• Title/Summary/Keyword: Medical Cost

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The analysis of Complex Type and the Facility Status of Community Mixed-support Facility (공동체복합지원시설의 시설현황 및 복합유형 분석)

  • Kim, Sumi;Kim, Suk-Young
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.507-517
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    • 2013
  • Welfare desire has been diversified according to the increase of economic level and rapid social change. The desire for comprehensive service on culture, medical, mental and information level has appeared. Accordingly, it is necessary to establish an integrated community mixed-support facility, a space of accepting administration, welfare, leisure, culture and informatization request in a small local community in the future. The community mixed-support facility is a meeting place of local resident for information change, various basic service and ultimately for activation of community in order to contribute to regeneration and activation of existing urban core. Thus, this study figured out general status of community mixed-support facility and physical mixed type and analyzed spatial characteristics. Current community mixed-support facility has insufficient program and space to participate in by local residents and to accommodate mixed function. The future planned community mixed-support facility must secure multiple opportunities for various types of life by returning time and cost to user through the introduction of creative mixed concept. While reflecting unique local characteristics, and considering diversity of users, it needs to make mixed facility to cope with social changes. This study is limited in that the study reached a conclusion by survey and analysis only. However, it is expected that the result can be used as basic research data for the planning of community mixed-support facility to cope with living conditions of local residents or realistic requirements.

The Relationship between MRO E-Commerce System and Purchase Effects

  • Kwon, Soon-Won;Kim, Young-Ei;Youn, Myoung-Kil;Jeon, Ta-Sik
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.5-15
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    • 2010
  • Business corporations have become specialized and on the basis of various interests try to strengthen their competitiveness through a cooperative system of purchase, distribution, service and IT technology. And an advanced Internet-based electronic commerce has witnessed explosive growth and a business-to-business (B2B) electronic commerce. Through E-marketplace. business corporations achieve such diverse utilities as expenditure curtailment, process reduction and prime cost reduction. And with business depression worldwide and soaring prices of materials, many business corporations consider the introduction of comprehensive purchase of MRO (maintenance, repair and operation) materials. The Purpose of this study was to examine the definition of B2B E-marketplace and the utilities of MRO commerce correctly focusing on an empirical analysis of cases of MRO supply and purchase business corporations. The indications acquired from this research results are as follows. Firstly, as for MRO integrated purchase under the characteristics of the market environment, it had to use the supplier obligatorily through the integrated purchase on the level of CEO's decision-making or the group rather than the voluntary will of the purchasing department or the procurement department. Secondly, as for the present B2B E-marketplace MRO purchase, the purchasing agency business has formed the mainstream, but it is aiming at the diversification of the benefit by supplementing/correcting the business model such as category type, mediation business type, MRO-type advancing in the store inclusive of the purchasing agency business, keeping pace with the potential market of MRO. Thirdly, as for analysis of the products, the purchaser wants more various products and assortment of goods than those of the present time, and also to be provided with the precise product information. Especially, as the importance of the product sourcing becomes high, the whole energy has been bestowed on acquirement of the excellent suppliers. Fourth, as for use of B2B E-marketplace MRO integrated purchasing system, there are the purchasing companies complaining the inconvenience even until now, and there is the demerit spending the long time during the image move and the process treatment. It shall try to shorten the searching time and the process treatment time as the system is centered on the purchaser. In order to enhance the efficiency of MRO E-marketplace purchase, followings must be considered: First, because the importance of product sources ever increases, an excellent supplier must be secured earnestly. Second, the time of process must be reduced focusing on purchasers. B2B E-marketplace will increase and diversify electronic commerce continuously. Through MRO E-marketplace, business corporations will reduce expenditure, achieve a transparent and speedy trade, and purchase products of fine quality, thus establishing a most effective market. In addition, in this study the investigator brings focus into MRO which has not been clearly discussed in the academic and business world so far and intensively highlights an indirect material-oriented expenditure curtailment effect. By taking all the aspects of supplier, purchaser and practical economical value into account, the investigator presents a strategic direction for the successful comprehensive purchase of B2B MRO.

