일부 병원에서의 입원비 본인부담양상

신영전,유원섭,하헌영,정설희 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1

The purpose of this study was to estimate the proportion of user charges out of total treatment costs and to investigate the occuring status of the charge of non-benefit service. The data were collected from 6 hospitals in 3 cities (Seoul 2, Incheon 3, Shihung 1), which containing 1,752 discharge-bills of discharged patients insured by health insurance. The data were analyzed after standardization of the items of non-benefit services. The result are as follows; 1. the average percent of the cost-sharing of discharged patients was 38.1%(benefit : 15.5%, non-benefit : 22.6%) and the proportion of the cost-sharing due to non-benefit services was greater than that due to benefit services. 2. The occurrence rate and the occurred number of non-benefit services were different among hospitals and showed characteristic occurrence rate in individual hospitals. 3. In acute appendicitis, the characteristics of the occurrence rate and the occurred number of non-benefit services by individual hospitals was similar to those of hospitals. It suggest that the hospitals intentionally applied non-benefit item to patients in order to increase their profit. These findings suggest that the burden of cost-sharing is still high especially due to non-benefit services, so it is necessary to extend the coverage of insurance benefits and to develop management system for the appliance of non-benefit services. Regarding the discharge-bill, all service charges should be included in the bill.

자동생화학 분석기 Hitachi 7180의 평가

신경섭,주대일,김영숙 충북대학교 의과대학 충북대학교 의학연구소 2003 忠北醫大學術誌 Vol.13 No.2

연구목적: 저자들은 본원에 응급화학검사기기로 새로 도입된 Hitachi 7180 (Hitachi, Tokyo, Japan)의 분석 능을 보기 위하여, 정밀도, 직선성, 정확성을 평가하였으며 기존의 화학검사기기인 Hitachi 747 (Hitachi, Tokyo, Japan)과의 상관성도 평가하였다. 대상 및 방법: 포도당, 크레아티닌, blood urea nitrogen (이하 BUN), 총단백, 알부민, aspartic transaminase (이하 AST), 나트륨, 칼륨, 클로라이드 등 총 9종목에 대하여 정밀도를 측정하였으며, 포도당, 크레아티닌, BUN, AST에 대하여 직선성 및 회수율을 구하였다. 포도당, 크레아티닌, AST 및 총 빌리루빈에 대하여 Hitachi 747과 상관관계를 평가하였다 결과: 일내 정밀도는 저농도 및 고농도 정도관리 물질에서 3.05% 및 2.02% 이하의 변이계수를 보였으며, 총 정밀도는 각각 4.4%와 2.42% 이하의 변이계수를 보였다. 직선성을 평가한 모든 항목의 결정계수(r²)는 0.999 이상이었다. 회수율은 평가한 4종목에서 100.0에서 103.08% 사이이었다. Hitachi 747과 상관검사에서 측정한 4종목의 상관계수(r)는 모두 0.9986 이상이었다. 결론: Hitachi 7180은 정밀도, 직선성 및 회수율이 우수하였으며, 기존의 기기와 좋은 상관성을 보여 임상검사실에서의 적용에 유용할 것으로 사료된다. Purpose: The authors evaluated a recently introduced chemical analyzer, Hitachi 7180 (Hitachi, Tokyo, Japan) for precision, linearity, accuracy and comparability with Hitachi 747 (Hitachi, Tokyo, Japan) to see if it was suitable for the stat analyzer. Material and Methods: The precision, linearity, accuracy and comparison study were performed. For twenty day, the precision was performed for glucose, creatinine, BUN, protein, albumin, AST, sodium, potassium and chloride. The linearity and recovery rates were performed for glucose, creatinine, AST, BUN. The comparison study was performed with Hitachi 747 for glucose, creatinine, AST and total bilirubin. Results: The within-run coefficients of variations (CVs) at low and high concentrations were less than 3.05% and 2.02%, respectively. The total CVs for each groups were less than 4.4% and 2.42%, respectively. The linearity was well maintained in range of medically significant levels(r²≥0.999). The recovery rates were good for all tested items (100-103.8%). In comparison study, coefficients of correlation exceeded 0.9986 for all tests. Conclusion: The precision, linearity and accuracy of Hitachi 7180 were good. The correlation with Hitachi 747 was good. We concluded that its analyzer can be useful for clinical laboratory.

