• Title/Summary/Keyword: Review Criteria

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Changes in Hospital and Clinic Care Patterns Under the Medical Insurance System (의료보험 실시후 2년간의 진료양상의 변화 -서울시내 의료기관 입원환자를 중심으로-)

  • Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.14 no.1
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    • pp.3-12
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    • 1981
  • To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

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A Feasibility Study on Developing Snow Melting Systems using CNT-Cement Composite (도로 융설체 개발을 위한 탄소나노튜브-시멘트 복합체 특성에 관한 실험적 연구)

  • Heo, Jinnyung;Park, Bumjin;Kim, Taehyeong
    • International Journal of Highway Engineering
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    • v.15 no.2
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    • pp.29-37
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    • 2013
  • PURPOSES : This study aims to review the possibility of developing a road snow-melting system that can prevent slip accidents by maintaining a constant temperature of the winter roads and enhance performance of structures, including improvement of compressive strength by mixing carbon nanotube (hereafter referred to as CNT) with cement paste, the basic material. METHODS : To achieve the above purpose, an experiment was conducted by mixing power-type CNT and wrap-type CNT up to cement paste formulation by weight of 0.0wt%~4.1wt% in accordance with "KS L ISO 679(of cement strength test method)", and compressive strength was measured at 28 days of curing. In addition, the volume resistivity of the specimen was measured to test thermal and electrical characteristics, and the rate of temperature changes in specimen surface by power consumption was measured by passing electricity through the cross-sections of the specimen. Meanwhile, the criteria for checking the performance as a road snow-melting system was determined as volume resistivity of $100{\Omega}{\cdot}cm$ or less. RESULTS : A comparative analysis between specimen with 0wt% CNT content in plain status and specimen containing various types of CNTs was carried out. From its results, it was found that compressive strength increased approximately 19%, showing the highest rate when 0.2wt% of wrap-type CNT was contained, but volume resistivity of $100{\Omega}{\cdot}cm$ or less appeared only in specimens containing more than 0.2wt% CNT. In addition, it was observed that the surface temperature increased by $4.62^{\circ}C$ per minute on average in specimens containing 3.2wt% CNT. CONCLUSIONS : In this study, CNT was examined as an underlying material for a road snow-melting system, and the possibility of developing the road now-melting system was reviewed by conducting various experiments using CNT-Cement composites. From the experimental results, the specimens were found to have a superior performance when compared to the existing road snow-melting systems that place the heat transfer medium such as copper on the road. However, satisfactory strength performance were not obtained from the specimen containing CNT(2.0% or more) that functions as a heating element, which leads to the need for reviewing methods to increase the strength by using plasticizer or admixture.

CT Based Hemoperitoneum Scoring for Clinicians: Objectifying the Severity of Splenic Injury and Recovery (CT를 이용한 혈복강의 등급: 비장 손상의 정도 및 회복의 객관화)

  • Shin, Hong Kyung;Song, Ra-Yeong;Han, Ho-Seong;Yoon, Yoo-Seok;Cho, Jai Young;Hwang, Dae Wook;Jung, Kyuwhan;Kim, Young Ki;Lee, Woo Hyung
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.273-279
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    • 2013
  • Purpose: In patients with splenic trauma, Computed Tomography (CT) scan is helpful in selecting treatment options and evaluating resolution after NOM (Non-Operative Management). The purpose of this study was to suggest a CT based hemoperitoneum (HP) scoring system that can easily be used by clinicians to evaluate the severity of injury and recovery. Methods: A retrospective review of patients with splenic trauma admitted to our hospital between May 2003 and January 2013 was conducted. Patients diagnosed with isolated spleen injury who had a CT scan on admission were included. 1 or 2 points were given according to location and amount of hematoma in the CT image. Using the existing ultrasonography (US) based HP scoring system, the same method was applied to obtain our CT based HP scoring (CBHS) system, which ranges from 0 to 8 points. The CBHS system can be easily used by clinicians for a quick assessment of splenic injury. Results: Of the 39 patients meeting the inclusion criteria, 6 patients were managed operatively and 33 nonoperatively. There was a significant difference in CBHS between the OM (operative management) group and the NOM group.(p=0.03) CBHS showed correlation with Hb (hemoglobin), Hct (hematocrit), spleen injury grade(AAST), and Hounsfield unit of ROI (Region of interest). (p=0.17, p=0.18, p<0.000, p=0.02, respectively) After successful NOM with stabilized Hb level, the amount of hemoperitoneum was scored in the follow-up CT. CBHS demonstrated correlation with decreased spleen injury grade, decreased Hounsfield unit of ROI (Region of interest) (p=0.039, p=0.049, respectively), and also objectively reflected patient recovery. Conclusion: CBHS can be used as an objective and intuitive tool for clinicians in grading the severity of splenic injury by scoring the amount of hemoperitoneum, and in assessing recovery.

