• The Journal of Korean Academy of Prosthodontics
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• v.46 no.1
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• pp.65-82
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• 2008

Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.188-198
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• 2002

Background: Reoperations on the aortic root or the ascending aorta are being performed with increasing frequency and remain a challenging problem. This study was performed to analyze the results of reoperations on the ascending aorta and aortic root. Material and Method: Between May 1995 and April 2001, 30 patients had reoperations on the ascending aorta and aortic root and were reviewed retrospectively. The mean interval between the previous repair and the actual reoperation was 56 months(range 3 to 142 months). Seven patients(23.3%) had two or more previous operations. The indications for reoperations were true aneurysm in 7 patients(23.3%), prosthetic valve endocarditis in 6(20%), false aneurysm in 5(16.7%), paravalvular leak associated with Behcet's disease in 4(13.3%), malfunction of prosthetic aortic valve in 4(13.3%), aortic dissection in 3(10%), and annuloaortic ectasia in 1(3.3%). The principal reoperations performed were aortic root replacement in 17 patients(56.7%), replacement of the ascending aorta in 8(26.7%), aortic and mitral valve replacement with reconstruction of fibrous trigone in 2(6.6%), patch aortoplasty in 2(6.6%), and aortic valve replacement after Bentall operation in 1 (3.3%). The cardiopulmonary bypass was started before sternotomy in 7 patients and the hypothermic circulatory arrest was used in 16(53.3%). The mean time of circulatory arrest, total bypass, and aortic crossclamp were 20$\pm$ 12 minutes, 228$\pm$56 minutes, and 143$\pm$62 minutes, respectively Result: There were three early deaths(10%). The postoperative complications were reoperation for bleeding in 7 patients(23.3%), cardiac complications in 5(16.7%), transient acute renal failure in 2(6.6%), transient focal seizure in 2(6.6%), and the others in 5. The mean follow-up was 22.8 $\pm$20.5 months. There were two late deaths(7.4%). The actuarial survival was 92.6$\pm$5.0% at 6 years. One patient required reoperation for complication of reoperation on the ascending aorta and aortic root(3.7%). The 1- and 6-year actuarial freedom from reoperation was 100% and 83.3$\pm$15.2%, respectively. One patient with Behcet's disease are waiting for reoperation due to false aneurysm, which developed after aortic root replacement with homograft. There were no thromboembolisms or anticoagulant related complications. Conclusions: This study suggests that reoperations on the ascending aorta and aortic root can be performed with acceptable early mortality and morbidity, and adequate surgical strategies according to the pathologi conditions are critical to the prevention of the reoperation.

• Journal of The Korean Society of Grassland and Forage Science
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• v.34 no.2
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• pp.129-140
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• 2014

This study was performed to evaluate the effects of replacing basic total mixed ration (TMR) with fermented soybean curd, Artemisia princeps Pampanini cv. Sajabal, and spent coffee grounds by-product on rumen microbial fermentation in vitro. Soybean in the basic TMR diet (control) was replaced by the following 9 treatments (3 replicates): maximum amounts of soybean curd (SC); fermented SC (FSC); 3, 5, and 10% FSC + fermented A. princeps Pampanini cv. Sajabal (1:1, DM basis, FSCS); and 3, 5, 10% FSC + fermented coffee meal (1:1, DM basis, FSCC) of soybean. FSC, FSCS, and FSCC were fermented using Lactobacillus acidophilus ATCC 496, Lactobacillus fermentum ATCC 1493, Lactobacillus plantarum KCTC 1048, and Lactobacillus casei IFO 3533. Replacing dairy cow TMR with FSC treatment led to a pH value of 6 after 8 h of incubation-the lowest value measured (p<0.05), and FSCS and FSCC treatments were higher than SC and FSC treatment after 6 h (p<0.05). Gas production was higher in response to 3% FSC and FSCC treatments than the control after 4-10 h. Dry matter digestibility was increased 0-12 h after FSC treatment (p<0.05) and was the highest after 24 h of 10% FSCS treatment. $NH_3-N$ concentration was the lowest after 24 h of FSC treatment (p<0.05). Microbial protein content increased in response to treatments that had been fermented by the Lactobacillus spp. compared to control and SC treatments (p<0.05). The total concentration of volatile fatty acids (VFAs) was increased after 6-12 h of FSC treatment (p<0.05), while the highest acetate proportion was observed 24 h after 5% and 10% FSCS treatments. The FSC of propionate proportion was increased for 0-10 h compared with among treatments (p<0.05). The highest acetate in the propionate ration was observed after 12 h of SC treatment and the lowest with FSCS 3% treatment after 24 h. Methane ($CH_4$) emulsion was lower with A. princeps Pampanini cv. Sajabal and spent coffee grounds treatments than with the control, SC, and FSC treatments. These experiments were designed to replace the by-products of dairy cow TMR with SC, FSC, FSCS, and FSCC to improve TMR quality. Condensed tannins contained in FSCS and FSCC treatments, which reduced $CH_4$ emulsion in vitro, decreased rumen microbial fermentation during the early incubation time. Therefore, future experiments are required to develop a rumen continuous culture system and an in vivo test to optimize the percentages of FSC, FSCS, and FSCC in the TMR diet of the dairy cows.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.671-682
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• 1996

Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

• Cartoon and Animation Studies
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• s.41
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• pp.455-486
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• 2015

The 3D printing technology, which started from the patent registration in 1986, was a technology that did not attract attention other than from some companies, due to the lack of awareness at the time. However, today, as expiring patents are appearing after the passage of 20 years, the price of 3D printers have decreased to the level of allowing purchase by individuals and the technology is attracting attention from industries, in addition to the general public, such as by naturally accepting 3D and to share 3D data, based on the generalization of online information exchange and improvement of computer performance. The production capability of 3D printers, which is based on digital data enabling digital transmission and revision and supplementation or production manufacturing not requiring molding, may provide a groundbreaking change to the process of manufacturing, and may attain the same effect in the character merchandise sector. Using a 3D printer is becoming a necessity in various figure merchandise productions which are in the forefront of the kidult culture that is recently gaining attention, and when predicting the demand by the industrial sites related to such character merchandise and when considering the more inexpensive price due to the expiration of patents and sharing of technology, expanding opportunities and sectors of employment and cultivating manpower that are able to engage in further creative work seems as a must, by introducing education courses cultivating manpower that can utilize 3D printers at the education field. However, there are limits in the information that can be obtained when seeking to introduce 3D printers in school education. Because the press or information media only mentions general information, such as the growth of the industrial size or prosperous future value of 3D printers, the research level of the academic world also remains at the level of organizing contents in an introductory level, such as by analyzing data on industrial size, analyzing the applicable scope in the industry, or introducing the printing technology. Such lack of information gives rise to problems at the education site. There would be no choice but to incur temporal and opportunity expenses, since the technology would only be able to be used after going through trials and errors, by first introducing the technology without examining the actual information, such as through comparing the strengths and weaknesses. In particular, if an expensive equipment introduced does not suit the features of school education, the loss costs would be significant. This research targeted general users without a technology-related basis, instead of specialists. By comparing the strengths and weaknesses and analyzing the problems and matters requiring notice upon use, pursuant to the representative technologies, instead of merely introducing the 3D printer technology as had been done previously, this research sought to explain the types of features that a 3D printer should have, in particular, when required in education relating to the development of figure merchandise as an optional cultural contents at cartoon-related departments, and sought to provide information that can be of practical help when seeking to provide education using 3D printers in the future. In the main body, the technologies were explained by making a classification based on a new perspective, such as the buttress method, types of materials, two-dimensional printing method, and three-dimensional printing method. The reason for selecting such different classification method was to easily allow mutual comparison of the practical problems upon use. In conclusion, the most suitable 3D printer was selected as the printer in the FDM method, which is comparatively cheap and requires low repair and maintenance cost and low materials expenses, although rather insufficient in the quality of outputs, and a recommendation was made, in addition, to select an entity that is supportive in providing technical support.

• Journal of Intelligence and Information Systems
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• v.22 no.4
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• pp.109-122
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• 2016

