• 보건행정학회지
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• 제21권2호
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• pp.179-194
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• 2011

Although there have been studies regarding the separating policy of dispensary and medical practice, little study have provided a concrete empirical evidence to what extent the policy objectives are achieved. In this paper, we try to provide empirical evidence whether the policy separating dispensary from medical practice achieved the policy objectives, which representatively are reducing the mis-use or over-use of anti-biotic prescriptions and medicines, and decreasing the government spending for the cost of pharmaceutical support. By comparing the average of the rate of change of the number of medicines prescribed, the rate of anti-biotics prescribed, and the government spending for the cost of pharmaceutical support between the areas where the separation policy was implemented and the exceptional areas, we concluded that it is difficult to conclude that the policy separating dispensary and medical practice achieved its policy objects, as it first announced to achieve in the introduction of the policy in 2000. However, the limitation of this study is that the data, that can thoroughly analyze the effect of separating policy of dispensary from medical practice, cannot be collected as expected. Hence, we could not use a parsimonious empirical model to evaluate the effect of the policy introduced in 2000. Rather we used a simple statistical method to extract enough empirical evidence fro m the data available. In the near future, we would expect to see more research that analyze the exact effect of policy separating dispensary and medical practice with concrete empirical model using more sophisticated dataset.

• 생물정신의학
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• 제21권4호
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• pp.118-127
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• 2014

Along with language, socialization is a unique feature of the human being. There is a continuous debate regarding whether the development of socialization is innate, and conducted by the environment in the growing process, or the result of the interaction of both aspects. If socialization is the result of the interaction with the environment or is an acquired developmental process, the following question rises. "Is there a 'critical period' for the development of socialization?" Although there are a huge number of studies seeking for treatment and solutions for developmental delay or deficits of socialization, it is very complicated question to answer. Historical figures such as 'Hugh Blair' of Borgue in England, and 'the wild boy of Aveyron' in France, seem to have innate socialization deficits. Nowadays patients with non-verbal learning disorder, social communication disorder, or autism spectrum disorder seem to have genetic defects. On the other hand, Harry Harlow's monkey experiments, hikikomori of Japan, Romanian orphans and patients with reactive attachment disorder seem to display social deficits due to environmental factors. However, it is not easy to clearly draw a line between innate or acquired factors. Therefore, rather than subdividing the diseases for etiological and pathophysiological approach to heterogenous groups with the common denominator of social deficit, and for the research of pathophysiology and treatment development, the authors suggest a comprehensive concept of "social dysfunction spectrum."

• Yonsei Medical Journal
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• 제59권9호
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• pp.1034-1040
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• 2018

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

• 대한의생명과학회지
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• 제19권1호
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• pp.1-8
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• 2013

Parkin is known to be a tumor suppressor protein. Previously, we determined that parkin expression restores susceptibility to TNF-${\alpha}$-induced death of HeLa cells, a human cervical cancer cell line resistant to TNF-${\alpha}$-induced cell death. MMP-3 is a zinc-dependent protease recently reported to activate intracellular apoptotic signaling. In this study we examined the regulation of MMP-3 expression by parkin in TNF-${\alpha}$-treated HeLa cells. Furthermore, we investigated the signaling pathway involved in parkin-induced expression of MMP-3. We found that HeLa cells exhibit low levels of MMP-3 but is induced after introduction of the parkin gene into HeLa cells. Furthermore, MMP-3 expression increased further when parkin expressing cells were treated with TNF-${\alpha}$. Using chemical inhibitors of cell signaling pathways, we found that MEK-1 (PD98059), PI3K (LY294002), p38 MAPK (SB203580), and JNK inhibitors alleviated parkin-induced up-regulation of MMP-3. Finally, we show that TNF-${\alpha}$-induced cell death in parkin expressing cells is inhibited by using a MMP-3 inhibitor. These results suggest that parkin expression induces prolonged expression of MMP-3 via MEK-1, PI3K, MAPK, and JNK pathway in HeLa cells allowing the HeLa cells to become sensitive to TNF-${\alpha}$-induced cell death. These results implicate a role of MMP-3 in parkin-induced cell death in TNF-${\alpha}$ treated HeLa cells.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.673-677
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• 2013

