• 보건행정학회지
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• 제18권2호
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• pp.1-18
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• 2008

As medical insurance had been implemented for Magnetic Resonance Imaging (MRI) from January 1, 2005, this study investigated whether there had been any change in the amount of the medical care utilization of patients who undertook MRI before and after the insurance coverage, and was to examine factors affecting the amount of medical care utilization of MRI. Data were collected from patients who undertook MRI before and after the insurance coverage for a year at a general hospital in Kyeanggi-do. $X^2$ and t-test were used for the analysis of their general characteristics, the number of MRI, and its medical costs before and after the insurance coverage, and hierarchical multiple regression analysis for the factors affecting the amount of the medical care utilization of MRI. The results of this study were as follows. First, the number of MRI after the insurance coverage was significantly decreased. Second, there was no significant difference in the total medical costs of MRI after the insurance coverage, but a significant difference was found in patient's share of medical costs. Third, six variables were found to be affecting the amount of the medical care utilization of MRI, and the variables showed to lead the number of MRI decrease after the insurance coverage. These six factors explained 21.4% of the total number of MRI. As MRI had been covered by insurance, the use of MRI and patient's share of the costs were deceased, but the total medical costs were not affected. Reasons for that could be found in that MRI insurance, different from the case of CT insurance coverage, was allowed not to cover some items and the kinds of diseases subjected to the insurance coverage were extremely limited, lowering insurance prescription rate. In addition to that, the average medical cost of MRI was not changed after the insurance coverage. Therefore, as future measures for the MRI insurance, coverage, it should be considered to allow insurance coverage to no coverage items and to expand the scope of benefit coverage, or to lower patient's share of the costs. Furthermore, researches should be done to explore how recipients will act and how suppliers will react if the coverage is expanded, including expanding the scope of coverage and reducing patient's share of the costs, as well as to conduct research on its economic analysis according to case mix.

• 한국콘텐츠학회논문지
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• 제9권12호
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• pp.339-347
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• 2009

연구목적: 64 절편 MDCT를 이용한 심장 CT의 진단일치도를 알아보고, 심박동수와 관상동맥 석회화가 진단일치도에 영향을 미치는지 확인하여 심장 CT 검사 시 기초 자료로 활용하고자 함이다. 연구방법: 심장 CT와 관상동맥 조영술을 함께 시행한 178명(남자 84명, 여자 94명)을 대상으로 심장 CT에서 관상동맥 협착과 심박동수, 석회화 수치를 측정하였고, 관상동맥조영술에서 좌전하행동맥, 좌회선동맥, 우관상동맥의 유의한 협착($\geq50%$)이 있는지 확인하였다. 관상동맥 조영술의 결과를 표준으로 심장 CT의 민감도, 특이도, 양성예측도, 음성예측도, kappa index($\kappa$)를 계산하였다. 연구결과: 환자별 협착의 정도를 평가한 결과 심장 CT의 정확도는 96.6%였다. 혈관별로는 LAD, LCX, RCA 각각 86.5%, 84.3%, 92.1%로 높은 진단일치도를 보였다. 체질량지수와 혈압은 심장 CT의 진단일치도에 영향을 미치지 않았다. 심박동수는 60/min 미만에서 정확도 90.1%, $\kappa$값 0.78이었고, 70/min 이상에서는 정확도가 75.8%, $\kappa$값 0.52이었다. 관상동맥 석회화지수 100 미만에서는 정확도가 91.3%, $\kappa$값 0.81이었고, 석회화지수 400 이상에서는 정확도 68.6%, $\kappa$값 0.33으로 떨어졌다. 결론: 64 절편 MDCT를 이용한 심장 CT는 관상동맥 조영술과 거의 비슷한 진단일치도를 나타냈다. 하지만 심박동수 70/min 이상, 관상동맥 석회화지수 400 이상에서는 진단일치도가 저하되었기 때문에 심장 CT 검사 시 심박동수와 관상동맥 석회화지수를 확인하여 검사하여야 하고, 심박동수가 70/min 이상이면 베타차단제를 사용하여 심박동수를 조절하여야 한다.

