• Health Policy and Management
• /
• v.20 no.2
• /
• pp.40-52
• /
• 2010

Health insurance fees are set by relative value scales and conversion factors. Since 2008 the conversion factor has been classified into 7 according to the provider type, and a separate contract has been made respectively. As such classification of the conversion factor reflects only the different characteristics of providers, however, further classification to reflect the different cost structures of providers is proposed. Cost varies according to the type of not only providers but also services each provider supply. In fact different cost structures of providers are the result of their different services. This study analyzed the cost structure of medical services to propose a new approach to the classification of the conversion factor. This study analyzed the cost structure of medical services using cost data constructed in the revision study of relative value scales. The cost data consist of doctor's fee, support staff's fee, cost of medical equipments, cost of medical supplies and indirect cost. The proportion of each cost component to the total cost was analyzed in terms of service department and service type. 72 service groups are defined in terms of the combination of service department and service type. Through cluster analysis, 72 service groups were reduced into 7 clusters each of which has a similar cost structure. Conversion factor is contracted annually to reflect the change in the cost of providing medical services. So the classification of conversion factor has to be based on the cost structures of medical services, not the characteristics of providers. Service clusters derived in this study can be used as a new classification for health insurance fee contract.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.21
• /
• pp.9113-9116
• /
• 2014

Purpose: : To assess the clinic value of application of laparospic ultrasonography (LU) in partial nephrectomy of small renal cell carcinoma. Materials and Methods: From 2007 to 2011, 28 small renal cell carcinoma patients in ou clinic underwent laparoscopic partial nephrectomy with LU. For comparison with preoperative conventional ultrasound and CT, we collected ultrasonic performance of the affected side kidney, renal tumor location, size, echo change, blood supply situation and the relationship with the surrounding tissue. Results: LU could more clearly show the tumor interior structure and blood supply, as well as the relationship with the surrounding tissue. It also can provided doctor assistance with real-time tumor resection, reducing operative complications. Conclusions: LU can clearly show tumor internal structure and blood supply, which is helpful for explicit diagnosis. Moreover, it supplies accurate information for surgeons and assists surgery. Therefore LU has an important guiding value in partial nephrectomy for small renal cell carcinoma.

• Archives of Plastic Surgery
• /
• v.39 no.5
• /
• pp.556-560
• /
• 2012

Zygomatic fractures are the second most common facial bone fractures encountered and treated by plastic surgeons. Stable fixation of fractured fragments after adequate exposure is critical for ensuring three-dimensional anatomic reduction. Between January 2008 and December 2010, 17 patients with zygomatic fractures were admitted to our hospital; there were 15 male and 2 female patients. The average age of the patients was 41 years (range, 19 to 75 years). We exposed the inferior orbital rim and zygomatic complex through a lateral brow, intraoral, and subciliary incisions, which allowed for visualization of the bone, and then the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperative complications such as malar asymmetry, diplopia, enophthalmos, and postoperative infection were not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17 patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report, we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures. Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and safely than other devices, without leaving facial scars.

• Korean Journal of Oriental Medicine
• /
• v.16 no.1
• /
• pp.19-27
• /
• 2010

Objectives & Method : We investigated toxicity, poisoning symptoms, poisoning treatment and prevention against poisoning of mind-tranquilizing herbal medicines(安神藥) in order to use herbal medicines accurately. Result : Cinnabaris(朱砂), Zizyphi Spinosae Semen(酸棗仁), Polygalae Radix(遠志), Ganoderma(靈芝) and Polygoni Multiflori Ramulus(夜交藤) may give rise to some side effects or toxic symptoms in mind-tranquilizing herbal medicines(安神藥). The representative methods of poisoning treatment in western medicines are washing out the stomach, promotion of vomiting, causing diarrhea, supplies of grape sugar and symptomatic treatment, etc. The representative methods of poisoning treatment in oriental medicine take advantage of herbs. And Oriental medical doctor should meet symptoms as patients call for attention. In order to prevent against poisoning of mind-tranquilizing herbal medicines(安神藥), the patients should keep usage, dosage and notes and oriental medical doctors should do processing drugs. Conclusion : We should pay attention to clinical using of Cinnabaris(朱砂), Zizyphi Spinosae Semen(酸棗仁), Polygalae Radix(遠志), Ganoderma(靈芝) and Polygoni Multiflori Ramulus(夜交藤) in mind-tranquilizing herbal medicines(安神藥).

