국가정신보건정책안의 우선 순위에 관한 전문가 설문조사

신영전,남정현,유원섭,이선영,유주영 漢陽大學校 精神健康硏究 2000 精神健康硏究 Vol.19 No.-

일부 병원에서의 입원비 본인부담양상

신영전,유원섭,하헌영,정설희 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1

The purpose of this study was to estimate the proportion of user charges out of total treatment costs and to investigate the occuring status of the charge of non-benefit service. The data were collected from 6 hospitals in 3 cities (Seoul 2, Incheon 3, Shihung 1), which containing 1,752 discharge-bills of discharged patients insured by health insurance. The data were analyzed after standardization of the items of non-benefit services. The result are as follows; 1. the average percent of the cost-sharing of discharged patients was 38.1%(benefit : 15.5%, non-benefit : 22.6%) and the proportion of the cost-sharing due to non-benefit services was greater than that due to benefit services. 2. The occurrence rate and the occurred number of non-benefit services were different among hospitals and showed characteristic occurrence rate in individual hospitals. 3. In acute appendicitis, the characteristics of the occurrence rate and the occurred number of non-benefit services by individual hospitals was similar to those of hospitals. It suggest that the hospitals intentionally applied non-benefit item to patients in order to increase their profit. These findings suggest that the burden of cost-sharing is still high especially due to non-benefit services, so it is necessary to extend the coverage of insurance benefits and to develop management system for the appliance of non-benefit services. Regarding the discharge-bill, all service charges should be included in the bill.

도시가계의 소득계층별 과부담의료비 실태

이원영,신영전 한국사회보장학회 2005 사회보장연구 Vol.21 No.2

이 연구는 가계소득 중 일정기준치(10-30%) 이상의 의료비를 부담하는 경우를 과부담의료비 지출(Catastrophic Health Expenditure)로 정의한 후, 제8차 (1998년~2002년) 도시가계조사 원자료를 이용하여 과부담의료비 가구들의 의료비가 전체의료비에서 차지하는 비중과 소득계층별 가구당 월평균 의료비(연간 3개월 이상 보고한 경우) 및 구성요소별 비중, 그리고 소득계층별 과부담의료비 지출 가구의 발생율을 연도별로 파악하였다. 또한 연도별 자료를 통합하여 일반화추정방정식(GEEs)에 의해 소득계층간 그 발생률 및 관련 요인을 분석하였다. 분석결과, 전체가구 대비 과부담의료비 지출 가구 의 규모(2.0-11.8%)에 비해 이들 가구들이 지출한 의료비가 전체의료비에서 차지하는비중(10.9-39.2%)이 상대적으로 높았으며, 동일한 과부담의료비 지출이지만 가구당 월평균 의료비의 크기는 저소득층이 고소득층 보다 통계적으로 유의하게 낮았다(p<0.05). 또한, 1998년에서 2002년사이 과부담의료비 지출가구의 발생률은 최하위소득계층(I)에서 1.5~l.9배로 다른 상위소득계층들에 비해 상대적으로 큰 폭으로 증가하였다 소득계층간 과부담의료비 지출 가구의 발생위험비는 가구소득 최하위소득계층(I)이 최상위소득계층(Ⅴ)에 비해 관련 요인 보정 전(1.39~2.02배), 보정 후(1.13~1.84배)모두 통계적으로 유의하게 높았다(p<0.05). 과부담의료비지출 가구의 발생은 가구원이적고 노인가구원이 많은 가구에서 유의하게 높았다(p<O.05). 과부담의료비의 발생은 한 가족에게는 빈곤화를 야기할 수 있는 경제적 부담이고, 국가에게는 의료보장의 재정악화로 이어질 수 있는 중요한 문제이다. 따라서 이들 과부담의료비 지출 가구에 대한 현황을 구체적으로 파악하고 집중적으로 관리할 필요가 있다. 더욱이 최근 5년간 저소득층 중 과부담의료비지출 가구수가 고소득층에 비해 더 빠르게 증가하고 있어 저소득층의 의료보장에 대한 추가적인 지원이 필요한 것으로 보인다. 특히 저소득계층의 과부담의료비 지출을 줄이기 위해서는 노인 가구원이 많은 가구들에 대한 지원이 우선적으로 이루어져야 할 것이다. This study defined `Catastrophic Health Expenditure (CHE)' as spending more than some pre-specified percent (10?30%) of an urbanite's household income on health care. Their total expenditure and the monthly mean expenditure outlay per household among income groups were analyzed together with their incidence during the period between 1998 and 2002. Additionally, we have identified influencing factors on their frequency of healthcare requirements by using the generalized estimating equations (GEEs) to account for the correlation between observations in generalized linear models. The data that we are using were taken from the 1998 -- 2002 Urban Household Expenditure Surveys. The results of this study show that the ratio (10.9?39.2%) of health care costs of the households with catastrophic health care expenditures to the total households' healthcare expenditures were higher than the proportions (2.0--11.8%) of total households They were the same cases, however the monthly mean health expenditure per household was significantly less in the poor(p<0.05). The incidence rates in the lowest income group were increased 1.5?1.9 times between 1998 and 2002. But, on the other hand, the other groups did not increase to that extent. Odds ratios of its incidence rate were significantly higher in only the lowest income group compared to the highest income group in both before (1.39?2.02, p<0.05 ) and just after that (1.13?1.84, p<0.05). The less family members there were with more of them being elderly, the higher the odds ratios of their incidence rates. Incidences of catastrophic health care expenditure may be potential things that contribute to the deficit of the national budget for health security. Additionally it is a financial burden that causes the poor to live in impoverishment. Consequently incidences of catastrophic health care expenditures need to be thoroughly investigated and more closely managed. As a priority, health security policies need to be developed that guarantee health coverage for the lowest income groups that have more elderly family members.

