• 동의생리병리학회지
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• 제23권3호
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• pp.540-547
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• 2009

There needs disease-predictable signs in order to enable preventive diagnosis and therapy. Then traditional Chinese medicine applies various medical diagnostic equipments used in western medicine to diagnosing sub-healthy state. But such data are not originated from inherent oriental medicine, and not obtained easily in ordinary clinical practice. This paper is to provide synopsis of the ante-disease diagno-therapeutics partly and to show predictable data based on the facial shapes and signs, especially of gall bladder's versus bladder's body and masculine versus feminine shape. Ante-disease means not only the complete healthy state, but also the state unseen any symptoms in macrographically in the course of outbreak of disease. It contains two stages, first one is the former state of disease and second one is untransmitted state of disease. The patterns of ante-disease consist of latent disease, pre-disease, transmission type like senescent syndrome, abnormal reactive syndrome(變證), syndrome of transmission and transmutation. The classification with gall bladder and bladder type manifests the differences of shape, color and size of each organ in comparison of the universal and standard figures of the human being. On the other hand, the classification with masculine and feminine shape contrasts the innate sexual difference and the shape, characteristics originated from in itself. These two classification theories have their own pathologic types and syndrome types with each disease so that disease-predictable data can be constructed based on such a relationship. In addition, this diagnostic method by facial shapes and signs is able to be applied to whole stages from prenatal to present state of disease even if the cause and inducement are not clear. Ante-disease diagno-theraputic system by Gall Bladder's versus Bladder's Body and Masculine versus Feminine Shape is getting more important in the chronic and internal disease in comparison of the acute and traumatic disease. So this study is able to make up for the limit of diagnosis on ante-disease in the field of oriental medicine clinic.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권2호
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• pp.130-137
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• 2007

Objectives: Studies investigating problematic internet use have increased rapidly and have been focused on its causes, psychopathology, prevalence, characteristics and so on. However, there are few studies concerning the correlation between problematic internet use and youth health risk behavior. Therefore, the purpose of this study was to examine the relationship between problematic internet use and youth health risk behavior. Methods: A community sample of 632 high school students in grades 10 and 11 was collected for the survey. The sample was assessed using the Youth Risk Behavior Surveillance System(YRBSS) and Young's Diagnostic Questionnaire of Internet Addiction(YDQ). The subjects were classified into two groups: normal and problematic internet use, and the problematic internet use group was further divided into at-risk use and addiction groups. Results: There were 56 subjects(8.9%) in the internet addiction group and 56 subjects(8.9%) in the at-risk internet use group. The other 507 subjects were classified as normal. The subjects in the internet addiction group kissed more frequently and ate less fruit than those in the normal group. They also showed a relatively higher tendency to watch TV, ride in a car driven by a drunk driver and to carry a weapon than those in the normal group. There were no differences in health risk behaviors between the subjects in the internet addiction group and those in the at-risk internet use group, except for the possibility of riding in a car driven by a drunk driver. Conclusion: Unlike the normal group, there was very little difference in health risk behavior between the internet addiction group and the at-risk internet use group, which indicates that the addiction group and the at-risk internet use groups are homogenous. It is important to focus on the behavior of individuals in the at-risk group, and preventive measures should be taken in order to reduce the possibility of at-risk adolescents becoming addicted.

• 한국결정성장학회지
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• 제27권4호
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• pp.196-205
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• 2017

