• Journal of Korean Dental Science
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• v.7 no.1
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• pp.38-42
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• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.51-64
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• 2018

Purposes : In February 2014, the government said that the National Health Insurance Service (NHIS) will enforce plan for reducing the financial burden from two major non-covered services including physician surcharges and private room charges, the main causes to increase uninsured, by 2017. The purpose of this study is to analyze the policy effect that performed so far by comparing out-of-pocket payment rates of policy process Methodology: This study analyzed admission medical expenses that occurred from January 2013 to March 2016 at a upper grade general hospitals in Daejeon. Number of study subjects were 134,924 and the data were analyzed with SPSS 22.0 program by using frequency, percentage, mean, standard deviation, ANOVA. The effect of two major non-payment improvement plan on out-of-pocket rates was ascertained via generalized estimating equation. Findings: Out-of-pocket payment rates was statistically significantly declined 2.7 percent than enforcement ago. Also, out-of-pocket payment, physician surcharge, the proportion of out-of-pocket payment of hospital room charge to out-of-pocket payment was statistically significantly declined. However, a further analysis of the cause of the decline in total medical costs is needed. Practical Implications: Physician surcharges and private room charges improvement policy had a positive effect on the decline of out-of-pocket payment rate. The policy of physician surcharges was very effective after the first policy enforcement but it was less effective to medical aids and near poor that was a more greater coverage than national health insurance. Since the policy has not been finalized, we have to continue a research for the successful implementation of the policy.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.1
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• pp.67-81
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• 2017

Objectives : The purpose of this study was to analyze the report conducted in 2014 by the Ministry of Health and Welfares on influences of private insurance coverage on the use of Korean medicine. Methods : We analyzed Ministry of Health and welfares report on the use and consumption of Korean medicine to fit the purpose of this study. Comparison between private insurance holders and non-holders was made in the areas of sociodemographic characteristics, patient distribution by disorders, total number of disorders and existence of complex diseases, general perception of Korean medicine, and medical expenses and visits. Logistic regression analysis was made to verify the private insurance coverage. Results : Among sociodemographic characteristics, significant differences were observed in age distribution, education, professions, income level, and housing factors. But genders, area of residence, and marital status didn't show significant differences. Other significant differences including side effects, experience with Korean medicine, herbal medicine and acupuncture treatments, and main visiting facilities were shown between private insurance holders and non-holders. Majority of disorders treated with Korean medicine were musculoskeletal issues, and criteria of number of disorders, multiple diseases factors, and medical expenses/visits showed significant differences between the two groups. Conclusions : Summarizing above results indicate that holding a private insurance in addition to National Health Insurance contributes significant influences on the use of Korean medicine.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.438-445
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• 2016

Background The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. Methods We used a scapular fascial free flap in 12 cases for soft tissue coverage of the extremities or facial soft tissue augmentation. Results The flaps ranged in size from $3{\times}12$ to $13{\times}23$ cm. No cases of total loss of the flap occurred. Partial loss of the flap occurred in 1 patient, who was treated with a turnover flap using the adjacent scapular fascial flap and a skin graft. Partial loss of the skin graft occurred in 4 patients due to infection or hematoma beneath the graft, and these patients underwent another skin graft. Four cases of seroma at the donor site occurred, and these cases were treated with conservative management or capsulectomy and quilting sutures. Conclusions The scapular fascial free flap has many advantages, including a durable surface for restoration of form and contours, a large size with a constant pedicle, adequate surface for tendon gliding, and minimal donor-site scarring. We conclude that despite the occurrence of a small number of complications, the scapular fascial free flap should be considered to be a viable option for soft tissue coverage of the extremities and facial soft tissue augmentation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5265-5270
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• 2014

Background: In Korea, the National Health Insurance program has initiated various copayment policies over a decade in order to alleviate patient financial burden. This study investigated healthcare spending and utilization in the last 12 months of life among patients who died with lung cancer by various copayment policy windows. Materials and Methods: We performed a retrospective cohort study using nationwide lung cancer health insurance claims data from 2002 to 2012. We used descriptive and multivariate methods to compare spending measured by total costs, payer costs, copayments, and utilization (measured by length of stay or outpatient days). Using 1,4417,380 individual health insurance claims (inpatients: 673,122, outpatients: 744,258), we obtained aggregated healthcare spending and utilization of 155,273 individual patient (131,494 inpatient and 103,855 outpatient) records. Results: National spending and utilization is growing, with a significant portion of inpatient healthcare spending and utilization occurring during the end-of-life period. Specifically, inpatients were more likely to have more spending and utilization as they got close to death. As coverage expanded, copayments decreased, but overall costs increased due to increased utilization. The trends were the same in both inpatient and outpatient services. Multivariate analysis confirmed the associations. Conclusions: We found evidence of the higher end of life healthcare spending and utilizations in lung cancer patients occurring as coverage expanded. The practice pattern within a hospital might be influenced by coverage policies. Health policy makers should consider initiating various health policies since these influence the long-term outcomes of service performance and overall healthcare spending and utilization.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.37 no.7A
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• pp.569-580
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• 2012

