A selective cyclin-dependent kinase 4, 6 dual inhibitor, Ribociclib (LEE011) inhibits cell proliferation and induces apoptosis in aggressive thyroid cancer

Lee, Hyun Joo,Lee, Woo Kyung,Kang, Chan Woo,Ku, Cheol Ryong,Cho, Yoon Hee,Lee, Eun Jig Elsevier 2018 Cancer letters Vol.417 No.-

<P><B>Abstract</B></P> <P>The RB-E2F1 pathway is an important mechanism of cell-cycle control, and deregulation of this pathway is one of the key factors contributing to tumorigenesis. Cyclin-dependent kinases (CDKs) and Cyclin D have been known to increase in aggressive thyroid cancer. However, there has been no study to investigate effects of a selective CDK 4/6 inhibitor, Ribociclib (LEE011), in thyroid cancer. Performing Western blotting, we found that RB phosphorylation and the expression of Cyclin D are significantly higher in papillary thyroid cancer (PTC) cell lines as well as anaplastic thyroid cancer (ATC) cell lines, compared with normal thyroid cell line and follicular thyroid cancer cell line. LEE011 dose-dependently inhibited RB phosphorylation and also decreased the expressions of its target genes such as <I>FOXM1, Cyclin A1,</I> and <I>Myc</I> in ATC. Furthermore, LEE011 induced cell cycle arrest in G0-G1 phase and cell apoptosis, and inhibited cell proliferation in ATC. Consistently, oral administration of LEE011 to ATC xenograft models strongly inhibited tumor growth with decreased expressions of pRB, pAKT and Ki-67, and also significantly increased tumor cell apoptosis. Taken together, our data support the rationale for clinical development of the CDK4/6 inhibitor as a therapy for patients with aggressive thyroid cancer.</P> <P><B>Highlights</B></P> <P> <UL> <LI> pRB and Cyclin D were expressed high in aggressive thyroid cancer. </LI> <LI> LEE011 suppressed pRB and also decreased the expressions of its target genes in ATC. </LI> <LI> LEE011 induced cell cycle G1 arrest and apoptosis, and inhibited cell proliferation. </LI> <LI> LEE011 inhibited in vivo tumor growth with decreased expressions of pRB and Ki-67. </LI> <LI> We could explain the anticancer effects with the RB-E2F pathway. </LI> </UL> </P>

항인지질 항체 증후군에서 항β₂glycoprotein-Ⅰ 항체의 의미

이찬희,서창희,이지수,이수곤 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

objective : This study investigated the significance of anti-β₂ glycoprotein-Ⅰ(β₂GPI) antibody in antiphospholipid syndrome from the results of the relationship between the antiphospholipid antibody test and the anti-β₂GPI antibody test. Methods : The IgM, IgG type of the anti-β₂GPI antibody was tested by ELISA in patients with antiphospholipid syndrome or those who were suspected of having antiphospholipid syndrome and compared with the anticardiolipin antibody and lupus anticoagulant results. As a control, the anti-β₂GPI antibody was tested in 12 normal healthy persons and 8 systemic lupus erythematosus patients. Results : In 6 patients with antiphospholipid syndrome, the positive rate of lupus anticoagulant, IgM and IgG anticardiolipin antibody was 33%, 50%, and 67%. However, the positive rate of the IgM and IgG anti-β₂GPI antibody test was 83%, 100%. Among the 6 patients, 3 patients were tested for the anti-β₂GPI antibody before and after treatment. In all 3 patients, the anti-β₂GPI antibody titer was lower after treatment. The anti-β₂GPI antibody test was positive in those patients suspected for having antiphospholipid syndrome, but tested negative to the anticardiolipin antibody or lupus anticoagulant. In the normal and disease controls, the anti-β₂GPI antibody test was negative in all cases. Conclusion : In diagnosing antiphosphotipid syndrome. the anticardiolipin antibody or lupus anticoagulant should be used as a screening test, and if necessary, an anti-β₂GPI antibody should be added. This might improve the sensitivity and specificity. Also, the anti-β₂GPI antibody titer may be used as a marker of disease activity.

