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Recognition and attitude to functional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city (대구시 개원의사와 개국약사의 의약분업에 대한 인식과 태도)

  • Lee, Moo-Sik;Yoon, Nung-Ki;Suh, Suk-Kwon;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.1-19
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    • 1993
  • Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.

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Fractional exhaled nitric oxide and forced expiratory flow between 25% and 75% of vital capacity in children with controlled asthma

  • Yoon, Ji-Yong;Woo, Sung-Il;Kim, Heon;Sun, Yong-Han;Hahn, Youn-Soo
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.330-336
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    • 2012
  • Purpose: Fractional exhaled nitric oxide (FeNO) and forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25-75}$) are not included in routine monitoring of asthma control. We observed changes in FeNO level and $FEF_{25-75}$ after FeNO-based treatment with inhaled corticosteroid (ICS) in children with controlled asthma (CA). Methods: We recruited 148 children with asthma (age, 8 to 16 years) who had maintained asthma control and normal forced expiratory volume in the first second ($FEV_1$) without control medication for ${\geq}3$ months. Patients with FeNO levels >25 ppb were allocated to the ICS-treated (FeNO-based management) or untreated group (guideline-based management). Changes in spirometric values and FeNO levels from baseline were evaluated after 6 weeks. Results: Ninety-three patients had FeNO levels >25 ppb. These patients had lower $FEF_{25-75}$ % predicted values than those with FeNO levels ${\leq}25$ ppb (P<0.01). After 6 weeks, the geometric mean (GM) FeNO level in the ICS-treated group was 45% lower than the baseline value, and the mean percent increase in $FEF_{25-75}$ was 18.7% which was greater than that in other spirometric values. There was a negative correlation between percent changes in $FEF_{25-75}$ and FeNO (r=-0.368, P=0.001). In contrast, the GM FeNO and spirometric values were not significantly different from the baseline values in the untreated group. Conclusion: The anti-inflammatory treatment simultaneously improved the FeNO levels and $FEF_{25-75}$ in CA patients when their FeNO levels were >25 ppb.

Should TPP Be Formed? On the Potential Economic, Governance, and Conflict-Reducing Impacts of the Trans-Pacific Partnership Agreement

  • Bergstrand, Jeffrey H.
    • East Asian Economic Review
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    • v.20 no.3
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    • pp.279-309
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    • 2016
  • The proposed Trans-Pacific Partnership (TPP) is a free trade agreement among 12 Pacific Rim countries whose joint gross domestic products (GDPs) account for 36 percent of world GDP and whose mutual trade accounts for approximately 24 percent of world trade. As for most proposed free trade agreements (FTAs), trade economists have provided ex ante computable general equilibrium (CGE) estimates to predict the trade, employment, and real per capita income effects of this agreement, such as ITC (2016). This paper-intended to complement these studies-examines the potential impacts of TPP beyond such traditional CGE estimates, taking a broader economic, governance, and historical perspective. First, we contrast these traditional CGE trade and welfare estimates that treat all firms within an industry as homogeneous with more recent CGE analyses that allow firms' productivities to be heterogeneous. We show that the latter models' trade predictions are much more consistent with ex post empirical evidence of average trade effects of FTAs. Second, empirical evidence now strongly confirms the existence of FTA "contagion." We review this evidence and show that predictive models of the evolution of FTAs indicate that the TPP should be formed. With China now having formed 12 FTAs and negotiating five new ones (including a sixteen member Asia-Pacific FTA), the United States would likely face considerable trade diversion without the TPP. Third, we examine empirical evidence on the likely further economic growth implications of FTAs by reducing firms' uncertainty over trade relations and trade policies. Fourth, we examine empirical evidence on the additional impact of FTAs on consolidating democratic institutions in countries. The TPP would likely help consolidate some of the less mature democracies. Fifth, we examine empirical evidence on the reductions of conflicts (and enhanced peace) between countries owing to the formations of FTAs. We conclude the paper noting that the potential net benefits to member countries of the proposed TPP extend well beyond the real income gains to households based upon traditional CGE models.

Cytotoxicity of Nigella Sativa Seed Oil and Extract Against Human Lung Cancer Cell Line

  • Al-Sheddi, Ebtesam Saad;Farshori, Nida Nayyar;Al-Oqail, Mai Mohammad;Musarrat, Javed;Al-Khedhairy, Abdulaziz Ali;Siddiqui, Maqsood Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.983-987
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    • 2014
  • Nigella sativa (N sativa), commonly known as black seed, has been used in traditional medicine to treat many diseases. The antioxidant, anti-inflammatory, and antibacterial activities of N sativa extracts are well known. Therefore, the present study was designed to investigate the anticancer activity of seed extract (NSE) and seed oil (NSO) of N sativa against a human lung cancer cell line. Cells were exposed to 0.01 to 1 mg/ml of NSE and NSO for 24 h, then percent cell viability was assessed by 3-(4, 5-dimethylthiazol-2yl)-2, 5-biphenyl tetrazolium bromide (MTT) and neutral red uptake (NRU) assays, and cellular morphology by phase contrast inverted microscopy. The results showed NSE and NSO significantly reduce the cell viability and alter the cellular morphology of A-549 cells in a concentration dependent manner. The percent cell viability was recorded as 75%, 50%, and 26% at 0.25, 0.5, and 1 mg/ml of NSE by MTT assay and 73%, 48%, and 23% at 0.25, 0.5, and 1 mg/ml of NSE by NRU assay. Exposure to NSO concentrations of 0.1 mg/ml and above for 24 h was also found to be cytotoxic. The decrease in cell viability at 0.1, 0.25, 0.5, and 1 mg/ml of NSO was recorded to be 89%, 52%, 41%, and 13% by MTT assay and 85%, 52%, 38%, and 11% by NRU assay, respectively. A-549 cells exposed to 0.25, 0.5 and 1 mg/ml of NSE and NSO lost their typical morphology and appeared smaller in size. The data revealed that the treatment of seed extract (NSE) and seed oil (NSO) of Nigella sativa significantly reduce viability of human lung cancer cells.