식도를 포함한 전위장관을 침범한 전이성 악성 흑색종 1예

최정영,김준기,신성하,고영춘,조상욱,서강석,강명원,임연근,여향순,김경수 全南大醫大 2001 전남의대학술지 Vol.37 No.1

백서 두개골 부분결손시 골막 유무에 의한 골치유 양상에 관한 연구

조병욱,심정원,송영완 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Bony defects may be found as a result of congenital anomalies, traumatic injury, automobile collisions and industrial accidents in the maxillofacial area. Such conditions are often associated with severs functional and esthetic problem. Various surgical procedure has been utilized in attempts to repair and reconstruct bony defects. Bone is a complex, living, constantly changing tissue. The architecture and composition of cancellous and cortical bone allow the skeleton to perform its essential mechanical functions. Periosteum covers the external surface of bone and consists of two layers: an outer fibrous layer and an inner more cellular and vascular layer. The inner osteogenic layer or cambium layer can form new bone while the outer layer firms part of the insertions of tendons, ligaments and muscles. This study was under taken to evaluate bone healing process on partial defect of calvarial bone with or without periosteum in rat. We made calvarial defects of different size(4mm, 6mm, 8mm) with periosteum or without periosteum in rat to study the effect of defect size on healing process. Control and experimental groups sacrified at 1, 2, 4, 6, 8 weeks, postoperatively. We examed the specimens by gloss findings, light microscophy, and fluorescent microscophy. The results were as follows. 1. Gloss findings: Control groups are larger bony defects than experimental groups after 2 weeks, and than control groups advanced healing of defected bone but experimental groups are lesser after 4, 6 weeks. After 8 weeks, bone defect has not been identified in control and experimental groups. 2. Light microscope: All defects of control groups are larger bony defects than experimental groups after 2 weeks. And than control groups show smaller defect after 4 weeks. After 8 weeks, the control group reveal pin-point sized, hardly identifiable defect space and the experimental group reveal small, but definite defect space. 3. Fluorescent microscope: Each week, new bone formation of control group is very similar to the experimental group. In this study, Ostegenesis of calvarial bone defects with periosteum or without periosteum was examined for 8 weeks in rats. The replaced periosteum had batter new bone formation than the removed periosteum.

