• Health Policy and Management
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• v.8 no.1
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• pp.1-14
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• 1998

Analysis of practice variations has been one of important issues in trying to contain costs as well as to manage quality in health care. This study was conducted to provide statistical model for analysing variations in inpatient costs by type of hospitals. Four K-DRGs including Cesarean section, appendectomy, cataract extraction, and pediatric pneumonia with CC class 0 were selected, and means and dispersions of inpatient procedure and operation costs were simultaneously compared between type of hospitals. The results indicated that joint modelling of means and dispersions by gamma distribution was a very useful analytic tool for identifying factors which might have relationship with variations in inpatient costs. This model can be expanded to test the significance of several independent variables in analysing cost variations. In surgical conditions, means and unit variations of procedure and operation costs showed consistent pattern which was tertiarty hospital, general hospital, and hospital in descending order. Different findings were identified in pediatric pneumonia, from which mean and unit variation of procedure and operation cost was the highest in general hospital. The practical implication of this difference could not be drawn from this study. It will be done by further sophisticated researches. In order to develop health policy for cost containment and quality management in Korea, it is essential to find out manageable factors affecting variations in practice patterns which include characteristics of population, providers, regions, and so on. The statistical model presented in this study will give health services researchers useful insights for future investigations in analysing cost variations.

• Journal of Society of Preventive Korean Medicine
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• v.1 no.1
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• pp.48-54
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• 1997

Scutellariae radix, has been used as a natural drug for fever, inflammation, cataract, and liver disease in traditional medicine. This study was performed in order to investigate the antioxidative effects of Scutellariae radix aqua-acupuncture solution (SRAS) on lipid peroxidation by free radicals. Lipid peroxidation levels were determined by TBA method during the autoxidation of linoleic acid. In this linoleic acid autoxidation system, SRAS markedly exhibited antioxidant activity, which inhibited 89% of linoleic acid peroxidation. SRAS showed scavenging effects on ${\alpha},{\alpha}-diphenyl-{\beta}-picrylhydrazyl$(DPPH) radical, inhibited superoxide generation in xanthine-xathine oxidase system, and also inhibited lipid peroxidation of rat liver tissue by hydroxyl radical derived from $H_2O_2-FE^{+2}$ system. These effects were similar to those of $dl-{\alpha}-tocopherol$, BHA and BHT. In addition, SRAS protected the cell death induced by ter-butyl hydroperoxide (t-BHP) and significantly increased cell viability in the normal rat liver cell (Ac2F). On the basis of these results, it is suggested that SRAS might play a protective role in lipid peroxidation by free radicals.

• Archives of Pharmacal Research
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• v.24 no.2
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• pp.150-158
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• 2001

The activity of nonsteroidal antiinflammatory drugs (NSAIDs) in rheumatoid arthritis is not only due to the inhibition of the production of prostaglandins, which can even have beneficial immunosuppressive effects in chronic inflammatory processes. Since we speculated that these drugs could also act by protecting endogenous proteins against denaturation, we evaluated their effect on heat-induced denaturation human serum albumin (HSA) in comparison with several fatty acids which are known to be potent stabilizers of this protein. By the Mizushimas assay and a recently developed HPLC assays we observed that NSAIDs were slightly less active [$EC_{50}~10^{-5}-10^{-4}$ M] than FA and that the HPLC method was less sensitive but more selective than the turbidimetric assay, i.e. it was capable of distinguishing true antiaggregant agents like FA and NSAIDs from substances capable of inhibiting the precipitation of denatured protein aggregates. In conclusion, this survey could be useful for the development of more effective agents in protein condensation diseases like rheumatic disorders, cataract and Alzheimers disease.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.97-101
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• 2010

A 13-year-old neutered female Maltese was referred to Veterinary Medical Teaching Hospital of Seoul National University with 8-month-history of gradually enlarging retrobulbar mass in the right eye. On the ophthalmic examinations, exophthalmos, exposure keratitis, and cataract were observed, and menace response was absent in the eye. The fellow eye was normal except for nuclear sclerosis. On the ocular ultrasonographic evaluation, a mass was identified in retrobulbar and periocular region in the right eye. Exenteration was performed in order to remove the mass. Histopathologic evaluation revealed that most part of the mass was composed of epithelial-like neoplastic cells. Invasion into adipose cells and osseous metaplasia around the mass were also confirmed. Based on the radiologic and histopathologic examination, the mass in the right eye was diagnosed as primary retrobulbar meningioma. Eleven months after the surgery, recurrence was not observed.

