• Title/Summary/Keyword: analysis system

Search Result 69,702, Processing Time 0.095 seconds

Study on Dehydrogenative Polymerization of Monolignols by Peroxidase/H2O2 (Peroxidase/H2O2 조건에서 리그닌 전구물질에 따른 탈수소 중합반응 특성 연구)

  • Moon, Sun-Joo;Kim, Kwang-Ho;Eom, In-Yong;Lee, Soo-Min;Kim, Yong-Hwan;Choi, Joon-Weon
    • Journal of the Korean Wood Science and Technology
    • /
    • v.38 no.3
    • /
    • pp.223-229
    • /
    • 2010
  • In this study diverse dehydrogenative polymers (DHPs) were synthesized with three precursors of native lignin [p-coumaryl alcohol (PCA), coniferyl alcohol (CA), sinapyl alcohol (SA)] in the presence of horseradish peroxidase (HRP, EC. 1.11.1.7)/$H_2O_2$. To compare the structural features between DHPs and native lignin, the DHPs as well as pine/poplar milled wood lignins were simultaneously subjected to gel permeation chromatography (GPC) to determine average molecular weights and derivatization followed by reductive cleavage (DFRC) to investigate the frequency of ${\beta}$-O-4 linkage. The highest yield of DHP was measured to 71% when CA was solely injected (G-DHP) and the yield of H-DHP was 42%. However, single injection of SA could not form any polymer in this system. The average molecular weights of DHPs were ranged between 3,000~4,700, which were only 1/2 fold compared with that of pine MWL (G-type lignin: Mw 7,340) and 1/3 scale compared with that of poplar MWL (GS-type lignin: Mw 13,250). DFRC analysis revealed that the formation of ${\beta}$-O-4 linkage during dehydrogenative polymerization was the highest in the GS-DHP with ca. 502 ${\mu}mol$/g, which was, however, remained to only 50% compared to that in poplar MWL (1107 ${\mu}mol$/g). The ${\beta}$-O-4 linkage was estimated to ca. 286 ${\mu}mol$/g In the G-DHP, which was twice as much as that of H-DHP(127 ${\mu}mol$/g). Similar to GS-DHP, only half amount of ${\beta}$-O-4 linkage, compared to pine MWL, was formed during in vitro polymerization of CA by horseradish peroxidase/$H_2O_2$.

Expression of CD40, CD86, and HLA-DR in CD1c+ Myeloid Dendritic Cells Isolated from Peripheral Blood in Primary Adenocarcinoma of Lung (원발성 폐선암환자의 말초혈액에서 분리한 CD1c+ 골수성 수지상 세포에서의 CD40, CD86 및 HLA-DR의 발현)

  • Kang, Moon-Chul;Kang, Chang-Hyun;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
    • /
    • v.43 no.5
    • /
    • pp.499-505
    • /
    • 2010
  • Background: There have been several reports using animal experiments that CD1-restricted T-cells have a key role in tumor immunity. To address this issue, we studied the expression of markers for CD1c+ myeloid dendritic cells (DCs) isolated from peripheral blood in the clinical setting. Material and Method: A total of 24 patients with radiologically suspected or histologically confirmed lung cancer who underwent pulmonary resection were enrolled in this study. The patients were divided according to histology findings into three groups: primary adenocarcinoma of lung (PACL), primary squamous cell carcinoma of lung (PSqCL) and benign lung disease (BLD). We obtained 20 mL of peripheral venous blood from patients using heparin-coated syringes. Using flow-cytometry after labeling with monoclonal antibodies, data acquisition and analysis were done. Result: The ratio of CD1c+CD19- dendritic cells to CD1c+ dendritic cells were not significantly different between the three groups. CD40 (p=0.171), CD86 (p=0.037) and HLA-DR (p=0.036) were less expressed in the PACL than the BLD group. Expression of CD40 (p=0.319), CD86 (p=0.036) and HLA-DR (p=0.085) were less expressed in the PACL than the PSqCL group, but the differences were only significant for CD86. Expression of co-stimulatory markers was not different between the PSqCL and BLD groups. Expression of markers for activated DCs were dramatically lower in the PACL group than in groups with other histology (CD40 (p=0.005), CD86 (p=0.013) HLA-DR (p=0.004). Conclusion: These results suggest the possibility that CD1c+ myeloid DCs participate in control of the tumor immunity system and that low expression of markers results in lack of an immune response triggered by dendritic cells in adenocarcinoma of the lung.

