• 보건행정학회지
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• 제23권3호
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• pp.210-223
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• 2013

Backgrounds: Escalating pharmaceutical expenditure has threatened the sustainability of National Health Insurance system in Korea. Generic medicines allow patients to access safe, effective, high-quality medicines at low cost, thus insurers could achieve significant financial savings by promotion of generics, if they are priced much lower than the originator. The purpose of this study was to review generic pricing as well as promotion policies in other countries and assess the implication of those policies. Methods: We reviewed the main measures adopted by the developed countries such as Austria, Belgium, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Sweden, United Kingdom, especially in countries where governments are the largest third-party payers or insurance finance resource is the national health insurance. Results: The foreign countries's experience with generic medicine policy shows that demand-side policies such as physician budgets, international nonproprietary name prescribing, generics substitution, patients co-payment as well as supply-side policies relating to pricing and reimbursement seems to play a critical role in developing the generic medicines market. Conclusion: Various strategy should be implemented to promote generic drug use.

• 대한임상독성학회지
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• 제15권2호
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• pp.101-106
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• 2017

Purpose: This study examined the patterns of drugs, poisons, and chemicals detected in autopsy samples performed in the Seoul Institute and other regional forensic offices of the National Forensic Service (NFS) between 2014 and 2016. Methods: The investigation carried out using the laboratory information management system. Forensic toxicological identification and quantitation were performed in autopsy samples, including heart blood, peripheral blood, liver, kidney, vitreous humor and etc. Gas chromatography/mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were used to analyze the drugs and poisons. Results: Forensic autopsies were performed on 9,674 cases in this period. Based on the autopsy reports, 699 cases (7.2%) were considered as unnatural deaths caused by fatal intoxication. The number of male deaths was higher than that of female deaths, with the age of 50-59 being the most common age group. Conclusion: Drugs comprised the largest number of deaths due to poison, followed by alcohol, agrochemicals, drug with alcohol, carbon monoxide, and cyanide, in that order. Zolpidem was the most frequently used drug in all drug-related intoxication cases.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.92-98
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• 2002

Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.

• 한국약용작물학회지
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• 제22권3호
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• pp.196-202
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• 2014

Depression is one of the most common neuropsychiatric disorders and has been associated with the neuroendocrine system and alterations in behavior. Schisandra chinensis Baillon is one of major medicinal plants used as a Korea medicine and food sources, and has been processed in the fields of various food products and medicinal herbs. The chronic mild stress (CMS) protocol is widely used to evoke depressive-like behaviors in laboratory mice or rat. The CMS procedure induced some behavioral changes that are compatible with the common expectations, i.e. 'anhedonic' behavior and can affect corticosterone level. The present study, Schisandra chinensis extract administration by daily gavage from the 3 weeks exhibited an antidepressant-like effect on CMS-induced depression in mice. Schisandra chinensis extract administration at dose of 200mg/kg significantly increased the sucrose consumption, and decreased the immobility durations in forced swim test and tail suspension test. Furthermore the corticosterone level decreased than control group. In conclusion, Schisandra chinensis extract showed antidepressant-like effects on sucrose preference test, forced swimming test and tail suspension test based on CMS model.

• 한국임상약학회지
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• 제26권4호
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• pp.306-311
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• 2016