• Journal of Korean Medical classics
• /
• v.32 no.4
• /
• pp.47-55
• /
• 2019

Objectives : The purpose of this study is to research the relations between the Renying pulse and Qikou pulse diagnosis(人迎氣口脈診法) and the Chong vessel(衝脈) based on Yin and Yang(陰陽). Methods : We set up locations of the Renying pulse and the Qikou pulse as ST9(Renying pulse) and LU9(Qikou pulse) respectively. Several medical texts and papers were examined from the ancient to modern periods, in which the relations between the Renying and Qikou pulse diagnosis(人迎氣口脈診法) and the Chong vessel(衝脈) were analyzed based on Yin and Yang(陰陽). Results & Conclusions : The Chong vessel(衝脈) goes around the whole body and its dysfuction can be determined at pulsating sites. Also the Chong vessel(衝脈) supplies Source Qi(原氣) to the Stomach where it generates Nutrient Qi(營氣) and Defense Qi (衛氣). Due to the Lung's function that balances Nutrient Qi(營氣) and Defense Qi(衛氣), the balance between Yin and Yang is accomplished. This Yin-Yang balance can be confirmed through pulse diagnosis of the Renying pulse and Qikou pulse(人迎氣口脈診法).

• Journal of Radiopharmaceuticals and Molecular Probes
• /
• v.1 no.1
• /
• pp.23-30
• /
• 2015

Radioisotopes emitting low-range highly ionizing radiation such as ${\beta}$-particles are of increasing significance in internal radiotherapy. Among the ${\beta}$-particle emitting radioisotopes, $^{67}Cu$ is an attractive radioisotope for various nuclear medicine applications due to its medium energy ${\beta}$-particle, gamma emissions, and 61.83-hour half-life, which can also be used with $^{64}Cu$ for PET imaging. The production and application of the ${\beta}$-emitting radioisotope $^{67}Cu$ for therapeutic radiopharmaceutical are outlined, and different production routes are discussed. A survey of copper chelators used for antibody labeling is provided. It has been produced via proton, alpha, neutron, and gamma irradiations followed by solvent extraction, ion exchange, electrodeposition. Clinical studies using $^{67}Cu$-labelled antibodies in lymphoma, colon carcinoma and bladder cancer patients are reviewed. Widespread use of this isotope for clinical studies and preliminary treatments has been limited by unreliable supplies, cost, and difficulty in obtaining therapeutic quantities.

• Clinical Endoscopy
• /
• v.56 no.4
• /
• pp.446-452
• /
• 2023

Background/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes. Methods: We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated. Results: Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, -0.76 [-1.49 to -0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28-0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27-0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, -0.48; 95% CI, -1.05 to 0.08; p=0.09) when using an abdominal compression device. Conclusions: Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.

• The Korean Journal of Emergency Medical Services
• /
• v.21 no.1
• /
• pp.87-98
• /
• 2017

Purpose: This study investigated the use of infection management and the frequency of emergency equipment sterilization by emergency rescue crews to provide basic guidelines and suggestions for infection control. Methods: A self-reported questionnaire was completed by 160 emergency medical technician rescue crews in J area from May 7 to May 22 in 2015. The questionnaire consisted of 95 items, including the general characteristics of the subjects (8 items), the use of emergency equipment (33 items), the frequency of facility sterilization (33 items), infection control (12 items), vaccination (4 items), and the use of personal protective equipment (5 items). Results: In all, 97.3% of respondents were aware of the "Guidelines of Infection management for Rescue Operators' and 90.9% received training on infection control. A total of 72.7% and 47.3% of rescue centers were equipped with disinfection facilities and laundry rooms, respectively. The average frequency of sterilization was $3.17{\pm}0.75$, which significantly differed for teams with more clinical experience (p=.050) and teams with three members (p=.030). The average score for individual protective equipment supplies was $1.95{\pm}0.66$. Conclusion: For proper infection management of emergency equipment, our results suggest that the number of crew members should be increased for each ambulance, protective equipment and rescue products should be supplied, and the number of facilities for sterilization and laundry at rescue centers should be doubled.

• Journal of Biomedical Engineering Research
• /
• v.43 no.6
• /
• pp.434-440
• /
• 2022

Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.

• Archives of Reconstructive Microsurgery
• /
• v.21 no.2
• /
• pp.159-164
• /
• 2012

Purpose: Soft tissue defect on posterior side of heel exposing Achilles tendon is vulnerable and require thin flap to improve aesthetic and functional results. Reverse superficial sural artery flap is simple and fast procedure, and it can preserves major arteries, supplies reliable constant blood, causes less donor site complication. Authors reviewed our cases and report the clinical results. Materials and Methods: Nine cases of soft tissue defects on the posterior side of heel exposing Achilles tendon were treated with distally based superficial sural artery flap. There were 6 male and 3 female and mean age was 48.4 years. The size of flap was from $4{\times}4cm$ to $10{\times}15cm$ and mean follow-up period was 23 months. Flap survival, postoperative complications were evaluated. Results: All flaps were survived completely without necrosis. There was one case of partial wound dehiscence that needed debridement and repair, and other one case had recurrent discharge that was healed after removal of calcaneal plate. All patient showed acceptable range of ankle motion. Conclusion: Authors suggest that the reverse superficial sural artery flap could be one of the useful treatment options for the soft tissue defect on posterior side of heel exposing Achilles tendon.