• Title/Summary/Keyword: 의료보험

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Diagnostic Conundrum: Fever and Pyuria Preceding Diagnosis of Kawasaki Disease in Children

  • Jiseon Park;Young June Choe;Seung Ah Choe;Jue Seong Lee;Hyung Eun Yim;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.139-144
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    • 2023
  • Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

Occurrence of Wilting Disease(Fusarium spp) according to Crop Rotation and Continuous Cropping of Sesame(Sesamun indicum) (참깨연작(連作) 및 윤작재배(輪作栽培)에 따른 시들음병(病)(Fusarium spp)의 발생상황(發生狀況))

  • Paik, Su-Bong;Do, Eun-Su;Yang, Jang-Seock;Han, Man-Jong
    • The Korean Journal of Mycology
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    • v.16 no.4
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    • pp.220-225
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    • 1988
  • This study was carried out to investigate the effect on the system of crop rotation of sesame(Sesamum indicum L). The results of infected plant percentage and yield of sesame wilting disease, fluctuation of density of Fusarium oxysporum and Actinomycetes, and their pathogenicity test on Fusarium spp isolated from sesame cultural soil were investigated. Density of F. oxysporum was the highest in a sesame continuous cropping soil but that of Actinomycetes was the lowest in that soil. And that of F. oxysporum and Actinomycetes according to investigation date was the highest at June. 30 and July. 30, respectively. Their pathogenicity of F. oxysporum and F. solani isolated from sesame cultural soil to sesame, peanut and green gram were recognized to all isolates except one isolate among F. oxysporum 8 isolates and one isolate to sesame, 2 isolates to peanut and all isolates to green gram among F. solani 4 isolates. F. oxysporum density and infected plant of wilting disease were increased as a result of replanted cultivation of sesame, and yield of that was prominantly reduced. Relation between density of F. oxysporum in cultural soil and infected plant percentage showed positive correlation and yield index highly negative. There was little difference between sesame-upland rice and sesame-peanut in the system of crop rotation.

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An Alternative Method for a Rapid Urease Test Using Back-table Gastric Mucosal Biopsies from Gastrectomy Specimen for Making the Diagnosis of Helicobacter pylori Infection in Patients with Gastric Cancer (위암 환자의 헬리코박터 파이로리 감염 진단에 있어서 위절제술 직후 생검된 위점막 조직을 이용한 신속 요소 분해 효소 검사법 도입의 의의)

  • Kim, Sin-Ill;Jin, Sung-Ho;Lee, Jae-Hwan;Min, Jae-Seok;Bang, Ho-Yoon;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.172-176
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    • 2009
  • Purpose: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. Materials and Methods: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. Results: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). Conclusion: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.

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A Three-dimensional Photoelastic Analysis of Stress Distributions Around Osseointegrated Implants and Abutment Teeth According to Bridge Connecting Type (골유착성(骨癒着性) 임플란트와 치아간(齒牙間)의 보철물(補綴物) 연결(連結) 형태(形態)에 따른 주위(周圍) 골조직(骨組織)의 응력분산(應力分散)에 관한 3차원적(次元的) 광탄성(光彈成) 분석(分析))

  • Lee, Moo-Geon;Cho, Sung-Am
    • The Journal of Korean Academy of Prosthodontics
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    • v.32 no.1
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    • pp.120-147
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    • 1994
  • This study was performed for the purpose of evaluating the stress distribution around threaded type implants, cylindrical type implants and teeth connected with rigid or non-rigid connector. The stress distribution around the surrounding bone was analyzed by three-dimensional photoelastic method. Twelve mandibular photoelastic epoxy resin models and a circular polariscope were used to record the isochromatic fringes. After the stress distribution around the implant and tooth was observed, the results were as follows ; 1. In threaded type implants, stress concentrated patterns were observed at the neck either vertical or 25 degree lateral force. 2. The stress concentrated patterns were observed at the tooth apical portion and neck portions of the implant and tooth when a threaded implant was connected with the tooth by either a rigid or non-rigid connector. More force was generated at the tooth neck portion by a rigid connector and more force at the implant neck portion by a non-rigid connector. 3. The stress concentrated patterns were observed at the apical portion of the implant and tooth when a cylindrical type ,implant was connected with the tooth either by a rigid or non-rigid connector. More force was generated at the tooth apical portion by a rigid connector and more force at the neck portion of the tooth and implant by a non-rigid connector. 4. The stress around the tooth was more equally distributed in a threaded type implant than in a cylindrical implant when the tooth was connected with either a rigid or non-rigid connector. 5. The stress around a threaded type implant was progressively more equally distributed in the following order : 1) when used a single implant, 2) a non-rigid connection with the implant and tooth, 3) a rigid connection with the implant and tooth, 4) a rigid connection with two implant fixtures.

