• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.442-452
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• 2022

Implant-assisted removable partial denture (IAPRD) can be considered as a simple and cost-effective treatment approach for an edentulous patient with anatomical or financial limitations. Recently, it was reported that the application of IARPD with implant supported fixed prostheses covered by the National Health Insurance Service (NHIS) were increasing. This case report describes the treatment of maxillary fully edentulous patient with anterior four-implant-supported fixed prosthesis and distal extension IARPD. This treatment approach may be advantageous over maxillary implant overdentures in some circumstances. The patient was satisfied with improved function and esthetics in the anterior area and financial benefit from the NHIS. Further long-term clinical studies are needed to establish clinical validity of the treatment approach described in this case report.

• Journal of Korean Clinical Health Science
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• v.5 no.1
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• pp.825-833
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• 2017

Purpose .This study aims to assess the influence factors on the level of satisfaction with hospital training and to provide basic data for more efficient hospital practice of students' public health administration . Methods . We have conducted a survey on students satisfaction with their hands on practice against 200 students in Busan, Kyeongnam and Kyungbook area, who have completed their practice in public health administration. We have identified the general characteristics of the target respondents, the current training status of the department for the hospital practice and training venue; also analyzed the characteristics composed of the apprentice student's attitude before the practice, satisfaction with the department training program and hospital for practice, as well as their practice at hospital. The general characteristics of the target respondents and clinic practice status at the hospital were measured in percentage and frequency analysis; the average and standard deviations of hospital size were also measured; and the correlations between satisfaction with the department, attitude towards the practice and satisfaction with the hospital were analyzed. Results . Most public health administration students experienced their practice at the hospital after the first semester on the $2^{nd}$year and they have received the foundation training for the practice. The survey allowed multiple responses and the results are as follows: medical terminology 49.5%, medical coordinator 36.7%, Hospital administration 26.5%, Health insurance 17.3%, and medical recording and practice 13.8% respectively. In terms of each individual student's attitude towards the practice at the hospital, the respondents answered as follows: I have completed the obligatory subjects for the practice before the practice 89.5%; I have been fully informed on the hospital for my practice. 74.5%; I responsibly practiced and worked with professionalism and sense of belonging to the hospital as a member of staff 90%; I have actively learned and adopted 95%; My knowledge and skills from the practice was relevant to the theory and practice from my course 83.5%. The findings of satisfaction by size of hospital were in order of a small clinic($3.24{\pm}0.63$), medium sized clinic($3.27{\pm}0.65$), hospital ($3.20{\pm}0.61$), and large sized comprehensive hospital ($2.93{\pm}0.74$). Consequently the satisfaction rate shows no significant difference by size of hospital. In relations between practice attitude and satisfaction with subject, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.04), the matter of a sense of belonging and responsibility at hospital during practice(p=0.33). the matter of active adaptation attitude during practice (p=0.42), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. In relations between practice attitude and satisfaction with the hospital for practice, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.01), the matter of a sense of belonging and responsibility at hospital during practice(p=0.04), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. Conclusion . The most essential subject for the practice in public health administration is medical terminology and there is no significance in satisfaction with the practice by size of hospital. Students were content with the hospital where they can experience as much as possible. Students content with their major show positive attitude towards the practice and so do those content with the hospital. Those with the positive attitude towards the practice show the high correlation of satisfaction with both the major and hospital. As a result, the satisfaction with the major is the significant attribute to the practice in the hospital.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.10
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• pp.591-599
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• 2016

Among the employer-supported subscribers to the National Health Insurance Service, 6,797 people with mild disabilities with western ages of 20 and up and who received health checkups were investigated. Of these 6,797 people, 3,186 and 3,611 received health checkups in 2009 and 2013, respectively. Those people who were diagnosed with physical handicaps, brain lesions, visual impairment, hearing impairment, intellectual disabilities, mental disorders, kidney disorders or other disorders according to the classification standard for people with disabilities were classified into disability groups of the 3rd through 6th degrees. The purpose of this study was to examine the dangerous influence of obesity of people with mild disabilities on their hyperglycemia, hypertension and high cholesterol. The items measured in this study were abdominal obesity, body mass index, fasting glucose, total cholesterol, systolic blood pressure and diastolic blood pressure. To look for connections between the obesity level and at-risk groups for each disease, cross tabulation and multinomial logistic regression analyses were utilized. Higher levels of abdominal obesity and BMI were found among those who were male, were younger and had higher incomes. The risks of abdominal obesity and BMI were higher in the abnormal groups for each disease. In 2009, the obesity group whose BMI was higher had a 1.51-fold higher risk of hypertension than the normal group. The abdominal obesity group had a 1.59-fold higher risk of high cholesterol, a 1.26-fold higher risk of hypertension and a 1.54-fold higher risk of hyperglycemia than the normal group. In 2013, the obesity group whose BMI was higher had a 1.72-fold higher risk of high cholesterol and a 1.43-fold higher risk of hypertension than the normal group. Those with abdominal obesity had a 1.59-fold higher risk of hyperglycemia than the normal subjects. As the risk of obesity was higher in those with disabilities than in those without disabilities, the former should be encouraged to undergo health checkups on a regular basis, and the coverage of the health checkups should be extended to keep track of their illness. In addition, appropriate education and concern are both required to prevent obesity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.26-34
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• 2003

