의료보험(醫療保險) 및 의료보호(醫療保護) 입원환자간(入院患者間) 의료이용(醫療利用) 비교(比較) 분석(分析)

김세라 ( Se Ra Kim ),조우현 ( Woo Hyun Cho ) 한국보건경제정책학회(구 한국보건경제학회) 2001 보건경제와 정책연구 Vol.7 No.1

The growth of health expenditures for the Medicaid enrollees is very rapid in spite of reduced enrollees in the Medicaid program. Therefore, the cost containment strategies in the Medicaid program is under progress these days. It has been concerned about the evaluation of utilization volume and pattern of healthcare services for the Medicaid enrollees. The existing findings showed that the utilization volume is larger for the Medicaid enrollees compared to the Medical Insurance enrollees, in terms of the length of stay(LOS) and health expenditures. However, the existing studies did not consider the severity of diseases between two groups. Moreover no study has been conducted on the differences of healthcare utilization pattern between two groups. In these context, this study investigated whether the Medicaid and the Medical Insurance enrollees have different healthcare utilization pattern based on the Korean Adjacent Diagnosis Related Group(KADRG). When significant differences were noted, the influencing factors to those differences were examined by analyzing six months medical record data from 30 hospitals. 1. For the ten most frequent KADRGs, the LOS of Medicaid Type 1 inpatients is longer than that of the insured over all 10 disease groups, but the Medicaid Type 1 inpatients have the lowest cost per day. However, the LOS of Medicaid Type 2 inpatients is not different to that of the insured, and their cost per day is even higher. 2. The regression analyses by disease groups show that the LOS of both Medicaid Type 1 and 2 is longer than that of the insured. However, while the cost per day for Medicaid Type 1 inpatients is lower than that for the insured, that for Medicaid Type 2 inpatients is higher than that for the insured.

The radioprotective effects of green tea and its fractions in Gamma-irradiated mice

김세라,이해준,김성호,Kim, Se-ra,Lee, Hae-june,Kim, Sung-ho The Korean Society of Veterinary Science 2003 大韓獸醫學會誌 Vol.43 No.4

We investigated the effect of green tea and its fractions of alcohol and polysaccharide on jejunal crypt survival, endogenous spleen colony formation, and apoptosis in jejunal crypt cells of mice irradiated with high and low dose of gamma-irradiation. Jejunal crypts were protected by pretreatment of green tea (i.p.: 50 mg/kg of body weight, at 12 and 36 hours before irradiation., p.o.: 1.25% water extract, for 7days before irradiation, p<0.01) and alcohol and polysaccharide fractions showed no significant modifying effects. Green tea and its fractions administration before irradiation (i.p. at 12 and 36hours before irradiation) resulted in an increase of the formation of endogenous spleen colony (p<0.05). The frequency of radiation-induced apoptosis in intestinal crypt cells was also reduced by pretreatment of green tea (i.p. at 12 and 36 hours before irradiation, p<0.05., p.o. for 7days before irradiation, p<0.001) and its fractions (p<0.001). These results indicated that green tea might be a useful radioprotector, especially since it is a relatively nontoxic natural product. Further studies are needed to characterize better the promotion nature of green tea and its components.

방사선 피폭의 생물학적 선량측정에 어류(조피볼락, Sebastes schlegeli) 및 조류(닭)의 세포질분열 차단 세포 적용의 부적절성

김세라,김태환,류시윤,장종식,안미영,김성호,Kim, Se-Ra,Kim, Tae-Hwan,Ryu, Si-Yun,Jang, Jong-Sik,An, Mi-Young,Kim, Sung-Ho 대한수의학회 2002 大韓獸醫學會誌 Vol.42 No.4

The purpose of the present experiment was to investigate the micronuclei (MN) frequency in cytokinesis-blocked (CB) cells after various doses of gamma-rays in two species (fish and fowl) and so to contribute to the clarification of the question whether these species are suitable as a target organism in the test system. The frequencies of binucleated cells, and gamma-ray-induced MN in CB cells at several doses were measured in three donors of two species. No binucleated cell was noted in erythrocyte. The peaks of binucleated lymphocyte formation were found at a concentration of 2% phytohaemagglutinin (PHA) and $3{\mu}g/m{\ell}$ cytochalasin B (Cyt-B) in fish at 144 hours after incubation and 2% PHA and $6{\mu}g/m{\ell}$ Cyt-B in fowl at 72 hours after incubation. But the micronucleus counts failed to show any evidence of radiation damage. Measurements performed after irradiation showed a dose-related decrease in the formation of binucleated cells in each of the donors studied. Results indicated that the assays were not suitable for this due to blastization inhibition (binucleation failure) after irradiation. We concluded that the use of CB cell from fish and fowl for detecting the results of mdiation exposure was highly questionable.