A Study on Factors Affecting Youth Employee's Labor Mobility and Employment Status Transition (청년취업자의 노동이동 및 고용형태 전환에 영향을 미치는 요인에 관한 연구)

  • Ban, Jung-Ho;Kim, Kyung-Hee;Kim, Kyung-Huy
    • Korean Journal of Social Welfare
    • /
    • v.57 no.3
    • /
    • pp.73-103
    • /
    • 2005
  • This study takes of youth panel data(2002-2003), there is the purpose to know to youth employed's labor mobility conditions of employment status conversion and examine on factors affecting conversion of employment status. Main analysis result and policy imply, is as following. First, although youth employed's non-standard employment shows some decrease, employment youth hierarchy was construed that youth of our country is consisting very changefully because appear great turnover that is converted by unemployment or Not economically activity population same period. Specially, non-standard employment phenomenon of woman or low in scholarship person appeared notedly, and because phenomenon that is converted by unemployment or Not economically activity population is expose that is deepened, discriminating policy of government dimension is required for employment stabilization of these class. Second, show result that danger to escape to non-standard job risk trap which seeking employment activity of youth class is arranged case or company which is formed by official path is suitable becomes low, must formulate path of employment about youth class and improve qualitative level of employment through suitable job placement education of youth class or function (technology) level. Third, when was construed, but take into account that the although large enterprise have low risk in non-standard job, recently employment of youth class consists very limited, rather small scale business or smaller enterprise's competitive power preferably need to be plan. Finally, danger to non-standard job youth employed's company form is government connection wonder was expose that high, Such result can do that it is difficult by limited research period, but reflect actuality that youth unemployment policy of our country is enforced laying stress on public labor or unregular job employment such as internship system. Therefore, current youth unemployment policy may have to change by employment policy that can secure stable work record by youth class or act as bridge-building that promote conversion by full-time job.

  • PDF

The Proteasome Inhibitor MG132 Sensitizes Lung Cancer Cells to TRAIL-induced Apoptosis by Inhibiting NF-κ Activation (폐암세포주에서 NFκ 활성 억제를 통한 Proteasome 억제제 MG132의 TRAIL-유도성 Apoptosis 감작 효과)

  • Seo, Pil Won;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
    • /
    • v.65 no.6
    • /
    • pp.476-486
    • /
    • 2008
  • Background: TRAIL (TNF-related apoptosis inducing ligand) is a newly identified member of the TNF gene family which appears to have tumor-selective cytotoxicity due to the distinct decoy receptor system. TRAIL has direct access to caspase machinery and induces apoptosis regardless of p53 phenotype. Therefore, TRAIL has a therapeutic potential in lung cancer which frequently harbors p53 mutation in more than 50% of cases. However, it was shown that TRAIL also could activates $NF-{\kappa}B$ in some cell lines which might inhibit TRAIL-induced apoptosis. This study was designed to investigate whether TRAIL can activate $NF-{\kappa}B$ in lung cancer cell lines relatively resistant to TRAIL-induced apoptosis and inhibition of $NF-{\kappa}B$ activation using proteasome inhibitor MG132 which blocks $I{\kappa}B{\alpha}$ degradation can sensitize lung cancer cells to TRAIL-induced apoptosis. Methods: A549 (wt p53) and NCI-H1299 (null p53) lung cancer cells were used and cell viability test was done by MTT assay. Apoptosis was confirmed with Annexin V assay followed by FACS analysis. To study $NF-{\kappa}B$-dependent transcriptional activation, a luciferase reporter gene assay was used after making A549 and NCI-H1299 cells stably transfected with IgG ${\kappa}-NF-{\kappa}B$ luciferase construct. To investigate DNA binding of $NF-{\kappa}B$ activated by TRAIL, electromobility shift assay was used and supershift assay was done using anti-p65 antibody. Western blot was done for the study of $I{\kappa}B{\alpha}$ degradation. Results: A549 and NCI-H1299 cells were relatively resistant to TRAIL-induced apoptosis showing only 20~30% cell death even at the concentration 100 ng/ml, but MG132 ($3{\mu}M$) pre-treatment 1 hour prior to TRAIL addition greatly increased cell death more than 80%. Luciferase assay showed TRAIL-induced $NF-{\kappa}B$ transcriptional activity in both cell lines. Electromobility shift assay demonstrated DNA binding complex of $NF-{\kappa}B$ activated by TRAIL and supershift with p65 antibody. $I{\kappa}B{\alpha}$ degradation was proven by western blot. MG132 completely blocked both TRAIL-induced $NF-{\kappa}B$ dependent luciferase activity and DNA binding of $NF-{\kappa}B$. Conclusion: This results suggest that inhibition of $NF-{\kappa}B$ can be a potentially useful strategy to enhance TRAIL-induced tumor cell killing in lung cancer.