Intraoral Vertical Ramus Osteotomy,along with Sagittal Split Ramus Osteotomy,is an popular surgical technique performed on mandibular prognathism. However Intraoral Vertical Ramus Osteotomy has been suspected for an initial mobilization at the healing phase of segment because it does not employ the rigid fixation between segments. To execute a study on the healing phase of segment after Intraoral Vertical Ramus Osteotomy on the horizontal plane, 102 patients (204 parts) who were diagnosed mandibular prognathism and took Intraoral Vertical Ramus Osteotomy at the Yonsei University dental hospital were observed during the period of before operation, immediately postoperation, 1 month, 3 months, 6 months, and 12 months. The change in the width of segment and horizontal angle of proximal segment and condylar head on the Submentovertex Cephalogram taken from those patients represented following results. 1. The width of proximal and distal segment decreased with the lapse of time. It decreased into 84.5% between immediate postoperative and 6M and even continued to decrease till 12M. 2. The horizontal angle of the proximal segment did medial rotation according as the lapse of time and rigorously continued till 3M. The rotation angle of condylar head indicated its tendency of recurrence to the original position but the entire recurrence was not allowed. The bigger an initial angle was, the higher was the tendency of recurrence after the operation while the rotation angle remained still bigger. 3. After grouping into group 1, group 2,and group 3 based on the extent of the variation of rotation angle of condylar head at immediate postoperative, the variation of rotation angle was measures in each group. The result presented that the initial rotation angle of condylar head had correlation with that of proximal segment but had no relation with the extent of setback of the mandible. However a quantitative analysis alone is not a sufficient method for analyzing the healing phase of segment on the horizontal plane.Therefore a multilateral analysis using 3 dimensional data such as CT is recommendable for the future study.

• The Journal of Advanced Prosthodontics
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• v.7 no.6
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• pp.496-505
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• 2015

PURPOSE. To determine the effect of fibronectin (FN)-conjugated, microgrooved titanium (Ti) on osteoblast differentiation and gene expression in human bone marrow-derived mesenchymal stem cells (MSCs). MATERIALS AND METHODS. Photolithography was used to fabricate the microgrooved Ti, and amine functionalization (silanization) was used to immobilize fibronectin on the titanium surfaces. Osteoblast differentiation and osteoblast marker gene expression were analyzed by means of alkaline phosphatase activity assay, extracellular calcium deposition assay, and quantitative real-time PCR. RESULTS. The conjugation of fibronectin on Ti significantly increased osteoblast differentiation in MSCs compared with non-conjugated Ti substrates. On the extracellular calcium deposition assays of MSCs at 21 days, an approximately two-fold increase in calcium concentration was observed on the etched 60-${\mu}m$-wide/10-${\mu}m$-deep microgrooved surface with fibronectin (E60/10FN) compared with the same surface without fibronectin (E60/10), and a more than four-fold increase in calcium concentration was observed on E60/10FN compared with the non-etched control (NE0) and etched control (E0) surfaces. Through a series of analyses to determine the expression of osteoblast marker genes, a significant increase in all the marker genes except type I collagen ${\alpha}1$ mRNA was seen with E60/10FN more than with any of the other groups, as compared with NE0. CONCLUSION. The FN-conjugated, microgrooved Ti substrate can provide an effective surface to promote osteoblast differentiation and osteoblast marker gene expression in MSCs.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.297-341
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• 2017

We searched out court rulings on medical affairs through court library search sites and specialized articles on medically relevant judgments sentenced in 2016. And we selected and analyzed the judgements of the court we considered important as follows. In relation to the medical civil judgements, (1) In the case of applying surgery for female infertility during cesarean section operation but it has not been done, we expressed the regret for the lack of judgment in the process of entering the medical contract, introducing the rights infringed and the scope of compensation, (2) We pointed out that the ruling on the medical malpractice estimation goes out of limit of negligence estimation doctrine, and that the court asked very high degree duty of the traditional Korean medicine doctors to cooperate with Western medicine doctors. (3) In the case of admitting hospital's 100% responsibility, we pointed out the court overlooked the uncertainty and good intention of the medical practice. (4) Additionally, We introduced the cases admitted the hospital's responsibility in the accident related to the psychiatric patients in closed ward. Relating to a medical criminal ruling, we analyzed the supreme court decision about whether the dentist's Botox injection on the patient's face is a medical practice within the scope of the license from the viewpoint whether it is within the possible range of the word. And, concerning decisions on healthcare administration, (1) we analyzed the case about when medical personnel operate multiple medical institutions, whether it is possible to get back medical care costs under the National Health Insurance Law, (2) We commented on the ruling regarding explanation obligation in terms of object, degree, subject of explanation as a prerequisite for permissible arbitrary uninsured benefits. Finally, we reviewed the decision of the Constitutional Court about the Article 24 of the Mental Health Law, which it had allowed for a mental patient to be hospitalized forcibly by the consent of two guardians and a diagnosis of a psychiatrist. Also we indicated the problems of the revised Mental Health Law.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.197-205
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• 2009

The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.