• 사상체질의학회지
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• 제13권2호
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• pp.49-61
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• 2001

The purpose of this article was to compare 'The Discourse on the Constitutional Symptoms and Disease' of ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ written in 1894(Old Edition(舊本)) with that of ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ published in 1901(In Edition(印本)), and to find the idea of pathologic mechanism and classification of 'the Exterior and Interior disease'. the conclusions were as follows. 1. The classification of constitutional symptoms and disease of Soeumin and Soyangin in 'Old Edition(舊本)' was almost equal to that in 'In Edition(印本)' 2. In pathological mechanism of constitutional symptoms and disease of Soeumin and Soyangin, 'The Exterior Disease' could be explained as the disease resulted from fight between 'Yang-chi(陽氣)(Hot-chi(熱氣))'of 'Thoracic vertebrae' and 'Yin-chi(陰氣)(Cold-chi(寒氣))' of 'Bladder' and 'The Interior Disease' between 'Hot-chi(熱氣)(Stomach-chi(胄氣))' of 'Stomach' and 'Cold-chi(寒氣)' of 'Large intestine'. 3. 'The Exterior Symptoms and Disease of the Exterior and the Interior Disease(表裏之表病)' could be explained as the disease occurring at the Branch portion(large portion)(標) by overcoming of Pathogenic factors but Vital energy still sufficient, and 'The Interior Symptoms and Disease of the Exterior and the Interior Disease(表裏之裏病)' occurring at Root portion(small portion)(裏) by invasion of Pathogenic factors and Vital energy almost exhausted. 4. In the classification of constitutional symptoms and disease of Taeumin, 'The Exterior Symptoms and Disease of the Exterior and the Interior Disease(表裏之表病)' in 'Old Edition(舊本)' were rearranged to 'The Exterior Disease' in 'In Edition(印本)', 'The Interior Symptoms and Disease of the Exterior and the Interior Disease(表裏之裏病)' to 'The Interior Disease'. 5. It was assumed that 'The Exterior and the Interior Disease' of Taeumin could be explained in relation between the exterior and e interior, based on the Healthy energy(保命之主) and e concept of the Branch and the Root portion

• 한국식품영양과학회지
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• 제35권7호
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• pp.881-885
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• 2006

Glucose-glutamine 모델반응에서 생성물의 종류와 갈변에 의한 색의 변화를 조사하기 위하여, 가열조건을 125, 150 및 $175^{\circ}C$에서 각각 10, 20 및 30분간 가열하고 반응물의 색을 Hunter colorimeter로 측정한 후, ethyl acetate로 추출하여 GC/MS로 생성물을 분석하였다. GC/MS 분석에서 acetic acid, butanoic acid, 2-butenoic acid, di-(2-ethylhexyl) phthalate, 2,3-dihydro-3.5-dihydroxy-6-methyl-4H-pyran-4-one 및 5-hydroxymethylfurfural의 6종의 다량 생성물과 1,3-dimethylbenzene, 2-ethylhexanol, fufural, 5-methylfurfural, 2-pyrrolidinone 그리고 2,6-di(t-butly)-4-hydroxy-4-methyl-2,5-cyclohexadien-1-one 6종의 미량 생성물이 확인되었다. 최대 생성물인 acetic acid와 미량 생성물인 2-ethylhexanol 및 2-pyrrolidinone은 온도 및 가열시간의 경과에 따라 전반적으로 증가하였으나, 그 외 9종의 화합물을은 $125^{\circ}C$부터 생성량이 증가하지만 $150^{\circ}C$ 또는 $175^{\circ}C$를 정점으로 그 이상 온도, 또는 가열시간을 증가할수록 생성량은 감소하였다. 반응생성물이 Hunter $L^*$값은 온도 및 시간의 증가에 따라 지속적으로 감소하여 암색이 반응의 최종산물에 의한 색으로 나타났으며, $a^*$ 및 $b^*$은 $125^{\circ}C$에서 낮고 $150^{\circ}C$ 또는 $175^{\circ}C$, 10분에서 최고점을 나타낸 후 온도 및 시간의 증가에 따라 감소하여 적색과 황색은 반응 중간생성물에 의한 발현이며 반응후기에는 고분자의 화합물에 고착되어 암색을 발현하는 것으로 추정되었으며, 가열조건의 변화에 따른 $a^*$ 및 $b^*$값의 변화는 앞서 언급한 9종 화합물들의 생성 변화와 유사하였다.

