• Health Policy and Management
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• v.18 no.4
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• pp.148-169
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• 2008

As the Korean Government began to perceive healthcare as one of foundational industries for national dynamics, there has been mounting advocacy for the introduction of for-profit hospitals with a view to bringing efficiency in healthcare services industries and improvement of their international competitiveness. The Government is now considering the issue from all angles in favor of permitting for-profit hospitals. However, There have been few precedent studies on this subject to provide helpful data for the discussion and in the health policy making. This study used private hospitals - for-profit and nonprofit - in Florida, USA as study subjects to accumulate basic data that may be utilized for those involved in debates and health policy making relating to the introduction of for-profit hospitals in Korea. Among all the private general hospitals in Florida, those surveyed by AHA(American Hospital Association) for four consecutive years from 2001 and 2004 and others reported about to MCR(Medicare Cost Report) included in the collected data for analysis. In total 139 private general hospitals consisting of 73 for-profit hospitals and 66 nonprofit hospitals were included in the collected analysis data. Results of analysis revealed no significant difference between for-profit hospitals and nonprofit hospitals in the usage aspects of healthcare services including the average length of stay and the ratio of Medicare vs Medicaid patients. However, financial performances indicated by such factors. as the pre-tax return on assets and the pre-tax operating margin showed to be significantly higher in for-profit hospitals compared with nonprofit hospitals. And the ratio of personnel expenses and the turn period of total assets showed to be significantly lower in for-profit hospitals. Based on the hypothesis that arguments about the introduction of for-profit hospitals have considerably different viewpoints depending on the size of hospital represented by the number of bed, these two hospital types were compared again using the number of beds as a controlled factor, but the results were similar. We, therefore, could conclude that the for-profit hospitals in Florida included in this study could, in their for-profit operation, improve their financial performance by pursuing cost reduction and effectively utilizing their assets without limiting the amount and the range of their services or avoiding less medically protected groups such as Medicare and Medicaid patients.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.76-84
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• 2005

Immediate breast reconstruction in breast cancer patients is universalized and now with a wide variety of methods to choose from, we can select a breast reconstruction method according to the patient's condition. Among these methods, immediate breast reconstruction with TRAM free flap is the most commonly used. Nipple reconstruction is usually performed as a secondary procedure, reconstructed. Nipple is reconstructed with contralateral nipple composite graft or with local flap. Areola is reconstructed with skin graft and tattooing. Therefore, to reconstruct complete breast, two or more staged operations are needed and are troublesome to both the surgeon and the patient. If we could reconstruct breast mound and nipple at same time, we would reduce the operative stages and heighten the patient's satisfaction. The author performed delayed or immediate breast reconstruction with TRAM free flap and nipple reconstruction at the same time. If the TRAM flap was to situate in the whole of the breast or at the center of the breast mound, nipple was reconstructed with a local flap from the TRAM flap. If the TRAM flap was not situated in center of breast mound, nipple was reconstructed with a local flap from remnant breast skin. Immediate nipple reconstructions in breast reconstruction consisted total of 22 cases. Among these, delayed breast reconstruction were 5 cases and immediate breast reconstruction were 17 cases. According to patient's condition and mastectomy method, nipple reconstruction method was selected; nipple reconstruction with contralateral nipple composite graft(3 cases); nipple reconstruction with remnant breast skin(6 cases); nipple reconstruction from flap margin(10 cases); nipple reconstruction with prefabricated nipple on flap(3 cases). Malposition of the reconstructed nipple was the most common and serious complication(6 cases). The other complications were atrophy of the nipple(1 case), and necrosis(1 case). Reconstruction of the breast and nipple at the same time can reduce the need of a secondary operation and use remnant skin or redundant flap tissue maximally. On the other hand, it must be considered that position and shape of nipple could be deformed, because the nipple reconstruction is performed before the shape of reconstructed breast settles completely. Prudent attention is needed, because the danger of complication is higher than delayed nipple reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.1
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• pp.36-48
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• 2008

