Park, No-Rai;Yun, Young-Ho;Shin, Soon-Ae;Jeong, Eun-Kyeong
Journal of Hospice and Palliative Care
/
v.2
no.2
/
pp.109-113
/
1999
Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.
The present study was conducted to examine the reprodutive performance and organs autopsy of culled dairy cows at alpine area. 795 culled dairy cows were managed and 206 culled dairy cows were examined by autopsy of reproductive organs at above 800m of sea level around the Daegwallryoung alpine area. The results of this study were at follows ; 1. Age and parity of culled dairy cows were 60.8 months and 3.0, respectively. 2. Age of first AI of heifer was 18.7 months, and age of pregnancy and parturition of heifer were 19.5 months and 28.6 months, respectively. 3. Al time per pregnancy was 1.7 and time of pregnancy after parturition, pregnancy period and calving interval were 140.9, 279.6 and 424.9 days, respectively. 4. Culled months after last parturition was 4.3 and the highest urogenital deseases of culled reason were 358(45.0%). 5. Reproductive organs deseases by autopsy were 120(58.4%), the highest ovary disease were 75(43.6%). 6. The highest ovary adhesions of reproductive organ diseases were 46(26.7%), infundibulum adhesion, obstruction of the oviduct and endometritis were 38(22.1%), 15(8.7%), and 14(8.2%), respectively. 7. In culled dairy cow for the reproductive organ disease, parity, age, culled months and AI number after last parturition were 3.2, 66.5 months, 7.9 months and 2.1, respectively.
Park, Chul Hyun;Lee, Woo Chun;Park, Jae Woo;Moon, Jeong Jae
Journal of Korean Foot and Ankle Society
/
v.19
no.3
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pp.91-96
/
2015
Purpose: The purpose of this study is to evaluate the sequential changes of clinical and radiographic results after proximal chevron osteotomy in patients with moderate to severe hallux valgus. Materials and Methods: Between January 2008 and December 2009, 93 patients (117 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. The mean age of patients was 51 years (range, 19 to 71) and the mean duration of follow-up was 27.5 months (range, 24 to 35). Clinical results were evaluated using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score preoperatively, at 3, 6, and 12 months after surgery, and at the last follow-up. Radiographic parameters including hallux valgus angle, intermetatarsal angle, and sesamoid position were evaluated preoperatively, immediately postoperatively, at 6 weeks, at 3, 6, and 12 months after surgery, and at the last follow-up. Results: VAS and AOFAS score showed significant improvement until 12 months after surgery. Hallux valgus angle and sesamoid position stabilized at 12 months after surgery and intermetatarsal angle stabilized at 6 months after surgery. Conclusion: Clinical and radiographic results were stabilized beyond 12 months after proximal chevron osteotomy in patients with moderate to severe hallux valgus.
Objective : To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. Methods : The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. Results : 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age af death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. Conclusion : An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.
Kim, Jong-Hwa;Kim, Young-Kyun;Yi, Yang-Jin;Yun, Pil-Young;Lee, Hyo-Jung;Kim, Myung-Jin;Yeo, In-Sung
The Journal of Advanced Prosthodontics
/
v.1
no.3
/
pp.136-139
/
2009
STATEMENT OF PROBLEM. Many dental clinicians are concerned about immediate loading of inserted implants. However, there have been few clinical studies surveying the success rates of immediate loading, based on Korean implant systems. PURPOSE. The aim of this study was to evaluate the outcome of immediate functional loading of the implant ($SinusQuick^{TM}$EB, Neobiotech Co., Seoul, Korea) in partially edentulous maxilla or mandible. MATERIAL AND METHODS. Total 15 implants were placed. Within 2 weeks after implant insertion, provisional implant-supported fixed partial dentures were delivered to the patients. Quantitatively, marginal bone loss was measured at the time of immediate loading, after 3-months of continued loading and at the last follow-up. The mean follow-up period was 4.8 months. RESULTS. Mean marginal bone loss from implant surgery to early loading, 3-months follow-up and last follow-up was $0.03\pm0.07$ mm, $0.16\pm0.17$ mm and $0.29\pm0.19$ mm. No implant failed up to 6 months after insertion, resulting in a 100% survival rate. CONCLUSION. Immediate loading exhibited high success rate in partial edentulism for up to 6 months. Well-controlled long term clinical studies with large sample size are necessary to confirm this finding.
Purpose: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. Materials and Methods: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. Results: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged $2.3{\pm}1.1$ rum postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). Conclusion: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.
