• Title/Summary/Keyword: K-DRG

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Effects of the Protein Fraction of Panax ginseng on Primary Cultured Chicken Brain Cells and DRG (인삼 단백분획물이 일차배양한 계배의 뇌세포 및 DRG에 미치는 영향)

  • Park, Mi-Jung;Song, Jin-Ho;Kim, Sun-Yeou;Kim, Young-Choong
    • YAKHAK HOEJI
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    • v.34 no.5
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    • pp.365-373
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    • 1990
  • The effects of the protein fraction of Panax ginseng on primary cultured chicken embryonic brain cells and DRG cultured with a deficient medium were studied. The protein fraction was further fractionated into four groups according to the molecular weight; larger than 10,000 dalton(fraction A), between 5,000 and 10,000 daltons(fraction B), between 1,000 and 5,000 daltons(fraction C), between 500 and 1,000 daltons(fraction D). All four protein fractions at the concentration of $100\;{\mu}g/ml$ significantly increased the number of the brain cells which promoted the neurite outgrowth. The activity of PDHC in the brain cells was elevated significantly by the protein fraction B at the concentration of $100\;{\mu}g/ml$. It was noted that $100\;{\mu}g/ml$ protein fraction C and D significantly enhanced the synthesis of protein in the brain cells. At the concentration of $100\;{\mu}g/ml$, the protein fraction B enhanced RNA synthesis and the protein fraction A significantly enhanced DNA synthesis in the brain cells. The protein fractions B, C, and D significantly promoted the neurite outgrowth of DRG at the concentration of $100\;{\mu}g/ml$.

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Reliability Evaluation of Electrical Distribution Network Containing Distributed Generation Using Directed-Relation-Graph

  • Yang, He-Jun;Xie, Kai-Gui;Wai, Rong-Jong;Li, Chun-Yan
    • Journal of Electrical Engineering and Technology
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    • v.9 no.4
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    • pp.1188-1195
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    • 2014
  • This paper presents an analytical technique for reliability evaluation of electrical distribution network (EDN) containing distributed generation (DG). Based on hierarchical levels of circuit breaker controlling zones and feeder sections, a directed-relation-graph (DRG) for an END is formed to describe the hierarchical structure of the EDN. The reliability indices of EDN and load points can be evaluated directly using the formed DRG, and the reliability evaluation of an EDN containing DGs can also be done without re-forming the DRG. The proposed technique incorporates multi-state models of photovoltaic and diesel generations, as well as weather factors. The IEEE-RBTS Bus 6 EDN is used to validate the proposed technique; and a practical campus EDN containing DG was also analyzed using the proposed technique.

Single-Channel Recording of TASK-3-like $K^+$ Channel and Up-Regulation of TASK-3 mRNA Expression after Spinal Cord Injury in Rat Dorsal Root Ganglion Neurons

  • Jang, In-Seok;La, Jun-Ho;Kim, Gyu-Tae;Lee, Jeong-Soon;Kim, Eun-Jin;Lee, Eun-Shin;Kim, Su-Jeong;Seo, Jeong-Min;Ahn, Sang-Ho;Park, Jae-Yong;Hong, Seong-Geun;Kang, Da-Won;Han, Jae-Hee
    • The Korean Journal of Physiology and Pharmacology
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    • v.12 no.5
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    • pp.245-251
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    • 2008
  • Single-channel recordings of TASK-1 and TASK-3, members of two-pore domain $K^+$ channel family, have not yet been reported in dorsal root ganglion (DRG) neurons, even though their mRNA and activity in whole-cell currents have been detected in these neurons. Here, we report single-channel kinetics of the TASK-3-like $K^+$ channel in DRG neurons and up-regulation of TASK-3 mRNA expression in tissues isolated from animals with spinal cord injury (SCI). In DRG neurons, the single-channel conductance of TASK-3-like $K^+$ channel was $33.0{\pm}0.1$ pS at - 60 mV, and TASK-3 activity fell by $65{\pm}5%$ when the extracellular pH was changed from 7.3 to 6.3, indicating that the DRG $K^+$ channel is similar to cloned TASK-3 channel. TASK-3 mRNA and protein levels in brain, spinal cord, and DRG were significantly higher in injured animals than in sham-operated ones. These results indicate that TASK-3 channels are expressed and functional in DRG neurons and the expression level is up-regulated following SCI, and suggest that TASK-3 channel could act as a potential background $K^+$ channel under SCI-induced acidic condition.

The Change of Medical Care Pattern and Cost of Cataract Surgery by the DRG Payment System in a General Hospital (한 종합병원의 포괄수가제 실시 전후 수정체수술환자의 의료서비스 및 진료비 비교분석)

  • Lee, Mi-Rim;Lee, Yong-Hwan;Koh, Kwang-Wook
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.48-70
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    • 2005
  • The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.

