• Title/Summary/Keyword: Slow medicine

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The Impact of Outpatient Coinsurance Rate Increase on Outpatient Healthcare Service Utilization in Tertiary and General Hospital (외래 본인부담률 인상이 상급종합병원과 종합병원 외래 의료이용에 미친 영향)

  • Kim, Hyo-Jeong;Kim, Young-Hoon;Kim, Han-Sung;Woo, Jung-Sik;Oh, Su-Jin
    • Health Policy and Management
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    • v.23 no.1
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    • pp.19-34
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    • 2013
  • Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

Long-term Activation of c-Jun N-terminal Kinase through Receptor Interacting Protein is Associated with DNA Damage-induced Cell Death

  • Seok, Jeong-Ho;Park, Kyeong-Ah;Byun, Hee-Sun;Won, Min-Ho;Shin, Sang-Hee;Choi, Byung-Lyul;Lee, Hyun-Ji;Kim, Young-Rae;Hong, Jang-Hee;Park, Jong-Sun;Hur, Gang-Min
    • The Korean Journal of Physiology and Pharmacology
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    • v.12 no.4
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    • pp.185-191
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    • 2008
  • Activation of c-Jun N-terminal kinase (JNK), a member of the mitogen-activated protein kinase family, is an important cellular response that modulates the outcome of the cells which are exposed to the tumor necrosis factor (TNF) or the genotoxic stress including DNA damaging agents. Although it is known that JNK is activated in response to genotoxic stress, neither the pathways to transduce signals to activate JNK nor the primary sensors of the cells that trigger the stress response have been identified. Here, we report that the receptor interacting protein (RIP), a key adaptor protein of TNF signaling, was required to activate JNK in the cells treated with certain DNA damaging agents such as adriamycin (Adr) and 1-${\beta}$-D-arabinofuranosylcytosine (Ara-C) that cause slow and sustained activation, but it was not required when treated with N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and short wavelength UV, which causes quick and transient activation. Our findings revealed that this sustained JNK activation was not mediated by the TNF (tumor necrosis factor) receptor signaling, but it required a functional ATM (ataxia telangiectasia) activity. In addition, JNK inhibitor SP-600125 significantly blocked the Adr-induced cell death, but it did not affect the cell death induced by MNNG. These findings suggest that the sustained activation of JNK mediated by RIP plays an important role in the DNA damage-induced cell death, and that the duration of JNK activation relays a different stress response to determine the cell fate.

Pathological Studies on Ovaries, Thyroid Glands and Hypophyses of Rabbits Following Administration of Sulfadimethoxine (Sulfadimethoxine(SDM) 투여(投與) 가토(家兎)의 난소(卵巢), 갑상선(甲狀腺) 및 뇌하수체(雷下垂體)에 관한 병리학적(病理學的) 연구(硏究))

  • Rim, Byung Moo
    • Korean Journal of Veterinary Research
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    • v.16 no.1
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    • pp.77-96
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    • 1976
  • In order to investigate the effects and acting mechanism on ovaries, thyroid glands and hypophyses of rabbits in short term administration of sulfadimethoxine (SDM) as medical dose, a total of 90 virgin albino rabbits (mean body weight, 1,362g) were selected at random and alloted to two groups. Rabbits in one group served as controls and the others were administered SDM of 50 mg/kg/day for 5 weeks, and then reared without medication for 4 weeks. Pathological changes of the three organs were observed each week for 9 weeks and the results obtained were summarized as follows: 1. Mean body weights of both groups manifested slow increasing tendency but mean hypophysis weights fluctuated throughout the experimental term. Mean ovary weights of experiments were decreased significantly from the 3rd to 6th week but mean thyroid weights of experiments were increased significantly from the 1st to 6th week compared with those of controls. 2. Many ovarian follicles of each developing stage showed follicular atresia accompanying atrophy or necrosis of oocytes and of disintegrated follicular cells. Theca interna cells and sudanophilic interstitial cells showed atrophy and diminished sudanophilic granules and also liquor folliculi were diminished. These changes icreased from the 1st week, remaining so for 5 weeks and returned to normal status in the 8th or 9th week. 3. The thyroid gland showed a typical hyperplastic goiter. Hypertrophic and hyperplastic epithelia follicular manifested cuboidal or columnar form showing tiny or small vacuoles in cytoplasm. The follicles showed atrophy and decreasing colloidal materials. Necrotic and regenerative changes were also present. The interfollicular vessels showed congestion and hemorrhage. These changes increased from the 1st week, remaining so for 5 weeks and returned to normal status in the 9th week. 4. The rates of differential cell counts of hypophyses revealed increase of basophils (gonadotrophs and thyrotrophs) and decrease of chromophobes. Basophils which had diminished granules stainable with HE, PAS and AF revealed hypertrophy, hyperplasia, and increasing of tiny or small vacuoles in cytoplasm. These changes increased from the 1st week, remaining so for 5 weeks and returned to normal status in the 8th or 9th week. As summarized above histologically, administration of SDM led thyrotrophs and gonadotrophs of pituitary glands to hyperactivity but revealed retrogressive and compensatory changes with functional disturbance in ovaries and thyroid glands. These changes were transitional and attributed to direct actions of the drugs on the ovaries and thyroid glands.

