• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.393-401
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• 2000

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1999년도 제51차 추계 학술대회 연제집
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• pp.75-76
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• 1999

• 약학회지
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• 제41권1호
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• pp.99-104
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• 1997

In order to elucidate the cytotoxic effect of oxygen radicals on cultured spinal dorsal root ganglion(DRG) neurons derived from mouse. the neurotoxic effect of oxygen radicals w as examined after cultured DRG neurons were exposed to xanthine oxidase(XO) and hypoxanthine(HX)-oxygen radical generating system. In addition. neuroprotective effect of epidermal growth factor(EGF) against oxidant-induced neurotoxicity was also evaluated in these cultures. The results were, as follows: 1. Lethal concentration 50(LC$_{50}$) was 35mU/ml XO and 0.1mM HX in cultured DRG neurons. 2. Oxygen radicals induced the morphological changes such as the decrease of cell number and loss of neurites in these cultures. 3. EGF increased the cell viability and neurofilament in neurons damaged by oxygen radicals. From above the results, it is suggested that oxygen radicals have a cytotoxic effect on cultured DRG neurons of neonatal mouse and selective neurotrophic factors such as EGF are, effective, in blocking the neurotoxicity induced by oxygen radicals in cultured spinal DRG neurons.

• 한국융합학회논문지
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• 제9권6호
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• pp.99-106
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• 2018

본 연구는 인구 고령화에 따라 증가하고 있는 안과 질병군(DRG)포괄수가 수정체 수술 환자를 중심으로 질병군(DRG)포괄수가 적정성 평가도입에 따른 수술합병증 발생률 변화를 파악하고자 시행하였다. 연구대상은 2016년 1월부터 12월까지 1년간, 전국소재, 전 종별(상급종합병원, 종합병원, 병원, 의원)에서 청구하는 질병군(DRG)포괄수가 수정체 수술 환자의 건강보험 및 보훈 진료비용이다. 본 연구에서 종속변수는 '유리체탈출', '안압상승', '기타합병증'으로 세 가지 항목을 포함하고 있어 다항로지스틱 회귀분석을 실시하였으며 분석결과 기타합병증군에 비해 유리체탈출군이 재원일수가 늘어날수록 0.27배(95% CI 0.08~1.00), 안압상승군은 0.14배(95% CI 0.03~1.59) 줄어들었고 이는 통계적으로 유의하였다. 이상과 같은 결과 질병군(DRG)포괄수가 적정성 평가 도입에 따른 수정체 수술 합병증 환자를 대상으로 질병군 적정성 평가 결과와 질병군 수술 합병증의 의료의 질을 비교를 하였다는 점에서 의의가 있다.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.93-98
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• 2010

Purpose: To investigate temporal changes in IL-1${\beta}$ mRNA expression in spinal dorsal horn (DH) and dorsal root ganglion (DRG) in a rat lumbar disc herniation (LDH) model. Methods: Autologous nucleus pulposus, harvested from the tail disc between the second and third coccygeal vertebrae (Co2-3), was implanted next to the left L5 nerve root just proximal to the DRG after partial laminectomy. IL-1${\beta}$ mRNA expression was investigated in DRG and DH in our LDH model. Real-time PCR assays were done using a 7500 Real Time PCR system (Applied Biosystems, USA). Results: Expression of IL-1${\beta}$ in DRG and DH was observed for 30 days postoperatively. Expression of IL-1${\beta}$ mRNA in the ipsilateral DRG of the LDH group gradually increased from 5 to 30 days after surgery. The amount of IL-1${\beta}$ in the contralateral DRG peaked 10 days after surgery and then gradually decreased. However, there was no difference in IL-1${\beta}$ mRNA expression in spinal DH between the LDH group and the sham-operated group. Conclusion: Long-term expression of IL-1${\beta}$ in the LDH model may worsen the chronic pain state. Future studies on inhibition of IL-1${\beta}$ expression in the LDH model will be needed to develop selective treatment strategies for patients with LDH.

