• Journal of dental hygiene science
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• v.21 no.1
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• pp.8-18
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• 2021

The purpose of this study is to provide the general history of fostering dentists in Japan and introducing their new roles. This research was conducted based on the government policy report on dentists and the information published by each educational institution. Based on the collected data, the official websites were used to represent the latest statistics of the institutions. The number of dentists in Japan has increased. The government established the National Examination for Dentists to guarantee the quality of dentists. After the standards for developing questions for the national examination were established in 1985, the contents of the examination have been appropriately improved by revising the standards every four years. This improvement has required dental students to study a variety of subjects for six years at dental school. Since dentists in Japan are required to respond to various demands from the nation; the Model Core Curriculum for Dental Education was developed to teach medical ethics and abilities to ensure that dentists conduct themselves professionally. Recently, the roles of dentists have been changing in Japan. When providing dental services to older patients over the age of 65, dentists and other dental professions focus on maintaining oral functions, such as saliva secretion, bite force, tongue movement, and masticatory/swallowing functions. However, oral function-related services for children are different. In addition to providing essential dental services, dental practitioners also provide special treatment, such as oral muscle training, myofunctional therapy, health guidance, and space retainers to the child patients with developmental insufficiency in oral functions. Dentistry in Japan has undergone numerous changes over the years and has continued to offer high-quality dental health services. Thus, information gained from the Japanese experience may be helpful to dental professions in other developed countries for planning oral health measures.

• Journal of Arbitration Studies
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• v.30 no.4
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• pp.121-138
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• 2020

The O2O services in the healthcare sector have only been in full swing for about three years, and unlike existing O2O consumer goods, the scale and scope of the dispute are more complicated due to restrictions on medical treatment. In this study, O2O service platform operators and medical institutions' roles and responsibilities were redefined as a countermeasure for resolving disputes in healthcare O2O services and the laws for changing the transaction environment. A change in institutional mechanisms was proposed. This study looked at the types of consumer disputes related to healthcare O2O services as insufficient information problems, problems in the course of medical service implementation, problems with immunity provisions for platform operators, cancellations, and non-compliance with refunds. All the information generated during transactions in the healthcare sector was extensive in scale and included the most sensitive information among personal information, stressing the importance of ensuring security. The area that started in the O2O range before the medical institution visit also proposed a plan to establish a system for the delivery of proven information as a pre-medical person. The scale and growth will grow faster, given that consumers can experience the information they want anytime, anywhere they want. However, the platform broker's role, a link player, will become more important because consumers who use the service will have their first meeting with non-face-to-face product providers. On the other hand, service providers may have side effects of misleading consumers by providing false information or misleading consumers through exaggerated advertisements. The O2O service market is expected to expand beyond distribution and dining out to the entire industry. However, since it is challenging to check accurate statistics on the detailed market, various disputes and consumer protection measures will be required for each detailed market, and comprehensive leading solutions will be essential in the future.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.255-268
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• 2022

Objective : Chronic subdural hematoma (CSDH) is a common disease in neurosurgical departments, but optimal perioperative management guidelines have not yet been established. We aimed to assess the current clinical management and outcomes for CSDH patients and identify prognostic factors for CSDH recurrence. Methods : We enrolled a total of 293 consecutive patients with CSDH who underwent burr hole craniostomy at seven institutions in 2018. Clinical and surgery-related characteristics and surgical outcomes were analyzed. The cohort included 208 men and 85 women. Results : The median patient age was 75 years. Antithrombotic agents were prescribed to 105 patients. History of head trauma was identified in 59% of patients. Two hundred twenty-seven of 293 patients (77.5%) had unilateral hematoma and 46.1% had a homogenous hematoma type. About 70% of patients underwent surgery under general anesthesia, and 74.7% underwent a single burr hole craniostomy surgery. Recurrence requiring surgery was observed in 17 of 293 patients (5.8%), with a median of 32 days to recurrence. The postoperative complication rate was 4.1%. In multivariate analysis, factors associated with CSDH recurrence were separated hematoma type (odds ratio, 3.906; p=0.017) and patient who underwent surgery under general anesthesia had less recurrence (odds ratio, 0.277; p=0.017). Conclusion : This is the first retrospective multicenter generalized cohort pilot study in the Republic of Korea as a first step towards the development of Korean clinical practice guidelines for CSDH. The type of hematoma and anesthesia was associated with CSDH recurrence. Although the detailed surgical method differs depending on the institution, the surgical treatment of CSDH was effective. Further studies may establish appropriate management guidelines to minimize CSDH recurrence.