To repair bone defects in the oral and maxillofacial field, bone grafts including autografts, allografts, and artificial bone are used in clinical dentistry despite several disadvantages. The purpose of this study was to evaluate new bone formation and healing in rat calvarial bone defects using hydroxyapatite (HA, $Ca_{10}[PO_4]_6[OH]_2,\;Bongros^{(R)}$, Bio@ Co., KOREA) and tricalcium phosphate (${\beta}-TCP,\;Ca_3[PO_4]_2$, Sigma-Aldrich Co., USA) mixed at various ratios. Additionally, this study evaluated the effects of type I collagen (Rat tail, BD Biosciences Co., Sweden) as a basement membrane organic matrix. A total of twenty, 8-week-old, male Sprague-Dawley rats, weighing 250-300g, were divided equally into a control group (n=2) and nine experimental groups (n=2, each). Bilateral, standardized transosseous circular calvarial defects, 5.0 mm in diameter, were created. In each experimental group, the defect was filled with HA and TCP at a ratio of 100:0, 80:20, 70:30, 60:40, 50:50, 40:60, 30:70, 20:80, and 0:100 with or without type I collagen. Rats were sacrificed 4 and 8 weeks post-operation for radiographic (standardized plain film, Kodak Co., USA), histomorphologic (H&E [Hematoxylin and Eosin], MT [Masson Trichrome]), immunohistochemical staining (for BMP-2, -4, VEGF, and vWF), and elementary analysis (Atomic absorption spectrophotometer, Perkin Elmer AAnalyst $100^{(R)}$). As the HA proportion increased, denser radiopacity was seen in most groups at 4 and 8 weeks. In general radiopacity in type I collagen groups was greater than the non-collagen groups, especially in the 100% HA group at 8 weeks. No new bone formation was seen in calvarial defects in any group at 4 weeks. Bridging bone formation from the defect margin was marked at 8 weeks in most type I collagen groups. Although immunohistochemical findings with BMP-2, -4, and VEGF were not significantly different, marked vWF immunoreactivity was present. vWF staining was especially strong in endothelial cells in newly formed bone margins in the 100:0, 80:20, and 70:30 ratio type I collagen groups at 8 weeks. The calcium compositions from the elementary analysis were not statistically significant. Many types of artificial bone have been used as bone graft materials, but most of them can only be applied as an inorganic material. This study confirmed improved bony regeneration by adding organic type I collagen to inorganic HA and TCP mixtures. Therefore, these new artificial bone graft materials, which are under strict storage and distribution systems, will be suggested to be available to clinical dentistry demands.

• Nuclear Engineering and Technology
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• v.47 no.6
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• pp.678-699
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• 2015

Although the harsh space environment imposes many severe challenges to space pioneers, space exploration is a realistic and profitable goal for long-term humanity survival. One of the viable and promising options to overcome the harsh environment of space is nuclear propulsion. Particularly, the Nuclear Thermal Rocket (NTR) is a leading candidate for nearterm human missions to Mars and beyond due to its relatively high thrust and efficiency. Traditional NTR designs use typically high power reactors with fast or epithermal neutron spectrums to simplify core design and to maximize thrust. In parallel there are a series of new NTR designs with lower thrust and higher efficiency, designed to enhance mission versatility and safety through the use of redundant engines (when used in a clustered engine arrangement) for future commercialization. This paper proposes a new NTR design of the second design philosophy, Korea Advanced NUclear Thermal Engine Rocket (KANUTER), for future space applications. The KANUTER consists of an Extremely High Temperature Gas cooled Reactor (EHTGR) utilizing hydrogen propellant, a propulsion system, and an optional electricity generation system to provide propulsion as well as electricity generation. The innovatively small engine has the characteristics of high efficiency, being compact and lightweight, and bimodal capability. The notable characteristics result from the moderated EHTGR design, uniquely utilizing the integrated fuel element with an ultra heat-resistant carbide fuel, an efficient metal hydride moderator, protectively cooling channels and an individual pressure tube in an all-in-one package. The EHTGR can be bimodally operated in a propulsion mode of $100MW_{th}$ and an electricity generation mode of $100MW_{th}$, equipped with a dynamic energy conversion system. To investigate the design features of the new reactor and to estimate referential engine performance, a preliminary design study in terms of neutronics and thermohydraulics was carried out. The result indicates that the innovative design has great potential for high propellant efficiency and thrust-to-weight of engine ratio, compared with the existing NTR designs. However, the build-up of fission products in fuel has a significant impact on the bimodal operation of the moderated reactor such as xenon-induced dead time. This issue can be overcome by building in excess reactivity and control margin for the reactor design.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.629-636
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• 2009