Transmission ability of Zika virus with artificially infected Aedes albopictus in Korea

Yang Sung‐Chan,Lee Hee-Il,Kim Hyunwoo,Lee Wook‐Gyo 한국곤충학회 2021 Entomological Research Vol.51 No.8

Zika virus (ZIKV), a virus mainly occurring in South America, is now globally distributed. Understanding the pathogen transmission cycle in a vector is exceptionally important in developing disease control strategies. In this study, we performed ZIKV microinjection in Aedes albopictus (Skuese), to estimate its vertical and horizontal transmission ability. The virus infection rate was confirmed by real-time qPCR in the F1 generation derived from the ZIKV-injected Ae. albopictus. The minimum infection rate (MIR) of the F1 generation was highest when they were injected with the virus at 6–12 h (MIR: 16.1) and lowest at 12–24 h (MIR: 4.7) after feeding. In the developmental stage of the F1 progeny, MIR values were 1.0, 1.3, and 6.7 in each egg, larval, and adult stage, respectively, but ZIKV was not detected in the pupa stage. Virus transmission ability was not significantly different between the collection areas (Tongyeong and Jeju). Ae. albopictus demonstrated a high venereal transmission rate of ZIKV and was detected in males (6 pool/7 pool) and females (6 pool/7 pool), confirming that ZIKV can be transmitted from infected mosquitoes to uninfected mosquitoes via mating. This is the first study of the administration of a ZIKV microinjection to Ae. albopictus in Korea and suggests a possibility of a potential mechanism for the virus to survive during adverse conditions via vertical transmission.

B16 멜라닌 세포에서 해양소재 추출물의 멜라닌 생성 저해 효과

이찬 ( Chan Lee1 ),장정희 ( Jung Hee Jang ),안은미 ( Eun Mi Ahn ),박찬익 ( Chan Ik Park ) 대한본초학회 2012 大韓本草學會誌 Vol.27 No.4

Objectives : Under normal condition melanin protects the skin from extracellular stimuli including ultraviolet (UV)-induced oxidative skin damages, but excess production and accumulation of melanin can induce hyperpigmentation causing esthetic problems. Therefore, in this study we tried to search for natural skin whitening materials from marine natural resources. Methods : Water and ethanol extracts of marine natural resources were prepared from Porphyra thalli (PT), Laminariae thallus (LT), Ostreae concha (OC), Sargassum thallus (ST), Undaria thallus (UT), Codium thalli (CT), Enteromorpha thalli (ET), Syngnathoides biaculeatus (SB), and Hippocampus coronatus (Hc). Their effects against UVB and α-melanocyte stimulating hormone (α-MSH)-induced melanogenesis were investigated based on melanin formation in B16 mouse melanoma cells. The mRNA and protein expression of enzymes involved in the melanogenic process were further examined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot analysis, respectively. Results : Water extract of Ostreae concha (OCW/E) effectively inhibited UVB and α-MSH-induced melanin production in B16 melanocytes, which seemed to be mediated by inhibition of mRNA expression of tyrosinase and tyrosinase-related protein 1 (TRP-1). In another experiment, ethanol extracts from Porphyra thalli (PTE/E), Laminariae thallus (LTE/E), Sargassum thallus (STE/E), Undaria thallus (UTE/E), Codium thalli (CTE/E), Syngnathoides biaculeatus (SBE/E), and Hippocampus coronatus (HcE/E) significantly suppressed UVB and α-MSH-induced melanin formation. Furthermore, ethylacetate fraction isolated form LTE/E (LTE/EEt) decreased UVB and α-MSH-elevated extracellular melanin levels via inhibition of tyrosinase protein expression. Conclutions : These results suggest that marine natural resources such as Porphyra thalli, Laminariae thallus, Ostreae concha, Sargassum thallus, Undaria thallus, Codium thalli, Syngnathoides biaculeatus and Hippocampus coronatus have anti-melanogenic effects, thereby exhibiting high potentials to be utilized as one of the ingredients for the development of new whitening functional cosmetics.

