• Archives of Pharmacal Research
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• 제15권2호
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• pp.162-168
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• 1992

Release characteristics of five different types of hydrophilic albumin microspheres (HAM) containing different ratios of methotrexate-albumin (MTX-HSA) conjugates to free MTX: 1 : 0 (HAMC), 3 :1 (HAMC 3F), 1 :1 (HAMCF), 1:3 (HAMCF3) and 0 : 1 (HAMF) were investigated in the absence or presence of protease using dissolution tester. In all the HAMs studied except HAMC, the MTX was released bi-exponentially in the absence of protease; an initial fast release period up to approximately 6h, and thereafter the release rate was very much slower. The fast release of MTX from the HAMs (such as HAMC3F, HAMCF, HAMCF3 and HAMF) at the initial phase in probably due to the release of "physically associated" MTX from the core of the HAMs. The initial rate constants were 7.2, 8.7, 8.5 and 5.9 times greater than the second rate constants for HAMF, HAMCF3, HAMCF and HAMC3F, respectively. MTX release from HAMC was very slow and mono-phasic. It was at most 2.2% of the total entrapped amount by 24 h. The protease accelerated the release of MTX from the HAMs. The percentages of MTX released from HAMs up to 24 h were 100, 89.0, 75.0, 66.0 and 61.0% for HAMF, HAMCF3, HAMCF, HAMC3F and HAMC, respectively in the presence of protease and the corresponding values in the absence of protease were 30.2 19.0, 10.0, 6.5 and 2.2%, respectively. In vitro release of MTX in the presence of protease varied according to the ratios of MTX-HSA conjugates to MTX; the data set from HAMF, HAMCF3 and HAMCF fits better to monophasic first-order profile more adequately than to zero-order profile, that of HAMC3 monophasic first-order, and that of HAMC to bi-phasic zero-order. Above results suggested that zero-order release rate can be achieved by adjusting the ratio of MTX-HSA conjugates to MTX in the preparation of HAMs such as HAMC3F.as HAMC3F.

• 한국치위생학회지
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• 제12권5호
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• pp.987-997
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• 2012

Objectives : This study was carried out in order to obtain basic data for students' efficient acquirement and instruction of radiography technology in the future by surveying dental hygiene students' recognition of periapical radiography. Methods : This study carried out a questionnaire survey targeting dental hygiene students from December 2009 to December 2010, and obtained the following results. Results : 1. As a result of examining recognition on periapical radiography, the bisecting angle technique was indicated to be averagely $3.84{\pm}0.566$ points. The paralleling technique was indicated to be $2.66{\pm}0.701$ points. 2. As a result of examining about problems given the bisecting angle technique, what had been most difficult given the bisecting angle technique was indicated to be the highest in cone positioning with 34.2%. The most difficulty given deciding on the X-ray vertical-angel irradiation direction was indicated to be the highest with 66.9% in adjusting the cone direction on the virtual bisector. 3. As a result of examining about problems given the paralleling technique, what had been most difficult in the process of the paralleling technique was indicated to be the highest with 56.7% in fixing the film immobilization device inside the mouth. Conclusions : Examining the above results, it is considered that there is a need of understanding morphological and anatomical structure inside the mouth in order to reduce the mistake rate given the periapical radiography, and that it is important to increase skill level by repetitively shooting several times with having enough time.

• Journal of Preventive Medicine and Public Health
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• 제38권2호
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• pp.132-140
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• 2005

