• Journal of Korean Academy of Nursing
• /
• v.10 no.1
• /
• pp.41-55
• /
• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• Journal of Korean Neurosurgical Society
• /
• v.61 no.2
• /
• pp.127-166
• /
• 2018

Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, world-wide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.

• Korean Journal of Soil Science and Fertilizer
• /
• v.15 no.4
• /
• pp.258-269
• /
• 1982

The nutritional status of fruit leaves of sweet persimmon and soil conditions were observed in the fifty five blocks of fruit farms of sweet persimmon in Gimhae, Gyeong-nam area. 1. The soil of fruit farm was composed of more than 20% of gravel in the most part of the fruit farms. 2. The strong acidity was observed in the soil of young fruit farms but the acidity of the farm soils was improved to week acid with increase of age of fruit trees. 3. The great variation in the content of available phosphate were observed in the soil from different fruit farm blocks and the lime content were relatively low in the most of the farm soils. 4. The contents of nitrogen, phosphate and potassium in leaves of sweet persimmon collected in July and October were lower than those collected in May but reverse tendency was observed in the content of calcium, magnesium and sodium. 5. The content of boron in leaves collected in May was similar to that collected in July but extremely high content of boron was observed in the loaves collected in October, harvesting period of sweet persimmon. 6. The contents of iron and manganese in the leaves of sweet persimmon were observed to be relatively high compared to the content in the leaves of other fruit trees. 7. The relatively great variation in such inorganic components as iron, copper and boron was observed in the fruit leaves of sweet persimmon according to the different fruit farm blocks. 8. The ages of fruit trees didn't have an effect on the content of inorganic components in the fruit leaves except the content of nitrogen which was decreased with the increase of the ages of fruit trees.

• The Journal of Dong Guk Oriental Medicine
• /
• v.7 no.2
• /
• pp.141-148
• /
• 1999

A simple and rapid FoLT(formamide low temperature)-PCR, whereby human genomic DNA from blood can be amplified without DNA preparative stps, is described using human insulin genes. By applicatin of FoLT-PCR in human insulin genes, intragenic polymorphism in non-coding regions of the human insulin gene was shown after amplification and analysis by restriction enzyme digestion. All nucleotide sequences were the same as the reported, and four necleotides, at 4 different positions were polymorphic, and polymorphic alleles ${\alpha}4$, ${\alpha}5$, ${\alpha}6$, and ${\beta}2$ were identified. The new alleles were originated from homologous recombination between the ${\alpha}1$ and ${\beta}1$ alleles, and the alleles were founded in heterozygotes only. Although allele ${\alpha}1$ was dominant, the new alleles and ${\beta}1$ were recessive. From the results, it was suggested that the new method of FoLT-PCR was highly applicable in genetic variation analysis.

• Journal of Yeungnam Medical Science
• /
• v.13 no.1
• /
• pp.110-115
• /
• 1996

The ESR is one of the oldest laboratory test still in use. Although it lacks specificity in diagnosis, it can be effective for monitoring disease activity and following-up. The Westergren method is used for reference method, however coefficient of variation has been described 0.8% to 22.9% according to the literature. Since the ESR was invented in 1921, measurement technique has developed and automated measurement is introduced. We analyzed one hundred forty-three patient samples using $SEDIsystem^{TM}$ automated ESR measuring system and compared with modified Westergren and Wintrobe methods. Comparison between $SEDIsystem^{TM}$ and modified Westergren for ESR measurement yields the following regression equation; y = 0.863x - 1.69 (r=0.830), $SEDIsystem^{TM}$ and Wintrobe y = 1.14x - 14.7 (r=0.789), respectively. We repeated measurement to evaluate reliability, results are not significant in statistically. In conclusion, $SEDIsystem^{TM}$ automated ESR measurement correlated with modified Westergren and Wintrobe methods, reveal reliable results after 4 hours and can report rapidly for large samples. Thus, these results indicate that $SEDIsystem^{TM}$ automated ESR measurement may be useful tool for clinical practice.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.1
• /
• pp.167-174
• /
• 2008

Mandibular first molar and primary molars usually have two roots, on the mesial and distal sides. Occasionally, these molars have an extra root located in the distolingual aspect. Prevalence of the 3-rooted first permanent molar shows ethnic variation, ranging from about 3% in Caucasian to about 20% in Mongoloid group, which includes Chinese, Japanese, Eskimo, American and Canadian Indians. The frequency of the mandibular molar with three roots decreases in the order of the first permanent molar, the second primary molar, and the first primary molar. If the mandibular first or second primary molar has an additional distolingual root, the adjacent molars, including the first permanent molar, posterior to it also may have it. Coronal morphologic change can occur in the mandibular first primary molars with three roots: the crown had more triangular-shape compared to the one with two roots, possibly affected by the presence of additional distolingual root. Clinically, exact diagnosis and treatment should be taken with those teeth for pulp canal treatment, extraction, and SS Cr.

