• Title/Summary/Keyword: Indirect treatment

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A Study on Socioeconomic Costs of Menopausal Syndrome Treated with Oriental Medicine (폐경기 증후군의 한의학적 치료에 따른 사회경제적 비용에 대한 연구)

  • Kang, Jung-Ah;Cho, Han-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.1
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    • pp.72-82
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    • 2010
  • Purpose: This study was conducted to estimate the annual socioeconomic costs of menopausal syndrome treated with oriental medicine in Korea 2008. Methods: Study subjects selected were patients aged 40 years or older who had national health insurance(NHI) claims record with menopausal syndrome(KCDO codes: K04, K04.0, K04.2, K04.3, K04.4) for oriental medicine treatment in 2008. Direct medical cost of oriental medicine treatment for menopausal syndrome were measured from NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting hospitals. Indirect costs were defined as patients' productivity loss associated with office visits or hospitalization. Also, the costs of unpaid-household chores were calculated. Results: The total cost for the oriental medicine treatment of menopausal syndrome in the nation was estimated to be 743,091,219 Korean won(KRW) which included direct costs at 442,971,637 KRW and indirect costs at 300,119,583 KRW. Conclusion: This study provides an important perspective of socioecnomic influence due to menopausal syndrome treated with oriental medicine. And this results can be used as elementary data for menopausal syndrome-related health policy of oriental medicine.

Usefulness of Indirect Open Reduction and External Fixation in Algorithm Oriented Treatment of Nasal Fracture (비골골절 치료 시 간접 관혈적 정복술 및 외고정술의 유용성)

  • Park, Ki Rin;Chung, Kyu-Jin;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.14 no.2
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    • pp.81-88
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    • 2013
  • Background: To suggest the need of more aggressive reduction techniques than closed reduction (CR) technique in nasal fracture treatment, we identified the usefulness of algorithm oriented treatment of nasal fracture that includes indirect open reduction (IOR) and external fixation (EF) as well as the CR. Methods: We compared the clinical course of the group A (n=128) where only the CR was performed regardless of the pattern of the nasal fracture and the group B (n=127) where algorithm oriented treatment including IOR and EF as well as CR was performed depending on the pattern of nasal fracture. And the degree of postoperative pain after CR and IOR technique was compared through the dose of analgesics and pain scores. Results: More than 80% of patients were satisfied the result of reduction in both group A and B. Good contour of nasal bone after reduction was showed 71% of group A and 81% of group B without significant difference. Minor (p>0.05) and major (p<0.05) deformity after reduction were less occurred in the group B than group A. Postoperatively, the dose of analgesics was significantly lower after IOR technique than CR technique (53 mg vs. 142 mg) (p<0.05). Conclusion: Algorithm oriented treatment of nasal fracture including IOR and EF as well as CR reduce major deformity after reduction than treatment of CR alone. It is useful to perform the more aggressive reduction techniques such as IOR and EF according to the pattern of fracture in treatment of nasal fracture.

Economic Evaluation of Gemcitabine-cisplatin Chemotherapy for Non Small-Cell Lung Cancer Patient in an Outpatient Setting (비용-효과 분석 기법을 이용한 Gemcitabine 외래 항암 치료의 경제성 평가)

  • Min, Su-Hyun;Ko, Su-Kyoung;Lim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.3
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    • pp.363-371
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    • 2008
  • Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

The effect of factors dental treatment fear of dental hygiene and non-dental hygiene students (치위생과학생과 비보건계열 학생의 치과치료공포수준에 미치는 요인)