Objectives: To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. Methods: The study sample included delivery claims data from January to September, 2003. A risk-adjustment model was built using the 1st quarter data, and the 2nd and 3rd quarter data were used for a validation test. Patients' risk factors were adjusted using a logistic regression analysis. The c-statistic and Hosmer-Lemeshow test were used to evaluate the performance of the risk-adjustment model. Crude, predicted and risk-adjusted rates were calculated, and compared to analyze the effects of the adjustment. Results: Nine risk factors (malpresentation, eclampsia, malignancy, multiple pregnancies, problems in the placenta, previous Cesarean section, older mothers, bleeding and diabetes) were included in the final risk-adjustment model, and were found to have statistically significant effects on the mode of delivery. The c-statistic (0.78) and Hosmer-Lemeshow test ($x^2$=0.60, p=0.439) indicated a good model performance. After applying the 2nd and 3rd quarter data to the model, there were no differences in the c-statistic and Hosmer-Lemeshow $x^2$. Also, risk factor adjustment led to changes in the ranking of hospital Cesarean section rates, especially in tertiary and general hospitals. Conclusion: This study showed a model performance, using medical record abstracted data, was comparable to the results of previous studies. Insurance claims data can be used for identifying areas where risk factors should be adjusted. The changes in the ranking of hospital Cesarean section rates implied that crude rates can mislead people and therefore, the risk should be adjusted before the rates are released to the public. The proposed risk-adjustment model can be applied for the fair comparisons of the rates between hospitals.

• 치위생과학회지
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• 제23권2호
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• pp.142-153
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• 2023

Background: Cognitive impairment has been reported to be closely associated with poor oral health, and the relationship is bidirectional, as older adults with poor oral health and chewing function are at a higher risk of cognitive decline (CD). This cross-sectional study aimed to determine whether masticatory discomfort in Korean elderly increases the risk of daily living difficulty (DLD) related to CD and whether there is a difference in risk according to gender and age. Methods: The data used were obtained from the Korean Community Health Survey (2019). The final analysis included 22,154 people aged 65 years and older who completed the survey and responded to all items on the variables used in the study. Chi-square test, trend test, and complex sample logistic regression were performed for statistical analysis, to clarify the purpose of this study. Results: As masticatory discomfort increased, the elderly's DLD tended to increase (p-for trend, p<0.001). For logistic regression, adjusting for all covariates, participants who reported masticatory discomfort as "discomfort" (adjusted odds ratio [AOR]=2.45, 95% confidence interval [CI]=2.11~3.50) and "severe discomfort" (AOR=2.95, 95% CI=2.49~3.50) had a more than a two-fold increased risk of CD-related DLD compared to participants who reported "no discomfort at all." In age-stratified analyses, elderly men aged 75~84 years and elderly women aged 65~74 years had the highest risk of developing CD-related DLD. Conclusion: Oral care interventions to improve masticatory function in older adults may slow CD and improve CD-related DLD. We hope that this study will raise awareness among caregivers and clinical professionals regarding the importance of oral care for older adults with CD.

• 동국한의학연구소논문집
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• 제4권
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• pp.25-52
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• 1995

'Sang Han Lon' became the sources for treatment and prescription in the Oriental medicine. After that, for some 1800 years the various writings for studying in many ways more than 1000 books which many old sages really intended to inquire into and study the value of books. It is considered that it is the result which the old sages tried to grope for many-sided directions in order to understand 'Sang Han Lon'. In this study, I tried to inquire into prescription and its relevant medicinal substances, that is to say, the crystalization of the physiology, pathology and treating method on the basis of the academic sources of his thoughts. The method to approach is "from what basis of thought system was 'Sang Han Lon' derived first of all?" Secondly, how was the thought system, which became the basis of 'Sang Han Lon', applied to concretely? I studied on the basis of the above important two problems. It is well known to everybody that 'Sang Han Lon' succeeded to the tradition of Naekyung(內經) as well as Cwuyek(周易, Chinese classic on divination). Besides, I inquired into and arrived at conclusion as follows that how the viewpoint on the balance(平衡觀), which was one of the common point between. Cwuyek(周易) and medical science in case of the 'Sanghan prescription'(傷寒方), was applied to concretely. 1. In naming, it is considered that from the same interconnection which the common point with Cwuyek(周易) was the same as obtaining the imigination(取象), the imagination was obtained and was named. 2. In case of being concerned in the gastro-intestinal track, namely, the core of the balance and harmony with the balance and harmony being emphasized, '理中'(It implies 'taking care of gasstro-intestinal track')" and '建中'(It implies 'establishing of gastro-intestinal track'), that is to say, '中'(It implies 'taking care of' & 'establishing of gastro-intestinal track') was emphasized much more. 3. In case of treatment taking advantage of three kinds of medicine in draught, powder and pills in the prescription, while treating during adjusting the slowness and fastness, I maintained the harmony not to damage the righteousness(正氣). 4. In case of the prescription, when exhaling(發散), astringing(收斂), loosing bowels, protecting the gastro-intestinal track and vomitting, he used the medicinal sustances in order to protect the gastro-intestinal track and treated not to damage the righteousness. 5. Especially, in case of the prescription in order to adjust the negative and positive principle of inside-outside(素囊陰陽), he composed of medicinal substances relevant to hot, cold, spicy and sour(寒熱辛酸) in conformity with the prescription and I paid much more attention to the one-sided treatment. Considering the various prescriptions, it is regarded that the adjusting prescription is kept its balance. 6. In the way of processing the medicinal substances in order to change effect of medicine in conformity with the reenactment, he tried to plan the balance of '一升一降' with the decrease of RHEI RADIX ET RHIZOMA(大黃) and increase of wine. 7. In boiling the medicine, he boiled the composed medicine in the time sequence for the purpose of adjusting the slowness and fastness and adapted to harmony of the negative and positive principle(陰陽調和) on the essence function(體峻用純). 8. In taking medicine, he tried to reduce the time of taking the medicine in case of being boiled slowly and tried to increase the dosage and eventually he planned the balance of one time slowness and one time fastness. As I inquired into the above result, a few steps for protecting method to boil the relevant medicinal substances, how to take the medicine and how to process the composed medicinal substances in order to change the effect of medicine can make the human body, which the disease penetrate into, go forward to the righteousness(正氣) and what is much beter, it is considered that this protecting method can be a carefully considerable one in order to protect the righteousness and can subdue the disease, not to damage the gastro-intestinal track and there can exist the viewpoint of balance(平衡觀) on its core.

