosphatase in hepatocytes with brief review fo related literatures.

• CRM연구
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• v.3 no.2
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• pp.43-68
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• 2010

One of the recent research trends that universities are increasingly adopting the concept of 'customer' and the customer-oriented strategy has urged us to research enterprise-wide CRM strategy adaptable to university administration. As the first step of CRM strategy for university management, we try to validate the difference of CRM strategic factors among university types. Drawing upon both CRM process and customer equity drivers, which have been recognized as core frameworks for CRM strategy, we developed those survey instruments adoptable into university industry, and validated statistically-significant difference among 12 types of university group constructed by the levels of university evaluation and the location of the universities. We collected 261 responses from 177 universities from all over the country and analyzed the data to see the levels of CRM processes consisting of customer acquisition, retention, and expansion, and customer equity drivers consisting of value equity, brand equity, and relationship equity by using multivariate ANOVA(MANOVA). The result confirms the explicit differences of the levels of CRM processes and customer equity drivers between the groups by university evaluation levels(high/middle/low). However, the analysis failed to show the significant differences of those between the group by university locations(the capital/the suburbs/the six megalopolises/other countries). More specifically, the level of activities for customer acquisition and retention of the universities in the higher-graded group are significantly different from those in the lower-graded group from the perspective of CRM process. In terms of customer equity drivers, the levels of both brand equity and relationship equity of the higher-graded group are significantly higher than those of both middle and lower-graded group. In addition, we found that the value equity between the higher and lower-graded groups, and the brand equity between the middle and lower-graded groups are different each other. This study provides an important meaning in that we tried to consider CRM strategy which has been mainly addressed in profit-making industries in terms of non-profit organization context. Our endeavors to develop and validate empirical measurements adoptable to university context could be an academic contribution. In terms of practical meaning, the processes and results of this study might be a guideline to many universities to build their own CRM strategies. According to the research results, those insights could be expressed in several messages. First, we propose to universities that they should plan their own differentiated CRM strategies according to their positions in terms of university evaluation. For example, although it is acceptable that a university in lower-level group might follow the CRM process strategy of the middle-level group universities, it is not a good idea to imitate the customer acquisition and retention activities of the higher-level group universities. Moreover, since this study reported that the level of universities' brand equity is just correlated with the level of university evaluation, it might be pointless for the middle or lower-leveled universities if they just copy their brand equity strategies from those of higher-leveled ones even though such activities are seemingly attractive. Meanwhile, the difference of CRM strategy by university position might provide universities with the direction where they should go for their CRM strategies. For instance, our study implies that the lower-positioned universities should improve all of the customer equity drivers with concerted efforts because their value, brand, and relationship equities are inferior compared with the higher and middle-positioned universities' ones. This also means that they should focus on customer acquisition and expansion initiatives rather than those for customer retention because all of the customer equity drivers could be influenced by the two kinds of CRM processes (KIm and Lee, 2010). Surely specific and detailed action plans for enhancing customer equity drivers should be developed after grasping their customer migration patterns illustrated by the rates of acquisition, retention, upgrade, downgrade, and defection for each customer segment.

• Korean Journal of Health Education and Promotion
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• v.18 no.2
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• pp.1-26
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• 2001

