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The Survey of Dentists: Updated Knowledge about Basic Life support and Experiences of Dental Emergency in Korea

  • Cho, Kyoung-Ah;Kim, Hyuk;Lee, Brian Seonghwa;Kwon, Woon-Yong;Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.17-27
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    • 2014
  • Background: Various medical emergency situations can occur during dental practices. Cardiac arrest is known to comprise approximately 1% of emergency situation. Thus, it is necessary for dentists to be able to perform cardiopulmonary resuscitation (CPR) to increase the chance of saving patient's life in emergency situation. In this paper, we conducted a survey study to evaluate to what extent dentists actually understood CPR practice and if they had experience in handling emergency situations in practice. Method: The survey was done for members of the Korean Dental Society of Anesthesiology (KDSA), who had great interest in CPR and for whom survey-by-mail was convenient. We had selected 472 members of the KDSA with a dental license and whose office address and contact information were appropriate, and sent them a survey questionnaire by mail asking about the degree of their CPR understanding and if they had experience of handling emergency questions before. Statistical analyses -frequency analysis, chi-square test, ANOVA, and so on- were performed by use of IBM SPSS Statistics 19 for each question. Result: Among 472 people, 181 responded (38.4% response rate). Among the respondents were 134 male and 47 female dentists. Their average age was $40.4{\pm}8.4$. In terms of practice type, there were 123 private practitioners (68.0%), 20 professors (11.0%), 16 dentists-in-service (8.8%), 13 residents (specialist training) (7.2%) and 9 military doctors (5%). There were 125 dentists (69.1%) who were specialists or receiving training to be specialist, most of whom were oral surgeon (57, 31.5%) and pediatric dentists (56, 30.9%). There were 153 people (85.0%) who received CPR training before, and 65 of them (35.9%) were receiving regular training. When asked about the ratio of chest pressure vs mouth-to-mouth respiration when conducting CPR, 107 people (59.1%) answered 30:2. However, only 27.1% of them answered correctly for a question regarding CPR stages, C(Circulation)- A(Airway)- B(Breathing)- D(Defibrillation), which was defined in revised 2010 CPR practice guideline. Dentists who had experience of handling emergency situations in their practice were 119 (65.6%). The kinds of emergency situations they experienced were syncope (68, 37.6%), allergic reactions to local anesthetic (44, 24.3%), hyperventilation (43, 23.8%), seizure (25, 13.8%), hypoglycemia (15, 8.3%), breathing difficulty (14, 7.8%), cardiac arrest (11, 6.1%), airway obstruction (6, 3.3%), intake of foreign material and angina pectoris (4, 2.2%), in order of frequency. Most respondents answered that they handled the situation appropriately under the given emergency situation. In terms of emergency equipment they had blood pressure device (70.2%), pulse oximetry (69.6%), Bag-Valve-Mask (56.9%), emergency medicine (41.4%), intubation kit (29.8%), automated external defibrillator (23.2%), suction kit (19.3%) and 12 people (6.6%) did not have any equipment. In terms of confidence in handling emergency situation, with 1-10 point scale, their response was $4.86{\pm}2.41$ points. The average point of those who received regular training was $5.92{\pm}2.20$, while those who did not was $4.29{\pm}2.29$ points (P<0.001) Conclusion: The result showed they had good knowledge of CPR but the information they had was not up-to-date. Also, they were frequently exposed to the risk of emergency situation during their dental practice but the level of confidence in handling the emergency situation was intermediate. Therefore, regular training of CPR to prepare them for handling emergency situation is deemed necessary.

OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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A Clinical Characteristics of Systemic Candidiasis in Neonatal Intensive Care Unit : Comparison with Systemic Bacterial Infection (신생아 집중치료실 입원아에 있어서 전신성 칸디다증의 임상적 특징 : 전신성 세균 감염증과 비교)