• Journal of Gastric Cancer
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• 제4권1호
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• pp.1-6
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• 2004

Purpose: Despite numorous reports on the relationship between the level of carcinoembryonic antigen (CEA) in gall bladder bile and liver metastasis in colorectal cancer, no similar studies have been carried out for gastric carcinomas. We, therefore, undertook the present study to establish the relationship between the gall bladder bile CEA and liver metastasis as well as the post-operative survival rate in gastric carcinoma patients with curative resections. Materials and Methods: In 373 gastric cancer patients (252 males, 121 females, age $21\∼76$ years) operated on at Kosin University Hospital between 1989 1996, the CEA concentration in the gall bladder bile was determined during the operation and the value was related to the rates of post-operative survival and liver metastasis during follow-up period. Results: The overall rate of patient survival decreased gradually with increase in TNM stage. The 13-year postoperative survival rates for stages Ia, Ib, II, IIIa, and IIIb were $95.7\%,\;92.5\%,\;79.9\%,\;50.9\%,\;and\;43.3\$, respectively, and the 10-year survival rate for stage IV was $22.6\%$. The patients with a high ($\geq$10 ng/ml) biliary CEA showed a significantly lower rate of survival than those with a low (<10 ng/ml) biliary CEA. The 13-year cumulative survival rate was $55.4\%$ for the high CEA group and $76.5\%$ for the low CEA group (P<0.01). Also, the patients with a high biliary CEA showed a significantly higher rate ($11.5\%$) of liver metastasis than those with a low biliary CEA ($1.9\%$) (P<0.000). In patients with TNM stages (I and II), the CEA level did not affect the post-operative survival rates ($95.4\%\;and87.7\%$ in the high and low CEA groups, P>0.10), but in those with high TNM stages (III and IV), the survival rate was significantly lower in the high CEA group ($25.9\%$) than in the low CEA group ($57.8\%$) (P<0.05). Conclusion: These result suggest that the gall bladder bile CEA level obtained in an advanced-staged gastric cancer operation may be used in predicting the post-operational survival rate and in sorting out patients with a high risk for cancer recurrence, especially in the liver area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.161-163
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• 2005

In the reconstruction of the hard tissue defect of the oral cavity, the usefulness of the chin bone graft, one of the intraoral donor site, is gradually increased. The advantages include reduced resorption rate after graft due to its membranous bone nature, relatively ease to harvest under local anesthesia, reduced operative time because of the same operative field, decreased morbidity, and relatively large amount of bone can be harvested compared to other intraoral donor site. It has also postoperative complications including paresthesia of the lip or chin area, discomfort of lower anterior teeth, and facial swelling around chin area. Of these complications, facial swelling occurs more frequently, is more severe as a early postoperative discomfort, and prevents fast recover of patient's social activity since this procedure is generally accomplished in the outpatient base under local anesthesia. So we applied a modified " gull-wing" type incision to minimize this complication, and now we report this simple but effective surgical technique with clinically favorable result.

• 대한핵의학회지
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• 제15권2호
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• pp.19-25
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• 1981

Radionuclide venographies were performed in 138 limbs of 58 patients and X-ray contrast venographies were performed in 23 paitents of them. Positive radionuclide venography findings were area of decreased sponding to the region of thrombosis, abnormal collateral flows below the lesion. The success rate of radionulide venography was 89% and the overall concordance between radionuclide venography and X-ray contrast venography was 91%. Radionuclide venography is simple and easy to perform and less invasive than X-ray contrast venography. These results indicate that radionuclide venography is the most ideal screening test for the detection of venous thrombosis in patient with signs & symptoms of deep vein thrombosis.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.659-666
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• 2010

Purpose: Blepharoplasty plays a vital role in facial rejuvenation. Aging eyelids are the result of relaxation of lid structures as the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudoherniation of intraorbital fat contents. Traditional blepharoplasty has often involved the excision of excessive lax skin and muscle and removal of fat, leaving the eyelid unnatural and even causing the brow ptosis. The authors propose the septal approach through which the amount of skin excision can be decreased and solid fixation can be achieved in the upper blepharoplasty. Methods: From November 2007 to February 2010, total of 15 patients underwent upper blepharoplasty with septal approach. In 9 patients, orbital septum anchored into the orbital periosteum only. But in 6 patients, the attenuated septum was strengthened through shortening and fixing into orbital periosteum with non-absorbable suture. Results: Pleasing results were obtained from most of the patients. But one patient who had septum anchoring procedure complained of slight undercorrection, therefore secondary operation with septum shortening procedure was followed. Conclusion: We found that the method using orbital septum fixation into orbital periosteum has several advantages: less amount of skin excision, less recurrence rate, and more natural appearance. And the results were reliable and satisfactory.

