• Medical Lasers
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• v.9 no.1
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• pp.51-57
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• 2020

Background and Objectives For experiments on simulated burn, the preparation of an animal model is a very important step. The purpose of the current experiment is to design a simple and controllable method for the preparation of third-degree scald in a mouse model using the boiling water method. Materials and Methods A total of 18 Swiss mice were used. After the anesthetization, the mice were scalded by boiling water (100℃) using a mold with a 1 cm² circle area on the dorsum at contact times of 3s, 5s, and 8s. After confirming that 8 seconds of scald can cause a third-degree scald, the skin samples were collected at day 2, 4, 6, 8, 10, and 12, and analyzed by histopathological examinations. The wound retraction index (WRI) was also measured. Results Third-degree scald involving full-thickness skin was observed in the 8-second scald group, while a 3-second scald caused a superficial second-degree scald and a 5-second scald caused a deep second-degree scald. After third-degree scald, the burn wound continued to contract until day 14. Conclusion The scalding model of mice can be successfully established by the boiling water method. This method is easy to operate, it has a low cost, and it can control the scald depth by controlling the scald time. This is adequate to study skin thermal injury in the future. The scald model established by this method can last for 14 days.

• Journal of dental hygiene science
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• v.14 no.4
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• pp.516-524
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• 2014

Workers' oral health is important to guarantee workers' right of health and increase productivity. The aim of this study was to investigate recognition and satisfaction of national oral examination for workers in Incheon and Daejeon. Three hundred seventy-nine workers who were selected by convenience cluster sampling answered the questionnaire about experience, recognition and satisfaction of national health examination and oral examination by self recording type. A total of 76.0 percent of the subjects had national health examination, and 51.7% had national oral examination. A total of 64.9 percent had experienced notice about national health examination from the company, and 28.2% about national oral examination. The subjects had high positive score about intention of treatment, dental scaling, and change of toothbrushing method depending on oral examination, need of national health and oral examination, and usefulness to one's health through national health and oral examination. Office workers, regular workers, and the workers with monthly income more than 2 million won had more notice about national health and oral examination compared with sales and production workers, contract workers and the workers with monthly income less than 2 million won. We suggest institutional management of the notice about national oral examination be needed, especially for economically poor, or contract workers to increase the ratio to have national oral examination.

• Korean Journal of Acupuncture
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• v.29 no.3
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• pp.385-395
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• 2012

Objectives : Meridian sinew theory was introduced in Miraculous Pivot, Huangdi's Internal Classic, to explain in relation with locations of meridian sinews, causes, mechanisms, and treatment of diseases. The meridian sinews are understood to include muscles, tendons and ligaments, or muscles in the superficial body made up with muscles, ligaments, tendons, fascia etc. This theory shows the similarity or organic relationship between the meridian sinews and muscles. From the Hippocrates(460-385 BC) ages, traction therapy was used as a treatment method on muscular diseases such as low back pain, scoliosis, etc in western medicine. The effects of traction therapy, however, were unclear so that this study was purposed to illustrate the effectiveness of continuous traction therapy and to develop meridian sinews treatment. Methods : We made 2 hypotheses to explain the cause of scoliosis occurrence, muscles contraction and relaxation. As the hypothesis, we made the spinal model having 3 joints with wood and rubber bands. Each of the three joints in the spinal model represents the case of normal(NT; control), contraction(AT 1)and relaxation(AT 2) condition, and distance between the vertebrae joints was measured. Results : Under normal circumstance models, the normal type 1(NT 1; muscle relax state) and normal type 2(NT 2; muscle contract state) all joints were being towed equally. But in an unusual contracted situation, regardless of the relationship of joint area, contracted part of joint was not released. And in a relaxed situation, regardless of joint areas, released parts of joint were further released. These observation results mean that the effects of traction might be different from the purpose of traction therapy of Hippocrates. Conclusions : To explain the effect of traction therapy for scoliosis, the spinal cord model and scoliosis model were made. After vertebral bodies were pulled with different tensile forces, we compared the observed length of the each joints pulled. The results suggested that there were no effects of traction in objected parts with traction method from Hippocrates' design, continuous traction method. Moreover, it may worsen the symptom in worst case. Of course, our results are just the result of experimental models and clinical results may be different. More careful studies, therefore, are required.

