• Anatomy and Cell Biology
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• v.57 no.2
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• pp.294-304
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• 2024

Type 2 diabetes mellitus is increasingly becoming more prevalent worldwide together with hospital care costs from secondary complications such as bone fractures. Femoral fracture risk is higher in diabetes. Therefore, this study aimed to assess the osteometric and microarchitecture of the femur of Zucker Diabetic Sprague-Dawley (ZDSD) femur. Ten-week-old male rats (n=38) consisting of 16 control Sprague-Dawley (SD) and 22 ZDSD rats were used. The rats were terminated at 20 weeks and others at 28 weeks of age to assess age, diabetes duration effects and its severity. Bilateral femora were taken for osteometry, bone mass measurements and micro-focus X-ray computed tomography scanning to assess the trabecular number (TbN), thickness (TbTh), spaces (TbSp), bone tissue volume to total volume (BV/TV) and volume (BV). Diabetic rats had shorter (except for 20-weeks-old), lighter, narrower, and less robust bones than SD controls that wered more robust. Although cortical area was similar in all diabatic and control rats, medullary canal area was the largest in ZDSD rats. This means that the diabetic rats bones were short, light and hollow. Diabetic rats aged 20 weeks had reduced BV, BV/TV, TbN with more spacing (TbSp). In contrast, the 28 weeks old diabetic rats only showed reduced BV and TbN. Discriminant function analysis revealed, for the first time, that osteometric parameters and TbTh, TbN, and TbSp were affected by diabetes. This knowledge is valuable in the management of diabetic complications.

• 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.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3336-3340
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• 2010

This study has been carried out against hospitals with less than 100 beds, which were excluded from the previous study on the discharged patients from January 1 to December 31, 2007. To analyze the discharged patients, the general characteristics of discharged patients, means of payment for medical costs, type of disease and surgery and current status of the use of medical services have been investigated based on the medical records. During the year of 2007, the number of discharged patients from the hospitals with less than 100 beds reached 4,697,095 (9.7% of total population). In other words, 9,693 people were discharged from a hospital per 100,000 populations with 9.8 days in terms of annual mean length of hospitalization. The number of patients who returned home after hospitalization reached 4,538,861 (male: 1,784,041, female: 2,754,821) while 119,378 patients were evacuated to other hospitals. Among them, 8,970 patients were returned back to the original hospital. Based on the results of this study, they could be used in could be used in planning a project which is aimed to reduce public health costs by investigating high-risk groups with particular injuries and preventing damage. In addition, the injury monitoring data which are continuously collected could be useful in monitoring and evaluating the efficiency of an injury prevention program.

• Journal of the Korea Convergence Society
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• v.8 no.5
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• pp.61-68
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• 2017

This study investigates the differences in medical practices and medical cost according to auto insurance companies based on 8,589,602 cases that were treated by auto insurance corporation for the year of 2015, from the beginning of January to the end of December. The results of this study can be summarized following. First, in terms of the general characteristic in medical treatment, especially the age, the highest figure in both non-life insurance and mutual aid cooperative was shown in the age of 50 to 59 at 22.8 per cent(p<0.001). Second, in terms of a medical cost per a hospital care, classified by clinic, the costs in the department of internal medicine were much higher than those in the surgical department, and the thoracic surgery among parts of the surgical department showed the highest figures in both non-life insurance and mutual aid cooperative. According to the above summarized results of this study, it can be concluded that Health Insurance Review and Assessment Service has to address the problem on the increase of unnecessary costs and the occurrence of social expenses caused by the delay of patients' rehabilitation and return to their daily lives, by carrying out the evaluation for the appropriateness to organizations that ask for payments of auto insurance.

• Journal of Oriental Neuropsychiatry
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• v.26 no.3
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• pp.225-234
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• 2015

Objectives: We aimed to evaluate the use of Korean medicine in patients with dizziness or vertigo, since such study has not been performed previously. Methods: In the current study, we included 3 diagnoses i.e., Disorders of vestibular function (H81), Vertiginous syndromes in diseases classified elsewhere (H82), and Dizziness and giddiness (R42) from the Health Insurance Review and Assessment Service (HIRAS) database for 4 years. We analyzed the database and compared treatment with Korean vs. Western medicine. Results: 1. Korean medical visits and cost have been increasing for 4 years, except 2011. Western medical visits are 11.9 times higher than Korean medical visits. 2. The number of women who received Korean medicine was 2.6 times higher than that of men. 3. Among all ages, the 70~79 years group were the most frequent users of Korean medicine. The older age was correlated with more patients' visits. 4. The comparative number of visits by patient care type for 4 years indicated that outpatients had more visits than hospitalization. Furthermore, outpatient visits have been increasing for 4 years. 5. The comparative number of visits by hospital type for 4 years indicated that visits to the Korean medical clinic were the highest. In primary care, patients used more Korean medicine than Western medicine. In tertiary care, patients used more Western medicine than Korean medicine. 6. Korean medical cost per patient by patient care type for 4 years was a total 89,000 won, hospitalization 449,000 won and outpatient 83,000 won. Costs of all patient care types have been increasing. 7. Korean medical cost per patient by hospital type for 4 years was 156,000 won for Korean medical hospital, 83,000 won for local clinic and 127,000 won for miscellaneous facilities. Costs of all types have been increasing. Conclusions: This study provided objective information about epidemiologic characteristics of Korean medicine in patients with dizziness or vertigo. Furthermore, it provides an understanding of the recent status and forms the basis for further expansion of demand for Korean medicine among patients with dizziness or vertigo.

