우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인

서수경,김윤,박종익,이명수,장홍석,이선영,이진석,Suh, Soo-Kyung,Kim, Yoon,Park, Jong-Ik,Lee, Myung-Soo,Jang, Hong-Suk,Lee, Sun-Young,Lee, Jin-Seok 대한예방의학회 2009 예방의학회지 Vol.42 No.6

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

시험관내 용출 및 장관막투과도와 생체이용률과의 상관성 연구

서수경(Soo Kyung Suh),양지선(Ji Sun Yang),손수정(Soo Jung Sohn),박인숙(In Sook Park),조혜영(Hea Young Cho),심영순(Young Sun Shim),이용복(Yong Bok Lee) 한국약제학회 1999 한국약제학회 총회 및 학술대회 요지집 Vol.- No.29

N/A N/A

시험관내 용출 및 장관막 투과도와 생체이용률과의 상관성

서수경(Soo Kyung Suh),손수정(Soo Jung Sohn),박인숙(In Sook Park),최기환(Ki Hwan Choi),김순선(Soon Sun Kim),유태무(Tae Moo Yoo),조혜영(Hea Young Cho),이용복(Yong Bok Lee),김동섭(Dong Sup Kim),양지선(Ji Sun Yang) 대한약학회 2000 약학회지 Vol.44 No.5

A biopharmaceutics drug classification system for correlation between in vitro dissolution and in vivo bioavailability is proposed based on recognizing that drug dissolution and gastrointestinal permeability are the fundamental parameters controlling the rate and extent of drug absorption. The objective of this study was to assess whether in vitro dissolution profiles of immediate-release beta-blocker tablets can be correlated with intestinal membrane permeability and/or in vivo bioavailability. In vitro dissolution of the beta-blocker tablets was examined using KP VII Apparatus II methods at various pH. Intestinal membrane permeability was determined in vitro using the diffusion chamber method. Bioavailablity parameters were cited from literatures. The dissolution profiles did not accurately represent the in vivo bioavailablity. However, there were good correlations between intestinal membrane permeability and log P (n-octano/buffer). The correlations obtained in this study indicated that in vitro diffusion chamber method could be used to predict intestinal absorption in vivo.

의료보호 정신분열병 환자의 의료이용 양상

서수경(Soo-Kyung Suh),신영전(Young-Jeon Shin),남정현(Jung-Hyun Nam),임민경(Min-Kyoung Lim) 대한사회정신의학회 2001 사회정신의학 Vol.6 No.1

