• Health Policy and Management
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• v.2 no.2
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• pp.131-151
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• 1992

The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.1
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• pp.67-81
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• 2017

Objectives : The purpose of this study was to analyze the report conducted in 2014 by the Ministry of Health and Welfares on influences of private insurance coverage on the use of Korean medicine. Methods : We analyzed Ministry of Health and welfares report on the use and consumption of Korean medicine to fit the purpose of this study. Comparison between private insurance holders and non-holders was made in the areas of sociodemographic characteristics, patient distribution by disorders, total number of disorders and existence of complex diseases, general perception of Korean medicine, and medical expenses and visits. Logistic regression analysis was made to verify the private insurance coverage. Results : Among sociodemographic characteristics, significant differences were observed in age distribution, education, professions, income level, and housing factors. But genders, area of residence, and marital status didn't show significant differences. Other significant differences including side effects, experience with Korean medicine, herbal medicine and acupuncture treatments, and main visiting facilities were shown between private insurance holders and non-holders. Majority of disorders treated with Korean medicine were musculoskeletal issues, and criteria of number of disorders, multiple diseases factors, and medical expenses/visits showed significant differences between the two groups. Conclusions : Summarizing above results indicate that holding a private insurance in addition to National Health Insurance contributes significant influences on the use of Korean medicine.

• Journal of Sasang Constitutional Medicine
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• v.25 no.3
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• pp.195-207
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• 2013

Objectives This study aimed to examine differences in the hepatic function disorders and prevalence rates of liver diseases in accordance with the Sasang constitutional type, and to analyze whether Sasang constitution is a significant risk factor for fatty liver. Methods A total of 1211 patients who underwent health check-up at the Ilsan Hospital of Dongguk University and had their physical constitutions diagnosed by a specialist in Sasang constitutional medicine from October 31, 2011 to September 28, 2012 were used as the subjects of this study. Presence of hepatobiliary diseases was analyzed from the results of the hepatic function test, lipid test and viral hepatitis infection marker test in the biochemistry tests, and abdominal ultrasonography. Results & Conclusion Subjects of the study were composed of 691 males and 520 females and, in terms of Sasang constitution distribution, 550 Taeeumin, 343 Soeumin and 318 Soyangin. As the results of analysis of prevalence rates in accordance with Sasang constitutions, significant differences were observed in the prevalence rates of abnormal groups in the cases of AST, ALT, GGT, Triglyceride, HDL-cholesterol and LDL-cholesterol, and all of their prevalence rates were in the descending order of Taeeumin, Soyangin and Soeumin. Soeumin displayed significantly higher positive rate for HBs Ab in comparison to Taeeumin and Soyangin. In the results of abdominal ultrasonography, the prevalence rates of fatty liver displayed significant differences and were in the descending order of Taeeumin, Soyangin and Soeumin. And as the result of logistic regression analysis in order to find the risk factors of fatty liver, the Sasang constitution was found to be a significant risk factor for fatty liver. The odds ratio of Taeeumin in fatty liver was found to be 1.634 higher than Soeumin and 1.773 higher than Soyangin

• The Journal of Korean Medical History
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• v.36 no.1
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• pp.99-112
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• 2023

This paper analyzes the historical context, the author, and the organization of contents of Dongseo uihak youi (Essentials of Eastern and Western Medicines), which was written by Do Jinwoo. In the colonial situation of the early twentieth century, the tradition of Korean medicine faced crises and challenges in many ways. Members of the Korean medicine community were simultaneously faced with continuing the tradition of Korean medicine and becoming healthcare providers with a specific role within the healthcare system of the time. Dongseo uihak youi is the result of the collective and official efforts of the Association of Korean Medicine of the time to maintain its tradition where only Western medicine was officially allowed to be taught and tested after the promulgation of the Rules of the Medical Student (ŭisaeng). Dongseo uihak youi was the first Korean medicine book to precisely describe and compare the names of diseases in Eastern and Western medicines. Dongseo uihak youi contained not only medical theories and prescriptions but also laws and forms, in that the purpose of the book was not simply to cultivate clinical skills but also to demarcate the boundary of medical knowledge and activities required of a practitioner of Korean medicine in the modern colonial health care system of the time.

• The Korea Journal of Herbology
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• v.25 no.4
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• pp.77-84
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• 2010

Objectives : Taraxaci Herba et Radix (THR) is widely used as a food and medicinal herb in Korea. It has been used for treatment of virus inflammatory disease, liver diseases and gastritis. So far, anti-inflammatory effects and constituents of various species in THR has not been studied for comparison. The aim of this study is to compare the anti-inflammatory effects of the aerial part and root from various THR. Also, we have compared the contents of its known constituents with each. Methods : In this study, we estimated anti-inflammatory effect and compared their constituent by HPLC. For the determination of anti-inflammatory effects, we investigated NO and $PGE_2$ production by ELISA. The expressions of iNOS was determined by western blotting in LPS-induced RAW 264.7 macrophage cells. And, standard compounds which are methyl gallate, gallic acid, syringic acid and esculetin of THR were analyzed by HPLC using a $C_{18}$ column. Results : Methanol extracts of THR decreased NO and $PGE_2$ production. The expressions of iNOS protein were also decreased in methanol extracts of THR. As a result, HPLC analysis showed that they showed similar patterns. Methyl gallate and esculetin showed the highest content. Methyl gallate was included over 10% content in each aerial part and root of THR. Conclusions : These results indicate that most of THR distributed in Korea might represent therapeutic agent for treatment of inflammatory diseases.

