• Health Policy and Management
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• v.16 no.2
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• Health Policy and Management
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• v.32 no.2
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• Korean Journal of Clinical Pharmacy
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• v.34 no.3
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• pp.194-201
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• 2024

Background: Asthma is a chronic inflammatory airway disease associated with systemic inflammation and increased prevalence of various comorbid conditions. This study investigates the prevalence of non-respiratory comorbidities among adult asthma patients in South Korea, aiming to elucidate potential correlations and impacts of asthma on overall health, thereby affecting patients' quality of life and healthcare systems. Methods: This retrospective cohort study utilized the National Health Insurance Service data (HIRA-NPS-2020) and included adults diagnosed with asthma. Non-respiratory diseases were identified using the Korean Standard Disease Classification (KCD-8) codes, with exclusions applied for other respiratory conditions. The prevalence of comorbidities was analyzed and compared between asthma and non-asthma patients, adjusting for confounders such as age, gender, and insurance status through inverse probability treatment weighting (IPTW). Results: The analysis revealed that asthma patients exhibit significantly higher rates of cardiovascular diseases, metabolic disorders, gastrointestinal conditions, and mental health issues compared to the control group. Notably, conditions such as heart failure, gastroesophageal reflux disease, and anxiety were more prevalent, with odds ratios (OR) ranging from 1.18 to 3.90. These results demonstrate a substantial burden of comorbidities associated with asthma, indicating a broad impact on health beyond the respiratory system. Conclusion: The findings highlight the systemic nature of asthma and the interconnectedness of inflammatory processes across different organ systems. This comprehensive analysis confirms previous research linking asthma with an increased risk of various non-respiratory diseases, providing insights into the multifaceted impact of asthma on patient health.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2001.05a
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• pp.503-506
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• 2001

There are four factors for patient monitoring : electrocardiography, blood pressure, temperature and respiration. While there are a lot of studies of E.C.C (electro-cardiography) monitoring system in the world, the studies of Respiratory system are not enough and leave much to be desired in the country. In this paper, we developed a respiratory system with the electrical impedance change of the lungs depending on the breath. Using the same electrode, we can monitor E.C.C and Respiration simultaneously, so we can monitor a patient's no-breathing state due to the central nerve paralysis in the emergency room easily. In this monitoring system, the analog part was made separated from the digital part for reducing power source noise and protecting patient from electric shock. The analog part consists of the several parts a high-frequency sine-wave generator, all amplifier for amplifying any impedance change signal, an analog processing part for rectifying and filtering. And the digital parts consists of three parts an AD convertor for converting analog signal to digital signal, digital filter, and a digital part for digital signal processing. This system's merits are using the same electrode with E.C.C and developing the multiple patient monitoring system easily.

• Biomolecules & Therapeutics
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• v.2 no.4
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• pp.336-342
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• 1994

The general pharmacological properties of EPO were investigated in various animals administering intravenously and in vitro system. The results were as follows. 1. Central nervous system: EPO at doses of 70, 700, 7000 U/kg showed no effect In mice on general behavior, on strychnine- and pentetrazol-induced convulsion and on acetic acid-induced writhing syndrome. The hexobarbital-induced sleeping time in mice was slightly reduced by EPO at a dose of 7000 U/kg but did not change at doses of 70, 700 U/kg. The body temperature in rats was slightly decreased by EPO at doses of 700, 7,000 U/kg but the change was in normal physiological range. 2. Respiratory and cardiovascular system: EPO showed no effect on respiratory rate, blood pressure, heart rate, femoral blood flow, and electrocardiogram in anesthetized dogs at doses of 70, 700, 7000 U/kg. 3. Smooth muscle: EPO at concentrations of 70, 700 U/ml had no effect on the contractile response of isolated guinea pig ileum to histamine and acetylcholine. 4. Water and electrolytes excretion: EPO at dose above 700 U/kg increased urine volume in rats but did not affect the concentrations of $Na^{+},\;K^{+},\;Cl^{-}$ in urine. 5. Gastrointestinal system: EPO(70, 700, 7000 U/kg) had no effect on the intestinal charcoal meal propulsion 6. Blood coagulation system: The administration of EPO(70, 700, 7000 U/kg) had no effect on the plasma prothrombin time(PT) and activated partial thromboplastin time(APTT) in mice. Platelet aggregation induced by ADP and collagen was not influenced by EPO(70 U/ml, 700 U/ml). The overall results obtained indicated that EPO exerts almost no serious pharmacological effect even at a 100-fold clinical dose(7000 U/kg).

• Journal of Life Science
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• v.16 no.3 s.76
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• pp.505-509
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• 2006

Membranes prepared from Bacillus cereus KCTC 3674, grown aerobically on a complex medium, oxidized NADH exclusively, whereas deamino-NADH was little oxidized. The respiratory chain-linkedNADH oxidase system exhibited an apparent $K_m$ value of about $65\;{\mu}M$ for NADH. Interestingly, the activity of NADH:DCIP oxidoreductase on NADH oxidase system was decreased remarkably by $Na^+$ or $K^+$, and its optimal pH was 5.5. The activity of NADH:DCIP oxidoreductase was very resistant to the respiratory chain inhibitors such as rotenone, capsaicin, and $AgNO_3$, whereas it was inhibited by about 40% with $40{\mu}M$ 2-heptyl-4-hydroxyquinoline-N-oxide (HQNO). From the results, we suggest the possibility that the aerobic respiratory chain-linked NADH oxidase system of B. cereus KCTC 3674 may possess the HQNO-sensitive NADH:DCIP oxidoreductase lacking an energy coupling site.

