• 한국미생물·생명공학회지
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• 제50권2호
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• pp.245-254
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• 2022

Cellulases are a group of biocatalyst enzymes that are capable of degrading cellulosic biomass present in the natural environment and produced by a large number of microorganisms, including bacteria and fungi, etc. In the current study, we isolated, screened and characterized cellulase-producing bacteria from soil. Three cellulose-degrading species were isolated based on clear zone using Congo red stain on carboxymethyl cellulose (CMC) agar plates. These bacterial isolates, named as HB2, HS5 and HS9, were subsequently characterized by morphological and biochemical tests as well as 16S rRNA gene sequencing. Based on 16S rRNA analysis, the bacterial isolates were identified as Bacillus cerus, Bacillus subtilis and Bacillus stratosphericus. Moreover, for maximum cellulase production, different growth parameters were optimized. Maximum optical density for growth was also noted at pH 7.0 for 48 h for all three isolates. Optical density was high for all three isolates using meat extract as a nitrogen source for 48 h. The pH profile of all three strains was quite similar but the maximum enzyme activity was observed at pH 7.0. Maximum cellulase production by all three bacterial isolates was noted when using lactose as a carbon rather than nitrogen and peptone. Further studies are needed for identification of new isolates in this region having maximum cellulolytic activity. Our findings indicate that this enzyme has various potential industrial applications.

• 대한한방소아과학회지
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• 제36권2호
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• pp.1-12
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• 2022

Objectives We analyzed visiting patterns to medical institutions and cost per visit according to the common cold patients aged 0-19 years. We analyzed Korean medical treatment for common cold. Methods Using the Pediatric Patient Sample data of the Health Insurance Review and Assessment Service (HIRA-PPS), we analyzed the data on health insurance claims of approximately 1 million people from 2017 to 2019. The data included the number of patients who visited the hospital due to common cold for the first and second time, the ratio of second visits by type of medical institution, and the status of prescriptions in Korean medical institutions. Results The number of patients visiting healthcare providers for common cold was higher in Western medical institutions than in Korean medical institutions. However, the number of second visits was higher in Korean medical institutions. Acupuncture is the most commonly used medical treatment in Korean medical institutions for common cold. Herbal medicine for common cold was usually prescribed for 2-3 days for children and adolescents. Conclusions Although the average medical cost of Korean medical institutions was higher than that of Western medical institutions, the rate of second visits to Korean medical institutions was higher because of the demand for Korean medical treatment

• 한국임상약학회지
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• 제32권3호
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• pp.155-165
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• 2022

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

• Parasites, Hosts and Diseases
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• 제60권4호
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• pp.261-271
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• 2022

This study provides an overview of the current status of clonorchiasis and cholangiocarcinoma (CCA), and their relationship in Korea during 2012-2020. Data were obtained from the Health Insurance Review & Assessment Service of Korea. Cluster, trend, and correlation analyses were performed. Gyeongsangnam-do and Seoul had the highest average number of cases (1,026 and 4,208) and adjusted rate (306 and 424) for clonorchiasis and CCA, respectively. The most likely clusters (MLC) for clonorchiasis and CCA were Busan/Gyeongsangnam-do/Ulsan/Daegu/Gyeongsangbuk-do (Relative Risk; RR=4.55, Likelihood Ratio; LLR=9,131.115) joint cluster and Seoul (RR=2.29, LLR=7,602.472), respectively. The MLC for clonorchiasis was in the southeastern part of Korea, while that for CCA was in the southern part. Clonorchiasis showed a decreasing trend in the southeastern districts, while increased in the southwestern districts. Cities in the central region had a decreasing trend, while the western districts had an increasing trend. In most adults (30-59), infection rate of clonorchiasis showed a significant decrease until 2018, while thereafter increased, although not significant. CCA showed a sharply decreasing tendency. The incidence of clonorchiasis and CCA were positively correlated. In general, the correlation was weak (r=0.39, P<0.001), but it was strongly positive around the 4 river basins (r=0.74, P<0.001). This study might provide an analytic basis for developing an effective system against clonorchiasis and CCA.

• 한국임상약학회지
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• 제33권3호
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• pp.168-177
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• 2023

Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

• 한국임상약학회지
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• 제33권1호
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• pp.8-21
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• 2023

Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

• 한국임상약학회지
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• 제33권2호
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• pp.113-121
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• 2023

Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.

