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The Change in the Outpatient Visit to Tertiary care Hospital after the Implementation of the Separation of Prescription and Drug Dispensing Policy (의약분업 전.후 3차 진료기관 외래이용 변화)

  • Cho, Dong-Yeong;Yu, Seung-Hum;Sohn, Tae-Yang
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.19-40
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    • 2002
  • The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

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Association Analysis of TEC Polymorphisms with Aspirin-Exacerbated Respiratory Disease in a Korean Population

  • Lee, Jin Sol;Bae, Joon Seol;Park, Byung-Lae;Cheong, Hyun Sub;Kim, Jeong-Hyun;Kim, Jason Yongha;Namgoong, Suhg;Kim, Ji-On;Park, Choon-Sik;Shin, Hyoung Doo
    • Genomics & Informatics
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    • v.12 no.2
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    • pp.58-63
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    • 2014
  • The tyrosine-protein kinase Tec (TEC) is a member of non-receptor tyrosine kinases and has critical roles in cell signaling transmission, calcium mobilization, gene expression, and transformation. TEC is also involved in various immune responses, such as mast cell activation. Therefore, we hypothesized that TEC polymorphisms might be involved in aspirin-exacerbated respiratory disease (AERD) pathogenesis. We genotyped 38 TEC single nucleotide polymorphisms in a total of 592 subjects, which comprised 163 AERD cases and 429 aspirin-tolerant asthma controls. Logistic regression analysis was performed to examine the associations between TEC polymorphisms and the risk of AERD in a Korean population. The results revealed that TEC polymorphisms and major haplotypes were not associated with the risk of AERD. In another regression analysis for the fall rate of forced expiratory volume in 1 second ($FEV_1$) by aspirin provocation, two variations (rs7664091 and rs12500534) and one haplotype (TEC_BL2_ht4) showed nominal associations with $FEV_1$ decline (p=0.03-0.04). However, the association signals were not retained after performing corrections for multiple testing. Despite TEC playing an important role in immune responses, the results from the present study suggest that TEC polymorphisms do not affect AERD susceptibility. Findings from the present study might contribute to the genetic etiology of AERD pathogenesis.

The Optimization of Human Sperm Decondensation Procedure for Fluorescence in Situ Hybridization (Fluorescence in Situ Hybridization 시행을 위한 인간정자 탈응축법의 적정화)

  • Pang, Myung-Geol
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.3
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    • pp.369-375
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    • 1997
  • Studies were conducted to determine the efficiency of decondensation protocols. Sperm obtained from seven normal donors was immediately washed after liquefaction and then decondensed using the method of West et al. (1989) and my original protocol. My optimized protocol entailed mixing 1 ml aliquots of semen with 4 ml phosphate buffered saline (PBS). Following centrifugation, pellets were resuspended in 1 ml PBS containing 6 mM EDTA. After centrifugation, pellets were resuspended in 1 ml PBS containing 2 mM dithiothreitol at $37^{\circ}C$ for 45 min. Following mixing with 2 ml PBS and centrifugation, pellets were resuspended by vortexing. While vortexing, 5 ml of fixative were gently added. Slide preparation was accomplished using the smear method and it was stored at $4^{\circ}C$. When comparing these protocols, the degree of sperm decondensation and head swelling was monitored by measuring nuclear length, area, perimeter, and degree of roundness using FISH analysis software. Apparent copy number for chromosome 1 and, separately, for the sex chromosomes was determined by FISH using satellite DNA probes for loci DIZ1, DXZ1 and DYZ3. Sperm treated by my decondensation protocol showed significant increases (p<0.05) in length, area, perimeter, and degree of roundness. There was a significant decrease (p<0.05) in the frequency of nuclei displaying no signal but no change in the frequency of nuclei with two signals in samples decondensed by my protocol. My data suggested that decondensation using my original protocol may lower the frequency of cells with spurious "nullisomy" due to hybridization failure without inducing spurious "disomy" resulting from increased distances between split signals.

