Lopez, Ruth Mery;Lopez, Jorge Skiold;Lozano, Jair;Flores, Hector;Carranza, Rosa Angelica;Franco, Antonio;Castillo, Enrique Fernando
The Korean Journal of Physiology and Pharmacology
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v.24
no.4
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pp.339-348
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2020
We aimed to characterize the participation of rapid non-genomic and delayed non-genomic/genomic or genomic mechanisms in vasoactive effects to triiodothyronine (T3), emphasizing functional analysis of the involvement of these mechanisms in the genesis of nitric oxide (NO) of endothelial or muscular origin. Influences of in vitro and in vivo T3 treatments on contractile and relaxant responsiveness of isolated rat aortas were studied. In vivo T3-treatment was 500 ㎍·kg-1·d-1, subcutaneous injection, for 1 (T31d) and 3 (T33d) days. In experiments with endothelium-intact aortic rings contracted with phenylephrine, increasing concentrations of T3 did not alter contractility. Likewise, in vitro T3 did not modify relaxant responses induced by acetylcholine or sodium nitroprusside (SNP) nor contractile responses elicited by phenylephrine or angiotensin II in endothelium-intact aortas. Concentration-response curves (CRCs) to acetylcholine and SNP in endothelium-intact aortic rings from T31d and T33d rats were unmodified. T33d, but not T31d, treatment diminished CRCs to phenylephrine in endothelium-intact aortic rings. CRCs to phenylephrine remained significantly depressed in both endothelium-denuded and endothelium-intact, nitric oxide synthase inhibitor-treated, aortas of T33d rats. In endothelium-denuded aortas of T33d rats, CRCs to angiotensin II, and high K+ contractures, were decreased. Thus, in vitro T3 neither modified phenylephrine-induced active tonus nor CRCs to relaxant and contractile agonists in endothelium-intact aortas, discarding rapid non-genomic actions of this hormone in smooth muscle and endothelial cells. Otherwise, T33d-treatment inhibited aortic smooth muscle capacity to contract, but not to relax, in an endothelium- and NO-independent manner. This effect may be mediated by delayed non-genomic/genomic or genomic mechanisms.
In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.
Our society is aging rapidly. In this super-aged society, the increase in healthcare costs are considered a national problem that undermines the sustainability of social security. Various services for healthcare for the elderly have been promoted to address this. However, most of them have focused on healthcare after the outbreak of chronic diseases and lack preventive healthcare. Most of the preventive healthcare projects are only pilots. In this paper, the current status of health care services for senior citizens at home and abroad was analyzed and based on this, the limitations and improvements were analyzed to propose the establishment of IoT-based Total Silver Care Center. IoT-based Total Silver Care Center may be conveniently monitored the health status of the elderly through various sensors, medical devices, and smart bands. And based on this, it can improve the quality of nursing services through time-saving and work efficiency of nursing providers. In addition, health care interventions may be provided in a timely manner if there is a change in the health status of users. And real-time imaging systems can help overcome mental difficulties.
The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.
Kim, Jang-Rak;Park, Jung-Han;Lee, Jae-Kyong;Seo, Sang-Hong;Bang, Joon-Yong
Journal of Preventive Medicine and Public Health
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v.26
no.4
s.44
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pp.599-613
/
1993
To study the pattern of prenatal care utilization and its determinants in rural Korea, 976 mothers (65.5%) out of 1,489 living mothers in Chinyang, Sachon and Hapchon Counties in Kyongsangnam Province who had delivered a baby between July 1, 1990 and June 30, 1991 were interviewed by the Myon health workers from January 3 through February 15, 1992. The Anderson's behavioral model for health service utilization was applied to develop the frames for analysis. The dependent variable was a number of prenatal care visits. And the independent variables included In the model were the variables pertaining to the predisposing, enabling, medical need and other components. The proportion of mother who had ever received the prenatal care service for the index pregnancy was 97.3%. However, the proportion of mothers who had made more than 10 visits was only 20.6%, which indicated that majority of mothers had paid far less visits than recommended $10{\sim}12$ visits for each normal pregnancy. The low utilization of prenatal care services (none or less than 4 visits) was related to mother's low educational level, the high birth order, beneficiary of the medical aid, the absence of clinic in the community, no diagnosed disease of mother during pregnancy, and mothers engaged in farming. Inequity of access seemed to exist because social structure variables and the variables of enabling component were important predictors. And there seemed to be high mutability in equalizing the distribution of prenatal care services because the variables of enabling component such as type of medical security and whether there was a clinic or not in the community were substantially important.