Climatological Spatio-Temporal Variation of Strong Wind in Korea (우리나라 강풍의 기후학적 시공간 변화 특성)

  • Kim, Hyun Uk;Kim, Baek-Jo;Nam, Hyoung-Gu;Jung, Jong Hyeok;Shim, Jae-Kwan
    • Atmosphere
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    • v.30 no.1
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    • pp.47-57
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    • 2020
  • In this study, the climatological spatio-temporal variation of strong wind and gust wind in Korea during the period from 1993 to 2018 was analyzed using daily maximum wind speed and daily maximum instantaneous wind speed data recorded at 61 observations. Strong wind and gust wind were defined as 14 m s-1 and 20 m s-1, which are the same as the KMA's criteria of special weather report. The frequency of strong wind and gust wind occurrence was divided into regions with the higher 25 percent (Group A) and the lower 75 percent (Group B). The annual frequency of strong wind and gust wind occurrence tended to be decreased in most parts of the Korean peninsula. In Group A with stations located at coastal region, strong wind and gust wind occurred most frequently in winter with higher frequency at 1200~1600 LST and 2300~2400 LST due to influence of East Asian winter monsoon. In addition, a marked decreasing trend throughout the four seasons was shown at Daegwallyeong, Gunsan and Wando observations. In contrast, it can be found in Group B that the monthly frequency of strong wind and wind gust occurrence was higher in August and September by effect of typhoon and hourly frequency was higher from 1200 LST to 1800 LST.

Economical Meaning and Problem concerning Industrial Differentiation of Laver Industry (김 산업의 산업적 분화가 가지는 경제적 의의와 문제점)

  • Kim, Byung-Ho;Lim, Dong-Hoon;Yi, Ju-Hyun
    • The Journal of Fisheries Business Administration
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    • v.47 no.1
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    • pp.47-61
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    • 2016
  • This study is aimed to analyze economical meaning and problems on the industrial differentiation of Korean laver industry. Based on the surveyed data, the export value of korean laver has increased over 28 times for last 20 years($10 million to $300 million) and the separation of farming and processing was an important success factor of rapid growth of korean laver industry. However, the result of the survey shows that the farming profit is 534.1 won out of the total price for a bunch of dried laver, 3,566.3 won. So, farming profit counts for just 15 percent of total price. In contrast, the processing profit is 1,143.5 won and it is 32.1 percent of total price. This means that laver farmers are not being guaranteed their profit properly. This phenomenon is occurred due to lower status of first-hand processors(which produce dried laver) to second-hand processors(which produce seasoned laver) due to advanced payment given by second-hand processors. So, fist-hand processors should provide their product in the price which was designated by second-hand processors. Besides, despite of many business risks caused from climate change and environmental pollution, the market price of raw laver has steadily decreased. For sustainable prosperity of korean laver industry, imbalance on korean laver industry concerning profit sharing is need to be changed. In future, self-processing of dried laver in fishery household and enhancing the role of The Fisheries Cooperative Union in laver industry can be considered.

Bone regeneration and graft material resorption in extraction sockets grafted with bioactive silica-calcium phosphate composite (SCPC) versus non-grafted sockets: clinical, radiographic, and histological findings

  • Adel-Khattab, Doaa;Afifi, Nermeen S.;el Sadat, Shaimaa M. Abu;Aboul-Fotouh, Mona N.;Tarek, Karim;Horowitz, Robert A.
    • Journal of Periodontal and Implant Science
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    • v.50 no.6
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    • pp.418-434
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    • 2020
  • Purpose: The purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets. Methods: Ten patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively. Results: A radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density. Conclusions: The resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function.