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Induction of Cytochrome P45O 1A and 2B by $\alpha$- and ${\beta}-lonone$ in Sprague Dawley Rats

  • Jeong, Tae-Cheon;Jeong, Hye-Gwang;Chun, Yong-Jin;Yun, Chul-Ho;Moon, Chang-Kiu;Lee, Hye-Sook;Han, Sang-Seop;Lee, Eung-Seok
    • Archives of Pharmacal Research
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    • v.25 no.2
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    • pp.197-201
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    • 2002
  • ${\beta}-lonone$ has been reported to induce the cytochrome P45O (P45O) 2B1 in rats. In this study, the effects of ${\beta}-ionone$ and an isomer, ${\alpha}-ionone$, on liver P45O IA and 2B expression in Sprague Dawley rats were investigated . Subcutaneous administration of ${\alpha}-$ and ${\beta}-lonone$ 72 and 48hr prior to sacrificing the animals induced the liver microsomal P45O 1A and 2B proteins. P45O 2Bl induction was associated with the accumulation of its corresponding mRNA. 1 Induction by ${\beta}-lonone$ was much higher than that by ${\alpha}-ionone$-ionone in both the mRNA and protein levels. When the route of administration was compared, P45O 2B was induced more strongly after oral administration compared to that after subcutaneous injection. A single oral dose of 100, 300 and 600 mg/kg of ${\alpha}-$ and ${\beta}-lonone$ for 24 h induced P45O 2B1 -selective pentoxyresorufin Odepentylase activity comparably in a dose-dependent manner In addition, ${\alpha}-$ and ${\beta}-lonone$ induced the P45O 1A and 2B proteins. These results suggest that ${\alpha}-$ and ${\beta}-lonone$ might be potent P45O 2Bl inducers in rats, and that both ionones may be useful for examining the role of metabolic activation in chemical-induced toxicity where metabolic activation is required.

A Study on Visiting Nurses' Perception of the Service Referral between Health and Welfare (보건 및 복지영역 서비스 연계에 대한 방문간호사의 인식)

  • 정문희;유인영
    • Korean Journal of Health Education and Promotion
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    • v.19 no.2
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    • pp.155-167
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    • 2002
  • This study was carried out to grasp visiting nurses' perception of the service referral between health and welfare with a view to providing the basic data for the visiting nursing activities. A questionnaire survey was conducted on public health nurses in 25 health centers in Seoul from Feb. 12, 2001 to Mar. 15, 2001. A total of 151 questionnaires were collected and they were analysed by use of SPSS/WIN 7.5. The results of the survey are as follows. 1. In general, visiting nurses were burdened with heavy workloads. On average, a visiting nurse covered 5 ‘dong's(the smallest administrative unit), 564 households, and 1223 persons. They spent almost a quarter of their working hours moving from home to home and recording the charts after home visiting. They took 30-60 minutes to provide their services when visiting homes. As for the frequency of home visiting, they were following the instructions recommended by the government. However, their services were still wasteful, not skill-oriented, in that they spent more time assessing ‘subjects’ rather than providing their ‘services’ for them. 2. As for the degree of service performance, visiting nurses scored average 2.94 and 2.28 on the four-point scale in the area of health and welfare respectively. The Pearson coefficient between the two variables was high(.56). According as the health services increased, the welfare services increased as well, which showed that the service referral between the two areas should be essential. 3. ‘The necessity of cooperation with social welfare staff’ scored average 4.49, and ‘the degree of cooperation with social welfare staff’ scored average 3.16 on the five-point scale; There was a statistically significant difference (average 1.33) between the two variables. Such a big difference between perception and practice results from the lack of political support that connects the two service areas comprehensively. Therefore it is recommendable to establish a so-called ‘Visiting Nursing Center’ in the ‘dong’ office in order to provide integrated services of health and welfare at once in cooperation with social welfare staff. That's the way to meet the public needs directly and it's more efficient as well in terms of cost-saving.