오늘날 의료분야의 서비스 디자인은 유 무형의 서비스 요소를 통합적으로 가시화하고 혁신적 해결책을 도출, 고객이 해당 서비스를 더 중요한 가치로 느낄 수 있도록 지원하는 실용적 서비스 연구개발로 발전하고 있는 상황이다. 개인의 소득수준이 향상되면서 의료복지와 웰빙에 대한 관심이 날로 높아지고 있어, 의료분야의 초점도 과거의 질병 질환에 대한 치료의 개념에서 예방 의료로 구심점이 이동하고 있다. 이런 추세에 맞추어 최근 의료복지에 유비쿼터스 개념을 접목하여 건강진단 및 건강관리의 시간과 공간 제약을 대폭 줄인 홈헬스케어 시스템의 연구개발이 활발히 진행되고 있고 헬스케어3.0 시대에 따른 사용자 중심의 의료 서비스와 사용자 니즈를 기반으로 한 제품 및 의료 환경 개선 요구가 증대하고 있어 그에 따라 사용자 중심 니즈와 요구가 반영된 현장 의료진단 제품 개발이 필요하다. 본 연구는 현장 의료진단 제품 중 하나인 '무선 X-ray 디텍터'를 연구 개발함에 있어 현장진단 제품에 적합한 소재와 외형을 적용하여 사용자의 요구가 충분히 반영된 제품을 개발 연구하는 것을 목표로 두고 있다.

• 동의생리병리학회지
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• 제28권1호
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• pp.1-8
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• 2014

The purpose of this study is to review the literature on Danggwisayeokgaohsuyusaenggang-tang. The classic literature review was carried out using "http://www.theqi.com". The journal search was performed using MEDLINE, EMBASE, National Digital Science Links(NDSL), OASIS, Korean studies Information Service system(KISS), RISS, China National Knowledge Infrastructure(CNKI), Japan Science and Technology information Aggreator, Electronic(J-STAGE) from search engine's opening day to November 2013. Searching key words were the various combination of "Danggwisayeokgaohsuyusaenggang-tang", "Danggwisayeok", "Danggwi", "ohsuyu", "saenggang". The inclusion criteria was all kinds of journals except for review, essay, and experiment study. 40 classic literatures and 37 journals(1 chinese randomized controlled trial, 25 chinese case studies, 1 Korean case study, and 10 japanese case studies) were selected finally. The literatures and journals reported that Danggwisayeokgaohsuyusaenggang - tang was used to treat diverse types of diseases with coldness of hands and feet.

• 대한임상검사과학회지
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• 제41권3호
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• pp.111-122
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• 2009

Cadmium (Cd) is known to exert gonadotoxic and spermiotoxic effects. The present study was performed to investigate the morphological effects and metallothionein (MT) expression by zinc pretreatment in the course of time of cadmium-induced testicular injury in rat. Fifty male Spraque-Dawley rats weighing 160~180 g were divided into two groups : saline-pretreated cadmium group and zinc-pretreated cadmium group. Rats of two groups received subcutaneous injection of saline and 100 mg/kg $ZnSO_4$ at 0, 2, 5 and 8 hrs intervals respectively. Cadmium chloride (4.5 mg/kg $CdCl_2$) was administrated intraperitoneally at 2 hrs after zinc injection and rats were killed 0, 12, 24, 48 and 72 hrs later. Testicular tissue damages, interstitial (Leydig) cells status and MT expression were determined using hematoxylin-eosin stained sections and a computerized image analysis system on sections immunostained with a mouse anti-metallothionein respectively. Zinc pretreatment was significantly reduced testicular damages in five pathological categories after cadmium administation. The number of surviving interstitial cells was significantly higher in the zinc-pretreated group than in the saline-preatreated group at 48 and 72 hrs after cadmium administration. Non-damaged testis showed the positivity of MT staining in spermatogenic cells, Sertoli cells and endothelium of blood vessel, but not in the Leydig cells. The positivity of MT staining in saline-pretreated group was significantly reduced at 24 hrs after cadmium administration, whereas zinc-pretreated group showed strong MT positive staining similar to the 0 hr by 42 hrs after cadmium administration. In damaged testis, MT positive staining was also observed in the Leydig cells of both groups. These results suggest that a major preventive effect of zinc against cadmium-induced testicular toxicity may be due to its ability to reduce the cytotoxicity of cadmium in spermatogenic cells and Leydig cells by inhibiting the susceptibility of the testis to cadmium but not MT production by cadmium.

