PURPOSE: The purpose of this study was to examine trends in number of nursing staff and skill mix. METHODS: Nursing staff and skill mix were measured using the number of nursing staff including nurse aids and registered nurses per bed. Descriptive and panel data regression analyses were conducted using data on long-term care hospitals which included yearly series data from 2006 to 2010 for 119 hospitals. RESULTS: The number of nursing staff per bed increased significantly but percentage of registered nurses decreased significantly from 2007 to 2010. The regression model explained this variation as much as 35% and 44%. CONCLUSION: The results showed that in long-term care hospitals there were more nurse aids employed instead of registered nurses after the implemention of differentiated inpatient nursing fees. Thus clarifying the job descriptions for nurses and nurse aids is needed and appropriate hospital incentive policies should be implemented.
Fees and Charges* ; Humans ; Inpatients* ; Job Description ; Long-Term Care* ; Motivation ; Nursing Staff ; Nursing*

The integration of medical devices with artificial intelligence (AI) software is rapidly advancing as technology progresses. AI machine learning can be used in commercial medical services to generate practical data; there is evidence that it can be integrated into newly developed devices. However, such devices must undergo approval, regulation, and supervision. The Food and Drug Administration approves regulations for numerous machine-learning medical devices and shares open lists with the public. In this article, we examine recent medical AI devices in different fields, including the diagnosis of colorectal polyps.Current Concepts: Currently, in the field of gastroenterology, there has been a significant amount of research aimed at enhancing adenoma detection rates using tools powered by AI, such as the EndoScreener and GI Genius. Various such devices have also been developed for other fields; examples include the 23andMe Personal Genome Service for DNA detection, Spectral MD’s DeepView platform for wound imaging in surgery, Gili Pro BioSensor for monitoring vital signs, DreaMed Advisor Pro for diabetes, Minuteful for urinary analysis, BrainScope TBI for cerebral diagnosis, Compumedics Sleep Monitoring System for sleep disorders, Idx-DR v2.3 for ophthalmology, and EarliPoint system for pediatrics.Discussion and Conclusion: By the time this article is published, it is likely that even more AI medical devices will have been approved and commercialized. The development of such devices should be strongly encouraged. Additionally, we anticipate greater involvement from practitioners in the development and validation of diverse medical AI devices in Korea.

No abstract available.
Periodontal Diseases*

Vertebral artery (VA) injuries usually accompany cervical trauma. Although these injuries are commonly asymptomatic, some result in vertebrobasilar infarction. The symptoms of VA occlusion have been reported to usually manifest within 24 hours after trauma. The symptoms of bilateral VA occlusions seem to be more severe and seem to occur with shorter latencies than those of unilateral occlusions. A 48-year-old man had a C3-4 fracture-dislocation with spinal cord compression that resulted from a traffic accident. After surgery, his initial quadriparesis gradually improved. However, he complained of sudden headache and dizziness on the 5th postoperative day. His motor weakness was abruptly aggravated. Radiologic evaluation revealed an infarction in the occipital lobe and cerebellum. Cerebral angiography revealed complete bilateral VA occlusion. We administered anticoagulation therapy. After 6 months, his weakness had only partially improved. This case demonstrates that delayed infarction due to bilateral VA occlusion can occur at latencies as long as 5 days. Thus, we recommend that patients with cervical traumas that may be accompanied by bilateral VA occlusion should be closely observed for longer than 5 days.
Accidents, Traffic ; Brain Infarction* ; Cerebellum ; Cerebral Angiography ; Dizziness ; Headache ; Humans ; Infarction ; Middle Aged ; Occipital Lobe ; Quadriplegia ; Spinal Cord Compression ; Vertebral Artery*

BACKGROUND: Diagnostic imaging fee had been reduced in May 2011, but it was recovered after 6 months because of strong opposition of medical providers. This study aimed to analyze the behavior of medical providers according to fee changes. METHODS: The National Health Insurance claims data between November 2010 and December 2012 were used. The number of exams per computed tomography was analyzed to verify that the fee changes increased or decreased the number of exams. Multivariate regression model were applied. RESULTS: The monthly number of exams increased by 92.5% after fee reduction, so the diagnostic imaging spending were remained before it. But medical provider decreased the number of exams after fee return. After adjusting characteristic of hospitals, fee reduction increased the monthly number of exams by 48.0% in a regression model. Regardless type of hospitals and severity of disease, the monthly number of exams increased during period of fee reduction. The number of exams in large-scaled hospitals (tertiary and general hospital) were increased more than those of small-scaled hospitals. CONCLUSION: Fee-reduction increased unnecessary diagnostic exams under the fee-for-service system. It is needed to define appropriate exam and change reimbursement system on the basis of guideline.
Diagnostic Imaging ; Fees and Charges ; Insurance, Health ; National Health Programs