This research is aimed to define how the depression, performing ability of IADL and muscular-skeletal pain of the Aged, according to their residential circumstance, sex and age, can affect the subjective health index and how all these are related and associated with. For the period of June 1 to July 31, 2000, in order to study and define how the depression, performing ability of IADL and muscular-skeletal pain are related to the subjective health index of the Aged, we have conducted an enquete through a direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent areas, divided into three different residential types “The Aged living at home”, “The Aged living at welfare facilities” and “The Aged living alone”. We have studied all the data and information obtained through this enquete and have analyzed χ²-test, t-test, ANOVA, analysis of simple correlation, analysis of factor. by SPSS10.0/PC+. The results were as follows: Generally, the four (4) factors depression, IADL performing ability, muscular-skeletal pain and the subjective health index of the Aged, are a lot influenced by and related to their residential circumstance, their sex and their age. With regard to the depression of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 48.3 point which reflects comparatively the higher points and the female-Aged is more depressed. In analyzing depression of the Aged by their age, it appears that the Aged between eighty (80) to eight-four (84) years of age, gains 49.2 point which is the highest points and simultaneously we could realize that depression follows age, - the more the age gets, the more the depression is increased. In analyzing depression of the Aged by their residential type, it shows that “the Aged living alone” gains 50.9 point and is most depressed. With regard to the IADL performance of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 23.8 point, which shows the performance of the female-Aged is less independent. In addition, it was also found that the IADL performing ability is becoming less and less independent following their age increasing. In analyzing IADL performance by their residential type, it appears that “the Aged living at welfare facilities” gains the lowest 21.5 point and is least independent. We conclude that some assistances from others are required for the Aged living at welfare facilities in their performing IADL. With regard to the muscular-skeletal pain of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 3.0 point and the female-Aged suffers from this pain more severely. In analyzing this pain by their residential type, it was found that, on an average, the 3.0 point goes for “the Aged living alone”, which explains the Aged living alone is having the most serious pain. With regard to the subjective heath index of the all Aged participated in this research, the analysis indicates 8.8 point and this is considered as a general standard (7-10 point). In analyzing this index by their sex, the female-Aged gains 8.6 point only and it explains a lot of female-Aged consider they are not really healthy. In analyzing this index by their residential type, “the Aged living at welfare facilities” and “the Aged living alone” gain the comparatively lower point, -respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged of these two residential types express they are obviously in a bad condition of health, which makes us think a lot. With regard to the factors affecting the subjective health index of the Aged, it was analyzed that this index can significantly be influenced by their depression, their pain, their age and by how much they are satisfied with their current living conditions, and also analyzed that the correlative relation certainly exists between the depression and pain, and the subjective health index, - that is, the more the depression and pain are serious, the lower the subjective health index indicates. As for the IADL, it appears that the IADL's relation with this index is not that significant and even not important.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.11
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• pp.1627-1634
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• 2014

The recipe for sujeonggwa, a Korean traditional sweet drink containing cinnamon, ginger, sugar, or honey, was modified by replacing sugar with alternative sweeteners [stevia or short-chain frutooligosaccharide (scFOS)] in order to improve the health functionality of sujeonggwa. The aim of this study was to evaluate the effects of modified sujeonggwa on lipid peroxidation and oxidized DNA damage in diet-induced hypercholesterolemic ApoE knockout mice. Hypercholesterolemia was induced in 6-week-old male mice by administration of a high cholesterol diet (1.25% cholesterol, 0.5% cholic acid, and 10% coconut oil) for 4 weeks, after which mice were divided into five groups: sucrose solution-fed control group, sujeonggwa containing sucrose group, sucrose+stevia group, sucrose+stevia+scFOS group, and commercially available sujeonggwa group as a positive control. After 6 weeks, sujeonggwa supplementation resulted in reduced hepatic thiobarbituric acid reactive substances (TBARS), regardless of sweetener type. However, reduction of hepatic TBARS by commercially available sujeonggwa was insignificant. Both endogenous and $H_2O_2$-induced DNA damage in hepatocytes and splenocytes were significantly reduced only in the sujeonggwa containing stevia group compared to the sucrose-fed control group. There were no significant effects of sujeonggwa supplementation on total radical trapping potential, lipid peroxidation, or DNA damage in blood. These results suggest that sujeonggwa has protective effects against hepatic lipid peroxidation and DNA damage in hepatocytes or splenocytes from diet-induced hypercholesterolemic ApoE knockout mice, and the type of sweetener should be modified to improve the health benefits of sujeonggwa.