Objective : The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). Methods : Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for $18.7{\pm}11.1$ months. The mean duration of the CD was $5.8{\pm}3.4$ years. The mean age at time of surgery was $54.2{\pm}10.2$ years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. Results : The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p=0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged $81.7{\pm}6.8%$ at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions : Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.
To evaluate the impact of drought on agriculture in N. Korea, SPI (standardized precipitation index) analysis was carried out by utilizing time-series precipitation data during 1996 - 2003 when severe drought occurred throughout the country. The SPI value was estimated to reach 12 in approximately 60% of the total period, indicating that agricultural productivity deteriorated rapidly due to the long-term drought. The national average drought cycle, based on SPI 12, was estimated as 32.5 months for the last 40 years. However, when examined on 20-year basis, the drought cycle was shortened by 10.6 months in last 20 years (30.3 months) as compared to previous 20 years (40.9 months). Annual crop production continued to increase mainly in rice and maize until the mid-1990s, but declined sharply thereafter due to the drought. After the drought period, the production of potatoes of which growth is more resistant to drought started to increase to the production level comparable to those of rice and soybean. It is expected that changes in the agricultural production environment in N. Korea will be inevitable due to the climate change. To this end, using the results of the drought cycle analysis, it is possible to analyze the changes in the agricultural production environment in N. Korea in the future.
Objective : Pituitary adenomas (PAs) are often detected as incidental findings. However, the natural history remains unclear. The objective of this study was to evaluate the natural history and growth pattern of untreated PAs. Methods : Between 2003 and 2014, 59 PAs were managed with clinico-radiological follow up for longer than 12 months without any kind of therapeutic intervention. Tumor volumes were calculated at initial and last follow-up visit, and tumor growth during the observation period was determined. Data were analyzed according to clinical and imaging characteristics. Results : The mean initial and last tumor volume and diameter were $1.83{\pm}2.97mL$ and $13.77{\pm}6.45mm$, $2.85{\pm}4.47mL$ and $15.75{\pm}8.08mm$, respectively. The mean annual tumor growth rate was $0.33{\pm}0.68mL/year$ during a mean observation period of $46.8{\pm}32.1months$. Sixteen (27%) PAs showed tumor growth. The initial tumor size (HR, 1.140; 95% confidence interval, 1.003-1.295; p=0.045) was the independent predictive factor that determined the tumor growth. Six patients (11%) of 56 conservatively managed non-symptomatic PAs underwent resection for aggravating visual symptoms with mean interval of 34.5 months from diagnosis. By Cox regression analysis, PAs of last longest diameter over 21.75 mm were a significant prognostic factor for eventual treatment. Conclusion : The initial tumor size of PAs was independently associated with the tumor growth. Six patients (11%) of conservatively managed PAs were likely to be treated eventually. PAs of last follow-up longest diameter over 21.75 mm were a significant prognostic factor for treatment. Further studies with a large series are required to determine treatment strategy.
The purposes this study were to a) analyze the revisiting ratio of resting customers after issuing online coupons, b) compare the characteristics of coupon redemption customers with non-redemption customers. For this study, the customers of M restaurant who did not revisit during the last 8 months were classified as 'resting customers', totaling 4,052 customers. The online coupons, valid for 9 months, were sent via e-mail to those customers. After that, the data collected from those who redeemed the coupon in September 2006 was utilized. As a result of sending the coupon to 4,052 resting customers, 1,288 customers redeemed the coupon during the study period, showing relatively high redemption ratio (31.6%). The average check of customers with the online coupon was decreased by 22% compared with customers without the coupon, but the party size remained almost the same, 2.6 customers, and also the redemption ratio was increasing as the expiration date of the coupon was approaching. The redemption ratio of female (35.3%) was much higher than male (19.2%), representing higher redemption possibility of the female customers by issuing the coupon. The redemption ratio of the twenties (69.1%) was obviously higher than other age groups. Also, the non-redemption ratio of other groups except the twenties was higher than the redemption ratio. The redemption ratio of low-educated was higher, under college degree (58.6%), college degree (35.4%), and over college degree (16.6%). Following the result of the average visiting frequency of redemption customers during last the 8 months was 4.2, the frequency of non-redemption customers was 9.8. The total average visiting of non-redemption customer was 10.5, and that of redemption customers was 8.6. Customers who visited the restaurant less frequently in the past have higher possibility to revisit after receiving the coupon.
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