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Effect of LED mixed light conditions on the glucosinolate pathway in brassica rapa (배추 유묘의 글루코시놀레이트 합성 기작에 미치는 LED 혼합광의 효과)

  • Moon, Junghyun;Jeong, Mi Jeong;Lee, Soo In;Lee, Jun Gu;Hwang, Hyunseung;Yu, Jaewoong;Kim, Yong-Rok;Park, Se Won;Kim, Jin A
    • Journal of Plant Biotechnology
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    • v.42 no.3
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    • pp.245-256
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    • 2015
  • In the agricultural industries, LEDs are used as supplementary, as well as main lighting sources in closed cultivation systems. In cultivation using artificial light sources, various light qualities have been tried to supplement fluorescent lamps to promote plant growth and metabolism. Microarray analysis of Brassica rapa seedlings under blue and fluorescent mixed with blue light conditions identified changes in three genes of the glucosinolate pathway. This attracted attention as functional materials highly expressed 3.6-4.6 fold under latter condition. We selected four more genes of the glucosinolate pathway from the Brassica database and tested their expression changes under fluorescent light mixed with red, green, and blue, respectively. Some genes increased expression under red and blue mixed conditions. The Bra026058, Bra015379, and Bra021429; the orthologous genes of CYP79F1, ST5a, and FMOGS-OX1 in Arabidopsis, are highly expressed in Brassica rapa under fluorescent mixed with blue light conditions. Further, Bra029355, Bra034180, Bra024634, and Bra022448; the orthologous genes of MAM1, AOP3, UGT74B1, and BCAT4 in Arabidopsis, are highly expressed in Brassica rapa under fluorescent mixed with red light conditions. The various light conditions had unique effects on the varieties of Brassica, resulting in differences in glucosinolate synthesis. However, in some varieties, glucosinolate synthesis increased under mixed blue light conditions. These results will help to construct artificial light facilities, which increase functional crops production.

Effect of Supplementary Herbs and Plant Extracts on the Performance of Laying Hens (허브 및 식물 추출물의 급여가 산란계의 생산성에 미치는 영향)

  • Kim, C.H.;Paik, I.K.
    • Korean Journal of Poultry Science
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    • v.35 no.1
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    • pp.71-78
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    • 2008
  • This study was conducted to investigate the effects of dietary supplementation of herbs and plant extracts (PE) on the performance, small intestinal microflora and immune response in laying hens. A total of 1,440 Hy-Line Brown laying hens of 67 wks old were assigned to one of the following 9 dietary treatments : T1 : Control (C), T2 : C + Avilamycine 6 ppm, T3 : C + Herb $Mix^{(R)}$ 0.2%, T4 : C + Biostrong $510^{(R)}$ 0.02%, T5 : C + $APEX^{(R)}$ 0.02%, T6 : C + $Digestarom^{(R)}$ 0.02%, T7 : C + $Phellozyme^{(R)}$ 0.1%, T8 : C + $Galicin^{(R)}$ 0.05%, T9 : C + CRINA $Poultry^{(R)}$ 0.05%. Each treatment was replicated 8 times with twenty birds housed in 2 bird cages. Twenty bird units were arranged according to completely randomized block design. Feeding trial lasted 6 wks under 16 hours lighting regimen. Hen-day egg production was not significantly different among the treatments, but that of supplemented groups tended to be higher than the control. There were significant differences among treatments in feed intake and feed conversion ratio. Feed intake was higher in the supplemented groups than the control. Feed conversion ratio was higher in T8 than other treatments. Egg shell color index and egg yolk color index were significantly different among treatments. Egg shell color was affected by supplements and egg yolk color index of T9 (PE-CRINA) was significantly higher than the control. Haugh unit was not significantly different among treatments. There were significant differences in leukocytes and erythrocytes parameters. The level of serum WBC and stress index (heterophil/lymphocyte) were higher in supplemented groups than the control. The level of RBC tended to be lower in the herb or PE groups than the control. The concentration of serum IgG was not significantly different among the treatments, but all those of the supplemented groups were higher than the control. The number of Lactobacilli spp. tended to increase and that of Cl. perfrigens decrease in the supplemented groups. The number of E. coli significantly decreased in the supplemented groups. The results of this experiment showed that feeding herbs and plant extracts to laying hens tended to improve the egg production and affect positively on the level of blood parameters and small intestinal microflora.