Purposes: Wide scars occurring on the lower face and neck are a source of both functional and esthetic problems. Consequently, we can use skin grafts, pedicled flaps, free flaps, and tissue expansion for the reconstruction of this area. Compared with other reconstruction techniques, tissue expansion is advantageous in that it enables the maintenance of a color and texture similar to that of the adjacent tissue. However, the conventional method of tissue expansion has been reported to lead to an unnatural cervicomental angle and to the deformity of adjacent structures. We have therefore made efforts to prevent these problems through the use of several operative procedures. Methods: Forty-one patients with lower facial and cervical scars underwent tissue expansion. The tissue expansion was performed using a rectangular-shaped Nagosil$^{(R)}$ tissue expansion device. On insertion of the tissue expander, the intermediate area of superficial fat layer was dissected and then the tissue expander was inserted to make a flap that was as thin as possible. In advancement of the flap, a capsule-formed by the tissue expander-was used for the interrupted fixed suture of the flap to the fascia of the platysma muscle of the neck. This procedure was performed multiple times and also performed between the flap and the periosteum of the mandible, such that the tension was removed during the suture of the flap margin. Finally, the patients were fitted with a Jobst$^{(R)}$ facial garment in order to stabilize the operation site at least twelve months. Results: The most prevalent location of the scar was the cheek (15 cases), followed by the chin in 14 cases and the neck in 12 cases. The mean size of scar was $55.7{\pm}39.4cm^2$. Conclusions: Using our procedures, we have experienced no significant deformities and have also achieved a more natural cervicomental angle in the patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2971-2980
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• 2014

To find the risk of cardiovascular disease for breast cancer patients received postoperative adjuvant anticancer therapy, this study was investigated the change of serum lipid profile (total cholesterol and trigyiceride) and the 10 year risk score of ischemic heart disease. Medical data of 432 breast cancer patients diagnosed at the breast cancer center in an university hospital from January, 2003 to December, 2006 were collected and analysed. The results showed that the levels of total cholesterol and triglyceride were increased at the points of 2 and 5 years after operation. The margin of increase of total cholesterol was higher in the patients without endocrine therapy compared to them with endocrine therapy, however there were no changes in the level of triglyceride regardless of endocrine therapy. There were also no significant changes in total cholesterol and triglyceride levels between chemotherapy, radiotherapy and endocrine therapy. 10 year-risk score of ischemic heart disease was increased by 0.44%p in the final observation compared to that of a baseline.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.12 no.4
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• pp.456-465
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• 2019

PHEV(Plug in Hybrid Electric Vehicle) and BEV(Battery Electric Vehicle) equip high voltage batteries to drive motor and vehicle electric system. Those vehicle require OBC(On-Board Charger) for charging batteries and LDC(Low DC/DC Converter) for converting from high voltage to low voltage. Since the charger and the converter actually separate each other in electrical vehicles, there is a margin to reduce the vehicle weight and area of installation by integration two systems. This paper studies a 1.5kW LDC converter that can be integrated into an OBC using an isolated current-fed converter by simplifying the design of LDC transformers. The proposed LDC can control the final output voltage of the LDC by using a fixed arbitrary output voltage of the bidirectional buck-boost converter, so that Compared to the existing OBC-LDC integrated system, it has the advantage of simplifying the transformer design considering the battery voltage range, converter duty ratio and OBC output turn ratio. Prototype of the proposed LDC was made to confirm normal operation at 200V ~ 400V input voltage and maximum efficiency of 91.885% was achieved at rated load condition. In addition, the OBC-LDC integrated system achieved a volume of about 6.51L and reduced the space by 15.6% compared to the existing independent system.

