• Title/Summary/Keyword: Partial insurance

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Using implants for worn dentition with the altered vertical dimension of occlusion based on shortened dental arch concept: a case report (과도한 마모를 보이는 환자에서, 임플란트를 활용해 수직 고경을 증가시키며 shortened dental arch 개념을 적용한 보철 수복 증례)

  • Lee, Jae Hyun;Kim, Tae Su;Lee, Chul Won;Lee, Won Sup;Lee, Su Young
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.49-56
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    • 2016
  • Excessive occlusal wear can result in unacceptable damage to the residual teeth structure, anterior guidance and masticatory function. An 86-year-old man presented with worn dentition and anterior deep bite due to loss of the posterior support. Two implants covered by Korean national health insurance, fixed partial denture and direct composite resin were used to restore the dentition, instead of removable prosthesis. The occlusal vertical dimension was increased by 2 mm in the premolar area and shortened dental arch concept was applied. This treatment was a less expensive alternative to full-mouth rehabilitation with positive esthetic and functional outcomes after 7 months of follow-up.

The National Hospice Care Service Development in Korea (한국형 호스피스 케어 개발을 위한 기초 조사 연구)

  • Lee, Soo-Woo;Lee, Eun-Ok;Ahn, Hyo-Seog;Heo, Dae-Seock;Kim, Dal-Sook;Kim, Hyun-Sook;Lee, Hiye-Ja
    • The Korean Nurse
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    • v.36 no.3
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    • pp.49-69
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    • 1997
  • The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

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Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage (한 대학병원에서 조사된 재택산소요법을 받고 있는 환자의 특성과 재택산소요법 처방에 대한 순응도: 건강보험급여전환 후 조사)

  • Koo, Ho-Seok;Song, Young Jin;Lee, Seung Heon;Lee, Young Min;Kim, Hyun Gook;Park, I-Nae;Jung, Hoon;Choi, Sang Bong;Lee, Sung-Soon;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Lee, Hyun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.192-197
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    • 2009
  • Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

Immediate Toe-to-Hand Transfer in Acute Hand Injuries (급성 수부 손상시 즉시 족지 전이술)

  • Woo, Sang-Hyun;Kim, Hak-Soo
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.19-28
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    • 2002
  • From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

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Clinical Effects of the Combination Chemotherapy of Heptaplatin and 5-Fluorouracil in Advanced Gastric Cancer (진행성 위암 환자에서 Heptaplatin과 5-Fluorouracil 복합요법의 임상효과)

  • Shin, Gashil;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.2
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    • pp.61-70
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    • 2004
  • Heptaplatin is a new platinum derivative with antitumor activity against gastric cancer. Preclinical studies showed that it is less toxic than other platinum analogues. The purpose of this study is to evaluate the efficacy and toxicity of the combination therapy of heptaplatin and 5-fluorouracil in Korean advanced gastric cancer patients. This study was investigated retrospectively. The patients group consisted of 65 advanced gastric cancer patients with no prior radiotherapy. All patients received heptaplatin $400\;mg/m^2$ by 2-3 hour infusion on Day 1 and 5-FU $1000\;mg/m^2by 12-24 hour continuous infusion for 5 days. After the first cycle, subsequent doses were adjusted according to the toxicity. Courses were repeated every 28 days. As results, objective response occurred in 16 patients $(24.6\%)$. Two were complete and 14 were partial response. Median progression free survival was 32 weeks with $29\%$ of patients progression free at 1 year. The most common hematologic toxicity was anemia. Grade 3 or 4 anemia was seen at $2.7\%$ of treatment cycles. Grade 3 or higher leucopenia was seen at $1.2\%$ of cycles. Grade 3 or 4 neutropenia and thrombocytopenia occurred at $6.1\%\;and\;1.5\%$ of cycles, respectively. The most common nonhematologic toxicity was proteinuria. Though no patients experienced grade 3 or 4 proteinuria, proteinuria was a considerable factor for this chemotherapy. Grade 3 or higher gastrointestinal toxicities were nausea and vomiting ($4.6\%$ of patients) and diarrhea ($1.5\%$ of patients). Grade 2 renal toxicity with elevation of serum creatinine was seen in $0.3\%$ of cycles, which is less than that of other platinum analogues. This study showed that combination therapy of heptaplatin and 5-FU have modest antitumor activity against advanced gastric cancer without severe renal toxicity.

