• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6825-6830
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• 2015

Opisthorchis viverrini is remains a public health problem in Thailand, particularly in the northeast and north regions which have the highest incidences of chonalgiocarcinoma (CCA). O. viverrini causes the disease opithorchiasis, and its has been classified as a group 1 biological carcinogen. Humans, dogs, and cats become infected with O. viverrini by ingesting raw or undercooked fish containing infective metacercariae. The first human cases of O. viverrini infection were reported in Thailand 100 years ago, and it's still a problem at the community level. Based on data for the year 2009, more than 6 million people were infected with O. viverrini. Associated medical care and loss of wages in Thailand costs about $120 million annually. This review highlights the current status of O. viverrini infection in communities of Thailand through active surveillance for the five years period from 2010 and 2015. A total of 17 community-based surveys were conducted, most in the northeast region. Some 7 surveys demonstrated a high prevalence over 20%, and the highest was 45.7%. Most commonly infection was found in age group of 35 years and older, males, and agricultural workers. Although, the national prevalence may be decreasing but the results show that the O. viverrini infection is still high in communities of the northeast region. Therefore, the focus in populations living in northeast Thailand should be screening of infection and changing their eating behavior.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.102-110
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• 2018

Debridement is a crucial component of wound management. Recent technologies such as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to represent interesting alternatives for wound debridement. The purpose of this systematic review was to describe, evaluate, and compare these three recently developed methods for the management of chronic wounds. In January 2016, an electronic database search was conducted of MEDLINE, PubMed Central, and Embase for articles concerning these three innovative methods for the management of chronic wounds. A total of 389 references were identified by our search strategy, and 15 articles were included. We extracted data regarding the number and age of patients, indications, operating time, number of procedures, costs, wound healing time, decrease in exudation, perioperative blood loss, bacterial load, and the occurrence of complications. The 15 articles included studies that involved 563 patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies), or Coblation (2 studies). Six randomized controlled trials were included that compared the use of a scalpel or curette to hydrosurgery (2 studies) or ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise and selective tool, allows significantly faster debridement. Ultrasound therapy provides a significant reduction of exudation, and improves the wound healing time. No comparative study dedicated to Coblation was identified. Despite the obvious clinical interest of the topic, our review of the current literature revealed a lack of prospective randomized studies comparing these devices with each other or with standard techniques, particularly for Coblation and hydrosurgery.

• 한국비블리아학회지
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• 제12권2호
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• pp.13-29
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• 2001

본 연구에서는 인쇄본 학술지 발행과정에서 발생된 학술지의 전자출판 파일을 활용하여 신속하고 효율적으로 초록 데이터베이스를 구축하는데 있어서, 2001년 현시점에서 무엇이 가능하며 어떤 것이 문제점인지를, 현재 국내에서 영문으로 구축되고 있는 한국 의학학술지 논문의 초록 데이터베이스인 KoreaMed를 중심으로 분석하였다. 학술지 인쇄출판시 생성된 컴퓨터 파일을 이용하여 초록정보 데이터베이스를 구축하는 KoreaMed의 구축방법론은 데이터의 정확성, 입력작업의 신속성, 비용절감 등에 있어서 그 효율성은 입증되었으나, 학회의 절대적인 협조 없이는 매우 어려운 작업이다. 국내 학회와 인쇄소의 영세성으로 학술지 파일의 보관이 잘 안되어 있어서 학술지 과월호 파일의 수집이 수월하지 않으며, 새로 발행되는 호의 컴퓨터 파일 수집을 위해 학회와 계속적인 관계를 유지하는 것 또한 매우 어려운 것으로 나타났다. 전자출판 파일을 이용하여 데이터를 가공하는데 있어서 제일 까다로운 문제는 특수문자의 처리이며, 학술지마다 출판형식 (layout과 format)과 파일 구성방식이 다르고, 사용하는 출판편집 소프트웨어가 다르며, 학술지 파일의 수록매체 등이 매우 다양한 것도 데이터 처리를 복잡하게 만드는 문제점인 것으로 나타났다. 앞으로 학술지 발행과 동시에 학술지 발행기관이 직접 XML로 가공하여 KoreaMed에 제출하는 등 KoreaMed 시스템을 신속하고 효율적으로 구축하기 위한 공조체제를 갖추기 위해서는, 학술지 전자출판파일의 관리와 XML파일 만들기 등에 대한 계속적인 홍보와 교육이 필요하다.

