This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6 86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 won in 1992 to 444,000 won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate in order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.
Health Care Costs ; Insurance ; Insurance Coverage ; Insurance, Health* ; Length of Stay ; Lenses, Intraocular*

Matrix metalloproteinases (MMPs) play an important role in the normal morphogenesis, maintenance, and repair of matrix and also have important functions in pathologic conditions characterized by excessive degradation of extracellular matrix, such as rheumatoid arthritis, osteoarthritis, periodontitis and in tumor invasion and metastasis. In this study, expression of MMP-1 and -2 mRNA in retrodiscal tissue of the temporomandibular joint (TMJ) was examined and compared with magnetic resonance imaging (MRI) and surgical findings. MMP mRNAs in the retrodiscal tissue samples were detected by reverse transcription - polymerase chain reaction. TMJ internal derangement (ID) was categorized as normal disc position, disc displacement with reduction, early stage of disc displacement without reduction (DDsR) and late stage of DDsR. TMJ osteoarthrosis (OA) was classified with normal, mild and advanced OA. The amount of synovial fluid collection was divided into not detected, small, large and extremely large amount on MR T2-weighted imaging. Perforation and adhesion were examined during open surgery of the TMJ. Six out of 37 samples were excluded because of little amount of extracted total mRNA. MMP-2 mRNA was detected whole joints, and so the MMP-2 mRNA seems to be expressed normally in retrodiscal tissue. However, MMP-1 mRNA was expressed in 8 of 31 joints. Frequencies of MMP-1 mRNA expression according to the TMJ IDs, amount of synovial fluid and surgical findings made no significant difference. MMP-1 mRNA was detected more frequently in OA groups (7/16 joints, 43.8%) than in normal bony structure group (1/15,joints, 6.7%). Expression of MMP-1 mRNA in retrodiscal tissue might be related with OA of the TMJ.
Arthritis, Rheumatoid ; Collagenases ; Extracellular Matrix ; Gelatinases ; Joints ; Magnetic Resonance Imaging ; Matrix Metalloproteinase 1* ; Matrix Metalloproteinases ; Morphogenesis ; Neoplasm Metastasis ; Osteoarthritis ; Periodontitis ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger* ; Synovial Fluid ; Temporomandibular Joint*

PURPOSE: To investigate the relationship between myopic progression and exodrift after surgery in patients with intermittent exotropia (X[T]). METHODS: Eighty-five patients who underwent bilateral lateral rectus recession for X(T) and had a follow-up of more than 1 year were recruited for the present study. Progression of myopia was determined by measuring the difference in spherical equivalent of both eyes between the initial and final refraction divided by the total follow-up time per patient. Postoperative exodrift was calculated by subtracting the deviation at postoperative 6 weeks from the deviation at the last follow-up, and the deviation at postoperative day 1 from the deviation at postoperative 6 weeks. Linear regression was conducted to determine the relationship between postoperative exodrift and myopic progression. The risk factors for recurrence, defined as exodeviation of 10 prism diopters or more at the final examination, were also analyzed. RESULTS: Sixty-eight (80.0%) subjects showed myopic progression of -0.50 diopters or more, and 47 (55.3%) had recurrence of exotropia during the mean follow-up period of 37.9 months. Patients with myopic progression showed more exotropic drift after postoperative 6 weeks than the patients without myopic progression (p < 0.01). Immediate postoperative overcorrection, oblique dysfunction, and a short follow-up period were associated with a low recurrence, whereas preoperative angle of exodeviation, sensory status, and age at the time of surgery were not. CONCLUSIONS: In patients who underwent bilateral lateral rectus recession for X(T), a greater myopic progression was related with greater postoperative exodrift. As the development of myopia was observed to be axial in nature, the results from the present study raises the possibility that ocular elongation may reduce the effect of recession.
Exotropia ; Eye ; Follow-Up Studies ; Humans ; Linear Models ; Myopia ; Recurrence ; Risk Factors

PURPOSE: This study was to investigate the relationships between spiritual well-being, attitude towards death and perception of hospice, and the factors influencing hospice perception of high school students. METHODS: A survey was conducted with 229 students in four high schools in B city from May 1, 2015 through May 31, 2015. The data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, stepwise multiple regression using the SPSS 18.0 program. This study was approved by the internal review board. RESULTS: The factors influencing hospice perception of the high school students were previous recognition of hospice (β=0.412, P<0.001), attitude towards death preparation among sub-variables of attitude towards death (β=-0.244, P<0.001), subjective school life satisfaction (β=-0.215, P<0.001), and sex (β=0.191, P<0.001). The more positive the attitude towards my body after death and that towards death preparation was, the more positive recognition for hospice was. The total explanatory power of these factors was 34.5%. CONCLUSION: To improve high school students' perception of hospice, it is necessary to provide them with a hospice education program to help them with their attitudes towards death preparation and their understanding of hospice.
Adolescent ; Attitude to Death ; Education ; Hospice Care ; Hospices* ; Humans ; Korea* ; Palliative Care* ; Spirituality