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A Social Historical Study on the Farmer's Welfare under the Rule of Japanese Imperialism (일제강점기 농민복리 -사회사 관점 중심으로-)

  • Choi, Okchai
    • Korean Journal of Social Welfare
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    • v.65 no.2
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    • pp.287-311
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    • 2013
  • This study has been planned to examine the three faces as follows; 1) systematization of research materials on the farmer's welfare served in the period of Japanese Imperialism, and 2) a social historical analyzation of the farmer's welfare in the context of politics, economy, social lives, and culture. The collected data focused on the primary resources has been organized such as seven categories: 1) public aid; 2) social insurance; 3) social welfare service; 4) farmer's welfare movement; 5) farm's social work; 6) mutual dependence; and 7) the others. The organized data has been analyzed in view of social history such as important themes: 1) being targeted in the confused society; 2) conspirative almsgiving; 3) being benefited from monopolistic capitalism and discrimination; 4) alienators' resistant self-help efforts; 5) reforming of civilized lives; 6) religious blessings within structural double torture; and 7) farmer's partial progress of lives. Finally, some various implications are suggested based on the analyzed results.

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Four-Year Experience Using an Advanced Interdisciplinary Hybrid Operating Room : Potentials in Treatment of Cerebrovascular Disease

  • Jeon, Hong Jun;Lee, Jong Young;Cho, Byung-Moon;Yoon, Dae Young;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.35-45
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    • 2019
  • Objective : To describe our experiences with a fully equipped high-end digital subtraction angiography (DSA) system within a hybrid operating room (OR). Methods : A single-plane DSA system with 3-dimensional rotational angiography, cone-beam computed tomography (CBCT), and real-time navigation software was used in our hybrid OR. Between April 2014 and January 2018, 191 sessions of cerebrovascular procedures were performed in our hybrid OR. After the retrospective review of all cases, the procedures were categorized into three subcategorical procedures : combined endovascular and surgical procedure, complementary rescue procedure during intervention and surgery, and frameless stereotaxic operation. Results : Forty-nine of 191 procedures were performed using hybrid techniques. Four cases of blood blister aneurysms and a ruptured posterior inferior cerebellar artery aneurysm were treated using bypass surgery and endovascular trapping. Eight cases of ruptured aneurysm with intracranial hemorrhage (ICH) were treated by partial embolization and surgical clipping. Six cases of ruptured arteriovenous malformation with ICH were treated by Onyx embolization of nidus and subsequent surgical removal of nidus and ICH. Two (5.4%) of the 37 cases of pre-mature rupture during clipping were secured by endovascular coil embolization. In one (0.8%) complicated case of 103 intra-arterial thrombectomy procedures, emergency surgical embolectomy with bypass surgery was performed. In 27 cases of ICH, frameless stereotaxic hematoma aspiration was performed using $XperGuide^{(R)}$ system (Philips Medical Systems, Best, the Netherlands). All procedures were performed in single sessions without any procedural complications. Conclusion : Hybrid OR with a fully equipped DSA system could provide precise and safe treatment strategies for cerebrovascular diseases. Especially, we could suggest a strategy to cope flexibly in complex lesions or unexpected situations in hybrid OR. CBCT with real-time navigation software could augment the usefulness of hybrid OR.

