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*

A multicenter post-marketing surveilance study has been conducted to evaluate the efficacy and safety of levocabastine eye drops(0.5mg/ml). Total 340 patients suffering from allergic conjunctivitis(96%) or other similar ophthalmic disorders were participated. Clinical symptoms(itching, hyperemia, tearing and chemosis) were assessed according to a four point scale before treatment and at every visit. Total symptom severity score before therapy, 6.67(N=340), was remarkably decreased to 3.28(N=252) at 1 week, and to 2.39(N=197) at 2 weeks. The physicians rated the application as `very effective` 1.5% of patients. Adverse reactions(10.3%) were limited to ocular irritation like stinging and burning sensation. These events were even lower in children(age< OR =14 yrs) and elderly(age> OR =65 yrs) showing 7.0% and 9.5% respectively. Patients with gepatic, renal impairment and hypertension did not experience any special adverse effects. The overall assessment by physicians showed that the application in 80.9% of the patients was evaluated above `useful`(i.e, `very useful`; 17.1%, `useful`; 63.8%, `slighty useful`; `7.1%). therefore, it was conclued that levocabastine eye drops is a a safe and effective treatment for allergic conjnctivitis and other similar ophthalmic disorders.
Bites and Stings ; Burns ; Humans ; Hyperemia ; Hypertension ; Ophthalmic Solutions ; Sensation

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: To investigate accommodation and progress of patients who showed myopia on manifest refraction in the early postoperative period after LASEK. METHODS: Forty-one eyes were included in the present study which had undergone LASEK surgery from February to March 2012. Seven eyes showed myopia over -0.25 D on manifest refraction at 1 month postoperatively, but showed decreased amount of myopia at 2 months postoperatively and were classified as group 1. The other 34 eyes were classified as group 2. The differences between cycloplegic and manifest refraction (CRSE-MRSE) were defined as the amount of latent accommodation and compared between the 2 groups. RESULTS: Amount of latent accommodation was 0.179 +/- 0.426 D in group 1 (7 eyes), 0.265 +/- 0.303 D in group 2 (34 eyes) preoperatively, 1.286 +/- 0.664 D in group 1, 0.368 +/- 0.536 D in group 2 at 1 month postoperatively, and 0.500 +/- 0.520 D in group 1, and 0.489 +/- 0.546 D in group 2 at 2 months postoperatively. The amount of latent accommodation in group 1 was significantly greater than that of group 2 one month postoperatively. As the amount of latent accommodation decreased, the amount of myopic shift decreased gradually over 2 months in group 1 after surgery. CONCLUSIONS: Transient myopic shift due to increased latent accommodation was observed in several patients one month postoperatively and the amount of myopic shift decreased with time without treatment. Thus, surgeons should consider cycloplegic refraction when planning treatment for patients with myopic regression.
Humans ; Keratectomy, Subepithelial, Laser-Assisted* ; Myopia ; Postoperative Period

No abstract available.
Erythrocyte Membrane* ; Erythrocytes* ; Hydroxyl Radical* ; Lipid Peroxidation* ; Macrophages, Alveolar* ; Mineral Fibers*

All the faculties at the prosthodontic department in Kyung Hee University Dental Hospital at Gangdong, have been implementing the Top-Down concept of treatment approach since 2006 in which the outcomes of the last prosthetic treatment are predicted in advance during the treatment planning stage of patients with dental tissue defects. Based on the Top-Down concept, this report is also an example of how the final prosthetic treatment was performed in advance before going into implant surgery for the missing teeth. Among the various methods of connecting implant fixture and restoration, the cement-retained method is relatively simple to manufacture restoration without being constrained by the angle of the implants placed, but difficult to remove remaining subgingival excess cement completely, and to detach it being when necessary. In the report, SB-locking method will be introduced which enables an aesthetic implant restoration without either a screw hole or residual excess cement.

Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P= 0.027). The overall satisfaction scores did not differ between the two groups (P= 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

BACKGROUND: Recently, the number of elderly patients with bacteremia has been increasing in the emergency room. Klebsiella pneumoniae is the second common agent of all gram negative bacteremia. We designed this study in order to describe the clinical characteristics and outcomes of elderly patients with K. pneumoniae bacteremia in the emergency room. METHODS: We retrospectively reviewed medical records of 109 patients infected with K. pneumoniae, who visited an emergency room of a tertiary hospital from March 2006 to October 2010. All patients were divided into two groups (83 survivors versus 26 nonsurvivors). We compared the outcomes and the clinical characteristics between the two groups. RESULTS: A total of 26 patients (23.9%) died in this study. There were no significant differences in age, sex, previous medical and surgical history between survivor and nonsurvivor groups. In the univariate logistic regression analysis, the significant favorable factors for survival associated with K. pneumoniae bacteremia were malignancy (odds ratio [OR], 0.311; p=0.018), Charlson comorbidity index (OR, 0.787; p=0.010), intensive care unit admission (OR, 0.260; p=0.032), mean arterial pressure (OR, 1.053; p=0.001), body temperature (OR, 2.250; p=0.001), blood urea nitrogen (OR, 0.969; p=0.002), albumin (OR, 6.739; p<0.001) and lactate (OR, 0.876; p=0.046). In a multiple logistic regression, the significant risk factors for predicting mortality were low body temperature (OR, 1.036; p=0.044) and low serum albumin (OR, 5.636; p=0.002) at the time of admission. CONCLUSION: Initial albumin level and body temperature were significant risk factors of mortality in elderly patients in the emergency room infected by K. pneumoniae bacteremia. Elderly patients with K. pneumoniae bacteremia in the emergency room should be carefully observed due to the high mortality rate.
Aged ; Arterial Pressure ; Bacteremia ; Blood Urea Nitrogen ; Body Temperature ; Comorbidity ; Emergencies ; Humans ; Intensive Care Units ; Klebsiella ; Klebsiella pneumoniae ; Lactic Acid ; Logistic Models ; Medical Records ; Pneumonia ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Survivors ; Tertiary Care Centers