교대로 운전되는 두 개의 UV/광촉매반응기로 구성된 폐가스 처리시스템에서의 광촉매의 비활성화 및 재생 특성

이은주 ( Eun Ju Lee ),정찬홍 ( Chan Hong Chung ),임광희 ( Kwang-hee Lim ) 한국화학공학회 2021 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.59 No.4

본 연구에서는 교대로 운전되는 두 개의 UV/광촉매 반응기로 구성된 폐가스 처리시스템의 운전단계와 단계별 광촉매의 비활성화의 상관관계를 사용된 광촉매에 대한 기기분석을 통하여 규명하였다. 선행연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]의 광촉매 반응기 시스템 운전에 사용되지 않은 광촉매를 담지한 다공성 SiO₂ 담체(A4), 1회 운전하는 동안 사용되고 재생을 경험하지 않은 광촉매를 담지한 다공성 SiO₂ 담체(A1), 2회 운전에 사용되고 1회 재생된 광촉매를 담지한 다공성 SiO₂ 담체(A2) 및 3회 운전에 사용되고 2회 재생된 광촉매를 담지한 다공성SiO₂ 담체(A3)와, 1차 재생(AD1) 또는 3차 재생(AD3)된 광촉매를 담지한 다공성 SiO₂ 담체에 대한 BET 분석, SEM, XPS, SEM-EDS 및 FTIR 분석 등을 수행하여, 광촉매를 담지한 다공성 SiO₂ 담체의 비활성화 및 재생 특성을 포함하는 특성 분석을 수행하였다. 그 결과로서, 3회 이상의 여러 번 재생을 수행하는 광촉매의 적정 재생 온도를 200℃ 미만으로 도출하였다. 이러한 광촉매의 적정 재생 온도는 BET 분석결과에서 도출된 기공에 흡착된 에탄올 산화분해 중간생성물의 대부분이 완전 분해가 되어 기공이 재생되는 재생 온도와 거의 일치하였다. 특히, XPS 분석 결과는, 선행 연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]에서 광촉매 반응기의 첫 번째 운전 후에 광촉매의 미세한 비활성화가 발생하였음을 나타내었다. 또한, XPS 분석 결과는, 선행연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]에서 광촉매 반응기의 두 번째 운전에서 비교적 큰 광촉매의 비활성화가 발생하여 첫번째 운전성능보다 약 5%만큼 못 미치는 에탄올과 황화수소 각각의 제거효율을 초래하였으나, 세 번째 운전에서의 에탄올과 황화수소의 제거효율은 두 번째 운전에서의 에탄올과 황화수소의 제거효율 실험 결과와 거의 비슷하였다는 연구 결과와 일치하였다. 한편, AD3를 사용하여 선행연구[Lee와 Lim, Korean Chem. Eng. Research, 59(4), 574-583 (2021)]에서와 같은 광촉매 반응기의 네 번째 운전을 수행할 것을 가정하면, 두 번째 운전에서보다 더 큰 광촉매의 비가역적 비활성화의 발생으로 인하여 에탄올과 황화수소 제거효율이 가장 크게 저하되리라 예상되었다. In this study, the correlation between operating stages of waste air-treating system composed of two alternatively-operating UV/photocatalytic reactors, and the deactivation of photocatalyst used in each operating stage, was investigated by instrumental analysis thereon. The repeated deactivation and subsequent re-generation of photocatalyst used in the waste air treating system of previous investigation performed by Lee and Lim (Korean Chem. Eng. Research, 59(4), 574-583(2021)), were characterized on virgin photocatalyst-carrying porous SiO₂ media (A4), used photocatalystcarrying porous SiO₂ media (A1, A2 and A3) collected from the corresponding photocatalytic reactor upon 1^st, 2^nd, and 3^rd run, respectively, regenerated photocatalyst-carrying porous SiO₂ media upon 1 time-run (AD1) and 3 times regenerated photocatalyst-carrying porous SiO₂ media upon 3 time-runs (AD3) by instrumental analysis including BET analysis, SEM, XPS, SEM-EDS and FT-IR. As a result, the proper regeneration-temperature for deactivated photocatalyst to be regenerated several times (more than 3 times), was suggested below 200℃. Such temperature of deactivated photocatalystregeneration was almost consistent to the one, according to BET analysis, at which tiny nano-pores blocked by adsorbed ethanol-oxidative and degraded intermediates (AEODI), were regenerated to be reopened through almost complete mineralization of AEODI. In particular, the results of XPS analysis indicated an incurrence of insignificant deactivation of photocatalysis upon 1^st run of UV/photocatalytic reactor (A or C) of the previous investigation. In addition, the results of XPS analysis were consistent with the experimental results of the previous investigation in that 1) deactivation of photocatalyst incurred during 2^nd run of the UV/photocatalytic reactor (A or C) resulted in decreased removal efficiency, by ca. 5% and 5%, of ethanol and hydrogen sulfide, respectively, compared with its 1^st run; 2) there was insignificant difference between the removal efficiencies of its 2^nd run and 3^rd run. Furthermore, the removal efficiencies of ethanol and hydrogen sulfide for hypothetical 4^th run of photocatalytic reactor in the previous investigation, using AD3, were expected to decrease, compared with its 3^rd run, by much more than those for 2^nd run in the previous investigation did, compared with its 1^st run.

