• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.16-23
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• 2022

Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

• 해양환경안전학회지
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• 제11권2호
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• pp.41-49
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• 2005

해양사고가 발생하게 되면 총론적으로는 해원의 형사책임은 자기부죄의 원칙상 해원이 직접 부담하지 아니할 수 없다. 그러므로 해원의 형사책임에 대한 대책은 형사상의 절차(영장실질심사제도, 구속적부심제도 등)를 최대한 이용하여 자신의 형사책임을 줄이는 방법 밖에는 없을 것이다. 기존법률의 개정을 통해 형벌을 낮추는 것도 하나의 방법이 될 것이다. 각론적으로 벌금 관련한 예로서 현행 해양오염방지법상의 과실로 인한 기름유출사고의 벌금인 3천만원은 유출량에 관계없이 최고액수가 벌금으로 나오는 경향이 있으므로 이를 유출량에 따라 차등화 시키는 것도 고려해볼 가치가 있을 것으로 판단된다. P&I의 벌금납부는 일반의 인식과는 달리 P&I가 법적의무를 부담하거나 P&I납부를 인정하는 경우에만 전보가 가능하다. 이러한 문제를 해결하기 위해서는 새로운 집단적 보험이나 공제제도를 신설하는 것도 하나의 대안이 될 것이다. 또한 해원들은 법률적인 문제에 대하여 전문가가 아니므로 법률적인 문제에 연루되게 되면 변호사 등 법률전문가의 조력을 체계적으로 받을 수 있도록 선주협회나 해기사협회 등에서 대안을 마련할 필요가 있다. (예 농어민무료법률구조지원사업 등). 끝으로 별도의 법률을 제정하든지 그렇지 않으면 기존의 교통사고처리특례법을 개정하여 해양사고부분을 삽입하는 것도 대안일 수 있을 것이다.

• 통상정보연구
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• 제10권2호
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• pp.283-304
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• 2008

According to globalization and localization of world economics international trade payment method was also changed. A traditional payment was Letter of Credit basis, however it is being increased to various methods such as remittance, documentary collection(D/P, D/A) and open account. In order to acquire a secure export payment, exporters prefer to L/C basis which is guaranteed by a reliable bank. However, the L/C should bear a security so that importers would rather documentary collection than L/C. The reasons for the preference of collection payment rather than L/C are a low commission cost, the conversion of buyer's market from seller's market due to severe competition in the world market, transaction increase between main office and branches and a right to control the goods until executing the payment by exporters. Besides of them, collection payment can handle safer and faster than open account basis. However, the collection payment has a risk which it isn't guaranteed by bank for the payment so that I would suggest countermeasures to minimize the payment risk utilizing the collection basis as follows; using export credit insurance system, a large domestic credit report provider such as D&B for absolutely fresh and new information, a collection proxy service for overseas deferred credit and suggestion specifying to order B/L not straight one on consignee in order to transfer the right of ownership with endorsement without problem.

• Korean Circulation Journal
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• 제54권5호
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• pp.256-267
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• 2024

Background and Objectives: Accumulating evidence shows that sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce adverse cardiovascular outcomes. However, whether SGLT2i, compared with other antidiabetic drugs, reduce the new development of atrial fibrillation (AF) is unclear. In this study, we compared SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4is) in terms of reduction in the risk of AF in individuals with type 2 diabetes. Methods: We included 42,786 propensity score-matched pairs of SGLT2i and DPP-4i users without previous AF diagnosis using the Korean National Health Insurance Service database between May 1, 2016, and December 31, 2018. Results: During a median follow-up of 1.3 years, SGLT2i users had a lower incidence of AF than DPP-4i users (1.95 vs. 2.65 per 1,000 person-years; hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.97; p=0.028]). In individuals without heart failure, SGLT2i users was associated with a decreased risk of AF incidence (HR, 0.70; 95% CI, 0.52-0.94; p=0.019) compared to DPP-4i users. However, individuals with heart failure, SGLT2i users was not significantly associated with a change in risk (HR, 1.04; 95% CI, 0.44-2.44; p=0.936). Conclusions: In this nationwide cohort study of individuals with type 2 diabetes, treatment with SGLT2i was associated with a lower risk of AF compared with treatment with DPP-4i.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.219-224
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• 2010