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Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

  • Keyhani, Elahe;Muhammadnejad, Ahad;Behjati, Farkhondeh;Sirati, Fereidoon;Khodadadi, Faranak;Karimlou, Masoud;Moghaddam, Fatemeh A.;Pazhoomand, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7651-7656
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    • 2013
  • Background: Breast cancer is the most common malignancy among women in both developed and developing countries. The burden is increasing in low-income and middle-income countries (LMCs) and threatens the public health of such societies. Introduction of expensive monoclonal antibodies to cancer treatment regimens poses a real challenge in the health systems of LMCs. Despite controversy of cost-effectiveness of bevacizumab in breast cancer, some studies indicate gain of patients from this drug. The present study aimed to propose a priority setting model for administration of anti-angiogenic agents in breast cancer via assessment of tumor angiogenesis by the microvessel density (MVD) method and associations with clinicopathological characteristics (including simultaneous mutations of TP53 and HER-2 genes). Materials and Methods: Age, axillary lymph nodes status, tumor size, stage and grade, estrogen and progesterone receptors status, HER-2/neu status (by immunohistochemistry and FISH test), TP53 mutation, Ki-67 (for proliferation assay) and CD34 (for angiogenesis assay) were assessed in 111 breast cancer patients. The molecular subtype of each tumor was also determined and correlations of simultaneous mutations of HER-2 and p53 genes with angiogenesis and other clinicopathological characteristics were evaluated. Results: There were significant associations between simultaneous mutations of HER-2 and p53 genes and all other parameters except tumor size. The degree of angiogenesis in the ERBB2 subtype was greater than the others. Younger patients showed a higher angiogenesis rate rather those older than 50 years. Conclusions: Our results demonstrated that patients with simultaneous mutations of HER-2 and p53 genes, those with ERBB2 molecular subtype and also younger women (often triple negative) seem more eligible for obtaining anti-angiogenic agents. These results suggest a model for priority setting of patients with breast cancer for treatment with anti-angiogenic drugs in LMCs.

Alternative Carcinogenicity Screening Assay Using Colon Cancer Stem Cells: A Quantitative PCR (qPCR)-Based Prediction System for Colon Carcinogenesis

  • Bak, Yesol;Jang, Hui-Joo;Shin, Jong-Woon;Kim, Soo-Jin;Chun, Hyun woo;Seo, Ji-Hye;No, Su-Hyun;Chae, Jung-il;Son, Dong Hee;Lee, Seung Yeoun;Hong, Jintae;Yoon, Do-Young
    • Journal of Microbiology and Biotechnology
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    • v.28 no.4
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    • pp.645-651
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    • 2018
  • The carcinogenicity of chemicals in the environment is a major concern. Recently, numerous studies have attempted to develop methods for predicting carcinogenicity, including rodent and cell-based approaches. However, rodent carcinogenicity tests for evaluating the carcinogenic potential of a chemical to humans are time-consuming and costly. This study focused on the development of an alternative method for predicting carcinogenicity using quantitative PCR (qPCR) and colon cancer stem cells. A toxicogenomic method, mRNA profiling, is useful for predicting carcinogenicity. Using microarray analysis, we optimized 16 predictive gene sets from five carcinogens (azoxymethane, 3,2'-dimethyl-4-aminobiphenyl, N-ethyl-n-nitrosourea, metronidazole, 4-(n-methyl-n-nitrosamino)-1-(3-pyridyl)-1-butanone) used to treat colon cancer stem cell samples. The 16 genes were evaluated by qPCR using 23 positive and negative carcinogens in colon cancer stem cells. Among them, six genes could differentiate between positive and negative carcinogens with a p-value of ${\leq}0.05$. Our qPCR-based prediction system for colon carcinogenesis using colon cancer stem cells is cost- and time-efficient. Thus, this qPCR-based prediction system is an alternative to in vivo carcinogenicity screening assays.

