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Evaluation of the Cost Effectiveness of Routine Histopathologic Femoral Head Analysis in Hip Arthroplasty

  • Zoe Brown;Michael Perry;Cameron Killen;Daniel Schmitt;Michael Wesolowski;Nicholas M. Brown
    • Hip & pelvis
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    • v.34 no.1
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    • pp.56-61
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    • 2022
  • Purpose: Histopathologic analysis of femoral head specimens following total hip arthroplasty (THA) is a routine practice that represents a significant use of health care resources. However, it occasionally results in discovery of undiagnosed hematopoietic malignancy and other discrepant diagnoses such as avascular necrosis. The purpose of this study was to determine the rate of discordant and discrepant diagnoses discovered from routine histopathological evaluation of femoral heads following THA and perform a cost analysis of this practice. Materials and Methods: A review of patients undergoing primary THA between 2004-2017 was conducted. A comparison of the surgeon's preoperative and postoperative diagnosis, and the histopathologic diagnosis was performed. In cases where the clinical and histopathology differed, a review determined whether this resulted in a change in clinical management. Medicare reimbursement and previously published cost data corrected for inflation were utilized for cost calculations. Results: A review of 2,134 procedures was performed. The pathologic diagnosis matched the postoperative diagnosis in 96.0% of cases. Eighty-three cases (4.0%) had a discrepant diagnosis where treatment was not substantially altered. There was one case of discordant diagnosis where lymphoma was diagnosed and subsequently treated. The cost per discrepant diagnosis was $141,880 and per discordant diagnosis was $1,669 when using 100% Medicare reimbursement and Current Procedural Terminology (CPT) code combination 88304+88311. Conclusion: Histopathologic analysis of femoral head specimens in THAs showed an association with high costs given the rarity of discordant diagnoses. Routine use of the practice should be at the discretion of individual hospitals with consideration for cost and utility thresholds.

The Present State and Solutions for Archival Arrangement and Description of National Archives & Records Service of Korea (국가기록원의 기록물 정리기술의 현황과 개선방안)

  • Yoon, Ju-Bom
    • Journal of Korean Society of Archives and Records Management
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    • v.4 no.2
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    • pp.118-162
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    • 2004
  • Archival description in archives has an important role in document control and reference service. Archives has made an effort to do archival description. But we have some differences and problems about a theory and practical processes comparing with advanced countries. The serious difference in a theory is that a function classification, maintenance of an original order, arrangement of multi-level description are not reflected in practical process. they are arranged in shelves after they are arranged by registration order in a unit of a volume like an arrangement of book. In addition, there are problems in history of agency change or control of index. So these can cause inconvenience for users. For improving, in this study we introduced the meaning and importance of arrangement of description, the situation and problem of arrangement of description in The National Archives, and a description guideline in other foreign countries. The next is an example for ISAD(G). This paper has chapter 8, the chapter 1 is introduction, the chapter 2 is the meaning and importance of arrangement of description, excluding the chapter 8 is conclusion we can say like this from the chapter 3 to the chapter 7. In the chapter 3, we explain GOVT we are using now and description element category in situation and problem of arrangement of description in Archives. In the chapter 4, this is about guideline from Archives in U.S.A, England and Australia. 1. Lifecycle Date Requirement Guide from NARA is introduced and of the description field, the way of the description about just one title element is introduced. 2. This is about the guideline of the description from Public Record Office. That name is National Archives Cataloguing Guidelines Introduction. We are saying "PROCAT" from this guideline and the seven procedure of description. 3. This is about Commomon Record Series from National Archives of Australia. we studied Registration & description procedures for CRS system. In the chapter 5, This is about the example which applied ISAD to. Archives introduce description of documents produced from Appeals Commission in the Ministry of Government Administration. In the chapter 6, 7. These are about the problems we pointed after using ISAD, naming for the document at procedure section in every institution, the lack of description fields category, the sort or classification of the kind or form, the reference or identified number, the absence description rule about the details, function classification, multi-level description, input format, arrangement of book shelf, authority control. The plan for improving are that problems. The best way for arrangement and description in Archives is to examine the standard, guideline, manual from archives in the advanced countries. So we suggested we need many research and study about this in the academic field.