• 대한한의학방제학회지
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• 제7권1호
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• pp.143-151
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• 1999

척수감각신경절세포에 대한 산소자유기의 신경독성효과에 대한 기전을 규명하기 위하여 여러 농도의 Glucose Oxidase(GO)를 배양 척수 감각신경절세포에 처리한 후 GO의 독성효과를 분석하였으며 또한 GO에 의하여 유발된 신경독성에 대한 음양곽(Epimedium Koreanum Nakai)의 방어효과를 MTT assay법에 의하여 조사하여 다음과 같은 결론을 얻었다. GO는 신경세포에 처리한 농도와 시간에 비례하여 세포의 생존율을 유의하게 감소시켰으며, 또한 음양곽이 GO의 독성효과를 효과적으로 방어하였다. 이상의 결과로부터 산소자유기인 GO는 생쥐의 배양 척수감각신경절세포에 독성을 나타냈으며 음양곽과 같은 한약추출물이 GO의 독성을 방어하는데 효과적인 것으로 나타났다.

• The Korean Journal of Pain
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• 제33권3호
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• pp.275-283
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• 2020

Background: Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. Methods: The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson's coefficient. Results: The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the P < 0.001), while the ADC values were significantly higher (P = 0.003, P < 0.001, and P = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 (P < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = -0.420, P = 0.037 and r = 0.531, P = 0.006, respectively) was found. Conclusions: DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.

• Biomolecules & Therapeutics
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• 제22권6호
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• pp.532-539
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• 2014

Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC ($50{\mu}mol/L$) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (> $25{\mu}m$), whereas ddC mainly affected small diameter DRG neurons (${\leq}25{\mu}m$). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.

• Applied Microscopy
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• 제40권1호
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• pp.15-19
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• 2010

이번 연구에서는 성체 랫드(Sprague-Dawley)의 척수신경절내 분포하는 zinc의 분포 관찰하기 위하여 zinc selenium autometallograpy(AMG)로 염색하였다. H-E염색표본에서 척수신경절 속에는 신경절세포들이 무리지어 분포하고 있었고, 세포체는 둥글거나 타원형이었으며, 작은 신경절세포, 큰 신경절세포로 대별되었다. 모든 신경절세포의 세포체는 한 층의 납작한 위성세포(satellite cell)에 의하여 둘러싸여 있었다. AMG 염색표본에서는 작은 신경절세포의 경우 강한 양성반응이 핵 주변부에서 관찰되었으나, 큰 신경절세포의 경우 전반적으로 미약한 AMG 양성반응을 보였고, 염색양상도 서로 달랐다. 그러나 큰 신경절세포를 둘러싸는 위성세포에서는 뚜렷한 AMG 양성반응이 관찰되었다. 이러한 조직화학적 본 연구의 결과는 zinc가 감각신경절인 랫드 척수신경절에서 통증을 포함한 감각의 전달과정에 의미있는 기능을 영위할 수 있음을 시사한다.

• 디지털융복합연구
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• 제11권6호
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• pp.289-298
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• 2013

본 연구는 2013년 7월부터 대학병원에서도 시작되는 산부인과 포괄수가제를 대비하여 일개 대학병원 산부인과에서 2012년 4월부터 2012년 9월까지 6개월 동안 산부인과 DRG에 속한 건강보험 환자군을 대상으로 진료행태의 변화를 모의실험을 통해 재원일수의 변화 가능성, 의료 서비스 제공량의 전이와 변화, 항생제를 포함한 약 주사 사용 및 각종 검사 등 항목별 처방량의 변화, 진료재료의 단가 조정 및 대체 효과의 가능성을 예측하였다. 약제비가 가장 변화폭을 보였으며 진료재료와 검사의 변화가 그 뒤를 이었다. 의료 서비스량 분석에서 재원일수의 단축은 의료비용의 감소로 혹은 병원의 수익성을 증가시킬 수 있는 요인으로 판단된다. 이러한 결과로 향후 산부인과에서 DRG 질병군에 대한 표준진료지침 개발에 기초 자료로 사용할 수 있을 것으로 사료되며, 진료의 효율성을 극대화시키고 비효율적인 병원자원 소모를 감소시켜 의료비용 절감 등 의료수익을 최대한 증대시키는 경영전략수립의 기초 자료 토대 마련이 가능할 것으로 사료된다.