  • Choi, Mi-Hye;Kim, Nam-Song
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.4
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    • pp.523-532
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    • 2011
  • Objectives : The purpose of this study was to measure the effect of factors analyes the associated by the dental treatment fear of level dental hygiene and non-dental hygiene students, and then to provide basic material which can help to improveoral health and effective dental treatment. Methods : The subject in this study were 275 students in Jeolla region. The data were collected from March through April 2010, by way of the self-reported questionnaire. Results : 1. Subjects, who correspond to 'high fear level' which is more than 60 points in the scale of Dental Fear Survey, were indicated to be larger in collegians of general-related departments(38.9%) than collegians of health-related department(36.3%).2. Among three detailed factors, the treatment-stimulator response factor showed the higher fear sense than other 2 factors. In the physiological response, 'muscular tension' was 2.72 points, there by having been indicated to be the highest.3. The more belonging to the group with high fear was indicated to lead to the more in direct pain experience, in non-anesthesia pain experience, and in indirect pain experience through brothers and sisters. Even the symptom and syndrome in oral disease were indicated to be much. 4. As a result of comparing difference in dental fear level depending on pain experience, it was indicated that the more belonging to the group with high fear leads to the more in direct pain experience, in non-anesthesia pain experience, and in indirect pain experience through brothers and sisters. Conclusions : Dental fear must be controlled carefully in order to promote oral health and effective dental treatment.

SHEAR BOND STRENGTH OF REPAIRED COMPOSITE RESIN RESTORATIONS (수리된 복합레진 수복물의 전단결합강도 연구)

  • Choi, Soo-young;Jeong, Sun-Wa;Hwang, Yun-Chan;Kim, Sun-Ho;Yun, Chang;Oh, Won-Mann;Hwang, In-Nam
    • Restorative Dentistry and Endodontics
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    • v.27 no.6
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    • pp.569-576
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    • 2002
  • This study was peformed to evaluate the interfacial shear bond strength of base (direct and indirect) and repair composites with aging and surface treatment methods. Direct composite resin specimens ($Charisma^{\circledR}$, Heraeus Kulzer, Germany) were aged for 5 min, 1 hour, 24 hours, and 1 week in $37^{\circ}C$ distilled water before surface treatment, and then divided into five groups Group 1, grinding; Group 2, grinding and application of bonding agent, Group 3, grinding, etching with 37% phosphoric acid for 30sec, and application of bonding agent, Group 4, grinding, etching with 37% phosphoric acid for 30sec, silane treatment, and application of bonding agent ; Group 5, grinding, etching with 4% hydrofluoric acid for 30sec. silane treatment, and application of bonding agent. Indirect composite resin specimens ($Artglass^{\circledR}$, Heraeus Kulzer, Germany) were aged for 1 week in $37^{\circ}C$ distilled water and divided into seven groups Group 1 - Group 5, equal to Charisma specimens; Group 6, grinding, etching with 37% phosphoric acid for 60sec, silane treatment, and application of bonding agent; Group7, grinding, etching with 4% hydrofluoric acid for 60 sec, silane treatment, and application of bond-ing agent. The repair material($Charisma^{\circledR}$) was then added on the center of the surface (5 mm in diameter. 5 mm in height). The shear bond strength was tested and the data was analyzed using one-way ANOVA and the Student- Newman-Keuls test. The following conclusions were drawn. 1 The shear bond strength of $Charisma^{\circledR}$ specimens aged for 1 hour was significantly higher in Group 2 and Group 5 than in Group 1 (p<0.05), and that of $Charisma^{\circledR}$ specimens aged for 1 week was signifi-cantly higher in Group 3 and Group 5 than in Group 1 (p<0.05). No significant difference was found in the bond strength of specimens aged for 5 min and 24 hours. 2. In Group 2 of the $Charisma^{\circledR}$ specimens, there was significant difference between the bond strength of 24 hours and that of 1 week (p<0.05). 3. In Group 4 of the $Charisma^{\circledR}$ specimens, the shear bond strength of specimens aged for 24 hours was significantly higher than the others(p<0.05) 4. There was no significant difference between the shear bond strength of the $Artglass^{\circledR}$ specimens, 5. Most of the $Charisma^{\circledR}$ specimens showed cohesive fractures. Artglass^{\circledR}$ specimens that were etched with acid (phosphoric or hydrofluoric) for 30 sec showed more cohesive fractures.