• Journal of radiological science and technology
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• v.45 no.3
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• pp.233-239
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• 2022

In the radiology department, where radiation is used in medical institutions to perform examinations with various equipment, the field of surgical treatment is the intervention angiography room. Accordingly, strict infection control is required. The purpose of this study was to determine the contamination status by detecting pathogens before and after disinfection in the intervention angiography room, and to determine the degree of death by using a disinfectant, sodium dichloride isocyanurate, which is mainly used in the intervention angiography room. The subjects were 10 medical institutions of general hospital level or higher with an intervention angiography room in the P city, and 12 places with high contact frequency during examinations and procedures were sampled and requested to an analysis institution. As for the sample collection method, up/down, left/right directions were used to increase precision. Before disinfection, all procedures were completed, and after disinfection, exposure was performed using a disinfectant for at least 10 minutes, and detection was performed using a transport medium. As a result, in the pathogen analysis, most pathogens were detected in a humid environment or in a place with high contact frequency for microorganisms to thrive. The detected pathogens were found in the general environment or were human flora. It is a pathogen that does not cause disease under normal healthy host conditions. However, it was found to be an opportunistic infection that causes opportunistic infection depending on the case or situation in which the body's resistance is weakened. In addition, as a result of using the disinfectant mainly used in the intervention angiography room, it was found that more than 93.3% of them died. Therefore, the data of this study will be used as good basic data for the evaluation of pathogens in the intervention angiography room and will be of great help in infection control.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.3
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• pp.17-28
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• 2022

Objectives : This study was conducted to prepare basic data for improving the system related to Extramural herbal dispensaries by analyzing the characteristic factors of Korean medicine clinics that affect the type of Extramural herbal dispensaries. Methods : This study utilized '2021 Korean Herbal Medicine Consumption Survey', with 1,817 final participants. We performed ANOVA to compare the characteristics of Korean medicine clinics according to the type of extramural herbal dispensary. Multinomial logistic regression analysis were conducted to analyze characteristics of Korean medicine clinics affecting the form of extramural dispensaries. Results : Among Korean medicine clinics, 71.22% of the institutions used only the intraherbal dispensaries, 11.12% of the institutions used the Extramural herbal dispensaries in parallel, and 17.67% of the institutions used only the Extramural herbal dispensaries. The characteristics of Korean medicine clinics that increased the probability of concurrently using extramural herbal dispensaries were institution area, bed presence or absence, number of regular workers, region, number of prescriptions for insurance herbal medicines, and number of prescriptions for uninsured herbal medicines. The characteristics of Korean medicine clinics, which increase the probability of using only extramural herbal dispensaries, were age, durations of clinical experience, specialist license, franchise, area, bed presence or absence, number of regular workers, number of prescriptions for uninsured herbal medicines, and price of treatment for diseases. Conclusion : The reason why Korean medicine clinics use extramural herbal dispensaries is the result of a combination of efficient use of clinic size and the preparation of uninsured herbal medicines.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.186-193
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• 2023