In this paper, an enhanced initial ranging algorithm for large-cell coverage fixed wireless communication system is proposed. In typical wireless communication system such as WiBro, because a round-trip delay between a transmitter and a receiver is within one OFDM (Orthogonal Frequency Division Multiplexing) symbol duration, a frequency-domain differential correlation method is generally used. However, the conventional method cannot be applied due to an increase of a maximum time delay in large-cell system. In case of an accumulative differential method, estimation errors can occur because of frequent sign transitions. In this paper, therefore, we propose an algorithm which can estimate a total timing offset in a ranging channel structure for 15 km cell. The proposed method can improve performance by sign comparison based sign error correction rule between the estimated values and using a weighting scheme based on channel correlation, the number of accumulations, and the noise reduction effect in normalization process. Also, it can estimate the integer timing offset of symbol duration by comparing peak-powers after compensating for the fractional timing offset of symbol duration.

• Ocean and Polar Research
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• v.24 no.3
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• pp.255-261
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• 2002

We investigated the distribution of sea ice using Topex/Poseidon (T/P) and ERS-1 .ada. altimeter data in the northwest Weddell Sea, Antarctica, between the area $45-75^{\circ}W\;and\;55-66^{\circ}S$. Using the Geo_Bad_1 flag of the Merged GDR of the T/P, we classified the surface into ocean, land, and sea. Total 257 cycles of altimeter measurements between Oct. 1992 and Sep. 1999 (for nearly 2570 days) were used to analyze the distribution of the Antarctic sea ice. We then calculated the surface area of ice coverage using SUTM20 map projection to monitor the periodic variations. Each year, the maximum and minimum coverage of the sea ice were found in late August and February in the study area, respectively. We also studied the sea ice distribution using ERS-1 altimeter data between $45-75^{\circ}W\;and\;55-81.5^{\circ}S$ to compare with the T/P Using the Valid/Invalid flag of the Ocean Product, we analyzed the sea ice distribution between March and August of 1995, which showed very good coherence with the T/P measurements. Our preliminary results showed that the altimeter measurements can be effectively used to monitor the distribution of the sea ice in the polar region. However, the size of radar footprint, typically 2-6km depending on the roughness of the sea surface, may be too big to monitor the sharp boundary between ice and water/land. If more other altimeter mission data with dense coverage such as Geosat GM are analyzed together, this limitation can be significantly improved. If we also combine other microwave remote sensing data such as radiometer, and SSM/I, the result will be significantly enhanced.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.33 no.10B
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• pp.911-918
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• 2008

In this paper, we propose new cell structures using multi-hop Relay Station(RS) based on IEEE802.16j in Narrow-Beam Trisector Cell (NBTC) and Wide-Beam Trisector Cell (WBTC), which are two methods for cell sectorization using 3-sector directional antennas. Then, we analyze our proposed structures compared with the existing system which does not use any RS about the numbers of optimized Base Station (BS) and multi-hop relay, the extended BS coverage, and the deployment cost according to the traffic density using optimization model. According to the results, we know the reduction of total deployment cost of the proposed systems and that WBTC is suitable when the traffic density is high and NBTC is suitable when the traffic density is low in our proposed multi-hop based NBTC and WBTC structures.

• Korean Journal of Environment and Ecology
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• v.20 no.1
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• pp.41-51
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• 2006

We investigated the flora of Ui Island sand dunes, consisting of 142 taxa; 52 families, 108 genera, 124 species, 15 varieties, and 3 forms. The total plants of floral region that were identified were 16 taxa; Elymus mollis, Salsola collina, and Farfugium japonicum in Class III; Ischaemum anthephephoroides, Carex kobomugi, Glehnia littoralis, Messerschmidia sibirica, Machilus thunbergii, Elaeagnus macrophylla, and Aster spathulifolius in Class I . Naturalized plants were 11 taxa; 7 families, 10 genera and the naturalization degree was 7.8%. On the Donmok seaside area, the coverage rate was about $20%{\sim}25%$ in 2002, but this time it had increased to more than three times or $65%{\sim}75%$. Also, on the Sungchon seaside area, the coverage rate was about $15%{\sim}20%$ in 2002, but this time it was $70%{\sim}75%$ as a result of the rapid increase of Zoysia macrostachya and Carex kobomugi. Pungseong sand dune area showed a monotonous state in variety and number, because of the strong wind and repetition of sand income and outcome.

• Journal of the Korean Society for Railway
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• v.10 no.5
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• pp.589-595
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• 2007

Korea Railroad Research Institute has developed the driverless rubber-tired K-AGT (Korean-Automated Guideway Transit) system from 1999 to 2005 and has done its performance and reliability tests on the test line at Gyeongsan-city. Radio Frequency Communication-Based Train Control system of K-AGT, which employed Advanced Automated Train Control scheme, detects train position using the radio propagation delay between wayside and vehicle radio equipment. In this paper, we investigate whether the transmission power of radio system can be reduced to the permitted level announced by the Ministry of Information and Communication for license-free ISM(Industrial Scientific Medical) frequency bands. We first determine radio propagation model, using the measured data at test line, and perform simulation for radio coverage prediction. From the simulation results, we identify that the radio system operated with reduced power can provide good link quality in total test line.