Establishment of Pre-Harvest Residue Limit (PHRL) of Fungicides Azoxystrobin and Difenoconazole on Prunus mume fruits (매실 중 살균제 azoxystrobin과 difenoconazole의 생산단계 잔류허용기준 설정)

  • Lee, Dong Yeol;Kim, Yeong Jin;Park, Min Ho;Lee, Seung Hwa;Kim, Sang Gon;Kang, Nam Jun;Kang, Kyu Young
    • The Korean Journal of Pesticide Science
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    • v.17 no.4
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    • pp.307-313
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    • 2013
  • This study was carried out to investigate the residual characteristics of fungicide azoxystrobin and difenoconazole in Prunus mume fruits, and establish pre-harvest residue limits (PHRL) based on dissipation and biological half-lives of fungicide residues. The fungicides were sprayed onto the crop at recommended dosage once and 3 times in 7 days interval, respectively. The samples were harvested at 0, 1, 2, 4, 6, 8, 10, 12 and 14 days after treatment. These residual pesticides were extracted with QuEChERS method, clean-up with $NH_2$ SPE cartridge, and residues were analyzed by HPLC/DAD and GLC/ECD, respectively. Method quantitative limits (MQL) of azoxystrobin were 0.03 mg $kg^{-1}$ and of difenoconazole were 0.006 mg $kg^{-1}$. Average recovery were $93.2{\pm}2.49%$, $85.5{\pm}1.97%$ for azoxystrobin at fortification levels at 0.3 and 1.5 mg $kg^{-1}$, and $100.8{\pm}6.74%$, $87.6{\pm}9.92%$ for difenoconazole at fortification levels at 0.06 and 0.3 mg $kg^{-1}$, respectively. The biological half-lives of azoxystrobin were 5.9 and 5.2 days at recommended dosage once and 3 times in 7 days interval, respectively. The biological half-lives of difenoconazole were 9.3 and 8.0 days at recommended dosage once and 3 times in 7 days interval, respectively. The PHRL of azoxystrobin and difenoconazole were recommended as 5.32 and 1.64 mg $kg^{-1}$ for 10 days before harvest, respectively.

The Fashion Professionals Required by the Ladies Apparel Manufacturers in Daegu (대구지역 숙녀복업계 기업주가 요구하는 패션전문인)

