• 대한족부족관절학회지
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• 제19권4호
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• pp.137-141
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• 2015

Recently, open reduction and internal fixation has been the treatment of choice for displaced intra-articular calcaneal fractures for many orthopaedic surgeons. However controversy still surrounds the optimal treatment with regard to whether displaced intra-articular calcaneal fractures should be treated operatively or conservatively. Conservative treatments include use of splint, rest, leg elevation, icing, use of analgesics and early mobilization. Operative treatment is open reduction and internal fixation, performed through an extensile lateral approach with interfragmentary screws and application of a neutralization plate. We reviewed the question of whether operative treatment by open reduction and internal fixation provides a benefit compared with conservative treatment for displaced intra-articular calcaneal fractures.

• Clinical and Experimental Pediatrics
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• 제62권7호
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• pp.245-251
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• 2019

Hemodynamically significant preterm patent ductus arteriosus (PDA) affects mortality; comorbidities such as necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia; and adverse long-term neurodevelopmental outcomes in preterm infants, particularly in very low birth weight infants. However, recent studies have indicated that there is no consensus on the causal relationship between PDA and neonatal outcomes, the benefit of PDA treatment, the factors guiding the need for treatment, and optimal treatment strategies. Such uncertainty has resulted in wide variations in practice for treating preterm PDA between units, regions, and nations. Nowadays, there has been a paradigm shift to more conservative treatment for preterm PDA, and suggestions regarding selective management of preterm PDA considering risk factors and hemodynamic significance are increasing. Neonatologist-performed echocardiography and advances in modalities to assess hemodynamic significance such as biologic markers and near-infrared spectroscopy also help improve the efficacy of selective treatment of preterm PDA.

• 대한본초학회지
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• 제21권4호
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• pp.1-10
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• 2006

Objectives : Recently, the total medical expenses of the korean oriental medical service in national health insurance is on the increase every year. Herbal medicines are one of the major methods of the medical treatment. But the expenses of these herbal preparations that can receive benefits from insurance system are decreasing. Methods : In this research, we obtained statistical data of the benefit states of herbal preparations in herbal heath insurance during year 2001-2003 from Health Insurance Review Agency. We analyzed top twenty main diseases in herbal health insurance and mainly used prescription in these diseases. Results : There were wide differences in the application of prescriptions among diseases. For example, musculoskeletal diseases occupied an important position and Ojucksan took more than 50 percentage. Conclusion : We hope that this study could be a basic data for improving the benefit system of herbal health insurance and further studies should be carried out subsequently.

• 한국임상약학회지
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• 제30권3호
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• pp.177-184
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• 2020

Background & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion: This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.89-94
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• 2015

The role of adjuvant chemotherapy in patients with stage II colon cancer remains a controversial issue. Adjuvant chemotherapy aims to eliminate any micrometastatic disease that may have been missed, at the time of surgery. Although one prospective study showed a small but statistically significant benefit with respect to the overall survival for those who received adjuvant chemotherapy, multiple pooled data did not demonstrate any benefit of this therapy in patients with stage II colon cancer. Current national and international guidelines for the adjuvant treatment of stage II colon dose not advise routine implementation of adjuvant chemotherapy, but rather recommend selective use of this therapy for patients with high risk of recurrence. High risk features for recurrence include T4 disease, poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, inadequate retrieval of lymph nodes, bowel obstruction, localized perforation, or positive margins. More recently, prediction tools using gene expression cancer profiles are proposed to identify patients who are most likely to have recurrence and therefore may benefit from postoperative chemotherapy in stage II colon cancer. These novel methods together with conventional prognosticators, will allow us to implement more optimized personalizing adjuvant therapy in these patients.

