• The Korean Journal of Air & Space Law and Policy
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• v.23 no.2
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• pp.31-66
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• 2008

Until Montreal Convention was established in 1999, the Warsaw System is undoubtedly accepted private international air law treaty and has played major role on the carrier's liability in international aviation transport industry. But the whole Warsaw System, though it was revised many times to meet the rapid developments of the aviation transport industry, is so complicated, tangled and outdated. This thesis, therefore, aim to introduce the Montreal Convention by interpreting it as a new legal instrument on the air carrier's liability, specially on the passenger's, and analyzing all the issues relating to it. The Montreal Convention markedly changed the rules governing international carriage by air. The Montreal Convention has modernized and consolidated the old Warsaw System of international instruments of private international air law into one legal instrument. One of the most significant features of the Montreal Convention is that it sifted its priority to the protection of the interest of the consumers from the protection of the carrier which originally the Warsaw Convention intended to protect the fledgling international air transport business. Two major features of the Montreal Convention adopts are the Two-tier Liability System and the Fifth Jurisdiction. In case of death or bodily injury to passengers, the Montreal Convention introduces a two-tier liability system. The first tier includes strict liability up to 100,000SDR, irrespective of carriers' fault. The second tier is based on presumption of fault of carrier and has no limit of liability. Regarding Jurisdiction, the Montreal Convention expands upon the four jurisdiction in which the carrier could be sued by adding a fifth jurisdiction, i.e., a passenger can bring suit in a country in which he or she has their permanent and principal residence and in which the carrier provides a services for the carriage of passengers by either its own aircraft or through a commercial agreement. Other features are introducing the advance payment, electronic ticketing, compulsory insurance and regulation on the contracting and actual carrier etc. As we see some major features of the Montreal Convention, the Convention heralds the single biggest change in the international aviation liability and there can be no doubt it will prevail the international aviation transport world in the future. Our government signed this Convention on 20th Sep. 2007 and it came into effect on 29th Dec. 2007 domestically. Thus, it was recognized that domestic carriers can adequately and independently manage the change of risks of liability. I, therefore, would like to suggest our country's aviation industry including newly-born low cost carrier prepare some countermeasures domestically that are necessary to the enforcement of the Convention.

• Journal of Intelligence and Information Systems
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• v.18 no.2
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• pp.143-156
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• 2012

People easily believe that news and stock index are closely related. They think that securing news before anyone else can help them forecast the stock prices and enjoy great profit, or perhaps capture the investment opportunity. However, it is no easy feat to determine to what extent the two are related, come up with the investment decision based on news, or find out such investment information is valid. If the significance of news and its impact on the stock market are analyzed, it will be possible to extract the information that can assist the investment decisions. The reality however is that the world is inundated with a massive wave of news in real time. And news is not patterned text. This study suggests the stock-index invest model based on "News Big Data" opinion mining that systematically collects, categorizes and analyzes the news and creates investment information. To verify the validity of the model, the relationship between the result of news opinion mining and stock-index was empirically analyzed by using statistics. Steps in the mining that converts news into information for investment decision making, are as follows. First, it is indexing information of news after getting a supply of news from news provider that collects news on real-time basis. Not only contents of news but also various information such as media, time, and news type and so on are collected and classified, and then are reworked as variable from which investment decision making can be inferred. Next step is to derive word that can judge polarity by separating text of news contents into morpheme, and to tag positive/negative polarity of each word by comparing this with sentimental dictionary. Third, positive/negative polarity of news is judged by using indexed classification information and scoring rule, and then final investment decision making information is derived according to daily scoring criteria. For this study, KOSPI index and its fluctuation range has been collected for 63 days that stock market was open during 3 months from July 2011 to September in Korea Exchange, and news data was collected by parsing 766 articles of economic news media M company on web page among article carried on stock information>news>main news of portal site Naver.com. In change of the price index of stocks during 3 months, it rose on 33 days and fell on 30 days, and news contents included 197 news articles before opening of stock market, 385 news articles during the session, 184 news articles after closing of market. Results of mining of collected news contents and of comparison with stock price showed that positive/negative opinion of news contents had significant relation with stock price, and change of the price index of stocks could be better explained in case of applying news opinion by deriving in positive/negative ratio instead of judging between simplified positive and negative opinion. And in order to check whether news had an effect on fluctuation of stock price, or at least went ahead of fluctuation of stock price, in the results that change of stock price was compared only with news happening before opening of stock market, it was verified to be statistically significant as well. In addition, because news contained various type and information such as social, economic, and overseas news, and corporate earnings, the present condition of type of industry, market outlook, the present condition of market and so on, it was expected that influence on stock market or significance of the relation would be different according to the type of news, and therefore each type of news was compared with fluctuation of stock price, and the results showed that market condition, outlook, and overseas news was the most useful to explain fluctuation of news. On the contrary, news about individual company was not statistically significant, but opinion mining value showed tendency opposite to stock price, and the reason can be thought to be the appearance of promotional and planned news for preventing stock price from falling. Finally, multiple regression analysis and logistic regression analysis was carried out in order to derive function of investment decision making on the basis of relation between positive/negative opinion of news and stock price, and the results showed that regression equation using variable of market conditions, outlook, and overseas news before opening of stock market was statistically significant, and classification accuracy of logistic regression accuracy results was shown to be 70.0% in rise of stock price, 78.8% in fall of stock price, and 74.6% on average. This study first analyzed relation between news and stock price through analyzing and quantifying sensitivity of atypical news contents by using opinion mining among big data analysis techniques, and furthermore, proposed and verified smart investment decision making model that could systematically carry out opinion mining and derive and support investment information. This shows that news can be used as variable to predict the price index of stocks for investment, and it is expected the model can be used as real investment support system if it is implemented as system and verified in the future.

