• Korea Journal of Hospital Management
• /
• v.18 no.2
• /
• pp.81-103
• /
• 2013

This study is to research cost accounting practice and to analyze propriety of patients' medical payment in artificiality kidney center. The researched cost datum of the year 2012 are as follows. - Hemodialysis medical treatment was reimbursed as much as 158,001 won in case of health insured patients, but payed-off as much as 135,810 won. - The average figure of the total hospitals and clinic center is 1,603,303 won, and one time cost of hemodialysis treatment is 154,487 won. Optimal treatment pay are suggested as follows. First, Regardless of the notified classification from MOHW(Ministry of Health and Welfare), 136,000 won of fixed price payment classification needs to be reclassified by patients, severity and tobe rearranged by fixed price payment system of hospitals. Second, Fixed payment code notified by the Ministry of Health and Welfare is recommended to be simplifies and to reflect according to contents of the medical treatment rendered to patients. Third, Establishment of artificial kidney center has to be risk managed because of its huge investment. Fourth, Cost analysis model has to be maintained as basis together with appropriate application of conversion index model mixed with SGR model.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.3
• /
• pp.2101-2105
• /
• 2013

Background: Long-term survival is a problem with locally advanced and metastatic renal cell carcinomas. Sunitinib malate is an oral multitargeted tyrosine kinase inhibitor, but data on sunitinib use as a second line treatment in metastatic renal cell carcinoma (mRCC) are limited. Prognostic and predictive value of peripheral blood markers has been shown for many cancers. Materials and Methods: Efficacy and safety profiles of sunitinib after interferon alpha (IFN-${\alpha}$) were evaluated based on retrospective data for 23 patients with mRCC. Hematological parameters (neutrophils, lymphocytes, platelets, mean platelet volume, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio) were recorded at the time of metastasis. It was evaluated whether hematological parameters were prognostic and predictive factors. Results: Median progression-free survival (PFS) time was 16.5 months (95%CI: 0-34.5). Median overall survival (OS) time was 25.7 months (95%CI: 10.8-40.0). Most common side effects were neutropenia (52.2%), stomatitis (26.1%) and hand-food syndrome (26.1%). PFS was found 3.13 vs 17.1 months in patients with neutrophil / lymphocyte ratio (NLR)>3 vs $NLR{\leq}3$ (p:0.012). Median OS was 6.96 vs 27.1 months in patients with NLR>3 vs $NLR{\leq}3$ (p:0.001).While 75% of patients who responded to sunitinib had $NLR{\leq}3$, in 72% of patients with no response to sunitinib NLR>3 was detected (p:0.036). The association between the Memorial Sloan-Kettering Cancer Center (MSKCC) criteria and NLR was statistically significant (p:0.022). Conclusions: Data on second line sunitinib treatment following cytokine in mRCC are limited. In our study, we observed second line sunitinib treatment following IFN-${\alpha}$ to be effective and tolerable. NLRappeared to have prognostic and predictive value.

• Journal of Oriental Medical Thermology
• /
• v.7 no.1
• /
• pp.1-13
• /
• 2009

Purpose: To evaluate the hot flush relief efficacy of Yiseontang-gami in climacteric women with hot flushes, a vasomotor symptom. Methods: The 20 subjects who signing on the clinical trial written consent by self-will is registered this clinical trial after decided suitable by selection and exception standard, after take a medical experiment and checkup according to clinical trial plan. Registered subject should valuated by settled schedule after take the testing medicine(Yiseontang-gami)during thirty-day. The evaluating indexes of this trial are hot flush VAS, hot flush frequency, hot flush consistence time, sweating VAS, palpitation VAS, sleep disturbance VAS, MRS, MENQOL, PGA. Results: The results were as follows 1. 4 subjects dropped out of the clinical trial and 16 subjects completed it. 2. After Yiseontang-gami treatment, hot flush VAS, hot flush frequent, sweating VAS, Palpitation VAS, sleep disturbance VAS improved significantly. 3. After Yiseontang-gami treatment, hot flush consistence time was not improved significantly. 4. After Yiseontang-gami treatment, blood test value were not different significantly. Conclusion: In this clinical trial we consider that Yiseontang-gami is suitable treatment for the hot flushes and related symptoms.

• The Korean Society of Law and Medicine
• /
• v.11 no.2
• /
• pp.309-335
• /
• 2010

This study is a paper reviewed legal status of medical personnel and issues of law on recently discovered medical records. As the increase of medical personnel who have gone through the administrative disposal in regards to the medical records, it is needed to examine the legal issue or dispute on the medical records under the current law. Medical records are the statement on patient's medical conditions made by the medical personnel. This records are used as important source for patient's further treatment. This becomes the communication route between the patients and the other medical personnel, and it provides the patients a right to find out their medical information. According to the Medical Service Act (Article 21), a medical personnel shall prepare respectively a record book of medical examination and treatment. And medical personnel shall make a signature. Furthermore, the medical personnel or the opener of the medical institutions must preserve the record book (including an electronic medical record). Meanwhile, the issues of a ban on false entry, additional record, revision or manipulation on the medical record have been recently on the rise. This paper briefly examined the major issues in regards to the medical records. It especially clarified the legal duty on medical records and its major-contentious-issues. At the same time, it pointed out the problems of the unreasonable over interpretation of the law. Furthermore, this suggested the guidelines for the further discussion and review.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.4
• /
• pp.1571-1574
• /
• 2015

