• International Journal of Advanced Culture Technology
• /
• 제8권2호
• /
• pp.1-5
• /
• 2020

As the world gradually advances to an aging society, the quality of human life is valued. Among them, 'quality of sleep' is very closely related to quality of life. Recently, Korea expanded health insurance coverage for "sleep disorders". Particularly, as the number of sleep multiple tests and prescriptions for sleep aids has increased rapidly, much attention has been focused on the related medical service environment. Therefore, this study looked at an in-depth interview of 11 hospitals to see what treatment delivery system is being established when the government applies health insurance for 'sleep disorders'. In conclusion, the organizations with the most average number of sleep polyp tests per day were found to have more sleep polyp labs (hardware) and more full-time specialists. Also, the polysomnography lab (hardware) and the specialist's full-time status (software) did not necessarily result in a "positive pressure regulator prescription" that can solve "sleep apnea" caused by "sleep ailments". Rather, it was found that the number of days of sleep multiple laboratories (hardware), the number of full-time specialists (software) or the specialty majors (software) had a greater impact. In particular, the higher the specialist's full-time personnel (software) index (=6.000), the higher the sleep-inducing agent prescription rate(=1.000), and the lower the specialist's full-time personnel (software) index (=1.000), the higher the sleep-inducer's prescription rate(= 0.010) Was low. In addition, even if the professional full-time personnel(software) index was the same (=1.000), the hospital type was lower as it was closer to the public hospital(=0.067) and higher at the specialized hospital (= 0.933). In the case of university hospitals, when the full-time specialists (software) are in the same condition (= 1.000), the frequency of use of the sleep laboratory (=1.000) and the sleep test rate (= 1.000) were all the same.

• 한국임상약학회지
• /
• 제29권2호
• /
• pp.79-88
• /
• 2019

Backgrounds: Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) increased prevalence and economic burden. Objectives: This study aimed to investigate drug use pattern in IBD patients in a real world. Methods: National Health Insurance claim data from 2010 to 2014 were used in this population-based study. All IBD patients diagnosed during study period were enrolled. IBD medications included 5-aminosalicylic acid (ASA), glucocorticoid, immunomodulator and anti-tumor necrosis factor-${\alpha}$ agent(anti TNF-${\alpha}$). Growth rate of IBD prevalence, prescribed drug classes, duration of drug therapy and medication cost were analyzed. Number and percentage of patients for categorical variables, and mean and median for continuous variables were presented. Results: Total numbers of patients were 131,158 and 57,286 during 5 years, and their annual growth rate were 3.2 and 5.7% for UC and CD. UC and CD were prevalent in the 40-50 (41.2%) and 20-30 age groups (36.0%). About 60% of IBD patients was prescribed any of medications. 5-ASA was the most frequently prescribed, followed by corticosteroid and immunomodulator. Anti TNF-${\alpha}$ use was the lowest, but 5 times higher than UC in CD. Combination therapies with different class of drugs were in 29% for UC and 62% for CD. Mean prescription days per patient per year were 306 and 378, and the median medication cost per patient per year was KRW 420,000 (USD 383) and KRW 830,000 (USD755), for UC and CD, respectively. Conclusions: Increasing prevalence of IBD requires further studies to contribute to achieve better clinical outcomes of drug therapy.

• Journal of Periodontal and Implant Science
• /
• 제38권2호
• /
• pp.125-134
• /
• 2008

Purpose: Bone morphogenetic protein (BMP) is a potent differentiating agent for cells of the osteoblastic lineage. It has been used in the oral cavity under a variety of indications and with different carriers. However, the optimal carrier for each indication is not known. This study evaluated the bone regenerative effect of rhBMP-2 delivered with different carrier systems. Materials and Methods: 8 mm critical-sized rat calvarial defects were used in 60 male Sprague-Dawley rats. The animals were divided into 6 groups containing 10 animals each. Two groups were controls that had no treatment and absorbable collagen membrane only. 4 groups were experimentals that contained rhBMP-2 only and applied with absorbable collagen sponge($Collatape^{(R)}$), $MBCP^{(R)}$, Bio-$Oss^{(R)}$ each. The histological and histometric parameters were used to evaluate the defects after 2- or 8-week healing period. The shape and total augmented area were stable in all groups over the healing time. Results: New bone formation was significantly greater in the rhBMP-2 with carrier group than control group. rhBMP-2/ACS was the highest in bone density but gained less new bone area than rhBMP-2/$MBCP^{(R)}$ and rhBMP-2/Bio-$Oss^{(R)}$. The bone density after 8 weeks was greater than that after 2 weeks in all groups. However, rhBMP-2 alone failed to show the statistically significant difference in new bone area and bone density compared to control group. Also $MBCP^{(R)}$ and Bio-$Oss^{(R)}$ particles remained after 8 weeks healing period. Conclusion: These results suggest that rhBMP-2 with carrier system is an excellent inductive agent for bone formation and we can use it as the predictable bone tissue engieering technique. Future study will likely focus on the kinetics of BMP release and development of carriers that is ideal for it.

• Journal of Preventive Medicine and Public Health
• /
• 제35권1호
• /
• pp.41-48
• /
• 2002

Objectives : To review the drug prescription pattern of antiulcerative agents for elderly inpatients, Methods : The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1594. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription, Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. Results : The number of patients prescribed antiulcerative agents was 1,059 (64,9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by $H_2$ antagonist (16.0%), Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the fetal omeprazole prescriptions. Conclusions : Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulceratiye agents.