BACKGROUND: It has been known that most of thyroid stimulating antibodies (TSAbs) may interact with epitopes near N-terminal, and thyroid stimulation blocking antibodies (TSBAbs) near C-terminal on the extracellular domain of TSH receptor. However, many authors have reported different results about epitopes reacting with TSH receptor autoantibody (TRAb). TSBAbs inhibit thyroid stimulation of TSH and TSAbs at the receptor level. However, it has been reported that there are some TSBAbs which bind to the other sites, not TSH receptor, or block post-reeeptor process. These findings raise the possibility that TRAbs may be heterogeneous according to the mechanism of action. In order to investigate the heterogeneity of TRAb, we undertook immuno-precipitation using synthetic peptides of TSH receptor and measured TRAb activities by FRTL-5 cells and chimeric CHO cells. METHODS: We studied 102 patients with autoimmune thyroid disease (Graves disease 32, Hashimotos thyroiditis 29, atrophic thyroiditis 41) and 35 healthy persons. Three synthetic peptide fragments of TSH receptor were used to perform immunoprecipitation with serum or IgG of patients and healthy persons, TSAb and TSBAb activities were measured by FRTL-5 cells and CHO cells transfected with wild-type and 2 mutant TSH receptor cDNA (Mc2, Mc1+2). Mc2 and Mcl+2 were rnade to substitute amino acid residues of 90-165, 8-165 of the TSH receptor with corresponding residues of LH/CG receptor, respectively. RESULTS: Two out of 10 IgGs extracted from Graves disease and 2 out of 9 IgGs from atrophic thyroiditis had specific bidings over 0.84% in immunoprecipitation with peptide I (amino acid residue 35-50). Four out of 18 IgGs from Graves disease, 9 out of 41 IgGs from atrophic thyroiditis, and 6 out of 14 IgGs from Hashimotos thyroiditis had specific bidings over 0.84% in immunoprecipitation with peptide II (amino acid residue 317-332). Only 2 out of 10 IgGs from Graves disease had specific bidings over 0.84% in immunoprecipitation with peptide III (amino acid residue 341-358). When 10 IgGs extracted from Graves disease were reacted with wild-type, Mc2, and Mcl+2 CHO cells, 7 IgGs in wild-type and 4 IgGs in Mc2 had positive for TSAb activities. In 10 IgGs from atrophic thyroiditis, 5 in wild-type, 5 in Mc2, and 3 in Mcl+2 CHO cells had positive for TSBAb activities. In Hashimoto's thyroiditis, only 1 with hyperthyroidism had positive for TSAb activity in wild-type and 1 with hypothyroidism had positive for TSBAb activities in both of wild-type and Mc2 CHO cells. Therefore, patients with Graves disease were divided into at least 3 groups according to the TSAb activities measured by wild-type, Mc2, Mcl+ 2 CHO cells and TBII activities. And patients with atrophic thyroiditis were divided into at least 4 groups according to the TBII activities, TSBAb activities by wild-type, Mc2, Mcl+2 CHO cells and FRTL-5 cells. CONCLUSION: From these results, epitopes of TSH receptor reacting with TSAb or TSBAb in autoimmune thyroid disease may be scattered in the TSH receptor, although epitopes of TSAb tend to be near N-terminal and those of TSBAb near C-terminal. Graves disease or atrophic thyroiditis were divided into 3 or 4 groups according to the TBII and TRAb activities. Therefore, TRAb detected in autoimmune thyroid disease may be heterogenous.
Animals ; Antibodies, Blocking ; Autoantibodies* ; CHO Cells ; Cricetinae ; DNA, Complementary ; Epitopes ; Graves Disease ; Humans ; Hyperthyroidism ; Hypothyroidism ; Immunoglobulin G ; Immunoglobulins, Thyroid-Stimulating ; Immunoprecipitation ; Peptide Fragments ; Peptides ; Population Characteristics* ; Receptors, Thyrotropin* ; Thyroid Diseases* ; Thyroid Gland* ; Thyroiditis