Effects of supplementation of spent mushroom (Flammulina velutipes) substrates on the fermentative quality of rye silage (팽이버섯 수확후배지 첨가가 호밀 사일리지의 발효 품질에 미치는 영향)

  • Moon, Yea-Hwang;Kim, Su Cheol;Cho, Woong Gi;Lee, Sung Sill;Cho, Soo Jeong
    • Journal of Mushroom
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    • v.12 no.2
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    • pp.138-143
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    • 2014
  • This study was conducted to know the optimal supplementary level of spent mushroom substrates (Flammulina velutipes) as an energy source and fermentation period in manufacturing of rye silage. Whole crop rye was harvested at full bloom stage and ensiled with spent mushroom substrates of 20%(S-20), 40%(S-40) and 60%(S-60) as fresh matter basis. Each silage was prepared in plastic buckets included with vinyl bag by three replications and fermented for 3, 6 and 9 weeks, respectively. Moisture contents of whole crop rye at full bloom stage and spent mushroom substrates were 62.3% and 54.3%, respectively, and those of silages was ranged from 58% to 64%. Ether extracts content of silages was significantly (P<0.05) increased in 6 weeks of fermentation period. The pH of silages ranged from 4.46 to 5.05, and fluctuated in the changes by fermentation period beside of decreased with elapsing the period in the S-60. The organic acid content of silages was higher in the order of lactic acid, butyric acid, acetic acid and propionic acid. Lactic acid content was higher when fermented for 6 weeks compared to the other fermentation period. Flieg's score for estimation of silage quality ranged from 63 to 80, and was relatively high level in the S-20 and the S-40 fermented for 6 weeks, and was high level in S-20, and was relatively low level in the silages fermented for 3 week. Hence, we suggest that supplementation of 20% spent mushroom substrates in fresh matter basis and fermentation for 6 weeks are resonable for a good quality of rye silage.

Management of plant genetic resources at RDA in line with Nagoya Protocol

  • Yoon, Moon-Sup;Na, Young-Wang;Ko, Ho-Cheol;Lee, Sun-Young;Ma, Kyung-Ho;Baek, Hyung-Jin;Lee, Su-Kyeung;Lee, Sok-Young
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.51-52
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    • 2017
  • "Plant genetic resources for food and agriculture" means any genetic material of plant origin of actual or potential value for food and agriculture. "Genetic material" means any material of plant origin, including reproductive and vegetative propagating material, containing functional units of heredity. (Internal Treaty on Plant Genetic Resources for Food and Agriculture, ITPGRFA). The "Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization (ABS) to the Convention on Biological Diversity (shortly Nagoya Protocol)" is a supplementary agreement to the Convention on Biological Diversity. It provides a transparent legal framework for the effective implementation of one of the three objectives of the CBD: the fair and equitable sharing of benefits arising out of the utilization of genetic resources. The Nagoya Protocol on ABS was adopted on 29 October 2010 in Nagoya, Japan and entered into force on 12 October 2014, 90 days after the deposit of the fiftieth instrument of ratification. Its objective is the fair and equitable sharing of benefits arising from the utilization of genetic resources, thereby contributing to the conservation and sustainable use of biodiversity. The Nagoya Protocol will create greater legal certainty and transparency for both providers and users of genetic resources by; (a) Establishing more predictable conditions for access to genetic resources and (b) Helping to ensure benefit-sharing when genetic resources leave the country providing the genetic resources. By helping to ensure benefit-sharing, the Nagoya Protocol creates incentives to conserve and sustainably use genetic resources, and therefore enhances the contribution of biodiversity to development and human well-being. The Nagoya Protocol's success will require effective implementation at the domestic level. A range of tools and mechanisms provided by the Nagoya Protocol will assist contracting Parties including; (a) Establishing national focal points (NFPs) and competent national authorities (CNAs) to serve as contact points for information, grant access or cooperate on issues of compliance, (b) An Access and Benefit-sharing Clearing-House to share information, such as domestic regulatory ABS requirements or information on NFPs and CNAs, (c) Capacity-building to support key aspects of implementation. Based on a country's self-assessment of national needs and priorities, this can include capacity to develop domestic ABS legislation to implement the Nagoya Protocol, to negotiate MAT and to develop in-country research capability and institutions, (d) Awareness-raising, (e) Technology Transfer, (f) Targeted financial support for capacity-building and development initiatives through the Nagoya Protocol's financial mechanism, the Global Environment Facility (GEF) (Nagoya Protocol). The Rural Development Administration (RDA) leading to conduct management agricultural genetic resources following the 'ACT ON THE PRESERVATION, MANAGEMENT AND USE OF AGRO-FISHERY BIO-RESOURCES' established on 2007. According to $2^{nd}$ clause of Article 14 (Designation, Operation, etc. of Agencies Responsible for Agro-Fishery Bioresources) of the act, the duties endowed are, (a) Matters concerning securing, preservation, management, and use of agro-fishery bioresources; (b) Establishment of an integrated information system for agro-fishery bioresources; (c) Matters concerning medium and long-term preservation of, and research on, agro-fishery bioresources; (d) Matters concerning international cooperation for agro-fishery bioresources and other relevant matters. As the result the RDA manage about 246,000 accessions of plant genetic resources under the national management system at the end of 2016.