Development of MRI Simulator Early Diagnosis Program for Self Learning (자가 학습을 위한 MRI Simulator 초기 검사 프로그램 개발)

  • Jeong, Cheon-Soo;Kim, Chong-Yeal
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.403-410
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    • 2015
  • Since 1970, MRI has greatly been developing in terms of strength of magnetic field, the number of receipt channels, and short time of examination. With the development of digital systems and wireless network, hospitals have also acquired, saved, and managed digital images taken by various kinds of medical imaging equipment. However, domestic universities fail to provide practice training course independently thanks to expensive practice equipment and high maintenance cost, and rely on clinical training. Therefore, this study developed a MR patient diagnosis program based on Windows PC to help out students before their working in clinical filed. The designed Relational Database of MRI Simulator is made up of seven tables according to functions and data characteristics. Regarding the designed patient information, each stepwise function was classified by the patient registration method in clinical field. In addition, on the assumption of the basic information for diagnosis, each setting and content were classified. The menu by execution step was arrayed on the left side for easy view. For patient registration, a patient's name, gender, unique ID, birth date, weight, and other types of basic information were entered, and the patient's posture and diagnosis direction were set up. In addition, the body regions for diagnosis and Pulse Sequence were listed for selection. Also, Protocol name and other additional factors were allowed to be entered. The final window was designed to check diagnosis images, patient information, and diagnosis conditions. By learning how to enter patient information and change diagnosis conditions in this program, users will be able to understand more theories and terms learned in practice and thereby to shorten their learning time in actual clinical work.

Assessment of Hemodynamic Properties of Trileaflet Polymer Heart Valve Manufactured By Vacuum Forming Process (진공성형을 이용한 삼엽식 고분자 심장판막의 제작과 혈류역학적 성능평가)

  • Kim, K.H.;Hwang, C.M.;Jeong, G.S.;Ahn, C.B.;Kim, B.S.;Lee, J.J.;Nam, K.W.;Sun, K.
    • Journal of Biomedical Engineering Research
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    • v.27 no.6
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    • pp.418-426
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    • 2006
  • In the artificial heart application, productivity and hemodynamic properties of artificial heart valves are crucial in successiful application to long term in vivo trials. This paper is about manufacture and assessment of trileaflet polymer heart valves using vacuum forming process(VFP). The VFP has many advantages such as reduced fabrication time, reproducibility due to relatively easy and simple process for manufacturing. Prior to VFP of trileaflet polymer heart valves, polyurethane(Pellethane 2363 80AE, Dow Chemical) sheet was prepared by extrusion. The sheets were heated and formed to mold shape by vacuum pressure. The vacuum formed trileaflet polymer heart valves fabrication is composed of two step method, first, leaflet forming and second, conduit forming. This two-step forming process made the leaflet-conduit bonding stable with any organic solvents. Hydrodynamic properties and hemocompatibility of the vacuum formed trileaflet polymer heart valves was compared with sorin bicarbon bileaflet heart valve. The percent effective orifice area of vacuum formed trileaflet polymer heart valves was inferior to bileaflet heart valve, but the increase of plasma free hemoglobin level which reflect blood damage was superior in vacuum formed trileaflet polymer heart valves Vacuum formed trileaflet polymer heart valves has high productivity, and superior hemodynamic property than bileaflet heart valves. Low manufacturing cost and blood compatible trileaflet polymer heart valves shows the advantages of vacuum forming process, and these results give feasibility in in vivo animal trials in near future, and the clinical artificial heart development program.

Drug Evaluation of Ursodeoxycholic Acid Use for Treatment of Cholestasis Associated with TPN Therapy in Neonate (신생아의 TPN 요법 시 발생되는 Cholestasis 치료를 위한 Ursodeoxycholic Acid의 약물사용 평가)

  • Lee, Jung-Ok;Song, Tae-Beom;Lee, Myung-Koo;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.270-281
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    • 2010
  • Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.

