• 보건행정학회지
• /
• 제27권4호
• /
• pp.359-365
• /
• 2017

Background: Computed tomography (CT) is one of the most efficient diagnostic methods for stroke patients. The number of CT scanners in South Korea, however, is higher than in other countries, and may cause the overuse of this tool in healthcare. We aim to study the relationship between using CT and various patient and hospital characteristics among patients with cerebral infarction. Methods: We analyzed nationwide health insurance claims data for patients due to cerebral infarction during the second half of 2013 for up to 3 months. We performed multilevel analysis, including both inpatient and hospital-level variables, to determine how factors affect CT spending and utilization. Results: The data used in our study consisted of 17,046 hospitalizations at 583 hospitals. Inpatients who visited more than one hospital had higher CT utilization numbers and cost (number: ${\geq}3$: ${\beta}$ hospitals, 2.27; p < 0.05; 2 hospitals: ${\beta}$, 0.70; p < 0.05; cost: ${\geq}3$ hospitals: ${\beta}$, 251,108; p < 0.05; 2 hospitals: ${\beta}$, 77,299; p < 0.05). People who visited a general hospital had higher numbers and cost of CT utilization than people who visited a smaller hospital. Conclusion: Increased sharing of records and improved continuity of care between hospitals are needed to help curb the overuse of CT.

• 대한정형외과스포츠의학회지
• /
• 제9권1호
• /
• pp.16-21
• /
• 2010

최근 스포츠 활동 증가로 인한 하지의 과사용증후군인 만성 구획증후군 및 스트레스 골절의 빈도가 늘어가고 있다. 만성구획증후군은 운동 중 근육의 부피 증가와 이로 인한 구획압 증가로 야기된 가역적인 허혈상태로, 보존적 치료로 호전되지 않는 경우 근막절개술 등의 수술적 치료를 고려할 수 있다. 스트레스 골절은 정상적인 골에 비정상적인 스트레스가 가해져서 발생하는 피로 골절과 비정상적인 골에 정상적인 스트레스에 의해서 발생하는 부전골절로 분류할 수 있으며, 대부분의 스트레스 골절은 하지, 특히 경골부에 호발한다. 운동선수에서 피로 골절은 훈련 방법의 변화에 기인할 수 있고 진단은 일차적으로 단순방사선 촬영을 시행하며, 자기공명영상을 통해 확진 할 수 있다. 대부분의 경우 휴식 및 단기간의 고정 등을 통한 보존적 치료만으로 증상의 호전 및 운동 복귀가 가능하나, 경골의 신연부에 발생한 경우 수술적 치료를 요할 수도 있다.

• 한국콘텐츠학회논문지
• /
• 제7권5호
• /
• pp.128-137
• /
• 2007

국내의 디지털 시네마 산업은 지금 급물살을 타고 있다. 디지털 시네마는 D.I(Digital Intermediate) 작업을 통한 영상의 향상, 제작비의 절감, 배급과 상영의 편의성, 이후 다른 플랫폼으로의 전환용이 등의 완연한 장점으로 국내영화산업의 토대를 바꾸고 있다. 이러한 디지털 시네마로의 빠른 전환은 대기업에 의해서 독과점으로 집중되어 운영되고 있는 한국영화산업 구조가 주요한 배경이다. 또한 최근에는 국내의 이동통신 대기업들이 네트워크와 플랫폼의 활용을 목적으로 영화산업에 적극적으로 진출 한 것도 또 다른 이유가 되고 있다. 그러나 반면에 국내의 디지털시네마 산업은 제작공정에 있어서 디지털에 대한 맹신과 남용, 데이터의 부족 과 배급에 있어서 표준화의 문제 등이 드러나고 있다. 지금은 국내의 디지털 시네마의 빠른 발전보다는 건강한 발전에 대해서 생각해보아야하는 시점이다.