Objective : A minimally invasive transforaminal lumbar interbody fusion (MIS TLlF) has recently been introduced. However, MIS TLlF is a technically challenging procedure. The authors performed retrospective analysis about MIS TLlF using a single interbody cage. Methods : Twenty-eight consecutive patients were treated by MIS TLlF. Of these 28 patients, 20 patients were included in this retrospective study. Perioperative, clinical, and radiologic outcomes were assessed. Clinical outcomes were assessed using Oswestry Disability Index (ODI) and Visual Analogue Scores (VAS). Fusion rates and cross-sections of operated spinal canals were assessed by CT. Results : Twelve patients underwent MIS TLlF at one segment and 8 patients at two segments (L3/4: 4, L4/5: 17, L5/S1: 7). Operation time for a single segment was 131.7 min and for two segment was 201.4 min, and corresponding blood losses were 208.3 mL and 481.2 mL, respectively. ODI and VAS scores were significantly improved at 6 months postop (ODI from 30.32 to 15.54, VAS from 7.80 to 2.20, p = 0.001) Twenty-two segments (78.6%) achieved grade I fusion, 4 segments (14.3%) achieved grade II, 2 segments (7.1%) achieved grade III and 0 segments achieved grade IV at 12 months. Postoperatively at 12 months, spinal canal cross sectional areas at disc spaces significantly increased from 157.5 to $294.3\;mm^2$ (p = 0.012). Conclusion : MIS TLlF achieved good clinical outcomes and high fusion rates. Our findings show that MIS TLlF performed with a single Interbody cage and a tubular retractor system can be used as a standard MIS TLlF technique.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.9015-9019
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• 2014

The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.

• 보건행정학회지
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• 제27권3호
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• 한국항해학회지
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• 제17권4호
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• pp.73-87
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• 1993

As a result of accepting the '71 FUND Convention and enforcing the Oil Pollution Compensation Act 1992, we observed some benefits and costa. This paper analyses those benefits and costs and suggests se-veral key policy recommendations for the estasblishment of an effective oil pollution compensation regime in Korea. This paper identifies the said benefits and costs as follows : First, by establishing the oil pollu-tion compensation system as same as the international level, most of small and medium size of oil pollution damage which are caused by coastal tankers will be compensated by FUND. Second, most of oil pollution damage which are not covered by '69 CLC will be compensated by FUND. Third, some parts of FUND Contribution Fee and CRISTAL Contribution Fee to be charged by major oil companies will be doubled. However the limit of international oil pollution compensation system and the loophole outside the Oil Pol-lution Compensation Act 1992 suggest followings : 1) Radical risk management and insurance manage-ment of ocean going tanker owners, 2) Establishment of oil pollution claim settlement system, 3) Enforce-ment of crew and ship management for coastal tanker and 4) Establishment of Korean P & I Club.

• 한국경제지리학회지
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• 제13권4호
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• pp.584-600
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• 2010

본 연구는 미국 동부 지역의 두 고속도로 회랑지대, I-95와 I-85 일대의 지식 기반 서비스업의 고용변화를 확장된 shift-share 분석을 통해 살펴보고 있다. 지식 기반 서비스업으로 선정된 산업은 금융, 보험, 비즈니스 서비스와 의료 산업이며 1977년부터 1990년, 1990년부터 2005년까지의 기간 동안의 대도시 지역이 연구 대상이다. 1977년부터 1990년 사이에는 생산량과 노동 생산성 측면에서 두 지역 모두 주변 지역 및 국가 전체 평균보다 월등한 성장세를 보였다. 그러나 1990년에서 2005년 사이에는 산업별 차이가 있었지만 평균에 미치지 못하는 성장 속도를 보이는 경우가 많이 나타났다. 또한 지리적으로 인접해 있거나 동일한 회랑지대에 위치한 대도시들도 유사한 고용 변화 패턴을 보이지는 않는다는 것이 밝혀졌다.