Review of 2010 Major Medical Decisions (2010년 주요 의료 판결 분석)

  • Lee, Jung-Sun;Seo, Young-Hyun;Yoo, Hyun-Jung
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.177-225
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    • 2011
  • Verdicts related to major medical litigation given by the Seoul Central District Court, the Seoul High Court and the Supreme Court in 2010 were analyzed. It's shown that in cases of the medical negligence regarding the occurrence of neonatal cerebral palsy, the plaintiff claims were dismissed using criteria proposed by associations of Obstetrics and Gynecology and Pediatrics in US, and thereof the burden of plaintiffs to prove the medical negligence has increased. In addition, in case of that the expected survival period of infants gets longer, payments for treatment and nursing after survival period determined by judges are made and it was judged to compensate it as a periodical indemnity. In case for the explanation obligation the most frequently mentioned in the medical litigation, in addition to cases of invoking the existing theory of explanation obligation, verdicts to mention the instructions of theory regarding instruction explanation obligation and the possibility of compensation for damages on property are given. Particularly, in cases for a liability of reparation by exaggerating the effects and not disclosing the risks related to treatment with stem cells, even if the treatment not approved by Food and Drug Administration is in violation of the Pharmaceutical Affairs Law, it's not illegal as violation in Pharmaceutical Affairs Law itself. But there is a certain verdict to present the possibility of an extension of the theory of explanation obligation by acknowledging the liability of reparation caused by illegal acts with no explanations of effects and risks of treatment with stem cell by doctors and pharmaceutical companies. In an incident in which a mental patient fell and died through the opened door of the roof at the hospital, a liability of reparation was acknowledged due to defects in structure installation management and this verdict drew an attention since the overall management responsibility about patients including structures was acknowledged to the hospital besides the obligations on medical practice. In case of the verdict without giving the opportunity to state the opinion with respect to the main legal issues, the responsibility of the court was emphasized since the court did not fulfill the explanation obligations. There were some cases in which payments for nursing and caring to a patient in vegetative state during the plastic surgery was admitted. However, in dental-related incidents, the proportion of cases in which plaintiff won was low since the difficulty of proving may be reflected. In the area of administrative litigation, unlike the existing position regarding arbitrary medical charge cover collected from patients in hospital, the verdict to admit the legitimacy of collection of medical treatment was given and attracted the attention of people. Verdict in which the expression related to medical advertisement was not exaggerated disposed the original verdict and pointed out the problem of excessive regulations on medical advertisement. The effort to analyze the trend of verdicts of court through reviewing the decisions and to organize should be continued, but the full decision should be disclosed as a base, and people and systems to enable the all time monitoring should be prepared.

