• Title/Summary/Keyword: 보험수가

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Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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Evaluation of Health Impact of Heat Waves using Bio-Climatic impact Assessment System (BioCAS) at Building scale over the Seoul City Area (생명기후분석시스템(BioCAS)을 이용한 폭염 건강위험의 검증 - 서울시 건물규모를 중심으로 -)

  • Kim, Kyu Rang;Lee, Ji-Sun;Yi, Chaeyeon;Kim, Baek-Jo;Janicke, Britta;Holtmann, Achim;Scherer, Dieter
    • Journal of Environmental Impact Assessment
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    • v.25 no.6
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    • pp.514-524
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    • 2016
  • The Bio-Climatic impact Assessment System, BioCAS was utilized to produce analysis maps of daily maximum perceived temperature ($PT_{max}$) and excess mortality ($r_{EM}$) over the entire Seoul area on a heat wave event. The spatial resolution was 25 m and the Aug. 5, 2012 was the selected heat event date. The analyzed results were evaluated by comparing with observed health impact data - mortality and morbidity - during heat waves in 2004-2013 and 2006-2011,respectively. They were aggregated for 25 districts in Seoul. Spatial resolution of the comparison was equalized to district to match the lower data resolution of mortality and morbidity. Spatial maximum, minimum, average, and total of $PT_{max}$ and $r_{EM}$ were generated and correlated to the health impact data of mortality and morbidity. Correlation results show that the spatial averages of $PT_{max}$ and $r_{EM}$ were not able to explain the observed health impact. Instead, spatial minimum and maximum of $PT_{max}$ were correlated with mortality (r=0.53) and morbidity (r=0.42),respectively. Spatial maximum of $PT_{max}$, determined by building density, affected increasing morbidity at daytime by heat-related diseases such as sunstroke, whereas spatial minimum, determined by vegetation, affected decreasing mortality at nighttime by reducing heat stress. On the other hand, spatial maximum of $r_{EM}$ was correlated with morbidity (r=0.52) but not with mortality. It may have been affected by the limit of district-level irregularity such as difference in base-line heat vulnerability due to the age structure of the population. Areal distribution of the heat impact by local building and vegetation, such as spatial maximum and minimum, was more important than spatial mean. Such high resolution analyses are able to produce quantitative results in health impact and can also be used for economic analyses of localized urban development.

Relationships between obesity, blood and urinary compositions, and dietary habits and depressed mood in Koreans at the age of 40, a life transition period (만 40세 생애전환기 건강진단 수검자의 우울기분과 영양 생활습관 및 건강특성과의 관련성)

  • Chu, Ji Eun;Lee, Ji Min;Cho, Han-Ik;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.46 no.3
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    • pp.261-275
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    • 2013
  • This study was designed to investigate the relationships of depressed mood with obesity, blood and urinary compositions, and dietary habits in Koreans at the age of 40, a critical transition to the middle adulthood stage. A total of 27,684 people who have taken the Life Transition Period Health Examination at the Korea Association of Health Promotion in 2011 were divided into two groups; the depressed mood group (DG) and the non-depressed group (NG) according to results of the primary questionnaire for mental health. The results were analyzed using the health examination criteria of the National Health Insurance Corporation. Women and medicaid recipients showed higher incidence of depressed mood than men and health insurance subscribers. People with underweight in BMI or abdominal obesity showed correlation with depressed mood, while there was no significant relationship with metabolic syndrome. Regarding blood and urinary compositions, DG was related to a higher level of hemoglobin and lower levels of HDL-cholesterol and triglyceride, although the relationships diminished after adjustment for other confounder effects. According to dietary habits, more people in DG were categorized as a group for "Needs Much Improvement", and the odds ratio of the depressed mood showed a significant increase. Significant difference regarding the frequency of food items such as milk products, animal proteins, Kimchi, and fruits was observed between DG and NG. In addition, a higher portion of subjects in DG did not consume regular meals and various kinds of food. In conclusion, the depressed mood of 40 year-old adults was significantly related to underweight, higher waist measurement, and undesirable dietary habits. Results of our study can be applicable as a basic resource for development of effective nutrition counseling and education programs for improvement of mental health promotion during the critical transition to the middle adulthood stage.