  • Lim, Jung Hwa;Park, Kyung Pil;Kim, Jin Kyung;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.847-854
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    • 2002
  • Purpose : Long term hospitalized infants in neonatal intensive care units(NICUs) are prone to systemic infection. It is important to differentiate systemic candidiasis from systemic bacterial infection early in the course. Thus, in this study, we have compared clinical characteristics of systemic candidiasis and systemic bacterial infection, in premature low birth weight infants. Methods : Retrospective chart review of the medical records of 20 patients with systemic candidiasis and 23 patients with systemic bacterial infection was performed. Results : Among the risk factors of systemic candidiasis, total parenteral nutrition(TPN), the use of broad spectrum antibiotics, central catheter insertion, endotracheal intubation and the use of H2 blockers were more frequent in neonates with systemic candidiasis than neonates with systemic bacterial infection. Apnea with bradycardia developed more frequently in neonates with systemic candidiasis compared with systemic bacterial infection(75% vs 39%). In laboratory findings at symptom onset, seven cases(35%) of systemic candidal infections and two cases(9%) of systemic bacterial infections showed leukopenia and thrombocytopenia(P=0.03). Blood was the most frequent isolation site of candida and bacteria. Conclusion : In neonates with systemic candidiasis, apnea with bradycardia, pneumonia and thrombocytopenia were prone to develop more frequently. The use of TPN, antibiotics and central catheters was strongly associated with systemic candidiasis. Empirical treatment with antifungal agent should be considered in critically ill neonates with above findings.

tans-Resveratrol Content of Varieties and Growth Period in Peanut (땅콩 품종 및 생육기별 trans-Resveratrol 함량)

  • Lee, Mi-Ja;Cheong, Young-Keun;Kim, Hyung-Soon;Park, Ki-Hun;Doo, Hong-Soo;Suh, Duck-Yong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.48 no.6
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    • pp.429-433
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    • 2003
  • trans-Resveratrol(3,5,4'-trihydroxystilbene) is phenolic compound present in grapes, wines, and peanuts, has been reported to have health benefits including anticarcinogenic effects, protection against cardiovascular diseases and reduced cancer risk. A simple method for the quantitative extraction of trans-resveratrol from peanut has been developed. Optimal conditions for extraction were investigated. Type of solvent, time, and temperature assayed influenced trans-resveratrol yield. Adequate extraction condition was decided to ethanol/water (80:20v/v) maintained at $25^{\circ}C$ for 45 min. After extraction, the protocol consists of sample preparation using a $\textrm{C}_{18}$ solid-phase extraction (SPE) cartridge after concentrate with rotary evaporator and quantified by reversed phase HPLC using a $\textrm{C}_{18}$ column at 308 nm. Analytical methods for measuring trans-resveratrol in peanut were adapted to isolate, identify, and quantify trans-resveratrol in 11 peanut varieties by HPLC (high-performance liquid chromatography) with UV detector, The 11 peanut varieties content ranged from 0.018 to 1.125 $\mu\textrm{g}/\textrm{g}$ with an average of 0.289 $\mu\textrm{g}/\textrm{g}$. The contents were higher in the seeds with than without testa, regardless of varieties. The trans-resveratrol content was Higher in 110, 130 days after sowing than that of other period.

Sister Chromatid Exchanges in Lymphocytes of Some Workers Exposed to Hexavalent Chromium (일부 6가 크롬 폭로 작업자의 임파구 자매염색분체교환)

  • Shin, Dong-Hoon;Yoon, Nung-Ki;Suh, Suk-Kwon;Yeh, Min-Hae
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.358-368
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    • 1990
  • To investigate the possibility of utilizing of sister chromatid exchange(SCE) analysis in lymphocytes as an indicator which could evaluate the effects of mutagenicity after in vivo exposure to hexavalent chromium, this study was conducted using some of chromium plating workers occupationally exposed to hexavalent chromium, chromium trioxide ($CrO_3$) in Taegu city. The study population was 12 Cr platers with perforation of nasal septum, 12 Cr platers without perforation of nasal septum and 20 controls. The SCE in peripheral blood lymphocytes of the subjects was analyzed and blood chromium concentration was estimated using the atomic absorption spectrophotometer (IL551) equipped with furnace atomizer (IL755). The mean SCE frequencies for Cr platers with and without perforation of nasal septum were statistically higher than those for control. The difference in SCE frequencies by age, smoking habits were not statistically significant both in Cr platers and controls. There was no difference in SCE frequencies by career of Cr platers workers. In Cr platers, the correlation between the mean SCE frequencies and chromium concentration in blood was not statistically significant. Using the transformation $y=(sum\;SCE)^{\frac{1}{2}}+(sum\;SCE+1)^{\frac{1}{2}}$, when the data was studied by multiple regression, it appeared that the influence of the occupation was the most important. Age, smoking, occupation and CrB(blood chromium concentration) together explain only 32.3% of interpersonal variation on SCE. The results in this study suggest tt a genetic risk due to occupationally exposure to hexavalent chromium is clearly inferable and thus, SCE analysis in human lymphocytes may be used indicator of biological toxic effects of chromium. Further, populatio analysis stuies are required before SCE frequency can be used as a mutagenic indicator in human population.