Although cavernous hemangiomas occur frequently in the intracranial structures, they are rare in the spine. Most of spinal hemangiomas are vertebral origin and "pure" epidural hemangiomas not originating from the vertebral bone are very rare. Our spinal hemangioma case is extremely rare because of its "pure" epidural involvement and intralesional hemorrhage. A 64-year-old man presented with progressive paraparesis from two months ago. His motor weakness was rated as grade 4/5 in bilateral lower extremities. He also complained of decreased sensation below the T4 sensory dermatome, which continuously progressed to the higher dermatome level. Magnetic resonance imaging demonstrated thoracic spinal tumor at T3-T4 level. The tumor was located epidural space compressing thoracic spinal cord ventrally. The tumor was not involved with the thoracic vertebral bone. We performed T3-5 laminectomy and removed the tumor completely. The tumor was not infiltrating into intradural space or vertebral bone. The histopathologic study confirmed the epidural tumor as cavernous hemangioma. Postoperatively, his weakness improved gradually. Four months later, his paraparesis recovered completely. Here, we present a case of pure spinal epidural cavernous hemangioma, which has intralesional hemorrhage. We believe cavernous hemangioma should be included in the differential diagnosis of the spinal epidural tumors.
Diagnosis, Differential ; Epidural Neoplasms ; Epidural Space ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage* ; Humans ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Paraparesis ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Spine

BACKGROUND: The purpose of this study is to find out the relationship between the airborne toluene concentrations and the daily urinary metabolites such as hippuric acid and o-cresol for a sequential 5 days and to provide the appropriate sampling time for a special physical examination in the workers exposed to toluene. METHODS: The volunteers of 36 workers in the shoe making company were selected to measure the concentrations of airborne toluene exposure and to sample the daily urines in pre and end-shift for sequential 5 days form Monday to Friday and to get self-administered questionnaire including the items such as job records, disease records, smoking, alcohol drinking, eating some foods containing benzoic acid before work. RESULTS: The geometric means of toluene concentrations showed 46.40 ppm as the lowest value on Monday and 62.31 ppm as the highest one on Thursday. But there is no significant difference between both of those. The concentrations of hippuric acid and o-cresol in urine sampled on end-shift were higher than that of the others and showed statistically significant differences on each day. The metabolites of toluene were not related with taking alcohol and some foods containing benzoic acid as a result of logistic regression. CONCLUSION: From the above results, it is suggested that the hippuric acid and o-cresol in urine be very useful for biological monitoring in the workers exposed to toluene. Moreover, the daily hippuric acid and o-cresol concentrations in urine are also important for toluene exposure assessment and the further study has to be conducted to find out the tendency of biological exposure indices for continuous toluene exposure.
Alcohol Drinking ; Benzoic Acid ; Eating ; Environmental Monitoring ; Logistic Models ; Physical Examination ; Shoes ; Smoke ; Smoking ; Toluene* ; Volunteers ; Surveys and Questionnaires

One of the important purposes in population pharmacokinetic studies is to investigate the relationships between parameters and covariates to describe parameter variability. The purpose of this study is to evaluate the model's ability to correctly detect the parameter-covariate relationship that can be observed in phase I clinical trials. Data were simulated from a two-compartment model with zero-order absorption and first-order elimination, which was built from valsartan's concentration data collected from a previously conducted study. With creatinine clearance (CLCR) being used as a covariate to be tested, 3 different significance levels of 0.001 Absorption ; Clinical Trials, Phase I as Topic* ; Creatinine ; Dataset ; Healthy Volunteers ; Hope

OBJECTIVES: We aimed to compare clinical outcomes, work status and total costs of care associated with typical and atypical treatment in patients with schizophrenia. METHODS: Cost data for services and prescription use were retrieved retrospectively for 40 and 27 patients with schizophrenia who were initiated on typical or atypical antipsychotics after registration in 1994 and 2000, respectively. Each patient was followed for 3 year after initiation of therapy. Direct and indirect cost were calculated for both groups and analyzed by SAS 8.2. RESULTS: There was not significant difference in clinical outcomes between two groups except the number of admission was higher in typical antipsychotics group (p<0.05). As for direct cost, patients prescribed on atypical antipsychotics have paid almost two-fold more than typical groups. However, the proportion of unemployment was higher in typical group than in atypical group, leading to much loss of productivity. Therefore, considered offset by lower indirect costs, total costs per patients over the study were 19% higher in typical treatment group than in aytpical treatment group. CONCLUSIONS: Atypical antipsychotics were estimated to be of advantage over typical antipsychotics, by offsetting the big difference of medication cost between two classes.
Antipsychotic Agents* ; Efficiency ; Humans ; Prescriptions ; Retrospective Studies ; Schizophrenia* ; Unemployment

This report describes the first clinical case of a transfusion-associated Mycoplasma haemocanis infection in a dog in Korea. A 6-year-old male Maltese underwent a red blood cell transfusion for idiopathic immune-mediated hemolytic anemia. Eighteen days after the blood transfusion, the recipient’s packed cell volume decreased and basophilic organisms were found on erythrocytes. A polymerase chain reaction and sequential analysis showed that both the donor dog and recipient dog had M. haemocanis. Six weeks after doxycycline administration, no organisms were detected and the recipient’s anemia had improved.