• Korean Journal of Health Education and Promotion
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• v.6 no.2
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• pp.23-39
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• 1989

There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

• The Korean Journal of Physiology
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• v.19 no.1
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• pp.15-23
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• 1985

Previous biochemical studies indicate that $(Na^++K^+)-ATPase$ is composed of two subunits, ${\alpha}$ and ${\beta}$, in a form of ${\alpha}_2{\beta}_2$ with a molecular weight of approximately 300,000 daltons. There is also suggestive evidence that the $Na^+$, $K^+$ pump in human erythrocytes occurs in a complex with some glycolytic enzymes. We assessed here in situ assembly size of the $(Na^++K^+)-ATPase$ of human erythrocytes by applying classical target theory to radiation inactivation data of the ouabain-sensitive sodium flux and ATP hydrolysis of intact cells and ghosts. Cells(in the presence of cryoprotective agent) and ghosts were irradiated at $-45^{\circ}C$ to $-50^{\circ}C$ with an increasing dose of a 1.5 MeV electron beam, and after thawing, the pump and/or enzyme activities were assayed. Each activity measured was decreased as a simple exponential function of radiation dose, from which a radiation sensitive volume (target size) was calculated. When intact cells were used, the target size of both $(Na^++K^+)-ATPase$ and $Na^+$, $K^+$ pump was found to be approximately 600,000 daltons. This target size of the ATPase was reduced to approximately 325,000 daltons if the cells were pretreated with strophanthidin. When ghosts were used, the target size of the ATPase was again approximately 325,000 daltons. Our target size measurement suggests that, in intact cells, the $(Na^++K^+)-ATPase/Na^+,K^+$ pump exists either as a dimer of $(\alpha\beta)_2$ which is a functional unit or as a monomer of $(\alpha\beta)_2$ but in tight complex with other enzyme or enzymes. The results also suggest that this dimeric or heterocomplex association is dissociated during ghost preparation and strophanthidin treatment.

• Journal of the Mineralogical Society of Korea
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• v.16 no.3
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• pp.201-213
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• 2003

The adsorption property and ability of domestic zeolites for some heavy metal ions (Ag, Pb, Cr, Cu, Zn, Mn), which may cause a serious environmental problem in industrial wastewater, were evaluated on ore unit through a series of adsorption experiments together with careful examinations of mineral composition and properties of the zeolites. Though the adsorption behavior basically took place in the form of a cation exchange reaction, the higher CEC value does not necessarily to imply the higher adsorption capacity for a specific heavy metal. A general trend of the adsorption selectivity for heavy metals in the zeolites is determined to be as follow: $Ag\geq$Pb>Cr,Cu$\geq$Zn>Mn, but the adsorption properties of heavy metal ions somewhat depend on the species and composition of zeolite. Clinoptilolite tends to adsorb selectively Cu in case of Cr and Cu, whereas heulandite prefers Cr to Cu. A dominant adsorption selectivity of the zeolite ores for Ag and Pb is generally conspicuous regardless of their zeolite species and composition. The zeolite ores exhibit a preferential adsorption especially for $Ag^{+}$ so as not to regenerate when treated with $Na^{+}$ . In the adsorption capacity for heavy meta ions, the zeolites differ in great depending on their species: ferrierite>clinoptilolite>heulandite. Considering the CEC value of mordenite, the mordenite-rich ore appears to be similar to the clinoptilolite ore in the adsorption capacity. The adsorption capacity for heavy metals is not positively proportional to the CEC values of the zeolites measured by the exchange reaction with ammonium ion. In addition, the adsorption capacity roughly tends to depend on the zeolite contents, i.e., the grade of zeolite ore, but the trend is not consistent at all in some ores. These may be caused by the adsorption selectivity for some specific heavy metals, the presence of possible stacking micro-faults and natural cations such as K hardly to exchange in the zeolite. Considering the economic availability and functional effectiveness as natural zeolite resources, clinoptilolite ores could be applicable to utilize the domestic zeolites for the removal of heavy metals.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.591-597
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• 2008

Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

• Asia pacific journal of information systems
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• v.19 no.3
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• pp.25-49
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• 2009

