• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.333-336
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• 2021

Verrucous carcinoma (VC) is a rare subtype of squamous cell carcinoma that commonly occurs in the oral cavity. However, VC of the facial skin is relatively rare. We report a case of a 91-year-old woman with VC of the facial skin in the left zygoma area. She was diagnosed with actinic keratosis (4×3 cm) of the same site approximately 12 years previously, but declined further treatment. The mass was excised with a minimum of 0.4 cm from gross margins with the result of free from tumor of all margins by frozen section, allowing for primary closure after skin undermining. Basal resection was performed in the preplatysmal plane. The diagnosis of VC was confirmed by histopathological examination. Postoperatively, the wound healed without incident and with no signs of facial nerve injury. To our knowledge, this is the first reported case of VC of facial skin arising from actinic keratosis.

• Korea Journal of Hospital Management
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• v.26 no.1
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• pp.71-82
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• 2021

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.1
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• pp.51-54
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• 2016

The present case report describes an external auditory canal injury following extraction of the lower molar. The external auditory canal was torn in the same fashion that occurs in an anterior tympanic plate fracture. This case demonstrates one of the rare complications associated with dental extractions.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.317-325
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• 2018

Purpose: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. Methods: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. Results: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. Conclusions: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.

• Health Policy and Management
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• v.31 no.3
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• pp.364-373
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• 2021

Background: This study aims to examine the regressiveness of national health insurance (NHI) premium burdens for local subscribers. The government has established a restructuring of health insurance contributions in 2017. Therefore, insurance premium reform began in 2018 and the second national health insurance premium reform will be carried out in 2022. We will analyze local subscribers before and after the policy reform of 2018. Methods: This study used data from 'local premium imposition elements' in the health insurance statistics annual reports (2017-2019) on National Health Insurance Service (NHIS). This study was calculated contribution rates according to levels of income and property for local insured by the method of comparing. Simulations of primary and secondary reforms were conducted in the study to determine regressiveness. Results: Insurance premiums for local subscribers were analyzed separately by income and property insurance premiums. In the income premium analysis, the higher the income, the lower the premium rate, and then the fixed rate was maintained from a certain section. The regressiveness of income insurance premiums has been eased in part. On the other hand, the property insurance premium burden was found to be regressive still by income class. Conclusion: Regressiveness analysis showed that a decrease in income contributions was achieved to local insured in the first phase of reform. But in the second phase of reform, more consideration should be given to reductions of property premium portions of local subscribers. Based on the results, the author suggested policy discussions to reorganizing the new systems of NHI contribution of local Insured.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.58-62
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• 2015

Benign symmetric lipomatosis, also known as Madelung's disease, Launois-Bensaude syndrome and multiple symmetric lipomatosis is a cutaneous condition characterized by extensive symmetric fat deposits in the neck, shoulders, and upper trunk. But symmetrical lipomatosis of the tongue is very rare and characterized by involvement exclusively of the tongue, invasiveness, and absence of encapsulation of the adipose tissue. A 75-year-old man presented with about a year history of painless tongue masses on both lateral border. Bilateral partial glossectomy was performed and subsequently was confirmed as symmetrical lipomatosis pathologically. We report this case with a review of the literatures.

• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.55-59
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• 2018

Meningioma originates from arachnoid cap cells and is the second most common intracranial tumor; however, it can also be found in an extracranial location. A very rare primary extracranial meningioma without the presence of an intracranial component has also been reported. Primary extracranial meningiomas have been found in the skin, scalp, middle ear, and nasal cavity. A computerized tomography or magnetic resonance imaging scan is necessary to determine the presence or absence of an intracranial meningioma, and a biopsy is essential for diagnosis. We report a case of primary extracranial meningioma located in the forehead skin of a 51-year-old male.

• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.28-31
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• 2014

Intraparotid facial nerve schwannoma is a rare benign neoplasm. Due to its rarity, it is not usually a prioritized diagnosis before surgery and may therefore lead to an unintentional treatment error. In this article, we report a single case of intraparotid facial nerve schwannoma. We were able to make a diagnosis with frozen biopsy. A complete resection of the mass while preserving the facial nerve was performed. Herein we present our clinical experience with regards to the treatment process of intraparotid facial nerve schwannoma.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.47-50
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• 2016

Angiokeratomas represent vascular lesions and are histologically characterized by superficial dermal vascular ectasia with overlying epidermal hyperkeratosis. Angiokeratoma circumscriptum is one of five types in the group of the angiokeratomas. The lesion is present from birth but may appear in childhood or adulthood. Angiokeratoma circumscriptum is typically hyperkeratotic papules or nodules situated unilaterally on the foot or distal aspect of the leg, but can occur elsewhere on the body. Isolated tongue involvement is very rare. We report a 12-year-old boy with angiokeratoma circumscriptum of the posterior dorsal tongue with a review of the literatures.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.71-75
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• 2021

Liposarcoma is a very rare malignant tumor affecting the head and neck area. Since it is an invasive and life-threatening disease, active treatments is necessary. However, differential it from lipoma, its corresponding benign counterpart, may be difficult. Herein, we report a rare case of posterior neck myxoid liposarcoma in a 72-year-old man who was initially misdiagnosed with lipoma, including a literature review of differential diagnosis between lipoma and liposarcoma.