• Journal of Korean Society of Transportation
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• v.20 no.7
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• pp.155-166
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• 2002

Since 1990s. there has been an increasing number of traffic accidents at intersection. which requires more urgent measures to insure safety on intersection. This study set out to analyze the road conditions, traffic conditions and traffic operation conditions on signalized intersection. to identify the elements that would impose obstructions in safety, and to develop a traffic accident prediction model to evaluate the safety of an intersection using the cop relation between the elements and an accident. In addition, the focus was made on suggesting appropriate traffic safety policies by dealing with the danger elements in advance and on enhancing the safety on the intersection in developing a traffic accident prediction model fir a signalized intersection. The data for the study was collected at an intersection located in Wonju city from January to December 2001. It consisted of the number of accidents, the road conditions, the traffic conditions, and the traffic operation conditions at the intersection. The collected data was first statistically analyzed and then the results identified the elements that had close correlations with accidents. They included the area pattern, the use of land, the bus stopping activities, the parking and stopping activities on the road, the total volume, the turning volume, the number of lanes, the width of the road, the intersection area, the cycle, the sight distance, and the turning radius. These elements were used in the second correlation analysis. The significant level was 95% or higher in all of them. There were few correlations between independent variables. The variables that affected the accident rate were the number of lanes, the turning radius, the sight distance and the cycle, which were used to develop a traffic accident prediction model formula considering their distribution. The model formula was compared with a general linear regression model in accuracy. In addition, the statistics of domestic accidents were investigated to analyze the distribution of the accidents and to classify intersections according to the risk level. Finally, the results were applied to the Spearman-rank correlation coefficient to see if the model was appropriate. As a result, the coefficient of determination was highly significant with the value of 0.985 and the ranks among the intersections according to the risk level were appropriate too. The actual number of accidents and the predicted ones were compared in terms of the risk level and they were about the same in the risk level for 80% of the intersections.

• Journal of Intelligence and Information Systems
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• v.19 no.1
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• pp.35-55
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• 2013