Background: Treatment of Helicobacter pylori (H. pylori) decreases the prevalence of gastric cancer, and may inhibit gastric precancerous lesions progression into gastric cancer. The aim of this study was to determine the effect of treatment on subsequent gastric precancerous lesion development. Materials and Methods: We prospectively studied 27 patients who had low grade dysplasia at the time of enrollment, in addition to dysplasia atrophic gastritis and intestinal metaplasia observed in all patients. All were prescribed quadruple therapy to treat H. Pylori infection for 10 days. Patients underwent endoscopy with biopsy at enrollment and then at follow up two years later. Biopsy samples included five biopsies from the antrum of lesser curvature, antrum of greater curvature, angularis, body of stomach and fundus. Results of these biopsies were compared before and after treatment. Results: Overall, the successful eradication rate after two years was 15/27 (55.6%). After antibiotic therapy, the number of patients with low grade dysplasia decreased significantly (p=0.03), also with reduction of the atrophic lesions (p=0.01), but not metaplasia. Conclusions: Treatment of H. pylori likely is an effective therapy in preventing the development of subsequent gastric premalignant lesions.

• Journal of Trauma and Injury
• /
• v.37 no.2
• /
• pp.106-113
• /
• 2024

Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

• Journal of muscle and joint health
• /
• v.3 no.2
• /
• pp.166-176
• /
• 1996

This is a study through survey with the purpose of analysing of treatment cost for arthritis. Treatment cost can be devided Into two characteristics, one is the direct cost and the other is the indirect cost. Direct cost contains fees of medical treatment Including cost of self treatment & purchsing price of herb durg. On the other hand indirect cost means the using money of tansportation, lodging charge & labor-losing-time cost. For the succession of medical treatment of chronic diseases patients have to control themselves to go shopping around for the cure remeadies. And also it is important that the cost for unefficient or probably hamful folk remeadies should be reduced in order to distribute appropriatively the limited financial resources. As the result of this study, the fees for self treatment & herb drug are two times as much as those of regural medical treatment. Within the direct cost, there are the mean cost of regural medical treatment 59,630 won/mon., self-treatment 42,790 won/mon., and herb drug 78,380won/mon. therefore total mean direct cost is 180,800won per month. Moreover patients intermittently pay the cost of prostheses If folk remedies, these are added to the direct cost as above mentioned. Attributes of folk remedies are various from cure & analgesics to nutrients and their virtues as medicine are not clear in view of scientific knowledge. But 56% of arthritis patients have ever been experienced folk remedies. the cost for these remedies has wide ranges from 40,000 won to 1,000,000won. Total mean indirect cost including the transfortation fee, lodging charge & labor-losing-time cost has the range from 82,825won/month to 106,150won/month. Among these cost, labor-losing-time cost has a mojority because the waiting times are too long for seeing a doctor. In conclusion those patients having arthritis have a large burden against the treatment cost for continuous care. Therefore health professional should make effort to guide the patient to determine themselves informed choice about the treatment process.

• IMMUNE NETWORK
• /
• v.21 no.3
• /
• pp.22.1-22.17
• /
• 2021

Chitinase-3-like-1 (CHI3L1) is known to induce inflammation in the progression of allergic diseases. Previous our studies revealed that 2-({3-[2-(1-cyclohexen-1-yl)ethyl]-6,7-dimethoxy-4-oxo-3,4-dihydro-2-quinazolinyl}sulfanyl)-N-(4-ethylphenyl)butanamide (K284-6111; K284), the CHI3L1 inhibiting compound, has the anti-inflammatory effect on neuroinflammation. In this study, we investigated that K284 treatment could inhibit the development of atopic dermatitis (AD). To identify the effect of K284, we used phthalic anhydride (5% PA)-induced AD animal model and in vitro reconstructed human skin model. We analyzed the expression of AD-related cytokine mediators and NF-κB signaling by Western blotting, ELISA and quantitative real-time PCR. Histological analysis showed that K284 treatment suppressed PA-induced epidermal thickening and infiltration of mast cells. K284 treatment also reduced PA-induced release of inflammatory cytokines. In addition, K284 treatment inhibited the expression of NF-κB activity in PA-treated skin tissues and TNF-α and IFN-γ-treated HaCaT cells. Protein-association network analysis indicated that CHI3L1 is associated with lactoferrin (LTF). LTF was elevated in PA-treated skin tissues and TNF-α and IFN-γ-induced HaCaT cells. However, this expression was reduced by K284 treatment. Knockdown of LTF decreased the expression of inflammatory cytokines in TNF-α and IFN-γ-induced HaCaT cells. Moreover, anti-LTF antibody treatment alleviated AD development in PA-induced AD model. Our data demonstrate that CHI3L1 targeting K284 reduces AD-like skin inflammation and K284 could be a promising therapeutic agent for AD by inhibition of LTF expression.

• The Journal of the Korea Contents Association
• /
• v.8 no.12
• /
• pp.236-245
• /
• 2008

The cancer patient who leads Bone scan and the PET study from in the nuclear medical study what is enforced with the link of early detection and the time which spreads, it will be able to accomplish a positive treatment with the data which presumes that time it researches a degree as cancer discovery initially and only difference of final period the bay it knows. The patient who receives a cancer decision it will be able to accomplish the necessary defense it will be able to delay the time in order, the maximum control the possibility of doing will be becomes the judgement. Cancer decision to initially the nuclear study and treatment it will be in parallel with effort and the investment which are constant and the schedule hour will elapse and to after difficulty some the case which comes to be negligent will be frequent and it will appear with him there to be a possibility of knowing, it will be caused by and the transfer of the cancer sell will be activity. It has a treatment objective and are to each medical treatment agency against and the medical treatment agency worker it will be able to overlook is not the portion is the private plan which needs a more positive disposal, it does.

• Journal of Yeungnam Medical Science
• /
• v.40 no.1
• /
• pp.12-22
• /
• 2023

Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient's drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.