• Health Policy and Management
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• v.34 no.2
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• pp.120-128
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• 2024

From February to now 2024, there continues to be controversy over the expansion of admission number to medical school. Some of the controversy arises from a mix of present and future time points. In the present time point, the controversy over whether physicians are some shortages or not has various aspects. Some aspects are presented as evidence of the physician shortage and others as non-shortage. Also, the presenting evidence of shortage is being disputed, and so is the evidence of the contrary. This controversy over whether there is a shortage or not in the present time point makes it difficult to reach a consensus. In 10 years, the shortage of doctors will increase due to the rapid increase in the elderly population, so the admission number of medical schools will need to be increased. However, the increase must be such that there is minimal deterioration in the quality of medical education. More admission numbers should be allocated to medical schools with a high quality of medical education. This study suggests that large-scale medical schools increase the admission number by 20%-30%, and small-scale medical schools increase the admission number by 40%-50%, if so, the total increasing number is 760 to 1,066. If the 2,000-person increase is enforced, the quality of medical education must be carefully evaluated and the results should be reflected in adjusting the admission number of medical schools. In 20 years later, the admission number of medical schools will have to be reduced. This is because the physician supply is changing to a linear function and the physician demand (medical care demand) is changing to a quadratic function. Even if the current number is maintained, there will be an excess of doctors from 2048, so the medical school admission number must be reduced and its size will be reduced to about 2,000, a 30% reduction from the current number. Because the same reduction rate for all medical schools will result in many small-scale medical schools, the M&A (mergers and acquisitions) strategy should be considered with 40 medical schools and 12 Korean medical schools. In Korea, the main contributor to estimating physician demand is the change in population structure. Due to the rapid decrease in the total fertility rate, future population projections are uncertain. The recent rapid increase in healthcare utilization should be reexamined in the forecasting of physician demand. Since the various factors that affect the estimate of doctor supply and demand are unclear, the estimate of physician supply and demand must be continuously conducted every five years, and the Health Care Workforce Committee must be established and operated. The effects of increasing the admission number of medical schools should be evaluated and adjusted annually.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.45-52
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• 2024

In this study, an AI-based algorithm was developed to prevent image quality deterioration and reading errors due to patient movement in PET/CT examinations that use radioisotopes in medical institutions to test cancer and other diseases. Using the Mothion Free software developed using, we checked the degree of correction of movement due to breathing, evaluated its usefulness, and conducted a study for clinical application. The experimental method was to use an RPM Phantom to inject the radioisotope 18F-FDG into a vacuum vial and a sphere of a NEMA IEC body Phantom of different sizes, and to produce images by directing the movement of the radioisotope into a moving lesion during respiration. The vacuum vial had different degrees of movement at different positions, and the spheres of the NEMA IEC body Phantom of different sizes produced different sizes of lesions. Through the acquired images, the lesion volume, maximum SUV, and average SUV were each measured to quantitatively evaluate the degree of motion correction by Motion Free. The average SUV of vacuum vial A, with a large degree of movement, was reduced by 23.36 %, and the error rate of vacuum vial B, with a small degree of movement, was reduced by 29.3 %. The average SUV error rate at the sphere 37mm and 22mm of the NEMA IEC body Phantom was reduced by 29.3 % and 26.51 %, respectively. The average error rate of the four measurements from which the error rate was calculated decreased by 30.03 %, indicating a more accurate average SUV value. In this study, only two-dimensional movements could be produced, so in order to obtain more accurate data, a Phantom that can embody the actual breathing movement of the human body was used, and if the diversity of the range of movement was configured, a more accurate evaluation of usability could be made.

• Journal of the Computational Structural Engineering Institute of Korea
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• v.37 no.1
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• pp.67-76
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• 2024

In this paper, we present a DIP-MLS testing method that combines digital image processing with a rigid body-based MLS differencing approach to measure mechanical variables and analyze the impact of target location and image resolution. This method assesses the displacement of the target attached to the sample through digital image processing and allocates this displacement to the node displacement of the MLS differencing method, which solely employs nodes to calculate mechanical variables such as stress and strain of the studied object. We propose an effective method to measure the displacement of the target's center of gravity using digital image processing. The calculation of mechanical variables through the MLS differencing method, incorporating image-based target displacement, facilitates easy computation of mechanical variables at arbitrary positions without constraints from meshes or grids. This is achieved by acquiring the accurate displacement history of the test specimen and utilizing the displacement of tracking points with low rigidity. The developed testing method was validated by comparing the measurement results of the sensor with those of the DIP-MLS testing method in a three-point bending test of a rubber beam. Additionally, numerical analysis results simulated only by the MLS differencing method were compared, confirming that the developed method accurately reproduces the actual test and shows good agreement with numerical analysis results before significant deformation. Furthermore, we analyzed the effects of boundary points by applying 46 tracking points, including corner points, to the DIP-MLS testing method. This was compared with using only the internal points of the target, determining the optimal image resolution for this testing method. Through this, we demonstrated that the developed method efficiently addresses the limitations of direct experiments or existing mesh-based simulations. It also suggests that digitalization of the experimental-simulation process is achievable to a considerable extent.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1258-1273
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• 2021

Purpose The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.

• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.129-139
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• 2023

Background: The elderly population aged 65 or older in Korea is expected to continue to increase to 18.4% in 2023, and to enter a super-aged society at 20.6% in 2025. In clinical practice, the elderly discrimination of dental hygienists may experience difficulties during dental hygiene treatment due to an increase in the number of elderly patients due to aging, which can lead to maladjustment to work and turnover, so education on the understanding of the elderly is essential for students in the Department of Dentistry, who are prospective dental hygienists. Accordingly, a study was conducted to prepare for a super-aged society by studying the relationship between elderly discrimination and the knowledge and attitudes of the elderly, and to change the curriculum of universities and develop programs related to the elderly. Method: 204 students enrolled in the Department of Dentistry in D area were analyzed using the SPSS/WIN 25.0 program. The subject's geriatric discrimination, knowledge about the elderly, and attitude toward the elderly were calculated as the mean and standard deviation. T-test and one-way ANOVA were performed to verify the difference in geriatric discrimination according to the general characteristics of the subject, with a Scheffe' test applied for post-hoc analysis. Correlation analysis was conducted on the subject's geriatric discrimination, knowledge about the elderly, and attitudes toward the elderly. Results: Geriatrics scored 2.03±0.36 out of 4. Knowledge about the elderly was categorized as follows: physical domain 0.57±0.15; social domain 0.36±0.17; and psychological domain 0.35±0.20. The attitude toward the elderly was 3.86±0.27. Knowledge of the elderly averaged 11.27±3.30 points out of 25. The question with the highest percentage of correct answers to knowledge about the elderly was 'physical strength tends to decrease with age', which was 93.1%. The attitude toward the elderly according to the general characteristics of the study subjects showed significant differences in gender (p=0.040), age (p=0.026), and life experience with grandparents (p=0.001). The elderly discrimination of the study subjects showed a negative correlation in both attitude and knowledge toward the elderly, and among the elderly discrimination, there was a high positive correlation with regard to emotional avoidance (r=.892, p<0.001). Conclusion: College students are the leading players in caring for the elderly and are directly affected by aging social problems. Therefore, it is considered necessary to apply various programs in the state, society, and educational institutions to avoid negative prejudices that lead to positive thinking and discrimination against the elderly.

• Journal of Venture Innovation
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• v.7 no.1
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• pp.183-200
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• 2024

Recently, with the MZ generation's entry into society and the social participation of the female population, conflicts are occurring between workplace groups that value WLB and existing groups that emphasize collaboration due to differences in work orientation. Public institutions and companies that utilize work-life balance support systems show differences in job Commitment depending on the nature of the work and the activation of the support system. Accordingly, it is necessary to verify the effectiveness of the WLB support system actually operated by the company and present universally valid standards. The purpose of this study is, first, to verify the effectiveness of the support system for work-life balance and to find practical consensus amid changes in policies and perceptions of the working environment. Second, the influence of work-life balance level and job immersion according to work characteristics was analyzed to verify the mutual influence in order to establish standards for WLB operation that reflects work characteristics. For the study, a 2X2 matrix model was used to analyze the impact of work-life balance and work characteristics on job commitment, and four hypotheses were established. First, analysis of the job involvement level of conflict-type group members, second, analysis of the job involvement level of leading group members, third, analysis of the job involvement level of agreeable group members, and fourth, analysis of the job involvement level of cooperative group members. To conduct this study, an online survey was conducted targeting employees working in public institutions and large corporations. The survey was conducted for a total of 9 days from October 23 to 31, 2023, and 163 people responded, and the analysis was based on a valid sample of 152 people, excluding 11 copies that were insincere responses or gave up midway. As a result of the study's hypothesis testing, first, the conflict type group was found to have the lowest level of job engagement at 1.43. Second, the proactive group showed the highest level of job engagement at 4.54. Third, the conformity group showed a slightly lower level of job involvement at 2.58. Fourth, the cooperative group showed a slightly higher level of job involvement at 3.80. The academic implications of the study are that it subdivides employees' personalities into factors based on the level of work-life balance and nature of work. The practical implications of the study are that it analyzes the effectiveness of WLB support systems operated by public institutions and large corporations by grouping them.