Objective: This study was performed to compare the changes in the blood concentrations of tacrolimus when either itraconazole or voriconazole is together with tacrolimus to prevent or treat invasive aspergillus pneumonia (IAP) in patients with lung transplants. Therefore we can compare the degree of drug-drug interactions between tacrolimus and itraconazole against tacrolimus and voriconazole. Methods: Patients who were admitted and had lung transplants in a territory referral hospital from September 2012 to May 2015 were analyzed retrospectively. The effects of itraconazole and voriconazole on the plasma concentrations of tacrolimus were analyzed. Results: Mean tacrolimus concentrations was $10.49{\pm}2.35ng/mL$ vs. $10.95{\pm}2.98ng/mL$ (p=0.722), and mean concentration of tacrolimus over the dose of tacrolimus per day was $8.510{\pm}5.890(ng/mL)/(mg/d)$ vs. $15.45{\pm}28.47(ng/mL)/(mg/d)$ (p=0.947) in itraconazole vs. voriconazole group each. The ratio of the number of the results out of target tacrolimus concentrations to the total number of tacrolimus concentration results was $18.0{\pm}13.3%$ vs. $24.4{\pm}18.5%$ (p=0.185). Conclusion: There were no significant differences between itraconzaole and voriconazole to have influences on mean concentrations of tacrolimus over tacrolimus dose per weight per day. However voriconazole tended to raise tacrolimus plasma concentrations more than itraconazole. Safer and more effective drug management to prevent and treat fungal infections should be done by therapeutic drug monitoring not only of tacrolimus but of itraconazole and voriconazole in lung transplant patients.

• 보건행정학회지
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• 제26권4호
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• pp.333-342
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• 2016

Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

• 한국식품위생안전성학회지
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• 제34권3호
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• pp.235-241
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• 2019

본 연구는 농산물 중 잔류허용기준 신설 예정 농약인 가스가마이신의 안전 관리를 위한 공정 시험법을 개발하기 위하여 수행되었다. 가스가마이신은 단백질 합성과정 중 번역 개시 단계를 저해하여 균의 증식을 억제하는 작용기작을 가지고 있으며 특히 사상균인 Piricularia oryzae에 의해 발병하는 도열병을 예방하는 데 효과적이다. 현재 우리나라에는 농산물 중 가스가마이신의 잔류물의 정의가 설정되어 있지 않고 모화합물 만을 잔류물의 정의로 예정하고 있다. 또한 잔류허용기준이 설정된 농산물이 없기 때문에 모든 국내 재배 농산물 또는 수입 농산물 유통 시 실시하는 잔류농약 검사에서 농약 허용물질목록관리제도(Positive List System; PLS)에 의하여 잔류량이 0.01 mg/kg 이하가 되어야 한다. 이에 농산물 중 잔류농약 분석 및 검사를 위한 공정 시험법 마련이 시급하여 본 연구에서는 대표농산물 5종(현미, 감자, 대두, 감귤, 고추)을 대상으로 시험법을 개발하고자 하였다. 따라서 수용성 유기용매인 메탄올의 적용과 수산화나트륨을 이용한 pH 조절을 통한 추출법 및 HLB 카트리지를 이용한 정제법을 최적화하여 LC-MS/MS에 의한 분석법을 확립하였다. 가스가 마이신의 시험법 정량한계는 0.01 mg/kg이며 5종의 농산물에 0.01, 0.1 및 0.5 mg/kg의 처리농도로 회수율 실험을 한 결과 평균 회수율은 71.2~95.4%이었고, 상대표준 편차는 12.1% 이하로 조사되었다. 이러한 검증 결과는 국제식품규격위원회 가이드라인(CAC/GL 40-1993, 2003)의 잔류농약 분석 기준 및 식품의약품안전평가원의 '식품등 시험법 마련 표준절차에 관한 가이드라인(2016)'에 적합한 수준임을 확인하였다. 따라서 본 연구에서 개발한 시험법은 국내 및 수입 농산물 중 가스가마이신의 안전 관리를 위한 공정시험법으로 활용될 수 있으며 잔류물의 정의 및 잔류허용기준을 설정하는 데 기초자료로써 활용 가능할 것이다.