Advances in technology have resulted in the emergence of new information systems. The convergence of IT and manufacturing sectors has blurred the boundaries among industries. Also, such convergence has become established as a paradigm to build a new area. Especially the convergence of broadcasting and telecommunication, notably in the case of IPTV (Internet Protocol Television), is among the most salient examples of its kind in recent years as a major case of disruptive technology innovation. Despite its much fanfare, such convergence, however, has not fulfilled the expectation; it has not produced positive economic effects while negatively affecting the growth of IPIV. Stakeholders in and around IPIV including telecommunication companies, broadcasting corporations, and government bodies wish to gain control of IPTV under their wings. IPTV has drifted in the midst of conflicts among the stakeholders in and around IPTV, particularly telecommunication and broadcasting organizations in a broad sense. Our empirical research intends to deal with how audiences accept IPTV and how firms provide IPTV services to utilize their resources. Three research questions in this paper include, first, whether Technology Acceptance Model (TAM) can sufficiently explain the acceptance of IPTV as an information system. The second question concerns with empirically testing the playful aspect of IPTV to increase its audience acceptance. Last, but not least, this paper deals with how firms can efficiently and effectively allocate their limited resources to increase IPTV viewers. To answer those three main questions of our study, we collect data from 197 current subscribers of high speed internet service and/or cable/satellite television. Empirical results show that 'perceived usefulness (PU) $\rightarrow$ Intention to use' and 'perceived ease of use (PEU) $\rightarrow$ Intention to use' are significant. Also, 'perceived ease of use' is significantly related to 'perceived usefulness.' Perceived ease of handling IPTV without much effort can positively influence the perceived value of IPTV. In this regard, engineers and designers of IPTV should pay more attention to the user-friendly interface of IPTV. In addition, 'perceived playfulness (PP)' of IPTV is positively related to 'intention to use'. Flow, fun and entertainment have recently gained greater attention in the research concerned with information systems. Such attention is due to the changing features of information systems in recent years that combine the functional and leisure attributes. These results give practical implications to the design of IPTV that reflects not just leisure but also functional elements. This paper also investigates the relationship between 'perceived ease of use (PEU)' and 'perceived playfulness (PP).' PEU is positively related to pp. Audiences without fear can be attracted more easily to the user-friendly IPTV, thereby perceiving the fun and entertainment with ease. Practical implications from this finding are that, to attract more interest and involvement from the audience, IPTV needs to be designed with similar or even more user friendly interface. Of the factors related to 'intention to use', 'perceived usefulness (PU)' and 'perceived ease of use (PEU)' have greater impacts than 'perceived playfulness (PP).' Between PU and PEU, their impacts on 'intention to use' are not significantly different statistically. Managerial implications of this finding are that firms in preparation for the launch of IPTV service should prioritize the functions and interface of IPTV. This empirical paper also provides further insight into the ways in which firms can strategically allocate their limited resources so as to appeal to viewers, both current and potential, of IPTV.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.60-66
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• 2003

Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

• Korean Journal of Poultry Science
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• v.7 no.2
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• pp.37-46
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• 1980

Hand deboned and mechanically deboned chicken meat were produced from domestic broilers and spent layers. Meat yield, chemical composition, functional characteristics, stability during storage, and microbiological properties were investigated Chicken patties and frankfurters were also manufactured by varying the relative proportion of MDCM to HDCM as raw materials, ana their palatability, shelf-life and textural properties were evaluated. The obtained results were as follows: 1) 35% of carcass wt was recovered as HDCM and 45% as MDCM, total meat yield reaching 80% of carcass wt. 2) Moisture, protein, fat, ash and Ca content of MDCM were 65, 12, 20, 1.7 and 0.2-0.4%,respectively. MDCM was higher in fat, ash and Ca, but significantly lower in moisture and protein. Total pigment content of MDCM was 2.5 times higher than that of HDCD such high content being attributed to the increased inclusion of hemoglobin. 3) The emulsifying capacity (ES) of MOCM per g meat was only 70% that of HDCM. but when ES was expressed on unit g of protein basis MDCM showed even higher ES than HDCM primarily due to tile higher proportion of salt soluble protein fraction. 4) Since the TBA values of MDCM increased rapidly after 4 weeks of frozen storage at -20$^{\circ}C$, the maximum possible storage period of MDCM is estimated to be about 4 weeks. 5) Total microbial counts of MDCM was approximately 1.8${\times}$10$\^$6/g/, showing no great difference from HDCM or red meat. 6) Chicken patty containing MDCM showed gradual increase in TBA value during frozen storage, but its storage up to 8 weeks presented no problems in flavor stability. 7) Color score an4 total palatability of chicken Patty were best for the product containing 30% MDCM. It was also concluded that MDCM can be included in the patties up to 50% of total meat with good results, but more than 70% was not recommended 8) The formulation of MDCM up to 50% in frankfurter gave quite satisfactory acceptability and textural properties comparable to frankfurter made of 100% MDCM, but the inclusion of more than 70% MDCM was not recommended 9) The TBA value of frankfurter containing MDCM did not increase to any great extent until 4 weeks of storage at 4$^{\circ}C$, indicating no unique problems in flavor instability compared to regular frankfurter. 10) It was concluded that processed meat products such as patties and frankfurters containing MDCM up to 30-50% of total meat ingredients gave satisfactory results in color, texture and palatability, comparable to regular products.