• 한국철학논집
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• 제28호
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• pp.61-85
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• 2010

이 글은 도가·도교의 생명주체주의를 기초로 도교의 환경윤리를 고찰한다. 동아시아 전통사상 가운데 생명 개념을 가장 포괄적이고 심도 있게 발전시킨 것은 도교이다. 도교에서 모든 개체생명은 도성을 갖기 때문에 인간의 가치평가와 무관하게 내재적 가치를 갖는다. 그런데 도교에서 인간은 다른 개체생명과 달리 생명주체성을 갖는다. 도교에서 인간은 자신의 생명을 타율적 자연의 흐름에 맡기는 것이 아니라, 자기의식 아래 자율적으로 조정할 수 있는 주체적 능동적 존재이다. 자신의 요절과 장수는 하늘에 의해 결정되는 것이 아니라 개체자아의 의지에 따라 결정된다. 그런데 인간의 생명주체성은 두 가지 상이한 의미를 내포한다. 하나는 인간이 다른 개체생명을 자신의 불로장생의 도구로 이용할 수 있다는 것이고, 다른 하나는 인간이 우주생명의 내재적 가치 즉 각 개체생명간의 조화로움을 실현하는 주체라는 것이다. 그런데 도교는 우주생명의 조화로움을 상위가치로 본다. 따라서 개체생명으로서 인간의 가치 실현은 우주생명의 조화로운 질서 유지와 다른 개체생명의 가치 실현이 전제되어야 한다. 도교의 환경윤리는 생명중심주의가 아니다. 생명중심주의는 존재의 선과 생명의 목적론적 중심이라는 측면에서 인간과 다른 생명체를 동등하게 취급함으로써 인간이 해야 할 역할과 책임을 축소시킨다. 그러나 도교는 우주생명의 조화 실현에 대한 인간의 역할과 책임을 강조한다. 그러므로 도교의 환경윤리는 생명중심주의가 아니라 생명주체주의이다. 도교의 생명주체환경윤리는 인간이 다른 개체생명과의 관계에서 책임적 존재가 되어야할 것을 강조한다는 점에서 생태환경회복의 하나의 대안이 될 수 있다.

• Asian-Australasian Journal of Animal Sciences
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• 제14권5호
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• pp.615-623
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• 2001

A study of mammary function in relation to glucose metabolism of first lactation Bali cows on grass-legume diets was carried out using 12 primiparous cows (initial BW $263.79{\pm}21.66kg$) for 16 weeks starting immediately post calving. The animals were randomly allocated into 4 dietary treatment groups R1, R2, R3 and R4, receiving from the last 2 months of pregnancy onwards, rations based on a mixture of locally available grass and legume feed ad libitum. On a DM basis R1 contained 70% elephant grass (PP, Penicetum purpureum) plus 30% Gliricidia sepia leaves (GS), R2 was 30% PP plus 25% GS supplemented with 55% Hibiscus tilliacius leaves (HT, defaunating effect), R3 and R4 were 22.5% PP+41.25% GS+11.25% HT+25% concentrate, with R4 supplemented with zinc-diacetate. TDN, CP and zinc contents of the diets were 58.2%, 12.05% and 18.3 mg/kg respectively for R1, 65.05%, 16.9% and 25.6 mg/kg respectively for R2, 66.03%, 16.71% and 29.02 mg/kg respectively for R3 and 66.03%, 16.71% and 60.47 mg/kg respectively for R4. Milk production and body weights were monitored, an energy and protein balance trial conducted, overall glucose kinetics parameters assessed, mammary blood flow (MBF) and metabolite arteriovenous differences (${\Delta}AVs$) measured to get uptake data and mammary performance relationships. Parameters of glucose kinetics at peak lactation or during dry condition were not affected by ration quality. Glucose pool size, space of distribution and flux increased by 61.77, 62.26 and 82.08%, respectively, during lactation compared to the dry period. Mean glucose flux of lactating Bali cows was $5.52mg/min.kgBW^{0.807}$ which resembles the range of values of temperate dairy cows. Calculation showed that glucose requirements for maintenance, milk lactose and fat-glycerol synthesis, and the formation of NADPH reached 461.69 g for a yield of 1 kg/d or equal to 320.62 mg/min, which was less than the average glucose flux of lactating Bali cows of 481.35 mg/min. Mammary blood flow (MBF) values ranged from 56 to 83 l/h for the different treatments and the ratio MBF per kg milk produced improved from av. 1540 l/kg for R1 to av. 967 l/kg for R4 treated cows. Mammary glucose uptake ranged from 6.27 to 12.03 g/h or 120 to 140 g/kg milk. Glucose uptake was mass-wise 2 to 4 times the amount secreted as lactose, which indicated values less than the calculated mammary glucose needs and that little lactose was synthesized. The excess glucose taken-up was used for other metabolic processes. Linear relationships between metabolite ${\Delta}AVs$ and arterial blood plasma concentration [A] showed that in Bali cows triglycerides (TG), phenylalanine (Phe) and tyrosine (Tyr) have high coefficients of determination, i.e. 0.77, 0.81 and 0.69, respectively. For glucose, the relationship is quadratic with an $R^2$ value of 0.49. It was concluded that lactose synthesis was inadequate, which led to a speculation that milk yield could be improved by increased lactose synthesis.