• 대한정형외과스포츠의학회지
• /
• 제2권1호
• /
• pp.44-49
• /
• 2003

목적: 본연구를통해성인배구선수들에있어서운동량과선수위치에따른슬개건염발생정도에대해알아보고자하였다. 대상및방법: 본원에 내원한 13명의 성인 남자 배구 선수들을 대상으로 설문조사를 통하여 현 시점에서 발생한 슬개건염과 과거력을 파악하는후향적연구를시행하였으며, 선수들의연령과배구경력, 훈련량과경기시간 및 이상소견등을 기록하였다. 선수들의연령은평균21.7세이었으며선수생활경력은평균8.7년이었고선수의위치는공격수10예, 리베로2예, 세터1예로구성되었다. 결과: 과거력과 이학적 검사상 슬부 동통을 호소한3예에서 슬개건염으로 진단되었고, 이중공격수2예에서 슬개골 하단에 동통을, 세터1예에서슬개골상단에동통을호소하였다. 결론: 본연구를통하여과 사용손상에의한슬개건염의발생은선수들의운동경력, 훈련량과위치에따른 공격 및 수비기술에 따라 영향을 받음을 알 수 있었다. 대부분의 경우 연습시감독자에 의한 훈련 및 기술의 조절은 이러한 과 사용에 의한슬개건염발생을줄일수있을것으로사료된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권4호
• /
• pp.1707-1710
• /
• 2014

Background: The objective of this study was to evaluate baseline use and positive rates of staging images (bone scan, CT) in newly diagnosed patients with prostate cancer (PCa) and to improve staging image overuse. Materials and Methods: This retrospective study covered a consecutive series of patients with PCa who underwent stage imaging at our institution between 2006 and 2011. Various clinical and pathological variables (age, PSA, biopsy Gleason score, clinical T stage, positive biopsy core rate) were evaluated by multivariate logistic regression analysis for their ability to predict a positive staging image. All patients were stratified according to the NCCN risk stratification and positive rates were compared in each risk group. Results: 410 patients (100%) underwent a bone scan and 315 patients (76.8%) underwent a CT scan. Some 51 patients (12.4%) had a positive bone scan, clinical T3 and T4 being significant independent predictors. Positive bone scan rates for low-, intermediate-, high-, and very high-risk groups were 0%, 0%, 8.25%, and 56.6%. Some 59 (18.7%) patients had a positive CT scan, with elevated PSA and clinical T3, T4 as significant independent predictors. Low-, intermediate-, high- and very high-risk group rates were 0%, 0%, 13.8% and 80.0%. Conclusions: The incidences of positive staging image in low- and intermediate- risk group were reasonably low. Following feedback on these results, staging in low- and intermediate- risk groups could be omitted.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권20호
• /
• pp.8749-8752
• /
• 2014

Purpose: This study aimed to determine the patterns of follow-up visits for cervix cancer in a national cancer center in Mexico. Materials and Methods: The National Cancer Institute of Mexico is cancer center with 119 beds that mostly cares for an underserved and socially disadvantaged population. The medical records of cases of cervical cancer that had at least one year of clinical follow-up after being in complete response at the end of primary treatment were analyzed. We recorded the numbers of total and yearly follow-up visits and these were compared with the number of follow-up visits recommended by the National Comprehensive Cancer Network 2013, version 2 for cervical cancer. Results: Between March and June 2007, the medical records of 96 consecutive patients were reviewed. Twenty (21%) of these met inclusion criteria and were selected. In the first year the median number of visits was 11 (4-20). In the ensuing years, $2^{nd}$, $3^{rd}$, $4^{th}$ and $5^{th}$, the number of analyzed patients remaining in follow-up decreased to 17, 14, 13 and 9 respectively. There were 462 follow-up visits to primary treating services (Gynecology Oncology, Radiation Oncology and Medical Oncology) as compared to 220 suggested by the NCCN guidelines ($X^2$ test p<0.0001). There were 150 additional visits to other services. Conclusions: Our results suggest that in our institution there is an overuse of oncological services by cervical cancer patients once treatment is completed.

• Journal of Preventive Medicine and Public Health
• /
• 제33권4호
• /
• pp.484-494
• /
• 2000

Objective : To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription System' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). Methods : The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was peformed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. Results : The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. Conclusion : The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.

