• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.3007-3013
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• 2016

Background: Gastrointestinal cancers are common malignancies associated with high mortality rates. Healthcare systems are always faced with high costs of treatment of gastrointestinal cancers including stomach cancer. Identification and prioritization of these costs can help determine economic burden and then improve of health planning by policy-makers. This study was performed in 2015 in Kerman City aimed at estimating the direct hospital costs for patients with gastric cancer. Materials and Methods: In this cross-sectional study, the medical records of 160 patients with stomach cancer admitted from 2011 to 2014 to Shafa Hospital were examined, the current stage of the disease and the patients' health status were identified, and the direct costs related to the type of treatment in the public and private sectors were calculated. SPSS-19 was used for statistical analysis of the data. Results: Of the patients studied, 103 (65%) were men and 57 (35%) were women. The mean age of patients was 65 years. Distribution into four stages of the disease was 5%, 20%, 30%, and 45%, respectively. Direct costs in four stages of the disease were calculated as 2191.07, 2642.93, 2877, and 2674.07 USD (63,045,879, 76,047,934, 82,783,019, and 76,943,800 IRR), respectively. The highest percentage of costs was related to surgery in Stage I and to medication in Stages II, III, and IV. According to the results of direct costs of treatment for stomach cancer in Kerman, the mean total cost of treating a patient in the public sector was estimated at 74,705,158 IRR, of which averages of 60,141,384 IRR and 14,563,774 IRR were the shares of insurance and patients, respectively. Conclusions: The high prevalence and diagnosis of disease in old age and at advanced stages of disease impose great costs on the patients and the health system. Early diagnosis through screening and selecting an appropriate treatment method might largely ameliorate the economic burden of the disease.

• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.37-69
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• 2001

A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.172-178
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• 1999

Purpose : To measure the basic structural characteristics of radiation oncology facilities in Korea during 1997 and to compare personnel, equipments and patient loads between Korea and developed countries. Methods and Materials : Mail serveys we conducted in 1998 and data on treatment machines, personnel and peformed new patients were collected. Responses were obtained from the 100 percent of facilities. The consensus data of the whole country were summarized using Microsoft Excel program. Results: In Korea during 1997, 42 facilities delivered megavoltage radiation theraphy with 71 treatment machines, 100 radiation oncologists, 26 medical physicist, 205 technologists and 19,773 new patients. Eighty nine percent of facilities in Korea had linear accelators at least 6 MeV maximum photon energy. Ninety five percent of facilities had simulators while five percent of facilities had no simulator, Ninety one percent of facilities had computer planning systems and eighty three percent of facilities reported that they had a written quality assurance program. Thirty six percent of facilities had only one radiation oncologist and thirty eight percent of facilities had no medical physicists. The median of the distribution of annual patients load of a facility, patients load per a machine, patients load per a radiation oncologist, patients load per a therapist and therapists per a machine in Korea were 348 patients per a year, 263 patients per a machine, 171 patients per a radiation oncologist, 81 patients per a therapist, and 3 therapists per a machine respectively. Conclusions : The whole scale of the radiation oncology departments in Korea was smaller than Japan and USA in population ratio regard. In case of hardware level like linear accelerators, simulators and computer planning systems, there was no big differences between Korea and USA. The patients loads of radiation oncologists and therapists had no significant differences as compared with USA. However, it was desirable to consider the part time system in USA because there were a lot of hospitals which did not employ medical physicists.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.365-374
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• 2015

The regular quality assurance (RQA) of X-ray images is essential for maintaining a high accuracy of diagnosis. This study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) of a computed radiography (CR) system for various periods of use from 2006 to 2015. We measured the pre-sampling MTF using the edge method and RQA 5 based on commission standard international electro-technical commission (IEC). The spatial frequencies corresponding to the 50% MTF for the CR systems in 2006, 2009, 2012 and 2015 were 1.54, 1.14, 1.12, and $1.38mm^{-1}$, respectively and the10% MTF for 2006, 2009, 2012, and 2015 were 2.68, 2.44, 2.44, and $2.46mm^{-1}$, respectively. In the NPS results, the CR systems showed the best noise distribution in 2006, and with the quality of distributions in the order of 2015, 2009, and 2012. At peak DQE and DQE at $1mm^{-1}$, the CR systems showed the best efficiency in 2006, and showed better efficiency in order of 2015, 2009, and 2012. Because the eraser lamp in the CR systems was replaced, the image quality in 2015 was superior to those in 2009 and 2012. This study can be incorporated into used in clinical QA requiring performance and evaluation of the performance of the CR systems.

• Child Health Nursing Research
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• v.22 no.1
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• pp.29-36
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• 2016

Purpose: The purpose of this study was to identify international students' use of university health centers by individual characteristics and seasons. Methods: This was a retrospective descriptive study using data obtained from the electronic record system of one university health center. The study participants were international undergraduate students who registered for any of two semesters between March 1, 2014 and February 28, 2015 and visited the university health center during their registration period. Results: The most common reasons for visits were problems of head, eye, nose and throat systems, followed by respiratory system. Their visits mostly occurred in the fall and spring. The most frequently used services were distribution of oral medication followed by wound treatment. The number of visits per individual was statistically different by gender (u=-3.307, p=.001), but not by their major (${\chi}^2$=.543, p=0.762) or nationality (${\chi}^2$=5.518, p=.271). Conclusion: Further study is necessary to better define health needs and related factors for this unique population. The electronic record system provides great opportunities in development and application of need based health services for international students and for research in this area.

