• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.4
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• pp.331-339
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• 2015

The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).

• Journal of The Korean Association For Science Education
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• v.38 no.3
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• pp.305-317
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• 2018

In this study, we investigated the characteristics of participant students' modeling with the blackbox simulation program and epistemic criteria. For this research, we developed a blackbox simulation program, which is an ill-structured problem situation reflecting the scientific practice. This simulation program is applied in the activities. 23 groups, 89 second year students of an education college participated in this activity. They visualized, modeled, modified, and evaluated their thoughts on internal structure in the blackbox. All of students' activities were recorded and analyzed. As a result, the students' models in blackbox activities were categorized into four types considering their form and function. Model evaluation occurred in group model selection. Epistemic criteria such as empirical coherence, comprehensiveness, analogy, simplicity, and implementation were adapted in model evaluation. The educational implications discussed above are as follows: First, the blackbox simulation activities in which the students participated in this study have educational implications in that they provide a context in which the nature of scientific practice can be experienced explicitly and implicitly by constructing and testing models. Second, from the beginning of the activity, epistemic criteria such as empirical coherence, comprehensiveness, analogy, simplicity, and implementation were not strictly adapted and dynamically flexibly adapted according to the context. Third, the study of epistemic criteria in various contexts as well as in the context of this study will broaden the horizon of understanding the nature of scientific practice. Simulation activity, which is the context of this study, can lead to research related to computational thinking that will be more important in future society. We expect to be able to lead more discussions by furthering this study by elaborating and systematizing its context and method.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.295-301
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• 1995

Background: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. Results: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. Conclusion: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.

• Journal of Gifted/Talented Education
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• v.22 no.1
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• pp.1-21
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• 2012

The objective of this study is to suggest improvement plan for invention gifted education based on the awareness of teachers and professionals who related to the invention gifted education for the expansion and development of invention gifted education through improvement of relevant problems. To this end, invention gifted education system and its operational status were analyzed, and questionnaire survey on the awareness of the development plan and satisfaction level was conducted, targeting professionals related to the invention gifted education and teachers in charge of invention gifted education classes or gifted education center. The research results are as follows. First, the level of satisfaction on the invention gifted education was greater than normal (M=3.0) in general, but in the field of 'educational materials', 'teacher training programs' and 'human and material support system of support agencies', the level of satisfaction was relatively low, which requires expansion of the support. Second, it is necessary for Korean Intellectual Property Office and Korea Invention Promotion Association to designate and establish specialized research institution to play a key role in enhancing development and efficiency of invention gifted education. As a result of the questionnaire survey, it turned out that expectation and necessity of the specialized research agency was highly recognized. In particular, demand for 'research and development of gifted education method and materials' and 'research and development of teacher training materials and implementation of teacher training' was high among the key areas of the specialized research institution. Third, teachers and professionals related to the invention gifted education responded that 'invention knowledge' in the areas of invention knowledge and thinking and 'entrepreneurship' in the area of invention attitude was somewhat low toward the question on the level of the 9 characteristics of gifted students with invention talents which current beneficiaries of invention gifted education have, which leads to conclusion that review on the model for the selection of gifted children with invention talents as well as research and development of invention gifted education program to enhance characteristics with low levels is required. If long-term development plans and initiatives are deduced based on this, an effective framework for the invention gifted education will be established in the near future. In addition, it is expected that the differentiated political visions and goals will be established in connection with master plan for the promotion of gifted education.

• Journal of Embryo Transfer
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• v.16 no.3
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• pp.193-201
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• 2001

This study was designed to examine the factors affecting in fertilization and development of embryos in vitro, and to examine whether zone drilling by laser irradiation can improve the hatching rate of IVF embryos from DNA marker-proved Hanwoo. DNA markers related to marbling score were identified using DNA fingerprinting with Ml3 probe and restriction enzyme Hae III. Oocytes were aspirated from immature ovarian follicles using a combined method of rectal ovarian-palpation and transvaginal ultrasound-guidance(6.5MHz) under local anesthesia. The aspirated oocytes were washed twice with fresh D-PBS containing 5% FBS and were rewashed 4 to 5 times with TCM-199 containing 5% FBS. A morphological grade of I to IV was assigned to each oocyte. Data were analyzed using the GLM procedure of SAS. Sperm separation methods did not have any significant effect on cleavage or developmental abilities of IVF embryos. Significantly(P<0.05) higher cleavage rate was observed in embryos from GI(60.0%, 3/5), GII(69.2%, 18/26) and GIII(62.1%, 59/95) compared to embryos from GIV oocytes(36.2%, 25/69). And the developmental rate to blastocyst stage was higher(P<0.05) in embryos from GI(33.3%, 1/3) and GII oocytes(38.9%, 7/18) than those from GIII(16.9%,10/59) and GIV oocytes(4.0%, 1/25). There was no significant difference in development of IVF embryos to blastocyst by media for in vitro culture. Proportion of hatched blastocyst was significantly(P<0.05) higher in embryos received zona drilling by laser than those of non-drilled.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.253-259
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• 2017