• Journal of Veterinary Science
• /
• 제22권3호
• /
• pp.31.1-31.12
• /
• 2021

Background: Blackened intestines in slaughtered pigs have been commonly observed in China in recent years. However, no cause has been reported. Objectives: We attempted to determine whether the blackening of the pig intestine was related to an excess of copper (Cu) in their feed. Methods: In this study, we observed and collected porcine intestines in small- and large-scale pig slaughterhouses in Shandong province from May to October 2018. Twelve types of metal ions were detected in the black intestinal samples. Results: The Cu level in the intestine samples was mostly higher than the Chinese national limit for food. Further study showed that Cu supplementation in most commercial porcine feed also exceeded the national standard. An animal model (mouse) that could mimic the intestinal blackening in pigs was established. Compared to control mice, Cu accumulated in the liver and intestines of mice fed an excessive Cu level, confirming the excessive Cu in the feed may be considered the major cause of blackened porcine intestines. Microscopic examination revealed that black intestines had many particles containing Cu in the lamina propria of the intestinal mucosa, and the intestinal mucosal epithelial cells showed degeneration and necrosis. Conclusions: In conclusion, overuse of Cu in animal feed can lead to animal poisoning and Cu accumulation in animal products. Such overuse not only harms the health of livestock but can also affect public health.

• 보건의료산업학회지
• /
• 제13권3호
• /
• pp.115-125
• /
• 2019

Objectives: Korea has been practicing the separation of dispensary from medical practice since 2000 as a national policy to prevent misuse or overuse of medicines. This study aimed to investigate prescription patterns from except pharmacies in order to determine the appropriateness of drug usage among those patients. Methods: Thirty-two pharmacies in the Yeongdong area of Gangwon Province were examined in this study. The same simulated patient complaining of cold symptoms for 3 days visited each pharmacy to obtain a prescription for medication. Results: At pharmacies prescribing medicine, steroids (53.1%) and antibiotics (50.0%) were used to treat the common cold. Duplicate prescriptions of drugs, such as antihistamines (47.0%) and decongestants (31.3%) were common. The average number of drug prescriptions was 6.59, and 53.2% of pharmacies had prescribed more than seven drugs. The average total cost of the prescriptions was 6,093 won, and the daily cost was 2,544 won. Conclusions: Steroids and antibiotics were frequently abused among patients whose medications had been prescribed by pharmacies. Also, there were a considerable number of drugs and duplicate prescriptions. The prices of the drugs were somewhat high.

• 대한정형도수물리치료학회지
• /
• 제28권3호
• /
• pp.21-32
• /
• 2022

Background: Instrument players are exposed to occupational musculoskeletal symptoms due to constant movement and strain to meet the needs of their audience. This can cause dissonance between the player and the instrument and can cause medical problems in the musculoskeletal system such as pain, tendinitis, muscle spasms, and joint hyperextension from overuse of body parts. Objective: The purpose of this study is to comparatively analyze the characteristics and occurrence of musculoskeletal symptoms in professional and student players, and to find out the awareness of the need for health care professionals and special exercise programs for orchestra players. Methods: The subjects were professional orchestral musicians 191 from the three symphony orchestras and music students 209 from the four universities volunteered to participate in this study; 393 subjects (98.25%) completed the questionnaire. symptom prevalence and related factors of playing-related musculoskeletal disorders (PRMDs) were surveyed with a self-administered questionnaire. Standardized Nordic Questionnaire was complemented by adding a visual-among scale and used to diagnose PRMD. Results: High prevalence of musculoskeletal complaints in both professional musicians (85.30%) and student musicians (82.30%). Professional musicians and student musicians also suffered the highest problem in shoulder and neck complaints. Significant differences were found between groups that recognized of necessity for specialized health professionals, professional organizations, and special programs for musicians. Conclusions: Professional musicians and student musicians, like orchestra players, are already exposed to overuse syndrome. However, student musicians lack awareness of the risk of injury compared to orchestra players. We suggest that an appropriate treatment management program for the prevention and early treatment of musculoskeletal system damage should be provided to performers at an early stage.