• 대한지역사회영양학회지
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• 제17권3호
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• pp.341-352
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• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• 한국치위생학회지
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• 제10권2호
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• pp.393-411
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• 2010

Objectives : The purpose of this study was to examine factors related to the satisfaction level of patients with dental services. Methods : The subjects in this study were 200 patients at three different dental clinics in South Gyeongsang Province, on whom a survey was conducted from June 1 to July 31, 2009. The collected data were analyzed, and the findings of the study were as follows. Results : In regard to the general characteristics of the patients investigated, the women(61.5%) out-numbered the men. By age, those who were at the age of 30 and down made up the largest age group(47.0%). By academic background, the greatest group received junior-college education(54.0%). By occupation, the company employees constituted the largest group (50.5%). By income, the greatest group earned an income of 2 to 2.99 million won(75.0%). Second, as to connections between the characteristics of dental treatment and the reason of choosing the dental clinics, the largest group(70.4%) chose the dental clinics by word of mouth or the recommendation of others. Concerning the reason of dissatisfaction, the biggest group(72.7%) was unsatisfied with medical costs. As for the degree of explicit complaint, the greatest group(49.7%) sort of complained about what made them dissatisfied. Regarding the type of treatment, the biggest group(49.0%) received prosthodontic treatment. In relation to fear for dental treatment, the largest group(34.0%) feared receiving the treatment, and the biggest group(42.6%) did that due to the sound of machines. Third, satisfaction with services(0.762) had the closest correlation to overall satisfaction level, followed by satisfaction with employees(0.735), satisfaction with dentists(0.644) and satisfaction with convenient facilities (0.579). Fourth, the factors that affected overall satisfaction level were gender, the reason of choosing the dental clinic, satisfaction with dentists, satisfaction with employees, satisfaction with services and satisfaction with convenient facilities. The patients who were better satisfied with services(p<0.001), who were more contented with dentists(p<0.001), who chose the dental clinics by the recommendation of others(p<0.01), who were male(p<0.05), who were more gratified with employees(p<0.05) and who were more contented with convenient facilities expressed better overall satisfaction. Conclusions : The above-mentioned findings suggested that dental institutions should keep track of the expectations of patients to prepare differentiated strategies for marketing and human-resources development in consideration of their own circumstances to boost the satisfaction level of patients. Specifically, it's required to heighten the satisfaction level of patients with dentists.

• The Korean Journal of Pain
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• 제30권4호
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• pp.272-280
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• 2017

Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients' satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient's actual medical costs and insurance information. Results: During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value (P < 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline (P < 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy. Conclusions: ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.

• 유통과학연구
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• 제15권1호
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• pp.105-114
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• 2017

Purpose - Recently, domestic pharmaceutical market is growing steadily, but top-tier companies are concentrating on sales growth. In this market, SMEs, which account for more than 80% of the entire market, suffer from the problem of lower margins and increasing inventory costs. According to the government's policy changes related to pharmaceuticals, it is pointed out that the management of existing customers and the control of salespeople are important issues for pharmaceutical companies. This study investigates the effect of the control system on the salesperson in domestic pharmaceutical distribution channel on customer-oriented selling behaviors and sales performance. Research design, data, and methodology - To verify the proposed research model and test hypotheses, the authors selected 244 MR(medical representatives)'s responses which have currently relationship with doctors or pharmacists. This study carefully investigated the reliability, content validity, convergent validity, and discriminant validity of the proposed model. Results - The authors find out the following results: capacity control, activity control, and self control have positive effects on customer-oriented selling behaviors and customer-oriented selling behaviors have a positive effect on sales performance. In addition, we present alternative model to check the direct effect between the control systems and the sales performance, but control system factors except self control have no direct influence. Conclusions - First of all, competency control and activity control increases the customer-oriented selling behavior of the salesperson. This means that the salesperson's sales skill, negotiation skill, customer access skill, presentation ability, monitoring, direction and evaluation are important and it is also important to control activities to check the number of visits to customers, report preparation, and customer service etiquette. Second, the fact that self-control of salesperson affects the customer-oriented selling behavior suggests that self-control is not controlled by external factors but rather establishes short/long-term goals. Therefore, it is important for sales organization to create an environment in which members can induce persistent incentives for self-control. Finally, output control did not affect customer-oriented sales behavior, which is less likely to form confidence or motivation to MRs when output control is perceived as a means of monitoring, supervising, or controlling rather than providing information to salespeople.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권6호
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• pp.498-510
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• 2001

Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.