Information technology is a critical resource necessary for any company hoping to support and realize its strategic goals, which contribute to growth promotion and sustainable development. The selection of information technology and its strategic use are imperative for the enhanced performance of every aspect of company management, leading a wide range of companies to have invested continuously in information technology. Despite researchers, managers, and policy makers' keen interest in how information technology contributes to organizational performance, there is uncertainty and debate about the result of information technology investment. In other words, researchers and managers cannot easily identify the independent factors that can impact the investment performance of information technology. This is mainly owing to the fact that many factors, ranging from the internal components of a company, strategies, and external customers, are interconnected with the investment performance of information technology. Using an agent-based simulation technique, this research extracts factors expected to affect investment performance on information technology, simplifies the analyses of their relationship with economic modeling, and examines the performance dependent on changes in the factors. In terms of economic modeling, I expand the model that highlights the way in which product quality moderates the relationship between information technology investments and economic performance (Thatcher and Pingry, 2004) by considering the cost of information technology investment and the demand creation resulting from product quality enhancement. For quality enhancement and its consequences for demand creation, I apply the concept of information quality and decision-maker quality (Raghunathan, 1999). This concept implies that the investment on information technology improves the quality of information, which, in turn, improves decision quality and performance, thus enhancing the level of product or service quality. Additionally, I consider the effect of word of mouth among consumers, which creates new demand for a product or service through the information diffusion effect. This demand creation is analyzed with an agent-based simulation model that is widely used for network analyses. Results show that the investment on information technology enhances the quality of a company's product or service, which indirectly affects the economic performance of that company, particularly with regard to factors such as consumer surplus, company profit, and company productivity. Specifically, when a company makes its initial investment in information technology, the resultant increase in the quality of a company's product or service immediately has a positive effect on consumer surplus, but the investment cost has a negative effect on company productivity and profit. As time goes by, the enhancement of the quality of that company's product or service creates new consumer demand through the information diffusion effect. Finally, the new demand positively affects the company's profit and productivity. In terms of the investment strategy for information technology, this study's results also reveal that the selection of information technology needs to be based on analysis of service and the network effect of customers, and demonstrate that information technology implementation should fit into the company's business strategy. Specifically, if a company seeks the short-term enhancement of company performance, it needs to have a one-shot strategy (making a large investment at one time). On the other hand, if a company seeks a long-term sustainable profit structure, it needs to have a split strategy (making several small investments at different times). The findings from this study make several contributions to the literature. In terms of methodology, the study integrates both economic modeling and simulation technique in order to overcome the limitations of each methodology. It also indicates the mediating effect of product quality on the relationship between information technology and the performance of a company. Finally, it analyzes the effect of information technology investment strategies and information diffusion among consumers on the investment performance of information technology.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.161-167
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• 2018

Purpose : This study evaluates the usefulness of the Modified Hybrid-VMAT scheme with consideration of background radiation when establishing a treatment plan for multiple bone metastatic cancer including multiple tumors on the same axis. Materials and Methods : The subjects of this study consisted of five patients with multiple bone metastatic cancer on the same axis. The planning target volume(PTV) prescription dose was 30 Gy, and the treatment plan was established using Ray Station(Ray station, 5.0.2.35, Sweden). In the treatment plan for each patient, two or more tumors were set as one isocenter. A volumetric modulated arc therapy(VMAT) plan, a hybrid VMAT(h) plan with no consideration of background radiation, and a modified hybrid VMAT(mh) with consideration of background radiation were established. Then, using each dose volume histogram(DVH), the PTV maximum dose($D_{max}$), mean dose($D_{mean}$), conformity index(CI), and homogeneity index(HI) were compared among the plans. In addition, the organ at risk(OAR) of each treatment site was evaluated, and the total MU(Monitor Unit) and treatment time were also analyzed. Results : The PTV $D_{max}$ values of VMAT, VMAT(h) and VMAT(mh) were 3188.33 cGy, 3526 cGy, and 3285.67 cGy, the $D_{mean}$ values were 3081 cGy, 3252 cGy, and 3094 cGy; the CI values were $1.35{\pm}0.19$, $1.43{\pm}0.12$, and $1.30{\pm}0.06$; the HI values were $1.06{\pm}0.01$, $1.14{\pm}0.06$, and $1.09{\pm}0.02$; and the VMAT(h) OAR value was increased 3 %, and VMAT(mh) OAR value was decreased 18 %, respectively. Furthermore, the mean MU values were 904.90, 911.73, and 1202.13, and the mean beam on times were $128.67{\pm}10.97$, $167.33{\pm}7.57$, and $190.33{\pm}4.51$ respectively. Conclusions : Applying Modified Hybrid-VMAT when treating multiple targets can prevent overdose by correcting the overlapping of doses. Furthermore, it is possible to establish a treatment plan that can protect surrounding normal organs more effectively while satisfying the inclusion of PTV dose. Long-term follow-up of many patients is necessary to confirm the clinical efficacy of Modified Hybrid-VMAT.