The Study of Yingchuangyicao - Focus on the Writer and Printed book (청대(淸代) 문언소설(文言小說) 『형창이초(螢窗異草)』의 판본과 국내유입)

  • YOU, hee June;Min, guan dong
    • Cross-Cultural Studies
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    • v.23
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    • pp.215-242
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    • 2011
  • Yingchuang yicao(${\ll}$螢窗異草${\gg}$) is a collection of short stories in Classical Chinese, whose style was much affected by Liaozhai zhiyi(${\ll}$聊齋志異${\gg}$). It consists of 3 chapters, 12 juan, and 138 stories. This work was written by a scholar with the pen name of Hao gezi(浩歌子) in the reign period of Qianlong in the Qing dynasty, and has drawn relatively little attention among the scholars thus far; it was not until 1980's that scholars figured out that the author Hao gezi was Yin Qinglan, the sixth son of the renowned Qing scholar Yin Jishan. Yingchaung yicao had circulated as a manuscript for more than one hundred years until it was printed by Shenbao guan(申報館) in Shanghai in the reign period of Guangxu 2-3 (1876-1877). This edition is currently collected at The Kyujanggan(奎章閣) Institute of National Seoul University. At present, no known study of its introduction to and circulation in premodern Korea is available. However, given that the late $Chos{\ddot{o}}n$ period saw high interest in Chinese narratives, it is speculated that this work was imported to Korea soon after its first publication in China. Later, two publishing houses in Shanghai also published illustrated editions of the work. Given that the Shenbao guan version is the first printed edition of Yingchuang yicao, the copy collected at Kyujanggak Institute should be regarded highly for its academic values.

A Primer on Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Medically Refractory Epilepsy

  • Lee, Eun Jung;Kalia, Suneil K.;Hong, Seok Ho
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.353-360
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    • 2019
  • Epilepsy surgery that eliminates the epileptogenic focus or disconnects the epileptic network has the potential to significantly improve seizure control in patients with medically intractable epilepsy. Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been an established option for epilepsy surgery since the US Food and Drug Administration cleared the use of MRgLITT in neurosurgery in 2007. MRgLITT is an ablative stereotactic procedure utilizing heat that is converted from laser energy, and the temperature of the tissue is monitored in real-time by MR thermography. Real-time quantitative thermal monitoring enables titration of laser energy for cellular injury, and it also estimates the extent of tissue damage. MRgLITT is applicable for lesion ablation in cases that the epileptogenic foci are localized and/or deep-seated such as in the mesial temporal lobe epilepsy and hypothalamic hamartoma. Seizure-free outcomes after MRgLITT are comparable to those of open surgery in well-selected patients such as those with mesial temporal sclerosis. Particularly in patients with hypothalamic hamartoma. In addition, MRgLITT can also be applied to ablate multiple discrete lesions of focal cortical dysplasia and tuberous sclerosis complex without the need for multiple craniotomies, as well as disconnection surgery such as corpus callosotomy. Careful planning of the target, the optimal trajectory of the laser probe, and the appropriate parameters for energy delivery are paramount to improve the seizure outcome and to reduce the complication caused by the thermal damage to the surrounding critical structures.

Contribution of foods to absolute nutrient intake and between-person variations of nutrient intake in Korean preschoolers

  • Kang, Minji;Shim, Jae Eun;Kwon, Kyungmin;Song, SuJin
    • Nutrition Research and Practice
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    • v.13 no.4
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    • pp.323-332
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    • 2019
  • BACKGROUND/OBJECTIVES: The aim of this study was to analyze specific foods influencing absolute nutrient intake and between-person variations of nutrient intake among Korean preschoolers. SUBJECTS/METHODS: This study included 2,766 participants aged 1-5 years in the 2009-2013 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a 24-h dietary recall method. Major food sources of absolute nutrient intake were evaluated based on percent contribution of each food. To assess the contribution of specific foods to between-person variations in nutrient intake, stepwise multiple regressions were performed and cumulative $R^2$ was used. RESULTS: White rice and milk were main food sources of energy, protein, carbohydrate, phosphorus, iron, potassium, thiamin, riboflavin, and niacin. The percentage of fat contributed by milk was 21.3% which was the highest, followed by pork, soybean oil, and egg. White rice accounted for 25% and 40% of total variability in total energy and carbohydrate intakes, respectively. About 39% of variation in calcium intake was explained by milk while 40% of variation in phosphorous intake was explained by cheese. The top 10 foods contributing to between-person variations in nutrient intakes were similar with food items that mainly contributed to absolute nutrient intakes. The number of foods explaining 90% of absolute amounts of nutrient intakes varied from 28 for vitamin A to 80 for iron. CONCLUSIONS: This study identified specific foods that contributed to absolute nutrient intakes and between-person variations in nutrient intakes among Korean preschoolers. Our findings can be used to develop dietary assessment tools and establish food-based dietary guidelines for young children.