• 보건행정학회지
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• 제25권2호
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• pp.140-148
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• 2015

Vaccination is the most powerful and useful preparation against infectious diseases. However, developing vaccines costs a lot and requires extensive long-term efforts. Therefore, the government should research and develop vaccines with a national-level policy. To greatly enhance the success rate of vaccine development, the policy should be set up considering priorities such as the current status of domestic research, the importance for public health, the urgency of research. The Delphi technique was utilized to draft this survey, through a brainstorming stage, then two inquiries, and finally the final panel meeting where unresolved items were discussed, to draw the conclusion. Among the results, firstly, the highest ranked item on centralized fields for vaccine development by the Ministry of Health was 'self-sufficiency of vaccines.' Secondly, 'emerging infectious disease' was most highly ranked in prioritized fields of vaccine development and research. Thirdly, for the vaccine that needs to be improved and developed further by the government to improve its efficacy and safety, BCG (Bacille de Calmette) for tuberculosis was ranked the highest on both types (intradermal and subcutaneous injection) from National Immunization Programme (NIP) and non-NIP. As for the high risk pathogens, 'anthrax' and 'smallpox' were first and second, consecutively. Lastly, 'development and control of vaccine candidates' was ranked the highest for the area in need for technique development in order to improve domestic vaccine's research level. The results of this study will be put to good use as basic data for the national vaccine research and development (R&D) policy of the country. This study was first step and more studies should be carried out for the final decision of the national vaccine R&D priority.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.397-407
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• 2010

목 적 : F9 유전자는 혈우병B의 병인 유전자이다. 기존의 RFLP를 이용한 연관분석은 정보제공율이 55.6%에 불과하였다. 직접 염기서열 분석법은 98%의 돌연변이를 진단할 수 있지만, 고가의 비용이 든다. 본 연구는 F9 유전자를 대상으로 돌연변이의 선별검사로써 mPCR-CSGE를 사용하고, 이후 특정 유전자 부위만을 염기서열 분석하여 mPCR-CSGE의 유용성을 확인하기 위해 고안되었다. 방 법 : 연구대상은 비혈연 관계인 27명의 혈우병B 환자였다. 직접염기서열 분석법은 독립된 다른 기관에서 시행하였고, mPCR-CSGE 선별 후 염기서열 분석법은 본 연구자의 기관에서 시행되었다. 직접 염기서열 분석법의 결과가 참고치가 되어 mPCR-CSGE 선별 후 염기서열 분석법을 정확성, 경제성, 신속성, 편이성 측면에서 비교하였다. 두가지 방법으로 진단이 되지 않는 환자에게는 MLPA를 이용하여 돌연변이를 발견하였다. 결 과 : 직접 염기서열 분석법으로 26명(96.3%)의 환자에서 돌연변이를 확인할 수 있었다. mPCR-CSGE 선별 후 염기서열 분석법으로는 23명(85.2%)의 환자에서 돌연변이를 찾아낼 수 있었다. 1명의 환자는 MLPA로써 돌연변이를 확인할 수 있었다. 27명의 환자에게 21개의 독립적인 돌연변이가 있었다. mPCR-CSGE 선별 후 염기서열 분석법은 직접 염기서열 분석법에 비해 비용은 55.7%로 줄일 수 있었으나, 실험 단계는 더욱 복잡하였고, 시간도 하루가 더 걸렸으며, 세심한 실험상의 주의가 필요하였다. 결 론 : mPCR-CSGE 선별 후 염기서열 분석법은 85.2%의 높은 돌연변이 선별력을 보이고, 직접 염기서열 분석법의 57.7%의 비용만 소모하였으나, 실험과정에 세한 주의가 요구되었으며, 노동집약적이고, 실험 시간도 하루가 더 소요되었다.