• Health Policy and Management
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• v.22 no.3
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• Health Policy and Management
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• v.21 no.2
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• pp.159-178
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• 2011

Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in 'out-of-pocket expenditure as a share of the ability to pay' and 'incidence rate of catastrophic health care expenditure' of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare Panel Study (KoWePS), conducted by the Korea Institute for Health and Social Affairs (KIHASA), were used for the analysis, where low-income households and ordinary households are sampled separately. While the absolute amount of 'out-of-pocket expenditure' occurred to the average household increased for the period 2005-2007, the 'out-of-pocket expenditure as a share of the ability to pay' decreased. At the same time, the share decreased in the case of low-income households and households with patients of chronic or serious case as contrasted with ordinary households. 'Incidence rates of catastrophic health care expenditure' of ordinary households for 2007 stood at 14.6%, 5.9% and 2.8% at the threshold of 10%, 20% and 30%, respectively. The rates decreased overall between 2005 and 2007, while those of low-income households with patients of serious case statistically significantly increased. An analysis of this study indicates that it is related with the medical bill ceiling system regardless of incomes introduced in 2007.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.57-70
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• 1998

The purpose of this study was to evaluate the clinical and microbiological effects of metronidazole 25% dental gel that was applied to periodontal pockets who have moderate to advanced chronic adult periodontitis were selected for this study. The quadrants that had 2 or 3teeth with 5-8mm probing pocket depth were selected and divided into test side and control side according to the split-mouth design. The metronidazole 25% dental gel applied on test side and 0.12% chlorhexidine solution applicated on positive control side, normal saline irrigation into periodontal pocket was applicated to negative control side respectively. Above procedures followed scaling and root planing at baseline(0week). The subgingival sterile saline irrigation and chlorhexidine irrigation were done for about 30 seconds respectively. The metronidazole 25% dental gel was applied to periodontal pocket at 0,1 week in the test side. The clinical and microbiological analysis carried out at baseline(0week) and 4,8 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth were significantly reduced in the test group. The relative proportions of spirochetes and motile rods were significantly reduced to negative control group and the proportion of cocci was correspondingly increased in the test group. 2. The sulcular bleeding index, probing pocket depth were significantly reduced in metronidazole group. and, there was a significant differences between 2 groups. Also, the relative proportions of spirochetes and motile rods were reduced in both group. And, there was a significant differences between 2 groups. In conclusion, application of metronidazole 25% dental gel as an adjunct to mechanical debridement of root surfaces may improved the clinical and microbiological status of periodontal disease sites.

• Journal of Periodontal and Implant Science
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• v.31 no.3
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• pp.501-511
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• 2001

Several indices have been developed that use bleeding and color changes as indicators of early gingival pathology. In the presence of gingivitis, vascular proliferation and reduction of keratinization owing to increase redness in gingiva. Descriptions of healthy gingiva are numerous, ranging from pale pink and coral pink to deep red and violet. This terms are not objective. Because of perception of color depends on a lot of factors such as light source, object, observer and so on. It is difficult to make an objective expression. Therefore the using of mechanical equipment is recommended to exclude these variables and observer's vias. The purpose of this study was to evaluate gingival color change after scaling & subgingival root planing. The other purpose of this study was to research the correlation of pocket depth, P.B.I. score and gingival color change. After photo-taking and storaging the image of gingival color into a computer, color change was examine with an image analysis program. Results were as follow; 1. Color of healed gingiva after scaling & subgingival root planing was significantly differ from color of inflamed gingiva(p<0.01). 2. Color of healed gingiva after scaling was similar to color of healed gingiva after subgingival root planing(p<0.05). 3. There was statistically significant correlation between color change of red component and pocket depth after scaling & subgingival root planing(p<0.01). 4. There was no correlation between color change of green, blue component and pocket depth after scaling & subgingival root planing(p<0.01). 5. There was statistically significant correlation between between color change of red component and P.B.I. score after scaling & subgingival root planing(p<0.01). 6. There was no correlation between color changes of green, blue component and P.B.I. score after scaling & subgingival root planing(p<0.01). 7. Increase of pocket depth and P.B.I. score were significantly correlated to the amount of color change(p<0.01). 8. P.B.I. score had a higher correlation with color change than pocket depth(p<0.01).

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.193-203
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• 1998

20 Subjects with clinical diagnosis of adult periodontitis with sites having average pocket depth of 4mm were selected for the study. After scaling and root planing of those sites, 30% minocycline-HCI contained in biodegradable device were inserted in one group, scaling and root planing was carried out in another group and the last group was without any periodontal treatment. the difference between the group was detemined by pocket dept, bleeding on prbing, attachment level, distribution of subgingval plaque bacteria. Conclusion was made for the comparisons between baseline and 4 week and the groups. 1. In analysis of pocket depth, there was significant sifference in scaling and root planing group only. 2. Both the scaling and root planing group and minocycline group showed significant decrease in bleeding on probing. 3. There was significant increase in the attachment level in scaling and root planing group, but no difference was foundbetween the groups. 4. There was significant decrease in the total number of subgingival bacteria in all groups and the number of motile bacteria decreased significantly in the minocycline group. These result indicate that insertion of Minocycline-HCI at the base of periodntal pocket was useful as an additional aid of mechanical trarment at the point of periodontal pocket, bleeding on probing, attachment level, microbial distribution.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.61-73
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• 2017