우리나라 논 관개용 지하수 수질 특성

김진호,조광래,임수정,이경자,경기천,엄미정,김희권,김찬용,이영한,이신찬,윤순강 한국환경농학회 2003 한국환경농학회지 Vol.22 No.4

This study was carried out to evaluate the status of the groundwater quality for paddy fields irrigation in Korea. Water samples were collected at 130 sites throughout the country. Samples were collected at three seasons-April, July and October-in 2000. According to our survey, the groundwater was found to be suitable for irrigation purpose. Average EC was shown 0.286 dS/m. Nitrate-nitrogen and Cl^(-) concentration was 5.6 ㎎/L, 32.95 ㎎/L which satisfied the Korean Standards for Irrigation Water. Nitrate-nitrogen concentration in each province was shown as following orders: Jeju (11.17 ㎎/L) > Chungnam (8.16 ㎎/L) > Gyeongbuk (6.64 ㎎/L) > Gyounggi (5.91 ㎎/L) > Chungnam (4.95 ㎎/L) > Gyeongnam (3.91 mgk) > Jeonbuk (3.50 ㎎/L) > Jeonnam (3.27 ㎎/L) > Gangwon (2.91 ㎎/L). The concentration by sampling seasons were October (6.62 ㎎/L) > July (5.88 mg&) > April (4.78㎎/L). As the soil of Jeju Province is usually derived from volcanic ash soils mainly used for upland drops, it may influence the nitrate-nitrogen concentration of groundwater. The amount of rainfall also influence the water quality. But the COD_(Cr), were shown April (3.17㎎/L) > July (2.91 ㎎/L) > October (2.40 ㎎/L), it is highly related in the basal dose of organic matter fertilizers. This study demonstrated that groundwater quality was suitable for irrigation, but continuous monitoring is recommended for agricultural policy and developing OECD agricultural environment indicators.

솔잎혹파리 피해임지의 수세변동에 관한 연구

이찬용,채희문,김종국 강원대학교 삼림과학연구소 2000 Journal of Forest Science Vol.16 No.-

솔잎혹파리 피해임지의 특성에 따른 수세변동을 구명하였다. 솔잎혹파리 피해도(「심), 「중), 「경))별로 구분하여 수세를 조사한 결과 피해가 심한 지역의 수목은 수세가 현저하게 약화되었으며, 수목의 임분밀도(「밀), 「중),「소」)별로 구분한 경우는 피해도와 관계없이 임분밀도가 낮은 임분에서 수목의 수세가 강하게 나타났다. 수목의 외형적 인자중 수관폭과, 흉고직경이 작은 개체에 비하여 큰 개체의 수세가 모든 임분에서 강하게 나타났다. 각 임분에서 전기저항치와 수관면적과의 관계는 피해도 「심」 임분에서는 수관면적이 13.4m2, 「중」 임분에서는 10.9m2, 「경」 임분에서는 7.9m2로 피해가 심할수록 수관면적이 넓어야 임목이 생존할 가능성이 높은 전기저항치(15kΩ이하)가 나타나는 것으로 파악되었다. This study investigated tree vigor of damaged forest by Thecodiplosis japonensis Uchida et Inouye. In damaged forest by pine gall midge, the investigation result of damaged rate section(severe, moderate, light) indicated that severe stand showed higher value of electric resistance(kΩ) than that of light stand, the investigation result of tree density section(crowed, middle, little) indicated that crowed stand showed higher value of electric resistance than that of little stand(the value of electric resistance at which low reading show high vigor tree and high reading low vigor tree). The crown width and DBH(diameter of breast height) of external factors showed lower value of electric resistance than that of small size. The results of comparative between Crown area and value of electric resistance in each stand were 13.4m2 in severe stand, 10.9m2 in moderate stand and 7.9m2 in light stand. Therefore, the tree which have big crown showed low value of electric resistance(below 15kΩ)that has high possible of survial. Key word : Thecodiplosis japonensis, electric resistance, crown area