• Animal cells and systems
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• v.1 no.1
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• pp.129-134
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• 1997

HLA-A2 is one of the most diversified HLA-class I antigen with 17 subtypes so far identified at the molecular level. HLA-A*02 subtyping has significant implications on the tissue typing for organ and bone marrow transplantations. Recently, DNA-based typing methods have been successfully applied to the elucidation of HLA gene polymorphisms. In the present study, HLA-A*O2 genotyping was established by using nested polymerase chain reaction-sequence specific primers (PCR-SSP) and distribution of A*O2 alleles were determined in Korean individuals. Genomic DNA prepared from four B-lymphoblastoid cell lines and lymphocytes from serologically defined 48 HLA-A2 Korean individuals by phenol/chloroform extractions was typed. The results of the four B-lymphoblastoid cells were consistent with the previous data typed by PCR analysis. Five A*O2 alleles-A*0201, A*0203, A*0206, A*0207 and A*0210-were commonly observed in a total of 17 A*02 alleles. Of these, A*0207 (f=49.0%) was the most frequent allele in Korean population. A*0206 (f=28.3%) and A*0201 (f=17.0%) were also found frequently while A*0203 and A*0210 types were observed in less than 5%. In conclusion, the high level of discrimination for HLA-A*O2 alleles will prove useful and informative in the study of transplant survival, and may identify the importance of allelic differences not readily detectable by serology on host and donor compatibility.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.27 no.2
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• pp.75-81
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• 2018

The aim of this study was to evaluate the biomechanical behavior and long-term safety of high performance polymer PEKK as an intraradicular dental post-core material through comparative finite element analysis (FEA) with other conventional post-core materials. A 3D FEA model of a maxillary central incisor was constructed. A cyclic loading force of 50 N was applied at an angle of $45^{\circ}$ to the longitudinal axis of the tooth at the palatal surface of the crown. For comparison with traditionally used post-core materials, three materials (gold, fiberglass, and PEKK) were simulated to determine their post-core properties. PEKK, with a lower elastic modulus than root dentin, showed comparably high failure resistance and a more favorable stress distribution than conventional post-core material. However, the PEKK post-core system showed a higher probability of debonding and crown failure under long-term cyclic loading than the metal or fiberglass post-core systems.

• Korean Journal of Schizophrenia Research
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• v.23 no.2
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• pp.71-77
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• 2020

Objectives: Tardive dyskinesia (TD) is a movement disorder that is characterized by hyperkinetic movements. Previous studies have suggested that the serotonergic systems are correlated with TD vulnerability. In this study, the association between a single-nucleotide polymorphism (SNP) of the serotonin 1A receptor gene (HTR1A) rs6295 and TD was investigated. Methods: We investigated whether HTR1A rs6295 SNP is associated with antipsychotic-induced TD in 280 Korean patients with schizophrenia. Patients with schizophrenia having TD (n=105) and those without TD (n=175) were matched for their antipsychotic exposures and other relevant variables. The HTR1A rs6295 SNP was analyzed using polymerase chain reaction (PCR)-based methods. Results: There was no significant difference in the distribution of genotypic (χ²=2.70, p=0.26) and allelic (χ²=1.87, p=0.17) frequencies between the patient groups with TD and without TD. There was no significant difference in total abnormal involuntary movement scale score (F=0.39, p=0.68) among the genotype group either. Conclusion: Although there were no differences in genotypic and allelic frequency between patient groups with and without TD, further studies on association of TD with other SNPs of HTRA1 are needed to understand the pathophysiological mechanism of TD.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.412-430
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• 2003

Functional stability is dependent on integrated local and global muscle function. Movement dysfunction can present as a local and global problem, though both frequently occur together. To good understand how movement induces pain syndrome, the optimal actions and interaction of the multiple anatomic and functional systems involved in motion must be considered. Minor alterations in the precision of movement cause microtrauma and, if allowed to continue, will cause macrotrauma and pain. These alteration of the movement result in the development of compensatory movement and movement impairment. Muscle that become tight tend to pull the body segment to which they are attached, creating postural deviation. The antagonistic muscles may become weak and allow postural deviations due to lack of balanced support. Both hypertonic and inhibited muscles will cause an alteration of the distribution of pressure over the joint(s) that they cross and, thus, may not only result from muscle dysfunction, but produce joint dysfunction as well. Alteration of the shoulder posture and movement dysfunction may sometimes result in compression of neurovascular structures in the shoulder and arm. There is a clear link between reduced proprioceptive input, altered motor unit recruitment and the neurovascular compression. This report start with understanding of the impaired alignment, movement patterns and neuromuscular compression of the shoulder girdle by movement impairment to approach method of the movement dysfunction.