Introduction: Capture-recapture methods have been suggested for reducing costs of disease registration as well as reducing bias in incidence estimations. This study aimed to estimate the gastric cancer incidence in the Tehran metropolis population during 2002-2006. Materials and Methods: We investigated new cases of gastric cancer reported by three sources; death certificates, pathology reports, and medical records to Tehran population-based cancer registry during 2002-2006. $G^2$ statistics and the two-source capture-recapture method were used to select the best-fitted log-linear model and to estimate incidence, respectively. EXCEL software version 2007 and SPSS software version 16 were used for this research. Results: The number of reported cases was 4,463, with an average age of 68.5 (${\pm}12.9$) years. We found the model that combined two sources of data including pathology reports and medical records and furthermore complemented by death certificates as the best model. The reported and the estimated incidences were 11.0 and 27.1 per 100,000 respectively. Conclusions: The incidence estimated by two-source capture-recapture method is about three times higher than the incidence reported by the sources under investigation. It is recommended to move towards the implementation of population-based cancer registration using various sources of data collection to achieve more accurate data.

• 임상간호연구
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• 제21권1호
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• pp.31-42
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• 2015

Purpose: This study was done to develop evidence-based nursing practice guidelines to prevent complications related to indwelling urinary catheterization (IUC) in patients in Korea. Methods: A guideline adaptation process was conducted according to the guideline adaptation manual which consists of three main phases, and 9 modules with a total of 24 steps. Results: The newly developed IUC guideline consisted of an introduction, urinary catheterization, summary of recommendations, recommendations, references, and appendices. There were 110 recommendations in 8 sections including assessment, equipment, catheter insertion, catheter maintenance, catheter change, catheter removal, management of complications, and education/consultation. For the grade of recommendations, there were 6.4% for A, 22.7% for B, 67.3% for C. Conclusion: The IUC guideline was developed based on evidence and therefore it is recommended that this guideline be disseminated and utilized by nurses nationwide to improve the quality of care for patients with IUC and decrease complications related to IUC and that it be revised regularly.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권3호
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• pp.129-142
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• 2018

Introduction: This systematic review evaluated the use of buffered versus non-buffered lidocaine to increase the efficacy of inferior alveolar nerve block (IANB). Materials and Methods: Randomized, double-blinded studies from PubMed, Web of Science, Cochrane Library, Embase, and ProQuest were identified. Two of the authors assessed the studies for risk of bias. Outcomes included onset time, injection pain on a visual analog scale (VAS), percentage of painless injections, and anesthetic success rate of IANB. Results: The search strategy yielded 19 references. Eleven could be included in meta-analyses. Risk of bias was unclear in ten and high in one study. Buffered lidocaine showed 48 seconds faster onset time (95% confidence interval [CI], -42.06 to -54.40; P < 0.001) and 5.0 units lower (on a scale 0-100) VAS injection pain (95% CI, -9.13 to -0.77; P=0.02) than non-buffered. No significant difference was found on percentage of people with painless injection (P = 0.059), nor success rate (P = 0.290). Conclusion: Buffered lidocaine significantly decreased onset time and injection pain (VAS) compared with non-buffered lidocaine in IANB. However due to statistical heterogeneity and low sample size, quality of the evidence was low to moderate, additional studies with larger numbers of participants and low risk of bias are needed to confirm these results.

• 한국응급구조학회지
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• 제1권1호
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• pp.42-53
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• 1997

To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

• 수면정신생리
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• 제8권2호
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• pp.107-112
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• 2001

