농어촌 지역의료보험의 정책과제와 전망

문옥륜 서울大學校 保健大學院 1994 보건학논집 Vol.31 No.1

The cost of rural health insurance has in creased 23.5% per annum for the past five years, which is equivalent to two-fold that of the industrial workers health insurance. Those 136 rural health insurance associations have made a surplus of 101 billion won by 1993. However, it is problematic that differences in the power of financial solvency among rural health insurance associations become greater. In fact, 8 rural associations ran financially red in 1993. The rural conditions expect to be aggravated rapidly under the pressure of the Uruguay Round agreement. The eight policy objectives are set to overcome the impending financial problems. This study recommended that: ① The grants-in-aid be provided to the worthy poor rural associations at the end of fiscal year. The worthy poor rural associations have indicated that those rural associations paying the national average amount of contributions, yet making a financial deficit. ② The average net amount of contributions for the rural health insurance be maintained less than that for industrial workers and public officials and private school teachers. It is decided that in the long run the rural farmers and fishmen pay contributions according to their financial ability. ③ The benefit period of 180 days per annum be gradually expanded to 365 days within three and six years. ④ The use of high cost technology such as CT and MRI be included under the benefit package. ⑤ The copayment of the poor be adjusted according to their ability to pay. ⑥ The corresponding preventive health services be included for members of rural insurance like those of other health insurances. ⑦ As to the efficient management, the optimum size of rural health insurance associations be pursued to get the advantage of economy of scale effect. ⑧ A change of payment method be considered for correcting the known disadvantages of fee-for-service payment. The DRGs is an example. Some proposals mentioned above are the same as those made by the National Medical Security Reforming Committee. This study recommends the six stepwise approach to implement the proposals: ① The law be amended in a manner for the government to subsidize rural health insurance for the half of administration costs and that of benefit expenses. About 100 billion won will be reserved from this measure. ② A financial adjustment scheme be developed for the assistance to elderly care. From the scheme, about 70 billion won will be reserved in 1996. ③ Another financial adjustment scheme be added for the financial solvency of the worthy poor association. ④ The corresponding raise of contribution is another potential source in accordance with the raise of insurance benefits. ⑤ (If financially in red still) the organization of a national farmers health insurance is another possibility. ⑥ (Despite these measures deficit financing continuing) the last approach is to switch into the tax system for farmers and fisbmen. The author believes that gradual reform can serve people better health. Thus, a stepwise approach is strongly needed in planning the rural health insurance program.

지역개발 운동과 지역 주민조직 : 日本 川奇市 南部 6개 町內會를 중심으로 (Machizukuri) Movements of the Southern Kawasaki City