• 한국의류학회지
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• 제34권8호
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• pp.1277-1289
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• 2010

This study investigates the effects of e-CRM on consumer satisfaction and repurchase intention depending on gender differences. A total of 400 surveys were distributed and 382 were used in the analysis. Surveys were conducted on the respondents who had purchased apparel from an internet website within six months. A factor analysis, reliability test, and path analysis were used in the study to analyze the data. After the factor analysis, 6 factors were found under e-CRM activities; benefit and advice, customer contact, service, post-purchase management, assistance with the purchase, and discriminative treatment. The results of this study showed that for male consumers, service and post-purchase management had a positive effect on consumer satisfaction that in turn had a positive effect on repurchase intention. However, for female consumers, benefit and advice, customer contact, service, and discriminative treatment had a positive effect on consumer satisfaction that in turn had a positive effect on repurchase intention. The results also showed that post-purchase management had a positive direct effect on repurchase intention for both genders.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.277-280
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• 2006

Objective : The aim of this study is to determine which patients with progressively deteriorating acute cerebellar infarction would benefit from surgical treatment and which surgical procedure would best benefit them. Methods : Seventy six patients were treated at our hospital for cerebellar infarction over the past 3 years. Sixty nine patients received conservative management in the neurological department of our hospital. Among them, 7 patients [5 males and 2 females; average age, 49 yrs] were referred to neurosurgical department because of mental deterioration and underwent emergency surgery. Five patients underwent external ventricular drainage with suboccipital craniectomy and two patients underwent suboccipital craniectomy alone. Results : Of the 7 surgically treated patients, 4 patients experienced good recovery and 2 patients experienced moderate disability [disabled but independent] and 1 patient experienced severe disability [conscious but disabled]. There was no death. Conclusion : In patients conservatively treated for cerebellar infarction and showing mental deterioration and radiologically evident brainstem compression and ventricular enlargement, we strongly recommend suboccipital craniectomy [plus optional external ventricular drainage in case of showing hydrocephalus] as a first treatment option.

• 대한환경공학회지
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• 제33권6호
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• pp.405-412
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• 2011

국내 TCE에 의해 오염된 산업 공단내의 지하수 정화 방법으로 양수 및 처리(pump and treatment) 공법이 제안되었다. TCE 농도 0.6 mg/L 오염 지하수를 30년 동안 이 공법에 의해 처리하여 0.005 mg/L 이하 농도로 방류할 경우 그 과정에서 발생하는 환경 비용과 환경 편익을 전과정평가에 의해 산출하였으며 그에 따른 환경 영향 및 환경 효과를 분석하였다. 방류 지하수의 총량은 $2.96{\times}10^7m^3$이며 제거된 TCE의 총량은 최대 17.6 kg이었다. 환경 비용은 에너지의 소비, 자원의 소비, 대기, 수질 및 고형 폐기물 형태의 오염 물질의 배출량 등으로 산출되었으며 환경 편익은 정화된 지하수의 사용으로 얻어졌다. 환경 비용에 따른 환경 영향은 30년 동안 구동하는 pump에 의한 전력 사용, 발전을 위해 소모되는 석유, 석탄 등의 원자재의 소모, 방출되는 지구 온난화 및 산성 가스, 부영양화, 폐기물의 발생을 포함하며 토양/지하수 정화 공정 전과정평가 모델의 사용으로 정량화하고 전세계 일인당 소모 또는 배출하는 표준량으로 나누어 표준화하여 비교한 결과 산성비 원인 오염물 배출이 가장 심각하였다.

• 한국환경과학회지
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• 제17권8호
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• pp.857-869
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• 2008

The objective of this research is to apply more scientific, quantitative methods and procedures of environmental investigation to the development of the natural environment and the improvement of the human environment during the establishment of a sewage treatment plant and special facilities using environmental accounting. This research was performed to develop a method of strategic environmental assessment on the operation of sewage treatment plant and reuse of shellfish seeding areas through the use of environmental accounting based on EMERGY evaluation. The result was applied to marine environment policy in order to evaluate the real wealth of the regional environment and economy for both the present phase and the proposed developed phase. Using results from the comparison of EMERGY indices between the present situation and future scenarios, cost benefit analysis was performed for three different scenarios: (I) construction of a new sewage treatment plant, (2) relocation and recovery of the shellfish seeding area, and (3) relocation and re-seeding of shellfish area and construction of a new sewage treatment plant. Cost-benefit ratios of the three scenarios are 1.88, 0.94, and 1.38, respectively.

• 한국병원경영학회지
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• 제22권4호
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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.