  • 김효은
    • Journal of the Korea Fashion and Costume Design Association
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    • v.4 no.1
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    • pp.111-130
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    • 2002
  • This study performed a structural questionnaire survey and non-structural interview of the ladies apparel manufacturers in Daegu on the qualification for the employees, skills required for job performance, job training, automatic manufacturing systems, and the use of computer. The results are as follows. 1. Almost all of the apparel manufacturing systems were Pair System, except one Line System in one company. In terms of outsourcing, most of the manufacturers answered “yes,” and in 1998 the outsourcing process was sewing, but in the year 2002, outsourcing has been increased :12 manufacturers(57.1%) outsourcing most of the processes except patterning, 3(14.3%) outsourcing the finish of sewing. 2. The workforce of 1998 and that of 2002 shows a significant difference(P<. 01) between office work and management. The number of office workers has decreased from 15 down to 5.3 people. On the other hand, that of the management has slightly increased from 5.3 to 9.2 people. The number of the manual workers has decreased from 32.2 to 28.7 people. And the number of tailoring and patterning workers has slightly decreased, but the number has increased in sewing from 3.7 to 7.0 people. 3. The wage of an employee shows a significant difference between a sewing assistant(P<. 01) and a production manager(P<. 05), and the wage of a sewing assistant, in particular, has slightly raised from ₩905,000 to ₩1,054,000. 4. The qualifications required of employees are “cooperative human relations”(30.8%), “diligence,” and “ability for job analysis”(26.9%), and “positive thinking” (15.4%) in 1998, and “ability for job analysis”(38.5%), “cooperative human relations”(34.6%), and “positive thinking” (15.4%) in 2002. The areas for job openings are significantly different(P<. 01) depending on the year. Job openings in the design section has increased from 1(3.8%) to 16 manufacturers (61.5%), and decreased in tailoring section from 22(84.6%) to 2 manufacturers(7.7%). Job openings in the sewing section have increased form 2(7.7%) to 6 manufacturers (23.1%). In terms of sex of the employees, there is a significant difference(P<. 001). 19 companies(73.1%) wanted “male” in 1998, but 8 companies(30.8%) answered that they want “female” and 17 companies(65.4%) answered that “it does not matter.” About the educational background, there was a significant difference between the years. The number of the companies that want junior college graduates with an associate degree has increased(15 companies(57.7%). There was a significant difference(P<. 05) in major of the employee. The number of the companies that want fashion majors has increased from 5(19.2%) to 20(76.9%). 5. In terms of job skills required, there was no significant difference. In 1998, “production skills” (46.2%) and “ability for job analysis” (26.9%) were required, and in 2002, “ability for job analysis” (42.3%) and “emotional skills” (26.9%). 6. In regard to training for job skills, “fashion professional training” has slightly decreased from 65.4% in 1998 to 46.2% in 2002, however, “training for job analysis” has slightly increased from 30.8% in 1998 to 46.2% in 2002, which indicates the fact that “fashion professional training” and “ability for job analysis” have been emphasized. 7. The number of the manufacturers purchased apparel CAD has increased from 1(3.8%) to 3(11.5%), and the number of the manufacturers that have no plan for purchase has increased from 16(61.5%) in 1998 to 15(57.7%), still taking up a big proportion. 8. About the use of computers in manufacturing, there is a significant difference(P<. 05). The number of the manufacturers using computer has increased from 5(19.2%) to 15(57.7%) and that of the manufacturers which do not use computers has decreased from 17(57.7%) to 8(30.8%). 9. In the interviews with the owners of the manufacturers, they pointed that schools should give more weight on practical training courses, the invitation of experts in the specific field, complex production systems, training courses for sewing, field trip courses, and furthering specialty education, personality and vocational education.

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Effect of LED Light Intensity on Seedling Quality and Tuber Production of Potato Stem Cuttings Grown in a Closed-Type Plant Production System (폐쇄형식물생산시스템을 이용한 감자 경삽묘 육묘시 묘소질과 괴경 생산에 대한 LED 광도의 영향)

  • Jo, Man Hyun;Ham, In Ki;Park, Kwon Seo;Cho, Ji Hong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.65 no.4
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    • pp.468-476
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    • 2020
  • This study was performed to establish light intensity conditions for producing stem cuttings for aeroponic systems suitable for seed potato production using a closed-type plant production system. Shoot tip cultured plantlets of 'Sumi' and 'Chubaek' potato (Solanum tuberosum L.) were acclimatized, cuttings were collected, and stem cuttings were planted. The seedlings were raised for 40 days at different LED light intensities (60, 120, 180, and 240 μmol·m-2·s-1), and were cultivated in an aeroponic system for 80 days. When stem cuttings were raised at 60 μmol·m-2·s-1 LED light intensity, the plant height was the longest, at 17.3 cm for 'Sumi' and 16.1 cm for 'Chubaek', and the number of nodes was the highest in both cultivars. The higher light intensities, produced smaller plants with fewer nodes. The leaf areas, SPAD values, and Fv/Fm values differed slightly between cultivars. The fresh weight of stem cuttings, and the production rate of healthy stem cuttings were the highest at 60 μmol·m-2·s-1. In the aeroponic system, seedlings raised at 60 μmol·m-2·s-1 with LED light intensity showed a difference between the cultivars, but the fresh weight of stems and leaves above the planting plate was the heaviest. In addition, below the planting plate the stem cuttings were longest and the root weight was heaviest at 60 μmol·m-2·s-1 LED light intensity. The number of stolons also differed between cultivars, but was greatest for seedlings raised at 60 μmol·m-2·s-1 LED light intensity, at 4.2/plant for 'Sumi' and 7.7/plant for 'Chubaek'. At 60 μmol·m-2·s-1 LED light intensity, the tuber number and total tuber weight were the best, but the higher the light intensity, the smaller the total tuber number and total tuber weight for both cultivars. In conclusion, when producing potato stem cuttings for aeroponic systems using a closed-type plant production system, the most suitable LED light intensity for raising seedlings was found to be 60 μmol·m-2·s-1.