문옥표 서울대학교 국제지역원 1993 국제지역연구 Vol.2 No.3

이 논문은 일본 川崎市 남부의 6개 町內會의 사례연구를 통하여 전통적 지역생활조직인 「쵸우나이카이」(町內會)가 1970년대 후반, 80년대初 이래로 일본 전역에 걸쳐 활발히 진행되고 있는 지역활성화의 움직임, 이른바「마찌즈쿠리」운동과 어떠한 관련성을 갖는가를 분석한 것이다. 연구의 목적은 지역개발에 대한 새로운 움직임, 아이디어 들에 대한 町內會의 반응을 통하여 町內會의 성격을 파악하고 나아가 同조직이 갖는 사회변동 및 문화변동의 動因으로서의 가능성을 파악해 보기위한 것이다. 조사지역의「마찌즈쿠리」활동은 1)지역주민조직(町內會), 2)그와는 별도의 조직을 갖는 商店街, 3) 市정부의 職員組合및 4) 靑丘社라고 하는 재일한국인 法人조직 등 4개의 서로 이해관계를 달리하는 집단이 모여 결성한 「오오힌 지구 마찌즈쿠리 협의회」라는 단체를 중심으로 진행되고 있다. 협의회의 공식적으로 천명된 네 가지의 활동목표는 첫째, 노인·여성·어린이를 위한 복지증대 및 治安의 향상, 둘째, 綠地환경의 정비, 셋째, 異文化의 共生, 넷째 주거환경의 개선으로 되어 있다. 이는 환경정비의 목적 외에 특히 외국인 住民의 비율이 높다는 종래의 지역의 否定的 이미지를, 최근 일본사회 전체의 흐름의 하나인 「국제화」의 가장 선진적인 지역으로서의 새로운 긍정적 이미지로 전환시켜 보고자 하는 정치적, 문화적 含意를 안고 있는 것이다. 이와같은 협의회의 의도는 민족문제, 불평등의 문제등에 대하여 매우 진보적인 성향을 나타내고 있는 川崎市 정부로부터 적극적 支援을 받고 있는 반면, 주민조직들은 이러한 변화의 움직임에 대하여 수동적이며 때로는 조직적 반대운동을 펴기도 하는 사실들이 조사결과 밝혀졌다. 이차대전 이후 보다 민주적이고 현대적인 주민조직의 형태가 自治會의 이름으로 등장한 지역들이 있으나 조사지역의 町內會들은 '자발적 시민조직'의 성격보다는 行政補助와 생활의 기본요구를 충족시키는 半官制의 비자발적이며 관습에 따른 의무적 조직의 성격이 강하며 따라서 이 지역의 마찌즈쿠리와 같은 이념적으로 진보적이며, 변화를 지향하는 움직임에 대하여 저항적이며 더우기 복잡한 역사적, 정치적 배경을 갖고 있는 민족문제 등의 개선에 행동의 주체로서 등장할 가능성은 매우 희박하다고 결론지을 수 있다. There are two contrasting interpretations concerning the revival of neighbourhood associations (chonaikai) in postwar Japan. One is to see them as non-voluntary, conventional, obligatory organisation whose functions are essentially those supplementing administrationas during the prewar years. The second view emphasizes a discontinuity between the prewar and postwar characteristics of neighbourhood associations and sees the postwar ones as voluntary citizen's organisation of a modern sort. The difference in interpretations may reflect regional variations, but both arguments seem to need further empirical substantiation. This paper attempts to delineate characteristic features of the institution in their contemporary setting by examining the response of six neighbourhood associations in the southern part of Kawasaki City to the newly arising and ideologically progressive 'town-making'(machizukuri) or 'community revitalisation'(Chiki Katsseika) movement. The machizukuri movement in this area is led by a recently formed citizens' association. The membership of the association includes four main acting groups with conflicting interests: 1) the neighbourhood associations, 2) the merchants' association, 3) the city government employees' union and 4) a Korean Japanese corporation. While basically in agreement with regard to most of the machizukuri programs put forward by the associationsuch as enhancing security and living conditions, environmental improvement, etc., the comprising groups display considerable disagreement with regard to the question of alien residents. But the progressive city government and the Korean Japanese corporation team are very keen on catching up the widespread national-level discourse of 'internationalisation'and turning the hitherto negative image of the region asa backward alien area into a positive one by publicizing the area as one which realises the ideals of 'internationalisation'. It is therefore one of their key strategies to emphasize the existence of aliens and todemonstrate how different ethnic groups can live together in harmony and equality (kyosei) by strengthening the inter-ethnic communication. The neighborhood associations on the other hand adopt a more traditional attitude toward the issue, which assumes an eventual integration of all alien elements into the main stream Japanese culture and are in general opposed to the kind of drastic innovative moves of the new strategy. The case study indicates that the neighbourhood associations in this region largely retains most of their prewar features in terms of the leadership patterns, organisational principles and decision making styles, the features that leave little room for innovation, and it is hence hardly possible to expect them to become a meaningful mobilishing force in the new kind of reform movement.