• 종양간호연구
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• 제3권2호
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• pp.133-144
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• 2003

This study is carrying out a before and after experiment design for the non-equal comparative group to identify the effects of the breast self-examination education on breast self-examination participant education compliance and health promotion in women. The subject of this study was 58 women residing in Chungju. Their age ranged from 20 to 40. These women were not pregnant or did not breast feed, as well as they did not have any breast disease, at the time of survey. They were available for the response to the questionnaires, and understood the purpose of this study. They also agreed to participate in the study, and responded to the 3rd time questionnaires to the end. Thus, brochures and lectures were provided side by side to a group of 19 of those women, and only brochures were provided to another group of 39 of those women. With regard to education, a brochure and a program using a breast model were applied. Then, the frequency of the breast self examination compliance, breast self examination capability and the relations between the breast self examination and activities to promote health were measured, before the education, after 4 weeks of education and after 12 weeks of education. Before education and after 4 weeks of education. I collected the questionnaires myself visiting them, and after 12 weeks of education, the questionnaires were collected by mail. In relation to the study tool, the breast self examination activity was measured by two measuring tools: breast self examination activity frequency and breast self examination compliance capability. As for the frequency, the number of self examination for the period of 3 months, before the questionnaire survey, was measured in the form of self report. In relation to the tool to measure the breast self examination capability, the BSEPRI tool, which was developed by Wood in 1994, was used. Here, as the score was higher, the capability was indicated to be higher. The translated and revised version of Health Promoting Lifestyle Profile II (Walker, Sechrist & Pender. 2002) was used as a tool for health promotion. As the measured score was higher, the health promoting activity was indicated to be higher. The results of this study were as follows: 1. As a result of checking the breast self examination compliance frequency between the experiment group that received the breast self examination participant education and the comparative group that did not receive the education, there was a significant difference in interaction between groups by time, as time passed by. 2. As a result of checking the breast self examination compliance capability between the experiment group and the comparative group, there was a significant difference in interaction between groups by time, as time passed by. 3. As a result of carrying out a repetitive measurement analysis, between the experiment group that received the breast self examination education and the comparative group that did not receive the education, which was carried out to validate the hypothesis that the former would have higher health promoting activities than the latter, there was no significant difference after the breast self examination education was conducted.

• 항공우주정책ㆍ법학회지
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• 제30권2호
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• pp.249-277
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• 2015