• The Korean Society of Law and Medicine
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• v.21 no.2
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• pp.105-162
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• 2020

In the pandemic of infectious disease, restrictions of individual liberty have been justified in the name of public health and public interest. In March 2020, the National Assembly of the Republic of Korea passed the revised bill of the 「Infectious Disease Control and Prevention Act.」 The revised bill newly established the legal basis for forced testing and disclosure of the information of confirmed cases, and also raised the penalties for violation of self-isolation and treatment refusal. This paper examines whether and how these individual liberty limiting clauses be justified, and if so on what ethical and philosophical grounds. The authors propose the theories of the philosophy of law related to the justifiability of liberty-limiting measures by the state and conceptualized the dual-aspect of applying the liberty-limiting principle to the infected patient. In COVID-19 pandemic crisis, the infected person became the 'Patient as Victim and Vector (PVV)' that posits itself on the overlapping area of 'harm to self' and 'harm to others.' In order to apply the liberty-limiting principle proposed by Joel Feinberg to a pandemic with uncertainties, it is necessary to extend the harm principle from 'harm' to 'risk'. Under the crisis with many uncertainties like COVID-19 pandemic, this shift from 'harm' to 'risk' justifies the state's preemptive limitation on individual liberty based on the precautionary principle. This, at the same time, raises concerns of overcriminalization, i.e., too much limitation of individual liberty without sufficient grounds. In this article, we aim to propose principles regarding how to balance between the precautionary principle for preemptive restrictions of liberty and the concerns of overcriminalization. Public health crisis such as the COVID-19 pandemic requires a population approach where the 'population' rather than an 'individual' works as a unit of analysis. We propose the second expansion of the harm principle to be applied to 'population' in order to deal with the public interest and public health. The new concept 'risk to population,' derived from the two arguments stated above, should be introduced to explain the public health crisis like COVID-19 pandemic. We theorize 'the extended harm principle' to include the 'risk to population' as a third liberty-limiting principle following 'harm to others' and 'harm to self.' Lastly, we examine whether the restriction of liberty of the revised 「Infectious Disease Control and Prevention Act」 can be justified under the extended harm principle. First, we conclude that forced isolation of the infected patient could be justified in a pandemic situation by satisfying the 'risk to the population.' Secondly, the forced examination of COVID-19 does not violate the extended harm principle either, based on the high infectivity of asymptomatic infected people to others. Thirdly, however, the provision of forced treatment can not be justified, not only under the traditional harm principle but also under the extended harm principle. Therefore it is necessary to include additional clauses in the provision in order to justify the punishment of treatment refusal even in a pandemic.

• Journal of Intelligence and Information Systems
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• v.24 no.4
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• pp.67-83
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• 2018

The Korean film industry with significant increase every year exceeded the number of cumulative audiences of 200 million people in 2013 finally. However, starting from 2015 the Korean film industry entered a period of low growth and experienced a negative growth after all in 2016. To overcome such difficulty, stakeholders like production company, distribution company, multiplex have attempted to maximize the market returns using strategies of predicting change of market and of responding to such market change immediately. Since a film is classified as one of experiential products, it is not easy to predict a box office record and the initial number of audiences before the film is released. And also, the number of audiences fluctuates with a variety of factors after the film is released. So, the production company and distribution company try to be guaranteed the number of screens at the opining time of a newly released by multiplex chains. However, the multiplex chains tend to open the screening schedule during only a week and then determine the number of screening of the forthcoming week based on the box office record and the evaluation of audiences. Many previous researches have conducted to deal with the prediction of box office records of films. In the early stage, the researches attempted to identify factors affecting the box office record. And nowadays, many studies have tried to apply various analytic techniques to the factors identified previously in order to improve the accuracy of prediction and to explain the effect of each factor instead of identifying new factors affecting the box office record. However, most of previous researches have limitations in that they used the total number of audiences from the opening to the end as a target variable, and this makes it difficult to predict and respond to the demand of market which changes dynamically. Therefore, the purpose of this study is to predict the weekly number of audiences of a newly released film so that the stakeholder can flexibly and elastically respond to the change of the number of audiences in the film. To that end, we considered the factors used in the previous studies affecting box office and developed new factors not used in previous studies such as the order of opening of movies, dynamics of sales. Along with the comprehensive factors, we used the machine learning method such as Random Forest, Multi Layer Perception, Support Vector Machine, and Naive Bays, to predict the number of cumulative visitors from the first week after a film release to the third week. At the point of the first and the second week, we predicted the cumulative number of visitors of the forthcoming week for a released film. And at the point of the third week, we predict the total number of visitors of the film. In addition, we predicted the total number of cumulative visitors also at the point of the both first week and second week using the same factors. As a result, we found the accuracy of predicting the number of visitors at the forthcoming week was higher than that of predicting the total number of them in all of three weeks, and also the accuracy of the Random Forest was the highest among the machine learning methods we used. This study has implications in that this study 1) considered various factors comprehensively which affect the box office record and merely addressed by other previous researches such as the weekly rating of audiences after release, the weekly rank of the film after release, and the weekly sales share after release, and 2) tried to predict and respond to the demand of market which changes dynamically by suggesting models which predicts the weekly number of audiences of newly released films so that the stakeholders can flexibly and elastically respond to the change of the number of audiences in the film.