• 대한통합의학회지
• /
• 제8권4호
• /
• pp.79-92
• /
• 2020

Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

• Clinical and Experimental Pediatrics
• /
• 제45권8호
• /
• pp.1033-1037
• /
• 2002

Doxylamine is an antihistamine of the ethanolamine class. It is used primarily as a sleep-inducing agent. Clinicians should be aware of the complications in rhabdomyolysis patients who ingest doxylamine succinate and over-the-counter antihistamines. The easy availability of these substances increases the potential not only of intentional overdose by adults but also of inadvertent ingestion by children. Prompt intervention and careful assessment of renal function, urinary output, and serum creatine kinase levels may represent the difference between an uncomplicated and acute renal failure. Recognition of the potential for rhabdomyolysis and institution of vigorous treatment may prevent acute renal failure in patients who have taken an overdose of the drug. A 14-year-old male was found to have hematuria and oliguria. Evaluation of the patient revealed myoglobinuria, and a creatine kinase(CK) level of 117,563 IU/L. He was recovered by massive fluid administration, urine alkalization and mannitol infusion. We report a case of a suicide attempt in a child where ingestion of the doxylamine complicated by non-traumatic rhabdomyolysis with brief review related literatures.

• 보건행정학회지
• /
• 제26권2호
• /
• pp.125-134
• /
• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• 디지털융복합연구
• /
• 제13권4호
• /
• pp.101-114
• /
• 2015

본 논문의 연구목적은 콜센터 상담사의 이직요인을 학문적 실무적 관점에서 고찰하고 이에 대한 완화방안으로 콜센터 서비스에 스마트워크 기술과 상사지원 서비스의 융복합이 상담사의 직무만족에 정의 효과를 나타내는지 여부를 검증하는데 있다. 본 연구는 상담사의 이직요인에 대한 선행 연구의 이론적 배경을 토대로 스마트워크 효과와 상사지원효과를 조절변수로 하는 연구모델과 가설을 설정하고, 금융분야의 콜센터 상담사를 대상으로 설문 조사를 실시하였다. 가설검증을 위하여 자료 분석은 SPSS 20.0을 사용하였으며, 영향관계 검증을 위해서는 다중회귀분석, 조절효과 검증을 위해서는 위계적 회귀분석을 사용하였다. 실증분석 결과 상담사의 개인적 이직요인에 대한 스마트워크 조절효과와 업무적 이직요인에 있어 업무 과부하는 상사지원이 상담사의 직무만족에 유의한 정(+)의 조절효과가 있는 것으로 나타났지만, 직무탈진감에 대한 상사지원 조절효과는 부(-)의 효과가 나타났다. 이는 상담사의 속사정을 모르는 지나친 상사의 지원은 오히려 상담사 개인의 자존심에 역효과를 주어 이직율 완화에 부정적인 영항을 줄 수 있다는 점을 의미할 수 있다.

• 지능정보연구
• /
• 제12권2호
• /
• pp.67-81
• /
• 2006

현재의 웹이 HTML을 바탕으로 인간 사용자와의 인터페이스에 초점을 맞추고 있는데 비하여, 차세대 웹은 XML 및 XML 기반 각종 표준들을 바탕으로 소프트웨어 에이전트간의 상호작용에 초점을 맞추어 나가고 있다. 차세대 웹에서 소프트웨어 에이전트의 두뇌 역할을 수행하기 위하여 추론엔진은 차세대 웹의 표준 언어인 시맨틱 웹 - (Semantic Web)을 충실히 이해할 수 있어야 한다. 이를 위한 기초 작업의 일환으로 OWL(Web Ontology Language) 과 RuleML(Rule Markup Language)을 조합한 SWRL(Semantic Web Rule Language)이 W3C에 제안된 바 있다. 본 연구에서는 SWRL을 규칙 표현 방법으로 사용하고, OWL을 사실 표현 방법으로 사용하는 역방향 추론엔진인 SMART-B(SeMantic web Agent Reasoning Tools -Backward chaining inference engine)를 개발하고자 하였다. 이를 위하여 SWRL 기반 역방향 추론을 위한 요구 기능을 분석하고, 기존 역방향 추론 알고리즘에 차세대 시맨틱 웹의 요구 기능을 반영한 역방향 추론 알고리즘을 설계하였다. 또한, 유비쿼터스 환경에서의 각종 플랫폼간의 독립성과 이식성을 확보하고 기기간의 성능 차이를 극복할 수 있도록 사실 베이스 및 규칙 베이스의 관리도구와 역방향 추론 엔진 등을 Java 프로그래밍 언어를 이용하여 단위 컴포넌트의 형태로 개발하였다.

• 한국건축시공학회지
• /
• 제9권1호
• /
• pp.103-109
• /
• 2009

Strong winds according to global warming cause the increase of the frequency and the repair cost of damaged roofs. In the United States, Factory Mutual Insurance Company(FMIC) promotes the roofing design that resists heavy wind-load, as the means of strict criteria. This fact reveals that more durable roofing system will be also required in Korea. Therefore, this study aims at developing such a system with high wind-resistance performance using Thermoplastic polyolefin(TPO) and Electromagnetic induction technology(EIT) than the previous systems. The system presented in this study consists of 4 main devices as follow; 1) a disc to fix sheets for TPO & EIT method, which can conduct structural design according to site condition, such as region, building height, and wind load. 2) a nail to have about 30% stronger lifting-up capacity than that of the previous nail. 3) a disc to fix sheets, which has triangle protuberance not to damage sheets in the repeatable wind load, and 4) a electromagnetic induction device to combine a disc and a sheet by heating uniformly and quickly adhesive agent on the disc. The results of mock-up test illustrate that the system provides wind-resistant performance to achieve satisfactorily the structural design criteria of FMIC. In addition, the system is faster, chipper, and easier than the existing system, and is expected that this roofing system can be applied to the rehabilitations of an existing as well as a new building.