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The Cut-off Values and Related Factors for Serum Total Cholesterol in Normal Korean Adults (정상 성인에서 총콜레스테롤의 분별치와 관련 요인)

  • 홍인선;김지식;여영규
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.187-198
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    • 1996
  • The cut-off values and related factors for total cholesterol of serum in normal Korean adults were studied from March to October, 1995, based on the data of 1,818 healthy adults of human involved the male and female. The comparisons of the serum total cholesterol levels were analyzed by sex, age, systolic blood pressure, diastolic blood pressure, body weight, height, PIBW, BMI and other biochemical tests. 1. The serum total cholesterol level were 194.4 mg/dl in total group, 186.9 mg/dl for male, and 197.6 mg/dl for female. 2. There was no significant differences by sex among the 21 to 50 ages group, but significantly higher in women than in men over 51 years old. 3. In general, the levels of serum total cholesterol were increased with age, the highest level in men was 192.7 mg/ dl in 51 to 60 years old, and 210.5 mg/dl in more than 60 years old in women. 4. The cut-off values of serum total cholesterol for moderate risk were 191 mg/dl in 21 to 30 years group, 195 mg/dl in 31 to 40 years,214 mg/dl in 41 to 50 years, 227 mg/dl in 51 to 60 years, and 222 mg/dl in more than 61 years. The cut-off values of serum total cholesterol for high risk were 214 mg/dl dl in 21 to 30 years group, 214 mg/dll in 31 to 40 years, 239 mg/dl in 41 to 50 years, 213 mg/dl in 51 to 60 years, and 248 mg/dl in more than 61 years. 5. The mean values of serum total cholesterol were showed positive correlation with age, PIBW, BMI, systolic blood pressure and diastolic blood pressure. 6. Serum total cholesterol level of drinking group(188.9$\pm$34.85mg/dl) was showed love. than those of non-drinking group(196.0$\pm$36.0 mg/dl). 7. Serum total cholesterol levels of regular excercise group(192.1$\pm$33.3 mg/dl) was significantly lower than those of non regular excercise group(195.8$\pm$37.0 mg/dl).

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A Study on the Health Insurance Management System; With Emphasis on the Management Operating Cost (의료보험 관리체계에 대한 연구 - 관리비용을 중심으로 -)

  • 남광성
    • Korean Journal of Health Education and Promotion
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    • v.6 no.2
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    • pp.23-39
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    • 1989
  • There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

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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.

A Study on the Characteristics of Intentional Self-Poisoning Patients : Comparison between Non-Prescription and Prescription Drugs (일반의약품과 전문의약품 의도적 음독 자살 시도자 특성 분석 연구)

  • Cho, Eulah;Cho, Ji Hyun;Jho, Kyeng Hyeng;Sim, Hyun-Bo
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.116-125
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    • 2020
  • Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.