• KEPCO Journal on Electric Power and Energy
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• v.5 no.1
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• pp.25-32
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• 2019

K-BEMS System was introduced to reduce peak load and to save total energy of the 200 buildings that KEPCO headquarter and branch offices use. And K-BEMS system is composed of PV, battery, and hybrid PCS. KEPCO research institute has carried out this K-BEMS research project for 3 years since January 2016. In this paper, the results of the project are shown. 9 modes of test results of K-BEMS system and are operational problems were analyzed. And measures to cure the trouble are also suggested. Batteries are operated more than 20% of SOC, and less than 20% of SOC battery protection switches are automatically shutting down the system and the system no longer respond to EMS, ending the supply of PV, and so therefore to continue the PV power supply it was turn out to be necessary that the EMS should automatically change its policy to change PV only supply mode automatically when the Battery Switch automatically operated. To operate the system continuously and automatically, it is necessary to modify the minimum operational SOC value, and in addition to that the EMS computer must remember the last shut-down SOC and Voltage which interrupted the system and add some margin to reflect the measurement error in the system.

• Nuclear Engineering and Technology
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• v.27 no.6
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• pp.877-887
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• 1995

YGN 3 is the first nuclear power plant to use the Core Protection Calculator (CPC) as the core protection system and the Core Operating Limit Supervisory System (COLSS) as the core monitor-ing system in Korea. The CPC is designed to provide on-line calculations of Departure from Nucleate Boiling Ratio (DNBR) and Local Power Density (LPD) and to initiate reactor trip if the core conditions exceed the DNBR or LPD design limit. The COLSS is designed to assist the operator in implementing the Limiting Conditions for Operation (LCOs) in Technical Specifications for DNBR/Linear Heat Rate (LHR) margin, azimuthal tilt, and axial shape index and to provide alarm when the LCOs are reached. During YGN 3 initial startup testing, extensive CPC/COLSS related tests ore peformed to ver-ify the CPC/COLSS performance and to obtain optimum CPC/COLSS calibration constants at var, -ious core conditions. Most of test results met their specific acceptance criteria. In the case of missing the acceptance criteria, the test results ore analyzed, evaluated, and justified. Through the analysis and evaluation of each of the CPC/COLSS related test results, it can be concluded that the CPC/COLSS are successfully Implemented as designed at YGN 3.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.22 no.6
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• pp.32-48
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• 2023

Autonomous driving technology is shaping the future of personalized travel, encouraging personalized travel, and traffic impact could be influenced by individualized travel behavior during the transition of driving entity from human to machine. In order to evaluate traffic impact, it is necessary to estimate the total number of trips based on an understanding of individual travel characteristics. The Activity-based model(ABM), which allows for the reflection of individual travel characteristics, deals with all travel sequences of an individual. Understanding the relationship between travel and travel must be important for assessing traffic impact using ABM. However, the ABM has a limitation in the data hunger model. It is difficult to adjust in the actual demand forecasting. Therefore, we utilized a Tour-based model that can explain the relationship between travels based on household travel survey data instead. After that, vehicle registration and population data were used for correction. The result showed that, compared to the KTDB one, the traffic generation exhibited a 13% increase in total trips and approximately 9% reduction in working trips, valid within an acceptable margin of error. As a result, it can be used as a generation correction method based on Tour, which can reflect individual travel characteristics, prior to building an activity-based model to predict demand due to the introduction of autonomous vehicles in terms of road operation, which is the ultimate goal of this study.