Establishment of Pre-Harvest Residue Limit(PHRL) of Insecticide Chlorfenapyr and Fungicide Fenarimol during Cultivation of Chwinamul(Aster scaber) (취나물의 재배기간 중 살충제 Chlorfenapyr와 살균제 Fenarimol의 생산단계 농약잔류허용기준의 설정)

  • Lim, Jong-Sung;Hong, Ji-Hyung;Lee, Cho-Rong;Han, Kook-Tak;Lee, Yu-Ri;Lee, Kyu-Seung
    • Korean Journal of Environmental Agriculture
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    • v.30 no.1
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    • pp.52-59
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    • 2011
  • BACKGROUND: This study was performed to investigate pre-harvest residue limit (PHRL) in Chwinamul, to estimate biological half-life for residue of each pesticide. Chwinamul was sprayed with pesticides of standard and double application rate. Chlorfenapyr and fenarimol were sprayed once on Chwinamul at 10 days before harvest, and it was sampled 7 times and analysed the residual change of two pesticides. METHODS AND RESULTS: Chwinamul sample was extracted with acetonitrile and partitioned with dichloromethane, and pesticide residues were determined with GCECD. Method quantitation limit (MQL) of chlorfenapyr was 0.10 mg/kg and that of fenarimol was 0.02 mg/kg. Recoveries of chlorfenapyr at two fortification levels of 1.0 and 5.0 mg/kg were $94.2{\pm}$1.70 and $99.0{\pm}1.61%$, respectively. Recoveries of fenarimol at two fortification levels of 0.2 and 1.0 mg/kg were $92.1{\pm}2.14$ and $83.1{\pm}1.98%$, respectively. CONCLUSION(s): The biological half-lives of chlorfenapyr were about 3.5 days at standard application rate, and 3.4 days at double application rate. The biological half-lives of fenarimol were about 6.0 days at standard application rate, and 5.9 days at double application rate. The PHRLs of chlorfenapyr were recommended as 13.02 and 6.25 mg/kg for 10 and 5 days before harvest, respectively. And the PHRLs of fenarimol were recommended as 2.80 and 1.67 mg/kg for 10 and 5 days before harvest, respectively.

Knowledge and Attitude on the Restaurant-Related Sanitation of New Restaurateurs (신규 일반음식점 영업자의 위생관리 지식 및 태도)

  • Park, Ki-Hong;Sohn, Seok-Joon
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.21-34
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    • 2006
  • Objectives: The purpose of this study was to investigate the knowledge, attitude and practice toward sanitary administration of the new restaurateurs, to carry out the sanitary management of business for improvement of sanitary level, and to provide basic data which were necessary for sanitary education of the restaurateurs. Methods: The self-recording survey on the attitude and the knowledge toward the sanitation, the sanitary administration, and its education was conducted against new 393 restaurateurs by the administrative division of Gwangju city in charge of the food industry which put in the regular sanitary education annually for the new restaurateurs. Results: In regard to food sanitation, some 87.9% to 94.4% got the right knowledge about the reason and precaution of food poisoning, storage methods of frozen or cold food, and the disposal of product after expiration of validity term. But it was about 56.0% to 63.0% who knew right about the cause and the major precaution of food poisoning, storage temperature in the refrigerator. 30.6% of the subject placed an emphasis on personal sanitation of the workers as the most important thing in the sanitary management. 83.6% replied that it was necessary to improve the sanitary level. Concerning the health examination, 78.3% replied it was needed. 76.4% pointed the need for education, but respondents with higher educational level less emphasized its needs. It was most frequently pointed out by 71.6% restaurateur's poor awareness about it. 36.7% indicated the environmental sanitation like facilities in the restaurants as the first thing to be improved. The rate of personal sanitation was 43.7%. Conclusions: To improve the poor sanitary conditions of the food service business, it was recommended to offer institutional backing and financial aid from administrative office, to encourage restaurateurs to take pride in their job, and to conduct the sanitary education effectively by the technical education institution.