• The Korean Journal of Archival Studies
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• no.25
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• pp.3-46
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• 2010

Digital records management is one whole system in which many social and technical elements are interacting. To maintain the trustworthiness, the repository needs periodical audit and certification. Thus, individual electronic records management agency needs toolkit that can be used to self-evaluate their trustworthiness continuously, and self-assess their atmosphere and system to recognize deficiencies. The purpose of this study is development of self-certification toolkit for repositories, which synthesized and analysed such four international standard and best practices as OAIS Reference Model(ISO 14721), TRAC, DRAMBORA, and the assessment report conducted and published by TNA/UKDA, as well as MoRe2 and current national laws and standards. As this paper describes and demonstrate the development process and the framework of this self-certification toolkit, other electronic records management agencies could follow the process and develop their own toolkit reflecting their situation, and utilize the self-assessment results in-house. As a result of this research, 12 areas for assessment were set, which include (organizational) operation management, classification system and master data management, acquisition, registration and description, storage and preservation, disposal, services, providing finding aids, system management, access control and security, monitoring/audit trail/statistics, and risk management. In each 12 area, the process map or functional charts were drawn and business functions were analyzed, and 54 'evaluation criteria', consisted of main business functional unit in each area were drawn. Under each 'evaluation criteria', 208 'specific evaluation criteria', which supposed to be implementable, measurable, and provable for self-evaluation in each area, were drawn. The audit and certification toolkit developed by this research could be used by digital repositories to conduct periodical self-assessment of the organization, which would be used to supplement any found deficiencies and be used to reflect the organizational development strategy.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.116-122
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• 2005

Background: Adverse effects of cardiopulmonary bypass can be avoided by 'Off-pump' coronary artery bypass (OPCAB) surgery. Recent studies have reported that OPCAB had the most beneficial impact on patients at highest risk by reducing bypass-related complications. The purpose of this study is to compare the outcome of OPCAB and conventional coronary artery bypass grafting (CCAB) in patients with poor left ventricular (LV) function. Material and Method: From March 1997 to February 2004, seventy five patients with left ventricular ejection fraction (LVEF) of $35\%$ or less underwent isolated coronary artery bypass grafting at our institute. Of these patients, 33 patients underwent OPCAB and 42 underwent CCAB. Preoperative risk factors, operative and postoperative outcomes, including LV functional change, were compared and analysed. Result: Patients undergoing CCAB were more likely to have unstable angina, three vessel disease and acute myocardial infarction among the preoperative factors. OPCAB group had significantly lower mean operation time, less numbers of total distal anastomoses per patient and less numbers of distal anastomoses per patient in the circumflex territory than the CCAB group. There was no difference between the groups in regard to in-hospital mortality $(OPCAB\; 9.1\%\;(n=3)\;Vs.\;CCAB\;9.5\%\;(n=4)),$ intubation time, the length of stay in intensive care unit and in hospital postoperatively. Postoperative complication occurred more in CCAB group but did not show statistical difference. On follow-up echocardiography, OPCAB group showed $9.1\%$ improvement in mean LVEF, 4.3 mm decrease in mean left ventricular end-diastolic dimension (LVEDD) and 4.2 mm decrease in mean left ventricular end-systolic dimension (LVESD). CCAB group showed $11.0\%$ improvement in mean LVEF, 5.1 mm decrease in mean LVEDD and 5.5 mm decrease in mean LVESD. But there was no statistically significant difference between the two groups. Conclusion: This study showed that LV function improves postoperatively in patients with severe ischemic LV dysfunction, but failed to show any difference in the degree of improvement between OPCAB and CCAB. In terms of operative mortality rate and LV functional recovery, the results of OPCAB were as good as those of CCAB in patients with poor LV function. But, OPCAB procedure was advantageous in shortening of operative time and in decrease of complications. We recommend OPCAB as the first surgical option for patients with severe LV dysfunction.

• Journal of Biomedical Engineering Research
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• v.25 no.3
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• pp.171-182
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• 2004

This study investigates the biomechanical efficacies of vertebroplasty which is used to treat vertebral body fracture with bone cement augmentation for osteoporotic patients using image and finite element analysis. Simulated models were divided into two groups: (a) a vertebral body, (b) a functional spinal unit(FSU). For a vertebral body model, the maximum axial displacement was investigated under axial compression to evaluate the effect of structural integrity. The stiffness of each FE model simulated was normalized by the stiffness of intact model. In the case of FSU model, 3 types of compression fractures were formulated to assess the influence on spinal curvature changes. The FSU models were loaded under compressive pressure to calculate the change of spinal curvature. The results according to the various factors suggest that vertebroplasty has the biomechanical efficacy of the increment of structural reinforcement in a patient who has relatively high level of BMD and a patient with the amount of 15％, PMMA injection of the cancellous bone volume. The spinal curvatures after compression fracture simulation vary from 9$^{\circ}$ to 17$^{\circ}$ of kyphosis compared to that the spinal curvature of normal model was -2.8$^{\circ}$ of lordosis. These spinal curvature changes cause the severe spinal deformity under the same loading. As the degree of compressive fracture increases the spinal deformity also increases. The results indicate that vertebroplasty has the increasing effect of the structural integrity regardless of the amount of PMMA or BMD and the restoration of decreased vertebral body height may be an important factor when the compressive fracture caused the significant height loss of vertebral body.