국가정신보건정책안의 우선 순위에 관한 전문가 설문조사

신영전,남정현,유원섭,이선영,유주영 漢陽大學校 精神健康硏究 2000 精神健康硏究 Vol.19 No.-

공황장애 환자의 성격요인과 방어기제의 특성에 관한 연구

심진현,백상빈,신영철,오강섭,노경선,이시형 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구는 공황장애 환자들을 대상으로 성격요인과 방어기제 검사를 실시하였으며 우울 및 사회기능 정도를 측정하여 상관관계를 알아보았다. 방 법: 1997년 9월부터 1998년 8월까지 환자들중 공황장애로 진단된 35명을 대상으로 성격요인검사(Sixteen Personality Questionnaire 한국판) 및 방어기제검사(이화방어기제검사)를 시행하여 스텐점수(1-10)화 하였고, 우울증척도(Beck Depressive Inventory 한국판) 및 사회기능장애척도(Sheehan Disability 한국판)를 시행하였다. 결 과: 1) 개별항목 (1) 성격요인과 방어기제의 척도별 평균점수에서 정상보다 높거나(8점이상) 낮은(3점이하) 척도는 없었다. (2) 성격요인중 불안감이 높았고 자아강도, 신중성, 사변성은 낮은 점수를 보였다. (3) 방어기제중 신체화, 행동화의 점수가 높았고 유우머, 억제, 이타주의, 회피, 합리화는 낮은 점수를 보였다. (4) BDI의 평균점수는 18.25±9.97이었다. (5) SDS의 평균점수는 업무항목 4.88±3.11. 사회활동/오락활동항목 4.57±2.92였다. 2) 상관관계 (1) 성별간 비교에서 성격요인은 사변성, 죄책감을 방어기제는 허세, 부정, 수동공격, 투사를 남성 이 높게 보였다(p<0.05). (2) 연령증가는 성격요인중 낮은지능과 방어기제는 예견, 해리와 상관을 허세와 역상관을 보였다(p<0.05). (3) BDI 점수는 성격요인중 지능도, 자아강도, 도덕성, 죄책감, 통제력, 불안감등과 방어기 제중 해리, 신체화등과 유의미한 상관관계를 나타냈다(p<0.05). (4) 사회기능장애척도의 업무항목은 성격요인중 죄책감, 진보성, 불안감, 도덕성과 방어기제의 신 체화, 투사등과 유의미한 상관이 있었고, 사회/오락활동항목은 성격요인의 죄책감, 불안감과 방어기제중 허세, 투사 등과 유의미한 상관관계가 있는 것으로 나타났다(p<0.05). 3) BDI와 사회기능장애척도의 업무항목간에는 유의미한 상관관계가 있는 것으로 나타났다(p<0.05). 결 론: 공황장애 환자는 성격요인검사상 불안감이 높고 자아강도, 신중성, 사변성은 낮게 나타 났으며, 신체화 등의 신경증적 방어기제를 주로 사용하는 반면 유우머, 억제, 이타주의, 회피, 합리화의 방어기제는 적게 사용하는 것으로 나타났다. 증상의 강도와 관련이 있는 우울증상은 업무활동에 영향을 미쳐 이와 관련된 중등도의 사회기능의 장애를 초래하고 있는 것으로 보인다. Objectives : The purpose of this study was to evaluate the characteristics of personality factor and defense mechanism and relationship with depression and disability. Methods : Study subjects consisted of 35 panic disorder patients diagnosed with the criteria of DSM-Ⅳ. Data were collected through Sixteen Personality Factor Questionnaire, Ehwa Diagnostic Test of Defense Mechanism, Beck Depression Inventory and Sheehan Disability Scale. Statistics employed for the analyses were Pearson correlation and independent sample t-test. Results : In personality factors and defense mechanisms, there were no definitely abnormal range of scores. But, among personality factors, tension/anxiety factor scored high and unstableness/stableness, shyness/boldness and praxernia/atunia were in low range of score. In defense mechanism, somatization and acting-out scored high and humor, suppression, altruism, avoidance and rationalization scored low. The mean BDI score was 18.25±9.97. The mean score of SDS were 4.88±3.11 in work category and 4.57±2.92 in social/leasure category. Male patients were significantly correlated with guit-proneness and atuia in personality factor and passive-aggressiveness, projection, denial and show-off in defense mechanism, compared with female patients(p<0.05). The patients` age was correlated with low intelligence in persolity factor and dissociation and anticipation in defense mechanism. It was negatively correlated with show-off(p<0.05). The BDI score was correlated with low intelligence, superego, unstableness, self-conflict, high superego and atunia in personality factor and dissociation and somatization in defense mechanism(p<0.05). There was a significant relationship between BDI score and SDS work category(p<0.05). Conclusions: Panic disorder patients show high score of tension/anxiety factor and they frequently use neurotic defense style like somatization. The depressive symptom, which depends on symptom severity, appears to have influence on work category and to cause social disability.