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Review of 2019 Major Medical Decisions (2019년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Park, Noh Min;Jeong, Hye Seung;Lee, Dong Pil;Lee, Jung Sun;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.107-152
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    • 2020
  • During the main ruling in 2019, a number of rulings that were of interest or meaningful were handed down, such as just because the complication of medical practice has occurred, there is no presumption of negligence, a case involving a fall accident in which a lot of culpability has recently been made. the death of a well-known singer that caused a sensation, a case about damages caused by MERS in 2015, which is more meaningful in connection with damages caused by COVID-19, an infectious disease that has recently hit the world, including Korea. In preaching the principles of the law, just because there has been a complication caused by medical practice, there is no presumption of negligence, 'The scope of the complication without presumption of negligence' was determined differently by the court, the court was not able to specify the criteria. Specific circumstances were presented to limit the responsibility of the medical institution while acknowledging the malpractice of the medical institution in relation to the fall accident. In relation to the scope of damages, judgment was made on issues related to the calculation of lost profits of medical malpractice; criteria for determining celebrities' daily income, criteria for determining daily income in case of receiving survivor's pension due to medical accident, an incident in which the daily income is denied if the labor capacity is already lost at the time of a medical accident. But, it seems that judgments should be made based on clearer and more reasonable standards. Related to Medical Advertise, specific logic of judgment was presented as to whether it was interpreted as being in accordance with the specific prohibition listed in Article 27 paragraph 3 of the Medical Law, which is the criterion for violation of the Medical Law, or if it constitutes a significant harm to the order of the medical market. In response to the prohibition of operating the multiple medical institutions, the Constitutional Court decided that it was constitutional because it did not violate the regulations on excessive funding, and rationally limited the scope of the prohibited 'redundant operation'. The Supreme Court ruled for the first time that even a medical institution established and operated in violation of the Medical Service Act did not make it impossible to receive all medical care benefits implemented by a medical institution under the National Health Insurance Act. Significant rulings were finalized that recognized the existence of specific protection obligations for the people of the country in the management of infectious diseases.

Knowledge and Attitude toward Restaurant-Related Sanitation of New Restaurateurs (일반음식점 신규영업주의 위생관리지식 및 위생행정에 대한 태도)

