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Investigating the Level of Competition between Public Health Centers and Private Clinics in Korea

  • Kim, Hyun Joo;Lee, Jin Yong;Jo, Min-Woo;Eun, Sang Jun
    • Korea Journal of Hospital Management
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    • v.21 no.2
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    • pp.37-49
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    • 2016
  • The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

Heat Resistant Electromagnetic Noise Absorber Films Using Poly(amide imide)/Soft Magnet Composite (내열성 전자기 노이즈 흡수 폴리(아미드-이미드)/연자성체 복합체 필름)

  • Han, Ji-Eun;Jeon, Byung-Kuk;Goo, Bon-Jae;Cho, Seung-Hyun;Kim, Sung-Hoon;Lee, Kyung-Sub;Park, Yun-Heum;Lee, Jun-Young
    • Polymer(Korea)
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    • v.33 no.1
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    • pp.91-95
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    • 2009
  • We fabricated the electromagnetic (EM) noise absorber films for high temperature use by blending a soft magnetic powder with poly(amide imide) (PAI). The EM noise absorber films of PAI/soft magnet composite were prepared by casting the solution of poly(amide amic acid)/soft magnet powder into glass substrate with casting applicator device and then thermal imidization. The obtained films were fully characterized and their physical properties including thermal behavior, thermal stability and mechanical properties were studied. The EM noise absorption ability was also investigated using micro-strip line method. At 1 GHz, the power loss of composite film with 150 ${\mu}m$ thickness was about 25%.

Relationship between Progressive Changes in Lamina Cribrosa Depth and Deterioration of Visual Field Loss in Glaucomatous Eyes

  • Kim, You Na;Shin, Joong Won;Sung, Kyung Rim
    • Korean Journal of Ophthalmology
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    • v.32 no.6
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    • pp.470-477
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    • 2018
  • Purpose: To investigate the relationship between the progression of visual field (VF) loss and changes in lamina cribrosa depth (LCD) as determined by spectral-domain optical coherence tomography (SD-OCT) enhanced depth imaging in patients with primary open angle glaucoma (POAG). Methods: Data from 60 POAG patients (mean follow-up, $3.5{\pm}0.7$ years) were included in this retrospective study. The LCD was measured in the optic disc image using SD-OCT enhanced depth imaging scanning at each visit. Change in the LCD was considered to either 'increase' or 'decrease' when the differences between baseline and the latest two consecutive follow-up visits were greater than the corresponding reproducibility coefficient value ($23.08{\mu}m$, as determined in a preliminary reproducibility study). All participants were divided into three groups: increased LCD (ILCD), decreased LCD (DLCD), and no LCD change (NLCD). The Early Manifest Glaucoma Trial criteria were used to define VF deterioration. Kaplan-Meier survival analysis and Cox's proportional hazard models were performed to explore the relationship between VF progression and LCD change. Results: Of the 60 eyes examined, 35.0% (21 eyes), 28.3% (17 eyes), and 36.7% (22 eyes) were classified as the ILCD, DLCD, and NLCD groups, respectively. Kaplan-Meier survival analysis showed a greater cumulative probability of VF progression in the ILCD group than in the NLCD (p < 0.001) or DLCD groups (p = 0.018). Increased LCD was identified as the only risk factor for VF progression in the Cox proportional hazard models (hazard ratio, 1.008; 95% confidence interval, 1.000 to 1.015; p = 0.047). Conclusions: Increased LCD was associated with a greater possibility of VF progression. The quantitative measurement of LCD changes, determined by SD-OCT, is a potential biomarker for the prediction of VF deterioration in patients with POAG.

Urine Cotinine Should Be Involved in Initial Evaluation of Tinnitus in Adolescents

  • Lee, Doh Young;Kim, Young Ho
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.242-249
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    • 2018
  • Objectives. Smoking is associated with hearing loss, while the correlation between tinnitus and smoking is not fully elucidated. This study aimed to evaluate risk factors of tinnitus in adolescents in terms of smoking, and we identified a rectifiable parameter that can be serially monitored. Methods. A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, with 2,782 participants aged 12 to 18 years, from 2008 through 2011. Participants with history of ear disease, hearing loss, and inadequate responses to questionnaires were excluded. We investigated the prevalence of tinnitus and tinnitus-related annoyance by questionnaire and sought potential risk factors in blood and urine tests and smoking history. Results. The prevalence of tinnitus in the 12- to 18-year-old population was 17.5%, with 3.3% reporting tinnitus-related annoyance. On univariate analysis, the prevalence of tinnitus increased with age (P<0.001) and was higher among girls (P=0.012). Blood tests and urinalysis showed significant correlation between tinnitus and red blood cell count, alkaline phosphatase levels, and urine cotinine (P=0.002, P<0.001, P=0.018, respectively). In multivariate analysis, the urine cotinine level was the only parameter associated with tinnitus (odds ratio, 1.000; 95% confidence interval, 0.999 to 1.000; P=0.038). Smoking was also significantly correlated with tinnitus (P=0.043), and amount of smoking with tinnitus-related annoyance (P=0.045). However, current smoking and past smoking were not correlated with tinnitus. Conclusion. Urine cotinine may be a rectifiable marker for management of tinnitus in adolescents. This suggests that smoking cessation should be incorporated in the management of tinnitus in adolescents.