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Art Therapy and Hospice & Palliative Care in Korea (한국의 예술치료와 호스피스 완화의료)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.85-96
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    • 2015
  • In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.

Effects of Dietary Organic Sulfur on Performance, Egg Quality and Cell-mediated Immune Response of Laying Hens (유기황의 수준별 급여가 산란계의 생산성, 계란품질 및 세포성 면역능에 미치는 영향)

  • Lim, Chun Ik;Choe, Ho Seong;Kang, Changwon;Lee, Byoung Keon;Ryu, Kyeong Seon
    • Korean Journal of Poultry Science
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    • v.45 no.2
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    • pp.97-107
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    • 2018
  • This study aimed to evaluate the dietary effect of organic sulfur (OS) supplementation on performance, egg quality and serum constituents in laying hens. A total of 360 Lohmann brown laying hens at the age of 31 weeks were distributed into four treatments having five replicates of 18 hens each until 54 weeks. The hens were fed four levels (0.0, 0.1, 0.2 and 0.4%) of OS with basal diet. The number of eggs was investigated daily, and egg quality was confirmed every 8 weeks. Sulfur content in eggs, interleukin 2 (IL-2), T help cells (CD4+) and cytotoxicity cells (CD8+) were measured at the termination of the experiment. The result of the study showed that egg production tended to increase with 0.4% OS in diet after 39 weeks of age and, there was a significant effect (P<0.05) from 47 to 54 weeks of age. Egg quality traits of albumen height and haugh unit increased significantly (P<0.05) owing to the addition of OS to the diet. The polyunsaturated fatty acids in yolk were gradually increased while saturated fatty acids were decreased with increasing levels in OS (P<0.05). Total sulfur concentration in the eggs increased significantly (P<0.05) in treatments fed OS. Moreover, albumin, AST and HDL cholesterol levels in serum improved significantly (P<0.05) owing to the addition of OS. The IL-2 concentration and the ratio of CD4+ and CD8+ in blood were generally higher (P<0.05) at 0.4% OS. Therefore, it can be recommended that supplementary OS diet affected the performance, egg quality and stimulated immune response in laying hens.

The Application of Dynamic Acquisition with Motion Correction for Static Image (동적 영상 획득 방식을 이용한 정적 영상의 움직임 보정)