  • Kim, Seun-Taek;Park, Jae-Yong;Kam, Sin;Han, Chang-Hyun
    • Korean Journal of Health Education and Promotion
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    • v.15 no.1
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    • pp.79-95
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    • 1998
  • The purpose of this study was to investigate the sanitation affairs of general restaurants. The questionnaire survey on the attitude and knowledge toward sanitation, the attitude for sanitary administration and the sanitary education was conducted against new 600 restaurateurs who were educated from June 20 to July 11, 1996, at the administration hall's division of Kyungsangbook-do in charge of food industry that offered regular sanitary education to new restaurateurs annually. And the visit survey on sanitary practice was also conducted over 93 restaurateurs who obtained the commercial license for food service business. The findings from the survey were as follows; In regard to food sanitation, some 87.1 to 88.3% got the right knowledge about the reason and precaution of food poisoning, food's frozen or cold-storage, and the disposal of products after expiration of validity term. But it was about 20.8% to 50.0% who knew right about major precaution, storage temperature in refrigerator, fermented milk product's storage temperature and validity term. There was therefore a necessity for education in food sanitation. 38.2% of the subjects placed an emphasis on sanitary storage of foodstuffs as the most important thing in sanitary management. 33.8% emphasized cooking sanitation. The environmental sanitation was counted as the most important thing by 19.2%, and personal sanitation of worker was counted by 8.8%. There was differences in what they thought the most important thing was, according to the respondent's educational level and cooker. 86.6% replied it necessary to improve the sanitary level. The respondents who were younger or had better educational level emphasized more the need for it. Concerning health examination, 90.2% replied it necessary. 81.4% answered the reason was because there was a potentiality Quests might be infected with contagious disease. 78.5% pointed the need for sanitary education, but respondents with higher educational level less emphasized its needs. As the reason for poor sanitation, restaurateur's poor awareness about it was most frequently pointed out, by 46.9%. Cooking sanitation was most frequently counted, by 38.5%, as the first thing to be improved. As the most critical point in sanitary education, 34.5% indicated food's sanitary Quality control 30.9% mentioned sanitary treatment of kitchen facilities and peripheral environment, and 27.1% emphasized the summary of the general food sanitation. 77.7% answered to correct immediately in case of violating the Food Hygiene Law, and 12.0% replied to correct in the same case if they would get the order from public official or administrative action would be taken. Respondents with higher educational level answered more to correct immediately. What they wanted the government office to do toward sanitary improvement was a fund aid an facilities and management which was pointed out by 38.9%, a periodical sanitary education by 26.3% and a on-the-spot guidance of sanitary officials by 22.3%. In view of the food service business's sanitary practice, the rate of wearing a sanitary clothes was 32.9% in city and 35.0% in county. The rate of hand-washing without soap or non-washing at cooking was 73.9%, 85%, respectively. The rate of personnel sanitation was 34.2% in city and 50.0% in county. These things indicated the sanitation was not well practiced. To improve the poor sanitary conditions of the food service businesses, it is recommended to offer institutional backing and financial aid from administrative office, and encourage restaurateurs to take pride in their job. and conduct the sanitary education effectively by sanitary education institution.

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Study on Influence of Water Fluoridation Program on the Economic Benefit (상수도수불화사업의 경제적 편익에 대한 조사연구)

  • Park, Myung-Suk;Yoo, Wang-Keun
    • Journal of dental hygiene science
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    • v.6 no.2
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    • pp.133-138
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    • 2006
  • To find out influence of water fluoridation program on the economic benefit effect, this study analyzed comparatively dental treatment indicators obtained from dental clinics at Sangdang-gu in Chenongju City, fluoridated community and Manan-gu in Anyang City, non-fluoridated community, from January 1, 2003 to the end of June, and the results are as follows: 1. If water fluoridation program is carried out in Anyang, non-fluoridated community, the number of treatment from caries and disease of tissues around dental pulp and root apex from age 6 to 18 for the first half of year 2003 is expected to decrease by 1,272, 636 for low estimation, and 1,908 for high estimation. And the treatment cost is expected to decrease by 40,888,000 Wons, 20,444,000 Wons for low estimation, and 61,333,000 Wons for high estimation. 2. Assuming that water fluoridation program is spread to all over the country, the number of treatment per year is expected to decrease by 2,492,018, 1,246,009 for low estimation, and 3,738,027 for high estimation. And the treatment cost is expected to decrease by 80,105,075,000 Wons, 40,052,537,000 Wons for low estimation and 120, 157,612,000 Wons for high estimation respectively. 3. For Yeong-un water supply management office which has 48,925 water supply personnel, the benefit/cost rate was 2.9 times, and for Jibuk water supply management office which has 239,751 water supply personnel, the benefit/cost rate was 9.0 times. As the water supply personnel increased, the cost increase of water fluoridation program was little and as the scale got large, the economic effect was very large. Improving national oral health is thought to be associated with expense retrenchment of oral health insurance financial. So it may need to extend using tap water to all the area of the country and additionally establish confidence through an active public relations and education of water fluoridation program.

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