• (The) Research of the performance art and culture
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• no.38
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• pp.349-383
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• 2019

This discussion is focused on Donghaeanbyulsingut's 'gutchum-pan to pray'. 'Gutchum-pan to pray' is repeated in almost all of the geori in Byulsingut, so it is a crucial chum-pan that can never be disregarded in understanding Byulsingutchum. Meanwhile, it supposes that Donghaeanbyulsingut is grounded on the activity of producing 'praying (words) and dance (motions)' within its relationship with the structure of capitalistic society along with the context of traditional rituals. The motion that is newly generated as a response to the concrete expression of 'praying' conducted by a mudang (a shaman), that is, the expression coming from the inside associated with the praying is seen as gutchum. This dance is bound to be in competition and interest among shaman groups, and they tend to influence one another. If praying leads to dance, a mudang can gain profits from capital as well as the value of labor. When the mudang succeeds in forming a bigger bond of sympathy with her praying, the object of praying gets more eager to select byulbi and dances a heoteunchum (impromptu dance) more vigorously. This means that a mudang's ability to perform a ritual is associated with the object of praying's consumption. With his impromptu motions, the object of praying comes to go into 'the field of consumption' within the structure of capitalistic competition before he is aware of it. Behind the communication that praying leads to dance, a lot of things are associated with one another organically. 'Gutchum-pan to pray' is generated by the continuous movement of diversity and unity that the time has within the ritual of the mudang and the object of praying. It continues to create the future 'self' that is different from the present 'self', and it means that he expects variability from the present 'self' through 'gutchum-pan to pray'. The mudang also prays for him arranging the variability of the other (the object of praying) inside her labor. In a big picture, of course, the mudang expects the variability of herself, too, which is connected to the value of her labor. The variability that they expect forms a crucial axis that determines where the flow of time and space that the 'gutchum-pan to pray' has is directed to. The contents of praying are directly related with the villagers' lives, and what leads to dance is mostly related with their jobs. This implies that what the mudang experiences in her everyday consuming activity is directly associated with the villagers' activity for earning money. In other words, the contents of that praying change constantly according to the flow of capitalistic economy. Also, those striving to respond to it before anyone else also expect better life for them by substituting their self to the 'gutchum-pan to pray' eagerly. If so, who are the ones that generate 'gutchum-pan to pray'? This can be understood through relationship among mudangs, relationship between the mudang and villagers, and also relationship among villagers. Their relationships can never be free from the concepts like labor in capitalistic society, consumption and expenditure, or time; therefore, they come to compete with the other, the present self, or the better self within the diverse relationships. This gets to be expressed in any ways, words or motions. And the range that covers the creation of either group or individual 'gutchum-pan to pray' in the village is the village community. Outside the range, it is upsized to the competition of the village unit, so individual praying may become diminished more easily. Although mudangs pray in each geori, it does not mean all praying leads to dance. Within various relationships between mudangs and villagers, 'gutchum-pan to pray' comes to be generated, repeated, and extinct. As it is mitigated to more positive competition, it does not lead to gutchum any longer. In other words, repeating 'gutchum-pan to pray' previously created has turned the object of praying into the state different from the former. Also, the two groups both have experienced the last step of Byulsingut, and at that point, praying does no longer lead to dance. In other words, from the position of the shaman group, it is the finish of their labor time and ritual performance, and from the perspective of the villagers, it means the finish of consuming activity and participation in a ritual. The characteristics of 'gutchum-pan to pray' can be summarized as follows. First, it goes through the following process: competition in the village group → competition in the group → competition among individuals. Second, repeated praying does not lead to 'gutchum'. Third, in the cases of praying for each of the occupation groups, the mudang can induce a bond of sympathy from the objects of praying directly, and this lead to dance. Fourth, the group that fails in being included in the category of praying gets to be alienated from 'gutchum-pan to pray' repeatedly.