• The Journal of the Korea Contents Association
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• v.19 no.10
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• pp.364-371
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• 2019

The World Health Organization (WHO) announced the 11th International Classification System (ICD-11), which classifies game addiction as a disease in 2018. Sin stocks are defined as the companies that have negative addictive properties and are taxed on social costs. If a game disorder is listed in the disease classification system in Korea, it is highly likely that Korean game companies may be considered as sin stocks that causes negative addictive properties and social costs such as the game addiction and the game addiction tax. This suggests that game companies could be newly included in the scope of sin stocks in Korea. In this study, we examine the effect of the inclusion of game companies in the scope of sin stocks on the job preferences of game companies. We found that there is a high level of opposition to the opinion of the listing sin stocks of game companies, and a high degree of addiction and gambling was suggested as the cause of the game companies being classified as sin stocks. We also found that firm value and job preference would be decrease if a game company was classified as sin stocks. The study is meaningful in that it suggests that game companies can be perceived negatively as sin stocks due to the disease code of game disorder, which has recently emerged as a social issue. Also, this study will contribute to the academia and market participants by reporting statistically the effect of the classification of sin stocks in game companies on job preferences for game companies.

• Journal of the Korean Applied Science and Technology
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• v.40 no.5
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• pp.1092-1103
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• 2023

This study is a study to investigate how the achievement goal orientation of domestic winter sports participants has an effect on fun factors and participation satisfaction. A total of 326 questionnaires were used in this study, SPSS(Version 27.0) was used as a data processing method, and frequency analysis, reliability analysis, exploratory factor analysis, correlation analysis, and multiple regression analysis were used as statistical methods. The results of verifying the statistical effects of achievement goal tendency, fun factors, and participation satisfaction are as follows. First, as a result of verifying the effect of achievement goal orientation on fun factors, self-goal orientation and task goal propensity, which are sub-factors of achievement goal orientation, had significant effects on exercise ability, exercise utility, promotion of friendship, and self-satisfaction factors. Second, self-goal and task goal propensity, which are sub-factors of achievement goal orientation, had significant effects on facilities, costs, classes, interpersonal relationships, and health factors. Third, the sub-factors of fun factors such as exercise ability, exercise utility, promotion of friendship, and self-satisfaction had significant impacts on facilities, costs, lessons, interpersonal relationships and health factors.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.511-514
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• 2013

Background: A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Materials and Methods: Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) detection rate and treatment costs were compared between the groups. Results: The detected rate of CIN2+ was higher in the HPV triage group compared to immediate colposcopy group (8% vs. 1.6%, p=0.011). In the HPV triage group, the total cost, cost per patient, and the cost for detecting one case of high grade CIN were higher than the immediate colposcopy group (p<0.001). Conclusions: In women with ASCUS cytology, HPV DNA testing followed by colposcopy is more costly than immediate colposcopy, but this approach is associated with a higher rate of CIN2+ detection. This findings suggest that HPV DNA testing combined with cervical cytology could reduce the referral rate to colposcopy.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.2
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• pp.134-145
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• 2015

Objectives: An objective of this study was to perform a risk assessment and social cost-benefit analysis for revising permissible exposure limits for seven substances: Nickel(Insoluble inorganic compounds), benzene, carbon disulfide, formaldehyde, cadmium(as compounds), trichloroethylene, touluene-2,4-diisocyanate. Materials and Methods: The research methods were divided into risk and hazard assessment and cost-benefit analysis. The risk and hazard assessment for the seven substances consists of four steps: An overview of GHS MSDS(1st), review of document of ACGIH's TLVs (2nd), comparison between international occupational exposure limits and domestic permissible exposure limits(3rd), and analysis of excess workplace and excess rate for occupational exposure limits based on previous work environment measurement data(4th). Total cost was estimated using cost of local exhaust ventilation, number of excess workplace and penalties for exceeding a permissible exposure limit. On the other hand, total benefit was calculated using the reduction rate of occupational disease, number of workplaces treating each substance and industrial accident compensation. Finally, the net benefit was calculated by subtracting total cost from total benefit. Results: All the substances investigated in this study were classified by CMR(Carcinogens, Mutagens or Reproductive toxicants) and their international occupational exposure limits were stricter than the domestic permissible exposure limits. As a result of excess rate analysis, trichloroethylene was the highest at 11%, whereas nickel was the lowest at 0.5%. The excess rates of all substances except for trichloroethylene were observed at less than 10%. Among the seven substances, the total cost was highest for trichloroethylene and lowest for carbon disulfide. The benefits for the seven substances were higher than costs estimated based on strengthening current permissible exposure limits. Thus, revising the permissible exposure limits of the seven substances was determined to be acceptable from a social perspective. Conclusions: The final revised permissible exposure limits suggested for the seven substances are as follows: $0.2mg/m^3$ for nickel, 0.5 ppm(TWA) and 2.5 ppm(STEL) for benzene, 1 ppm(TWA) for carbon disulfide, $0.01mg/m^3$(TWA) for cadmium, 10 ppm(TWA) and 25 ppm(STEL) for trichloroethylene, 0.3 ppm(TWA) for formaldehyde, and 0.005 ppm(TWA) and 0.02 ppm(STEL) for toluene diisocynate(isomers).