사회공포증 환자의 성격요인과 방어기제에 대한 연구

이시형,백상빈,노경선,오강섭,신영철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 사회공포 환자의 성격요인과 방어기제의 특징을 알아보고, 비가해형 및 가해형에 따라 유의미한 차이가 있는지 알아보고자 본 연구를 시행하였다. 방 법: 강북삼성병원 외래치료 환자중 DSM-Ⅳ에 근거하여 사회공포로 진단된 환자 28명을 대상으로 성격요인검사(Sixteen Personality Factor Questionnaire 한국판) 및 이화방어기제검사를 시행하였고 통계처리는 각 검사에 대한 빈도분석과 비가해형과 가해형에 대한 Independent-Sample t-test를 시행하였다. 결 과: 사회공포 환자에서 성격요인(평균점수) 중 shyness/boldness 요인이 정상보다 낮은 소견을 보였으며 방어기제에서는 유우머 항목이 정상보다 낮은 소견을 보였다. 성격요인과 방어기제 모두에서 비가해형과 가해형간에 유의미한 차이는 보이지 않았다. 결 론: 성격요인의 결과상 사회공포 환자들은 감정 표현을 억제하며 비사교적이다. 또한 자기주장을 못하여 타인에게 순종적, 동조적이며 정서적 불안정감이 심하다. 이러한 성격요인들은 모두 자율신경계의 약화, 불안의 증가, 공포증의 유발가능성의 증가등으로 사회공포와 관련되어 있다. 또한 방어기제의 결과상 사회공포 환자들은 유우머가 부족하고 지나치게 긴장, 경직되어 있어 사회공포 증세를 유발하기 쉬운 것으로 판단되었다. 사회공포의 두 유형인 비가해형과 가해형간에는 성격요인, 방어기제 모두에서 유의미한 차이가 없는 것으로 나타났다. Objectives: The purpose of this study was to evaluate the characteristics of personality factor and defense mechanism and to compare the difference between non-offensive and offensive types of social phobia patients. Methods: Study subjects consisted of 28 social phobia patients diagnosed with the criteria of DSM-Ⅳ. Data were collected through Sixteen Personality Factor Questionnaire and Ehwa Diagnostic Test of Defense Mechanism. We employed was the independent sample t-test for the analysis. Result: Among the personality factor, the shyness/boldness factor scored lower than normal in social phobia patients. Humor defense scored lower than normal among defense mechanisms. There was no significant correlation between non-offensive and offensive types of social phobia in personality factors and defense mechanisms. Conclusions: Social phobia patients were shier and less frequently use humor defense than the ordinary people. There was no significant correlation between non-offensive and offensive types of social phobia patients in personality factors and defense mechanisms.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

Treatment Outcomes and Prognostic Factors of Patients with Recurrent Hepatocellular Carcinoma after Liver Transplantation

( Young Seob Shin ),( Sang Min Yoon ),( Young-in Yoon ),( Gi-won Song ),( Ki-hun Kim ),( Jinhong Jung ),( Jin-hong Park ),( Sung-gyu Lee ) 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

(Book Reviews) Capital Accumulation and Women's Labour in Asian Economies by Peter Custers, London: Zed Book, 1997