전방 도달법과 수장부 T자형 금속판 고정을 통한 원위 요골 골절의 치료

최우성,김원유,최동원,신윤학,김진영 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목적 : 원위 요골 골절에 대해 전방 도달법을 이용한 관혈적 정복 및 수장부 T자형 금속판 내고정술의 방사선학적 및 임상적 결과를 분석하여 문헌 고찰과 함께 보고하고자 한다. 대상 및 방법 : 도수 정복이 되지 않았거나, 심한 분쇄 골절로 인해 도수 정복 상태가 유지되지 못했거나, 부적절한 관절면의 정복 등의 이유로 원위 전완부 전방 도달법을 이용한 관혈적 정복 및 수장부 T자형 금속판을 이용한 내고정술을 시행 후 최소 1년 이상 추시 관찰이 가능하였던 19예를 대상으로, 수술 전 후의 방사선학적인 평가와 최종 추시시의 기능적 평가를 Green과 O'Brein의 방법을 이용하여 평가하였다. 결과 : 수술 직후 모든 예에서 관절면의 해부학적 정복을 얻을 수 있었다. 방사선학적 결과에서 요골 관절면의 요골 길이는 수술 전 평균 8.8 ㎜ (±4.8 ㎜)에서 수술 후11 ㎜ (±3 ㎜)로, 요골 경사각은 평균 15˚ (±5.7˚)에서 20˚ (±5˚)로, 전방 경사는 평균 -11˚ (±13˚)에서 7˚ (±4˚)로, 척골 양성 변이는 평균 4 ㎜ (±3 ㎜)에서 0 ㎜ (±1 ㎜)로 향상되었으며, 기능적 결과에 있어서는 우수 9예, 양호 7예, 보통 2예, 불량 1예 이었다. 추시 중 초기 수상이 심하였던 1 예에서는 정복의 소실과 함께 장 무지 굴건의 파열이 초래하였다. 결론 : 원위 요골 골절의 수술적 치료에서 일부 제한된 범위에서만 적응증이 되었던 수장부 금속판 내고정술로 방사선학적 측면과 기능적인 측면에서도 만족할 만한 결과를 얻었으며, 초기 분쇄 골절이 심할 경우에는 정복의 소실을 예방하기 위하여 외고정기를 부수적으로 장착하는 것이 좋을 것으로 생각된다. Purpose : To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture. Materials and Methods : We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up. Results : All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 ㎜±4.8 ㎜ vs. 11 ㎜±3 ㎜), radial inclination (15˚±5.7˚ vs. 20˚±5˚), volar tilt (-11˚±13˚ vs. 7˚±4˚) and ulnar plus variant (4 ㎜±3 ㎜ vs. 0 ㎜±1 ㎜) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and I poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury. Conclusion : Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.

Flexible Video Authentication based on Aggregate Signature

Weon Shin,Young Jin Hong,Won Young Lee,Kyung Hyune Rhee 한국멀티미디어학회 2009 멀티미디어학회논문지 Vol.12 No.6

Poster Session 2 : Protein Structure and Function Signal Transduction ; NMR Structural Studies on Human CD99 Cytoplasmic Domain

( Young Mee Kim ),( Joon Shin ),( Young Kee Shin ),( Seong Hoe Park ),( Weon Tae Lee ) 한국생화학분자생물학회 (구 한국생화학회) 2002 추계학술대회집 Vol.2002 No.-

Effects of Water Stress by PEG on Growth and Physiological Traits in Rice Seedlings

Weon-Young Choi,Si-Yong Kang,Hong-kyu park,Sang-Su Kim,Ki-Sang Lee,Kyu-Seong Lee,Hyun-Tak Shin,Sun-Young Choi 韓國作物學會 2000 Korean journal of crop science Vol.45 No.2

This study was conducted to evaluate the drought tolerance of Japonica and Indica rice cultivars during germinating and seedling stages by using the polyethylene glycol (PEG) solution. Each 5 cultivars of Japonica and Indica were cultured from 14 days after seeding(DAS) to 21 DAS using the PEG solution in a moderate water potential (-0.63 MPa). The lengths of radicle and plumule during the germinating stage were inhibitied by the PEG treatment to about 50% and 85%, respectively. The application of PEG to the seedling of two rice types caused to inhibit the plant height and leaf age about 23 % and 10%, respectively. Shoot and root dry weights by PEG treatment were inhibited more severely in Japonica than those in Indica. The difference on delaying of leaf area expansion between both rice types was not found with treatment of PEG, while the leaf color was increased in both Japonica and Indica by 19.9% and 9.2%, respectively. The average photosynthetic ability was inhibited more in Japonica to 36.0% than did Indica to 27.9%. The stomatal conductance was severely affected by PEG treatment, and the degree was varied in both rice types, ranged with 80-85% in Japonica and 29.3-81.6% in Indica. These results indicate there is little relationship between seed germination and seedling growth under the stress of low water potential.

Flexible Video Authentication based on Aggregate Signature

Shin, Weon,Hong, Young-Jin,Lee, Won-Young,Rhee, Kyung-Hyune Korea Multimedia Society 2009 멀티미디어학회논문지 Vol.12 No.6

In this paper we propose a flexible video authentication scheme based on aggregate signature, which provides authenticity of a digital video by means of cryptographic signature to guarantee right of users. In contrast to previous works, the proposed scheme provides flexible usages on content distribution system, and it allows addition of new contents to the signed contents and deletion of some parts of the signed contents. A modification can be done by content owner or others. Although contents are modified by one or more users, our scheme can guarantee each user's right by aggregation of the each user's signatures. Moreover, proposed scheme has half size of Digital Signature Algorithm (DSA) with comparable security.