Recently, big data analysis has developed into a field of interest to individuals and non-experts as well as companies and professionals. Accordingly, it is utilized for marketing and social problem solving by analyzing the data currently opened or collected directly. In Korea, various companies and individuals are challenging big data analysis, but it is difficult from the initial stage of analysis due to limitation of big data disclosure and collection difficulties. Nowadays, the system improvement for big data activation and big data disclosure services are variously carried out in Korea and abroad, and services for opening public data such as domestic government 3.0 (data.go.kr) are mainly implemented. In addition to the efforts made by the government, services that share data held by corporations or individuals are running, but it is difficult to find useful data because of the lack of shared data. In addition, big data traffic problems can occur because it is necessary to download and examine the entire data in order to grasp the attributes and simple information about the shared data. Therefore, We need for a new system for big data processing and utilization. First, big data pre-analysis technology is needed as a way to solve big data sharing problem. Pre-analysis is a concept proposed in this paper in order to solve the problem of sharing big data, and it means to provide users with the results generated by pre-analyzing the data in advance. Through preliminary analysis, it is possible to improve the usability of big data by providing information that can grasp the properties and characteristics of big data when the data user searches for big data. In addition, by sharing the summary data or sample data generated through the pre-analysis, it is possible to solve the security problem that may occur when the original data is disclosed, thereby enabling the big data sharing between the data provider and the data user. Second, it is necessary to quickly generate appropriate preprocessing results according to the level of disclosure or network status of raw data and to provide the results to users through big data distribution processing using spark. Third, in order to solve the problem of big traffic, the system monitors the traffic of the network in real time. When preprocessing the data requested by the user, preprocessing to a size available in the current network and transmitting it to the user is required so that no big traffic occurs. In this paper, we present various data sizes according to the level of disclosure through pre - analysis. This method is expected to show a low traffic volume when compared with the conventional method of sharing only raw data in a large number of systems. In this paper, we describe how to solve problems that occur when big data is released and used, and to help facilitate sharing and analysis. The client-server model uses SPARK for fast analysis and processing of user requests. Server Agent and a Client Agent, each of which is deployed on the Server and Client side. The Server Agent is a necessary agent for the data provider and performs preliminary analysis of big data to generate Data Descriptor with information of Sample Data, Summary Data, and Raw Data. In addition, it performs fast and efficient big data preprocessing through big data distribution processing and continuously monitors network traffic. The Client Agent is an agent placed on the data user side. It can search the big data through the Data Descriptor which is the result of the pre-analysis and can quickly search the data. The desired data can be requested from the server to download the big data according to the level of disclosure. It separates the Server Agent and the client agent when the data provider publishes the data for data to be used by the user. In particular, we focus on the Big Data Sharing, Distributed Big Data Processing, Big Traffic problem, and construct the detailed module of the client - server model and present the design method of each module. The system designed on the basis of the proposed model, the user who acquires the data analyzes the data in the desired direction or preprocesses the new data. By analyzing the newly processed data through the server agent, the data user changes its role as the data provider. The data provider can also obtain useful statistical information from the Data Descriptor of the data it discloses and become a data user to perform new analysis using the sample data. In this way, raw data is processed and processed big data is utilized by the user, thereby forming a natural shared environment. The role of data provider and data user is not distinguished, and provides an ideal shared service that enables everyone to be a provider and a user. The client-server model solves the problem of sharing big data and provides a free sharing environment to securely big data disclosure and provides an ideal shared service to easily find big data.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.472-480
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• 1998

We reviewed the surgical results of intracardiac lateral tunnel Fontan procedure for the repair of functional single ventricles. Between 1990 and 1996, 104 patients underwent total cavopulmonary anastomosis. Patients' age and body weight averaged 35.9(range 10 to 173) months and 12.8(range 6.5 to 37.8) kg. Preoperative diagnoses included 18 tricuspid atresias and 53 double inlet ventricles with univentricular atrioventricular connection and 33 other complex lesions. Previous palliative operations were performed in 50 of these patients, including 37 systemic to pulmonary artery shunts, 13 pulmonary artery bandings, 15 surgical atrial septectomies, 2 arterial switch procedures, 2 resections of subaortic conus, 2 repairs of total anomalous pulmonary venous connection and 1 Damus-Stansel-Kaye procedure. In 19 patients bidirectional cavopulmonary shunt operation was performed before the Fontan procedure and in 1 patient a Kawashima procedure was required. Preoperative hemodynamics revealed a mean pulmonary artery pressure of 14.6(range 5 to 28) mmHg, a mean pulmonary vascular resistance of 2.2(range 0.4 to 6.9) wood-unit, a mean pulmonary to systemic flow ratio of 0.9(range 0.3 to 3.0), a mean ventricular end-diastolic pressure of 9.0 (range 3.0 to 21.0) mmHg, and a mean arterial oxygen saturation of 76.0(range 45.6 to 88.0)%. The operative procedure consisted of a longitudinal right atriotomy 2cm lateral to the terminal crest up to the right atrial auricle, followed by the creation of a lateral tunnel connecting the orifices of either the superior caval vein or the right atrial auricle to the inferior caval vein, using a Gore-Tex vascular graft with or without a fenestration. Concomitant procedures at the time of Fontan procedure included 22 pulmonary artery angioplasties, 21 atrial septectomies, 4 atrioventricular valve replacements or repairs, 4 corrections of anomalous pulmonary venous connection, and 3 permanent pacemaker implantations. In 31, a fenestration was created, and in 1 an adjustable communication was made in the lateral tunnel pathway. One lateral tunnel conversion was performed in a patient with recurrent intractable tachyarrhythmia 4 years after the initial atriopulmonary connection. Post-extubation hemodynamic data revealed a mean pulmonary artery pressure of 12.7(range 8 to 21) mmHg, a mean ventricular end-diastolic pressure of 7.6(range 4 to 12) mmHg, and a mean room-air arterial oxygen saturation of 89.9(range 68 to 100) %. The follow-up duration was, on average, 27(range 1 to 85) months. Post-Fontan complications included 11 prolonged pleural effusions, 8 arrhythmias, 9 chylothoraces, 5 of damage to the central nervous system, 5 infectious complications, and 4 of acute renal failure. Seven early(6.7%) and 5 late(4.8%) deaths occured. These results proved that the lateral tunnel Fontan procedure provided excellent hemodynamic improvements with acceptable mortality and morbidity for hearts with various types of functional single ventricle.

• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.555-577
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• 1989

This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

• (The) Research of the performance art and culture
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• no.36
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• pp.441-471
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• 2018

East Coast Gut, Korean shamanism ritual on its east coastal area, is a Gut held in fishing villages alongside Korean east coastal area from Goseong area in Gangwon-Do to Busan area. East Coast Gut is performed in a series mainly by a successor shaman, Korean shaman, who hasn't received any spiritual power from a God, and the implications of this thesis lie in that we look over the learning aspects of Seokchool Kim shaman group among other East Coast Gut successor shaman groups after dividing it into 2 categories, successor shaman and learner shaman and based upon this, we reveal the meaning of the learning aspects of East Coast Gut. For successor shamans, home means the field of education. Since they are little, they chased Gut events performing dance in a series to accumulate onsite experiences. However, in the families of successor shamans that have passed their shaman work down from generation to generation, their descendents didn't inherit shaman work any longer, which changed the way of succession and learning of shaman work. Since 1980's, Gut has been officially acknowledged as a kind of general art embracing songs, dance and music and designated as a cultural asset of the state and each city and province, and at art universities, it was adopted as a required course for its related major, which caused new learner shamans who majored in shamanism to emerge. These learner shamans are taking systematical succession lessons on the performance skills of East Coast Byeolshin Gut at universities, East Coast Byeolshin Gut preservation community, any places where Guts are held and etc.. As changes along time, the successor shamans accepted the learner shamans to pass shaman work down and changes appeared in the notion of towners who accept the performer groups of Gut and Gut itself. Unlike the past, as Gut has been acknowledged as the origin of Korean traditional arts and as the product of compresensive learning on songs, dance and music and it was designated as a national intangible cultural asset, shaman's social status and personal pride and dignity has become very high. As shaman has become positioned as the traditional artist getting both national and international recognition unlike its past image of getting despised, at the site of Gut event or even in the relation with towners, their status and the treatment they get became far different. Even towners, along with shift in shaman groups' generation, take position to acknowledge and accept the addition of new learning elements unlike the past. Even in every town, rather than just insisting on the type or the event purpose of traditional Gut, they think over on the type of festival and the main direction of a variety of Guts with which all of towners can mingle with each other. They are trying to find new meanings in the trend of changing Gut and the adaptation of new generation to this. In our reality of Gut events getting minimalized along with rapid change of times, East Coast Gut is still very actively performed in a series until now compared to Guts in other regions. This is because following the successor shamans who have struggled to preserve the East Coast Gut, the learner shamans are actively inflowing and the series performance groups preserve the origin of Gut and try hard to use Gut as art contents. Besides, the learner shamans systematically organize what they learned on shamanism from the successor shamans and get prepared and try to hand it down to descendents in the closest possible way to preserve its origin. In the future, East Coast Gut will be succeeded by the learner shamans from the last successor shamans to inherit its tradition and develop it to adapt to the times.