• Korean Journal of Plant Resources
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• v.37 no.4
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• pp.392-400
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• 2024

This study was conducted to find the flowering and growth characteristics according to the different altitudes (plains and mid-mountain regions) and cultivation methods (field and plastic houses cultivation) of Elsholtzia splendens. Experimental regions located at 12 meters and 500 meters above sea level were selected for the plains and the mid-mountain, respectively, and the same method was applied for cultivation management by different altitudes and cultivation methods. In the mid-mountain region, flower bud emergence (2-3 days), flowering (9 days), and full bloom (6-7 days) stages of Elsholtzia splendens were earlier than in the plains, and field cultivation was earlier than plastic house cultivation. The plant height, the main stem diameter, and the number of branches tended to increase gradually after an initial rapid growth at 59 to 69 days after planting date. The days of duration of sunshine (less than 8 hours) from the rainy season (June 20) to the period when vegetative growth increases gradually (59 to 69 days after planting) was 22 to 29 days and 26 to 35 days in the plains and the mid-mountain regions respectively, and this period was estimated time of transition from vegetative growth to reproductive growth. The spikes growth of Elsholtzia splendens by cultivation altitudes was higher in the mid-mountain region than in the plains, and there were no statistically significant differences in growth characteristics except for the main stem diameter, the number of branches, and the dry matter. Also, the amount of flowering and growth was higher in the plastic house cultivation compared to the field cultivation. As a result, some differences in flowering amount were observed when cultivating Elsholtzia splendens for landscaping purposes, but it was considered possible to cultivate in both plains and mid-mountain regions. This study therefore provides ecological information for understanding the relationship between weather characteristics and growth of Elsholtzia splendens.

• Journal of Digestive Cancer Research
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• v.8 no.2
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• pp.102-108
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• 2020

Background: This study was performed to evaluate the effect of gastric cancer screening through analysis of screening-related data. Methods: We investigated claims data of gastric cancer from 2009 to 2015. We evaluated whether the screening was performed to prior to registration as patients with gastric cancer. The effect of gastric cancer screening was also analyzed by gender. Results: We collected total 196,293 patients with gastric cancer. 74% of them had previous experience of gastric cancer screening. In patients with screening, early gastric cancer was 33.4% and advanced gastric cancer was 17.3%. 22,548 (15.5%) patients were diagnosed with gastric cancer within 2 years after screening. In the case of patients without screening, early gastric cancer was 15.1% and advanced gastric cancer was 25.3%. In case of men, 76% of them confirmed gastric cancer through screening, and 70.2% of women confirmed the gastric cancer. In both men and women, the rate of early gastric cancer was higher among those with screening than those without screening. Conclusion: In this study, we were able to indirectly confirm the stage shift of gastric cancer screening. However, within 2 years after screening, not a few patients with gastric cancer were diagnosed. Therefore, more studies are warranted to in the future.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.420-429
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• 2002