일본관광의 사회조직: 단체여행의 역사와 문화

문옥표 서울대학교 국제지역원 1997 국제지역연구 Vol.6 No.1

이 글의 목적은 일본인들의 관광행위의 독특한 유형으로 드러나는 단체여행, 집단여행의 역사 및 사회조직적 배경에 대한 분석을 통하여 일본 문화의 일면을 이해해 보려는 것이다. 최근들어 점차 그 비율이 줄어들고 있으며, 특히 젊은층이나 지식층에서는 가능한한 지양(止揚)해 보고자 하는 움직임도 발견되나 그럼에도 불구하고 여전히 일본인들 사이에서는 국내여행이나 해외여행에서나 가족이나 친지단위를 넘어 여행사에 의해 조직되는 단체관광이나 패키지 투어가 가장 보편적 여행유형으로 나타나고 있다. 이 글에서는 먼저 일본인들의 단체여행, 집단여행의 관행은 일찍이 중세때부터 발달한 순례여행에서부터 유래되고 있다는 점과 그러한 순례여행을 가능하게 하였던 오시(御師)와 센타츠(先達)의 역할을 살펴 보았다. 신도신앙과 관련된 종교적 司祭의 일종이었던 이들은 지방을 돌며, 유명 신사나 사찰의 참배객들을 모집하여 목적지까지 안내하고 숙박장소를 제공하는 등 포괄적 여행안내 서비스를 제공하였던 제도로 귀족들을 중심으로 하는 순례여행이 등장하기 시작한 헤이안 시대 말기부터 몇치초에 이르기까지 존재한 제도였다는 점과 또한 주로 이들의 영향으로 각 지역에 조직되었던 종교적 결사체의 일종인 코(講)조직은 특히 토쿠가와시대에 들어 이세신궁을 포함한 유명 신사나 사찰에의 참배영향을 일반민들에게까지 대중화시키는 데 큰 역할을 하였음을 지적하였다. 이어 중세이후 사사참예(寺社參詣)를 위한 여행에서 발전되어 나온 단체여행의 전통이 현대사회의 수학여행, 사원여행, 농협이나 부인회 등 농촌지역사회의 여러 단체들의 여행, 그리고 해외로 나가는 패키지 투어의 형태로 이어지게 되는 역사적 과정을 살피고, 나아가 현대적 단체여행을 조직하고 알선하는 여행업 역시 중세이래 순례여행을 안내하는 체계로 발전되었던 오시·센타츠 제도로부터의 연속선 상에서 이해될 수 있음을 제시하였다. 또한 일본인들에 있어 여행은 개인의 행위라기 보다는 소곡집단의 한 성원으로서의 행위로 인지되는 경우가 많다는 점에 주목하고 그러한 사실을 보여주는 문화적 관행으로 「카도지메(門注連)」, 「카게젠(陰膳)」, 「사카무카에(坂迎)」및 「센베츠(餞別)」와「오미야게(士産, 선물)」의 풍습을 제시하였다. 여행과 관련된 이러한 문화적 관행들은 일본사회에서 집단에의 소곡이 갖는 중요성을 상징적으로 강조하여표현하는 것으로 해석하였는데, 그것은 집단이나 공동체로부터의 일시적 이탈을 의미하는 여행에 대하여 출발할 때와 여행에서 돌아와 집단으로 다시 통합되는 단계를 의식을 통하여 극화하고, 또한 여행 중에도 떠난 사람의 편에서나 남아있는 편에서나 끊임없이 집단과의 관계성을 기억하도록 한다는 것은 결과적으로 집단에의 소속을 재확인하는 기능을 하는 것으로 보았기 때문이다. This paper aims at an understanding of Japanese culture by examining the characteristic features of Japanese touristic behaviour. The focus of study lies with the well-known pattern of Japanese group tourism. Although one may hear some criticism against and a move away from this pattern recently, the patternof travelling in relatively large groups seems to remain a dominant pattern for Japanese tourists both in domestic and overseas journeys. This paper has shown that, historically, the practice of group tourism in Japan has its origin in the middle age tradition of pilgrimage that had first appeared among the aristocrats in the late Heian period and popularised among the commoners during the Edo period. It is also indicated that the highly developed modern tourist business in Japan can be traced back to the comprehensive travel guide system of oshi-sentatsu developed along with this pilgrimage tradition. Later, during the early Meiji period, the institutionalization of regular trips in such modern organizations as schools, firms, agricultural cooperatives and other associations has effectively contributed toward continuation of the dominant travelling pattern as a universal 'rite of passage' and hence an essential part of national culture. While the ostensible purposes of these institutionalized trips are both educational and recreational, they are also believed to strengthen the group solidarity and enrich human relationships. Finally, the heavy ritualization of relationships between those who go out travelling and those who remain behind is noted as another distinct feature of Japanese touristic behaviour, and the customs of kadojime, kagezen, sakamukae, and senbetsu and omiyage are explained in this connection.