유럽연합이 제정하여 시행하고 있는 Regulation (EC) No 261/2004 ("Regulation")는 비자발적 탑승거부, 운항취소, 운항지연 등의 사안에 대해 항공승객을 보호하는데 주목적을 두고 있다. 이와 관련하여 항공편 지연으로 불편을 겪은 승객들이 탑승거부, 운항취소에 대해 명시적으로 적용되는 제7조에 따른 금전 보상청구권을 청구한 사건들이 있었다. 이에 대해 유럽연합 사법법원(Court of Justice of the European Union, CJEU)은 승객들에게 시간적인 손실이 발생한다는 점에서 항공편이 운항취소된 경우와 운항지연된 경우는 동일하므로, 당초 항공사가 설정한 총 비행시간 보다 3시간이 초과되어 운항이 지연된 경우에는 해당 승객이 자발적 탑승거부나 운항취소와 마찬가지로 금전손실 보상청구권을 행사할 수 있다고 판단하였다. Regulation상에 운항지연의 경우 제7조의 보상청구권이 적용된다는 명시규정이 존재하지 않음에도 불구하고, 승객의 보호라는 Regulation의 입법취지를 고려하여 법원이 적극적으로 그러한 권리를 긍정한 것이다. 이러한 법원의 관점은 규정의 유추해석이라는 비판을 받을 가능성도 있지만, Regulation에 산재되어 있는 운항취소와 운항지연에 관한 일괄적 취급에 관한 근거 및 승객보호라는 Regulation의 입법취지를 고려할 때 설득력을 가진다. 더욱이 법원은 운항지연의 경우 Regulation과 몬트리올 협약이 동일한 내용을 규정하고 있지 않으므로 몬트리올 협약 제29조는 이 경우에 적용되지 않고 양자는 충돌되지 않는다고 보고 있다. 즉, Regulation은 항공편의 지연이라는 사실에 관한 승객의 불편과 손실을 보호하는 규범인 반면, 몬트리올 협약은 지연이라는 사실로 인하여 인과관계가 인정되는 범위에서 발생된 손해에 관한 배상을 규정하고 있다는 것이다. 위와 같은 유럽연합의 규정과 법원의 견해는 승객보호에 관한 진보적인 성향을 잘 보여주는 선구적인 내용이라고 할 수 있다. 구체적인 규정 없이 승객보호를 위한 절차와 계획의 수립의무만을 선언적으로 규정하고 있는 현재의 우리나라 항공법이 참고할 필요가 있을 것으로 본다.

• 산학경영연구
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• 제17권2호
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• pp.63-87
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• 2004

인터넷 쇼핑몰의 수는 2004년 2월 현재 3,415개이며, 이는 2003년 동월대비 333개가 늘어난 것으로 10.8%의 증가를 보여주고 있다. 그러나 많은 기업들이 수익성 부족으로 어려움을 겪고 있는 실정이다. 이는 전자상거래를 이용하는 소비자들에 대한 연구와 조사 분석이 부족했음을 뜻한다. 지금과 같이 고객에 대한 체계적인 연구가 없이 개인적인 감각이나 세태의 추세에 의존하여 무분별하게 점포를 개설할 경우에 적자의 가능성은 더욱 높아질 것이다. 따라서 본 연구는 전자상거래의 한 영역인 기업-소비자간 인터넷 쇼핑몰을 중심으로 소비자의 기대-성과에 대한 차이를 보고자 하였다. 이에 따른 연구결과는 다음과 같다. 첫째, 인터넷 쇼핑몰 유형에 따른 고객만족요인의 유의적인 차이를 알아본 결과, 소비자 불안 인터넷 유용성만 쇼핑몰 유형에 따라 차이가 있는 것으로 나타났으며, 고객서비스는 인터넷 쇼핑몰 유형에 따른 기대-성과 차이가 나타나지 않았다. 소비자들은 소비자 불안에 대해 쇼핑몰의 유형에 상관없이 성과보다 기대가 높은 것으로 조사되었다. 특히, 기대-성과 차이에 있어서 종합형과 전문점에서는 개인정보유출이 가장 큰 차이를 보여주고 있는 반면에 중개형의 기능불안은 기대-성과차이가 가장 적은 것으로 조사되었다. 또한 인터넷 유용성에 있어서 기대-성과 차이를 알아본 결과, 전문형에서는 제품 정보 풍부, 정보 탐색비용 절감성이 가장 큰 차이를 나타내고 있는 반면에 중개형은 정보탐색 비용의 절감성이 가장 적은 차이를 보여주고 있다. 둘째, 고객서비스, 인터넷 유용성, 소비자 불안과 고객만족과의 관련성을 알아보기 위하여 회귀분석을 실시한 결과 고객 서비스, 인터넷 유용성, 소비자 불안은 모두 고객만족에 영향을 미치는 것으로 나타났다. 그리고 고객만족과 구전의도, 재구매 의도에 대한 관련성을 알아본 결과 고객만족은 구전의도, 재구매 의도에 모두 정(+)의 영향을 미치는 것으로 조사되었다. 3차원 영상으로 표현하여 보여주고, 환자에 관한 각종 정보와 진단정보 등을 신속하게 제공한다. 본 논문에서 제안하는 의료영상정보시스템은 초고속 정보통신 망을 통하여 원격의료시스템을 구축하는데 활용될 수 있을 것이다. 외 해수 중에서 생물입자 size 분포 보다 더 광범위한 분포와 다양한 환경(입자의 비중, 해상의 바람, 저질상태, 수심 등)에 의한 것으로 추정되었다.ents should be given this natural ground of proof.understanding with multiple, dynamic representations of the problem using visualization. The strategies used in making a plan were collecting data, using pictures, inductive, and deductive reasoning, and creative reasoning to develop abstract thinking. In carrying out the plan, students can solve the problem according to their strategies they planned in the previous phase. In looking back, the program is very useful to provide students an opportunity to reflect problem-solving process, generalize their solution and create a new in-depth problem. This program was well matched with the dynamic and oscillation Polya#s problem-solving process. Moreover, students can facilitate their motivation to