Shin, Young Seob 숙명여자대학교 아세아여성문제연구소 1998 Asian Women Vol.7 No.-

After the outbreak of the Asian currency crisis in the summer of 1997, there has been a lot of debates and discussions en the cause of, and en the remedy for the currency crisis, most of which are dominated by neo-liberalism and globalism. One of the most disastrous results from the currency crisis is that Asian people face massive involuntary unemployment, and thus a drastically deteriorated living standard, which means a "collapse of middle class." This has enhanced the economic burden of Asian women, whe belong to the traditionally alienated and oppressed social classes. Capital Accumulation and Women's Lobour in Asian Economies employs Marxian theoretical concepts, such as the primitive accumulation of capital, the prolongation of working days, the turn-over time of capital, and the reserve army of labor, to analyze women's labour in Asian economies. The author argues that Marxist perspective and analytical tools are still relevant and applicable to the realities in Asian economies. This arguement sounds interesting and stimulates intelligent curiosity because of the chads of mainstream economic theories resulting from the surprise of economic crisis and his suggestion of an alterative perspective. This book is composed of four parts; part 1 review the history of women's labor part 2 and 3 describe the realities of women's labor in Indian and Bangladesh garment industry and Bangladesh agriculture, and part 4 analyzes the role of Japanese women's labor as a reserve army of labor.

Spontaneous reporting of adverse drug events by Korean regional pharmacovigilance centers

Shin, Yoo Seob,Lee, Yong-Won,Choi, Young Hwa,Park, Byungjoo,Jee, Young Koo,Choi, Sung-Kyu,Kim, Eung-Gyu,Park, Jung-Won,Hong, Chein-Soo John Wiley Sons, Ltd. 2009 PHARMACOEPIDEMIOLOGY AND DRUG SAFETY Vol.18 No.10

<B>Purpose</B><P>Patterns of prescriptions are markedly influenced by regional disease entities, medical education, culture, economic status, and available pharmaceutical companies. Features of adverse drug reactions (ADRs) may vary in different countries. In this study, we analyzed the causative drugs and clinical manifestations of spontaneously reported ADRs in Korea.</P><B>Methods</B><P>Six Korean Regional Pharmacovigilance Centers collected 1418 cases of spontaneously reported adverse drug events (ADEs) by doctors, pharmacists, and nurses, and the clinical features and causative drugs were evaluated. The data were collected from general hospitals (76.5%), primary clinics, and pharmacies (23.5%).</P><B>Results</B><P>Based upon the World Health Organization (WHO)-Uppsala Monitoring Center criteria (certain—13.7%, probable—46.1%, possible—32.1%), 91.9% of the collected events were suspected to be ADRs and 15.8% of patients experienced serious ADRs. The most prevalent causative drugs were antibiotics (31.6%), followed by contrast dyes (14.0%), non-steroidal anti-inflammatory drugs (NSAIDs) (11.1%), anti-psychotics (5.4%), anti-convulsants (5.2%), cardiovascular agents (4.8%), anti-neoplastics (4.6%), and opiates and non-opiate pain killers (3.5%). Among the antibiotics, cephalosporins (8.1%) were the most common, followed by anti-tuberculosis agents (5.7%), quinolones (4.0%), vancomycin (3.1%), and penicillin (2.8%). The most common side effect was skin manifestations, which were seen in 42% of the patients, followed by neurologic manifestations (14%), gastrointestinal involvements (12.9%), generalized reactions (9.4%), and respiratory involvements (4.5%).</P><B>Conclusion</B><P>Antibiotics, contrast dyes, and NSAIDs were the most common causative drugs for ADRs, which reflects the prescription pattern and the prevalence of diseases in Korea. These data may be useful in establishing a Korean pharmacovigilance system. Copyright © 2009 John Wiley & Sons, Ltd.</P>

Bilateral Calcified Chronic Subdural Hematoma in a Patient with Ventriculoperitoneal Shunt: A Case Report

Shin Yo Seob,Lee Young Woo,Shin Dong Gyu,Shin Woo Ram 대한말초신경학회 2019 The Nerve Vol.5 No.2

Chronic subdural hematoma (CSDH) is a common condition. However, it is rarely calcified. Among various causes, hydrocephalus and ventriculoperitoneal shunts in CSDH are uncommon causes of calcification. A 38-year-old woman presented with visual disturbance. Computed tomography and magnetic resonance imaging of the brain demonstrated compressed optic chiasm by planum sphenoidale meningioma. And massive bilateral calcified CSDH with cerebral convexity. Surgery was performed to remove the tumor and ipsilateral calcification. The symptoms improved following discharge after surgery. As this is a rarely performed surgery, caution is advised to prevent damaging the dura matter when cutting the bone and to prevent damaging the brain during dissection.