• The Plant Pathology Journal
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• 제40권1호
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• pp.59-72
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• 2024

A comprehensive survey of mungbean-growing areas was conducted to observe leaf spot disease caused by Alternaria alternata. Alternaria leaf spot symptoms were observed on the leaves. Diversity of 50 genotypes of mungbean was assessed against A. alternata and data on pathological traits was subjected to cluster analysis. The results showed that genotypes of mungbean were grouped into four clusters based on resistance parameters under the influence of disease. The principal component biplot demonstrated that all the disease-related parameters (% disease incidence, % disease intensity, lesion area, and % of infection) were strongly correlated with each other. Alt a 1 gene that is precisely found in Alternaria species and is responsible for virulence and pathogenicity. Alt a 1 gene was amplified using gene specific primers. The isolated pathogen produced similar symptoms when inoculated on mungbean and tobacco. The sequence analysis of the internal transcribed spacer (ITS) region, a 600 bp fragment amplified using specific primers, ITS1 and ITS2 showed 100% identity with A. alternata. Potato virus X (PVX) -based silencing vector expressing Alt a 1 gene was constructed to control this pathogen through RNA interference in tobacco. Out of 50 inoculated plants, 9 showed delayed onset of disease. Furthermore, to confirm our findings at molecular level semi-quantitative reverse transcriptase polymerase chain reaction was used. Both phenotypic and molecular investigation indicated that RNAi induced through the VIGS vector was efficacious in resisting the pathogen in the model host, Tobacco (Nicotiana tabacum). To the best of our knowledge, this study has been reported for the first time.

• 한국치위생학회지
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• 제24권1호
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• pp.9-16
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• 2024

Objectives: The demand for dental care is expected to increase as the population ages. This study aimed to predict the utilization of dental implant care following the expansion of national health insurance benefits for dental implants. Methods: Multiple linear regression analysis was performed on HIRA big data open portal data and DNN-based artificial intelligence models to forecast the utilization of dental care in relation to the national health insurance coverage for dental implants. Results: National health insurance coverage of dental implants was found to be associated with the number of patients using dental implant services and demonstrated a statistical significance. The dental implant services utilization increased with the increased dental implant health insurance benefits for the elderly population, increased mean by region, increased number of dental institutions by region, and increased health insurance coverage rate for dental implants. However, the dental implant services utilization decreased with the increased number of older people living alone and increased size of dental institutions. Conclusions: With the expansion of the national health insurance coverage for dental implants, it is predicted that the utilization of dental implant medical services will increase in the future.

• KDI Journal of Economic Policy
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• 제30권2호
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• pp.129-155
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• 2008

급성상기도감염증에 대한 항생제 처방률은 의료기관의 유형, 표시과목, 의료기관이 위치한 지역 등 여러 요인에 따라 차이를 보인다. 본 연구는 1차 의료기관인 의원들 중 내과, 소아과, 이비인후과 의원의 급성상기도감염증에 대한 항생제 처방률에 환자의 특성과 같은 의학적 요인이 아닌 의원의 수입과 밀접한 관계가 있는 의원 수의 변화(경쟁 정도의 변화)와 같은 경제적 요인이 미치는 영향을 실증 분석하였다. 2006년 건강보험심사평가원에서 발표한 전국 각 의료기관의 급성상기도감염증에 대한 항생제 처방률을 주 자료원으로 하여, 경쟁지수를 두 가지 형태로 정의하고 수요 측면을 나타내는 변수와 공급 측면을 나타내는 변수를 통제변수로 선정하여 회귀분석을 실시한 결과 경쟁지수를 어떤 형태로 정의하든, 의원이 위치한 지역의 경쟁정도는 의사들의 항생제 처방률에 통계적으로 유의한 영향을 미친 것으로 분석되었다. 이러한 결과는 시장지역 내 경쟁 정도의 변화와 같은 경제적 요인이 의사들의 처방행태에 영향을 미치는 요인 중 하나라고 해석할 수 있다. 아울러 인과관계의 방향과 관련하여, 의사가 진료하는 지역의 경쟁 정도가 높아질수록 항생제 처방률이 통계적으로 유의하게 높아지는 것으로 나타났다. 이러한 결과는 의사의 진료수입 감소를 초래할 것으로 예상되는 시장환경의 변화에 대해 자신의 진료수입을 예전상태로 보전하기 위해 불필요한 의료서비스 소비를 유도해서 얻는 편익(소득효과)이 이를 위해 자신이 지불해야 할 비용(대체효과)보다 크기 때문에 항생제 처방률을 증가시킨 것으로 해석할 수 있으며, 또한 경제적 유인체계의 변화에 대하여 의사의 진료행태가 영향을 받을 수 있음을 실증적으로 뒷받침하는 것으로 이해할 수 있을 것이다.