The objective of this study is to supply the good quality of experts the radiation industries in Korea and develop the major subject matter needed in the radiation industries and the curriculum in order to execute it for the variation of fields of employment at the department of radiation in the junior college and the development of the percentage of employment. In addition, this study is to improve the level of radiation experts engaged in the industries in quality, and it is to improve the social recognition of radiation rather negative now because of the development of radiation industry. As for the core results of this research, it was to suggest the detailed choice method curriculum proper to the service fields of radiation industries, but it may be subject to change due to each college's property and the educational objectives. From the result of this research above, it may be summed up as follows. First, as for the detailed curriculum by the service field, this study was to organize two subject matters: 1. the subject matter proper to the field of using the radiation, and 2. the subject matters proper to the safety control field of radiation. Second, as for the detailed curriculum by the pattern of industries, this study was to organize the four subject matters: 1. the subject matter needed in the manufactures, 2. the subject matter needed in the nondestructive testing industries, 3. the subject matter needed in the sales agencies, and 4. the subject matter needed in the laboratories. This study was to suggest the operational model about the curriculum in order to execute these subject matters. It could be executed as two methods below. First, one method is to execute the major systems by the medical field and industrial field in the third course at the department of radiation in the junior college now. Second, the other method is to make them specialize the industrial radiation in the Advanced Course(one year course) after the graduation of junior college. To operate these curricula successively it needs to assume the deeper research and the development of materials about the subject matters related to the nuclear radiation industries hereafter. In addition, it needs to solve the security of finance like the manpower of professor, space for practice, and the educational appliances, etc. needed in the operation of subject matters. Finally, the effect and result from the development or revision of college curriculum did not come out in a short time. It will require considerable time until the undergraduates at the department in the junior college finish a set of curriculum newly developed, and graduate the university, and can get the results while they engage in their works in the industrial sites. Accordingly, all the interested parties have to anticipate the results of this research with the patience in long-standing point of view. Also, this researcher considers it as it is willing to give them the continuous interest and support.
The main theme of this paper centers on how to promote Three Major Works of Daesoon Jinrihoe, charity aid, social welfare, and education projects, during the unification period. Determining the best methods of promotion is crucial because the Three Major Works must be carried out after unification, and the works must remain based on the practice of the philosophy of Haewon-sangsaeng (the Resolution of Grievances for Mutual Beneficence). The idea of Haewon-sangsaeng is in line with the preface of the U.N. Charter and the aim of world peace. North Korean residents are suffering from starvation under their devastated economy, which is certain to face a crisis of materialistic deficiency during reunification. In this study, the peaceful unification of Germany, unification under a period of sudden changes in Yemen, and the militarized unification of Vietnam were taken as case studies to diagnose and analyze the conditions which would affect the implementation of the Three Major Works. These three styles of unification commonly required a considerable budget and other forms of support to carry out the Three Major Works. Especially if unification were to occur after a period of sudden changes, this would require solutions to issues of food, shelter, and medical support due to the loss of numerous lives and the destruction of infrastructure. On the other hand, the UNHCR model was analyzed to determine the implications of expanding mental well prepared and sufficiently qualified professionals, reorganizing standard organizations within complex situations, task direction, preparing sufficient relief goods, budgeting, securing bases in border areas with North Korea, and establishing networks for sponsorship. Based on this, eight detailed tasks in the field of system construction could be used by the operators of the Three Major Works to prepare for unification. Additionally, nine tasks for review were presented in consideration of the timing of unification and the current situation between South and North Korea. In conclusion, in the event of unification, the Three Major Works should not be neglected during the transition period. The manual "Three Major Works during the Unification Period" should include strategic points on organizational formation and mission implementation, forward base and base operation, security and logistics preparation, public relations and external cooperation, safety measures, and transportation and contact systems.
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