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Perceived Weight and Health Behavior Characteristics -Normal and Overweight Middle-aged women- (도시일부 중년여성의 체중상태와 건강행위 선택 비교 연구)

  • 조현숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.387-398
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    • 1996
  • The objective of this study was to clarify whether there are any differences between normal and over-weight middle-aged(40∼59yrs)women in their perceived weight, health status, health conception and health behavior choices. The sample consisted of 39 normal weight and 55 over-weight (11% above on the Body Index Scale) women who live in Juan, Inchon. The Participants were randomly selected in each weight group considering socio-demographic factors. The findings from this study are summarized below. 1) Among the 55 overweight middle-aged women, 16 were above 20% on the Body Index Scale and 14 were above 30%. Twenty-five(45.5%) of the overweight group and 12(30.8%) of the normal weight group had one disease, and there were 12(21.8%) in the overweight group and 8(20.5%) in the normal weight group where one of the family members had a disease, but these differences were not statistically significant. The average monthly family income for the overweight group was ₩l,880,000 compared to ₩2,140, 000 for the normal weight group, but this difference was also not significant. The age range for the whole group was between 40 and 59(mean=46.8 for total, 48.6 for overweight and 45.7 for normal weight group). Again no significant difference found. Occupations were housemaker 53(56.4%), private business(13.8%), salarywoman(9.6%), and teacher (2.1%). Thirty housemaker(54.5%) from the overweight group and 23(59%) from the normal group did not constitute a statistically significant different. For the educational status, 34(61.8%) of the overweight women and 33(84.6%)of the normal weight group finished high school or more educational courses, but there was no significant statistical difference. Eleven(20.0%) of the overweight women and 5(12. 8%) of the normal weight group were single, but again no significant statistical difference was found. 2) A test for difference in health characteristics between two weight groups indicated that two groups do not show statistical differences in their perceived health status, health conception or health behavior choice. That is, the overweight group, also perceive their health status as good as the normal group, and regard ‘Health’ as a state that enables them to carry out social roles and functions rather than as the traditional concept of health as no disease or no symptoms. Moreover. the overweight group selected their health behaviors not for the prevention of diseases or maintenance of health but for promotion of health. To determine if no statistical difference might be related to the overweight group's failure of perceive themselves as overweight, the perceived and objective overweight status were compared by the chi-square analysis, and no difference was found(X/sup²=49.37, df=1, p=.000). However, 7(17.9%) of the normal group perceived themselves as being overweighted and 7(12.7%) of the overweight group thought they were of normal weight. Even though the overweight group employed in this study perceived themselves as being overweight, they regarded themselves as healthy as those in the normal weight group. It was shown that there was no statistical difference between two groups in health conception, and that they chose health behaviors to promote health status. 3) Perceived health conception was shown to be significantly related to health behavior choice (r= .28, p=.006 for whole group : r=.33, p=.014 for overweight group : and r=.12. p=.463 for normal group) .There was an indication that the more complicated the perceived health conception was, the more the trend of health behavior choice to promote health. This was especially true for the overweight group. But, the perceived health status did not related to health behavior choice statistically(r=.13, p=.202), and it was thought that reasons for selecting health behaviors were not related to their health status. That is, the overweight group perceive themselves as healthy as the normal weight group or thought that overweight itself does not incur any risk on their health. Data from two groups were combined and analyzed with multiple regression methodology, because the relationship pattern of the two groups was similar. The analysis showed that health behavior has a significant relationship with age and the perceived health conception(r/sup²=.1517, p=.05, F=8.133). It means they come to health behavior along with their health conception and their age rather than their weights, perceived weight, health status or other social characteristics. This study was intended to understand how overweight middle-aged women perceive ‘weight’ and ‘health’, and how they meet their health related needs in comparison with normal weight middle-aged women. Other factors related to the health behavior in overweight middle-aged woman need to be determined through further descriptive studies outlined in the following recommendations. a) Reseach with the study area expanded. b) Reseach with grouping more detailed : much more overweight and underweight group c) Reseach on restricted relationship between overweight and age or profession. d) Reseach on what overweight middle-aged women do to reduce their weight and what factors motivate them to do it

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Risk Aversion in Forward Foreign Currency Markets (선도환시장(先渡換市場)에서의 위험회피도(危險回避度)에 관한 연구(硏究))