  • Yoon, Seok-Hwan;Seung, Jong-Min;Kim, Kye-Hwan;Kim, Jae-Il;Lee, Hyung-Jin;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.46-53
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    • 2010
  • Purpose: The static image of nuclear medicine study should be acquired without a motion, however, it is difficult to acquire static image without movement for the serious patients, advanced aged patients. These movements cause decreases in reliability for quantitative and qualitative analysis, therefore re-examination was inevitable in the some cases. Consequently, in order to improve the problem of motion artifacts, the authors substituted the dynamic acquisition technique for the static acquisition, using motion correction. Materials and Methods: A capillary tube and IEC body phantom were used. First, the static image was acquired for 60 seconds while the dynamic images were acquired with a protocol, 2 sec/frame${\times}$30 frames, under the same parameter and the frames were summed up into one image afterwards. Also, minimal motion and excessive motion were applied during the another dynamic acquisition and the coordinate correction was applied towards X and Y axis on the frames where the motion artifact occurred. But the severe blurred images were deleted. Finally, the resolution and counts were compared between the static image and the summed dynamic images which before and after applying motion correction, and the signal of frequency was analysed after frequency spatial domain was transformed into 2D FFT. Supplementary examination, the blind test was performed by the nuclear medicine department staff. Results: First, the resolution in the static image and summed dynamic image without motion were 8.32 mm, 8.37 mm on X-axis and 8.30 mm, 8.42 mm on Y-axis, respectively. The counts were 484 kcounts, 485 kcounts each, so there was nearly no difference. Secondly, the resolution in the image with minimal motion applying motion correction was 8.66 mm on X-axis, 8.85 mm on Y-axis and had 469 kcounts while the image without motion correction was 21.81 mm, 24.02 mm and 469 kcounts in order. So, this shows the image with minimal motion applying motion correction has similar resolution with the static image. Lastly, the resolution in the images with excessive motion applying motion correction were 9.09 mm on X-axis, 8.83 mm on Y-axis and had 469 kcounts while the image without motion correction was 47.35 mm, 40.46 mm and 255 kcounts in order. Although there was difference in counts because of deletion of blurred frames, we could get similar resolution. And when the image was transformed into frequency, the high frequency was decreased by the movement. However, the frequency was improved again after motion correction. In the blind test, there was no difference between the image applying motion correction and the static image without motion. Conclusion: There was no significant difference between the static image and the summed dynamic image. This technique can be applied to patients who may have difficulty remaining still during the imaging process, so that the quality of image can be improved as well as the reliance for analysis of quantity. Moreover, the re-examination rate will be considerably decreased. However, there is a limit of motion correction, more time will be required to successfully image the patients applying motion correction. Also, the decrease of total counts due to deletion of the severe blurred images should be calculated and the proper number of frames should be acquired.

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A cross-sectional study on prevalence rate and contributing factors of fatty liver diagnosed by ultrasonography (초음파로 진단된 지방간의 유병율 조사 및 그 유발인자에 대한 연구)

  • Ahn, Jae-Eog;Ham, Jung-Oh;Hwang, Kyu-Yoon;Kim, Joo-Ja;Lee, Byung-Kook;Nam, Tack-Sung;Kim, Joung-Soon;Kim, Hun
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.195-210
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    • 1991
  • Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following ; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are $40{\sim}50's$ in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows ; If the odds ratio of below 29 year of age is 1.0 then that of $30{\sim}39$ is 1.74 (p=0.33), $40{\sim}49$ is 2.47 (p=0.10), $50{\sim}59$ is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of $0{\sim}9$ is 5.08 (p<0.01), $10{\sim}19$ is 12.37 (p<0.01), $20{\sim}29$ is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of $100{\sim}120$ is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below $29{\mu}/1{\gamma}-GT$ is 1.0 then that of $30{\sim}s59$ is 2.11 (p<0.01), $60{\sim}90$ is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then $150{\sim}199$ is 1.49 (p=0.05), $200{\sim}250$ is 1.09 (P=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and nm triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.

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A Study on the Restoration of the Wangheungsa Temple's Wooden Pagoda (왕흥사 목탑의 복원 연구)