A Small GTPase RHO2 Plays an Important Role in Pre-infection Development in the Rice Blast Pathogen Magnaporthe oryzae

  • Fu, Teng;Kim, Joon-Oh;Han, Joon-Hee;Gumilang, Adiyantara;Lee, Yong-Hwan;Kim, Kyoung Su
    • The Plant Pathology Journal
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    • v.34 no.6
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    • pp.470-479
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    • 2018
  • The rice blast pathogen Magnaporthe oryzae is a global threat to rice production. Here we characterized RHO2 gene (MGG_02457) that belongs to the Rho GTPase family, using a deletion mutant. This mutant ${\Delta}Morho2$ exhibited no defects in conidiation and germination but developed only 6% of appressoria in response to a hydrophobic surface when compared to the wild-type progenitor. This result indicates that MoRHO2 plays a role in appressorium development. Furthermore, exogenous cAMP treatment on the mutant led to appressoria that exhibited abnormal morphology on both hydrophobic and hydrophilic surfaces. These outcomes suggested the involvement of MoRHO2 in cAMP-mediated appressorium development. ${\Delta}Morho2$ mutation also delayed the development of appressorium-like structures (ALS) at hyphal tips on hydrophobic surface, which were also abnormally shaped. These results suggested that MoRHO2 is involved in morphological development of appressoria and ALS from conidia and hyphae, respectively. As expected, ${\Delta}Morho2$ mutant was defective in plant penetration, but was still able to cause lesions, albeit at a reduced rate on wounded plants. These results implied that MoRHO2 plays a role in M. oryzae virulence as well.

Evaluation of Scintillation Camera Applications of 3D Printing Phantom (3D 프린팅 팬텀의 섬광카메라 적용 평가)

  • Park, Hoon-Hee;Lee, Ju-young;Kim, Ji-Hyeon
    • Journal of radiological science and technology
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    • v.44 no.4
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    • pp.343-350
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    • 2021
  • 3D printing technology is an additive manufacturing technology produced through 3D scanning or modeling method. This technology can be produced in a short time without mold, which has recently been applied in earnest in various fields. In the medical field, 3D printing technology is used in various fields of radiology and radiation therapy, but related research is insufficient in the field of nuclear medicine. In this study, we compare the characteristics of traditional nuclear medicine phantom with 3D printing technology and evaluate its applicability in clinical trials. We manufactured the same size phantom of poly methyl meta acrylate(PMMA) and acrylonitrile butadiene styrene(ABS) based on the aluminum step wedge. We used BrightView XCT(Philips Health Care, Cleveland, USA) SPECT/CT. We acquired 60 min list mode for Aluminum, PMMA and ABS phantoms using Rectangular Flood Phantom (Biodex, New York, USA) 99mTcO4 3 mCi(111 MBq), 6 mCi (222MBq) and 57Co Flood phantom(adq, New Hampshire, USA). For the analysis of acquired images, the region of interest(ROI) were drawn and evaluated step by step for each phantom. Depending on the type of radioisotope and radiation dose, the counts of the ABS phantom was similar to that of the PMMA phantom. And as the step thickness increased, the counts decreased linearly. When comparing the linear attenuation coefficient of Aluminum, PMMA and ABS phantom, the linear attenuation coefficient of the aluminium phantom was higher than that of the others, and the PMMA and ABS phantom had similar the linear attenuation coefficient. Based on ABS phantom manufactured by 3D printing technology, as the thickness of the PMMA phantom increased, the counts and linear attenuation coefficient decreased linearly. It has been confirmed that ABS phantom is applicable in the clinical field of nuclear medicine. If the calibration factor is applied through further research, it is believed that practical application will be possible.