중증 재생불량성 빈혈 환자의 동종골수이식 후에 병발한 간정맥폐색질환(Hepatic Veno-Occlusive Disease)의 임상 경과 및 혈액응고 인자들의 변화

이제환,이규형,최성준,민영주,김신,이정신,김상희,박찬정,지현숙,김우건 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

연구배경: 재생불량성 빈혈 경우에는 조혈모세포 이식 후 VOD의 발생에 관한 보고가 거의 없는 실정이다. 저자 등은 cyclophosphamide와 antithymocyte globulin으로 전처치 후에 동종골수이식을 시행한 재생불량성 빈혈 환자들을 대상으로 하여 VOD의 발생과 임상 양상, 혈액응고 인자들의 변화에 관하여 분석하여 보았다. 방법: 재생불량성 빈혈로 동종골수이식을 시행 받은 13예 환자를 대상으로 하였다. 임상적 기준에 따라 VOD를 진단하였으며 임상 경과에 따라서 경중을 분류하였다. Protein C, protein S, antithrombin Ⅲ, tPA, PAI-1 등의 혈액응고 인자들을 전처치 투여전, 골수 주입당일, 이식 후 제7, 14, 21일에 측정하였다. 결과: 7예(53.8%)에서 VOD가 발생하였으며, 경증 5예, 중등도 2예였다. VOD군에서 혈소판치가 20.000/㎕ 이상을 유지하는 데까지 걸리는 시간이 더 길었다(p=0.026). 또한 VOD군에서 적혈구 및 혈소판의 수혈 요구량이 각각 유의하게 많았다(p=0.025, 0.015). 혈액응고 인자들의 변화를 보면, 제 0일에 VOD군에서 PAI-1의 혈중 농도가 유의하게 더 높았다.(p=0.034). 결론: 재생불량성 빈혈환자에서도 조혈모세포 이식 후에 VOD의 높은 발생률을 관찰하였으며, 대부분이 경증이었다. VOD 환자에서의 혈액응고 인자들의 변화는 PAL-1이 VOD의 감별 진단을 위하여 이용될 수 있음을 시사하고 있다. Background: There are few reports about the occurrence of hepatic veno-occlusive disease(VOD) after bone marrow transplantation (BMT) for severe aplastic anemia (SAA). We analyzed the incidence and clinical outcomes of VOD and changes of coagulation factors in patients with SAA who were conditioned with cyclophosphamide plus ATG and underwent allogeneic BMT. Methods: Thirteen patients with SAA who underwent allogeneic BMT were included. A diagnosis of VOD was made according to clinical criteria, and severity of VOD was classified according to clinical course. Plasma levels of protein C, protein S, antithrombin Ⅲ, t-PA, and PAI-1 were determined before preparative chemotherapy, in the day of marrow infusion, and days 7, 14, and 21. Results: VOD occurred in 7/13(53.8%). Five were mild VOD and two were moderate VOD. Time to platelet ≥20,000/L was slower (p=0.026) and red cell and platelet transfusion requirements were higher (p=0.025,0.015) in patients with VOD . The mean plasma level of PAI-1 at 0 were higher in patients with VOD (p=0.034). Conclusion: We observed the high incidence of VOD after allogeneic BMT in patients with SAA. A majority of cases of VOD were mild. The changes of PAI-1 after BMT may be useful marker of hepatic VOD

