• 제목/요약/키워드: HUM

검색결과 531건 처리시간 0.034초

지역의료보험 가입자의 외래 의료이용 변화 (Changing Patterns of Ambulatory Care Utilization of a Rural Community in a Regional Medical Insurance Scheme)

  • 유승흠;조우현;손명세;박종연
    • Journal of Preventive Medicine and Public Health
    • /
    • 제21권2호
    • /
    • pp.419-430
    • /
    • 1988
  • This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

  • PDF

인구구조의 변화에 따른 의료비 추계 (The Projection of Medical Care Expenditure in View of Population Age Change)

  • 유승흠;정상혁;남정모;오현주
    • Journal of Preventive Medicine and Public Health
    • /
    • 제25권3호
    • /
    • pp.303-311
    • /
    • 1992
  • It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data(1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows : 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10.4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,101 billion Won in 2010, and 5,699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged(65 years old and over) will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.

  • PDF

지르코늄 나프테네이트를 이용한 나노결정질 ZrO2 박막의 제조와 칼슘 포스페이트 형성 능력의 평가 (Preparation of Nanocrystalline ZrO2 Film by Using a Zirconium Naphthenate and Evaluation of Calcium Phosphate Forming Ability)

  • 오정선;안준형;윤연흠;강보안;김상복;황규석;심연아
    • 한국세라믹학회지
    • /
    • 제39권9호
    • /
    • pp.884-889
    • /
    • 2002
  • 나노 결정질 $ZrO_2$ 박막을 제조하여 박막의 표면에서 인산칼슘을 유도하는 능력을 편가하기 위하여, 지르코늄 나프테네이트를 출발물질로 사용하고 화학적 용액법을 이용하여, $ZrO_2/Si$ 구조를 제작하였다. 코팅용액을 (100)Si 기판 위에 스핀코팅한 후, 500$^{\circ}C$에서 10분간 전열처리와 800$^{\circ}C$에서 30분간 최종열처리를 행하였고, 모든 열처리는 공기분위기에서 실시하였다. X-ray diffraction analysis를 이용하여 열처리된 박막의 결정화도를 조사하였고, 표면의 미세구조와 표면 거칠기를 field emission-scanning electron microscope와 atomic force microscope를 이용하여 관찰하였다. 열처리 후의 박막은 표면에 미세한 $ZrO_2$ 나노 결정이 생성되어 있었으며, 박막의 계면은 매우 균질 하였다. 유사생채용액에 1일 및 5일간 침적된 샘플의 표면위에 형성된 인산칼슘을 energy dispersive X-ray spectrometer를 이용하여 관찰하였고, fourier transform infrared spectroscopy를 이용하여 인산칼슘에 카본이 치환되어 있음을 확인하였다.

한우 육질등급이 난포란의 배반포 체외생산에 미치는 영향 (Correlation of Hanwoo (Korean Native Cattle) Carcass Classification and Oocyte Donor for Blastocyst Production In Vitro)

  • 김강식;이홍철;박용수;김소섭;박흠대
    • 한국수정란이식학회지
    • /
    • 제30권3호
    • /
    • pp.161-170
    • /
    • 2015
  • These studies were conducted to establish the practical Hanwoo (Korean native cattle) improvement system through the combining of embryo transfer technology and confirming individual Hanwoo oocyte culture system and to investigate that correlation of Hanwoo carcass classification (intramuscular marbling) and oocyte donor for blastocyst production in vitro. In case of Hanwoo, the carcass meat quality grades were divided to grade $1^{{+}{+}}$, $1^{+}$, 1, 2, and 3 depends on fat distribution of longest muscle cross-sectional surface. As results, the numbers of follicular oocytes collected from individual fundamentally-registered Hanwoo yielded $1^{{+}{+}}$, $1^{+}$, 1, 2 and 3 meat quality were 9.5, 9.4, 8.5, 8.8 and 8.8 per ovary, respectively. The numbers of retrieval oocyte from follicles were significantly higher in the cattle yield $1^{{+}{+}}$, $1^{+}$ meat quality than in the cattle yield 1, 2 and 3 meat quality (p<0.05). The rates of blastocyst formation were 18.2, 21.3, 29.4, 30.9, and 31.5% in the cattle yield $1^{{+}{+}}$, $1^{+}$, 1, 2 and 3 meat quality of after in vitro maturation, respectively. It was significantly lower in the cattle yield $^{{+}{+}}$ and $1^{+}$ meat quality than in the cattle yield 1, 2 and 3 meat quality (p<0.05). In order to evaluate embryos quality, TUNNEL assay was conducted for each meat quality grade using blastocyst stage embryo on day 8. The results showed that apoptosis cell number was higher tendency in the cattle yield $1^{{+}{+}}$and $1^{+}$ meat quality (81 and 79, respectively) than in the cattle yield 1, 2 and 3 meat quality (51, 48 and 50, respectively) but there was no statistical significance in each group. After embryo transfer, the conception rate of recipient was 53.5 (23 out of 43), 52.1 (38 out of 73) and 58.0% (58 out of 100) in the meat quality of 1, $1^{+}$ and $1^{{+}{+}}$, respectively. These results showed that the conception rate was significantly higher in the cattle yield 1 meat quality than in the cattle yield $1^{{+}{+}}$, $1^{+}$, 2, and 3 meat quality (p<0.05). In summary, these results indicate that the application of confirming Hanwoo individual oocyte culture system and embryo transfer technology can make good use of the genetic resources conservation and improvement of Hanwoo. Relevance of the meat quality grade and reproductive ability of carcasses of Hanwoo will be considered to be one of the effective means for the associated research with obesity and reproduction.