韓國現代人體彫刻의 흐름과 表現樣相에 관한 小考

文玉子 호남대학교 1991 호남대학교 학술논문집 Vol.12 No.2

The real situation of sculpture for human body in Korea nowadays is that an incorrect point of view that the man who makes the human body an object of sculpture seems to be regarded a common sculptor is expanded outrageously in a course that recreates an object of human body as one sculpture work due to a lack of original consciousness or an unskilled modelling rather than a viewpoint of criticism not to obtaining an artistic realization. So it develops to the situation that even the students who major the sculpture in the university deny the modelling for the human body that is one of the basic education for sculpture. Thus, in this thesis, I try to make an appropriateness for the human body sculpture undestand by studing the human body sculpture as the object of sculpture and the aspect of human body sculpture through an art history as a human body expression background of sculpture in order to rectify the wrong point of view. As a result that I study the tendency and the expression aspect of modern sculpture in Korea by period from the stage of early introduction to the modern period in an objective view. I recognize the our modern sculpture for the human body that has a long history contains somewhat a standardized tendency due to a formative immitation of Western modern and contempoary sculpture for the human body and the problematic consciousness and the original consciousness is also lacked.

비안와대뇌형 모균증 치험 3례

문영일,김종남,홍순관,이지애,정옥경,김문정 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.3

Rhinocerebral mucormycosis is a well-described fulminant fungal infection that typically presents in a rapidly fulminant manner. This condition is more likely to occur among patient with diabetes mellitus, malignant tumors, who have long-term steroid treatment, or who suffer from some debilitating diseases. We report 3 cases of rhinoorbitocerebral mucormycosis, all suffered from diabetes mellitus. In all 3 cases, endoscopic sinus surgery was done and the antifungal agent(amphotericin B) was administered intravenously, and two patients died. One survivor who had focal extension of paranasal sinus and orbit, required one surgical intervention without orbital exenteration and he is alive without recurrence disease. The severity of the disease is probably dependent upon the gost resistance to the invasion of phycomycetes. Early diagnosis and immediate, effective treatment are the key for cure of the disease.

디지털 제어 방식에 의한 온실의 환기제어 시뮬레이션

문성동,이상옥 三陟大學校 産業科學技術硏究所 2003 産業科學技術硏究論文集 Vol.8 No.2

Heating control system of the greenhouse has been achieved by a simple ON-OFF control method conventionally. It has such disadvantages as decreasing of control accuracy and cycling of control response induced by- wide dead band. To solve these problems of OK-OFF control. serial evaluations for establishment of mathematical model of the heating control system of greenhouse, identification of the recursive model, analysis of characteristics of Proportional(P) control, Proportional Integrated Derivative(PID) control and Model Reference Adaptive Control(MRAC) based on digital control methods. respectively. and simulation and evaluation of the investigated control system were carried out. A computer system was used for measuring the weather condition and controlling the power devices. The experimental greenhouse consisted of three gutter-connected round roof. covered with two layer polyethylene film, and equipped an air-heater with an oil burner.