계룡산 구룡사지 당간지주의 기원암, 암석학적 및 보존과학적 진단

이찬희,최석원,김사덕,서만철 공주대학교 문화재보존과학연구소 2003 문화재과학기술 Vol.2 No.1

구룡사지 당간지주의 암석학적 풍화와 훼손를 진단하였으며, 보존처리를 대비한 동일 종류의 기원암을 추적하였다. 이 당간지주는 홍장석 화강암으로 구성되어 있으며 주좌는 흑운모 화강암이다. 왼쪽 지주는 완전히 파괴되어 방치되어 있으며, 오른쪽 지주는 하나의 부재로 구성되어 있으나 계단식으로 절단되어 있어 도괴의 우려가 있다. 이 지주들은 균열 및 탈락과 훼손이 심하여 박리와 박락현상이 발생하였고 석재의 표면은 입상분해 작용이 진행 중이다. 이차적 오염현황도 심각하여, 황갈색 수산화철에 의한 암석의 변색과 강수의 유동흔적을 따라 나타나는 암회색 철과 망간의 침전물이 산재한다. 지주의 주변과 암석의 표면에는 지의류와 선태류의 오염이 심각하며, 기단부는 토양화의 진행에 의하여 잡초가 암석의 생물학적 풍화작용을 가중시키고 있다. 따라서 부지 주변의 나무와 잡초 및 불연속면에 서식하는 부착생물을 제거하기 위한 생화학적 처리도 필요하다. 이 당간지주는 석재자체의 성능이 저하되어 있으므로, 균열부의 장기적인 모니터링과 함께 석재의 표면을 강화할 수 있는 처리방법을 강구해야 할 것이다. 특히 왼쪽 지주는 보존처리도 어려운 상태여서 교체하여야 할 상황이다. 이 당간지주와 동일한 암종은 하신리 무지개 농장 부근의 도로변 노두에 있다. The Flag Pole Supporting Rocks (Dangganjiju) of the Guryongsa temple site, Korea was studied on the basis of petrological weathering, conservational scientific diagnosis and presumed to source area of the original supporting rocks. Constituting rocks of this supporting rocks are pink feldspar granite, and the rounded basement is biotite granite. However, the left supporting rock is remained at perfectly destruction state in situ. The right supporting rock showed also highly fractured as step-like cutting plane which is very dangerous state because of possible collapse. As a whole supporting rocks occurred with fracturing, exfoliation or deterioration, and rock surface appeared to grain dissolution. Host rock of the supporting rocks were highly secondary contaminations, and most rock surface was color changed to the dark black to dark brown due to the clay, iron and manganese hydroxides along the rain water flow. In the vicinity of the supporting rocks and rock surface show partly green and black patchs because of coated by algae, lichen and moss. The lower part of the basement rocks are transition to the some weeds. This biological problems are need for cleaning and chemical treatments. The main materials of the supporting rocks is highly degradation, therefore the supporting rocks need to be long term monitoring in the fracture planes and to prepare for synthetic conservation treatments. Especially, the left supporting rock is difficult to conservation owing to nearly perfect destruction. In the Hashinri Mujigae farm area, the same kind of pink feldspar granitic rocks with this supporting rocks are occurred.

일부 의료이용자의 민간의료보험에 대한 태도와 정책적 시사점

이찬희,김원중 인제대학교 2007 仁濟論叢 Vol.22 No.1

The main objective of this study is to examine the attitudes of some medical consumers to private health insurance so that the results can be utilized in establishing the government's health insurance policy and hospitals' management strategies. Based on this objective, an interview survey was conducted through structured questionnaire for the patients of four general hospitals located in Busan Metropolitan City during the period of 3/1-4/30/2005, and data from 520 patients were utilized in the final analysis. Survey items included general characteristics of the patients(sex, age, education, income, etc.), various factors related to patients' satisfaction on National Health Insurance and supplementary private health insurance, and their opinions on the introduction of substitute private health insurance. SPSS(version 12.0) was used to process the data. Major findings are as follows: 1) Overall satisfaction of the patients on National Health Insurance(NHI) was generally low, as 43.6% of the respondents were 'unsatisfied,' whereas only 7.0% 'satisfied.'(The remainder was 'neutral.') Main reason for the dissatisfaction was found to be 'insufficient benefits.' 2) 75.6% of the respondents possessed some kind of supplementary private health insurance policies, and their satisfaction level was relatively higher than that of NHI 3) 69.9% replied that the government should allow substitute private health insurance, and, when allowed, 62.2% would purchase such insurance policies. 4) However, based on economic abilities and attitudes to high-grade medical services, only 10-20% could be considered to have 'actual' or 'effective' demand for substitute private health insurance. 5) Logistic regression analysis suggested that the probability of purchasing substitute private health insurance policies was higher when the respondents were younger, richer and more dissatisfied with NHI.