• 한국농공학회지
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• 제7권1호
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• pp.861-876
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• 1965

During my stay in the Netherlands, I have studied the following, primarily in relation to the Mokpo Yong-san project which had been studied by the NEDECO for a feasibility report. 1. Unit hydrograph at Naju There are many ways to make unit hydrograph, but I want explain here to make unit hydrograph from the- actual run of curve at Naju. A discharge curve made from one rain storm depends on rainfall intensity per houre After finriing hydrograph every two hours, we will get two-hour unit hydrograph to devide each ordinate of the two-hour hydrograph by the rainfall intensity. I have used one storm from June 24 to June 26, 1963, recording a rainfall intensity of average 9. 4 mm per hour for 12 hours. If several rain gage stations had already been established in the catchment area. above Naju prior to this storm, I could have gathered accurate data on rainfall intensity throughout the catchment area. As it was, I used I the automatic rain gage record of the Mokpo I moteorological station to determine the rainfall lntensity. In order. to develop the unit ~Ydrograph at Naju, I subtracted the basic flow from the total runoff flow. I also tried to keed the difference between the calculated discharge amount and the measured discharge less than 1O~ The discharge period. of an unit graph depends on the length of the catchment area. 2. Determination of sluice dimension Acoording to principles of design presently used in our country, a one-day storm with a frequency of 20 years must be discharged in 8 hours. These design criteria are not adequate, and several dams have washed out in the past years. The design of the spillway and sluice dimensions must be based on the maximun peak discharge flowing into the reservoir to avoid crop and structure damages. The total flow into the reservoir is the summation of flow described by the Mokpo hydrograph, the basic flow from all the catchment areas and the rainfall on the reservoir area. To calculate the amount of water discharged through the sluiceCper half hour), the average head during that interval must be known. This can be calculated from the known water level outside the sluiceCdetermined by the tide) and from an estimated water level inside the reservoir at the end of each time interval. The total amount of water discharged through the sluice can be calculated from this average head, the time interval and the cross-sectional area of' the sluice. From the inflow into the .reservoir and the outflow through the sluice gates I calculated the change in the volume of water stored in the reservoir at half-hour intervals. From the stored volume of water and the known storage capacity of the reservoir, I was able to calculate the water level in the reservoir. The Calculated water level in the reservoir must be the same as the estimated water level. Mean stand tide will be adequate to use for determining the sluice dimension because spring tide is worse case and neap tide is best condition for the I result of the calculatio 3. Tidal computation for determination of the closure curve. During the construction of a dam, whether by building up of a succession of horizontael layers or by building in from both sides, the velocity of the water flowinii through the closing gapwill increase, because of the gradual decrease in the cross sectional area of the gap. 1 calculated the . velocities in the closing gap during flood and ebb for the first mentioned method of construction until the cross-sectional area has been reduced to about 25% of the original area, the change in tidal movement within the reservoir being negligible. Up to that point, the increase of the velocity is more or less hyperbolic. During the closing of the last 25 % of the gap, less water can flow out of the reservoir. This causes a rise of the mean water level of the reservoir. The difference in hydraulic head is then no longer negligible and must be taken into account. When, during the course of construction. the submerged weir become a free weir the critical flow occurs. The critical flow is that point, during either ebb or flood, at which the velocity reaches a maximum. When the dam is raised further. the velocity decreases because of the decrease\ulcorner in the height of the water above the weir. The calculation of the currents and velocities for a stage in the closure of the final gap is done in the following manner; Using an average tide with a neglible daily quantity, I estimated the water level on the pustream side of. the dam (inner water level). I determined the current through the gap for each hour by multiplying the storage area by the increment of the rise in water level. The velocity at a given moment can be determined from the calcalated current in m3/sec, and the cross-sectional area at that moment. At the same time from the difference between inner water level and tidal level (outer water level) the velocity can be calculated with the formula $h= \frac{V^2}{2g}$ and must be equal to the velocity detertnined from the current. If there is a difference in velocity, a new estimate of the inner water level must be made and entire procedure should be repeated. When the higher water level is equal to or more than 2/3 times the difference between the lower water level and the crest of the dam, we speak of a "free weir." The flow over the weir is then dependent upon the higher water level and not on the difference between high and low water levels. When the weir is "submerged", that is, the higher water level is less than 2/3 times the difference between the lower water and the crest of the dam, the difference between the high and low levels being decisive. The free weir normally occurs first during ebb, and is due to. the fact that mean level in the estuary is higher than the mean level of . the tide in building dams with barges the maximum velocity in the closing gap may not be more than 3m/sec. As the maximum velocities are higher than this limit we must use other construction methods in closing the gap. This can be done by dump-cars from each side or by using a cable way.e or by using a cable way.