Regulatory Effect of Cannabidiol (CBD) on Decreased β-Catenin Expression in Alopecia Models by Testosterone and PMA Treatment in Dermal Papilla Cells

  • Park, Yoon-Jong;Ryu, Jae-Min;Na, Han-Heom;Jung, Hyun-Suk;Kim, Bokhye;Park, Jin-Sung;Ahn, Byung-Soo;Kim, Keun-Cheol
    • Journal of Pharmacopuncture
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    • v.24 no.2
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    • pp.68-75
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    • 2021
  • Objectives: The hair follicle is composed of more than 20 kinds of cells, and mesoderm derived dermal papilla cells and keratinocytes cooperatively contribute hair growth via Wnt/β-catenin signaling pathway. We are to investigate β-catenin expression and regulatory mechanism by CBD in alopecia hair tissues and dermal papilla cells. Methods: We performed structural and anatomical analyses on alopecia patients derived hair tissues using microscopes. Pharmacological effect of CBD was evaluated by β-catenin expression using RT-PCR and immunostaining experiment. Results: Morphological deformation and loss of cell numbers in hair shaft were observed in alopecia hair tissues. IHC experiment showed that loss of β-catenin expression was shown in inner shaft of the alopecia hair tissues, indicating that β-catenin expression is a key regulatory function during alopecia progression. Consistently, β-catenin expression was decreased in testosterone or PMA treated dermal papilla cells, suggesting that those treatments are referred as a model on molecular mechanism of alopecia using dermal papilla cells. RT-PCR and immunostaining experiments showed that β-catenin expression was decreased in RNA level, as well as decreased β-catenin protein might be resulted from ubiquitination. However, CBD treatment has no changes in gene expression including β-catenin, but the decreased β-catenin expression by testosterone or PMA was restored by CBD pretreatment, suggesting that potential regulatory effect on alopecia induction of testosterone and PMA. Conclusion: CBD might have a modulating function on alopecia caused by hormonal or excess of signaling pathway, and be a promising application for on alopecia treatment.

Associations of periodontal status in periodontitis and rheumatoid arthritis patients

  • Rovas, Adomas;Puriene, Alina;Punceviciene, Egle;Butrimiene, Irena;Stuopelyte, Kristina;Jarmalaite, Sonata
    • Journal of Periodontal and Implant Science
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    • v.51 no.2
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    • pp.124-134
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    • 2021
  • Purpose: The aim of this study was to assess the association between the clinical status of rheumatoid arthritis (RA) and periodontitis (PD) in patients diagnosed with PD and to evaluate the impact of RA treatment on the severity of PD. Methods: The study included 148 participants with PD, of whom 64 were also diagnosed with RA (PD+RA group), while 84 age-matched participants were rheumatologically healthy (PD-only group). PD severity was assessed by the following periodontal parameters: clinical attachment loss, probing pocket depth (PPD), bleeding on probing (BOP), alveolar bone loss, and number of missing teeth. RA disease characteristics and impact of disease were evaluated by the Disease Activity Score 28 using C-reactive protein, disease duration, RA treatment, the RA Impact of Disease tool, and the Health Assessment Questionnaire. Outcome variables were compared using parametric and non-parametric tests and associations were evaluated using regression analysis with the calculation of odds ratios (ORs). Results: Participants in the PD+RA group had higher mean PPD values (2.81 ± 0.59 mm vs. 2.58 ± 0.49 mm, P=0.009) and number of missing teeth (6.27±4.79 vs. 3.93±4.08, P=0.001) than those in the PD-only group. A significant association was found between mean PPD and RA (OR, 2.22; 95% CI, 1.16-4.31; P=0.016). Within the PD+RA group, moderate to severe periodontal disease was significantly more prevalent among participants with higher RA disease activity (P=0.042). The use of biologic disease-modifying antirheumatic drugs (bDMARDs) was associated with a lower BOP percentage (P=0.016). Conclusions: In patients with PD, RA was associated with a higher mean PPD and number of missing teeth. The severity of PD was affected by the RA disease clinical activity and by treatment with bDMARDs, which were associated with a significantly lower mean BOP percentage.