A STUDY ON THE BOND STRENGTH OF REINFORCED INDIRECT COMPOSITE RESINS TO DENIAL ALLOYS (강화형 간접복합레진과 치과용 합금의 결합강도에 관한 연구)

  • Yoon, Dong-Joo;Shin, Sang-Wan;Lim, Ho-Nam;Suh, Kyu-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.5
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    • pp.620-639
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    • 1999
  • Indirect composite resins are used as an popular effective esthetic material in prosthetic dentistry, often with metallic substructure that provides support for restorations. Recently, new indirect composite resins as a substitute of ceramic have been developed. These resins provide good esthetics, with a wide range of hue and chroma. And the flexural strength of those is in the range of 120-150MPa, Which is higher than that of feldspathic Ceramic, and similar th that of Dicor. Although it has many merits, one of the major clinical problems of composite resins is the bond failure between metal and resin due to insufficient interfacial bond strength. The purpose of this study was to evaluate shear bond strength of the reinforced indirect composite resin to dental alloys. Three different composite resin systems($Artglass^{(R)},\;Sculpture^{(R)},\;Targis^{(R)}$) as test groups and ceramic($VMK\;68^{(R)}$) as control group were bonded to Ni-Cr-Be alloy($Rexillium\;III^{(R)}$) and gold alloy(Deva 4). All specimens were stored at $^37{\circ}C$ distilled water for 24 hours and the half of specimens were thermocycled 2000 times at temperature from $5^{\circ}C\;to\;60^{\circ}C$. The shear bond strengths of reinforced indirect composite resins to dental alloys were measured by using the universal testing machine, and modes of debonding were observed by stereoscope and scanning electron microscope. The results were as follows: 1 The shear bond strengths of reinforced indirect composite resins to dental alloys were approximately half those of ceramic to dental alloys(P<0.01). 2. There was no significant difference between the shear bond strength of several reinforced indirect composite resins to metal. 3. Alloy type did not affect on the shear bond strengths of resin to metal, but the shear bond strengths of ceramic to gold alloys were higher than those of ceramic to Ni-Cr alloys(P<0.05). 4. The shear bond strengths of Artglass and Targil to gold alloys were significantly decreased after thermocycling treatment(P<0.01). 5. Sculpture showed cohesive, adhesive, and mixed failure modes, but Artglass and Targis showed adhesive or mixed failures. And ceramic showed cohesive and mixed failures.

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Comparative efficacy of photo-activated disinfection and calcium hydroxide for disinfection of remaining carious dentin in deep cavities: a clinical study

  • Sharma, Sidhartha;Logani, Ajay;Shah, Naseem
    • Restorative Dentistry and Endodontics
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    • v.39 no.3
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    • pp.195-200
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    • 2014
  • Objectives: To comparatively evaluate the efficacy of photo-activated disinfection (PAD), calcium hydroxide (CH) and their combination on the treatment outcome of indirect pulp treatment (IPT). Materials and Methods: Institutional ethical clearance and informed consent of the patients were taken. The study was also registered with clinical registry of India. Sixty permanent molars exhibiting deep occlusal carious lesion in patients with the age range of 18 - 22 yr were included. Clinical and radiographic evaluation and set inclusion and exclusion criteria's were followed. Gross caries excavation was accomplished. In group I (n = 20) PAD was applied for sixty seconds. In group II (n = 20), CH was applied to the remaining carious dentin, while in group III (n = 20), PAD application was followed by CH placement. The teeth were permanently restored. They were clinically and radiographically followed-up at 45 day, 6 mon and 12 mon. Relative density of the remaining affected dentin was measured by 'Radiovisiography (RVG) densitometric' analysis. Results: Successful outcome with an increase in radiographic grey values were observed in all three groups. However, on inter-group comparison, this change was not significant (p > 0.05). Conclusions: PAD and CH both have equal disinfection efficacy in the treatment of deep carious dentin. PAD alone is as effective for treatment of deep carious lesion as calcium hydroxide and hence can be used as an alternative to CH. They can be used independently in IPT, since combining both does not offer any additional therapeutic benefits.