• 대한임상검사과학회지
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• 제42권3호
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• pp.136-148
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• 2010

Cadmium (Cd) is known to exert gonadotoxic and spermiotoxic effects. The present study was performed to investigate the morphological effects and metallothionein (MT) expression by zinc pretreatment in the course of time of cadmium-induced testicular injury in rat. Fifty male Spraque-Dawley rats weighing 160-180 g were divided into two groups: saline-pretreated cadmium group and zinc-pretreated cadmium group. Rats of two groups received subcutaneous injection of saline and 100 mg/kg $ZnSO_4$ at 0, 2, 5 and 8 hrs intervals respectively. Cadmium chloride (4.5 mg/kg $CdCl_2$) was administrated intraperitoneally at 2 hr after zinc injection and rats were killed 0, 12, 24, 48 and 72 hrs later. Testicular tissue damages, Interstitial (Leydig) cells status and MT expression were determined using hematoxylin-eosin stained sections and a computerized image analysis system on sections immunostained with a mouse anti-metallothionein respectively. Zinc pretreatment was significantly reduced testicular damages in five pathological categories after cadmium administation. The number of surviving interstitial cells was significantly higher in the zinc-pretreated group than in the saline-preatreated group at 48 and 72 hrs after cadmium administration. Non-damaged testis showed the positivity of MT staining in spermatogenic cells, Sertoli cells and endothelium of blood vessel, but not in the Leydig cells. The potitivity of MT staining in saline-pretreated group was significantly reduced at 24 hrs after cadmium administration, whereas zinc-pretreated group showed strong MT positive staining similar to the 0 hr by 42 hrs after cadmium administration. In damaged testis, MT positive staining was also observed in the Leydig cells of both groups. These results suggest a major preventive effect of zinc against cadmium-induced testiculat toxicity may be due to its ability to reduce the cytotoxicity of cadmium in spermatogenic cells and Leydig cells by inhibiting the susceptibility of the testis to cadmium but not MT production by cadmium.

• 대한소아치과학회지
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• 제43권4호
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• pp.382-390
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• 2016

청소년기에는 초기 우식 병소를 진단 기준에 포함시키는 것이 더 유리하기에 본 연구에서는 WHO basic methods 와 ICDAS-II 점수를 활용하여 13세와 16세 청소년의 우식 상태를 조사하였다. 전체 우식경험영구치지수는 3.71, 우식영구치지수는 1.94이었으며 16세에서 13세보다 높았다. 군별로는 대구치, 소구치, 전치의 순으로 우식경험영구치지수와 우식영구치 지수가 높았다. 전체 치아의 ICDAS-II code 0은 77.46%이었으며, 후방치열로 갈수록 우식치아의 수가 증가하였다. 전치와 소구치의 우식은 모두 법랑질에 국한되었다. ICDAS-II 점수는 초기우식병소 발견에 용이하여 우식관리의 예방적 접근이 가능한 방법이다.

• 의료법학
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• 제17권1호
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• pp.3-43
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• 2016

