• 대한예방한의학회지
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• 제17권1호
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• pp.65-76
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• 2013

Objectives : Aim of this study is to contribute to establishment of the Traditional Korean Medicine (TKM) policies in the future. Final assessment for 12 of the forecasting projects was carried out on the TKM policies that deduced by professionals in 1996 whether or not to realize in 2013. Methods : We investigated governmental and private research projects, reports and papers, and laws and systems on the forecasting projects. We reviewed them through the Traditional Korean Medicine Information Portal OASIS (http://oasis.kiom.re.kr), Korean studies Information Service System (KISS) (http://kiss.kstudy.com/) and DBpia (http://www.dbpia.co.kr/), Akomnews(http://www.akomnews.com/), THE MINJOK MEDICINE NEWS(http://www.mjmedi.com/), Ministry of Government Legislation(http://www.law.go.kr/). Results : Of the 12 forecasting projects, five were judged as 'realization', four were as 'partial realization' and three were as 'un-realization', The realization rate was 75.0%. Three un-realized projects included the TKM insurance coverage for various herbal medicines, leadership secure on medical technicians and commercialization of the TKM managing system on senior medicare policy. Realization of the future forecasting TKM policy projects was decided depending on conditions such as the importance, domestic capability levels, principal agents, methods and restrains. Conclusions : Continuous studies and new developed forecasting projects for the TKM policies will be required to realize the projects in the future.

• 한국임상약학회지
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• 제29권2호
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• pp.109-114
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• 2019

Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease that manifests as joint damage or athletic disability via sustained inflammation of the synovial membrane. The risk of cardiovascular disease (CVD) is higher in RA patients. This study aimed at evaluating the association between CVD comorbidities and RA by comparing a pharmacotherapy group with a non-pharmacotherapy group. Methods: Patient sample data from the Health Insurance Review and Assessment Service (HIRA-NPS-2016) were used. Inverse probability of treatment weighting (IPTW) using the propensity score was used to minimize the differences in patient characteristics. Logistic regression analysis was used to evaluate the risk of CVD comorbidities. Results: The analyses included 1,207,213 patients, of which 33,122 (2.8%) had RA. The odds ratios (OR) of CVD comorbidities were increased in RA patients; ischemic heart disease (IHD: OR 1.75; 95% CI 1.73, 1.77), cerebral infarction (CERI: OR 1.28; 95% CI 1.26, 1.30), hypertension (HTN: OR 1.44; 95% CI 1.43, 1.45), diabetes mellitus (DM: OR 2.04; 95% CI 2.03, 2.06), and dyslipidemia (DL: OR 3.49; 95% CI 3.47, 3.51). The ORs of IHD, CERI, HTN, and DM in the traditional DMARD and biologic treatment groups were decreased, compared with those in the non-pharmacotherapy group. Conclusions: Thus, CVD risk was higher in RA patients, considering age, sex, and socioeconomic status. Appropriate pharmacotherapy could decrease the risk of CVD comorbidities in RA patients.

• 지능정보연구
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• 제12권2호
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• pp.67-81
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• 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.

• 한국임상약학회지
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• 제28권3호
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• pp.188-193
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• 2018

Background: Previous studies have noted that the simultaneous use of sulfonylureas and antimicrobials, which is common, could increase the risk of hypoglycemia. In particular, an age of 65 years or older is a known risk factor for sulfonylurea-related hypoglycemia in hospitalized patients. Therefore, we performed this study to determine the potential risk of hypoglycemia from the concurrent use of antimicrobials and sulfonylureas. Methods: We performed a cross-sectional study on the National Health Insurance Service-National Sample Cohort from 2013. The eligibility criteria included patients of 65 years of age or older taking a sulfonylurea with 25 different antimicrobials. Different risk ratings of severity in drug-drug interactions (potential DDIs), level X, D, or C in Lexi-$Interact^{TM}$ online, and contraindicated, major, or moderate severity level in $Micromedex^{(R)}$ were included. SAS version 9.4 was used for data analysis. Results: A total of 6,006 elderly patients with 25,613 prescriptions were included. The largest age group was 70 to 74 (32.7%), and 39.7% of patients were men. The mean number of prescriptions was 4.3 per patient. The most frequently used antimicrobials were levofloxacin (6,583, 25.7%), ofloxacin (6,549, 25.6%), fluconazole (4,678, 18.0%), and ciprofloxacin (2,551, 9.8%). Among sulfonylureas, glimepiride was prescribed most frequently, followed by gliclazide, glibenclamide, and glipizide. Conclusion: Of the antimicrobials with a high potential of hypoglycemia, levofloxacin, ofloxacin, fluconazole, and ciprofloxacin were used frequently. Thus, the monitoring of clinically relevant interactions is required for patients concurrently administered sulfonylureas and antimicrobials.