Comparison of the effect of three licorice varieties on cognitive improvement via an amelioration of neuroinflammation in lipopolysaccharide-induced mice

  • Cho, Min Ji;Kim, Ji Hyun;Park, Chan Hum;Lee, Ah Young;Shin, Yu Su;Lee, Jeong Hoon;Park, Chun Geun;Cho, Eun Ju
    • Nutrition Research and Practice
    • /
    • 제12권3호
    • /
    • pp.191-198
    • /
    • 2018
  • BACKGROUD/OBJECTIVES: Neuroinflammation plays critical role in neurodegenerative disorders, such as Alzheimer's disease (AD). We investigated the effect of three licorice varieties, Glycyrhiza uralensis, G. glabra, and Shinwongam (SW) on a mouse model of inflammation-induced memory and cognitive deficit. MATERIALS/METHODS: C57BL/6 mice were injected with lipopolysaccharide (LPS; 2.5 mg/kg, intraperitoneally) and orally administrated G. uralensis, G. glabra, and SW extract (150 mg/kg/day). SW, a new species of licorice in Korea, was combined with G. uralensis and G. glabra. Behavioral tests, including the T-maze, novel object recognition and Morris water maze, were carried out to assess learning and memory. In addition, the expressions of inflammation-related proteins in brain tissue were measured by western blotting. RESULTS: There was a significant decrease in spatial and objective recognition memory in LPS-induced cognitive impairment group, as measured by the T-maze and novel object recognition test; however, the administration of licorice ameliorated these deficits. In addition, licorice-treated groups exhibited improved learning and memory ability in the Morris water maze. Furthermore, LPS-injected mice had up-regulated pro-inflammatory proteins, such as inducible nitric oxide synthase (iNOS), cyclooxygenase-2, interleukin-6, via activation of toll like receptor 4 (TLR4) and nuclear factor-kappa B ($NF{\kappa}B$) pathways in the brain. However, these were attenuated by following administration of the three licorice varieties. Interestingly, the SW-administered group showed greater inhibition of iNOS and TLR4 when compared with the other licorice varieties. Furthermore, there was a significant increase in the expression of brain-derived neurotrophic factor (BDNF) in the brain of LPS-induced cognitively impaired mice that were administered licorice, with the greatest effect following SW treatment. CONCLUSIONS: The three licorice varieties ameliorated the inflammation-induced cognitive dysfunction by down-regulating inflammatory proteins and up-regulating BDNF. These results suggest that licorice, in particular SW, could be potential therapeutic agents against cognitive impairment.

전립선비대증의 진료지침 개발을 위한 한국문헌의 메타분석 (Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic Hyperplasia)

  • 유승흠;김춘배;강명근;송재만
    • Journal of Preventive Medicine and Public Health
    • /
    • 제30권3호
    • /
    • pp.643-664
    • /
    • 1997
  • This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

  • PDF

한국표준의료행위 분류체계 개발 (The Development of Classification System of Medical Procedures in Korea)

  • 박형욱;손명세;김한중;박은철;유승흠
    • Journal of Preventive Medicine and Public Health
    • /
    • 제29권4호
    • /
    • pp.877-897
    • /
    • 1996
  • In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, WHO was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion II. Evaluation and Management III. Diagnostic Procedures IV. Endoscopy V. Therapeutic Procedures VI. Rehabilitation Chapter three Diagnostic Procedures is divided into four parts : Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.