• The Journal of the Korean life insurance medical association
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• v.24
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• pp.49-78
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• 2005

Ⅰ. 연구(硏究) 배경(背景) 및 목적(目的) o 우리나라 보험시장의 세대가입율은 86%로 보험시장 성숙기에 진입하였으며 기존의 전통적인 전업채널에서 방카슈랑스의 도입, 온라인전문보험사의 출현, TM 영업의 성장세 等멀티채널로 진행되고 있음 o LTC(장기간병), CI(치명적질환), 실손의료보험 등(等)선 진형 건강상품의 잇따른 출시로 보험리스크 관리측면에서 언더라이팅의 대비가 절실한 시점임 o 상품과 마케팅 等언더라이팅 측면에서 매우 밀접한 영역의 변화에 발맞추어 언더라이팅의 인수기법의 선진화가 시급히 요구되는 상황하에서 위험을 적절히 분류하고 평가하는 선진적 언더라이팅 기법 구축이 필수 적임 o 궁극적으로 고객의 다양한 보장니드 충족과 상품, 마케팅, 언더라이팅의 경쟁력 강화를 통한 보험사의 종합이익 극대화에 기여할 수 있는 방안을 모색하고자 함 Ⅱ. 선진보험시장(先進保險市場)Risk 세분화사례(細分化事例) 1. 환경적위험(環境的危險)에 따른 보험료(保險料) 차등(差等) (1) 위험직업 보험료 할증 o 미국, 유럽등(等) 대부분의 선진시장에서는 가입당시 피보험자의 직업위험도에 따라 보험료를 차등 적용중(中)임 o 가입하는 보장급부에 따라 직업 분류방법 및 할증방식도 상이하며 일반사망과 재해사망,납입면제, DI에 대해서 별도의 방법을 사용함 o 할증적용은 표준위험율의 일정배수를 적용하여 할증 보험료를 산출하거나, 가입금액당 일정한 추가보험료를 적용하고 있음 - 광부의 경우 재해사망 가입시 표준위험율의 300% 적용하며, 일반사망 가입시 $1,000당 $2.95 할증보험료 부가 (2) 위험취미 보험료 할증 o 취미와 관련 사고의 지속적 다발로 취미활동도 위험요소로 인식되어 보험료를 차등 적용중(中)임 o 할증보험료는 보험가입금액당 일정비율로 부가(가입 금액과 무관)하며, 신종레포츠 등(等)일부 위험취미는 통계의 부족으로 언더라이터가 할증율 결정하여 적용함 - 패러글라이딩 년(年)$26{\sim}50$회(回) 취미생활의 경우 가입금액 $1,000당 재해사망 $2, DI보험 8$ 할증보험료 부가 o 보험료 할증과는 별도로 위험취미에 대한 부담보를 적용함. 위험취미 활동으로 인한 보험사고 발생시 사망을 포함한 모든 급부에 대한 보장을 부(不)담보로 인수함. (3) 위험지역 거주/ 여행 보험료 할증 o 피보험자가 거주하고 있는 특정국가의 임시 혹은 영구적 거주시 기후위험, 거주지역의 위생과 의료수준, 여행위험, 전쟁과 폭동위험 등(等)을 고려하여 평가 o 일반사망, 재해사망 등(等)보장급부별로 할증보험료 부가 또는 거절 o 할증보험료는 보험全기간에 대해 동일하게 적용 - 러시아의 경우 가입금액 $1,000당 일반사망은 2$의 할증보험료 부가, 재해사망은 거절 (4) 기타 위험도에 대한 보험료 차등 o 비행관련 위험은 세가지로 분류(항공운송기, 개인비행, 군사비행), 청약서, 추가질문서, 진단서, 비행이력 정보를 바탕으로 할증보험료를 부가함 - 농약살포비행기조종사의 경우 가입금액 $1,000당 일반사망 6$의 할증보험료 부가, 재해사망은 거절 o 미국, 일본등(等)서는 교통사고나 교통위반 관련 기록을 활용하여 무(無)사고운전자에 대해 보험료 할인(우량체 위험요소로 활용) 2. 