연구목적: 1992년부터 1998년까지 7년간 우리나라 의료보호 정신분열병 환자수, 치료유병률 및 구성변화와 의료이용 양상의 변화를 파악함으로써, 정신질환과 관련한 의료보호 정책수립과 시행에 필요한 기초적인 자료를 제공하고자 한다. 방 법: 1992년 1월 1일부터 1998년 12월 31일까지 의료보호관리공단의 의료보호 청구자료와 의료보호통계연감을 가지고 의료보호 청구명세서에서 주상병이 정신분열병인 의료보호 대상자를 대상으로 하여, 환자의 특성과 이용양상을 살펴보았다. 결 과: 1) 의료보호 대상자 중 정신분열병 환자수는 1992년 24,373명이었으나 1998년에는 32,285명이었다. 치료유병률도 1992년 대상자 100명당 1.12명에서 1998년에는 2.44명이었다. 치료유병률은 여성에 비해 남성이 높았다. 연령군별로는 모든 연도에 걸쳐 30-39세군의 치료유병률이 가장 높았다. 유형별 치료유병률은 시설수용자가 가장 높았다. 2) 의료보호 정신분열병 환자는 남성이 여성보다 높은 비율을 차지하였으며 연령별로는 입원, 외래모두에서 젊은 군의 비율이 증가하고 있었다. 유형별로는 입원군에서는 거택보호환자의 비율이, 외래군에서는 시설수용자군의 비율이 높았으나 점차 거택보호대상자군의 비율이 높아지고 있었다. 3) 의료보호 정신분열병 환자의 이용률, 1인당 내원일수, 진료일수 및 1인당 진료비는 입원서비스의 경우, 1996년과 1997년에 모두 급격히 증가하는 양상이었고, 외래서비스는 1995년부터 급격히 감소하는 경향을 보였다. 성별로는 입원서비스에서 여성이 차지하는 비율이 높았지만 외래서비스에서는 남녀간 차이가 분명하지 않았다. 연령별로는 입원서비스에서 50대군, 외래서비스에서는 3·40대군이 가장 높았다. 유형별로는 입원서비스에서 거택보호대상자, 외래서비스에서는 시설수용자가 차지하는 비율이 높았다. 결 론: 의료보호 대상자 군내에서 정신분열병 환자의 비율과 진료비가 지속적으로 증가하고 있는 것으로 나타나 의료보호 정책상의 정신분열병 환자에 대한 효과적인 관리의 중요성이 더욱 커지고 있다. 1995년부터의 입원서비스 이용의 급증과 외래서비스 이용의 감소가 관찰되었는데 이는 병상수의 증가, 의료보호 기간의 연장 등과 같은 정책요인이 작용하였을 것으로 추측된다. Objective:To understand the trend in the numbers of schizophrenic patients, treatment prevalence, composition and health care utilization of schizophrenic patients under the Medical Aid Program(Sch-MA) from 1992 to 1998, and to provide basic information necessary to establish and conduct the Medical Aid Program. Method:The analysis is based on claims data of the Medical Aid Program from 1992 to 1998. Results:1) The number of schizophrenic patients among of beneficiaries of the Medical Aid Program are 24,373 in 1992, and has gradually increased to 32,258 in 1998. The treatment prevalence is 1.12 per 100 persons in 1992, and has gradually increased to 2.44 per 100 persons. Sex and age differences are both present. Treatment of men through Sch- MA is more prevalent than that of women, and the prevalence of treatment of patients in the age bracket 30-39 is the highest. 2) Sch-MA is composed of more male than female patients, and this trend is more prominent in patients that used admission services. Among patients that used outpatient services, younger groups have increased in size gradually. Among patients that used admission services, patients in type-1 households form the largest group, and among the patients that used outpatient services, institutional residents form the largest group. However, the number of Sch-MA (type-1) patients has increased from year to year. 3) Service utilization rates, visit days per person, prescribing days per persons, and the medical costs per person in utilization of admission services have increased since 1995, and was highest in 1996 and 1997. In contrast, the utilization of outpatient services, service utilization rates, visit days per person, prescribing days per person, and medical costs per person have decreased since 1995. Utilization of admission services is highest among 50-59 years-olds, and utilization of outpatient services is highest among 30-39 years-olds, with 40-49 years-olds utilization being higher than that of 50-59 years-olds. Utilization of admission services is highest among those utilizing type-1 household, and utilization of outpatient services is highest among the institutional residents. Conclusion:The proportion of schizophrenic patients among the Medical aid clients and the cost of service utilization is increasing continually. Therefore the importance of effective policy and management for Sch-MA is also increasing. Especially, the rapid increase in the utilization of admission services and the rapid decrease in the utilization of outpatient services since 1995 which has been observed, may be due to policy factors such as the increase in the number of beds and the prolongation of the duration of service utilization.