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EFFECT OF PLATELET-RICH PLASMA ON BONE FORMATION IN DISTRACTED AREA OF CANINE MANDIBLE (성견하악골의 신연 부위에서 골형성에 대한 혈소판-풍부 혈장의 효과)

  • Ryu, Soo-Jang;Yi, Choong-Kook;Choi, Byung-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.498-510
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    • 2001
  • Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.

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The absorption and excretion times of carp, Cyprinus carpio, treatment with oxolinic acid (향어에서의 oxolinic acid 흡수와 배설속도)

  • Jeong, Hyun-Do;Ha, Jai-Yi;Huh, Min-Do;Chung, Joon-Ki
    • Journal of fish pathology
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    • v.5 no.2
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    • pp.135-142
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    • 1992
  • The absorption and excretion times of oxolinic acid(OX) used in farms as new aquatic antibiotics commonly were evaluated with determination of the effects of water temperature and feeding to parameters by using the bioassay technique. On the same time, antibacterial activity and the complex formation of oxolinic acid with serum proteins of two different fishes were compared to those oxytetracycline(OTC). With more than 10 times lower MIC values than those of OTC in the strains among 13 analyzed fish pathogens. OX did not show the decresed antibacterial activity by the binding of serum proteins in carp and tilapia. It implies more powerful potential of OX as aquatic medicine OTC. The serum concentration of OX after different administrations the oral, i.m., i.v and dipping methods were compared. The higher beginning concentration in serum and faster excretion times were obserbed in i.m. and dipping methods respectively. In the oral and i.m. administration, peak serum concentration after 24-48 hrs and slow excretion times demonstrated in both methods. These pharmacokinetic characteristics similar at $30^{\circ}C$ and $20^{\circ}C$ water temperature conditions, however, beginning serum concentration of OX in fish dipped in $50mg/\ell$ sol after starvation for 2 wks was appeared lower than those of fed fish. It suggests the importance of biological condition of the gill or skin for absorption of antibiotics after dipping administration.

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Exophytic Verrucous Hyperplasia of the Oral Cavity - Application of Standardized Criteria for Diagnosis from a Consensus Report

