• 한국방사선학회논문지
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• 제12권2호
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• pp.209-216
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• 2018

혈관조영 및 중재적 방사선학 분야의 경우, 업무 특성상 눈의 방사선 피폭에 대한 위험성이 높다고 알려져 있으나, 현재 구분된 선량평가 및 관리가 이루어지지 않는 실정이다. 이에 본 연구에서는 시술 환경 내 종사자의 눈에 대한 선량평가 및 차폐분석을 위해 첫 번째로, 시술자가 주로 위치하는 지점을 선정하고, 두경부 팬텀 눈의 외안각 지점에 포켓선량계를 부착한 뒤 눈에 대한 피폭선량을 평가하였고, 현재 상용화된 납 안경 착용 시 차폐효과를 산정하였다. 두 번째로, 실측과 동일한 기하학적 구조 내 모의실험을 통해 눈의 피폭선량에 대한 경향성 평가와 차폐효과에 대해 분석하였다. 그 결과, 선량계를 이용한 측정의 경우, 방사선 투시촬영 시간이 증가함에 따라 누적선량이 증가하였고, 또한 시술자의 위치에 따라 각기 다른 양상을 보였다. 모의실험의 경우, 수학적 팬텀 내 눈의 수정체의 경우 각막보다 약 1.1 ~ 1.3배 높은 선량분포를 나타내는 것을 확인하였고, 납 안경의 방호효과는 눈의 각 기관별로 최소 3.7 ~ 최대 21.4% 차폐효과를 보였다.

• 한국병원경영학회지
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• 제23권3호
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• pp.28-38
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• 2018

Purposes: 본 연구는 전립선암 환자의 의료비 지출을 평가하기 위해 남성호르몬 박탈 치료와 근치적 전립선적출술의 비용을 비교하였다. Methods: 본 연구는 스마트 전립선암 데이터베이스(Smart Prostate Cancer Database)의 전립선암 환자 357명의 데이터와 청구데이터베이스에서 의료비 관련 데이터를 도출하였다. 근치적 전립선적출술과 남성호르몬 박탈 치료간 비교를 위해 독립표본 t검정을 실시하였다. 또한 남성호르몬 박탈 치료와 근치적 전립선적출술에 영향을 미치는 요인을 검증하기 위해 다중회귀 분석을 실시하였다. Findings: 치료 후 1년까지 남성호르몬 박탈치료가 근치적 전립선적출술 보다 비용이 낮은 것으로 나타났으며, 치료 후 4년까지 낮게 유지되었다. 그러나 4년이 지나면 남성호르몬 박탈 치료의 누적의료비가 근치적 전립선적출술보다 더 유의미하게 높게 나타났다. 환자의 병기가 높거나 나이가 많은 경우 근치적 전립선적출술보다 남성호르몬 박탈 치료를 할 확률이 더 높았다. Practical Implications: 본 연구는 조기 암 발견이 환자 뿐 아니라 국민건강보험공단의 의료비를 줄일 수 있다는 것을 보여 준다. 또한 의료비를 정확히 평가하기 위해서는 오랜 기간의 정보를 평가해야 하며, 이를 기반으로 평가 및 예측이 필요함을 증명하였다.

• Journal of Periodontal and Implant Science
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• 제30권2호
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• pp.305-324
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• 2000

This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes($BioMesh^{(R)}$) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.

• 보건행정학회지
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• 제15권4호
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• pp.136-160
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• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• 수산해양기술연구
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• 제37권4호
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• pp.267-274
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• 2001

어구 크기를 대폭적으로 줄이면서 어획성능을 향상시킨 어구를 개량하고 조업자동화를 이룩할 수 있도록 하기 위하여 신광수산에서 사용하고 있는 실물어구를 가지고 양선간격 및 예망속도의 변화에 따른 해상실험을 통하여 어구 각부의 망고와 수중형상을 측정·분석한 결과를 요약하면 다음과 같다. 1. 실물어구 각 부분의 망고는 양선간격과 예망속도가 증가함에 따라 낮아지는 경향을 보였다. 2. 실물어구의 양선간격에 따른 오비기, 수비, 앞창, 자루 입구, 깔때기와 자루 뒤끝의 망고는 각각 8.4∼6.6, 17.4∼15.7, 17.9∼12.9, 19.0∼l3.6, 8.4∼8.3, 14.7∼11.1m이었고, 각 부분의 전개율은 16∼12, 24∼22, 38∼27, 83∼59, 93∼92, 54∼41%로 나타났다. 3. 실물어구의 예망속도에 따른 오비기, 수비, 앞창, 자루 입구, 깔때기, 자루 뒤끝의 망고는 각각 10.5∼7.7, 21.6∼l9.6, 16.9∼15.2, 17.1∼15.4, 8.2∼8.0, 14.7∼13.7m이었고, 각 부분의 전개율은 각각 19∼14, 30∼27, 36∼32, 74∼67, 91∼89, 54∼51%로 나타났다. 4. 오비기의 망고가 매우 낮게 형성되어 수비와 앞창의 망고가 불안정하고 극히 낮은 전개율로 인하여 포켓현상이 매우 뚜렷하게 나타났다. 5. 실물어구의 예망깊이는 양선간격과 예망속도의 증가에 따라 약간씩 말아지는 현상을 보였는데, 뜸줄 쪽보다는 발줄 쪽이 더 뚜렷하였다.