Octylmethoxycinnamate의 SPF 지수와 피부자극지수와의 상관성 연구

서수경(Soo Kyung Suh),김종원(Jong Won Kim),최주영(Ju Young Choi),서경원(Kyung Won Seo),박창원(Chang Won Park),김규봉(Kyu Bong Kim),김광진(Kwang Jin Kim),이선희(Sun Hee Lee) 한국환경성돌연변이발암원학회 2002 한국환경성돌연변이·발암원학회지 Vol.22 No.4

In recent years, the safety of sunscreens have been challenged based on the reports of its adverse effects on users; dermatitis, allergic contact dermatitis, photoallergic contact dermatitis. In the toxicological aspect, the need to investigate the safety of sunscreens is steadily increasing. However, there were few studies on the correlation between sun protection factor (SPF) and the safety of sunscreens. The objective of this study was to assess whether there was a correlation between SPF and the skin irritation index of sunscreens. Octyl methoxycinnamate (OMC) was selected, which was the most frequently used (about 92% in korea and about 90% in the world) in sunscreens. In vitro SPF test was performed using the standard samples recommended by KFDA guideline. We examined primary and cumulative skin irritation and eye irritation of OMC standard sample as well as homosalate. As in vitro SPF was increased, skin irritation index was increased in primary skin irritation test (r²=0.986) and cumulative skin irritation test (r²=0.939). In addition, OMC was non-irritating and non-sensitizing.<br/> In this results, there was a good correlation between SPF index and skin irritation index.

Rat에서의 Octylphenol의 독성동태 연구

손수정(Soo Jung Sohn),강현구(Hyun Gu Kang),이선우(Sun Woo Yi),서수경(Soo Kyung Suh),박인숙(In Sook Park),안미령(Mee Ryung Ahn),최홍석(Hong Seok Choi),조재민(Jae Min Cho),손동환(Dong Hwan Sohn),유태무(Tae Moo Yoo),양지선(Ji Sun Yang) 한국환경성돌연변이발암원학회 2001 한국환경성돌연변이·발암원학회지 Vol.21 No.2

4-tert-octylphenol (OP) is a surfactant additive widely used in the manufacture of a variety of detergents and plastic products. Also, OP is known to have estrogenic activity by interacting with development and functions of endocrine system. This study was carried out to obtain toxicokinetic parameters of OP in male<br/> Sprague-Dawley rats. Male rats were administered OP, by either single oral (gavage) applications of 50, 100 or 200 mg/kg body weight. or a single intravenous injections of 1, 5 or 10 mg/kg body weight. Blood samples taken at several time intervals after administration were obtained from the femoral artery. Analysis of blood samples for OP was performed by gas chromatography mass spectrometry (GC/MS). The detection limit of OP was 1.9 ng/ml at SIM (selected ion monitoring) mode of GC/MS. Calibration curve for analysis of the concentrations of OP in plasma was (OP/butylphenol peak area ratio) = 0.0294 × (plasma conc.) + 0.028 (r²= 0.9991). The OP plasma concentration was 3921 ng/ml immediately after single intravenous application, decreased rapidly within 45 min, and was detectable at low concentration up to 6 hr after application. When administered orally in rats (50, 100 and 200 mg/kg), OP was detected in the blood early after gavage administration, indicating the rapid initial uptake from gastrointestinal tract, with Tmax obtained from 0.67~0.83 hr. Using the AUC (area under the curve) of plasma concentration vs. time, low oral bioavailabilities of 1.2, 5.0 and 5.3% were calculated for the 50, 100 and 200 mg/kg groups, respectively.

마우스세포주 Balb/c 3T3 A31-1-1에서 Epigallocatechin gallate(EGCG)의 세포암화 억제효과에 대한 유전자발현 해석

정기경,서수경,김태균,박문숙,이우선,박순희,김승희,정해관,Jung, Ki-Kyung,Suh, Soo-Kyung,Kim, Tae-Gyun,Park, Moon-Suk,Lee, Woo-Sun,Park, Sue-Nie,Kim, Seung-Hee,Jung, Hai-Kwan 한국환경성돌연변이발암원학회 2006 한국환경성돌연변이·발암원학회지 Vol.26 No.4