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.251-254
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• 2005

An 11-year-old, 3.3 kg, male Maltese dog was referred to Veterinary Teaching Hospital of Konkuk University because of diarrhea and severe anemia. Abnormal physical examination findings included left submandibular lymph node enlargement, pale mucous membrane, cataract, and bloody diarrhea. Results of hematologic examination revealed a marked lymphocytosis resulting in leukocytosis and the markedly increased numbers of small, well-differentiated lymphocytes in the peripheral blood. Serum biochemical abnormalities consisted of elevated AST and ALP, hyperphosphatemia, hypoglycemia, and hypoalbuminemia. Radiographic examination showed cardiomegaly and hepatosplenomegaly. Results of urinalysis included bilirubinuria and proteinuria. Based on results of examination described above, chronic lymphocytic leukemia was diagnosed. Chemotherapy was initiated with cyclophosphamide ($300mg/m^2$, IV once every 2 weeks), vincristine ($0.75mg/m^2$, IV once every 2 weeks, alternating weeks with the cyclophosphamide), and plus prednisolone ($50mg/m^2$, PO, SID for a week, then $20mg/m^2$, PO every other day). The response to chemotherapy was partially present. This study first demonstrates clinicopathological findings and chemotherapeutic response of chronic lymphocytic leukemia in Korea.

• Korean Journal of Clinical Pharmacy
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• v.10 no.1
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• pp.1-6
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• 2000

백내장 수술 추 염증치료를 위해 일반적으로 부작용이 많은 국소 점안 스테로이드를 사용해왔다. 최근 NSAID계열의 점안액이 항염증 치료약물로 개발되면서 선택적인 약물치료가 가능하게 되었으나 단일치료약물로 사용하는 경우는 드물다. 본 연구는 NSAID계 diclofenac 점안액의 백내장 수술 후 염증치료 효과를 스테로이드체 dexamethasone 점안액과 비교하여 단일 치료약물로서 사용할 수 있는 지 연구하고자하였다. 백내장 수술을 받은 환자로서 안압이 22 mmHg 이상 당뇨환자, 수술대상 눈에 이미 질환 및 수술 경력이 있는 자를 제외하였다. 백내장 수술 후 항염종 약물로서 diclofenac 또는 dexamethasone을 28일 동안 투여하고 항염증효과의 평가를 위하여 세극등 검사로저 전방내 염증세포와 결막, 각막등의 전안부 관찰을 수술 전, 수술 후 1, 3, 7, 14, 28일에 시행하였고, 시력검사는 수술 추 7, 28일에 시행하였다. 안전성의 평가는 안압검사와 세극등 검사상 관찰된 이상소견으로 평가하였다. 총 73명의 연구대상 중 dexameasone군은 41명, diclofenac군은 32명이며 두 군간에 나이, 백내장의 심한 정도, 안구질환 등에 있어 유의한 차이가 없었다 전방내 항염증세포수의 감소에서 두 군간에 유의할 만한 차이가 없었고, 수술 후 최대 교정 시력에서도 동일한 효과를 보였다. 안전성에서 안압의 상승이 두군간에 통계적인 유의한 차이를 보이지 않았으나 dexamethasone군에서 1명의 환자가 45 mmHg 이상 증가하여 약물치료가 필요하였으나 diclofenac군에서는 안압이 상승한 환자가 없었다. 결론적으로 효능 및 안전성에서 두 약물간에 통제적, 임상적으로 유의한 차이가 없었으며 diclofenac 점안액은 백내장 수술 후 항염증치료제로서 충분한 효과가 있으며 안압상승, 감염 등 부작용이 우려되는 dexamethasone점안액의 대체약물로 사용될 수 있을 것으로 평가된다.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.115-120
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• 1990

Scatter-air ratios are used for the purpose of calculating scattered dose in the medium. The computation of the primary and the scattered dose separately is particularly useful in the dosimetry of irregular fields with shielding block in radiation field, dose distribution of scattered radiation using 18MeV Linear accelerator and Co-50 teletherapy measured. The effect of scattered radiation dose by protecting block was been ignored in radiation therapy, 2-3% of scattered radiation may be 90-200 cGy which could be influence vitial complications such as cataract, oligospermia or sterility. So that exect calculation of such scattered radiation especially for large field $\bar{c}$ small protection of vitial organ is very important. The purpose of this article is to calculate scattered radiation by protecting block exactly for irregular field $\bar{c}$ Linac or Co-60 irradiation and to applicate these data in clinical radiation field. Authors could obtain following results. 1. The lesser angle between shielding block showed more scattered radiation. 2. With decreasing distance between shielding blocks, the dependent of scattered radiation were increased. 3. Output of 18MeV Linear accelerator and Co-60 was related linear proportion on field size, but independent according to the size of shielding block in 18MeV Linear accelerator.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.121-127
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• 2016

Purpose: To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. Materials and Methods: From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Results: Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Conclusion: Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma.

• Health Policy and Management
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• v.3 no.1
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• Journal of Veterinary Science
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• v.22 no.2
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• pp.22.1-22.9
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• 2021

Background: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naive to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.