• Journal of Preventive Medicine and Public Health
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• 제40권3호
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• 한국산업보건학회지
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• 제30권2호
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• pp.99-108
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• 2020

Objectives: This study aimed to compare the regulatory systems for laboratory safety and health management between Korea and Germany and discuss the implications. Methods: Laboratory safety and health regulations for legal enforcement and relevant technical guidelines in Korea and Germany were reviewed. Results: Lab safety and health management is enforced by the Act on the Establishment of Safe Laboratory Environment in Korea. Most provisions focus on supervisory control, that is, the principal's liability is emphasized. In addition, there is a lack of laboratory-specific procedures for safety and health management in the act since it is stipulated that other relevant regulations apply to some technical contents. Non-compulsory technical guidelines for lab safety and health management are also provided by the Korea Occupational Safety and Health Agency (KOSHA) in order to enable researchers to follow safe procedures. There is no independent regulation for lab safety and health in Germany, and it is also governed by several regulations. The German Social Accident Insurance Institute provides technical guidelines on lab safety and health, and these contain more specific content to allow them to be followed more easily compared to the KOSHA guidelines. The most remarkable differences between the regulation of each country were contents of the risk assessment and specific protect measures from hazardous agents. Conclusions: Regulatory control is an essential way to prevent accidents, but it is more important to create an environment in which all stakeholders, including individual lab members, are allowed to participate actively in safety and health management activities.

• 대한건축학회연합논문집
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• 제20권6호
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• pp.121-129
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• 2018

The present study analyzed what policies are being executed for deteriorated apartments in Japan and what characteristics each policy had in order to examine policy direction and implications for the improvement of vitalization of remodeling business of deteriorated apartments in Korea. The study results are as follows. Japan recognized social problems of deteriorated apartments and pushed forward a national level remodeling actively by preparing financial support of central government and supporting plan by city and province. First, Japan maintained initial performance of buildings through phased maintenance for deterioration of buildings and aimed to reduce environmental load and maintain asset values of buildings through enlarging durability of buildings by responding to lifestyle according to social changes. To this end, they promoted the long life of buildings through the establishment of systematic long term repair plan from the stage of moving in the buildings. Second, in order to reduce the risk of remodeling projects, they prepared an environment where business could be carried out with an easy mind in various aspects by introducing remodeling business registration system and large scale repair construction defect insurance system. Third, they reduced economic burden of main agents of remodeling business with tax preferential treatment and financial support policies. Fourth, they have established remodeling support system based on overall social issues and connected it with social effect that could be obtained through this. The remodeling policies of Japan were carried out in the direction of solving social problems and considering economic aspect rather than just improving individuals' residence environment.

• 대한통합의학회지
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• 제8권4호
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• pp.79-92
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• 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.

• 한국임상약학회지
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• 제33권2호
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• pp.113-121
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• 2023

Background: Globally, the number of patients with aspergillosis is increasing, and the mortality rate remains high. This study aimed to investigate prescribing patterns of antifungal drugs for patients with aspergillosis in South Korea using real-world data. Methods: This retrospective cross-sectional study was performed using National Patient Sample (NPS) data collected by the Health Insurance Review and Assessment Service (HIRA) during 2011-2020. The use of antifungal drugs in patients with aspergillosis was investigated. Results:A total of 1374 patients were identified: 333 patients with invasive pulmonary aspergillosis (IPA) (24.2%), 436 patients with other PA (31.7%), 73 patients with other forms of aspergillosis (5.3%), and 532 patients with unspecified aspergillosis (38.7%). The odds of receiving an antifungal prescription were higher for IPA than for other PA (aOR, 0.233; p<0.001), and higher for hematologic malignancies than for respiratory disorders other than cancer or infections (aOR, 10.018; p<0.001). During each hospitalization period, 56.1% (97/173) and 6.4% (11/173) of IPA hospitalizations received voriconazole and itraconazole monotherapy, respectively, whereas 44.3% (27/61) and 27.9% (17/61) of other PA hospitalizations received itraconazole and voriconazole monotherapy, respectively. Among outpatients with IPA, 67.5% (85/126) and 26.2% (33/126) received voriconazole and itraconazole alone, respectively, whereas among outpatients with other PA, 86.1% (68/79) and 12.7% (10/79) received itraconazole and voriconazole alone, respectively, during the year. Conclusion: In Korea, voriconazole monotherapy was preferred in IPA inpatients, and itraconazole monotherapy was preferred in other PA inpatients. In the ambulatory care settings for IPA and other PA, itraconazole monotherapy was preferred.