  • Jang, Ik-Hwan
    • The Korean Journal of Financial Management
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    • v.8 no.1
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    • pp.179-197
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    • 1991
  • 선도환의 가격을 결정하는 접근방법에는 2차자산(derivative assets)이라는 선도계약의 기본특성에 기초한 재정거래(arbitrage)에 의한 방법이 가장 많이 이용되고 있다. 재정거래방식에는 선도환과 현물외환가격간의 상호관련성에 의하여 선도환가격을 이자율평가설(covered interest rate parity : CIRP), 즉 현물가격과 양국간의 이자율차이의 합으로 표시하고 있다. 특히 현물가격과 이자율은 모두 현재시점에서 의사결정자에게 알려져 있기때문에 선도환가격은 확실성하에서 결정되어 미래에 대한 예측이나 투자자의 위험회피도와는 관계없이 결정된다는 것이 특징이다. 이자율평가설에 관한 많은 실증연구는 거래 비용을 고려한 경우 현실적으로 적절하다고 보고 있다(Frenkel and Levich ; 1975, 1977). 다른 방법으로는 선도환의 미래예측기능에만 촛점을 맞추어 가격결정을 하는 투기, 예측접근방법(speculative efficiency approach : 이하에서는 SEA라 함)이 있다. 이 방법 중에서 가장 단순한 형태로 표시된 가설, 즉 '선도환가격은 미래기대현물가격과 같다'는 가설은 대부분의 실증분석에서 기각되고 있다. 이에 따라 SEA에서는 선도환가격이 미래에 대한 기대치뿐만 아니라 위험프리미엄까지 함께 포함하고 있다는 새로운 가설을 설정하고 이에 대한 실증분석을 진행한다. 이 가설은 이론적 모형에서 출발한 것이 아니기 때문에, 특히 기대치와 위험프레미엄 모두가 측정 불가능하다는 점으로 인하여 실증분석상 많은 어려움을 겪게 된다. 이러한 어려움을 피하기 위하여 많은 연구에서는 이자율평가설을 이용하여 선도환가격에 포함된 위험프레미엄에 대해 추론 내지 그 행태를 설명하려고 한다. 이자율평가설을 이용하여 분석모형을 설정하고 실증분석을 하는 것은 몇가지 근본적인 문제점을 내포하고 있다. 먼저, 앞서 지적한 바와 같이 이자율평가설을 가정한다는 것은 SEA에서 주된 관심이 되는 미래예측이나 위험프레미엄과는 관계없이 선도가격이 결정 된다는 것을 의미한다. 따라서 이자율평가설을 가정하여 설정된 분석모형은 선도환시장의 효율성이나 균형가격결정에 대한 시사점을 제공할 수 없다는 것을 의미한다. 즉, 가정한 시장효율성을 실증분석을 통하여 다시 검증하려는 것과 같다. 이러한 개념적 차원에서의 문제점 이외에도 실증분석에서의 추정상의 문제점 또한 존재한다. 대부분의 연구들이 현물자산의 균형가격결정모형에 이자율평가설을 추가로 결합하기 때문에 이러한 방법으로 설정한 분석모형은 그 기초가 되는 현물가격모형과는 달리 자의적 조작이 가능한 형태로 나타나며 이를 이용한 모수의 추정은 불필요한 편기(bias)를 가지게 된다. 본 연구에서는 이러한 실증분석상의 편기에 관한 문제점이 명확하고 구체적으로 나타나는 Mark(1985)의 실증연구를 재분석하고 실증자료를 통하여 위험회피도의 추정치에 편기가 발생하는 근본원인이 이자율평가설을 부적절하게 사용하는데 있다는 것을 확인 하고자 한다. 실증분석결과는 본문의 <표 1>에 제시되어 있으며 그 내용을 간략하게 요약하면 다음과 같다. (A) 실증분석모형 : 본 연구에서는 다기간 자산가격결정모형중에서 대표적인 Lucas (1978)모형을 직접 사용한다. $$1={\beta}\;E_t[\frac{U'(C_{t+1})\;P_t\;s_{t+1}}{U'(C_t)\;P_{t+1}\;s_t}]$$ (2) $U'(c_t)$$P_t$는 t시점에서의 소비에 대한 한계효용과 소비재의 가격을, $s_t$$f_t$는 외환의 현물과 선도가격을, $E_t$${\beta}$는 조건부 기대치와 시간할인계수를 나타낸다. Mark는 위의 식 (2)를 이자율평가설과 결합한 다음의 모형 (4)를 사용한다. $$0=E_t[\frac{U'(C_{t+1})\;P_t\;(s_{t+1}-f_t)}{U'(C_t)\;P_{t+1}\;s_t}]$$ (4) (B) 실증분석의 결과 위험회피계수 ${\gamma}$의 추정치 : Mark의 경우에는 ${\gamma}$의 추정치의 값이 0에서 50.38까지 매우 큰 폭의 변화를 보이고 있다. 특히 비내구성제품의 소비량과 선도프레미엄을 사용한 경우 ${\gamma}$의 추정치의 값은 17.51로 비정상적으로 높게 나타난다. 반면에 본 연구에서는 추정치가 1.3으로 주식시장자료를 사용한 다른 연구결과와 비슷한 수준이다. ${\gamma}$추정치의 정확도 : Mark에서는 추정치의 표준오차가 최소 15.65에서 최대 42.43으로 매우 높은 반면 본 연구에서는 0.3에서 0.5수준으로 상대적으로 매우 정확한 추정 결과를 보여주고 있다. 모형의 정확도 : 모형 (4)에 대한 적합도 검증은 시용된 도구변수(instrumental variables)의 종류에 따라 크게 차이가 난다. 시차변수(lagged variables)를 사용하지 않고 현재소비와 선도프레미엄만을 사용할 경우 모형 (4)는 2.8% 또는 2.3% 유의수준에서 기각되는 반면 모형 (2)는 5% 유의수준에서 기각되지 않는다. 위와같은 실증분석의 결과는 앞서 논의한 바와 같이 이자율평가설을 사용하여 균형자산가격 결정모형을 변형시킴으로써 불필요한 편기를 발생시킨다는 것을 명확하게 보여주는 것이다.