Dental implant cost estimation using the Activity-Based Costing approach (활동기준원가(Activity Based Cost)를 적용한 치과 임플란트 원가산정)

  • Shin, Ho-Sung;Ahn, Eun-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.292-299
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    • 2013
  • Purpose: There is a growing concern for the cost management of medical institutions. The purpose of this study was to estimate Activity-Based Costing (ABC) for dental implant cost. ABC refers to allocating resources or cost based on the activities of services. Materials and methods: A dental institution located in the metropolitan area was selected in this study. The tax accounting data of the institution were utilized to confirm total cost, and the institution was asked to make out clinical activities to figure out what activities were carried out. The direct cost and indirect cost for dental implant were separately estimated, and cost driver was analyzed to estimate the indirect cost accurately. Results: The rates of the direct and indirect cost respectively stood at 35.8 and 49.5 percent. The cost for a dental implant was found to be approximately 1,579 won, and the cost of prosthetic surgery and treatment that included implant surgery accounted for the largest portion of the cost, which was 470 thousand won (30%). And the weight of training and education on dentistry was relatively higher than that of the other kinds of treatment. Conclusion: In order to ensure accurate and scientific costing for dental implant, not only direct medical procedure but every pre- and post-procedure activity should fully be taken into account. Pre-activities, post-activities, education and training are included in the indirect cost, but all these activities are mandatory and associated with the quality of treatment and the satisfaction level of patients.

A Case Study on the Resolution of International Investment Disputes Caused by Aggravation of Political and Economic Situation of the Host State - Focusing on the case of CMS Gas Transmission Company v. Argentine Republic (투자유치국의 정치.경제상황 악화로 인한 국제투자분쟁의 해결에 관한 사례연구 -CMS Gas Transmission Company v. Argentine Republic 사건을 중심으로)

  • Oh, Won-Suk;Hur, Hai-Kwan
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.36
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    • pp.87-109
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    • 2007
  • This Comment explores the ICSID case of CMS Gas Transmission Company v. Argentine Republic, awarded on May 12, 2005. The Part II of this Comment first describes the relevant facts of the case including the some background for readers' understanding and the Part III summaries the claimant's requests and the decisions rendered by the Arbitral Tribunal in the Award. At Part IV, the Comment addresses the issue of determinating laws applicable to the merits of dispute in case that the parties of the case have not chosen a governing law, and at Part V, takes a close look into three main issues of (i) the indirect expropriation of the investment, (ii) the breach of fair and equitable treatment and (iii) the protections under umbrella clauses. In this CMS case, we see first that while the Tribunal affirmed that any indirect expropriation can occur from incidental interference depriving the foreign investor of the use or reasonable-to-be-expected economic benefit even if not necessarily to the obvious benefit of the host State, the Tribunal denied the occurrence of indirect expropriation in this case by holding that the Government of Argentina has not breached the standard of protection laid down in the Treaty. Secondly, however, regarding the issue of fair and equitable treatment, we see that the Tribunal, finding Argentina's breach of obligations, affirmed that the foreign investor can expect the host State to act in a consistent manner, free from ambiguity and totally transparently in its relations with the foreign investor, which can give the foreign investor certain degree of foreseeability. Thirdly and finally, we see that, on base of the effect of the umbrella clause, the Tribunal recognized the obligation of the host State undertaken not to freeze the tariff regime or subject it to price controls and not to alter the basic rules governing contracts between the foreign investor and the host State without the first's written consent. However, the protection under the umbrella clause is available only when there is a specific breach of rights and obligations under BIT or a violation of contract rights protected under BIT.

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