An Analysis of Nursing Managerial Competencies;Military Hospital Head Nurses (병동선임간호장교의 간호관리역량 격차분석과 원인조사)

  • Lee, Sun-Mee
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.37-50
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    • 1997
  • The purpose of this study was to identify the gap between need-level and demonstration-level in nursing managerial competencies. In addition, the study proposes solutions to narrow this gap. The results of this study are as follows : 1) The mean score for need-level of each item was 4.0, and for demonstration-level, 3.5. This indicates that military hospital head nurses demonstrate a higher level of managerial competencies than the moderate level on all items. But items which were related to resource/ cost/ information managament, staff development management and professionalism management got relatively low ratings in the need-level. 2) The mean score for need-level of each category was 4.14, and for demonstration-level, 3.53. Categories on the individual dimension got a higher rating than categories on the group or organization dimension in both need-level and demonstration level. 3) The gap between need-level and demonstration-level appeared in all items(p<.05) and categories(p<.001). Although the gap was relatively low, it indicates that it is essential to plan a developmemt program for all nursing management competencies for military hospital head nurses. 4) There were significant differences in the gap between need-level and demonstration-level according to specific characteristics of the subjects. The gap did not appear in many categories on the individual dimension where the number of nursing staff was more than 10, a major grade, ICU head nurse or for head nurses having a long career. 5) Need-level and demonstration-level showed a difference according to specific characteristics of the subjects, because need-level and demonstration-level were higher where the number of nursing staff was more than 10, a major grade, and for ICU or Medical ward head nurses. The categories which showed need-level difference and demonstration-level differences according to specific characteristics of the subjects existed almostly completely in the group and organization dimension. Gap-level differences according to the number of hospital bed existed in only two categories. 6) The general causes of the gap were indicated to be 'Knowledge/ skill/ experience deficit', 'Limitation of rules and systems/ Inappropriate organizational environment' for most items, categories, and dimensions. The results of this study indicate that extensive competency developing strategies must be developed, because a gap was found in all items and categories. Specially, there is a need to concentrate attention on competencies in the group and organizational dimension which had a wider gap level. And it is important to take an individual approach according to the cause for each gap. In order to produce effective competency developing strategies, top managers must have sinsights into the importance of nursing staff development and nursing officer's efforts to develop themselves must be achieved. Further multi-dimensional(education, personnel-policy, nursing/ organizational environment) solutions to the gap must be developed and utilized.

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한국 농촌지역의 임신효율 (Reproductive Efficiency)에 관한 연구 : 충남 서산지역을 중심으로

  • An, Mun-Yeong
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.74-79
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    • 1982
  • Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

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Survey and Analysis of Major Newspapers and Broadcastings about Public Health Policy: through 17th Presidential Election in 2007 and 18th Election in 2008 (보건의료정책에 관한 주요 언론의 선거보도 조사 분석 -17대 대선과 18대 총선을 중심으로-)

  • Choi, Jin-Ah;Yang, Min-Joo;Chung, Won-Gyun;Kim, Cheoul-Sin
    • Journal of dental hygiene science
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    • v.9 no.1
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    • pp.69-74
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    • 2009
  • The purpose of this study is to investigate the actual attitude of the major newspapers and broadcastings about public health policy during last $17^{th}$ presidential election and $18^{th}$ election for a member of the National Assembly and apply it to the study of procedure of making decision of policy as a fundamental data. Two researchers surveyed and analyzed all articles from three broadcasting stations, KBS, MBC, and SBS, and from four newspaper companies, Donga, Jungang, Chosun, and Hangyoreh. Among the major articles, the articles related to policies are ranked in last (10.8%). And among the reported 284 articles related to the policies, the social section (75 articles, 26.4%) and the economic section (73 articles, 25.7%) took part of over 50% of all. However, the articles related to public health policy took part of only 9.9% (28 articles). Among the articles of public health policy, the articles related to the cost of the medical service were ranked in the first (39.3%). Therefore, to solve the problems of the major public health policy, it needs effort to develop the public health policy and use the media to realize the developed policies.

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