In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.477-488
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• 2001

The present study evaluated of regeneration effect of platelet rich plasma on the treatment of grade II furcation involvement, with coralline calcium phosphate bone in humans. 30 teeth with grade II furcation defect were selected and 15 teeth(control) were treated with coralline calcium phosphate bone, the others(test) were treated with coralline calcium phosphate bone and platelet rich plasma. Pocket depth, clinical attachment level, width of keratinized gingiva width were measured at baseline, postoperative 3, 6months. from cementoenamel junction to alveolar crest and fundus were measured at baseline, 6months(re-entry). Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Mann-whitney Test using SPSS program(5% significance level). The results were as follows: 1. Pocket depth, clinical attachment level, keratinized gingva width, cementoenamel junction - alveolar crest, cementoenamel junction - fundus were not differ significantly in both groups at baseline 2. The change of pocket depth, clinical attachment level, keratinized gingva width, cementoenamel junction - alveolar crest, cementoenamel junction - fundus in both groups were decreased significantly at 3, 6months(p<0.05). 3. The change of pocket depth, clinical attachment level in test group decreased significantly than control at 3, 6months(p<0.05). 4. The change of keratinized gingiva width, cementoenamel junctional - alveolar crest, cementoenamel junction - fundus were not differ significantly in both groups at 3, 6months. 5. The pocket depth, clinical attachment level, keratinized gingiva width exhibited marked changes at 3 months in both groups. In conclusion, the results of this study suggest that platelet rich plasma have adjunctive clinical treatment effect to periodontal regeneration in grade II furcation defects.

• Tribology and Lubricants
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• v.37 no.4
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• pp.129-135
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• 2021

An air-bearing stage uses externally pressurized air as the lubricant between the stage and the rail. The supporting force generated by the supplied air makes the stage rise and move smoothly with extremely low friction. Mechanical contacts rarely happen, the bearing surfaces do not produce wear particles, and dust is not generated. It also has the advantage of having low energy loss and high precision. Because of its advantages, an air-bearing stage is used in several types of machines that require high precision. In this article, the effect of the pocket depth on the hammering phenomena of the air bearing is studied. An analysis program is developed to calculate the dynamic behavior of the stage by solving the Reynolds equation between the stage and the guideway and the equations of motion on the stage. The acceleration, constant movement, and deceleration are applied to the stage. The stage is modeled as a five-degree-of-freedom system. In the course of the dynamic behavior, the hammering phenomena occur under some special conditions. The deeper the pocket, the more unstable the behavior of the stage, and air hammering occurs when it exceeds a certain depth. In addition, the higher the supply pressure, the more unstable the behavior of the stage. However, hammering occurs even with a shallow pocket depth. Other conditions that affect the hammering phenomena are calculated and discussed.

• Journal of Periodontal and Implant Science
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• v.52 no.5
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• pp.383-393
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• 2022

Purpose: Aloe-emodin (AE), a natural anthraquinone abundant in aloe plants and rhubarb (Rheum rhabarbarum), has long been used to treat chronic inflammatory diseases. However, AE's underlying mechanisms in periodontal inflammation have not been fully elucidated. Acidic mammalian chitinase (AMCase) is a potential biomarker involved in bone remodeling. This study aimed to evaluate AE's effect on periodontitis in rats and investigate AMCase expression. Methods: Eighteen Sprague-Dawley rats were separated into the following groups: healthy (group 1), disease (group 2), vehicle (group 3), AE high-dose (group 4), and AE low-dose (group 5). Porphyromonas gingivalis ligatures were placed in rats (groups 2-5) for 7 days. Groups 4 and 5 were then treated with AE for an additional 14 days. Saliva was collected from all groups, and probing pocket depth was measured in succession. Periodontal pocket tissues were subjected to histomorphometric analysis after the rats were sacrificed. Bone marrow-derived macrophages and murine macrophages were stimulated with receptor activator of nuclear factor-κB ligand (RANKL) and treated with different concentrations of AE. AMCase expression was detected from the analysis of saliva, periodontal pocket tissues, and differentiated osteoclasts. Results: Among rats with P. gingivalis-induced periodontitis, the alveolar bone resorption levels and periodontal pocket depth were significantly reduced after treatment with AE. AMCase protein expression was significantly higher in the disease group than in the healthy control (P<0.05). However, AE inhibited periodontal inflammation by downregulating AMCase expression in saliva and periodontal pocket tissue. AE significantly reduced RANKL-stimulated osteoclastogenesis by modulating AMCase (P<0.05). Conclusions: AE decreases alveolar bone loss and periodontal inflammation, suggesting that this natural anthraquinone has potential value as a novel therapeutic agent against periodontal disease.

• Health Policy and Management
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• v.32 no.3
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.