1.Structure of Medical Cost in the Medical Insurance System.
Kyung Hwan CHO ; Myung Ho HONG ; Jae Boung SEO
Journal of the Korean Academy of Family Medicine 1997;18(9):898-909
BACKGROUND: This study intends to clear that the current cost reimbursement system of Korean medical insurance of health care. METHODS: By using insured medical record of Federation of Korean Medical Insurance Societies used in the demand tendency research of the type of services from feburary 1st to 28th of the year 1990, authors analyze the characterist,ic of components of charges per case in the type of health care facilities. RESULTS: The charge per case in the out-patient care of primary health care facility is 13,498 won, which is 54.6% by comparison with the secondary health care facility and 30.7 % by comparison wit,h the tertiary health care facility. Among these charges the amount of the cost for medical examinations and oral drugs are 73.9% in the primary health care facility and 71.8% in the secondary and 67.5% in the tertiary. Consequently, the services in the primary care are chiefly composed with the medical examinations and oral drugs. In addition to this point the author also finds that the charge per case is 3.5 times, the cost for oral drugs is 5.6 times larger than those of primary care, and therefore tertiary health care facility conduct various diagnostic examinations and prescript more expensive. CONCLUSIONS: There is a difference of basic medical cost ratio between primary, secondary and tertiary health care facility. These points can be lead to the presumption that the diseases under the structure of current medical insurance are overlapped irrespective of the charact.erisitcs of the type of health care facilites, and this is profitable to the tertiary health care facilities which can conduct various types of services. In conclusion, the frame a policy is needed to encourage primary care which are nothing but simple structure of charges.
Delivery of Health Care
;
Humans
;
Insurance*
;
Medical Records
;
Outpatients
;
Primary Health Care
2.Contribution of Thymidylate Synthase Enhancer Region (TSER) Polymorphism to Total Plasma Homocysteine Levels in Korean Patients with Recurrent Spontaneous Abortion.
Yoon Kyung CHOI ; Myung Seo KANG ; Nam Keun KIM ; Sun Hee KIM ; Dong Hee CHOI ; Myung Ok AN ; Suman LEE
Korean Journal of Fertility and Sterility 2004;31(3):183-190
OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual
;
Abortion, Spontaneous*
;
Female
;
Genotype
;
Homocysteine*
;
Humans
;
Hyperhomocysteinemia
;
Immunoassay
;
Metabolism
;
Methylenetetrahydrofolate Reductase (NADPH2)
;
Plasma*
;
Polymerase Chain Reaction
;
Pregnancy
;
Risk Factors
;
Tandem Repeat Sequences
;
Thymidylate Synthase*
3.Prevalence of hepatitis C virus in liver diseases and high risk groups in Kangwon area.
Myung Seo KANG ; Won Keun SONG ; Kap Jun YOON ; Kyung Won LEE
Korean Journal of Blood Transfusion 1991;2(2):199-204
No abstract available.
Gangwon-do*
;
Hepacivirus*
;
Hepatitis C*
;
Hepatitis*
;
Liver Diseases*
;
Liver*
;
Prevalence*
4.Causes of Korean Infant Death by Gestational Age and Other Characteristics.
Kyung SEO ; Myung Ik LEE ; Young Jin HONG ; Young Ja HAN ; Se Rok DOH
Korean Journal of Perinatology 2001;12(3):321-327
No abstract available.
Gestational Age*
;
Humans
;
Infant*
6.Concentration of prostaglandin E2 in amnion tissue at term and preterm delivery.
Myung Chul SHIN ; Kyung Ho LIM ; Kee Hyun PARK ; Kyung SEO ; Yong Won PARK ; Sei Kwang KIM ; Chan Ho SONG
Korean Journal of Obstetrics and Gynecology 1993;36(7):1775-1782
No abstract available.
Amnion*
;
Dinoprostone*
7.Burnout Experience of HIV Counseling Nurses.
Myoung Hee SEO ; Seok Hee JEONG ; Myung Ha LEE ; Hyun Kyung KIM
Journal of Korean Academy of Nursing Administration 2013;19(4):544-554
PURPOSE: This study was designed to describe the burnout experiences of nurses counseling people living with HIV/AIDS (PLWHA) in hospital-based counseling services in Korea. METHODS: A qualitative research technique with focus group interviews was used and the data were collected in 2012. Participants were 13 counseling nurses from 16 medical hospitals in South Korea who had worked full-time for more than six months as a counseling nurse for PLWHA. The 13 nurses made up 68.4% of all 19 official HIV counseling nurses in South Korea. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe-Wamboldt. RESULTS: Burnout experience of counseling nurses for PLWHA was analyzed for two domains-causes of, and effects of burnout. Each domain was classified into three categories; personal, job-related, and relationships. Further 17 sub-categories and 47 concepts were discovered. CONCLUSION: In this study various causes and effects of burnout experienced by nurses counseling PLWHA were identified. These findings can be used in developing effective strategies for nurses, administrators, and health policy makers to solve the burnout of counseling nurses. Further research is required to develop detailed and practical job description for nurses counseling PLWHA.