No abstract available.
Dopamine* ; Injections, Spinal*

No abstract available.
Dopamine* ; Injections, Spinal*

PURPOSE: This study examined the effectiveness of an adolescent school-based smoking prevention program. METHODS: The study was done with a nonequivalent control group pretest-posttest design. The subjects of the present study were 399 non-smoking high school students in Kyongbuk province. The subjects were divided into 184 experimental group members in G city who participated in a school-based smoking prevention program and 216 control group members in K city who did not participate. Data were collected from June to November 2011. collected data were analyzed using SPSS/WIN 18.0 through chi2-test, independent t-test and ANCOVA. RESULTS: The experimental group had significantly increased knowledge of smoking, knowledge of smoking prevention program, attitude of smoking, skill of smoking prevention in comparison to the control group. CONCLUSION: The school-based smoking prevention program delivered to non-smoking adolescents is an effective method of encouraging smoking prevention and can be utilized as an effective nursing intervention for non-smoking adolescents.
Adolescent ; Ecosystem ; Humans ; Smoke ; Smoking

OBJECTIVES: This study aimed to investigate the current status of infectious disease research in North Korea by analyzing recent trends in medical journals from North Korea in comparison with research from South Korea. METHODS: Three medical journals (Preventive Medicine, Basic Medicine, and Chosun Medicine) were analyzed from 2012 to 2016. Articles on tuberculosis (TB), malaria, and parasitic diseases were selected and classified by their subtopics and study areas. Two medical journals published in the South Korea were selected for a comparative analysis of research trends. RESULTS: Of the 2792 articles that were reviewed, 93 were extracted from North Korea journals. TB research in North Korea was largely focused on multi-drug resistant TB and extrapulmonary TB, whereas research in South Korea more frequently investigated non-tuberculous mycobacteria. Research on parasitic diseases in North Korea was focused on protozoan and intestinal nematodes, while the corresponding South Korea research investigated various species of parasites. Additionally, the studies conducted in North Korea were more likely to investigate the application of traditional medicine to diagnosis and treatment than those conducted in South Korea. CONCLUSIONS: This study presents an analysis of research trends in preventive medicine in North Korea focusing on infectious diseases, in which clear differences were observed between South and North Korea. Trends in research topics suggest a high prevalence of certain parasitic diseases in North Korea that are no longer widespread in South Korea. The large proportion of studies examining traditional medicine implies a lack of affordable medicine in North Korea.
Communicable Diseases* ; Democratic People's Republic of Korea* ; Diagnosis ; Korea ; Malaria ; Medicine, Traditional ; Parasites ; Parasitic Diseases ; Prevalence ; Preventive Medicine ; Tuberculosis

Bronchogenic cysts are rare congenital anomalies that are most frequently found in the mediastinum along the tracheobronchial tree, especially in the posterior aspect of the superior mediastinum. Bronchogenic cysts have also been reported in intrapulmonary, intrapericardial, abdominal, and retroperitoneal locations. Herein, we report a case of a retroperitoneal bronchogenic cyst in the presacral space. The patient was diagnosed based on a post-operative histopathological examination.

Fungal contamination of built-in furniture is a frequent problem in Korea when new apartment is built. However, domestic information on the contaminating fungi is very limited. This study was conducted to isolate, identify and characterize the fungi of the problem in one of the apartment houses where the fungi were claimed in the built-in furniture before the house owner moves in. Fungi present in the furniture installed in a main room, dress room, and kitchen side were visually and microscopically confirmed and purely isolated on PDA. The isolated fungi were identified by analyzing the morphological characteristics and nucleotide sequence of the ITS, calmodulin gene, and TEF-1α gene. Aspergillus creber, A. niger, A. pseudoglacus, A. ruber, Cladosporium perangustum and Penicillium commune were identified. Four out of the six fungal species were positive for at least one enzyme in six kinds of extracellular enzyme assays. When these four species (A. creber, A. niger, C. perangustum and P. commune) were inoculated onto four kinds of wood chips of furniture materials, they were able to colonize all of the wood chips. Their settlement was better at 95% humidity condition than at 30% humidity condition. Among the four species, C. perangustum caused the darkest discoloration and secreted the most number of extracellular enzymes. The four species were re-isolated from the colonized wood chips and confirmed as the problematic fungi in the built-in furniture.