• 한국전자통신학회논문지
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• 제12권2호
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• pp.401-410
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• 2017

본 연구는 일 종합병원 산부인과 환자를 대상으로 2013년 7월 1일 포괄수가제가 확대시행 전 후의 재원일수와 진료비를 비교 분석하여 포괄수가제 시행의 효과를 파악하고자 수행되었다. G광역시 소재 일 종합병원에서 2013년 1년간 산부인과 포괄수가제 질병군의 수술(자궁 및 자궁부속기 수술, 제왕절개술)을 받고 퇴원한 환자로, 행위별 수가제 적용 대상자는 2013년 1월~6월까지 입원한 환자 204명이었고, 포괄수가제 적용 대상자는 2013년 7월~12월까지 입원한 환자 194명으로 총 398명의 재원일수 및 진료비를 공분산분석(ANCOVA)하였다. 본 연구결과 재원일수는 행위별수가제에서 6.65(0.13)일, 포괄수가제에서 6.40(0.12)일로 감소하였고(p=0.013), 급여총진료비는 행위별수가제에서 1,726,333(46,331)원, 포괄수가제에서 2,271,115(37,069)으로 증가하였고(p<0.001), 보험자부담금은 행위별수가제에서 1,387,142(41,938)원, 포괄수가제에서 1,800,914(28,300)원으로 증가였다(p<0.001). 급여본인부담금은 행위별수가제에서 339,190(8,404)원, 포괄수가제에서 70,201(9,255)원으로 감소하였고(p<0.001), 비급여비용은 행위별수가제에서 642,243(22,039)원, 포괄수가제에서 197,507(9,091)원으로 감소하였고(p<0.001), 환자 총본인부담금도 행위별수가제에서 981,433(25,947)원, 포괄수가제에서 667,708(13,286)원으로 감소하였다(p<0.001). 본 연구결과 산부인과 환자에 대한 포괄수가제 적용은 재원일수, 비급여비용, 총본인부담금을 감소시켰고, 급여본인부담금, 보험자부담금, 급여총진료비를 증가시키는 효과를 보였다.

• 보건의료산업학회지
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• 제11권3호
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• pp.23-35
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• 2017

Objectives : This study analyzed the trends of patient costs in 7diagnosis-related groups(DRG) since July 2013 when the government made it mandatory for all hospitals and clinics. Methods : Data were collected from the 7DRG score chart published by the Ministry of Health and Welfare(MoHW) from July 2013 to January 2017. The average value of the weekday relative value scale was multiplied by unit price, referred to as'- "patient costs by disease group"-' and they were analyzed by time series. Results : Patient costs had increased among all patients with a comprehensive disease. Small and medium-sized hospitals (hospitals and clinics) showed a slight increase in patient costs. Conclusions : Enforcement of the Korean diagnosis-related groups has led to management crisis in small and medium-sized hospitals and deterioration medical service quality. To solve this problem, The weekday relative value scale of small and medium-sized hospitals should be increased significantly.

• 약학회지
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• 제56권2호
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• pp.108-115
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• 2012

The hyperpolarization-activated current ($I_h$) is an inward cation current activated by hyperpolarization of the membrane potential and plays a role as an important modulator of action potential firing frequency in many excitable cells. In the present study we investigated the effects of extracellular divalent cations on $I_h$ in dorsal root ganglion (DRG) neurons using whole-cell voltage clamp technique. $I_h$ was slightly increased in $Ca^{2+}$-free bath solution. BAPTA-AM did not change the amplitudes of $I_h$. Amplitudes of $I_h$ were decreased by $Ca^{2+}$, $Mg^{2+}$ and $Ba^{2+}$ dose-dependently and voltage-independently. Inhibition magnitudes of $I_h$ by external divalent cations were partly reversed by the concomitant increase of extracellular $K^+$ concentration. Reversal potential of $I_h$ was significantly shifted by $Ba^{2+}$ and $V_{1/2}$ was significantly affected by the changes of extracellular $Ca^{2+}$ concentrations. These results suggest that $I_h$ is inhibited by extracellular divalent cations ($Ca^{2+}$, $Mg^{2+}$ and $Ba^{2+}$) by interfering ion influxes in cultured rat DRG neurons.