• 농촌의학ㆍ지역보건
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• 제22권1호
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• pp.1-18
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• 1997

본 조사는 농촌지역 농업종사자들의 건강진단 수검실태를 파악하여 이들을 위한 건강관리의 필요성을 고취하기 위해 실시하였다. 1996년 8월에 대구시 인근 1개군의 8개면에 거주하는 농협조합원 및 18세 이상 성인가족을 대상으로 사전에 훈련받은 의과대학생들이 직접 가구를 방문하여 면접조사를 실시하였다. 면접완료 인원은 751명으로서 남자가 314명(41.8%), 여자가 437명(58.2%)이었다. 이들 중 전업으로 농사일을 가끔 하는 경우가 184명(24.4%), 전혀 하지 않는 경우가 206명(27.3%)이었다. 농부증 양성률을 전체적으로 응답자 745명 중 171명(23.0%)이었는데 전업농이 361명 중 84명(23.3%), 비전업농이 384명중 88명(22.9%)으로서 두 군간에 차이가 없었으며 남자가 314명 중 51명(16.2%), 여자가 431명 중 120명(27.8%)으로서 여자가 남자에 비해 유병률이 높았다(p<0.01). 농약을 직접 살포하는 농민288명 중 113명 (39.2%)이 최근 1년간 농약중독과 관련된 증상을 경험한 적이 있었으나 의료기관을 방문한 경우는 증상경험지 중에서 18명(15.9%)에 지나지 않았다. 농약취급에 관한 교육을 직접 받은 적이 있는 사람은 응답자 285명 중 70명(24.6%)이었는데 피교육 경험과 농약살포시 보호구 착용간에 유의한 관련성이 있었다.(p<0.001). 당해년 및 작년의 건강진단 수검률은 응답자 736명(62.6%), 유료검진 수검자가 105명(37.4%)이었다. 유료검진의 비용은 10만원에서 30만원 미만이 45.7%를 차지하였고 30만원 이상도 11.4%가 되었다. 성인병 검진은 533명 중 124명(23.3%)이 받았는데 전업농의 수검률이 304명 중 84명(27.6%)으로서 비전업농의 229명 중 40명(17.5%)에 비해 유의하게 높았다(p<0.001). 성인병 검진을 하지 않으려는 221명의 이유는 '몸이 건강하므로'가 76명(34.4%)으로 가장 많았고 '귀찮아서'(48명, 21.7%), '도움이 안될 것 같아서'(25명,11.3%) 등의 순이었다. 지역의 보피보험자와 직장 및 공교보험 피부양자의 건강진단에 대한 필요성에 대한 생각은 651명 중 180명(27.6%)이 '꼭 필요하다'고 하였고 1년에 한번씩 정기적 무료검진을 해 준다면 256명(39.3%)이 '꼭 하겠다'고 하였다. 지역의료보험에 들어있는 193가구의 월 의료보험료는 2만~3만원 미만(66가구,34.2%), 1만-2만원 미만(51가구, 26.4%), 3만-4만원 미만(40가구, 20.7%) 등의 순이었는데 지역의 보피보험자 340명 중 263명(77.4%)이 매우 비싸다고 생각하였으며 45명(13.2%)이 조금 비싸다고 하였다. 농촌지역의 농업종사자들은 농약 등의 유해물질에 폭로되고 소득수준에 비해 도시주민이나 산업체 근로자보다 상대적으로 더 많은 보험료를 내면서도 산업안전보건법의 적용 대상이 되지 않아 일반 주민과 마찬가지로 40세 이상에 대해서 격년제로 실시하는 성인병 검진의 혜택밖에 보지 못하고 있다. 그나마 건강진단의 필요성에 대한 인식에 비해 성인병 검진의 수검률은 매우 낮은 반면 검진수검자 중 유료검진 수검자가 3분의 1이 넘어 무료 검진에 대한 홍보가 미진함을 알 수 있었다. 따라서 기존 성인병 검진 등 보건예방 사업의 활성화와 어울러 농업종사자들에 대해 산업체의 유해물질 폭로 근로자에게 제공되는 특수 건강진단과 같은 별도의 건강관리 시스템을 개발하는 것이 필요하다고 생각된다.