Administrative Personnel
;
Counseling
;
Focus Groups
;
Health Policy
;
HIV
;
Humans
;
Job Description
;
Qualitative Research
;
Republic of Korea
8.Three Cases of Unresectable Cholangiocarcinoma Diagnosed after Removal of Hepatolithiasis by Percutaneous Transhepatic Cholangioscopy.
Kyung A LEE ; Sung Koo LEE ; Joo Sang PARK ; Sang Soo LEE ; Dong Wan SEO ; Myung Hwan KIM ; Young Il MIN
Korean Journal of Gastrointestinal Endoscopy 2002;24(3):181-186
Hepatolithiasis is common in east Asia, but rare in the Western world. Recently, epidemiologic study on Korea gallstone disease showed that the portion of patients with hepatolithiasis among total gallstone patients is 14.1%. Hepatolithiasis is the cause of recurrent cholangitis and it is that risk factor of liver abscess, hepatic failure, or sepsis. Also, biliary cirrhosis and cholangiocarcinoma were developed from hepatolithiasis. The incidence of cholangiocarcinoma associated with hepatolithiasis is about 2.4~10% . We present three cases of unresectable cholangiocarcinoma diagnosed after removal of hepatolithiases by percutaneous transhepatic cholangioscopy.
Cholangiocarcinoma*
;
Cholangitis
;
Far East
;
Gallstones
;
Humans
;
Incidence
;
Korea
;
Liver Abscess
;
Liver Cirrhosis, Biliary
;
Liver Failure
;
Risk Factors
;
Sepsis
;
Western World
9.Clinical Observation on Ruptured Aortic Sinus of Valsalva.
Kyung Pyo HONG ; Myung Mook LEE ; Yun Shik CHOI ; Jeongdon SEO ; Young Woo LEE ; Yung Kyoon LEE ; Man Chung HAN
Korean Circulation Journal 1980;10(1):57-63
A Clinical observation was made on five patients with ruptured aortic sinus of Valsalva who visited Seoul National university hospital during the period of May, 1975~Jan., 1980. 1. Age distribution was from 19 to 32 years and four patients were male and the rest one case was female. 2. Chief complaints on admission were dyspnea in 3 cases and chest pain in 2 cases. Onset of symptoms was abrupt in 4 cases. 3. Continuous murmur was heard at third and fourth intercostal space along left sternal border with thrill in all cases. 4. Cardiac catheterization and aortography showed regurgitant flow from aorta to right ventricle in all cases. 5. Operation was done successfully in 3 cases, of which aortic insufficiency was persistent in one case.
Age Distribution
;
Aorta
;
Aortography
;
Cardiac Catheterization
;
Cardiac Catheters
;
Chest Pain
;
Dyspnea
;
Female
;
Heart Ventricles
;
Humans
;
Male
;
Seoul
;
Sinus of Valsalva*
10.A Clinical Study on Pentoxifylline (Trental(R)) in the Treatment of Cerebrovascular Disease.
Myung Mook LEE ; Kyung Pyo HONG ; Byung Heui OH ; Yun Shik CHOI ; Jeongdon SEO ; Young Woo LEE
Korean Circulation Journal 1980;10(1):51-55
Pentoxifylline (Trental(R)) is a drug which blocks pathophysiologic process of cerebrovascular disease by inhibiting platelet aggregation, improving cerebral microcirculation preventing development of cerebral edema. In an attempt to evaluate the effect of pentoxifylline for the treatment of 25 patients (male 17 cases, female 8 cases) with cerebrovasculaar disease, we administered pentoxifylline 600mg daily in devided dosage for 1 to 7 months. Most of them were patients with cerebral thrombosis (52%), cerebral embolism (24%), cerebral hemorrhage (12%) and transient ischemic attack (12%). Clinical effects were evaluated at least 1 month later by the criteria using scoring method of serverity of symptoms. In summary, definite effect was found in 15 cases (60%), mild effect in 6 cases (24%) and no efect or aggravation in 4 cases (16%), especially in patients with cerebral hemorrhage. During treatment there was no significant side effect except mild elevation of serum creatinine in one case who was associated with chronic renal failure.
Brain Edema
;
Cerebral Hemorrhage
;
Creatinine
;
Female
;
Humans
;
Intracranial Embolism
;
Intracranial Thrombosis
;
Ischemic Attack, Transient
;
Kidney Failure, Chronic
;
Microcirculation
;
Pentoxifylline*
;
Platelet Aggregation
;
Research Design