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김록영,정구복,성좌경,이주영,장병춘,윤홍배,이예진,송요성,김원일,이종식,하상건 한국토양비료학회 2011 한국토양비료학회지 Vol.44 No.5
A new Korean standard for the determination of Cr(VI) in soils has been officially published as ES 07408.1 in 2009. This analytical method is based on the hot alkaline digestion and colorimetric detection prescribed by U.S. EPA method 3060A and 7196A. The hot alkaline digestion accomplished using 0.28 M Na_2CO_3 and 0.5 M NaOH solution (pH 13.4) at 90~95°C determines total Cr(VI) in soils extracting all forms of Cr(VI), including water-soluble, adsorbed, precipitated, and mineral-bound chromates. This aggressive alkaline digestion, however,proved to be problematic for certain soils which contain large amounts of soluble humic substances or active manganese oxides. Cr(III) could be oxidized to Cr(VI) by manganese oxides during the strong alkaline extraction, resulting in overestimation (positive error) of Cr(VI). In contrast, Cr(VI) reduction by dissolved humic matter or Fe(II) could occur during the neutralization and acidic colorimetric detection procedure, resulting in underestimation (negative error) of Cr(VI). Futhermore, dissolved humic matter hampered the colorimetric detection of Cr(VI) using UV/Vis spectrophotometer due to the strong coloration of the filtrate, resulting in overestimation (positive error) of Cr(VI). Without understanding the mechanisms of Cr(VI) and Cr(III)transformation during the analysis it could be difficult to operate the experiment in laboratory and to evaluate the Cr(VI) results. For this reason, in this paper we described the theoretical principles and limitations of Cr(VI) analysis and provided useful guidelines for laboratory work and Cr(VI) data analysis.
김록영,조민호,위세아 건강보험심사평가원 심사평가연구소 2020 연구보고서 Vol.2020 No.0
As part of coverage expansion plan, the government decided to include brain-related MRI scan into the benefit package, and raised external MRI image decipher service fee for healthcare service providers in an attempt to induce appropriate level of service use. As MRI scan of spine and musculoskeletal system are planned to gradually come into national health insurance package, there is a need for a continued improvement of MRI coverage policy. To enable such improvement, this study aims to provide effectiveness assessment and suggestions for proper management measures. This study analyzed policy effectiveness of health service usage pathway before and after MRI inclusion into the benefit package of national health insurance system. Regarding analysis method, 30-day healthcare service use data of patents who received brain-related MRI scan were structured by episode and analyzed with t-test and Logit, in order to see the difference between before and after the policy implementation. The result showed that the increased decipher authority of specialist physicians led to more MRI image decipher cases of external clinics. As a result of increased MRI image decipher fee, there was an uplift of external MRI decipher cases, when compared to before the policy change. It means that more providers chose to use MRI scan taken by other clinic or hospital, rather than performing another scan at their own facility. The type of providers performing MRI scan was divided into two groups: general/tertiary hospitals, and hospitals and clinics. Policy effect was analyzed by patients' route, and it was shown that different routes had different policy effect. Based on the result, raise of MRI decipher fee was proposed for rational use pattern of healthcare resource, such as getting MRI scan with 3 Tesla MRI at a general or tertiary hospital, and visiting a hospital or clinic to get it deciphered. In order to build and operate an efficient and comprehensive healthcare resource management system, exchange of medical image data should be available more easily and conveniently. Such improvement is expected to contribute to reduction of reduced social cost and stabilization of the National Health Insurance fund.
아동치과주치의 건강보험 시범사업 효과평가 모형개발 -2세부(비용효과 분석 방안)-
김록영,조민호 건강보험심사평가원 심사평가연구소 2021 연구보고서 Vol.2021 No.0
The Ministry of Health and Welfare plans to run the National Health Insurance pilot program of family doctor for pediatric dentistry for 3 years from 2021 in order to improve oral health and reduce dental health gap among children. In order to make evidence-based decision for the implementation of the pilot, evaluation models were required in different perspective, such as level of oral health and cost-effectiveness. This study was conducted to develop a cost-effectiveness evaluation model. Based on performance of previous programs and expert's advise, direction for cost-effectiveness analysis was reviewed, and data collection method and relevant indicators were prepared. Cost-effectiveness analysis application methods were provided, which included Decision Tree and Makov model. Panel Study and other forecasting models were additionally offered, as cost occurs in short term but the benefit of the cost should be analyzed in the mid and long term. Based on the framework for cost-effectiveness evaluation model proposed in this study, the real world data from the pilot should be leveraged to conduct follow up research in order to further develop the cost-effectiveness analysis model and produce regular performance production method in mid and long term.
대설증을 주소로 내원한 다발성 골수종 관련 아밀로이드증 1예
김록영,이재운,이동훈,이준규 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.1
Amyloidosis is a condition of abnormal deposition of extracellular insoluble fibrillar proteins, termed amyloid, in tissue and organs throughout the body. Systemic amyloidosis, consisting of light amyloid protein (AL protein), the spectrum of multiple myeloma and plasmacytoma, is categorized as a primary amyloidosis; secondary amyloidosis consists of an acute phase reactant serum amyloid A protein (AA protein), which is associated with neoplasm. Amyloid involvement of the tongue is almost always secondary to systemic AL amyloidosis. Macroglossia due to amyloid depositions can lead to serious airway obstruction. We report a case of a 68-year-old woman suffering from dyspnea due to macroglossia. She was diagnosed with amyloidosis associated with multiple myeloma.