Design and Performance Analysis of 5G Mobile Communication Array Antenna in Millimeter-Wave (mm-Wave) Band (밀리미터파(mm-Wave) 대역 5G 이동통신 Array 안테나의 설계와 성능분석 연구)

  • Lee, Sung-hun;Lee, Chang-Kyo;Park, Jae-Hong;Cho, Soo-Hyun;Choi, Seung-Ho;Kim, Tae-Hyung
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.9
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    • pp.1165-1171
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    • 2020
  • In this study, we designed a single antenna taking into account the performance, such as return loss and radiation pattern, of 28 GHz and 38 GHz array antennas for 5G mobile devices. In millimeter wave band communication, high path loss occurs between transmission and reception, unlike in conventional microwave bands. In the design of array antennas for 5G millimeter wave terminals, antenna performance such as antenna gain, bandwidth, isolation between antenna elements, side-lobe level(SLL), etc. should be further considered. The performance of the designed array antennas was analyzed by spacing the antenna elements at half a wavelength. Our results proved the validity of the design and its suitability for applications in mm-Wave by showing that the 28 GHz and 39 GHz array antennas had antenna gains of 13.5 dBi and 11.3 dBi and return losses below -18.4 dB and -20 dB, correspondingly.

Long-term administration of red ginseng non-saponin fraction rescues the loss of skeletal muscle mass and strength associated with aging in mice

  • Cho, Da-Eun;Choi, Gwang-Muk;Lee, Yong-Seok;Hong, Joon-Pyo;Yeom, Mijung;Lee, Bombi;Hahm, Dae-Hyun
    • Journal of Ginseng Research
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    • v.46 no.5
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    • pp.657-665
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    • 2022
  • Background: Sarcopenia is a new and emerging risk factor aggravating the quality of life of elderly population. Because Korean Red Ginseng (RG) is known to have a great effect on relieving fatigue and enhancing physical performance, it is invaluable to examine its potential as an anti-sarcopenic drug. Methods: Anti-sarcopenic effect of non-saponin fraction of Korean Red Ginseng (RGNS) was evaluated in C2C12 myoblasts treated with C2-ceramide to induce senescence phenotypes, and 22-month-old mice fed with chow diet containing 2% RGNS (w/w) for 4 further months. Results: The RGNS treatment significantly alleviated cellular senescence indicated by intracellular lipid accumulation, increased amount of lysosomal β-galactosidase, and reduced proliferative capacity in C2C12 myoblasts. This effect was not observed with saponin fraction. In an aged mouse, the 4-month-RGNS diet significantly improved aging-associated loss of muscle mass and strength, assessed by the weights of hindlimb skeletal muscles such as tibialis anterior (TA), extensor digitorum longus (EDL), gastrocnemius (GN) and soleus (SOL), and the cross-sectional area (CSA) of SOL muscle, and the behaviors in grip strength and hanging wire tests, respectively. During the same period, an aging-associated shift of fast-to slow-twitch muscle in SOL muscle was also retarded by the RGNS treatment. Conclusions: These findings suggested that the long-term diet of RGNS significantly prevented aging-associated muscle atrophy and reduced physical performance, and thus RGNS has a strong potential to be developed as a drug that prevents or improves sarcopenia.

A case of cataract surgery using phacoemulsification in a 12-year-old poodle

  • Kang, Myeong-Gon;Han, Dong-Hyun;Han, Sei-Myoung;Jung, Eun-Gyeom;Kim, Gyeong-Min;Cho, Jae-Hyeon;Koh, Phil-Ok;Won, Chung-Kil;Kim, Chung-Hui;Lee, Dongbin
    • Korean Journal of Veterinary Service
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    • v.45 no.3
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    • pp.221-228
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    • 2022
  • Cataracts occur commonly in older dogs, which can lead to partial or complete vision loss. In the present study, a 12-year-old male poodle presented for evaluation of ocular sinister (OS) cataract. This study was a clinical case report on the process of performing surgery using phacoemulsification (PHACO) and the problems that arise in patient diagnosed with OS cataract. In the oculus dexter (OD), the artificial eye was inserted because there was no electroretinography (ERG) response. In the OS, the ERG was 51.6 μV, so operation was performed because the visual pathway function remained. Slit-lamp biomicroscopy of the OS showed complete loss of vision as a hypermature cataract and that the lens was hardened. During the cataract surgery using PHACO, visco-elastic agents were used to maintain the shape of the eyeball, and the PHACO procedure took 3.13 minutes. The hardened lens and visco-elastic agents were removed from the eye through PHACO surgery, and the operation was completed by inserting an intraocular lens (IOL). As a result of managing IOP for 2 months after surgery, it remained stable at a maximum of 19 mmHg, and no postoperative ocular hypertension (POH) occurred. Currently, one year has passed since the operation, and the dog maintains its daily life with its left eye without any problems.

Protocol for management of pregnant patients requiring emergency minor oral surgical procedures: a prospective study in 52 patients

  • Ajinath Nanasaheb Jadhav;Shushma G;Uzma Hamidullah Siddiqui;Minal Sharma;Yaseer Irfan Shaikh;Pooja Raosaheb Tarte
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.1
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    • pp.21-29
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    • 2023
  • Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.