  • Zain, Rosnah Binti;Kallarakkal, Thomas George;Ramanathan, Anand;Kim, Jin;Tilakaratne, WM;Takata, Takashi;Warnakulasuriya, Saman;Hazarey, Vinay Kumar;Rich, Alison;Hussaini, Haizal Mohd;Jalil, Ajura
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4491-4501
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    • 2016
  • Verruco-papillary lesions (VPLs) of the oral cavity described in the literature involve a spectrum of conditions including squamous papilloma, verruca vulgaris, focal epithelial hyperplasia, condyloma, proliferative verrucous leukoplakia and verrucous carcinoma. A majority of the VPLs are slow growing, benign in nature and have a viral aetiology. Virus associated benign mucosal outgrowths are not too difficult to diagnose either clinically or by microscopy. Apart from virus-associated lesions, VPLs harboring malignant potential or behaviour such as verrucous carcinoma, proliferative verrucous leukoplakia, oral verrucous hyperplasia (OVH), oral papillary squamous cell carcinoma (PSCC) and oral conventional squamous cell carcinoma with papillary features (CSCC) need to be further clarified for better understanding of their predictable biologic behavior and appropriate treatment. Current understanding of potentially malignant VPLs is perplexing and is primarily attributed to the use of confusing and unsatisfactory terminology. In particular, the condition referred to as oral verrucous hyperplasia (OVH) poses a major diagnostic challenge. OVH represents a histopathological entity whose clinical features are not well recognised and is usually clinically indistinguishable from a verrucous carcinoma and a PSCC or a CSCC. A consensus report published by an expert working group from South Asia as an outcome of the 'First Asian Regional Meeting on the Terminology and Criteria for Verruco-papillary Lesions of the Oral Cavity' held in Kuala Lumpur, Malaysia, recognised the clinical description of these OVH as a new entity named 'Exophytic Verrucous Hyperplasia'. Previously described clinical features of OVH such as the 'blunt' or 'sharp' variants; and the 'mass' or 'plaque' variants can now collectively fall under this newly described entity. This paper discusses in detail the application of the standardized criteria guidelines of 'Exophytic Verrucous Hyperplasia' as published by the expert group which will enable clinicians and pathologists to uniformly interpret their pool of OVH cases and facilitate a better understanding of OVH malignant potential.

The Effects of Visual Flow Speed's Modulation-Based Virtual Reality Program on Gait Function in Stroke Patients (시각 흐름 속도에 따른 가상현실 프로그램이 뇌졸중 환자의 보행에 미치는 영향)

  • Kang, Hyung-Kyu;Chung, Yi-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.247-253
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    • 2012
  • The purpose of this study was to evaluate the effects of a visual flow speed's modulation-based VR(virtual reality) program on gait function in stroke patients. Thirty one stroke patients were randomly selected at Dep. of Rehabilitation medicine of M hospital in Seoul. We carried out the gait analysis by dividing them with four conditions : one condition had applied without the visual flow modulation-based VR and another had done three visual flow speed's modulation-based VR(0.25, 1, 2 times). The gait analysis was used with GaitRite system. The data were collected using gait velocity, cadence, stride length, step length, single support time, and double support time during treatment. The results were as follows. First, the slow visual flow(0.25 times)-based VR program on the condition was significant decrease gait velocity, cadence, stride length, step length and increase single support time, double support time(p<.05). Second, the fast visual flow(2 times)-based VR program on the condition was significant increase gait velocity, cadence, stride length, step length, single support time on paretic lower limb and decrease single support time on non-paretic lower limb, double support time(p<.05). Third, the normal visual flow(1 times)-based VR program on the condition was not significant differ gait velocity, cadence, stride length, step length, single support time, double support time. In conclusion, the visual flow speed's modulation-based VR program improves gait function in chronic stroke patients.

Non-Adrenergic Non-Cholinergic Responses of Gu mea- Pig Tracheal Smooth Muscle (기니피그 기도 평활근의 비아드레날린성 비꼴린성 반응에 관한 연구)

  • Jo, Eun-Yong;Choe, Hyeong-Ho;Jeon, Je-Yeol
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.487-494
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    • 1996
  • The neurogenic responses of tracheal smooth muscles to electrical field stimulation (EFS) is biphasic, consisting firstly of cholinergic contraction followed by a slow and sustained relaxation. It is well known that a sustained relaxation involves the inhibitory non-adrenergic non-cholinergic systems. This study was done to Investigate the relaxing agents and their action mechanisms by use of an organ bath with plati- ilum . The tracheal smooth muscle relaxation due to EFS was suppressed by L-NAME, the WO (Nitric Oxide) synthase inhibitor, and these effects were reversed by L-arginine, the precursor of NO. Also, L-WAME (HG-nitro-L-arginine methyl ester) increased the basal tension. Nitroprusside, the NO-donor, suppressed the tracheal basal tension greatly. Methylene blue, the inhibitor of guanylate cyclase, decreased EFS-induced relaxations and increa ed basal tension. Forskolin and isoprenaline, which are activators of adenylate cyclase, suppressed tracheal basal tension in the same way as nitroprusside. TEA (tetraethylammonium), the non-specific K'channel blocker, and apamin, the Ca"-activated K'channel blocker, increased tracheal basal tension and EFS-induced relaxations. Our results indicate that Pr3 Is released upon stimulation of the NANC (Won Adrenergic Won Cholinergic) nerves in guinea-pig tracheal smooth muscle and that the release of NO related with the K+ channel, as well as the release of other inhibitory agents< e. g.)VIP (Vasoactive Intestinal Polypeptide), PHI (Peptide Histidine Isoleusine) > mediated via CAMP (cyclic Adenosine Monophosphate) may be Involved In sustained relaxation.