신체적위험도(身體的危險度)에 따른 보험료차등(保險料差等) (1) 표준미달체 보험료 할증 1) 총위험지수 500(초과위험지수 400)까지 인수 o 300이하는 25점단위, 300점 초과는 50점 단위로 13단계로 구분하여 할증보험료를 적용중(中)임 2) 삭감법과 할증법을 동시 적용 o 보험금 삭감부분만큼 할증보험료가 감소하는 효과가 있어 청약자에게 선택의 기회를 제공할수 있으며 고(高)위험 피보험자에게 유용함 3) 특정암에 대한 기왕력자에 대해 단기(Temporary)할증 적용 o 질병성향에 따라 가입후 $1{\sim}5$년간 할증보험료를 부가하고 보험료 할증 기간이 경과한 후에는 표준체보험료를 부가함 4) 할증보험료 반환옵션(Return of the extra premium)의 적용 o 보험계약이 유지중(中)이며, 일정기간 생존시 할증보험료가 반환됨 (2) 표준미달체 급부증액(Enhanced annuity) o 영국에서는 표준미달체를 대상으로 연금급부를 증가시킨 증액형 연금(Enhanced annuity) 상품을 개발 판매중(中)임 o 흡연, 직업, 병력 등(等)다양한 신체적, 환경적 위험도에 따라 표준체에 비해 증액연금을 차등 지급함 (3) 우량 피보험체 가격 세분화 o 미국시장에서는 $8{\sim}14$개 의적, 비(非)의적 위험요소에 대한 평가기준에 따라 표준체를 최대 8개 Class로 분류하여 할인보험료를 차등 적용 - 기왕력, 혈압, 가족력, 흡연, BMI, 콜레스테롤, 운전, 위험취미, 거주지, 비행력, 음주/마약 등(等) o 할인율은 회사, Class, 가입기준에 따라 상이(최대75%)하며, 가입연령은 최저 $16{\sim}20$세, 최대 $65{\sim}75$세, 최저보험금액은 10만달러(HIV검사가 필요한 최저 금액) o 일본시장에서는 $3{\sim}4$개 위험요소에 따라 $3{\sim}4$개 Class로 분류 우량체 할인중(中)임 o 유럽시장에서는 영국 등(等)일부시장에서만 비(非)흡연할인 또는 우량체할인 적용 Ⅲ. 국내보험시장(國內保險市場) 현황(現況)및 문제점(問題點) 1. 환경적위험도(環境的危險度)에 따른 가입한도제한(加入限度制限) (1) 위험직업 보험가입 제한 o 업계공동의 직업별 표준위험등급에 따라 각 보험사 자체적으로 위험등급별 가입한도를 설정 운영중(中)임. 비(非)위험직과의 형평성, 고(高)위험직업 보장 한계, 수익구조 불안정화 등(等)문제점을 내포하고 있음 - 광부의 경우 위험1급 적용으로 사망 최대 1억(億), 입원 1일(日) 2만원까지 제한 o 금융감독원이 2002년(年)7월(月)위험등급별 위험지수를 참조 위험율로 인가하였으나, 비위험직은 70%, 위험직은 200% 수준으로 산정되어 현실적 적용이 어려움 (2) 위험취미 보험가입 제한 o 해당취미의 직업종사자에 준(準)하여 직업위험등급을 적용하여 가입 한도를 제한하고 있음. 추가질문서를 활용하여 자격증 유무, 동호회 가입등(等)에 대한 세부정보를 입수하지 않음 - 패러글라이딩의 경우 위험2급을 적용, 사망보장 최대 2 억(億)까지 제한 (3) 거주지역/ 해외여행 보험가입 제한 o 각(各)보험사별로 지역적 특성상 사고재해 다발 지역에 대해 보험가입을 제한하고 있음 - 강원, 충청 일부지역 상해보험 가입불가 - 전북, 태백 일부지역 입원급여금 1일(日)2만원이내 o 해외여행을 포함한 해외체류에 대해서는 일정한 가입 요건을 정하여 운영중(中)이며, 가입한도 설정 보험가입을 제한하거나 재해집중보장 상품에 대해 거절함 - 러시아의 경우 단기체류는 위험1급 및 상해보험 가입 불가, 장기 체류는 거절처리함 2. 