Influence on PET Exam Caused by Density Differences of Barium-sulfate Contrast Media (Barium 조영제의 농도 차이가 PET 검사에 미치는 영향)

  • Choi, Woo-Joon;Shin, Sang-Ki;Nam, Ki-Pyo;Park, Soon-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.27-32
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    • 2008
  • Purpose: The evaluation of SUV (Standardized Uptake Values) for quantitative analysis in PET exam is the most significant. In PET exam, we make attenuation correction images by using $^{68}Ge$, $^{137}Cs$ or CT data. At this time, a distorted attenuation map affects quantitative analysis. After the exam using barium-sulfate and high density of barium contrast make attenuation map distorted. And then it brings bed influences on SUV. The aim of this study is to verify the relationship between high density barium-sulfate and SUV in PET exam. Materials and Methods By using $^{18}F$-FDG, we made barium-sulfate powder, density of 0, 1.5, 3, 5, 10 and 15% respectively and acquired PET and PET/CT images per each density. And we examined SUV variations from PET and PET/CT images according to differences of barium's density. Moreover, we finally calculated SUV causing variations in HU (Hounsfield Units) values to justify whether the differences of barium density bring any changes in PET/CT exam. Results: From PET images acquired from transmission scan with $^{68}Ge$, we got SUV figures from 6.46 to 6.8 in barium density between 0 to 15 percent. On the other hand, In PET images acquired from Tx scan that using CT, SUV was 6.77 to 23.73, derived from the same barium density. And CT HU values range from 29 to 2004. Conclusion: PET images from Tx data using $^{68}Ge$ weren't affected by barium density and had no differences in SUV. But in the PET/CT images using CT Tx data, there's considerable variations in HU and SUV values according to a difference of barium density in HU values. To perform a precise examination, barium sulfate should be removed from a human body before performing a PET exam.

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A Study on Framing Techniques of Landscape Assessment Using the Analytic Hierarchy Process - The Assessment on the Landscape Control Points - (AHP 기법을 활용한 경관평가법 작성에 관한 연구 - 경관통제점에서의 평가 -)

  • Suh Joo-Hwan;Yang Hee-Seung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.32 no.4
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    • pp.94-104
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    • 2004
  • This study creates the LCP (Landscape Control Point) through the survey of spot sites for the quality of landscape assessment, which is based on an objective and departmentalized data base; the landscape assessment was achieved by production of weight value with the AHP (Analytic Hierarchy Process) technique, selection of requisites for the landscape assessment with the IVERSON method and visual area analysis with GIS (Geographic Information System). Futhermore, validity of the landscape assessment was verified by analysis of the correlation between physical amount and aesthetic amount. The purpose of this study is to suggest the basic essential data for landscape assessment and landscape planning by the characteristics of landscape based on verification of the suggested landscape assessment methods. The results of this study are summarized below. 1. In the adaptation of landscape assessment using GIS, the landscape assessment points of LCP 18, 17 and 16, which have more visible elements such as hill area, mountain area, and forest and farm land, were indicated to be higher than the others. In contrast, the landscape assessment points of LCP 13, 6 and 10, which have less visible elements, were relatively lower than the others. 2. In the visible preference measuring method, LCP 4, 14, and 16 showed high points of landscape assessment with 3.46, 3.4, and 3.18 each. With the more natural environments such as hill area, mountain area, and forest and farm land, higher results were shown. In contrast, LCP 7, 1, and 9 showed low points of landscape assessment with 2.24, 2.36, and 2.53 each. 3. In this study, a coefficient of 0.746 was gained by the analysis of correlation between the points of landscape assessment method and the points of visual preference from a slide show. This has 99 percent of probability in statistical data. 4. In conclusion, with the demonstration of the correlation between the landscape assessment method based on the AHP technique and the aesthetic amount (preference proportion), the practical use of landscape assessment can be demonstrated by the suggested landscape assessment method.

The Utility of Contrast Enhanced Ultrasound and Elastography in the Early Detection of Fibro-Stenotic Ileal Strictures in Children with Crohn's Disease

  • Sarah D. Sidhu ;Shelly Joseph;Emily Dunn;Carmen Cuffari
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.4
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    • pp.193-200
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    • 2023
  • Purpose: Crohn's disease (CD) is a chronic, idiopathic bowel disorder that can progress to partial or complete bowel obstruction. At present, there are no reliable diagnostic tests that can readily distinguish between acute inflammatory, purely fibrotic and mixed inflammatory and fibrotic. Our aim is to study the utility of contrast enhanced ultrasound (CEUS) in combination with shear wave elastography (SWE) to differentiate fibrotic from inflammatory strictures in children with obstructive CD of the terminal ileum. Methods: Twenty-five (19 male) children between 2016-2021 with CD of the terminal ileum were recruited into the study. Among these patients, 22 had CEUS kinetic measurements of tissue perfusion, including wash-in slope (dB/sec), peak intensity (dB), time to peak intensity (sec), area under the curve (AUC) (dB sec), and SWE. In total, 11 patients required surgery due to bowel obstruction. Histopathologic analysis was performed by a pathologist who was blinded to the CEUS and SWE test results. Results: Patients that underwent surgical resection had significantly higher mean area under the curve on CEUS compared to patients responsive to medical therapy (p=0.03). The AUC also correlated with the degree of hypertrophy and the percent fibrosis of the muscularis propria, as determined by histopathologic grading (p<0.01). There was no difference in the mean elastography measurements between these two patient groups. Conclusion: CEUS is a useful radiological technique that can help identify pediatric patients with medically refractory obstructive fibrotic strictures of the terminal ileum that should be considered for early surgical resection.