한국인 기호 차류의 방사선 장해 경감효과 평가

김세라,이해준,오헌,이진희,김휴경,김태환,조성기,김성호,Kim, Se-Ra,Lee, Hae-June,Oh, Heon,Lee, Jin-Hee,Kim, Hu-Kyung,Kim, Tae-Hwan,Jo, Sung-Kee,Kim, Sung-Ho 대한수의학회 2002 大韓獸醫學會誌 Vol.42 No.4

We performed this study to determine the effect of Korean favorite teas (green tea, ginseng tea, coffee and barley tea) on jejunal crypt survival, endogenous spleen colony formation and apoptosis in jejunal crypt cells of mice irradiated with high and low dose of ${\gamma}$-radiation. Jejunal crypts were protected by pretreatment of green tea (P.O.: 1.25% water extract, for 7 days before irradiation., I.P.: 50 mg/kg of body weight, at 12 and 36 hours before irradiation, p<0.01) or ginseng (I.P.: 50 mg/kg of body weight, at 12 and 36 hours before irradiation, p<0.05). Green tea (p<0.05) or ginseng (p<0.05) administration before irradiation (I.P. at 12 and 36 hours before irradiation) resulted in an increase of t formation of endogenous spleen colony. The frequency of radiation-induced apoptosis was also reduced by pretreatment of green tea (P.O.: p<0.005, I.P.: p<0.05), pretreatment of ginseng (P.O.: p<0.005, I.P.: p<0.005) or posttreatment of ginseng (I.P.: 50 mg/kg of body weight, at 30 minutes after irradiation, p<0.05). Treatment with coffee or barley tea showed no significant modifying effects on the radiation-induced damages. These results indicated that green tea and ginseng might be a useful radioprotector, especially since it is a relatively nontoxic natural product. Further studies are needed to characterize better the promotion nature of green tea, ginseng and its components.

사전심사제도 도입에 따른 의사의 진료행태 변화

김세라 ( Se Ra Kim ),김진희 ( Jin Hee Kim ) 한국보건행정학회 2004 보건행정학회지 Vol.14 No.4

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system`s influence on physicians` behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by \3,154, days of visit per claim by 0.1 day, and amount per visit by \412, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

원자력발전소 사육 재래산양의 방사선 생물학적 평가

김세라,김태환,이해준,오헌,조성기,오기석,박인철,손창호,김성호,Kim, Se-Ra,Kim, Tae-Hwan,Lee, Hae-Jun,Oh, Heon,Cho, Sung-Ki,Oh, Ki-Seok,Park, In-Chul,Son, Chang-Ho,Kim, Sung-Ho 한국임상수의학회 2003 한국임상수의학회지 Vol.20 No.3

Cytogenetic and hematological analysis was performed in peripheral blood from the Korean native goat bred in the nuclear power plant (Wolsong and Uljin) and control area. The frequency of micronuclei (MN) in peripheral blood lymphocytes from goat was used as a biomarker of radiobiological effects resulting from exposure to environmental radiation. An estimated dose of radiation was calculated by best fitting linear-quadratic model based on the radiation-induced MN data over the range from 0 to 4 Gy from the goat lymphocytes with in vitro irradiation. MN rates in goats from the Wolsong and Uljin nuclear power plant, and control area were 9.60/1000, 6.83/1000 and 9.88/1000, respectively. There were no significant differences in MN frequencies and hematological values in goats between nuclear power plant and control area. High level of platelet in the goat from Uljin nuclear power plant was observed, which seemed to be related to the goat management.