• The Journal of Internal Korean Medicine
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• v.26 no.2
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• pp.379-389
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• 2005

Objectives: It is well known that aging and aging-related diseases are linked to the increased level of oxidative stress caused by reactive oxygen species(ROS) and reactive nitrogen species(RNS). Nonprotein-SH decreases during aging, while substances such as ROS, nitric oxide(NO), peroxynitrite($ONOO^-$), myeloperoxidase(MPO), and dityrosine show a significant increase. This study investigated the effect of Ichungwhan on the aging process by examining its effect on the generation of the above-mentioned substances. Methods: Four comparison groups of SD rats were used. They were 6 month-old rats, 24 month-old rats, and 24 month-old rats fed with food containing 0.1% and 0.3% of Ichungwhan extract. The amount of NO, $ONOO^-$, and ROS in the rats' kidneys were examined using a fluorescence microplate reader. The reagents used for this purpose include: dihydrorhodamine 123 (DHR 123), 2',7' -dichlorodihydrofluorescein, diacetate(DCFDA), and 4,5-diaminofluorescein(DAF-2). A spectrophotometer was used to investigate the reactivity of nonprotein-SH and myeioperoxidase(MPO), using reagents such as trichloroacetic acid(TCA) and tetramethylbenzidine(TMB). The amounts of MPO protein and dityrosine were measued by western blot. Results: The observed effects of Ichungwhan on rats were as follows: increase of nonprotein-SH; effective decrease of RNS level by suppression of the generation system of $ONOO^-$ and NO; decrease of ROS level; decrease of the MPO reactivity and the subsequent reduction of amount of MPO protein; retardation of dityrosine formation. It can be hypothesized, therefore, that Ichungwhan affects both the earlier and later phases of the molecular inflammatory process, and retards the aging process. Conclusions: Empirical evidence in this study supports a role for Ichungwhan in generation mechanisms of aging process-linked substances ROS, NO, $ONOO^-$, nonprotein-SH, MPO and dityrosine. Affects contrary to the aging process observed in rats beg further empiricism to investigate potential application of Ichungwhan as a medication for age-related diseases in humans.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.922-932
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• 2021

Objective : It is challenging to make solid fusion by posterior screw fixation and laminectomy with posterolateral fusion (PLF) in thoracic and thoracolumbar (TL) diseases. In this study, we report our experience and follow-up results with a new surgical technique entitled posterior thoracic cage interbody fusion (PTCIF) for thoracic and TL spine in comparison with conventional PLF. Methods : After institutional review board approval, a total of 57 patients who underwent PTCIF (n=30) and conventional PLF (n=27) for decompression and fusion in thoracic and TL spine between 2004 and 2019 were analyzed. Clinical outcomes and radiological parameters, including bone fusion, regional Cobb angle, and proximal junctional Cobb angle, were evaluated. Results : In PTCIF and conventional PLF, the mean age was 61.2 and 58.2 years (p=0.46), and the numbers of levels fused were 2.8 and 3.1 (p=0.46), respectively. Every patient showed functional improvement except one case of PTCIF. Postoperative hematoma as a perioperative complication occurred in one and three cases, respectively. The mean difference in the regional Cobb angle immediately after surgery compared with that of the last follow-up was 1.4° in PTCIF and 7.6° in conventional PLF (p=0.003), respectively. The mean durations of postoperative follow-up were 35.6 months in PTCIF and 37.3 months in conventional PLF (p=0.86). Conclusion : PTCIF is an effective fusion method in decompression and fixation surgery with good clinical outcomes for various spinal diseases in the thoracic and TL spine. It provides more stable bone fusion than conventional PLF by anterior column support.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.255-264
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• 2017

Background:N-acetyl transferase (NAT) inactivates the pro-drug isoniazid (INH) to N-acetyl INH through a process of acetylation, and confers low-level resistance to INH in Mycobacterium tuberculosis (MTB). Similar to NAT of MTB, NAT2 in humans performs the same function of acetylation. Rapid acetylators, may not respond to INH treatment efficiently, and could be a potential risk factor, for the development of INH resistance in humans. Methods: To understand the contribution of NAT of MTB and NAT2 of humans in developing INH resistance using in silico approaches, in this study, the wild type (WT) and mutant (MT)-NATs of MTB, and humans, were modeled and docked, with substrates and product (acetyl CoA, INH, and acetyl INH). The MT models were built, using templates 4BGF of MTB, and 2PFR of humans. Results: On the basis of docking results of MTB-NAT, it can be suggested that in comparison to the WT, binding affinity of MT-G207R, was found to be lower with acetyl CoA, and higher with acetyl-INH and INH. In case of MT-NAT2 from humans, the pattern of score with respect to acetyl CoA and acetyl-INH, was similar to MT-NAT of MTB, but revealed a decrease in INH score. Conclusion: In MTB, MT-NAT revealed high affinity towards acetyl-INH, which can be interpreted as increased formation of acetyl-INH, and therefore, may lead to INH resistance through inactivation of INH. Similarly, in MT-NAT2 (rapid acetylators), acetylation occurs rapidly, serving as a possible risk factor for developing INH resistance in humans.

• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.329-334
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• 2020

Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.