목 적 : 본 연구는 기면병 환자와 정상 대조군에서 사람 백혈구 항원(human leukocyte antigen, 이하 HLA) DQB1*0602와 DR2의 발현 빈도를 조사하여 한국인 기면병 환자의 표지자로서의 가능성을 확인하고자 하였으며, 동시에 기면병 환자에서 나타나는 증상의 특성을 조사하였다. 방 법 : 야간수면 다원검사 및 입면잠복기 반복검사에서 입면잠복기의 평균값이 5분 이하이며, 최소 2회 이상의 수면시작 REM기(sleep onset REM periods)가 발생한 기면병 환자 20명(남자 11명, 여자 9명, 연령분포 $8{\sim}55$세, 평균연령 $28.2{\pm}13.0$세)과 정상 대조군 21명(남자 9명, 여자 12명, 연령분포 $21{\sim}39$세, 평균연령 $28.6{\pm}4.4$세)을 대상으로 하여 HLA typing을 시행하였다. 기면병의 제반 임상증상은 면담과 수면설문지를 통하여 수집하였다. 결 과 : 1) 기면병 환자군의 입면잠복기 반복 검사 결과 입면잠복기의 평균값은 $2.4{\pm}2.0$분이었으며, Sleep onset REM periods의 발생 평균 회수는 $3.0{\pm}1.6$회로 나타났다. 2) 기면병 환자군 모두에서 기면병의 주요 증상인 과도한 주간 졸리움 및 탈력발작을 나타냈고, 수면마비, 입면환각 및 야간수면장애는 각각 12명(60.0%), 14명(70.0%) 및 15명(75.0%)에서 발생하였다. 3) 탈력발작은 주로 감정적인 자극에 의하여 유발되어, 웃을때(80%, n=16)와 농담할 때(70%, n=14)에 가장 흔하게 유발되었으며, 탈력발작 발생부위의 빈도는 무릎과 다리 부분이 95%(n=19)이었으며, 턱부위는 30%(n=6)로 나타났다. 4) HLA-DQB1*0602는 환자군 20명중 18명(90.0%), 정상 대조군 21명중 5명(23.8%)에서 양성으로 나타났으며, HLA-DR2는 환자군 중 18명(90%), 정상 대조군 중 7명 (35%)에서 양성으로 나타났다. 결 론 : 이상의 결과에서 한국인 기면병 환자에서 HLADQB1*0602 양성이 높은 빈도로 나타났으며, 여러 인종들을 대상으로 한 여러 연구 결과와도 일치하여 HLA-DQB1*0602가 인종을 초월한 매우 유용한 표지자가 될 수 있을 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1077-1084
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• 2008

목 적: 세균성 수막염은 소아에서 심각한 감염 질환이지만 우리나라에서 그 빈도와 원인균, 사망률, 나이별 분포에 대한 연구가 많지 않다. 본 연구에서는 서울의 한 대학 병원에서 세균성 수막염의 연령별, 원인균 별 빈도와 임상 양상에 대해 알아보았다. 방법: 1993년 9월부터 최근 2006년 8월까지 13년간 이화여자대학교 목동 병원에 세균성 수막염으로 입원한 신생아에서 18세까지의 소아를 대상으로 하여 연령별 원인균 및 발생 빈도와 역학을 후향적으로 분석하였다. 세균성 수막염의 정의는 첫째로 뇌척수액에서 세균이 분리 배양되었거나, 둘째로 뇌척수액에서 세균은 배양되지 않았지만 뇌막 자극 증상이 있고 뇌척수액에 백혈구수의 증가가 있으며 혈액에서 세균이 배양되어 배양된 세균이 수막염의 원인으로 추정되는 경우로 하였다. 결과: 총 81례 중 GBS가 30례(37.0%)로 가장 흔한 원인균이었고 이어서 H. influenzae가 22례(27.2%), S. pneumoniae가 12례(14.8%), E. coli가 3례(3.7%), N. meningitidis가 1례(1.2%), 기타균이 13례(16.0%)이었다. 신생아와 2개월 이하의 수막염에서 GBS가 가장 흔한 균이었다. 3개월에서 5세에서는 H. influenzae가 가장 흔한 균이었으며 5세 이상에서는 S. pneumoniae가 가장 흔했다. 31례에서 합병증이 있었으며 사망률은 과거에 비해 감소하였다. 결론: 신생아에서 세균성 수막염의 원인으로 GBS가 가장 많았다. Hib 백신의 도입 이후 H. influenzae에 의한 수막염의 빈도가 감소하는 추세였다. 단백결합 폐구균 백신의 효과에 대한 연구가 필요하며 GBS에 대한 예방전략을 세워야 한다.