• Journal of Periodontal and Implant Science
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• 제51권5호
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• pp.342-351
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• 2021

Purpose: The aim of this study was to compare the inflammatory and lipid profile of patients with and without peri-implantitis. Methods: A cross-sectional biochemical study was carried out in which blood samples were collected from 16 patients with peri-implantitis and from 31 subjects with healthy implants. Clinical peri-implant parameters were obtained from all subjects. Levels of tumor necrosis factor-alpha and interleukin-10 (IL-10) were measured in serum. Lipid fractions, glucose and creatinine levels, and complete blood count were also assessed. Results: After controlling for a history of periodontitis, statistically significant differences between peri-implantitis patients and controls were found for total cholesterol (estimated adjusted mean difference, 76.4 mg/dL; 95% confidence interval [CI], 39.6, 113.2 mg/dL; P<0.001), low-density lipoprotein (LDL) cholesterol (estimated adjusted mean difference, 57.7 mg/dL; 95% CI, 23.8, 91.6 mg/dL; P<0.001), white blood cells (WBC) (estimated adjusted mean difference, 2.8×10³/µL; 95% CI, 1.6, 4.0×10³/µL; P<0.001) and IL-10 (estimated adjusted mean difference, -10.4 pg/mL; 95% CI, -15.8, -5.0 pg/mL; P<0.001). The peri-implant probing pocket depth (PPD) was modestly positively correlated with total cholesterol (r=0.512; P<0.001), LDL cholesterol (r=0.463; P=0.001), and WBC (r=0.519; P<0.001). A moderate negative correlation was observed between IL-10 and PPD (r=0.609; P<0.001). Conclusions: Otherwise healthy individuals with peri-implantitis showed increased low-grade systemic inflammation and dyslipidemia.

• 대한치과의료관리학회지
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• 제8권1호
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• pp.15-23
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• 2020

The aim of this study is to identify future-oriented tasks for Korean dental hygienists based on a literature review. A literature search is performed using 14 keywords related to tasks carried out by dental hygienists, and included articles published from 2000 to 2019 in the databases KISS, RISS, DBpia, NDSL, Papersearch, Pubmed, and Google Scholar. Six reviewers assessed the titles and abstracts of articles, and an article was selected if the study was considered to cover future-oriented tasks for Korean dental hygienists. Based on the results six local studies and two foreign studies were used for literature review and data extraction. In total, 38 tasks were classified as future-oriented tasks of dental hygienists according to the following criteria: 1) tasks that were specifically referred to as future-oriented tasks, and 2) tasks that could be classified as future-oriented tasks although no specific reference was made. Of these, the most frequently mentioned tasks were measuring periodontal pocket depth, dental hygiene assessment, providing dietary advice, infiltration anesthesia, and root planing. These were extracted from five of the eight studies, including both local and foreign studies. Dental hygiene planning, emergency, emergency management, and smoking cessation were the next most common tasks based on four studies. Even though some of these future-oriented tasks for Korean dental hygienists are included in the dentistry curriculum, and are currently performed as clinical practice for dental hygienists. Nonetheless, the reference to the legal scope is unclear. It is necessary to reconsider the scope of tasks of dental hygienists to reflect changes in domestic and foreign dental care delivery, thereby contributing to the oral health promotion of the public, where safety is guaranteed under legal protection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권4호
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• pp.225-231
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• 2022

Objectives: This study aims to evaluate the efficacy and safety of two types of sandblasted with large-grit and acid-etched (SLA) surface implants with different surface roughness. Patients and Methods: This study was conducted based on a clinical record review of 55 patients (mean age, 53.00 years). A total of 80 SLA surface implants was placed. Among the 80 implants, 38 implants placed in 29 subjects had surface roughness (Ra) of 3.09 ㎛ (test group, TG), while the other 42 implants placed in 31 subjects had a surface roughness (Ra) of 2.50 ㎛ (control group, CG). A comparison was made of implant primary/secondary stability; success and survival rates; marginal bone loss; and soft tissue assessment including probing pocket depth (PPD), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) between the groups at 1 year after implant placement. Results: Among the implants that were initially registered, 1 from the TG and 4 from the CG dropped out, leaving 37 implants in the TG and 38 implants in the CG to be traced and analyzed. Although 1 TG case showed unstable primary stability, all cases showed stable secondary stability. Success and survival rates at 1 year after implant placement were 100% in both groups. Marginal bone loss was 0.07 mm and 0.00 mm for the TG and CG, respectively, but the difference was not significant. Among the several parameters for evaluation of soft tissue, the TG showed lower PI at 1 year after implant placement (TG=0.00, CG=0.29; P=0.0004), while the remaining categories showed no significant difference between the groups. Conclusion: This study shows that the two types of SLA implants with different surface roughness have no difference in efficacy or safety. Therefore, both of the implants can be used safely and with promising outcomes.

• 보건행정학회지
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• 제30권2호
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• 보건행정학회지
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• 제19권3호
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• pp.92-108
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• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.