• Korea Journal of Hospital Management
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• v.12 no.3
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• pp.120-144
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• 2007

In 1997, in the course of overcoming economic crisis caused by the shortage of foreign currency there was a significant phenomenon, the irregularization of human labour resources. There was no exception in hospital, either. Most hospitals put a lot of thought to solve the problem about irregular workers. Between employee and employer the problem of irregular workers has been raised as a main topic of all. The objectives of this study were to inspect the actual state of irregular workers and to understand the positive effect of protecting irregular workers, recently established and revised, on the human resources management of hospitals. After enacting irregular labours protection acts there were many opinions that the labour rules of hospitals would be changed.(56.7%). The plan to solve irregular worker's wage issues would he carried out step by step, but some hospitals have not examined the plan yet,(81.9%). Many hospitals had a plan that irregular worker's wage would be actualized in two or three years.(78.3%) The method, to solve the problem of irregular workers arc as follows: 1) the introduction of functional wage system, 2) the convert from automatic rising wage system to annual wage system, 3) the incentive grade system according to management result, 4) lower functional group wage system, 5) non-term contract wage system. From the point of the opening medical market and securing competitive power of hospitals, it is prospected that irregular works would be increased also in future. So to manage irregular workers effectively would be essential in maintain hospital's competitive power and improve medical service. The result, of this study were a, follow: (1) In hospital, the ratio of irregular workers in hospitals was lower than that of all irregular workers in Korea. (2) In hospital, the wage level of irregular workers was higher than that of irregular workers in Korea. (3) In hospital, the social insurance application ratio of irregular workers was higher than that of all workers in Korea. (4) In hospital, there seems to be no appropriate and active measures to improve labour condition of irregular workers, yet. (5) In many hospitals, the policy of irregular workers would be expected to revised for the law standards. In this study the actual conditions and problems of irregular workers were proposed and it was expected to contribute decisions-making in hospital management, especially when using human resources.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.87-130
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• 2015

In a case in which National Health Insurance Corporation (NHIC) pays medical care expenses to a victim of a traffic accident resulting in injury or death and asks the assailant for compensation of its share in the medical care expenses, as the precedent treats the subrogation of a claim set by National Health Insurance Act the same as that set by Industrial Accident Compensation Insurance Act, it draws the range of its compensation from the range of deduction, according to the principle of deduction after offsetting and acknowledges the compensation of all medical care expenses borne by the NHIC, within the amount of compensation claimed by the victim. However, both the National Health Insurance Act and the Industrial Accident Compensation Insurance Act are laws that regulate social insurance, but medical care expenses in the National Health Insurance Act have a character of 'an underinsurance that fixes the ratio of indemnification,' while insurance benefit on the Industrial Accident Compensation Insurance Act has a character of full insurance, or focuses on helping the insured that suffered an industrial accident lead a life, approximate to that in the past, regardless of the amount of damages according to its character of social insurance. Therefore, there is no reason to treat the subrogation of a claim on the National Health Insurance Act the same as that on the Industrial Accident Compensation Insurance Act. Since the insured loses the right of claim acquired by the insurer by subrogation in return for receiving a receipt, there is no benefit from receiving insurance in the range. Thus, in a suit in which the insured seeks compensation for damages from the assailant, there is no room for the application of the legal principle of offset of profits and losses, and the range of subrogation of a claim or the amount of deduction from compensation should be decided by the contract between the persons directly involved or a related law. Therefore, it is not reasonable that the precedent draws the range of the NHIC's compensation from the principle of deduction after offsetting. To interpret Clause 1, Article 58 of the National Health Insurance Act that sets the range of the NHIC's compensation uniformly and systematically in combination with Clause 2 of the same article that sets the range of exemption, if the compensation is made first, it is reasonable to fix the range of the NHIC's compensation by multiplying the medical care expenses paid by the ratio of the assailant's liability. This is contrasted with the range of the Korea Labor Welfare Corporation's compensation which covers the total amount of the claim of the insured within the insurance benefit paid in the interpretation of Clauses 1 and 2, Article 87 of the Industrial Accident Compensation Insurance Act. In the meantime, there are doubts about why the profit should be deducted from the amount of compensation claimed, though it is enough for the principle of deduction after offsetting that the precedent took as the premise in judging the range of the NHIC's compensation to deduct the profit made by the victim from the amount of damages, so as to achieve the goal of not attributing profit more than the amount of damage to a victim; whether it is reasonable to attribute all the profit made by the victim to the assailant, while the damages suffered by the victim are distributed fairly; and whether there is concrete validity in actual cases. Therefore, the legal principle of the precedent concerning the range of the NHIC's compensation and the legal principle of the precedent following the principle of deduction after offsetting should be reconsidered.