In Search of "Excess Competition" (과당경쟁(過當競爭)과 정부규제(政府規制))

  • Nam, II-chong;Kim, Jong-seok
    • KDI Journal of Economic Policy
    • /
    • v.13 no.4
    • /
    • pp.31-57
    • /
    • 1991
  • Korean firms of all sizes, from virtually every industry, have used and are using the term "excessive competition" to describe the state of their industry and to call for government interventions. Moreover, the Korean government has frequently responded to such calls in various ways favorable to the firms, such as controlling entry, curbing capacity investments, or allowing collusion. Despite such interventions' impact on the overall efficiency on the Korean economy as well as on the wealth distribution among diverse groups of economic agents, the term "excessive competition", the basis for the interventions, has so far escaped rigorous scrutiny. The objective of this paper is to clarify the notion of "excessive competition" and "over-investment" which usually accompanies "excessive competition", and to examine the circumstances under which they might occur. We first survey the cases where the terms are most widely used and proceed to examine those cases to determine if competition is indeed excessive, and if so, what causes "excessive competition". Our main concern deals with the case in which the firms must make investment decisions that involve large sunk costs while facing uncertain demand. In order to analyze this case, we developed a two period model of capacity precommitment and the ensuing competition. In the first period, oligopolistic firms make capacity investments that are irreversible. Demand is uncertain in period 1 and only the distribution is known. Thus, firms must make investment decisions under uncertainty. In the second period, demand is realized, and the firms compete with quantity under realized demand and capacity constraints. In the above setting, we find that there is "no over-investment," en ante, and there is "no excessive competition," ex post. As measured by the information available in period 1, expected return from investment of a firm is non-negative, overall industry capacity does not exceed the socially optimal level, and competition in the second period yields an outcome that gives each operating firm a non-negative second period profit. Thus, neither "excessive competition" nor "over-investment" is possible. This result will generally hold true if there is no externality and if the industry is not a natural monopoly. We also extend this result by examining a model in which the government is an active participant in the game with a well defined preference. Analysis of this model shows that over-investment arises if the government cannot credibly precommit itself to non-intervention when ex post idle capacity occurs, due to socio-political reasons. Firms invest in capacities that exceed socially optimal levels in this case because they correctly expect that the government will find it optimal for itself to intervene once over-investment and ensuing financial problems for the firms occur. Such planned over-investment and ensuing government intervention are the generic problems under the current system. These problems are expected to be repeated in many industries in years to come, causing a significant loss of welfare in the long run. As a remedy to this problem, we recommend a non-intervention policy by the government which creates and utilizes uncertainty. Based upon an argument which is essentially the same as that of Kreps and Wilson in the context of a chain-store game, we show that maintaining a consistent non-intervention policy will deter a planned over-investment by firms in the long run. We believe that the results obtained in this paper has a direct bearing on the public policies relating to many industries including the petrochemical industry that is currently in the center of heated debates.

  • PDF

Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service (119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 -)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
    • /
    • v.9 no.2
    • /
    • pp.111-128
    • /
    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

  • PDF

UBVI CCD Photometry of NGC 7790 (NGC 7790의 UBVI CCD 측광)

  • Choi, Dong Yeol;Kim, Hee Soo;Lim, Beomdu;Sung, Hwankyung
    • Journal of the Korean earth science society
    • /
    • v.36 no.7
    • /
    • pp.661-673
    • /
    • 2015
  • UBVI CCD photometry of the intermediate age open cluster NGC 7790 has been obtained using AZT-22 1.5 m telescope (f/7.74) at the Maidanak Astronomical Observatory in Uzbekistan. NGC 7790 contains three ${\delta}$ Cep variable stars including CEa Cas, CEb Cas, and CF Cas. PSF photometry was carried out using IRAF/DAOPHOT for all observations. The total number of stars observed both in V and I filter was 1008 and the limiting magnitude was $V{\approx}22$. To determine atmospheric extinction coefficients and photometric zero points, many blue and red standard stars as well as the standard stars in the celestial equator under various airmass were observed. Photometric data were transformed into the standard Johnson-Cousins' UBVI standard system. From the analysis of UBVI color-magnitude diagram and color-color diagram, the color excess in V and I filter [$E(B-V)=0.58{\pm}0.02$], the selective extinction ratio in V and I filter [$R_V{\equiv}A_V/E(B-V)=3.02{\pm}0.09$] and distance modulus ($V_0-M_V=12.65{\pm}0.10$) of the cluster were determined. The age of the cluster was estimated to be log $age=8.05{\pm}0.05$ [yr] based on the position of these three Cepheid variables in the color-magnitude diagram, the isochrone of the Geneva group ($Ekstr{\ddot{o}}m$ et al., 2012-Z=0.019), and the isochrone of the Padova group (Bressan et al., 2012-Z=0.014) were used to compare each other. Of them, the Geneva models that considered stellar rotation well described the position of ${\delta}$ Cepheid variables in the blue loop. Although they were well consistent with standard period-luminosity relation of ${\delta}$ Cepheid variables, three Cepheid variables in NGC 7790 were, on average, brighter by about 0.5 mag than the absolute magnitude estimated from the mean period-luminosity relation at a given period.