북한의 의료법규는 '헌법'을 정점으로 크게 '인민보건법'과 '의료법'으로 구성되어 있다. 인민보건법이 제정되기 이전에도 다수의 의료관계법규가 존재하고 있었으나, 그 의료관계법규가 이후 어떻게 개정되었으며, 현재에도 유효한지 여부는 알 수 없다. 1980년 제정된 인민보건법은 북한의 보건의료에 대한 기본원칙과 방침을 선언하고 있다. 1997년 제정된 의료법은 북한 의료의 기본법으로서, 북한 의료의 목표와 기본원칙을 제시하고, 이어서 '검진과 진단', '환자치료', '의료감정'에 관한 기본적인 내용을 규정하고 있다. 북한 의료법은 남한에 비해 상당히 늦게 제정되었을 뿐만 아니라, 조문의 수가 적고 추상적이거나 선언적인 내용이 많다. 특히, 북한 의료법에는 의료인의 종류나 자격요건, 의료기관의 종류와 개설요건 등에 관한 규정이 전혀 없어, 북한 의료법만을 가지고는 북한 의료체계를 한꺼번에 파악하기 어렵다. 북한 의료법상 진료에 관한 내용은 남한 의료법과 유사한 부분이 많지만, 신의학과 고려의학을 배합하고 고려의학적방법과 자연요법을 환자진료에 널리 사용하도록 한 규정, 진단내용이 환자치료에 나쁜 영향을 줄 수 있는 경우 환자 보호자에게만 알려주도록 한 부분 등은 남한 의료법과 차이가 있다.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.325-340
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• 1998

대구의 경우 최근 지하철의 개통과 더불어 대규모 지하상가가 건설 중에 있어 지하공간 근무자의 급속한 증가가 예상되며 이에 따른 보건학적인 문제에 관한 관심과 준비가 필요하다. 이 연구는 지하상가를 중심으로 지하공간 근무자들의 건강 양상을 파악하고 지하공간 실내공기의 오염원을 추정함으로써 지하공간 생활자의 보건학적인 문제점을 규명하고 대책을 세우기 위한 자료로 활용하기 위하여 이루어졌다. 1998년 8월에 대구 중앙지하상가 근무자 130명과 대명동 지역 지상상가 근무자 60명을 대상으로 미국 국립산업안전보건원에서 개발한 실내공기오염 설문지를 이용하여 건강 및 증상(예; 천식, 알레르기질환 이환여부, 눈, 코, 목, 호흡기, 피부 동의 비특이적 증상 등), 근무환경에 관한 사항(예; 환기, 온도, 습도, 냄새 등) 및 개인적인 사항(예; 연령, 성별, 흡연유무 등)을 조사하였다. 실내공기질의 측정은 지하상가를 6개 구역으로 나누고 구역별 온도, 산소, 이산화탄소, 일산화탄소와 포름알데히드를 측정하고 기존자료를 활용하였다. 대조군에 비해 지하상가에서 근무하는 고위험군은 기관지염과 먼지알레르기를 경험한 율이 유의하게 높였다. SBS의 진단기준은 NIOSH의 기준과 동일한 지난 한 달 동안 일주일에 하루 이상 눈, 코, 목, 호흡기 동의 증상과 두통, 피로감을 한가지 이상 경험하였고 지하공간을 벗어나면 증상이 호전되는 경우로 하였다. 지난 한달 동안 경험한 증상에 관한 조사에서 눈이 건조하다, 가렵다, 따갑다, 목이 따갑거나 건조함을 느낀다, 가슴이 답답하다, 눈이 피곤하고 충혈된다 및 피부가 가렵다, 건조하다 항목에서 두 군의 유병률은 유의한 차이가 있었다. 18개의 SBS 증상 중 1주일에 1-3회 이상 경험하는 증상의 개수는 고위험군에서 대조군에 비해 유의하게 많았다. 이상의 조사 및 분석결과를 종합하면 일부 지하상가 근무자들은 지하의 제한된 공간에 장기간 근무함으로써 부적절한 인간공학적 환경, 물리적 환경, 부족한 환기량 등에 의해 실내공기 오염으로 인한 증상 경험이 대조군에 비해 유의하게 높았으며 68.5%의 지하상가 근무자가 SBS를 경험하고 있었다. 그러므로 지하공간 근무자의 SBS 발생을 예방하기 위해서는 실내공기질의 정확한 평가를 통한 예방대책 수립이 필요하다. 또 의료인의 관심을 통해 SBS의 진단, 치료 및 예방 등과 같은 적절한 의학적 조치 및 연구가 이루어져야겠으며 근무자들의 환경에 대한 교육이 필요하다고 생각된다.