• 보건행정학회지
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• 제24권3호
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• pp.271-282
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• 2014

Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The purpose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy development in reducing cancer mortality. Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period between 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators. Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer except for pancreatic cancer. Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by selecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.

• 한방안이비인후피부과학회지
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• 제22권2호
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• pp.39-49
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• 2009

Objective : Phyllostachyos Folium (PF) has been used to treat patients with febrile disease consuming the body fluids marked by fever with restlessness, thirst etc. In the theory of herbology, PF can clear away heat and promote the production of the body fluids, relieve restlessness. Recently PF is known to have anti-bacterial, anti-oxidantic effects. Methods : The present study was carried out to investigate the effects of PF on solid tumor in mice in terms of immune-potentiating and direct cytotoxic action of PF in vitro and vivo study. The present author investigated thymocyte and splenocyte proliferation to confirm immune-potentiating activity of PF and also investigated tumor/body weight ratio and survival rates in tumor bearing mice. Result : In this study, administration of PF decreased tumor/body weight ratio significantly, and prolonged survival duration compared to non-treated control. In addition, treatment with PF suppressed proliferation rate of Sarcoma 180 (S-180) cells significantly, and elevated proliferation rates of thymocytes isolated from normal mice. These results were co-related with in vivo study. Conclusion : In conclusion, these results suggest that PF is useful to treat patient with solid tumor, because PF has direct toxic action for tumor cell and immune -potentiating action for T cells. Further study will need to elucidate exact mechanisms related in anti-cancer action of PF.

• 한방안이비인후피부과학회지
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• 제23권1호
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• pp.158-168
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• 2010

Objective : Jeungson-Ojeok-Hwan Bijukbang(JOH) has been used to treat patients with tumor etc. In the theory of Korean medicine, JOH can treat Juk-Chui. JOH is known to have treat Juk-Chui. Juk-Chui is analogous to tumor. Methods : For these reasons, the present study was designed to investigate the effects of JOH on solid tumor in mice in terms of immune-potentiating and direct cytotoxic action of JOH in vitro and vivo study. The present author investigated thymocyte and splenocyte proliferation to confirm immune-potentiating activity of JOH and also investigated tumor/body weight ratio and survival rates in tumor bearing mice. Results : In this study, administration of JOH decreased tumor/body weight ratio significantly, and prolonged survival duration compared to non-treated control. In addition, treatment with JOH suppressed proliferation rate of Sarcoma 180 (S-180) cells significantly, and elevated proliferation rates of thymocytes isolated from normal mice. These results were co-related with in vivo study. Conclusion : these results suggest that JOH is useful to treat patient with solid tumor, because JOH has direct toxic action for tumor cell and immune-potentiating action for T cells. Further study will need to elucidate exact mechanisms related in anti-cancer action of JOH.

• 대한한방내과학회지
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• 제22권4호
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• pp.547-555
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• 2001

Objectives: Obesity is regarded as the aggregation of needless risk factors, for instance, cardiovascular disease, joint disease, induce cancer. We studied on interrelation between abnormal liver function and obesity. Methods: We analyzed liver function, T.Cholesterol, Triglyceride before and after lose weight treatment. The collateral condition is over 6 weeks period on obesity treatment, no liver injury and no complicated another disease on personal past history and found out abnormal impression on biochemical liver function blood test. Results: The improvement rate of LFT, compare with before treatment is 10.6% in T.Bilirubin, 11.1% in ALP, 21% in AST, 38% in ALT, 37.3% in r-GTP, 9.2% in LDH and decreased 2.7% in T.Protein, increased 2.3% in Albumin. Hyperlipidemia is 19.4% in T.Cholesterol, 42.5% in Triglyceride. Conclusions: LFT and Hyperlipidemia of abnormal liver function patients, caused by obesity, is improved to normal limit in proportion to reduce patient's weight.