  • PDF

천연 고분자가 함유된 락타이드 글리콜라이드 공중합체 필름에서 슈반세포의 부착과 증식 거동 비교평가 (Comparison between Poly(lactic-co-glycolic acid) Films Contained Natural Polymers on Adhesion and Proliferation of Schwann Cells)

  • 고현아;장지은;김형석;박찬흠;권순용;정진화;강길선
    • 폴리머
    • /
    • 제38권2호
    • /
    • pp.164-170
    • /
    • 2014
  • 본 연구에서는 신경세포인 슈반세포(SC)의 증식에 가장 적합한 생체재료를 연구하였다. 락타이드 글리콜라이드 공중합체(PLGA)에 탈미네랄 골분(demineralized bone particle, DBP), 소장점막하조직(small intestine submucosa, SIS), 그리고 실크를 각각 20% 첨가하여, 용매 증발법으로 각각의 필름을 제조하고, SC세포의 부착과 증식을 확인하기 위해 MTT, SEM 그리고 RT-PCR 분석을 실시하였다. 또한 필름의 친수성을 확인하기 위해 접촉각을 측정하였다. 분석 결과, PLGA/DBP 20% 필름에서 높은 친수성을 보였으며, SC의 부착과 증식률이 다른 군에 비해 크게 증가한 것을 확인할 수 있었다. 따라서 PLGA/DBP 필름은 중추신경재생 재료로 활용할 수 있을 것으로 사료된다.

하이드록시아파타이트/락타이드 글리콜라이드 공중합체 지지체 조성에 따른 염증 완화 효과 (Inflammatory Responses to Hydroxyapatite/Poly(lactic-co-glycolic acid) Scaffolds with Variation of Compositions)

  • 장지은;김혜민;김형석;전대연;박찬흠;권순용;정진화;강길선
    • 폴리머
    • /
    • 제38권2호
    • /
    • pp.156-163
    • /
    • 2014
  • 하이드록시아파타이트는 골 전도가 우수하고 생체 적합성이 우수하며 염증 반응을 일으키지 않아 임상에서 골이식재로 널리 사용되고 있다. 본 연구에서는 하이드록시아파타이트를 함유한 poly(lactic-co-glycolic acid) (PLGA) 지지체를 제조하였으며 생체 내/외의 실험을 통하여 골 이식재로서의 응용가능성을 평가하였다. 하이드록시아파타이트/PLGA 지지체는 0, 10, 20, 40 및 60 wt%의 함량으로 제조하였다. 기계적 특성을 알아보기 위하여 압축강도, SEM, FTIR을 측정하였으며 MTT, RT-PCR, FACS, 조직학적 염색(H&E, ED-1)을 실시하였다. 그 결과 하이드록시아파타이트를 함유한 PLGA 지지체에서 염증 반응이 감소하는 것을 확인할 수 있었으며 골 이식재로서의 가능성을 보여주었다.

ICSI significantly improved the pregnancy rate of patients with a high sperm DNA fragmentation index

  • Chi, Hee-Jun;Kim, Seok-Gi;Kim, Youn-Young;Park, Ji-Young;Yoo, Chang-Seok;Park, Il-Hae;Sun, Hong-Gil;Kim, Jae-Won;Lee, Kyeong-Ho;Park, Hum-Dai
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제44권3호
    • /
    • pp.132-140
    • /
    • 2017
  • Objective: Correlations between semen parameters and sperm DNA fragmentation index (DFI) were investigated to identify characteristics of sperm without DNA damage that could be used in selecting sperm for intracytoplasmic sperm injection (ICSI). Pregnancy outcomes were compared to determine whether in vitro fertilization (IVF) or ICSI is a better choice for patients who have sperm with a high-DFI. Methods: Semen analysis was carried out in 388 patients who visited our IVF center for the first time to investigate correlations between sperm DFI and semen parameters. In addition, 1,102 IVF cycles in 867 patients were carried out in the present study; 921 cycles in the low-DFI group (DFI < 30%) and 181 cycles in the high-DFI group ($DFI{\geq}30%$). Both the low- and high-DFI groups were subdivided into IVF and ICSI cycle groups. Results: Sperm DFI showed significant inverse correlations with sperm motility (r = -0.435, p< 0.001) and morphology (r = -0.153, p< 0.05). Sperm DFI also showed significant correlations with rapid motility (r = -0.436, p< 0.001), and the kinetic parameters of average-path velocity (r = -0.403) and linearity (r = -0.412). Although there was no significant difference in the pregnancy rates between IVF (48.6%) and ICSI (44.8%) in the low-DFI group, the pregnancy rate of ICSI cycles (44.8%, p< 0.05) was significantly higher than IVF cycles (25.0%) in the high-DFI group. No significant difference was observed in the abortion rates between the low-DFI (52 of 921, 5.6%) and high-DFI groups (7 of 181, 3.8%). Conclusion: ICSI is a better choice than IVF for improving the pregnancy outcomes of patients who have sperm with a high DFI.