• Journal of Intelligence and Information Systems
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• v.16 no.2
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• pp.73-94
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• 2010

The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8521-8526
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• 2014

In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.19.1-19.6
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• 2019

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.4
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• pp.201-209
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• 2020

In this study, issues related to changes in base year, which have controversial effects on fees in service contracts, were reviewed. In this regard, sensitivity analysis was conducted on the effects of changes in base year on conversion factor by type. The benefits and disadvantages of each specific type of medical institution were examined. Main conclusions are as follows. First, changing the base year to be closer to the present time had a beneficial effect on the conversion factor of hospitals. Second, changing the base year to be closer to the current point of time had an adverse effect on the conversion factor of pharmacies and clinics and had a significant adverse effect on clinics. Third, assuming that a single conversion factor is collectively applied to all types, a favorable effect occurred in all cases when the base year was changed to be closer to the present time. Base year changes can bring about conflicts of interest between insurer and providers, and within providers. Therefore, changing the base year should be pursued upon mutual agreement on a reasonable basis for resource allocation. In addition, it is necessary to provide incentives for temporary compensation for the types of losses incurred.

• The Korean Journal of Physiology and Pharmacology
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• v.24 no.4
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• pp.339-348
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• 2020

We aimed to characterize the participation of rapid non-genomic and delayed non-genomic/genomic or genomic mechanisms in vasoactive effects to triiodothyronine (T3), emphasizing functional analysis of the involvement of these mechanisms in the genesis of nitric oxide (NO) of endothelial or muscular origin. Influences of in vitro and in vivo T3 treatments on contractile and relaxant responsiveness of isolated rat aortas were studied. In vivo T3-treatment was 500 ㎍·kg^-1·d^-1, subcutaneous injection, for 1 (T3_1d) and 3 (T3_3d) days. In experiments with endothelium-intact aortic rings contracted with phenylephrine, increasing concentrations of T3 did not alter contractility. Likewise, in vitro T3 did not modify relaxant responses induced by acetylcholine or sodium nitroprusside (SNP) nor contractile responses elicited by phenylephrine or angiotensin II in endothelium-intact aortas. Concentration-response curves (CRCs) to acetylcholine and SNP in endothelium-intact aortic rings from T3_1d and T3_3d rats were unmodified. T3_3d, but not T3_1d, treatment diminished CRCs to phenylephrine in endothelium-intact aortic rings. CRCs to phenylephrine remained significantly depressed in both endothelium-denuded and endothelium-intact, nitric oxide synthase inhibitor-treated, aortas of T3_3d rats. In endothelium-denuded aortas of T3_3d rats, CRCs to angiotensin II, and high K⁺ contractures, were decreased. Thus, in vitro T3 neither modified phenylephrine-induced active tonus nor CRCs to relaxant and contractile agonists in endothelium-intact aortas, discarding rapid non-genomic actions of this hormone in smooth muscle and endothelial cells. Otherwise, T3_3d-treatment inhibited aortic smooth muscle capacity to contract, but not to relax, in an endothelium- and NO-independent manner. This effect may be mediated by delayed non-genomic/genomic or genomic mechanisms.