A Study on the K-REITs of Characteristic Analysis by Investment Type (K-REITs(부동산투자회사)의 투자 유형별 특성 분석)

  • Kim, Sang-Jin;Lee, Myenog-Hun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.66-79
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    • 2016
  • A discussion has recently emerged over the increase of approvals of K-REITs, which is concluded on the basis of how to raise funds for business activity, fulfill the expected rate of return and maximize the management of managing investment funds. In addition, corporations need to acknowledge the necessity of the capital structure reflected in the current economic environment and decision-making processes. This research analyzed the characteristics by investment types and influence factors about the debt ratio of K-REITs. The data were collected from general management about business state, investment, and finance from 2002 to 2015 in K-REITs (except for the GFC period of 2007~2009). The results of the research demonstrated the high ratios of the largest shareholder characteristics, which are corporation, pension funds, mutual funds, banks, securities, insurance, and, recently, the increasing ratio of the largest shareholder and major stockholder. The investment of K-REITs is increasing the role of institutional investors that take a leading development of K-REITs. The behaviors of simultaneous investment of institutional investors were analyzed to show that they received higher interest rates than other financial institutions and ran in parallel with attraction and compensation. The results of the multiple regressions analysis, utilizing variables about debt ratio were as follows. The debt ratio showed a negative (-) relation that profitability is increasing, which matches the pecking order theory and trade off theory. On the other hand, investment opportunities (growth potential) showed a negative (-) relation and assets scale that indicated a positive (+) relation. The research results are reflected as follows. K-REITs focused on private equity REITs more than public offering REITs, and in the case of financing the capital of others, loan capital is operated under the guarantee of tangible assets (most of real estate) more than financing of the stock market. Further, after the GFC, the capital of others was actively utilized in K-REITs business, and the debt ratio showed that the determinant factors by the ratio and characteristics of the largest shareholder and investment products.

Study on the Legal Issues of New Draft of Civil Aviation Law in China (중국 민용항공법 개정 최근 동향과 주요 법적쟁점)

  • Lee, Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.31 no.2
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    • pp.177-214
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    • 2016
  • During more than 20 years of practice, Civil Aviation Law has experienced three times of amendments since it was enacted in 1995. But these revisions are limited to the technical level. The problems and limitations have become increasingly prominent in its implementation. Firstly, the civil aviation law is the result of interests game among several departments and some legal issues was left behind and the regulation was very vague as a result. Secondly, the process of aviation legislation is the process that the country has undergone profound changes and social transformation. The 20 years is long enough for the society to undergo tremendous changes and 1995 version of civil aviation law does not keep pace of development of economy. There was a serious lag between reality and the law. In order to actively promote the development of the aviation industry and overcome implementation issues of the Civil Aviation Law, Civil Aviation Administration of China (CAAC) initiated modification procedure the law and published new draft of Civil Aviation Law in August 2016. The spirit of this modification is to learn and absorb new achievements of domestic and foreign legislation and the International Convention on civil aviation. Furthermore, the purpose of the revision is to provide favorable policy for the development of civil aviation industry and improve aviation safety and supervision, strengthen and protection of consumer rights and interests, to enhance the safety of civil aviation activities, and promote the development of general aviation. This revision concerned to the 78 articles which are revised or deleted and 24 articles added. The highlights of the draft include but not limited to the enhancement of security management, clarification of the main responsibility for production safety. And also it added the provisions related to the construction of effective tracking capability of public air transport enterprises and license system on the transport of dangerous goods. Compared with the existing civil aviation law, the draft has made a great improvements. But there are several deficiencies and limitations in the drafts. These problems need to be supplemented and perfected through further amendments in near future.

Studies on the Zanthoxylum piperitum $D_E$ $C_{ANDOLIE}$ - 1. Pungent principles and Essential oil composition - (천초(川椒)에 관(關)한 연구(硏究) - 1. 신미성분(辛味成分)과 정유성분(精油成分) -)

  • Jung, Hyun-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.16 no.2
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    • pp.123-127
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    • 1987
  • The Pungent principles and Essential oil compositions of Zanthoxylum piperitum $D_E$ $C_{ANDOLIE}$(peel, barb) were analysed by HPLC and GC, respectively. Total Pungent principle contents of peels were about as 12 times as those of barks. The Sanshool I, Sanshool IV, Sanshool III and Sanshoo V were the major Pungent principles in the peels and barks. Besides, several Unknown Pungent principles were discovered in the peels and barks, too. Total Essential oil contents of peels were higher than those of barks at the ratio of 1.8 % to 0.5%. The Cineol+Limonene(37.7%) were the main Essential oil compositions in the peels, while ${\alpha}-Terpineol(16.5%)$ and Pinene(15.5%) were the major portion in the barks. The Essential oil of peels and barks were composed Pinen, Myrcene, Cineol+Limonene, Linalool, Isopulegol, Terpinen-4-ol, ${\alpha}-Terpineol$ and Piperitone. Besides, seven Unknown compositions were discovered, too.