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Strategies for the development of GM crops in accordance with the environmental risk assessment (I) (환경위해성 평가를 고려한 GM작물의 개발 전략 (I))

  • Lee, Shin-Woo
    • Journal of Plant Biotechnology
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    • v.38 no.2
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    • pp.125-129
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    • 2011
  • Environmental risk assessment (RA) is essential prior to the environmental release of GM crops. RA, however, costs at least 7 to 15 million US dollars and requires several years to complete field tests. Therefore, it is strongly suggested that developers of GM crops must consider all criteria for RA at the beginning stage of the development if it aims for commercialization. Previous review papers have pointed out that the "death valley" for the commercialization of GM crops is the screening stage of early GM events since many candidates are given up due to insufficient data on the molecular characterization of a GM event such as inserted gene's copy number, position of inserted site of a chromosome, flanking sequence of recombinant T-DNA, rearrangement of chromosome, and knock out of endogenous gene of host plant. Recently, Rural Development Administration (RDA) in South Korea has launched a Grand National Project named as "Next Generation of BioGreen 21 Project" from 2011 to 2020 and research funding for the development of global GM crops has been allocated to accelerate the commercialization of GM crops. In this regard, I strongly suggest that researchers involved in the development of GM crops for commercialization must conduct RA by themselves at the screening stage of pre-GM event based on the data for molecular characterization.

A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area (일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구)

  • Jang, In-Sun
    • Journal of Home Health Care Nursing
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    • v.2
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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Charaeteristics and Applications of the Established Testosterone Immunoassays (Testosterone 면역측정법의 정립 특성과 응용)

  • Lee, Chang-Joo;Lee, Joon-Yeoung;Yoon, Yong-Dal
    • Development and Reproduction
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    • v.5 no.1
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    • pp.59-71
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    • 2001
  • Since the first radioimmunoassay (RIA) was developed in 1970s, many conventional RIAs and non-isotopic immunoassays (NIA) had been developed in which the degree of precision, accuracy, specificity and practicability have progressively increased. Recently ultrasensitive assay method at femtogram to determine testosterone in serum, saliva and feces is required for the study of sexual dysfunctions in male and female, monitoring the psychological stress and conditions, aging process such as menopause and partial androgen deficiency in aging male, the hormonal changes of small experimental animals etc. This review discussed the recentd evelopments of steroid assay methods, based upon the testosterone assay results of authors far 20 years, and the problems associated the assay set-up, the characterizations and applications of the established procedures, and desifls of assay, reliablity criteria, and the practical aspects of assay set-up and application, based upon the data of the authors. The present study demonstrates the general problems methods to be consider in order to set up the highly sensitive assay methods and to increase the assay quality and the necessity of assay quality control program. To improve the assay quality of each laboratory and to compare the assay results in homeland, the national QC programs should be organized.

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Clinical Characteristics of Subacute Necrotizing Lymphadenitis (아급성 괴사성 림프절염의 임상적 고찰)

  • Park Chan-Hum;Kim Hee-Dong;Park Jun-Young;Jo Hyeong-Ju;Jun Jin-Hyoung;Park Youn-Kyu;Rho Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.217-221
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    • 1999
  • Background and Objectives: Subacute necrotizing lymphadenitis or Kikuchi's disease has now become recognized in many parts of the world as a well-defined clinicopathologic entity. It typically affects cervical lymph nodes of young women, and subsides spontaneously within a few months without recurrences. The purpose of this study is to report the clinicopathologic finding, radiologic finding and many laboratory tests to elaborate the criteria that are useful in distinguishing this entity from inflammatory disease, granulomatous disease, lymphoma, malignant disease. Material and Methods: Authors evaluated 22 patients, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy or fine needle aspiration cytology with retrospective chart review. Results: The patient population consisted of 21 women and 1 men. The mean age was 25 years old(range 17 to 42 years). All patient had palpable neck mass and associated fever, headache, weight loss, otalgia, diarrhea, night sweating. and associated disorder is dermatitis, hepatitis B, SLE, Hashimoto's thyroiditis, albinism et al. The multiple bilateral involvement of cervical lymph node was 20 cases(91%) and multiple unilateral 18 cases(82%), multiple bilateral 2 cases(9%). Solitary involvement was 2 cases(9%), mean size of involved lymph node was 2.0cm. In laboratory tests, leukopenia 17 cases(72%), elevated ESR 12 cases(54%), elevated GOT, GPT 3 cases(13%). In CT finding, lymph nodes enhanced in homogeneous fashion, and there was no evidence of central necrosis. Conclusion: Subacute necrotizing lymphadenitis, Kikuchi's disease may be easily confused clinically, pathologically, radiologically with malignant lymphoma, inflammatory disease, granulomatous disease. We should consider open biopsy of lymph node in the patient which had unilateral multiple cervical lymph node and in laboratory tests, were leukopenia, elevated ESR, especially in young women. otherwise, result of fine needle aspiration biopsy is nonspecific, excisional biopsy is recommended in order to differentiate other disease.

