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      • KCI등재후보

        한국형 출혈열 이환 후 발생된 뇌하수체 기능 저하증 2 예 보고

        최정규,윤경우,최수봉,강찬규,김종설 대한내과학회 1987 대한내과학회지 Vol.32 No.2

        Korean hemorrhagic fever is a disease that most patients recover without sequelae after clinical course of febrile, hypotensive, oliguric, diuretic and convalescent phases. In the autopsy findings of Korean hemorrhagic fever patients, coagulation necrosis of anterior pituitary gland is known as one of the most characteristic macroscopic findings, but there has been rare reports of panhypopituitarism in patients with Korean hemorrhagic fever. Recently we have experienced panhypopituitarism in two patients who had past history of Korean hemorrhagic fever. First patient, who had Korean hemorrhagic fever 2 and half years ago was presented with chief complaint of sexual dysfunction, Second patient, who had Korean hemorrhagic fever 12 years ago was presented with Addison crisis-like manifestations. Both patients were confirmed as panhypopituitarism by combined anterior pituitary function test. There was no evidence of hypothalamic or pituitary diseases by history and several tests including brain CT scan. Past history of Korean hemorrhagic fever was confirmed by the high titers of antibody against Hantaan virus in patients serum. Our experience shows that Korean hemorrhagic fever can be a cause of panhypopituitarism and high index of suspicion should be maintained to detect hypopituitarism in patients with past history of Korean hemorrhagic fever when appropriate symptoms and signs are present.

      • KCI우수등재
      • KCI등재

        신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향

        최정규,김선희,장정하,윤종민,강중구 한국보건행정학회 2020 보건행정학회지 Vol.30 No.2

        Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

      • KCI등재

        신포괄수가 시범사업 모형 개선 이후의 지불정확도 변화

        최정규,김선희,신동교,강중구,Choi, Jung-Kyu,Kim, Seon-Hee,Shin, Dong-Gyo,Kang, Jung-Gu 한국보건행정학회 2017 보건행정학회지 Vol.27 No.3

        Background: Korea set up new diagnosis related group (DRG) as demonstration project in 2009. The new DRG was reformed in 2016. The main purpose of study is to identify the effect of reform on accuracy of payment. Methods: This study collected inpatient data from a hospital which contains medical information and cost from 2015 to 2016. The dependent variables were accuracy of total, bundled, unbundled payment, and payment for procedures. To analyze the effect of reform, this study conducted a multi-variate regression analysis adjusting for confounding variables. Results: The accuracy of payment increased after policy reform. The accuracy of total, bundled, unbundled payment, and payment for procedures significantly increased 3.90%, 2.92%, 9.03%, and 14.57% after policy reform, respectively. The accuracy of unbundled payment showed the largest increase among dependent variables. Conclusion: The results of study imply that policy reform enhanced the accuracy of payment. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG.

      • KCI등재

        경제학에서 생물학을 받아들일 수 있는가?

        최정규 대동철학회 2012 大同哲學 Vol.59 No.-

        이 글은 경제학과 생물학의 교류 속에서 경제학이 어떤 식으로 진화 생물학에서의 발견을 수용해왔는지를 되돌아보는 목적으로 씌어졌다. 경제학에서의 진화 패러다임의 수용의 역사는 길지만 각 시기마다 경제학에서 진화 패러다임을 이용함으로써 ‘무엇을’ 밝히고자 했는가는 다르다. 어떤 시기에는 경제주체들의 합리성을 전제하지 않더라도 합리적 의사결정 모형이 도출해낸 결론과 동일한 균형에 도달할 수 있음을 보이는 데 진화 패러다임이 이용되기도 했고, 또 어떤 시기에는 특정 환경하에서는 최적화보다 모방이 더 효과적이을 보이는데 진화 패러다임이 이용되곤 했다. 최근 들어서면서 경제주체의 사회적 선호 혹은 도덕적 감정 등이 확인되고, 또 이렇나 감정이 경제적 성과에 크게 영향을 준다는 것이 확인되면서 그것의 기원 및 유래를 밝히는 데 진화 패러다임이 매우 중요하게 다루어지기 시작했다. 이러한 과정은 한편으로는 진화 패러다임을 통해 규명하고자 하는 것이 변화하는 과정이기도 했고, 다른 한편으로 경제이론의 발전과 함께 시장, 경쟁 그리고 경제주체들을 기존과 다른 방식으로 이해하기 시작하는 과정이기도 했다. This Thesis reviews the academic interaction between economics and biology and the way that economics has incorporated the theoretical development in biology. In the long history of the interaction between two disciplines, it differs that 'what' economics would focus on by using the biological analogy in each stage. In earlier stage, evolutionary approach were widely used for proving that market process reaches the same efficient equilibrium without assuming the rationality of economic agents and in the later stage for proving that imitation could be more effective than optimization under certain condition. Recently in economics as social preferences and moral sentiments have been recognized as an important issue, the biological approach received attention by economists because it could shed lights on the origin of social preferences and moral sentiments. The academic interactions between two disciplines have been changing as what economists would show with the biological analogy changes. At the same time biology helps economists understand the market, competition and economic agents from the different view points.

      • 국내 방음벽 구조물 개별요소에 대한 강풍취약도 평가

        최정규,전오현,정우영 한국복합신소재구조학회 2017 복합신소재구조학회 학술발표회 Vol.2017 No.04

        Recently, the damage caused by typhoons and strong winds, which frequently occur as a result of global climate change, is on the rise. Soundproofing and windshield walls installed on roads often fail to function because of damage due to strong winds. Therefore, in this study, strong wind fragility evaluation was performed to predict the probability of failure of soundproof / windproof walls from wind loads. A three-node bending experiment was carried out to investigate the material characteristics of the aluminum frame which was installed on the actual soundproof wall. Based on the results of this experiment, the resistance performance of target structure was calculated, and the frame damage was selected as the performance limit state. Wind loads acting on 4m x 1m individual element soundproof wall was compared with the resistance capacity by Monte Carlo simulation method. In the future, the evaluation of the strong wind safety of the sound barrier structure should be proceeded by setting the limit state and performing the vulnerability evaluation through the additional experimental data. This work can become guideline information for future design of soundproof and windproof wall.

      • KCI등재

        국내 154kV급 송전철탑 구조물의 강풍취약도 평가

        최정규,정우영 한국복합신소재구조학회 2018 복합신소재구조학회논문집 Vol.9 No.2

        In this study, the fragility for transmission tower subjected to wind disaster, which has the greatest influence on transmission tower, was developed for 154kV transmission tower located between Yangyang and Sokcho city. The resistance capacity and the limit state required for the evaluation of the fragility were divided into the major part and the auxiliary part in the steel tower. Moreover, the failure of tower was defined as the yielding stress of each member in the tower which could be used to determine their resistance performance. Domestic wind design guideline and criteria for transmission tower was used to determine the wind loads demand on the tower. By comparing the loading demand and resistance capacity, the failure of tower could be determined which in turn used to derive the wind fragility. The results obtained in this study could be used as a reference for damage prediction system of transmission tower and similar structures.

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