• 약학회지
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• 제36권3호
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• pp.212-219
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• 1992

Although oral route is the most convenient route for drug administration, the short and variable transit of drug through GI tract restricts the sustained drug absorption after oral administration. Thus, for sustained absorption of drugs, it is desirable to prolong the GI transit time by retaining the dosage forms in the stomach. In this study, the enzyme-digestible swelling hydrogel was synthesized by heating the mixed solution of N-vinyl-2-pyrrolidone[monomer], acrylated albumin[crosslinking agent] and proxyphylline[drug] at $65^{\circ}C$ for 10 hours in the cylindrical test tube. The resultant hydrogel tablet (diameter; 0.77 cm, thickness; 0.47 cm) was designed to swell in the gastric fluid after oral administration to such a size that passing through the pylorus could be inhibited during the drug release. After releasing drug, the hydrogel was expected to be degraded by pepsin, an enzyme in the stomach, and eventually solubilized. Actually, the hydrogel synthesized in the study swelled to a size larger than the diameter of the pylorus ($1.3{\pm}0.7$ cm) and slowly digested in the presence of pepsin. Drug release from the hydrogel was prolonged up to about 12 hours. The swelling kinetics was dependent on albumin acrylation time, drug content and gel thickness. Particularly the gel thickness was the most important factor that influences on drug release. By adjusting these factors, the albumin-crosslinked hydrogel was expected to be retained in the stomach for up to 60 hours and used as a potential platform of drugs for long-term GI absorption.

• 한국병원경영학회지
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• 제28권1호
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• pp.14-23
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• 2023

Purposes: The Specialty hospital designation policy had launched in 2011 and 110 designated specialty hospitals have been operating nationwide in 2022. This study was to estimate the market share of specialty hospitals for the specific diseases compared to other types of hospitals. Methodology: Data were derived from the National Health Insurance Claim data from 2018 to 2019. Subjects were all the inpatients with MDC(Major Disease Category) that specialty hospitals specialized in. A total of 34,231,387 claims were analyzed to estimate the market share. Findings: 90 specialty hospitals were responsible for 2.4 percent of inpatient care with specific diseases for specialty hospitals. There were regional variations in the market share of the specialty hospitals as the number of specialty hospitals in regions. Specialty hospitals' market shares were relatively high in burn(31.3%), ophthalmology(16.4%), obstetrics and gynecology(7.1%), alcohol(6.0%), joint(3.7%), spine(2.7%). After adjusting the number of inpatients per hospital, hospitals specialized in burn, alcohol, ophthalmology, breast, joint, obstetrics and gynecology, and hand replantation had treated more patients than tertiary hospitals. Practical Implications: Although specialty hospitals' market share was small, some types of specialty hospitals had an impact on the regional market as well as the national level market. To improve patients' accessibility to a specialty hospital, it is necessary to government supports non-specialized hospitals to change into specialty hospitals in certain fields and regions where the number of specialty hospitals is insufficient.