• Economic and Environmental Geology
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• v.22 no.4
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• pp.303-314
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• 1989

The electrum-silver-sulfide mineralization of the Geojae island area was deposited in three stages (I, II, and carbonate) of quartz and calcite veins that crosscut Late Cretaceous volcanic rocks and granodiorite(83 m.y.). Stages I and II were terminated by the onset of fractunng and breCCIation events. Fluid inclusion data suggest that the gold-sulfide-bearing stages I and II each evolved from an initial high temperature( near $370^{\circ}C$) to a later low temperature(near $200^{\circ}C$). Each of those stages represented a separate mineralizing system which cooled prior to the onset of the next stage. The relationship between homogenization temperature and salinity in stages I and II suggests a complex history of boiling, cooling and dilution. Evidence of boiling indicates a pressure of < 100 bars, corresponding to a depth of 500 to 1,250m assummg hthostatlc and hydrostatic pressure regimes, respectively. Fluid inclusion and mineralogical evidence suggest that the electrum-silver mineralization was deposited at a temperature of $220-260^{\circ}C$ from ore fluids with salinities between 1.9 and 8.1 equivalent wt.% NaCl. Total sulfur concentration is estimated to be $10^{-3}$ to $10^{-4}$ molal. The estimated $fs_2$ and $fo_2$ range from $10^{-11.8}$ to $10^{-14}$ atm and $10^{-35}$ to $10^{-36}$ atm, respectively. The chemical conditions indicate that the dominant sulfur species in the ore forming fluids was a reduced form($H_2S$). Rapid cooling and dilution of ore-forming fluids by mixing with less-evolved meteoric waters led to gold-silver deposition through the breakdown of the bisulfide complex($Au(HS)_2$) as the activity of $H_2S$ decreased.

• Korean journal of food and cookery science
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• v.13 no.4
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• pp.462-471
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• 1997

Effect of citron on Dongchimi (watery radish kimchi) fermentation was investigated by sensory evaluation and the measurement of non-volatile organic acids, soluble pectin, and the texture during fermentation up to 36 days. Dongchimi with various levels of citron (0, 1, 2, 4, 6％) was fermented at 10$^{\circ}C$. In sensory evaluation, citron-added Dongchimi showed the higher scores in most characteristics than Dongchimi without citron in which Dongchimi with 2％ citron was the most preferable. The non-volatile organic acids of Dongchimi were identified as lactic acid, oxalic acid, succinic acid, malic acid, and citric acid. There were significant changes in the contents of lactic acid, succinic acid, malic acid, and citric acid during fermentation. Generally, the content of hydrochloric acid-soluble pectin (HSP) of Dongchimi occupied the higher ratio in the total soluble pectin content. Generally, the content of hot water-soluble pectin (HWSP) of Dongchimi decreased and that of sodium hexametaphosphate-soluble pectin (NaSP) increased during fermentation. The hardness of radish in Dongchimi showed the highest score on 23$\^$rd/ day and decreased thereafter.

• Korean Journal of Poultry Science
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• v.36 no.2
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• pp.125-131
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• 2009

This study was conducted to investigate the effects of dietary supplementation of mannan-oligosaccharides (MOS) and fructo-oligosaccharides (FOS) on the performance, immune response and small intestinal microflora in laying hens. A total of 960 Hy-Line $Brown^{(R)}$ laying hens of 27 wks old, housed in 2 bird cages, were assigned in a completely randomized block design into one of the following 6 dietary treatments: control, antibiotic (6 ppm avilamycine), 0.025% MOS, 0.05% MOS, 0.25% FOS, and 0.5% FOS. Each treatment had 4 replicates of 40 birds and was fed ad libitum for 6 wks under 16 h lighting regimen. There were significant differences among treatments in hen-day and hen-housed egg production. Hen-day egg production in 0.025% MOS was significantly higher than that of control. Hen-housed egg production in antibiotic-treated group was significantly higher compared with control. Egg weight, feed intake and feed conversion were not significantly different among treatments. Egg shell thickness was highest in 0.25% FOS, but was not significantly different among the rest of treatments. There were no significant differences among treatments in egg shell strength, egg shell color, egg yolk color and Haugh unit. IgG concentrations in serum were not significantly different among treatments. On the other hand, IgA concentrations of the treated birds tended to be increased compared with control. Dietary treatments tended to decrease Cl. perfringens and E. coli, and to increase Lactobacillus spp. The result of this experiment showed that dietary supplementation of MOS and FOS in laying hens tended to improve egg production comparable to the supplementation of antibiotics. The level of serum IgA and small intestinal microflora were also significantly affected by the treatments.