Background: Complete surgical excision is the only curative treatment for primary cardiac tumors. For wide excision, interatrial septal reconstruction (ISR) is commonly performed. We hypothesized that ISR may increase the risk of postoperative atrial tachyarrhythmia (AT) after surgical resection of cardiac myxoma. Methods: After excluding patients with a history of cardiac surgery and concomitant procedures unrelated to tumor resection and those with AT or permanent pacemakers, we finally enrolled 272 adult patients who underwent benign cardiac tumor surgery from 1995 to 2021 at our institution. They were divided into the ISR (n=184) and non-ISR (n=88) groups. The primary outcome was postoperative new-onset AT. Results: The study cohort predominantly consisted of women (66.2%), with a mean age of 57.2±13.6 years. The incidence of postoperative new-onset AT was 15.4%. No 30-day mortality or recurrence was observed. The cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the ISR group than in the non-ISR group (p<0.001). The median duration of hospital stay of all patients was 6.0 days (interquartile range, 5.0-7.0 days), and no significant difference was observed between the 2 groups (p=0.329). ISR was not an independent predictor of new-onset AT (p=0.248). Male sex and hypertension were found to be independent predictors of new-onset AT. Conclusion: ISR was not a significant predictor of postoperative new-onset AT. ISR might be a feasible and safe procedure for surgical resection of cardiac myxoma and should be considered if needed.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.82-89
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• 2023

Objective : Rathke's cleft cysts (RCCs) are nonneoplastic cysts. Most of them are asymptomatic and stable; when symptomatic, RCCs are surgically fenestrated and drained. However, the outcomes remain unclear. The authors evaluated the outcomes of RCC decompression. Methods : Between 2004 and 2019, 32 RCCs were decompressed in a single tertiary institution. The clinical characteristics, intraoperative findings, postoperative complications, and endocrinological and surgical outcomes were retrospectively reviewed. Patients who underwent sequential imaging at least twice and at least 12 months after surgery were included in the analysis. Results : Patients' mean age was 40.8±14.9 years, and 62.5% were women. The mean follow-up duration was 62.3±48.6 months. In 21 patients (65.6%), no residual cysts were identified on postoperative magnetic resonance imaging. Of the 18 patients with preoperative visual field defects, 17 (94.4%) experienced postoperative visual improvement. Postoperative complications included endocrinological deterioration in 11 patients (34.4%), permanent diabetes insipidus in 11 (34.4%), infection in four (12.5%), intrasellar hemorrhage in three (9.4%), and cerebrospinal fluid leak in two (6.3%). Follow-up images revealed cyst recurrence in nine patients (28.1%), an average of 20.4 months after surgery; in three patients, the cysts were symptomatic, and resection was repeated. Multivariable analysis revealed that postoperative endocrinological deterioration was the only independent factor associated with cyst recurrence (p=0.028; hazard ratio, 6.800). Conclusion : Our findings showed that although only cyst fenestration for decompression was performed to preserve pituitary function, more pituitary dysfunction occurred than expected. Besides, the postoperative hormonal deterioration itself acted as a risk factor for cyst recurrence. In conclusion, surgery for RCC should be more careful.

• The Journal of the Convergence on Culture Technology
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• v.9 no.1
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• pp.443-448
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• 2023

Over the past five years, the number of patients with sleep disorders has increased by about 250,000 from 840,000 in 2017 to 1.09 million in 2021. In addition, sleep disorder is a factor that causes dementia risk factors, and furthermore, the population with sleep disorder is a very important policy issue in terms of stable health insurance financial management in the future in terms of national health management in the super-aging trend. Therefore, this study aims to establish an efficient treatment environment in medical institutions responsible for the current status of polysomnography and effective reimbursement policies for the recently increasing population with sleep disorders, and appropriate sleep management policies for future sleep disorders through correct implementation. We are trying to find out the actual condition and improvement plan through interviews with related organizations and experts.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.1
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• pp.73-77
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• 2022

Blood products (BPs) can only be obtained through blood donation and hence represent a finite resource. BPs should therefore be used conservatively. However, BPs are being used indiscriminately without evidence. The purpose of this study was to evaluate the reasons for the use of BPs and their appropriateness. The investigation was carried out based on hemoglobin levels. Data were obtained from Nov 1, 2020, to Oct 31, 2021, from a hospital's OCS/EMR systems. The BPs were dispensed in 21,303 cases, and the number of hemoglobin levels >7.0 g/dL or higher among red blood cell drugs used by each treatment department was 1,173 (>7.0 g/dL). The misuse of blood transfusions is increasing social costs, with the adequacy of transfusion becoming increasingly important. Hence, each medical institution should review the transfusion guideline evaluation index, check the status of the release of BPs, and institute educational programs covering transfusion guidelines and continually evaluate their adequacy.