• 한방재활의학과학회지
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• 제19권2호
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• pp.261-273
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• 2009

Objectives : This study was performed to figure out the effects of herbal mesotherapy on abdominal fat in obese women. Methods : Forty obese women those who were diagnosed abdominal obesity had been recruited during February, 2008. They were randomly assigned experimental or control group under block-randomization. Experimental group were treated with Sobi-eum(Xiaofei-yin) injection during 6 weeks (2 times a week) and placebo group were treated with normal saline injection under same procedures. Anthropometry, body impedance analysis, fat computed tomography, blood test, and questionnaires had been administered before and after the treatment. Results : Four subjects were dropped out (voluntary give up), so 18 in experimental group and 18 in placebo group were evaluated. There were significant changes after treatments in both groups. Although no significant differences have been found in the result of anthropometry, body impedance analysis and fat computed tomography between two groups, in the experimental group, the changes of total fat area had a highly significant relationship with all part of abdominal fat. While the placebo group had highly significant relationships with subcutaneous fat area, superficial and deep subcutaneous fat area but not with visceral fat area. Conclusions : Compaired with saline group, herbal mesotheraphy Sobi-eum(Xiaofei-yin) is effective in reduction of visceral fat after adjusting TFA.

• 치위생과학회지
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• 제18권1호
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• pp.1-8
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• 2018

Stroke is the second cause of death worldwide, although the survival period is increasing after the occurrence of stroke, severe physical disability is caused with aftereffect. Oral inflammation is not limited to the oral cavity, it can cause malignant changes in other tissues and organs. In previous studies, we confirmed the relationship between tooth loss and stroke due to periodontal inflammation. The purpose of this study was to investigate the relationship between oral health and stroke such as oral hygiene behavior, tooth loss and periodontal disease among Korean adults over 40 years of age. This study was analyzed using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3,389 adults over 40 years of age were analyzed as final subjects. Socioeconomic statuses and oral health status was analyzed using a complex sample analysis technique. Logistic regression was used to analyze the relationship of oral health and stroke, and 95% confidence intervals were computed using SPSS. When the prevalence of stroke according to oral hygiene behavior was checked, the prevalence of strokes was lower in subjects who had a lot of brushings per day and subjects who used oral hygiene products (p<0.05). The risk of stroke was 2.17 times (95% confidence interval, 1.43~3.28) higher in the group with less than 19 remaining teeth, but it was not statistically significant as a result of adjusting for age and sex, income level, education level, drinking and smoking (p>0.05). Loss of teeth was found to be associated with the risk factor of stroke. Therefore, loss of teeth due to periodontal disease is an additional issue that should be considered as a risk factor for stroke.

• Journal of Preventive Medicine and Public Health
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• 제53권2호
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• pp.73-81
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• 2020

Objectives: The purpose of this study was to determine whether eating non-home-prepared meals (NHPM), including fast food, ready-to-eat foods, and frozen foods, was associated with self-reported infertility in the United States women. Methods: Data on diet and infertility from women aged 20-49 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n=2143). Dietary information, including the number and types of NHPM consumed, was obtained from a self-reported questionnaire, and infertility status was analyzed using the following question, "Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant" Results: The frequency of NHPM consumption was positively associated with self-reported infertility after adjusting for confounding effects (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.48 to 5.38 of >1 vs. 0 NHPM/d). The odds of infertility were 2-3 times higher in women who consumed fast food than in those who did not consume fast food (OR, 2.73; 95% CI, 1.15 to 6.48 of >1 vs. 0 times/d). Conclusions: The frequency and types of NHPM may be a factor contributing to infertility. Although our findings require confirmation, they suggest that eating out may be deleterious to women fecundity.