Analysis of Factors Affecting the Length of Stay in Children(Aged 0 to 12) with Injuries: Centering Around the Data from the Korea National Hospital Discharge In-Depth Injury Surveys (어린이(0-12세) 손상환자의 재원일수에 미치는 요인분석: 퇴원손상심층자료를 중심으로)

  • Lee Chae Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.3
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    • pp.137-143
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    • 2023
  • This study was conducted to analyze factors affecting the length of stay in children with injuries by determining relationships between length of stay and characteristics of children(aged 0 to 12) with injuries. 7,804 patients aged 0 to 12 who participated in the Korea Nation Hospital Discharge In-Depth Injury Surveys, got a diagnosis of sequelae of injuries and of other consequences of external causes(S00-T98), and were discharged between 1 January 2016 and 31 December 2020 were investigated. A frequency analysis, independent samples t-test, and ANOVA were performed. Also, to identify factors affecting the length of stay, a regression analysis was performed. The average length of stay for the patients investigated in this study was 5.5 days. The length of stay for school-age children(aged 7 to 12) and children who had either public or private coverage was higher than that for preschoolers(aged 0 to 6) and children who didn't have public or private coverage, respectively. The length of stay for children admitted to a hospital in a rural area(Jeolla-do or Gyeongsang-do) was higher than that for children admitted to a hospital in a metropolitan area and the length of stay for children admitted to a hospital that had 100-299 hospital beds was relatively long. However, children who first visited a hospital for outpatient care stayed relatively short in hospital and children who had been burned or injured in traffic crashes stayed relatively long in hospital. Children who got a secondary diagnosis and had a principal procedure or who died after being discharged were in hospital for a long time. The findings of this study shall be useful, as they identified characteristics related to the length of stay for Korean children with injuries and factors that determine the length of stay for those children by analyzing the national dataset, or more specifically, the data from the Korea National Hospital Discharge In-Depth Injury Surveys. The risk of child injuries can be easily reduced by taking actions to prevent them and providing safety education programs. The present study has provided essential baseline data for the provision of aggressive care for child injuries and the establishment of a range of policies for child injury prevention.

Health Concern, Health Practice and ADL of The Elderly Who Stay at Home in a Rural Community (농촌(農村) 재택노인(財宅老人)들의 건강관심도(健康關心度), 건강실천행위(健康實踐行爲)와 일상생활동작능력(日常生活動作能力))

  • Eom, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.269-289
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    • 1999
  • This study was conducted to examine the relationship among health concern, health practice and ADL of elderly staying at home in a rural community and their affecting factors. Data were collected through direct interviews made with 480 old people aged more than sixty-five from November 15, 1998 to December 20, 1998. Out of 189 male and 291 female, the high-level group that showed high health concern accounted for 44.4%, the medium-level group for 13.1%, and the low-level group for 42.5%, in the health practice, the high-level group accounted for 3.8%, the medium-level group for 18.8%, and the low-level group for 77.5%. In the self-rated health status, the high-level group accounted for 29.0%, the medium-level group for 31.0%, and the low-level group for 40.0%, and in the ADL, the high ADL group accounted for 91.5%, and the low-level ADL group for 8.5%. The result of the chi-square test showed that for male, there was a significant relation between the health concern and the health practice index score. In the relation between the health practice index score and the self-rated health status, there was significant positive relationship between health practice index and self-rated health status, and in the relation between the health practice Index score and the ADL, old people with higher health practices showed good ADL(but not significant). Old people with good ADL also showed good self-rated health status. In the multiple regression analysis where the health practice was used as a dependent variable, the health concern was added to the sociodemographic variables as an independent variables, a formula was formed for male old people only and ones with high concern in health showed good health practice. In the multiple logistic regression analysis where the sociodemographic variables to which the health practices was added were used as an independent variable and the ADL as a dependent variable, the ADL appeared to be not good if for male old people the living costs were born by their sons and daughters and as for female old people their ages increased, but it was good if old people had sources of health information such as hospitals or health centers. The self-rated health status was worse, for male old people, if they had short living costs or diseases and for female old people, if they had spouses, living costs born by their sons and daughters or diseases, but it was better, for male old people, if they had periodical gatherings or carried out health practices a lot, and for female old people, if they had sources of health information such as hospitals or health centers or carried out health practices a lot. In view of the results stated above, the higher the old people had health concern, the more they carried out health practices, and the more they carried out health practices, the better they had ADL and self-rated health status that served as the level of health. Further, the better ADL, the better self-rated health status.

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