• Health Policy and Management
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• v.15 no.4
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• pp.46-64
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• 2005

This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.

• Journal of the Korean Institute of Intelligent Systems
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• v.11 no.4
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• pp.340-346
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• 2001

This paper proposes a new design method for the GBAM: (general bidirectional associative memory) model. Based on theoretical investigations on the GBAM: model, it is shown that the design of the GBAM:-based bidirectional associative memeories can be formulated as optimization problems called GEVPs (generalized eigenvalue problems). Since the GEVPs arising in the procedure can be efficiently solved within a given tolerance by the recently developed interior point methods, the design procedure established in this paper is very useful in practice. The applicability of the proposed design procedure is demonstrated by simple design examples considered in related studies.

• Korean Management Science Review
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• v.13 no.2
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• pp.205-213
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• 1996

This paper develops a simple interactive procedure which can be efficiently used to solve a bicriteria linear programming problem. The procedure exploits the relatively simple structure of the bicriterion linear programming problem. Its application to a transportation problem is also presented. The results demonstrate that the method developed in this paper could be easily applicable to any bicriteria linear program in general.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.80-84
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• 2017

Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema. To the best of our knowledge, our management of the radical vulvectomy defect with a labia majora sharing procedure is novel and has not been previously described. The labia major flap presented in this report is a shared flap; that is, a transposition flap based on the dorsal clitoral artery, which has consistent vascular anatomy, making this flap durable and reliable. This procedure epitomises the principle of replacing like with like, does not interfere with leg movement or patient positioning, has minimal donor site morbidity, and preserves other locoregional flap options for future reconstruction. One limitation is the need for a lax contralateral vulva. This labia majora sharing procedure is a viable option in carefully selected patients.

• Journal of the Korean Institute of Telematics and Electronics
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• v.12 no.6
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• pp.9-13
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• 1975

Employing indefinite admittance matrix analysis method, a novel synthesis procedure of general active-RC filters using 2 operational amplifiers has been shown in this paper. With this procedure, a stable active-RC bandpass filter hart been designed, which provides for independent adjustment of the uning and band-width control. The predicted and actual performance is in good agreement.

• Journal of Digestive Cancer Research
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• v.11 no.3
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• pp.125-129
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• 2023

Appropriate sedation and analgesia are crucial for successful endoscopic procedures, patient safety, and satisfaction. Endoscopic resection for upper gastrointestinal tumors requires a deep sedation level because the procedure is lengthy and induces moderate to severe pain. Continuous patient consciousness assessment and vigilant vital signs monitoring are required for deep sedation. General anesthesia may unintentionally occur even during deep sedation for endoscopic tumor resection, which may cause unexpected complications, especially in high-risk patients. Previous studies have revealed that general anesthesia increases the en bloc resection rate and decreases the procedure time. Complications, such as perforation, aspiration pneumonia, and cardiopulmonary instability, including hypoxemia, hypotension, and arrhythmia, occurred more frequently in patients with sedation compared to those with general anesthesia. Therefore, general anesthesia demonstrated potential benefits in endoscopic treatment results and patient safety. General anesthesia should be considered a useful alternative for sedation in patients undergoing endoscopic gastrointestinal tumor resection. However, more high-quality prospective studies are required to determine the safety and effectiveness of general anesthesia in endoscopic upper gastrointestinal tumor resection because most studies comparing general anesthesia and sedation in these procedures have been retrospectively conducted and the results were inconsistent.

• Proceedings of the Korean Nuclear Society Conference
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• 1996.05b
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• pp.691-698
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• 1996

This paper propose a procedure to estimate the system lifetime distribution using simulation method in a parametric framework and also develop the criterion for terminating the simulation. We assume that a system is composed of many components whose lifetime and repair time distributions are general, and repair of each component is imperfect or not. General simulation algorithms can not be adopted for this case, due to the dependency of successive operating times and the discontinuity in base line intensity function of failure process. Then we propose algorithms for generating failure times subject to imperfect repair. We develop the event time tracking logic for identifying the system failure time, and also develop the criterion for terminating the simulation. Our procedure is composed of two phases. The first phase of the procedure is to generate the system failure times from the inputs. The second phase is to estimate the lifetime distribution of the system. The best model is selected by a fully automated procedure among well-known parametric families, and the required parameters are estimated. We give examples to show the accuracy of our procedure and the effect of repair effect of components to system MTTF(Mean Time To Failure).

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.12-15
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• 2018

Rib fixations for flail chest or displaced rib fractures are not a new technique. However, reports on rib fixations involving costal cartilage fractures are very few and surprisingly there are no reports of internal fixations involving only the costal cartilage in the English literature. The diagnosis is difficult and the necessity of the procedure may be quite controversial. Placing plates in screws into the costal cartilage alone may seem unstable and easily dislodged or stripped through the cartilage. We report a 31-year-old male scuba diver instructor who underwent rib fixations over his 7th and 8th costal cartilage ribs for severe pain. The procedure was done with conventional plates and screws. He had the plates and screws removed 2 months later due to lingering pain, but with them removed he is now quite happy with the results without pain. The procedure for fixation of painful overlapped costal cartilage is quite simple and can be done with the usual conventional methods, fixating plate and screws directly over the cartilage alone without fixation over the bony rib.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.465-471
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• 2011

Purpose: Blepharoptosis is often associated with telecanthus and the presence of epicanthal fold in telecanthus is one of unique features in Asian eyelids. The purpose of this article is to define telecanthus and pseudotelecanthus, and to determine optimal surgical procedure depending on classification of telecanthus. Methods: Among 187 patients with blepharoptosis who had the advancement procedure of the Muller's musclelevator aponeurosis composite flap for ptosis, 55 patients underwent Flowers' split V-W plasty concomitantly with shortening the medial canthal tendon for correction of telecanthus from September 2003 to January 2011. Among them, 52 patients were followed up for 16 months. We newly defined telecanthus because Mustarde ratio is inaccurate to measure in certain cases and then made a definition of pseudotelecanthus. Besides, we also classified telecanthus into mild, moderate and severe types based on its severity. Results: Telecanthus is defined when the ICD (inner canthal distance) is greater than 110% of normal ICD. Pseudotelecanthus is a telecanthus like a wide skin bridge formed between the eyes because of the epicanthal fold in the normal ICD. Flowers' split V-W plasty combined with shortening medial canthal tendon was very effective in mild and moderate telecanthus with almost invisible scar and no recurrence occurring. In severe types, however, it showed high incidence (28%) of incomplete correction of telecanthus. Conclusion: New definition of telecanthus can be easily applied to any case and we think the classification of telecanthus is useful to select an appropriate operative procedure. Split V-W plasty with shortening of medial canthal tendon is a very effective procedure in mild and moderate telecanthus. Besides, it is also effective in improving the treatment outcomes of ptosis in cases of blepharoptosis associated with telecanthus.

• Communications for Statistical Applications and Methods
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• v.16 no.5
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• pp.871-880
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• 2009

Recently, there has been much development on burn-in models in reliability area. Especially, the previous burn-in models have been extended to more general cases. For example, (i) burn-in procedures for repairable systems have been developed (ii) an extended assumption on the failure rate of the system has been proposed and (iii) a stochastic model for burn-in procedure in accelerated environment has been developed. In this paper, recent extensions and advances in burn-in models are introduced and some issues to be considered in the future study are discussed.