• Journal of the Korean Recycled Construction Resources Institute
• /
• v.8 no.3
• /
• pp.325-332
• /
• 2020

In the safety diagnosis of fire-damaged concrete structures, it is difficult to evaluate the strength and changes in materials due to high temperatures with the existing durability analysis method. In particular, the compressive strength of specimen with different damage levels by thickness is used as a representative value for reducing the compressive strength of the structural member. In this study, a heating experiment was performed with only top face heating and fully heating conditions at 400℃ to 800℃. After heating, splitting tensile test and color analysis were performed to sliced specimens with a thickness of 20mm accompanied by the compressive test of a fully heated specimen. As a result of the experiment, the compressive strength reduction rate calculated from the splitting tensile strength of every sliced specimen appeared to be within 10% of the fully heated specimen on aver age, and the hue value analysis showed consistent color values were observed by red at 400℃-600℃ and gray at 700℃ or above. It follows that the techniques proposed in this study are reasonably assessable to estimate heated temperature and residual compressive strength and damage depth of concrete.

• Korean Journal of Radiology
• /
• v.24 no.10
• /
• pp.1006-1016
• /
• 2023

Objective: Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). Materials and Methods: In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. Results: We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), edge sharpness (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), image noise (4.0 [4.0-4.0] vs. 3.0 [3.0-4.0]), lesion conspicuity (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), and diagnostic confidence (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Conclusion: Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.2
• /
• pp.213-221
• /
• 2001

Background : There is a well recognized interlaboratory variation in the results using the polymerase chain reaction(PCR) to detect the IS6110 sequence. The clinical utility of a commercially developed PCR test(Amplicor) in bronchial washings for detecting pulmonary tuberculosis in smear negative patients was evaluated. The sensitivity and specificity of Amplicor was compared with that of an in-house PCR test used for detecting the IS6110 sequence of Mycobacterium tuberculosis(M.tbc) in the bronchial washing fluid. Methods : 66 patients whose sputum smear for M. tbc were negative or who could not produce any sputum were recruited from January 1999 to July 1999. They all had a bronchoscopy performed to determine if there were signs of hemoptysis, patients who could not cough up sputum, lung lesion that exclude pulmonary tuberculosis. Pulmonary tuberculosis was diagnosed on the basis of a positive culture or a response to anti-tuberculosis therapy. Results : 19 patients with tuberculosis were identified and samples from 16 patients were later confirmed by culture. Bronchial washing for Amplicor PCR revealed a sensitivity, specificity, positive and negative predictive values of 94.7%, 97.9%, 94.7%, 97.9%, respectively. Using IS6110 based PCR, the sensitivity, specificity, positive and negative predictive values were of 73.7%, 87.2%, 70%, 89.1% respectively. Conclusion : Bronchial washing for Amplicor PCR proved to be more useful than IS6110 based PCR in rapidly diagnosing smear negative pulmonary pulmoary tuberculosis in patients where tuberculosis was likely to be differential and rapid diagnosis was essential for optimal treatment.

• Korean journal of applied entomology
• /
• v.60 no.4
• /
• pp.387-401
• /
• 2021

Thrips infesting hot peppers were monitored in greenhouses using yellow sticky traps. In addition, the hot peppers infected with tomato spotted wilt virus (TSWV) were observed during the monitoring period. The flower thrips (Frankliniella intonsa) were initially trapped at a low density just after transplanting seedlings of hot peppers at late March. The western flower thrips (Frankliniella occidentalis) were trapped after mid April. These two thrips represented more than 98% of the total thrips attracted to the traps after May, in which F. intonsa showed higher occurrence frequency than F. occidentalis. The total number of thrips had two peaks at mid May with a small and short-term peak and at June-July with a large and long-term peak. The trapped thrips exhibited inconsistent sex ratios, suggesting a seasonal parthenogenesis. Different geographical populations were varied in cytochrome oxidase I sequences, in which local populations in Andong shared a high sequence similarity. TSWV-infected hot peppers, which might be mediated by these two thrips species, were observed and confirmed by an immunoassay kit and a molecular diagnosis using RT-PCR. In addition, the TSWV was detected in F. occidentalis collected from the infected hot peppers. Three open reading frames (NS_S, N, and NS_M) of the isolated TSWV genomes were sequenced and showed multiple point mutations containing missense mutations among geographical variants. When the isolated TSWV was fed to nonvirulent thrips of F. occidentalis, the virus was detected in both larvae and adults. However, the viral replication occurred in larvae, but not in adults.