The study examines changes in calcium volume on born by comparing two figures; one is measured by dual energy computed tomography(DECT) followed by applying variation in monochromatic energy selection(keV), material decomposition(MD), and material suppressed iodine(MSI) analysis, and the other is measured by conventional single source computed tomography(CSCT). For this study, based on CSCT images taken by using human mimicked phantom, 70, 100, 140 keV and MSI, MD material calcium weighting(MCW) and MD material iodine weighting(MIW) of DECT were applied respectively. Then calculated calcium volume was converted to Agatston score for comparison. Volume of human mimicked phantom was in inverse proportion to keV. The volume decreased while keV increased(p<0.05). The most similar DECT volumes were reconstructed at 70 keV, the difference was showed $35.8{\pm}12.2$ for rib, femur ($16.1{\pm}24.1$), pelvis($13.7{\pm}18.8$), and spine($179.0{\pm}61.8$). However, the volume of MSI was down for each organ; the volume of rib was 5.55%, femur(76.34%), pelvis(55.16%) and spine(87.58%). The volume of MSI decreased 55.9% for rib, femur(80.7%), pelvis(69.6%) and spine(54.2%) while MD MIW reduced for rib(83.51%), femur(87.68%), pelvis(86.64%), and spine(82.62%). With the results, the study found that outcomes were affected by the method which examiners employed. When using DECT, calcium volume of born dropped with keV increased. It also found that the most similar DECT images were reconstructed at 70 keV. The results of experiments implied that the users of MSI and MD should be cautious of errors as there are big differences in scores between those two methods.

• The Korean Journal of Mycology
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• v.27 no.6 s.93
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• pp.394-398
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• 1999

Taxonomic and genetic analysis of Phytophthora species belonging to six different morphological groups (GI, GII, GIII, GIV, GV, GVI) was conducted using RAPD method. Amplified fragments ranged $0.3{\sim}3.2$ kb in their molecular weights. Among total of 145 bands, there were 109 polymorphic bands. Seven isolates of P. infestans showed high similarities of $0.92{\sim}0.99$, and P. infestans isolate 3 from potato showed similarities of $0.93{\sim}0.95$ compared with other P. infestans. Among isolates of P. capsici, similarities of $0.77{\sim}0.86$ were observed and they were grouped in 80% level. P. cinnamomi and P. cryptogea isolates which belonging to group GVI showed very similar RAPD fingerprinting pattern. Primers OPA-04, OPA-17, OPA-18, OPA-19, and OPB-12 showed high level of differences among the tested isolates in major bands and molecular weights. The similarity between the isolates was 0.67. P. megasperma and P. sojae in group GV showed similarity of 0.65. These two isolates showed big differences in single major band in reactions with primers OPA-08, OPA-17, and OPA-19. Phytophthora-specific and P. infestans-specific molecular markers were also selected with one of the random primers tested. In reaction with primer OPA-20, all the genus Phytophthora showed common band at 600 bp, and all the P. infestans isolates showed specific band at 680 bp. These markers can be useful for identification of Phytophthora speices or P. infestans. As a result, P. infestans isolated from tomato and/or potato can easily be differentiated from other Phytophthora species with this primer.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.616-621
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• 2005

Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.

• Journal of the Korean Institute of Gas
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• v.5 no.4 s.16
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• pp.1-7
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• 2001

This paper presents a 'consequence analysis' for vapor cloud explosions caused by heavy gas leakages from commercially used storage tanks at petrochemical plants. Particularly, this paper emphasizes on evaluating the results of various vapor cloud explosion accidents from Butane storage tanks. Also this paper analyses the impact of variables on the accidents in order to acquire the optimum conditions for variables. $SuperChems^{TM}$ Professional Edition was applied to analyse the impact (If atmospheric and other variables in the situation where vapor cloud continuously disperses from the ground level. Under the assumption that practical operating conditions are selected as a standard condition, and Butane leaks from the storage tank for 15 minutes, the results show that the maximum distance of LFL (Lower Flammable Limit) was 52 meters and overpressure by the vapor cloud explosion was 1 psi at 128.2 meters. It is observed that the impact of the variables on accidental Butane storage tank leakage mainly varied upon atmospheric stability, wind velocity, pipe line size, visible length, etc., and changes in the simulation result occurred as the variables varied. The maximum distance of the LFL (Lower Flammable Limit) increased as the visible length became shorter, the size of the leak became larger, the wind velocity was decreased, and the climatic conditions became more stable. Thus, by analysing the variables that influence the simulation results of explosions of Butane storage tanks containing heavy gases, I am presenting the most appropriate method for 'consequence analysis' and the selection of standards for suitable values of variables, to obtain the most optimal conditions for the best results.