Moderate hypothermic cardiopulmonary bypass (CPB) has commonly been used in cardiac surgery. Several cardiac centers recently practice normothermic CPB in cardiac surgery, However, the clinical effect and safety of normothermic CPB on cerebral metabolism are not established and not fully understood. This study was prospectively designed to evaluate the clinical influence of normothermic CPB on brain metabolism and to compare it with that of moderate hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to receive normothermic (nasopharyngeal temperature ＞34.5 $^{\circ}C$, n=18) or hypothermic (nasopharyngeal temperature 29~3$0^{\circ}C$, n=18) CPB with nonpulsatile pump. Middle cerebral artery blood flow velocity (VMCA), cerebral arteriovenous oxygen content difference (CAVO$_{2}$), cerebral oxygen extraction (COE), modified cerebral metabolic rate for oxygen (MCMRO$_{2}$), cerebral oxygen transport (TEO$_{2}$), cerebral venous desaturation (oxygen saturation in internal jugular bulb blood$\leq$50 %), and arterial and internal jugular bulb blood gas analysis were measured during six phases of the operation： Pre-CPB (control), CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ in the hypothermic group), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ in the both groups), CPB-off and Post-CPB (skin closure after CPB-off). Postoperaitve neuropsychologic complications were observed in all patients. All variables were compared between the two groups. Result： VMCA at Rewarm-2 was higher in the hypothermic group (153.11$\pm$8.98%) than in the normothermic group (131.18$\pm$6.94%) (p＜0.05). CAVO$_{2}$ (3.47$\pm$0.21 vs 4.28$\pm$0.29 mL/dL, p＜0.05), COE (0.30$\pm$0.02 vs 0.39$\pm$0.02, p＜0.05) and MCMRO$_{2}$ (4.71 $\pm$0.42 vs 5.36$\pm$0.45, p<0.05) at CPB-10 min were lower in the hypothermic group than in the normothermic group. The hypothermic group had higher TEO$_{2}$ than the normothermic group at CPB-10 (1,527.60$\pm$25.84 vs 1,368.74$\pm$20.03, p＜0.05), Rewarm-2 (1,757.50$\pm$32.30 vs 1,478.60$\pm$27.41, p＜0.05) and Post-CPB (1,734.37$\pm$41.45 vs 1,597.68$\pm$27.50, p＜0.05). Internal jugular bulb oxygen tension (40.96$\pm$1.16 vs 34.79$\pm$2.18 mmHg, p＜0.05), saturation (72.63$\pm$2.68 vs 64.76$\pm$2.49 %, p＜0.05) and content (8.08$\pm$0.34 vs 6.78$\pm$0.43 mL/dL, p<0.05) at CPB-10 were higher in the hypothermic group than in the normothermic group. The hypothermic group had less incidence of postoperative neurologic complication (delirium) than the normothermic group (2 vs 4 patients, p＜0.05). Lasting periods of postoperative delirium were shorter in the hypothermic group than in the normothermic group (60 vs 160 hrs, p<0.01). Conclusion: These results indicate that normothermic CPB should not be routinely applied in all cardiac surgery, especially advanced age or the clinical situations that require prolonged operative time. Moderate hypothermic CPB may have beneficial influences relatively on brain metabolism and postoperative neuropsychologic outcomes when compared with normothermic CPB.

• Korean Journal of Animal Reproduction
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• v.26 no.3
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• pp.275-289
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• 2002

The objective of this study was to develop an in vitro assessment of sperm fertilizing capacity of bulls and investigate the factors influencing sperm function and characteristics of frozen-thawed bovine spermatozoa. in vitro fertilization (IVF), the evaluation of motility and normal morphology, HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, luminol and lucigenin-dependent chemiluminescence for the measurement of reactive oxygen species (ROS), the measurement of malondialdehyde formation for the analysis of lipid peroxidation (LPO), and the evaluation of DNA fragmentation using the method of 747-mediated nick end labelling (TUNEL) by flow cytometry were performed in frozen-thawed bovine spermatozoa. Correlations between the rates of fertilization, blastocyst formation after IVF and the values of respective assays were investigated. 1. IVF rate and blastocyst formation rate averaged 64.4% and 34.3% for spermatozoa from high -fertility bull group and averaged 18.5% and 6.2% for spermatozoa from low-fertility bull group, respectively. There were significantly different between two bull groups. Sperm motility and percentage acrosome reaction averaged 79.0% and 66.2% for spermatozoa from high-fertility bull group and averaged 40.7% and 22.9% for spermatozoa from low-fertility bull group, respectivitely. There were not different between two bull groups. 2. Luminol depenent chemiluminescence, LPO and DNA fragementation averaged 6.4, 2.0 nmol and 2.6% from spermatozoa from high-fertility bull group and averaged 6.5, 3.1 nmol and 7.4% for spermatozoa from low-fertility bull group, respectively. There were significantly different between two bull groups. There was no significant difference in lucigenin dependent chemiluminescence between two bull groups. 3. Fertilization rate was positively correlated with motility and the rate of Ca-ionophore induced acrosome reaction, but negatively correlated with the frequency of luminol-dependent chemiluminescence, the rate of LPO, and the percentage of sperm with DNA fragmentation. There was no correlation between fertilization rate and the percentage of swollen spermatozoa, normal morphology, and the frequency of lucigenin-dependent chemiluminescence. 4. Blastocyst formation rate was positively correlated with the rate of Ca-ionophore induced acrosome reaction, but negatively correlated with the frequency of luminol-dependent chemiluminescence, the rate of LPO, and the percentage of sperm with DNA fragmentation. There was no correlation between blastocyst formation rate and motility, the percentage of swollen spermatozoa, normal morphology, and the frequency of lucigenin-dependent chemiluminescence. In conclusion, these data suggest that ROS significantly impact semen quality. The assays of this study may provide a basis fur improving in vitro assessment of sperm fertilizing capacity.