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Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

A Study on the Establishment of Management Methods about Occupational Dermatoses (직업성 피부질환에 대한 현황 파악 및 관리 대책 수립을 위한 연구)

  • Lim, Hyun-Sul;Cheong, Hae-Kwan;Choi, Byung-Soon;Kim, Ji-Yong;Sung, Yeol-Oh;Kim, Yang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.617-637
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    • 1996
  • Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

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Pulmonary Embolism In Childhood Minimal Change Nephrotic Syndrome (소아 미세변화 신증후군에서 폐색전증에 대한 연구)

  • Sung, Seung-Joon;Hong, Ki-Woong;Kim, Eun-Ryoung;Kim, Il-Soo;Cho, Byung-Soo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.100-108
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    • 2001
  • Purpose : We investigated the incidence and predisposing factors of pulmonary embolism in minimal change nephrotic syndrome(MCNS). Methods : Lung perfusion scan using 99mTC-MAA were done on 14 patients who were diagnosed to minimal change nephrotic syndrome. Group h: Five patients who had perfusion defects on scan, Group B; Nine patients who had no perfusion defect on scan. Between the two groups, the differences of platelet number, hematocrits, albumin, cholesterol, triglyceride, proteinuria were evaluated. Results : Five patients were found to have perfusion defect consistent with pulmonary embolism($35.7\%$). However, there were minimal or no respiratory symptoms and signs. In our laboratory studies, the mean proteinuria on admissions was $676{\pm}31\;mg/m2/hr$ in the group with pulmonary embolism, and $313{\pm}28\;mg/m2/hr$ in the group without pulmonary embolism. There were more severe proteinuria in group with pulmonary embolism(P<0.05). The mean platelet count at early stage of remission after steroid treatment was $746,600{\pm}280,000/mm3$ in the group with pulmonary embolism, $511,890{\pm}90,000/mm3$ in the group without pulmonary embolism. There were significant difference of platelet count between the two groups(P<0.01). In patients with pulmonary embolism, there were more higher and sustained increasement of platelet count. All cases of pulmonary embolism were treated with dipyridamole(5 mg/kg). In 4 cases the perfusion defects were improved in two weeks, however, one case showed persistent perfusion defect after 1 month. Conclusion : Our study suggested that pulmonry embolism might be one of tile major complications in childhood MCNS The occurrence rate was correlated with severity of proteinuria before treatment and sustained increasement of platelet counts in early remission state after steroid treatment. Therefore, the scintigraphic pulmonary perfusion study is mandatory in childhood MCNS, especially in the high risk patients, such as the patients with severe proteinuria and sustained increasement of platelet count. (J Korean Soc Pediatr Nephrol 2001;5 : 100-8)

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