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Comparison of Clinical Outcomes in ACL Reconstruction using auto-Hamstring Tendon and allo-Tibialis Anterior Tendon (자가슬괵건 및 동종전경골건을 이용한 전방십자인대 재건술 후 임상적 결과의 비교)

  • Kim, Jae-Hwa;Lee, Yoon-Seok;Rhee, Seung-Yong;Chung, Ju-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.104-110
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    • 2007
  • Purpose: The purpose of this study is comparison of clinical outcomes in ACL reconstruction between auto-hamstring tendon and allo-tibialis anterior tendon. Materials and Methods: In this prospective study, we included 60 subjects who underwent ACL reconstruction using 30 hamstring autograft(mainly, national health insurance) and 30 tibialis anterior allograft(including MVA and industrial injuries) between May 2003 and June 2005 by a single surgeon, with a minimum follow-up of 12 months. Outcome measurements were the range of motion, the Lachman test, the IKDC score, the Lysholm score, KT-1000 arthrometer and one-leg hop test. Results: For all the cases, the range of motion was above 135 degrees. The Lachman test, KT-1000 arthrometer and one-leg hop test showed no significant difference between two groups. The IKDC score of auto-hamstring group($87.840{\pm}2.106$) was significantly higher than that of allo-tibialis anterior group($85.273{\pm}2.782$). The Lysholm score of auto-hamstring group($88.067{\pm}2.586$) was also significantly higher than that of allo-tibialis anterior group($85.300{\pm}3.030$). Conclusion: The results of ACL reconstruction using the auto-hamstring tendon and allo-tibialis anterior tendon showed no significant difference in objective items but auto-hamstring group showed better results in subjective scoring. This difference may result from individual factors such as economic problem, secondary gain.

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$H_2$ Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study (노인 인구에서 $H_2$ Receptor Antagonist와 위암과의 관련성: 코호트 내 환자-대조군 연구)

  • Kim, Yoon-I;Heo, Dae-Seog;Lee, Seung-Mi;Youn, Kyoung-Eun;Koo, Hye-Won;Bae, Jong-Myon;Park, Byoung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.245-254
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    • 2002
  • Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.

The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병환자에서 임상영앙치료의 임상적 효과와 비용효과 연구)

  • Cho, Youn-Yun;Lee, Moon-Kyu;Jang, Hak-Chul;Rha, Mi-Yong;Kim, Ji-Young;Park, Young-Mi;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.147-155
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    • 2008
  • Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

A Study on the ICAO international aviation safety policy, a change of paradigm and the government response to the direction (ICAO 국제항공안전정책 패러다임의 변화 분석과 우리나라 신국제항공안전정책 검토)

  • Chang, Man-Heui;Hwang, Ho-Won
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.1
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    • pp.73-96
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    • 2013
  • ICAO's Universal Safety Oversight Audit Programme (USOAP) was initially launched in January 1995, in response to widespread concerns about the adequacy of aviation safety oversight around the world. The recent reduction in aircraft accidents and effective role that is evaluated on the basis of these results, and in 2013 the existing 'snapshot approach' to 'regular monitoring system (USOAP-Continuous Monitoring Approach)' was converted to. ICAO aviation safety assessment of the state in today's international community 'aviation safety credibility' as objective indicators to judge the enormous impact on the aviation industry, the state is not satisfactory, especially if the results of the evaluation and expansion of code-share airline ban, reduced international air transit passengers, including premium increases business and economic penalties should. In addition, ICAO implementation of the existing laws and regulations(Prescriptive Approach), but based on the Risk-based prevention model, Proactive Approach introduced the concept of aviation safety system, including international aviation safety policy has been to switch paradigms. This new ICAO international aviation safety policy also applies to the Government of the Republic of Korea in line with the aviation safey policies have changed. In particular, the systematic implementation of safety management for the existing laws and regulations in the center of the safety oversight system of risk-based introduction of the concept of proactive safety management, and According to international standards ICAO aviation service providers operate their own Safety Management System was set out in Aviation Law ever. In addition, the aviation safety is at the center of the field of the safety of aircraft operations and maintenance for the promotion is promoting various safety policies. This new paradigm shift in the international aviation safety policy in line with our state in the international community with the most exemplary aviation safety system firmly established itself as a model, the Government will strengthen the competitiveness of our aviation plans to support. To do this, the government, airlines, aviation officials try all the practical effect would be expected.

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