액중건조법으로 제조한 Retinol 함유 마이크로캡슐의 방출 거동

김세라 ( Se Ra Kim ),신영재 ( Young Jae Shin ),이천일 ( Chun Il Lee ),표형배 ( Hyeong Bae Pyo ),신재섭 ( Jae Sup Shin ) 한국 접착 및 계면학회 2008 접착 및 계면 Vol.9 No.2

전치 태반의 임상적 고찰

김수평(Soo Pyung Kim),이초희(Cho Hi Lee),김사진(Sa Jin Kim),허수영(Soo Young Hur),이귀세라(Gui Se Ra Lee),이지현(Jee Hyun Lee),권인(In Kweon),송승규(Seung Kyu Song) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective: A Clinical Study of Placenta P#revia done by cesarean section and the study of preterm delivery that is major cause of premature motality even thought expected managment of placente previa. Methods: This study was evaluated for the clinical analysis on the 641 patients with placenta previa among total deliveries of 56,120 cases at the St. Mary and Holy Family hospital of Catholic University from Jan. 1,1989 to Dec.31,1997. Results: The following results were obtained: 1. The total incidence of placenta previa was 1.14%. 2. The incidence of placenta previa increases with age. 3. Placenta previa has occurred more often in multipara(60.2%) than primipara(39.8%), and placenta previa has occurred more often in women who had experienced abortion(71.8%) than women who hadnt(28.2%). 4. The types of placenta previa distributed 326 cases of totalis(50.9%), 110 cases of partialis(17.2%), 99 cases of marginal(15.4%) and 106 cases of low lying placenta(16.4%). 5. The fetal presentation distributed 557 cases of vertex(86.9%), 49 cases of breech(7.6%), 28 cases of transverse lie(4.4%). 6. The types of uterine incision included 543 cases of low sepnent transverse incision(84.7%), 46 cases of classical incision(7.2%), 9 cases of inverted T incision and 43 cases of cesarean hysterectomy(6.7%). 7. Premature delivery of placenta previa prior to completion of 37 weeks was 186 cases(29.0%) and low birth infant less than 2,500gm was 128 cases(20.0%).and perinatal mortality rate was 28.0 per 1,000. 8. During delivery, 278 cases of placenta previa(43.4%) were transfused with mean 3.6 pints. Incidence of vaginal bleeding was 49.3% of placenta previa,mean admission day until delivery was about 5 day. Conclusion: there is a strong association between advancing age and incidence of placenta previa, and then. the risk increases with parity & the number of abortion. Considering the mean volume of blood loss more than 3 pints of blood should be prepared befor delivery.

수자궁질증의 산전 태아 초음파 소견 1 예

김사진(Sa Jin Kim),김수평(Soo Pyung Kim),김민정(Min Joung Kim),이상호(Sang Ho Lee),이희중(Hee Joong Lee),문희봉(Hee Bong Moon),이지현(Jee Hyun Lee),박철훈(Chul Hun Park),이귀세라(Gui Se Ra Lee),신종철(Joung Chul Shin) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.3

Cloacal anomalies are very rare congenital malformations with the incidence of 1/50,000-250,000 births. Hydrocolpos involves the dilatation of the vagina due to obstruction of the genital tract, leading to accumulation of secretions. Because of wide spectrum of abnormal anatomy involving urogenital and gastrointestinal systems, prenatal diagnosis is difficult. As ultrasound becomes more and more reliable, prenatal diagnosis is possible as early as in the second trimester. The presence of prenatally detected hydro (metro) colpos warrants a systematic evaluation of fetal and neonatal anatomy to rule out a large variety of possibly associated malformations or syndromes. We present a case of urogenital sinus maldevelopment which was initially presented as a fetal ascites.

세포질 분열 차단 림프구를 이용한 월성원자력발전소 주변 소의 미소핵 발생 평가

김세라,김태환,김성호,Kim, Se-ra,Kim, Tae-hwan,Kim, Sung-ho 대한수의학회 2003 大韓獸醫學會誌 Vol.43 No.3

Cytogenetic and hematological analysis was performed in bovine peripheral blood from the regions around Wolsong nuclear power plant and control area. The frequency of micronuclei (MN) in peripheral blood lymphocytes from cattle was used as a biomarker of radiobiological effects resulting from exposure to environmental radiation. An estimated dare of radiation was calculated by a best fitting linear-quadratic model based on the radiation-induced MN formation from the bovine lymphocytes exposed in vitro to radiation over the range from 0 Gy to 4 Gy. MN rates in lymphocytes of cattle from Wolsong nuclear power plant and control area were 9.87/1,000 and 9.60/1,000, respectively. There were no significant differences in MN frequencies and hematological values in cattle between Wolsong and control area. The study indicates that the MN assay is a rapid, sensitive and accurate method that can be used to monitor a large population exposed to radiation.