  • Kim, Kyeong-Pyo;Sung, Sang-Mo
    • Journal of architectural history
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    • v.19 no.3
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    • pp.7-29
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    • 2010
  • The form of the Wangheungsa Temple's wooden pagoda site is that of the traditional form of the wooden pagodas constructed during the Baekjae Period. Likewise, it is an important ruin for conducting research on the form and type of the wooden pagodas constructed during the Baekjae Period. In particular, the method used for the installation of the central pillar's cornerstone is a new technique. The purpose of this research is to restore the ruin of the Wangheungsa Temple's wooden pagoda of the Baekjae Period that remains at the Wangheungsa Temple's wooden pagoda site. Until now, research conducted on the wooden pagoda took place mostly centered on the Hwangryongsa Temple's wooden pagoda. Meanwhile, the reality concerning Baekjae's wooden pagoda is one in which there were not many parallel cases pertain to the design for restoration. This research paper wants to conduct academic examination of the Wangheungsa Temple's wooden pagoda to organize the intention of design and design process in a simple manner. This research included review of the Baekjae Period's wooden pagoda related ruins and the review of the existing wooden pagoda ruin to analyze the wooden pagoda construction technique of the era. Then, current status of the Wangheungsa Temple's wooden pagoda site is identified to define the characteristics of the wooden pagoda, and to set up the layout format and the measure to estimate the size of the wooden pagoda in order to design each part. Ultimately, techniques and formats used for the restoration of the wooden pagoda were aligned with the wooden pagoda of the Baekjae Period. Basically, conditions that can be traced from the current status of the Wangheungsa Temple site excavation using the primary standards as the standard. Wangheungsa Temple's wooden pagoda was designed into the wooden pagoda of the Baekjae's prosperity phase. The plane was formed into $3{\times}3$ compartments to design into three tier pagoda. The height was decided by factoring in the distance between the East-West corridors, size of the compartment in the middle, and the view that is visible from above the terrace when entering into the waterway. Basically, the origin of the wooden structure format is based on the Goguryeo style, but also the linkage with China's southern regional styles and Japan's ancient wooden pagoda methods was factored in. As for the format of the central pillar, it looks as if the column that was erected after digging the ground was used when setting up the columns in the beginning. During the actual construction work of the wooden pagoda, central pillar looks as if it was erected by setting up the cornerstone on the ground. The reason that the reclaimed part of pillar that use the underground central cornerstone as the support was not utilized, was because the Eccentric Load of the central pillar's cornerstone was factored in the state of the layers of soil piled up one layer at a time that is repeated with the yellow clay and sandy clay and the yellow clay that were formed separately with the $80cm{\times}80cm$ angle at the upper part of the central pillar's cornerstone was factored in as well. Thus, it was presumed that the central pillar was erected in the actual design using the ground style format. It is possible to presume the cases in which the reclaimed part of pillar were used when constructed for the first time, but in which central pillar was installed later on, after the supplementary materials of the underground column is corroded. In this case, however, technique in which soil is piled up one layer at a time to lay down the foundation of a building structure cannot be the method used in that period, and the reclamation cannot fill up using the $80cm{\times}80cm$ angle. Thus, it was presumed that the layers of soil for building structure's foundation was solidified properly on top of the central pillar's cornerstone when the first wooden pagoda construction work was taking place, and that the ground style central pillar was erected on its upper part by placing the cornerstone once again. Wangheungsa Temple's wooden pagoda is significant from the structure development aspect of the Korean wooden pagodas along with the Hwangryongsa Temple's wooden pagoda. Wangheungsa Temple's wooden pagoda construction technique which was developed during the prosperity phase of the Baekjae Period is presumed to have served as a role model for the construction of the Iksan Mireuksa Temple's wooden pagoda and Hwangryongsa Temple's wooden pagoda. With the plan to complement the work further by excavating more, the basic wooden pagoda model was set up for this research. Wangheungsa Temple's wooden pagoda was constructed as at the Baekjae Kingdom wide initiative, and it was the starting point for the construction of superb pagoda using state of the art construction techniques of the era during the Baekjae's prosperous years, amidst the utmost interest of all the Baekjae populace. Starting out from its inherent nature of enshrining Sakyamuni's ashes, it served as the model that represented the unity of all the Baekjae populace and the spirit of the Baekjae people. It interpreted these in the most mature manner on the Korean peninsula at the time.

Analysis of utilization and profit for CT and MRI after implementation of insurance coverage for CT (CT 보험급여 전후의 CT 및 MRI검사의 이용량과 수익성 변화)

  • Suh, Chong-Rock;Yu, Seung-Hum;Chun, Ki-Hong;Nam, Chung-Mo
    • Korea Journal of Hospital Management
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    • v.2 no.1
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    • pp.1-21
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    • 1997
  • In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

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