1.An analysis on medical expenses of multidisciplinary cancer care under health insurance
Journal of the Korean Medical Association 2021;64(10):711-716
Cancer has been the leading cause of death in Korea for more than 40 years. As the aging population in the country increases, this trend is expected to continue. Cancer care is also being subdivided into specialties according to the development of medical technology. This division of care has made it difficult for a single physician to set up a complete cancer treatment plan. As a result, the call for multidisciplinary care has risen. Multidisciplinary cancer care allows physicians to share opinions and choose optimal patient treatment plans across multiple specialties. In August 2014, the Ministry of Health and Welfare designated a set number of approved multidisciplinary treatments and has included them under its health insurance coverage. As a result, multidisciplinary care is rapidly increasing.Current Concepts: An analysis on cancer care was conducted from 2014 to 2018, which examined the average medical expenses, hospitalization costs, and surgery costs per person according to therapeutic modality. Findings showed that multidisciplinary care decreased the overall cost of medical care in cancer patients compared to segmented care provided by single specialty physicians.Discussion and Conclusion: This study predicted that multidisciplinary care would be effective in reducing medical expenses. Cancer patients do not need to be treated by individual subspecialty physicians when personalized care treatment plans through a multidisciplinary approach is possible. The results of this study show that the Korean government should expand health insurance premium support and coverage for multidisciplinary cancer care.
2.The effect of 6% hydroxyethyl starch 130/0.4 preloading on the blood glucose levels in diabetic patients undergoing orthopedic surgery with spinal anesthesia: a randomized pilot study
Soo Yeon CHO ; Tae Hun AN ; Soo Bin SHIM ; Myungjin LEE ; Ki Tae JUNG
Anesthesia and Pain Medicine 2023;18(2):139-147
Background:
Perioperative hyperglycemia can occur in surgical patients and may increase postoperative morbidity and mortality, especially in patients with diabetes. Therefore, we conducted the present study to evaluate whether the administration of 6% hydroxyethyl starch (HES)-130/0.4 increases blood glucose levels in patients with diabetes.
Methods:
Forty patients undergoing lower limb surgery under spinal anesthesia were randomly allocated into two groups according to the fluids administered 20 min before spinal anesthesia (Group L, lactated Ringer’s solution; Group H, 6% HES-130/0.4). Patient characteristics, intraoperative variables, blood glucose levels, mean blood pressure (MBP), and heart rate (HR) were recorded at five time-points (0, 20, 60, 120, and 240 min).
Results:
A total of 39 patients were analyzed (Group L, n = 20; Group H, n = 19). The amount of intraoperative fluid was significantly higher in Group L than in Group H (718.2 ml vs. 530.0 ml, P = 0.010). There were no significant differences in the changes in blood glucose levels, HR, or MBP between the two groups (P = 0.737, P = 0.896, and P = 0.141, respectively). Serial changes in mean blood glucose levels from baseline also showed no significant differences between the groups (P = 0.764).
Conclusions
There were no significant changes in blood glucose levels when lactated Ringer’s solution or 6% HES-130 was used. When compared to the lactated Ringer’s solution, no evidence that 6% HES-130/0.4 produces hyperglycemia in diabetic patients could be found. Further evaluation of larger populations is needed.
3.Retrospective Clinical Study on the Survival Rate and the Evaluation of Marginal Bone Resorption on SNUCONE AF+II® Implants
Panjun KIM ; Myungjin JUNG ; Jihye JEONG ; Sungyu CHOI ; Sunghwi HUR ; Seulki LEE
Journal of Korean Dental Science 2020;13(1):1-10
Purpose:
This study analyzes the clinical results of SNUCONE AF+II® (SNUCONE Implant) implants placed in the edentulous region to determine the implant survival rate and the marginal bone healing pattern in the healing process.
Materials and Methods:
Two hundred forty implants placed in 131 patients with SNUCONE AF+II® implant system from January 1, 2014 to December 31, 2014 at Cheongju Hankook General Hospital were followed up for 5 years.Result: We evaluated 240 SNUCONE AF+II® implants of 131 patients from January 1, 2014 to December 31, 2014 at Cheongju Hankook General Hospital, and the results are as following: 1) Three implants were failed out of 240 implants of 131 patients and the survival rate was 98.75%. 2) The marginal bone resorption was 0.95±1.84 mm for 4 years after prosthesis placement, showing favorable result.
Conclusion
Although long-term cumulative evaluations and studies should be performed in the future, SNUCONE AF+II® implants show high cumulative survival and low marginal bone resorption according to the results of this study, which believed to give outstanding result in various dental implant procedure.
4.The Prevalence and Clinical Characteristics of Hepatitis-delta Infection in Korea.
Sook Hyang JEONG ; Jung Min KIM ; Heui June AHN ; Myung Joon PARK ; Kwang Hyun PAIK ; Won CHOI ; Jin KIM ; Chul Joo HAN ; Yoo Cheoul KIM ; Jhin Oh LEE ; Young Joon HONG ; Hyo Young PARK ; Ha Hyun JEONG ; Mi Yong YOON ; Myungjin LEE ; Kee Ho LEE
The Korean Journal of Hepatology 2005;11(1):43-50
BACKGROUND/AIMS: The prevalence of hepatitis delta virus (HDV) infection has been estimated as being approximately 5% among global HBsAg carriers. The anti-delta positive rate in Koreans had been reported as being 0.85% in 1985. While the prevalence of HBV has been decreased from nearly 10% to 5% during the past twenty years, there have been no more studies on the anti-delta prevalence in Koreans. The aim of this study was to estimate the anti-delta prevalence in Koreans and to study the clinical characteristics of anti-delta positive patients in a single center. METHODS: Serum anti-delta was measured in one hundred ninety four HBsAg-positive patients who were admitted to our hospital from February 2003 to August 2003. We checked the genotypes of the HBV in the anti-delta positive patients. The clinical features of the anti-delta positive patients were compared to those clinical features of the anti-delta negative patients from the aspect of age, gender, mode of transmission, the positivity of HBeAg and serum HBV DNA. RESULTS: Serum anti-delta was positive in seven patients among the 194 subjects, giving a 3.6% positive rate. Among these seven patients, six had hepatocellular carcinoma (HCC) and the other one had cholangiocarcinoma. All of the anti-delta positive patients had the C genotype of HBV. The anti-delta positive patients showed significantly suppressed HBV DNA replication compared to the anti-delta negative patients. CONCLUSIONS: In Koreans, anti-delta was positive mainly in HCC patients with an approximate prevalence of 4%, and this rate has not changed much for the past twenty years. HBV DNA replication was suppressed by HDV infection.
Adult
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Carcinoma, Hepatocellular/virology
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English Abstract
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Female
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Hepatitis Antibodies/analysis
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Hepatitis D/complications/*epidemiology/immunology
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Hepatitis Delta Virus/immunology
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Hepatitis delta Antigens/analysis
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Humans
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Korea/epidemiology
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Liver Neoplasms/virology
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Male
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Middle Aged
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Prevalence