• 대한핵의학회지
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• 제28권3호
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• pp.357-363
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• 1994

1990년 1월부터 1992년 12월까지 서울대학교병원 소아과 및 소아외과에 황달을 주소로 입원하여 원인이 규명되었던 70명의 환아들에서 $^{99m}Tc$-DISIDA 신티그라피와 초음파검사를 실시하여 다음과 같은 성적을 얻었다. 1) 선천성 담도폐쇄증 30명 전예에서 소장방사능이 관찰되지 않았고 신생아간염 40명 중 31예에서 소장 방사능이 관찰되어 소장방사능의 유무에 따른 선천성 담도폐쇄증의 진단은 예민도 100% 특이도 78%, 정확도는 87%이었다. 2) 소장방사능이 관찰되지 않았던 환아에서 간정체 지표는 선천성 담토폐쇄증 16예가 $1.5{\pm}0.6$으로 신생아간염 7예의 $1.2{\pm}0.2$보다 높았고(p<0.05), 신생아간염의 간정체지표의 2표준편차 상한값인 1.5보다 높은 간정체지표를 보인 경우는 7예로 모두 선천성 담도폐쇄증이었다. 그러나 간정체지표가 1.5 이하인 16명중 9예는 선천성 담도폐쇄증, 7예는 신생아간염으로 이들에서는 간정체지표로 구별되지 않았다. 3) 간기능장애를 나타내는 요소를 분석하였을 때 간섭취도는 선천성 담도폐쇄증과 신생아간염에서 유의한 차이가 없었다. 연령과 간섭취지표는 일정한 상관관계가 없었고 총 빌리루빈치와 간섭취지표는 간섭취도가 정상인 환아의 총빌리루빈치가 상대적으로 낮다는 소견 이외에는 일정한 상관관계가 없었다. 신생아간염에서 소장방사능이 보이는 31예의 연령이 $2.1{\pm}0.7$ 개월로 보이지 않는 9예의 연령평균 $1.7{\pm}0.5$개월 보다 많았다(P<0.01). 4) 간섭취지표와 간정체지표와의 관계는, 간섭취지표가 높을 때 즉 간기능 저하가 심할 때 간정체지표가 높으면 즉 간섭취에이은 간정체가 일정이상 수준이면 신생아간염보다 선천성 담도폐쇄증일 가능성이 높았다. 이상의 결과로 연령이 증가하면 선천성 담도폐쇄증환아의 간기능이상은 진행하지만 신생아간염환아의 간기능장애의 정도는 연령과 무관하여, 간섭취지표로 기능을 평가하고 간정체지표로 판독하면 선천성 담도폐쇄증을 감별할 수 있다고 생각하였다. 그러나 간기능저하가 가볍고 간정체지표가 좋지 않을 때에는 역시 구별되지 않아 다른 검사결과를 참조한 임상판단에 의존하여야 할 것이며 수술적 간담도 조영술의 대상 예로 삼아야 한다고 생각하였다. 이 연구의 결과를 통하여 신생아에서 발생하는 황달의 원인을 규명하는데, $^{99m}Tc$-DISIDA 신티그라피가 유용한 검사법이며, 소장방사능이 관찰되지 않는 경우에는 간정체지표와 간섭취지표와의 관계를 고려하여 간섭취지표보다 간정체지표가 상대적으로 좋을 경우 선천성 담도폐쇄증의 가능성이 높아 감별에 도움되는 소견으로 사용할 수 있을 것으로 생각하였다.

• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.339-348
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• 2003

Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.