Reconstruction of cutaneous defects of the nasal tip and alar by two different methods

  • Kim, Yong Hun;Yoon, Hyung Woo;Chung, Seum;Chung, Yoon Kyu
    • Archives of Craniofacial Surgery
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    • v.19 no.4
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    • pp.260-263
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    • 2018
  • Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape. Methods: We analyzed 36 patients with skin tumors who underwent flap coverage after tumor ablation. Rotation flaps were used in 26 cases and croissant-shaped V-Y advancement flaps were used in 10 cases. The primary cause of the defects was skin cancer, except for one benign tumor. Results: The mean patient age was 71 years. The size of the defects ranged from $0.49cm^2$ to $3.5cm^2$. No recurrence of skin cancer was noted and all flaps lasted until the end of follow-up. Partial desquamation of the epidermis was noted in one case. The postoperative appearance for most patients was excellent, objectively and subjectively. Conclusion: For cutaneous defects of up to about $4.0cm^2$ of the alar and nasal tip, local flaps using our methods offered a good cosmetic and therapeutic result. The main advantage of our flaps is the minimal dissection required compared to bilobed and other local flap methods. We believe our flaps are a suitable option for alar and nasal tip reconstruction.

A Study on the Influence of Service Nature by Service Industry on Job Performance (서비스산업별 서비스본질이 직무성과에 미치는 영향 연구)

  • Byun, MiYoung;Kim, Hyunsoo
    • The Journal of the Korea Contents Association
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    • v.20 no.4
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    • pp.331-347
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    • 2020
  • In the modern economic area of service-based logic, the importance of the service industry continues to increase. Yet in spite of the various promotional policies of the government, growth remains at a standstill. It is now time to turn away from the outwardly visible form of the issue and to contemplate its root cause. This study thus investigated the service essentials based on philosophical thought in order to secure the continuous growth and competitive advantage of a service industry with an unshakable foundation. The effect of service essentials on job performance by service industry was also empirically analyzed. To conduct the study, a research hypothesis was verified by using the final 900 copies of survey data for service industry workers for data analysis. The results of the study on service essentials showed that interaction and harmony were found to have a positive effect on job performance in the transportation industry, while it verified the positive effects on job performance for interactivity and horizontality in the finance and insurance industry, and interactivity, horizontality and harmony in the hotel and resort industries. As a result, it was confirmed that service essentials had a partial effect on performance in the service industry. Various and in-depth studies on service essentials are thus required in the future, and it is also necessary to expand the parameters or adjustment variables that are capable of affecting performance.

The Relationship Between Viewing Value and Viewing Satisfaction According to the Factors for Viewing Dance Performances (무용공연 관람요인에 따른 관람가치와 관람만족 관계)

  • Baek, U-Young;Cho, Dong-Min;Lee, Sang-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.237-250
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    • 2020
  • The purpose of this study was to investigate the relationship between the performance factors of dance performance and the intention to revisit the audience, and to investigate the structural relationship between viewing satisfaction and viewing value. For data processing, SPSS Ver. 21.0 and AMOS Ver. The program of 21.0 was used. Structural relationships were analyzed using a two-step approach, and the significance of the effects was verified using bootstrapping. In addition, a full mediating effect and a partial mediating effect were presented using the three-step regression analysis mediating effect. The results of the study are as follows. First, it was found that the viewing factors influenced the viewing satisfaction and the viewing value. Second, it was found that viewing satisfaction had an intention to revisit and influenced the viewing value. It was also found that the viewing value had an effect on the intention to revisit. Third, in the relationship between the viewing factors of the dance performance and the viewing value, it was found that the viewing satisfaction had a partial mediating effect. Fourth, it was found that the attendance factor of the dance performance was not related to the intention to revisit. However, it was found that the satisfaction of viewing and the value of viewing had a complete mediating effect in relation to the viewing factors of dance performances and the intention to revisit. Through these studies, the dance performance should overcome the inherent limitations of space-time limitations and present basic data for establishing a mid- to long-term marketing strategy that can respond quickly.