신체적위험도(身體的危險度)에 따른 인수차별화(引受差別化) (1) 표준미달체 인수방법 o 체증성, 항상성 위험에 대한 초과위험지수를 보험금삭감법으로 전환 사망보험에 적용(최대 5년(年))하여 5년(年)이후 보험 Risk노출 심각 o 보험료 할증은 일부 회사에서 주(主)보험 중심으로 사용중(中)이며, 총위험지수 300(8단계)까지 인수 - 주(主)보험 할증시 특약은 가입 불가하며, 암 기왕력자는 대부분 거절 o 신체부위 39가지, 질병 5가지에 대해 부담보 적용(입원, 수술 등(等)생존급부에 부담보) (2) 비(非)흡연/ 우량체 보험료 할인 o 1999년(年)최초 도입 이래 $3{\sim}4$개의 위험요소로 1개 Class 운영중(中)임 S생보사의 경우 비(非)흡연우량체, 비(非)흡연표준체의 2개 Class 운영 o 보험료 할인율은 회사, 상품에 따라 상이하며 최대 22%(영업보험료기준)임. 흡연여부는 뇨스틱을 활용 코티닌테스트를 실시함 o 우량체 판매는 신계약의 $2{\sim}15%$수준(회사의 정책에 따라 상이) Ⅳ. 언더라이팅 기법(技法) 선진화(先進化) 방안(方案) 1. 직업위험도별 보험료 차등 적용 o 생 손보 직업위험등급 일원화와 연계하여 3개등급으로 위험지수개편, 비위험직 기준으로 보험요율 차별적용 2. 위험취미에 대한 부담보 적용 o 해당취미를 원인으로 보험사고(사망포함) 발생시 부담보 제도 도입 3. 표준미달체 인수기법 선진화를 통한 인수범위 대폭 확대 o 보험료 할증법 적용 확대를 통한 Risk 헷지로 총위험지수 $300{\rightarrow}500$으로 확대(거절건 최소화) 4. 보험료 할증법 보험금 삭감 병행 적용 o 삭감기간을 적용한 보험료 할증방식 개발, 고객에게 선택권 제공 5. 기한부 보험료할증 부가 o 위암, 갑상선암 등(等)특정암의 성향에 따라 위험도가 높은 가입초기에 평준할증보험료를 적용하여 인수 6. 보험료 할증법 부가특약 확대 적용, 부담보 병행 사용 o 정기특약 등(等)사망관련 특약에 할증법 확대, 생존급부 특약은 부담보 7. 표준체 고객 세분화 확대 o 콜레스테롤, HDL 등(等)위험평가요소 확대를 통한 Class 세분화 Ⅴ. 기대효과(期待效果) 1. 고(高)위험직종사자, 위험취미자, 표준미달체에 대한 보험가입 문호개방 2. 보험계약자간 형평성 제고 및 다양한 고객의 보장니드에 부응 3. 상품판매 확대 및 Risk헷지를 통한 수입보험료 증대 및 사차익 개선 4. 본격적인 가격경쟁에 대비한 보험사 체질 개선 5. 회사 이미지 제고 및 진단 거부감 해소, 포트폴리오 약화 방지 Ⅵ. 결론(結論) o 종래의 소극적이고 일률적인 인수기법에서 탈피하여 피보험자를 다양한 측면에서 위험평가하여 적정 보험료 부가와 합리적 가입조건을 제시하는 적절한 위험평가 수단을 도입하고, o 언더라이팅 인수기법의 선진화와 함께 언더라이팅 인력의 전문화, 정보입수 및 시스템 인프라의 구축 등이 병행함으로써, o 보험사의 사차손익 관리측면에서 뿐만 아니라 보험시장 개방 및 급변하는 보험환경에 대비한 한국 생보언더라이팅 경쟁력 강화 및 언더라이터의 글로벌화에도 크게 기여할 것임.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.