濟州道 一部地域의 絲狀蟲症患者와 象皮病患者에 對한 學的調査 및 Spatonin에 依한 集團化學療法의 臨床報告

文玉綸 서울大學校 保健大學院 1968 公衆保健雜誌 Vol.5 No.2

Filariasis survey was carried out on 1107 subjects of 3 villages located in southern county of Che Ju Do from June to October of 1968. Mass chemotherapy with spatonin (Diethylcarbamazine) on 208 microfilaria positive cases was followed after the survey. The summarized results are as follows: 1. Epidemiological characteristics of microfilaria positives and elephantiasis patients. Microfilaria rates varied by areas with average of 20.9% ranging from 17.3% to 27.1%. Distribution of microfilaria rate by sex did not show any significant difference, however, the distribution of microfilaria rate by age showed two peaks, one for 21-30 years and the other for 41-50 age group. For the remarkable dropped rate for 31-40 years age group, more studies may be necessary to give explanations. The range of microfilaria counts per 40㎣ of blood (density) varied widely from 1 to 788, although the most of microfilaria positives (40%) had less than 25 Mf (microfilaria) per unit of blood. Also the microfilaria density showed interesting correlation between Mf. rate and the density by villages; where the rate was high, the density was proportionately high. The survey by family unit revealed that 40% (average) of total households surveyed had Mf positives, and 80% of positive households had one or two positive family members. On the survey of clinical filariasis, 41 of 1107 subjects were found to have elephantiasis. Female showed predominantly higher rate (2.2 times) compared with that of male. The distribution by age showed definite tendency of increasing rate by increasing age; in more than 80% of the cases, the elephantiasis appeared after 20 years of age, even though the earlest case was 14 years old girl. Sites for elephantiasis were found in 75% on lower extremities, 5% on upper extremities and 20% on both extremities. Erythematous swellings of extremities accompanied by fever seemed to occur once or twice annually. Some contributing factors for the episodes seemed to be related to over exhaustion and/or injuries. 2. Mass treatment with spatonin, its efficacy and side reactions. Mass chemotherapy with spatonin on 208 microfilaria positives gave all excellent efficacy according to the results of blood smear immediately after the last dose of the drug; four experimental groups (by village) treated with 6mg of spatonin/kg body weight every day, every other day for 6 doses, same amount of the drug 6mg/kg of b.w. every other day for first 2 doses and every day for rest of doses, and 3mg/kg of b.w. every other day for 14 doses, showed similar results (92.6%, 91.2% and 88.4% of rate turning to microfilaria negative) for 6mg/kg of b.w. groups regardless of way of administration except 3mg/kg of B.W. group, which had much inferior efficacy than the another groups(only one of five became negative). Six doses of 6mg/kg b.w. spatonin may be enough to turn the positives to negative, although long term follow up study is strongly desired. The side reactions due to the drug was relatively severe especially after the first and second doses. More frequent symptoms were anorexia, fever, headache, joint pain, and dizziness, which became milder when the drug was administered every other day. From this study, it was tentatively concluded that filariasis is one of important endemic diseases in the area studied. and spatonin could be a potent drug for control of filariasis when administered properly.

가정의례에 나타난 한국인의 예절 : 전통관혼상제를 중심으로

문옥표 연세대학교 인문과학연구소 1997 人文科學 Vol.76-77 No.-

단풍취 분획물이 알콜대사효소에 미치는 영향

문형인,지옥표,문세훈,신말식 성균관대학교 약학연구소 1998 成均藥硏論文集 Vol.10 No.1

Spraque-Dawley계 수컷랫트에 계통분획한 단풍취의 각 분획물을 경구투여하고 혈청 ethanol농도와 간의 ADH활성에 미치는 효과를 검색 추적한 결과 알코올대사를 촉진시키는 성분은 주로 에탄올가용부에, 억제시키는 성분은 에탄올불용부에 주로 존재함을 추정할 수 있었고 현재 활성성분을 분리중에 있다.(1998년 9월 25일 접수, 1998년 10월 14일 수리) Effects of organic solvents fraction from Ainsliaea acerifolia ethanol extract on alcohol metabolism in rats were examined and the results were as follows: Ethanol souble fraction, after a single oral administration to rats, was found to cause a significant decrease in the serum ethanol concentration as well as enhancement of liver cytosolic alcohol dehydrogenase(ADH) activity, on the other hand, the fraction insouble in ethanol was found to cause an increase ethanol concentration in the blood and inhibit ADH activity.

학교보건조직의 강화방안

문옥륜 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.1