• Journal of Korean Neurosurgical Society
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• 제46권1호
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• pp.11-15
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• 2009

Objective: Two findings easily found at coronal source images of MR myelography (MRM) were evaluated : dorsal root ganglion (DRG) swelling and running course abnormality (RCA) of L5 exiting root at foramen or extraforamen. We tried to find the sensitivity of each finding when root was compressed. Methods: From 2004 July to 2006, one hundred and ten patients underwent one side paraspinal decompression for their L5 root foraminal or extraforaminal compression at L5-S1 level. All kinds of conservative treatments failed to improve leg symptom for several months. Before surgery, MRI, CT and MRM were done. Retrospective radiologic analysis for their preoperative MRM coronal source images was done to specify root compression sites and L5 root morphologic changes. Results: DRG swelling was found in 66 (60%) of 110 patients. DRG swelling has statistically valuable meaning in foraminal root compression (chi-square test, p<0.0001). Seventy-two (66%) in 110 patients showed abnormal alteration of running course. Abnormal running course has statistically valuable meaning in foraminal or extraforaminal root compression (chi-square test, p<0.0001). Conclusion: Three-dimensional MRM provides precise thin sliced coronal images which are most close to real operative views. DRG swelling and running course abnormality of L5 exiting root are two useful findings in diagnosing L5 root compression at L5-S1 foramen or extraforamen. MRM is thought to provide additional diagnostic accuracy expecially in L5-S1 foraminal and extraforaminal area.

• Molecules and Cells
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• 제21권2호
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• pp.237-243
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• 2006

Brain-derived neurotrophic factor (BDNF) is a neuromodulator of nociceptive responses in the dorsal root ganglia (DRG) and spinal cord. BDNF synthesis increases in response to nerve growth factor (NGF) in trkA-expressing small and medium-sized DRG neurons after inflammation. Previously we demonstrated differential activation of multiple BDNF promoters in the DRG following peripheral nerve injury and inflammation. Using reporter constructs containing individual promoter regions, we investigated the effect of NGF on the multiple BDNF promoters, and the signaling pathway by which NGF activates these promoters in PC12 cells. Although all the promoters were activated 2.4-7.1-fold by NGF treatment, promoter IV gave the greatest induction. The p38 mitogen-activated protein kinase (MAPK) inhibitor, SB203580, phosphatidylinositol 3-kinase (PI-3K) inhibitor, LY294003, protein kinase A (PKA) inhibitor, H89, and protein kinase C (PKC) inhibitor, chelerythrine, had no effect on activation of promoter IV by NGF. However, activation was completely abolished by the MAPK kinase (MEK) inhibitors, U0126 and PD98059. In addition, these inhibitors blocked NGF-induced phosphorylation of extracellular signal-regulated protein kinase (ERK) 1/2. Taken together, these results suggest that the ERK1/2 pathway activates BDNF promoter IV in response to NGF independently of NGF-activated signaling pathways involving PKA and PKC.

• The Korean Journal of Physiology and Pharmacology
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• 제5권6호
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• pp.511-519
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• 2001

Nimopidine, one of dihydropyridine derivatives, has been widely used to pharmacologically identify L-type Ca currents. In this study, it was tested if nimodipine is a selective blocker for L-type Ca currents in sensory neurons and heterologous system. In mouse dorsal root ganglion neurons (DRG), low concentrations of nimodipine $(<10\;{\mu}M),$ mainly targeting L-type Ca currents, blocked high-voltage-activated calcium channel currents by ${\sim}38%.$ Interestingly, high concentrations of nimodipine $(>10\;{\mu}M)$ further reduced the 'residual' currents in DRG neurons from ${\alpha}_{1E}$ knock-out mice, after blocking L-, N- and P/Q-type Ca currents with $10\;{\mu}M$ nimodipine, $1\;{\mu}M\;{\omega}-conotoxin$ GVIA and 200 nM ${\omega-agatoxin$ IVA, indicating inhibitory effects of nimodipine on R-type Ca currents. Nimodipine $(>10\;{\mu}M)$ also produced the inhibition of both low-voltage-activated calcium channel currents in DRG neurons and ${\alpha}_{1B}\;and\;{\alpha}_{1E}$ subunit based Ca channel currents in heterologous system. These results suggest that higher nimodipine $(>10\;{\mu}M)$ is not necessarily selective for L-type Ca currents. While care should be taken in using nimodipine for pharmacologically defining L-type Ca currents from native macroscopic Ca currents, nimodipine $(>10\;{\mu}M)$ could be a useful pharmacological tool for characterizing R-type Ca currents when combined with toxins blocking other types of Ca channels.

• 대한간호
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• 제25권2호통권135호
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• pp.40-48
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• 1986

• 대한약리학회:학술대회논문집
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• 대한약리학회 2006년도 The 6th Congress of the Federation of Asian and Oceanian Physiological Societies
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• pp.84.1-84.1
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• 2006

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.334-335
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• 2002

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.338-339
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• 2002