Previous studies showed that epigallocatechin gallate(EGCG) have substantial effects of suppressing the N-methyl-N'-nitro-N-nitrosoguanidine(MNNG)-initiated cell transformation process on the bases of foci formation frequency and loss of anchorage dependency. In this study we tried to clarify the molecular mechanism of suppressing the cell transformation process. Mouse cell line balb/c 3T3 A31-1-1 was exposed 2 days to MNNG followed by 15 days 12-O-tetradecanoylphorbol-13-acetate(TPA) treatment for our transformation process. EGCG was added after the time point of 24 hours exposure to TPA and incubated for 19 days. 2029 genes were selected in our transformation process that showed fold change value of 1.5 or more in the microarray gene expression analysis covering the mouse full genome. These genes were found to be involved mainly in the cell cycle pathway, focal adhesion, adherens junction, TGE-$\beta$ signaling, apoptosis, lysine degradation, insulin signaling, ECM-receptor interaction. Among the genes, we focused on the 631 genes(FC>0.5) reciprocally affected by EGCG treatment. Our study suggest that EGCG down-regulate the gene expressions of up stream signaling factors such as nemo like kinase with MAPK activity and PI3-Kinase, Ras GTPase and down stream factors such as cyclin D1, D2, H, T2, cdk6.

자외선 차단제의 SPF 지수와 피부자극지수와의 상관성 연구

김종원 ( Jong Won Kim ),서수경 ( Soo Kyung Suh ),최주영 ( Ju Young Choi ),박창원 ( Chang Won Park ),서경원 ( Kyung Won Seo ),김규봉 ( Kyu Bong Kim ),김광진 ( Kwang Jin Kim ),김재희 ( Jae Hee Kim ),이선희 ( Sun Hee Lee ) 한국응용약물학회 2002 Biomolecules & Therapeutics(구 응용약물학회지) Vol.10 No.4

우리나라 주택 내에서 발생하는 비의도적 손상의 양상

이은정,이진석,김윤,박건희,은상준,서수경,김용익,Lee, Eun-Jung,Lee, Jin-Seok,Kim, Yoon,Park, Kun-Hee,Eun, Sang-Jun,Suh, Soo-Kyung,Kim, Yong-Ik 대한예방의학회 2010 예방의학회지 Vol.43 No.1

Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

산화적 스트레스에 의한 N'-methyl-N'-nitroguanidine의 유전독성증가

강진석(Jin Seok Kang),정기경(Ki Kyung Jung),서수경(Soo Kyung Suh),김주환(Joo Hwan Kim),이화옥(Hwa Ok Lee),정해관(Hai Kwan Jung),김승희(Seung Hee Kim),박순희(Sue Nie Park) 환경독성보건학회 2007 환경독성보건학회지 Vol.22 No.4

To investigate the possible enhancement of genotoxicity in stress environment, we examined the effect of genotoxic material in oxidative stress-induced condition using human cell line. Human lymphoblast cell line, TK6 was treated with hydrogen peroxide (H₂O₂) for induction of oxidative stress, and treated with N’-methyl-N’-nitroguanidine (MNNG), as a genetoxic material. We carried out MTS assay to set treatment doses. TK6 was treated with H₂O₂ as 6.75 (low dose) or 13.5 μM (high dose) for 2 h, and treated with MNNG as 0.117 (low dose), 0.234 (middle dose), 0.468 μM (high dose) for 2 h. As results, a treatment of MNNG induced DNA damage as dose dependently. And TK6 treated with H₂O₂ at low as well as high dose followed by MNNG treatment showed higher DNA damage compared to MNNG alone treated groups. Malondialdehyde, as a marker of lipid peroxidation was increased in H₂O₂ and MNNG treated groups. Real-time RT-PCR analyses for expression sion of several antioxidative enzymes showed that catalase mRNA and glutathione peroxidase 1 mRNA expression were decreased in H₂O₂ and MNNG treated groups. Taken together, we conclude that genotoxicity induced by MNNG is enhanced in a condition of oxidative stress induced by H₂O₂ and it suggests that it should be associated with induction of lipid peroxidation and decrease of antioxidant enzymes.