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Parotid Mass as First Presentation of Malignant Lymphoma (이하선 종괴로 발현된 악성 림프종)

  • Chung Woong-Youn;Lee Hyo-Sang;Seo Jin-Hak;Yang Woo-Ik;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.26-31
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    • 2001
  • Background: Primary malignant lymphoma of the parotid gland is a rare disease and defined as any malignant lymphoma that first manifests in the parotid gland, regardless of the subsequent stage of the diseases, whether it arises in the parenchyma or intraglandular lymph nodes. This study was performed to review the clinicopathological characteristics of primary parotid lymphoma and identify its optimal treatment modality. Materials and Methods: Six cases with parotid mass as first presentation of malignant lymphoma between 1988 and 2000, were studied on the basis of clinical features, diagnostic tools, treatment modality, treatment outcomes, and clinical stage by Ann Arbor Criteria. All were microscopically reevaluated and classified by NCI working formulation. Results: All patients were males and mean age was 36.7 years (2-66 years). Rapid growing non-tender mass was presented in all the cases and cervical lymphnodes were palpated in 4 cases. However, there was not any evidence of concurrent autoimmune disease such as Sjogren's syndrom or Rheumatoid arthritis. One case was confirmed by surgical specimen after superficial parotidectomy, 2 by excisional biopsy, and 3 by incisional biopsy. The stage of disease by NCI working formulation was IE in 1 patient, IIE in 4 and IV in 1. All were classified into non-Hodgkin' lymphoma, of which there were 5 cases of B-cell type and 1 case of T-cell type. There were 3 diffuse large cell lymphomas, 1 Burkitt lymphoma, 1 MALT lymphoma and 1 T-lymphoblastic lymphoma. Three cases were treated by chemotherapy only, 2 by radiotherapy only and 1 by chemo-radiotherapy. One case with Burkitt lymphoma was died from the disease and one case was lost to follow-up. The others are alive with no evidence of recurrence. Conclusions: Although primary parotid lymphoma is rare and difficult to diagnose preoperatively, most were detected in early stage and showed a relatively good response to the chemotherapy or radiotherapy like other types of extranodal malignant lymphoma.

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From a Literature Review to a Conceptual Framework, Issues and Challenges for Smart Campus (스마트 캠퍼스 문헌고찰을 통한 프레임워크 개발 및 주요 이슈 분석)

  • Rha, Jong-Youn;Lee, Jin-Myong;Li, Hua-Yu;Jo, Eun-Bit
    • Journal of Digital Convergence
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    • v.14 no.4
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    • pp.19-31
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    • 2016
  • With the development of information and communication technologies, a new paradigm in higher education is required. Accordingly, establishing a smart campus has emerged as an important issue in universities worldwide. This study aims to discuss key issues and to provide useful academical and practical implications on smart campus by reviewing related literatures. For this purpose, this study examined recent literatures on smart campus by four research perspectives; 1) learning/knowledge-centric approach, 2) technology-centric approach, 3) integrated approach, and 4) user-centric approach, then developed smart campus framework. Smart campus user criteria contained members of university as well as local community and business stockholders. Smart campus framework presented specific service areas each belongs to smart education, smart life and smart administration domains and motivating factors of using smart campus. Moreover, by considering key issues and problems raised in previous studies, this study suggested practical implications for successful development of smart campus.