• Korean Journal of Microbiology
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• v.35 no.4
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• pp.307-314
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• 1999

This study was aimed at the investigation of the possibility of the addition of lactic acid bacteria as "starter"for the preparation of radish juice. Forty strains of lactic acid bacteria were isolated from dongchimi that was fermented by a traditional method. The isolates were assorted into 5groups, Leuconostoc mesenteroides subsp. mesenteroides (J-9), Lacobacillus brevis (J-12), Lactobacillus fermentum (J-7), Lactobacillus sake (J-20), and Lactobacillus plantarum (J-39). Leuconostoc mesenteroides was predominated in the sample of dongchimi with frequency of 52.5%. Each of the strain, which exhibited the beat growth in the species, was selected in the 5species, and investigation of the fermentation characteristcis was carried out. The fermentation were performed for 9 days at 25${\circ}C$ after the inoculation of 0.3% ($10^{6}$ cfu/㎖) to each ultra-filtrated radish juice. The pH, total acidity, content of non-volatile organic acids were examined during the fermentation period. Lactobacillus plantarum showed the highest growth rate and the growth rate of Lactobacillus sake was the lowest. The pH (6.3-6.36) and total acidity (0.09-1.0 %) fo the ultrafiltrated radish juice before fermentation were changed to 3.2-4.3 and 0.65-1.2% after 9days, respectively. The changes of the pH and total acidity were related with the growth of the lactic acid bacteria; the better growth of lactic acid bacteria, the more rapid decrease of pH and increase of the total acidity. when the amount of non-volatile organic acids were estimated during fermentation, citric acid, malic acid, malonic acid, and succinic acid were decreased in all cases. However, the content of lactic acid increased with the progression of fermentation. L. mesenteroides (J-9), L. brevis (J-12) and L. fermentum (J-7) were chosen for the candidates of the starter for the lactic fermentation of radish juice based on the biochemical analysis and sensory evaluation.

• Progress in Medical Physics
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• v.19 no.4
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• pp.269-275
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• 2008

Although MR imaging is generally applicable to depict knee joint deterioration it, is sometimes occurred to mis-read and mis-diagnose the common knee joint diseases. In this study, we employed magnetization transfer ratio (MTR) method to improve the diagnosis of the various knee joint diseases. Spin-echo (SE) T2-weighted images (TR/TE 3,400-3,500/90-100 ms) were obtained in seven cases of knee joint deterioration, FSE T2-weighted images (TR/TE 4,500-5,000/100-108 ms) were obtained in seven cases of knee joint deterioration, gradient-echo (GRE) T2-weighted images (TR/TE 9/4.56/$50^{\circ}$ flip angle, NEX 1) were obtained in 3 cases of knee joint deterioration, In six cases of knee joint deterioration, fat suppression was performed using a T2-weighted short T1/tau inverse recovery (STIR) sequence (TR/TE =2,894-3,215 ms/70 ms, NEX 3, ETL 9). Calculation of MTR for individual pixels was performed on registration of unsaturated and saturated images. After processing to make MTR images, the images were displayed in gray color. For improving diagnosis, three-dimensional isotropic volume images, the MR tristimulus color mapping and the MTR map was employed. MTR images showed diagnostic images quality to assess the patients' pathologies. The intensity difference between MTR images and conventional MRI was seen on the color bar. The profile graph on MTR imaging effect showed a quantitative measure of the relative decrease in signal intensity due to the MT pulse. To diagnose the pathologies of the knee joint, the profile graph data was shown on the image as a small cross. The present study indicated that MTR images in the knee joint were feasible. Investigation of physical change on MTR imaging enables to provide us more insight in the physical and technical basis of MTR imaging. MTR images could be useful for rapid assessment of diseases that we examine unambiguous contrast in MT images of knee disorder patients.