• The Journal of Korean Physical Therapy
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• 제10권2호
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• pp.13-32
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• 1998

A questionaire was conducted to obtain ran satisfactions in information of the 325 disabled persons among the total 9,314 handicapped people in Taejon area, and was surveyed during the period of June 1 to August 31, 1997. The results are as follows: 1. Among the studied disabled persons, $54.5\%$ of male, and $45.5\%$ of female. 2. Before disabled in occupation, $32.0\%$ of out of work group were high, $6.5\%$ of farm, student group were low. Before disabled in occupation by gender, male group is $29.9\%$ of out of work group were high, $0.6\%$ of housework group were low. female group is$34.5\%$ of out of work group were high, $4.7\%$ of student group were low(P<0.001). 3. After disabled in occupation, $75.1\%$ of out of work group wert high, $10.8\%$ of in working group were low. After disabled in occupation by gender, male group is $87.6\%$ of out of work group were high, $1.7\%$ of housework group were low. female group is $60.1\%$ of out of work group were hgh, $10.8\%$ of in working group were low(P<0.001). 4. Medical security status, $64.9\%$ of medical aid group wore high, $35.1\%$ of medical insurance group were low. Medical security status by gender, male group is $71.2\%$ of medical aid group were high, $28.8\%$ of medical insurance group were Iew. female group is $57.4\%$ of medical aid group wan high, $42.6\%$ of medical insurance were low(P<0.01). 5. Disabled record status, $68.6\%$ of record group were high, $31.4\%$ of non group were low. Disabled record status by gender, male group is $78.5\%$ of record group were high, $21.5\%$ of non record group were low. female group is $56.6\%$ of record group were high, $43.4%$ of non record group were low(P<0.001). 6. Disabled duration status, $42.2\%$ of loss than 9 year group were high, $10.2\%\;of\;20-29,\;30-39$ year group were low. Disabled duration status by gender,'male group is $44.6\%$ of less than 9 year group were high, $6.2\%$ of 20-29 year group wert low. female group is $39.2\%$ of less than 9 year were high, $39.2\%$ of 30-39 year group were low (P<0.05). 7. Cause of disabled status, $26.5\%$ of other group, $23.7\%$ of congenital group were high. $9.2\%$ of unknown group, $6.8\%$ of industry accident, $2.5\%$ of drug poisoning group were low. Cause of disabled status by gender, male group is $27.7\%$ of other group, $23.7\%$ of congenital group were high, $2.3\%$ drug poisoning group were low. female group is $25.0\%$ of other group, $20.9\%$ of congenital group were high, $2.5\%$ of drug poisoning group were low (P<0.001). 8. Disabled type status, $19.4\%$ of double disabled group were high, $2.2\%$ of muscle paralysis group were low. Disabled type status by gender, male group is $22.0\%$ of double disabled group were high, $2.3\%$ of muscle paralysis group were low. female group is $23.3\%$ of rheumatism group were high, $0.7\%$ of amputation group were low(P<0.001). 9. Smoking status, $73.2\%$ of non smoking group were high, $26.8\%$ of smoking group were low. Smoking status by gender, male group is $59.9\%$ of double non smoking group were high, $40.1\%$ of Smoking group were low, female group is $89.2\%$ of non smoking group were high, $10.8\%$ of smoking group were low(P<0.001). 10. Drinking status, $80.0\%$ of non drinking group were high, $20.0\%$ of drinking group were low. Drinking status by gender, male group is $72.3\%$ of non drinking group were high, $27.7\%$ of drinking group were low. female group is $89.2\%$ of non drinking group were high, $10.8\%$ of drinking group were low(P<0.001). 11. Stress level status, $52.9\%$ of high stress group were high, $1.8\%$ of very severe stress group were low. Stress level status by gender, male group is $50.8\%$ of high stress group were high, $2.3\%$ of very severe stress group were low. female group is $55.4\%$of high stress group were high, $1.4\%$ of very severe stress group were low. 12. Heed status, $28.0\%$ of economic support were high, $4.6\%$ of speech therapy, brace group were low. Need status by Sender, male group is $2i2\%$ of economic support group were high, $4.5\%$ of bracegroup were low. female group is$27.7\%$ of economic support group were high, $3.4\%$ of speech therapy group were low. 13. Care satisfaction comparision, 3.09, 0.55 point of IBR, 4.01, 0.45 point of CHR(P<0.001). 14. The variables which had positive correlation with IBR were gender(r=0.1406, P<0.01), age(r=0.1872, p<0.001), economic level(r=0.1246, P<0.05), disabled record(r=0.1137, P<0.05), education level(r=-0.1122. p<0.05). 15. The variables which had positive : correlation with CBR were gender(r=0.1613, P<0.01), age(r=0.2255, P<0.001). list of family(r=0.12i3, P<0.01), disabled record(r=0.1273, P<0.05). education level(r=-0.1294, P<0.01).