• 보건행정학회지
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• 제34권2호
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• pp.178-184
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• 2024

연구배경: 본 연구는 의료질평가지원금 drug utilization review (DUR) 평가지표 도입 전·후의 DUR 점검률 및 의약품 중복처방 예방률 변화 차이를 비교하여 DUR 평가지표의 도입과 안전한 의약품 사용 간의 효과성을 파악하고자 한다. 방법: 본 연구는 2018년 건강보험심사평가원(Health Insurance Review and Assessment Service) DUR 자료(DUR 평가지표 도입 전)와 2023년 의료질평가지원금 평가 결과 산출 자료(DUR 평가지표 도입 후)를 활용하였다. 종속변수는 DUR 평가지표로, DUR 점검률과 의약품 중복처방 예방률 지표를 활용하였다. 독립변수는 DUR 평가지표 도입 여부이며, 통제변수는 의료기관 단위변수로, 종별 구분, 설립 구분, 소재지, DUR 청구 software 업체, 병상 수를 선정하였다. 결과: DUR 평가지표 도입 전·후의 의약품 중복처방 예방률 변화 차이를 분석한 결과, DUR 평가지표 도입 전·후의 의약품 중복처방 예방률은 통계적으로 유의미한 차이가 있었으며, DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의미하게 증가하였다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, DUR 시스템의 지속적인 평가 진행이 필요하다. 본 연구를 통해 DUR 평가지표 도입 후 의약품 중복처방 예방률이 유의하게 증가한 것을 확인하였다. 따라서 DUR 시스템의 효과를 계속해서 검토하고 의약품 사용의 안전성을 확대하기 위해 DUR 시스템의 지속적인 평가 진행이 필요할 것으로 판단된다. 둘째, DUR 시스템 정보를 활용하는 의료기관과 이를 관리하는 기관과의 협력 파트너십 구축이 필요하다. 의료기관의 적극적인 DUR 점검 참여와 관리기관의 다각적인 지원을 바탕으로 공동의 노력과 협력이 이루어진다면, DUR 시스템의 활성화를 통해 안전한 의약품 사용을 보장하고 국민건강을 보호하며, 의료의 질적 수준 향상을 불러올 것으로 판단된다.

• International Journal of Computer Science & Network Security
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• 제21권7호
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• pp.257-266
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• 2021

This article examines the features of improving the public management of the market of medical and social services using information technology to improve the efficiency of public activity in modern conditions. The interpretation of the essence of the categories "information technologies" and "information support" is analyzed. The importance of the organization of information support of public authorities in the insurance of the state apparatus of information management for the adoption and solution of state issues of the market of medical and social services has been studied. Issues and system of information support of public management of the market of medical and social services are considered. The stages of the ICT implementation process in the market of medical and social services are described. The tools of state regulation in the market of medical and social services and the introduction of targeted programs for the development of the social sphere and health care are highlighted. Recommendations for improvement are formulated public management of the market of medical services and social way introduction of ICT tools, which provide for the implementation of a set of measures aimed at intellectualizing the entire system public data management spheres. The necessity of development of innovative tools of public management of the market of medical and social services of Ukraine for the purpose of working out of strategies of increase of quality of medical and social services in the XXI century is substantiated. A number of benefits from the implementation of an effective process of application of information support of public management of the market of medical and social services to ensure the efficiency of public authorities of Ukraine. It is proposed to create a "Department of information support of self-government" and electronic health care system (e-Health) to improve the management decision-making process, which will provide an opportunity to accumulate, process, analyze, and as a result, get the expected effect in the form of balanced management decisions by public authorities of Ukraine.

• 한국경영과학회:학술대회논문집
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• 한국경영과학회/대한산업공학회 2003년도 춘계공동학술대회
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• pp.620-627
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• 2003

The real option pricing theory has emerged as the new investment decision-making techniques superceding the traditional discounted cash flow techniques and thus has greatly received muck attention from academics and practitioners in these days the theory has been widely applied to a variety of corporate strategic projects such as a new drug R&D, an internet start-up. an advanced manufacturing system. and so on A lot of people who are interested in the real option pricing theory complain that it is difficult to understand the true meaning of the real option value. though. One of the most conspicuous reasons for the complaint may be due to the fact that there exit many different ways to calculate the real options value in this paper, we will present a replicating portfolio method. a risk-neutral probability method. a risk-adjusted discount rate method (quasi capital asset pricing method). and an opportunity cost concept-based method under the conditions of a binomial lattice option pricing theory.