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Impacts of the Implementation of the DRG Based Prospective Payment System on the Medicare Expenditures (DRG 도입이 메디케어 의료비 증가억제에 미친 효과)

  • Kim, Han-Joong;Nam, Chung-Mo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.1 s.45
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    • pp.107-116
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    • 1994
  • The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

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Is the Hospital Caseload of Diagnosis Related Groups Related to Medical Charges and Length of Stay? (DRGs(Diagnosis Related Groups)별 환자집중도 수준에 따른 입원진료비와 재원일수의 차이 분석)

  • Kwak, Jin-Mi;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.13-24
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    • 2014
  • This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

The Effect of Mandatory Diagnosis-Related Groups Payment System (포괄수가제도 당연적용 효과평가)

  • Choi, Jae-Woo;Jang, Sung-In;Jang, Suk-Yong;Kim, Seung-Ju;Park, Hye-Ki;Kim, Tae Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.26 no.2
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    • pp.135-147
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    • 2016
  • Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.

Effect of Herba Epimedii on hydrogen peroxide induced neurotoxicity in cultured rat dorsal root ganglion neurons

  • Park Seung-Taeck;Lee Young-Mi;Hong Gi-Youn;Choi Ki-Uk;Min Bu-Ki;Yoon Hyang-Suk;Chang Chul-Ho;Lee Kang-Chang;Juhng Seon-Kwan;Han Du-Seok;Lee Gap-Sang;Seong Kang-Kyung;Lee Geon-Mok
    • Advances in Traditional Medicine
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    • v.2 no.1
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    • pp.36-40
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    • 2002
  • Effects of hydrogen peroxide $(H_2O_2)-induced$ neurotoxicity were investigated in cultured newborn rat spinal dorsal root ganglion (DRG) neurons after DRG neurons were treated in the media containning various concentrations of $H_2O_2$. In addition, the protective effect of Herba Epimedii (HE) extract against $H_2O_2-induced$ neurotoxicity was examined. Cytotoxic values were determined by the cell viability of living cells using 3-(4,5-dimethylthiazol-2-yl) -2,5-diphenyltetrazolium bromide (MTT) assay. In the present study, exposure of neurons to $H_2O_2$ resulted in a significant cell death in a dose- and time-dependent manners in cultured DRG neurons. The decrement of cell viability by $H_2O_2$ was blocked by HE. These results suggest that the neuroprotective effect of HE against $H_2O_2-induced$ cytotoxicity may result from the prevention of injury induced by $H_2O_2$.

Differences of Medical Costs by Classifications of Severity in Patients of Liver Diseases (중증도 분류에 따른 진료비 차이: 간질환을 중심으로)

  • Shin, Dong Gyo;Lee, Chun Kyoon;Lee, Sang Gyu;Kang, Jung Gu;Sun, Young Kyu;Park, Eun-Cheol
    • Health Policy and Management
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    • v.23 no.1
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    • pp.35-43
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    • 2013
  • Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.

Effects of Nefopam on Streptozotocin-Induced Diabetic Neuropathic Pain in Rats

  • Nam, Jae Sik;Cheong, Yu Seon;Karm, Myong Hwan;Ahn, Ho Soo;Sim, Ji Hoon;Kim, Jin Sun;Choi, Seong Soo;Leem, Jeong Gil
    • The Korean Journal of Pain
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    • v.27 no.4
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    • pp.326-333
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    • 2014
  • Background: Nefopam is a centrally acting non-opioid analgesic agent. Its analgesic properties may be related to the inhibitions of monoamine reuptake and the N-methyl-D-aspartate (NMDA) receptor. The antinociceptive effect of nefopam has been shown in animal models of acute and chronic pain and in humans. However, the effect of nefopam on diabetic neuropathic pain is unclear. Therefore, we investigated the preventive effect of nefopam on diabetic neuropathic pain induced by streptozotocin (STZ) in rats. Methods: Pretreatment with nefopam (30 mg/kg) was performed intraperitoneally 30 min prior to an intraperitoneal injection of STZ (60 mg/kg). Mechanical and cold allodynia were tested before, and 1 to 4 weeks after drug administration. Thermal hyperalgesia was also investigated. In addition, the transient receptor potential ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) expression levels in the dorsal root ganglion (DRG) were evaluated. Results: Pretreatment with nefopam significantly inhibited STZ-induced mechanical and cold allodynia, but not thermal hyperalgesia. The STZ injection increased TRPM8, but not TRPA1, expression levels in DRG neurons. Pretreatment with nefopam decreased STZ-induced TRPM8 expression levels in the DRG. Conclusions: These results demonstrate that a nefopam pretreatment has strong antiallodynic effects on STZ-induced diabetic rats, which may be associated with TRPM8 located in the DRG.