An Estimation of Concentration of Asian Dust (PM10) Using WRF-SMOKE-CMAQ (MADRID) During Springtime in the Korean Peninsula (WRF-SMOKE-CMAQ(MADRID)을 이용한 한반도 봄철 황사(PM10)의 농도 추정)

  • Moon, Yun-Seob;Lim, Yun-Kyu;Lee, Kang-Yeol
    • Journal of the Korean earth science society
    • /
    • v.32 no.3
    • /
    • pp.276-293
    • /
    • 2011
  • In this study a modeling system consisting of Weather Research and Forecasting (WRF), Sparse Matrix Operator Kernel Emissions (SMOKE), the Community Multiscale Air Quality (CMAQ) model, and the CMAQ-Model of Aerosol Dynamics, Reaction, Ionization, and Dissolution (MADRID) model has been applied to estimate enhancements of $PM_{10}$ during Asian dust events in Korea. In particular, 5 experimental formulas were applied to the WRF-SMOKE-CMAQ (MADRID) model to estimate Asian dust emissions from source locations for major Asian dust events in China and Mongolia: the US Environmental Protection Agency (EPA) model, the Goddard Global Ozone Chemistry Aerosol Radiation and Transport (GOCART) model, and the Dust Entrainment and Deposition (DEAD) model, as well as formulas by Park and In (2003), and Wang et al. (2000). According to the weather map, backward trajectory and satellite image analyses, Asian dust is generated by a strong downwind associated with the upper trough from a stagnation wave due to development of the upper jet stream, and transport of Asian dust to Korea shows up behind a surface front related to the cut-off low (known as comma type cloud) in satellite images. In the WRF-SMOKE-CMAQ modeling to estimate the PM10 concentration, Wang et al.'s experimental formula was depicted well in the temporal and spatial distribution of Asian dusts, and the GOCART model was low in mean bias errors and root mean square errors. Also, in the vertical profile analysis of Asian dusts using Wang et al's experimental formula, strong Asian dust with a concentration of more than $800\;{\mu}g/m^3$ for the period of March 31 to April 1, 2007 was transported under the boundary layer (about 1 km high), and weak Asian dust with a concentration of less than $400\;{\mu}g/m^3$ for the period of 16-17 March 2009 was transported above the boundary layer (about 1-3 km high). Furthermore, the difference between the CMAQ model and the CMAQ-MADRID model for the period of March 31 to April 1, 2007, in terms of PM10 concentration, was seen to be large in the East Asia area: the CMAQ-MADRID model showed the concentration to be about $25\;{\mu}g/m^3$ higher than the CMAQ model. In addition, the $PM_{10}$ concentration removed by the cloud liquid phase mechanism within the CMAQ-MADRID model was shown in the maximum $15\;{\mu}g/m^3$ in the Eastern Asia area.

Analysis of the Effect of the Revised Ground Amplification Factor on the Macro Liquefaction Assessment Method (개정된 지반증폭계수의 Macro적 액상화 평가에 미치는 영향 분석)

  • Baek, Woo-Hyun;Choi, Jae-Soon
    • Journal of the Korean Geotechnical Society
    • /
    • v.36 no.2
    • /
    • pp.5-15
    • /
    • 2020
  • The liquefaction phenomenon that occurred during the Pohang earthquake (ML=5.4) brought new awareness to the people about the risk of liquefaction caused by the earthquake. Liquefaction hazard maps with 2 km grid made in 2014 used more than 100,000 borehole data for the whole country, and regions without soil investigation data were produced using interpolation. In the mapping of macro liquefaction hazard for the whole country, the site amplification effect and the ground water level 0 m were considered. Recently, the Ministry of Public Administration and Security (2018) published a new site classification method and amplification coefficient of the common standard for seismic design. Therefore, it is necessary to rewrite the liquefaction hazard map reflecting the revised amplification coefficient. In this study, the results of site classification according to the average shear wave velocity in soils before and after revision were compared in the whole country. Also, liquefaction assessment results were compared in Gangseo-gu, Busan. At this time, two ground accelerations corresponding to the 500 and 1,000 years of return period and two ground water table, 5 m for the average condition and 0 m the extreme condition were applied. In the drawing of liquefaction hazard map, a 500 m grid was applied to secure a resolution higher than the previous 2 km grid. As a result, the ground conditions that were classified as SC and SD grounds based on the existing site classification standard were reclassified as S2, S3, and S4 through the revised site classification standard. Also, the result of the Liquefaction assessments with a return period of 500 years and 1,000 years resulted in a relatively overestimation of the LPI applied with the ground amplification factor before revision. And the results of this study have a great influence on the liquefaction assessment, which is the basis of the creation of the regional liquefaction hazard map using the amplification factor.

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
    • /
    • v.2 no.1
    • /
    • pp.1-21
    • /
    • 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.

  • PDF