• YAKHAK HOEJI
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• v.56 no.2
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• pp.126-135
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• 2012

Purpose: To develop therapeutic duplication criteria for the drugs used for respiratory diseases. Method: Therapeutic duplication was defined as "more than 2 drug ingredient-usage in which each has the same therapeutic effect and combination therapy does not confer additional therapeutic benefit". Respiratory system drugs approved in Korea were examined for the study. The WHO's Anatomical Therapeutic Chemical Classification System was used for grouping of the corresponding drug ingredients. The principles and recommendations on combination usage or multiple drug regimens were reviewed by using the clinical practice guidelines, textbooks, product labelings, and clinical articles. Clinical expert group consultation was performed and expert opinions were incorporated into the final criteria. Results: Nine hundred sixty two drug products with Korean Food and Drug Administration classification codes of 141, 149, 222, and 229 were evaluated, of which 87 active ingredients were composed. The drug ingredients were classified into 12 groups (antihistamines, oral nasal decongestants, leukotriene receptor antagonists, inhaled anticholinergics, inhaled corticosteroids, oral ${\beta}2$-agonists, long-acting ${\beta}2$-agonists, short-acting ${\beta}2$-agonists, xanthines, antiallergics, mucolytics and cough suppressants). The use of more than 2 drug ingredients including the same group was therapeutic duplication, and thus combination should be recommended not to be used. Conclusion: Twelve drug groups were identified as therapeutic duplication criteria. Combination therapy within each group should not be used otherwise therapeutic benefits outweigh potential risks.

• The Journal of Korean Medicine
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• v.33 no.3
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• pp.82-94
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• 2012

Objectives: The aim of study was to develop a standard clinical oriental medicine evaluation instrument for chronic obstructive pulmonary disease (COPD). Methods: We appointed 10 respiratory professors of oriental medicine as the advisory committee. The committee was organized and met several times to discuss the patterns of syndrome differentiation (辨證) and its items based on clinical symptoms of COPD patients and review of published literature. Then the committee investigated the importance of items by e-mail and decided the weight and final weight, respectively. Results: According to the answers and conferences, we determined the Korean oriental medical assessment tool for COPD comprised of the 7 type of patterns of syndrome differentiation which have 9 items with the mean weight and final weight of each item, respectively. Conclusions: This Korean oriental medical assessment tool for COPD was newly developed through expert consensus. We expect to apply this tool to subsequent research as its validity and reliability is further confirmed.

• The Korean Journal of Zoology
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• v.4 no.1
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• pp.7-12
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• 1961

1) Respiratory metabolism patterns and its enzyme systems in the gill tissue of the fresh water mussels, Cristaria plicata were investigated through the examination on the effects of respiratory enzyme inhibitors, (KCN, NAF) and succinoxidase assay, while studying the effects of neutral salts (NaCL, KCL, CaCl2) and pH on oxygen consumption of the gill tissue. 2) In the limited concentration of KCL (0.3mM) and NaCl (0.4mM) solutions, oxygen consumption of the intact gill tissue was accelerated, but in CaCl2(0.5mM) solution, it showed no significant effect. The oxygen consumption was gradually decreased at the above concentrations of these limitations. The optimum pH for the respiration of the gill was 7.3. 3)Cyanide in 10-8M solution inhibited 88.8% of the respiration of the intact gill tissue. Methylene blue accelerated the respiration of the noral gill tissue, and slightly but significantly reversed the cyaniide poisoned respiration. 4)Oxygen consumption of the gill homogenate was apparently increased by the mixed addition of succinate, cytochrome c and activators (AlCl3 and CaCl2). This results suggested that succinoxidase system acts on the respiratory pattern of the gil tissue. 5) It was able to recognize that the enolase, which acts on the anaerobic glycolytic system, participated in the tissue respiration of the gill for NaF in 5$\times$10-2 M solution inhibited 55.5% of the respiration of the same intact tissue.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.6
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• pp.1226-1233
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• 2009

Common cold occurs frequently and occupies an important position in medical treatment however obvious treatment is not suggested. There has been no agreement of pattern identification for common cold in oriental medicine. The purpose of this study is to develop a standard instrument of pattern identification for common cold which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 9 oriental respiratory internal medicine professors of 11 oriental medical colleges nationwide. The experts attended 3 consultation meetings and discussed developing the instrument, and we also took professional advices by e-mail. The results were as follows; First, we divided the pattern identification of common cold into nine pattern: Wind-cold type, Wind-heat type, Contain summerheat type, Contain dampness type, Qi deficiency type, Blood deficiency type, Yang deficiency type, Yin deficiency type, Influenza. Second, we got the mean weights to each symptom of nine pattern identification which had been scored on a 5-point scale - ranging from 0 to 4 by the 9 experts. Third, we made out the Korean instrument of the pattern identification for common cold. It was composed self reporting questionnaire and researcher reporting questionnaire. Though this study is not proved about validity, reliability, the instrument of pattern identification for common cold is meaningful and expected to be applied to the subsequent research. And also, we hope to improve the instrument and make up for this study through various research and discussion.