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Effect of Dunggulle(Polygonatum odoratum) Extracts on Quality of Yakju (둥굴레 엑스첨가가 약주의 품질에 미치는 영향)

  • Lee, Seong-Tae;Kim, Man-Bae;Song, Geon-Woo;Choi, Sang-Uk;Lee, Hong-Jae;Heo, Jong-Soo
    • Food Science and Preservation
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    • v.7 no.3
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    • pp.262-266
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    • 2000
  • The rhizomes of Polygonatum odoratum(Dunggulle in korean name) have been used as a traditional medicine for a tonic, remedy of fevers of influenza, cough and lung trouble. In this experiment, water extract of Dunggulle was added in brewing korean traditional rice wine. Fermentation characteristics such as content of total acid, pH, temperature, total sugar and alcohol concentration were investigated during fermentation periods. Changes of fermentation characteristics were remarkable in the initial period(0~3 days), slow in the middle(4~6 days), and almost unchangeable in the final(7~10 days). Total acid content was remarkably increased during the initial period but slowly decreased afterward. As the content of Dunggulle extract is increased, total sugar content was slightly increased. At the first day of fermentation, total sugar content was 19.6% in control, 22.6, 23.3 and 25.6% in Dunggulle extract 2.5, 5.0 and 7.5% added group, respectively. In the initial period, content of alcohol in control was highest than in Dunggulle extract added group. The content of alcohol in 4 kinds of wine showed highest value at the sixth day and those of control and Dunggulle extract 2.5% were 16.0, 16.1%, respectively. Sensory evaluation in taste was not significantly different among control and Dunggulle extract added group.

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Preparation of equine blood typing reagents by isoimmunization (동종면역(同種免疫)에 의한 말항혈청(抗血淸)제조에 관한 연구)

  • Han, Bang-keun;Matsumoto, Hiroshi;Chang, Duk-gi
    • Korean Journal of Veterinary Research
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    • v.30 no.2
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    • pp.145-156
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    • 1990
  • This study was purposed to produce blood typing reagents for classifing Cheju horse's blood group factors. The blood typing reagents were prepared by immunization of sixteen pairs out of fourty eight heads of Cheju horses, and seventeen different blood typing reagents (anti-$A_1$, A', H, Z, $ZZ_2$, C, J, K, $P_1$, Q, R, S, $T_1$, $N_1$, $U_2$, X and $E_2$) were prepared from equine isoimmunization. The result for the reagent production and the variation of agglutinin and hemolysin titer are as follows: 1. Anti-K, R, S, $N_1$, $U_2$ and X acted exclusively as hemolysins whereas anti-J, $P_1$, $T_1$ and $E_2$ acted exclusively as agglutinins, however, Anti-$A_1$, A', H, Z, $ZZ_2$, C and Q reacted both as hemolysins and agglutinins. 2. Among the antibodies in most of the reagents reacted both as hemolysins and agglutinins, But anti-$A_1$, H, Z, $ZZ_2$ and Q elevated higher agglutin titers than hemolysin titers, Anti-A' and anti-C elevated higher hemolysin titers than agglutinin titers. 3. Complex antibody $A_1U_2$ was adsorbed $U_2$ and unified to $A_1$, while complex antibody X $N_1$ went through an adsorption process and produced simple antibody X and $N_1$, respectively. 4. In the hemolytic reaction, anti-K and anti-R showed the highest titer, In the agglutination reaction, anti-Z and anti-$ZZ_2$ showed the highest titer. 5. In the case of No.138~No.140 horse immunization combination and No.133~No.146 horse immunization combination, Although production of complex antibody $CE_2$ and $JP_1$ were expected, only anti-$E_2$ and anti-J were produced respectively. 6. The degree of elevation of antibody titer was varied by the blood types and by the types of donor and recipient combination. The fast elevating types, slow elevating types and types that never elevate the antibody titer were identified.

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