Background: Transportation costs can be a barrier to healthcare services, especially for low-income, disabled, elderly, and geographically isolated populations. This study aimed to estimate the transportation costs of healthcare service utilization and related influencing factors in Korea in 2016. Methods: Transportation costs were calculated using data from the 2016 Korea Health Panel Study. A total of 14,845 participants were included (males, 45.07%; females, 54.93%), among which 2,148 participants used inpatient and 14,787 used outpatient care services.Transportation costs were estimated by healthcare types, transportation modes, and all disease and injury groups that caused healthcare service utilization. The influencing factors of higher transportation costs were analyzed using multivariable regression analysis. Results: In 2016, the average transportation costs were United States dollars (USD) 43.70 (purchasing power parity [PPP], USD 32.35) per year and USD 27.67 (PPP, USD 20.48) per visit for inpatient care; for outpatient case, costs were USD 41.43 (PPP, USD 30.67) per year and USD 2.09 (PPP, USD 1.55) per visit. Among disease and injury groups, those with neoplasms incurred the highest transportation costs of USD 9.73 (PPP, USD 7.20). Both inpatient and outpatient annual transportation costs were higher among severely disabled individuals (inpatient, +USD 44.71; outpatient, +USD 23.73) and rural residents (inpatient, +USD 20.40; outpatient, +USD 28.66). Transportation costs per healthcare visit were influenced by healthcare coverage and residential area. Sex, age, and income were influencing factors of higher transportation costs for outpatient care. Conclusion Transportation cost burden was especially high among those with major noncommunicable diseases (e.g., cancer) or living in rural areas, as well as elderly, severely disabled, and low-income populations. Thus, there is a need to address the socioeconomic disparities related to healthcare transportation costs in Korea by implementing targeted interventions in populations with restricted access to healthcare.

No abstract available.
Foreign Bodies* ; Granuloma, Foreign-Body* ; Lipectomy*

An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.
Animals ; Cardiomyopathy, Hypertrophic* ; Child ; Diagnostic Imaging ; Dogs* ; Female ; Heart Murmurs ; Humans ; Hypertension, Pulmonary ; Hypertrophy ; Hypertrophy, Right Ventricular ; Myocardial Infarction ; Pulmonary Valve Stenosis

PURPOSE: The purpose of this study was to suggest agenda priorities for nursing service R&D (Research and Development) related policies development. METHODS: Two steps in developing the agendas and priorities were performed in this descriptive study. First, nursing service R&D agendas were extracted through needs assessment of nursing researchers and practitioners. Then, the priority of agendas was set by Analytic Hierarchy Process by ten experts who were representatives of nursing and other healthcare professionals. RESULTS: Six core areas and forty-six nursing service R&D agendas were developed. The priority of agendas was different according to the evaluation criteria depending on weight value of nursing services. CONCLUSION: In order to select and promote nursing service R&D projects within national healthcare policy, nursing service R&D policy should be proposed with consideration to the importance of the criteria in reflecting characteristics of nursing care. By strengthening R&D capabilities for quality improvement and sensitive awareness of national directions for healthcare R&D policies, nursing service R&D can be appropriately promoted.
Delivery of Health Care ; Needs Assessment ; Nursing ; Nursing Care ; Nursing Research ; Nursing Services* ; Quality Improvement

The retinal degeneration resulting from elevated intraocular pressure was evaluated through functional and morphological analyses, for better understanding of the pathophysiology of glaucoma. Ocular hypertension was induced via unilateral episcleral venous cauterization in rats. Experimental time was set at 1 and 3 days, and 1, 2, 4, and 8 weeks post-operation. Retinal function was analyzed using electroretinography. For morphological analysis, retinal tissues were processed for immunochemistry by using antibodies against the calcium-sensing receptor and calcium-binding proteins. Apoptosis was analyzed using the TUNEL method and electron microscopy. Amplitudes of a- and b-wave in scotopic and photopic responses were found to be reduced in all glaucomatous retinas. Photopic negative response for ganglion cell function significantly reduced from 1-day and more significantly reduced in 2-week glaucoma. Calcium-sensing receptor immunoreactivity in ganglion cells remarkably reduced at 8 weeks; conversely, protein amounts increased significantly. Calcium-binding proteins immunoreactivity in amacrine cells clearly reduced at 8 weeks, despite of uneven changes in protein amounts. Apoptosis appeared in both photoreceptors and ganglion cells in 8-week glaucomatous retina. Apoptotic feature of photoreceptors was typical, whereas that of ganglion cells was necrotic in nature. These findings suggest that elevated intraocular pressure affects the sensitivity of photoreceptors and retinal ganglion cells, and leads to apoptotic death. The calcium-sensing receptor may be a useful detector for alteration of extracellular calcium levels surrounding the ganglion cells.
Amacrine Cells ; Animals ; Antibodies ; Apoptosis ; Calcium ; Calcium-Binding Proteins ; Cautery ; Electroretinography ; Ganglion Cysts ; Glaucoma ; Immunochemistry ; In Situ Nick-End Labeling ; Intraocular Pressure ; Methods ; Microscopy, Electron ; Ocular Hypertension ; Rats ; Receptors, Calcium-Sensing ; Retina ; Retinal Degeneration ; Retinal Ganglion Cells ; Retinaldehyde

The purpose of this study was to investigate the application of various electroretinography (ERG) to the diagnosis of inner retinal dysfunction induced by mild intraocular pressure (IOP) elevation in a rat glaucoma model. For inner retinal function measurements, available photopic ERG protocols were applied under various light conditions including monochromatic combinations, which complement conventional scotopic ERG. Three episcleral veins in the right eyes of Sprague-Dawley rats were cauterized to induce an experimental model of glaucoma, leading to mild IOP elevation. ERG responses were measured before surgery and at 1, 2, 4, and 8 weeks after cauterization. We first confirmed that the amplitude reduction in the standard photopic b-wave was almost comparable to the amplitudes of scotopic a- and b-waves in glaucomatous eyes over time. We have implemented additional photopic ERG protocols under different stimulus conditions, which consisted of a longer duration and different monochromatic combinations. Such a change in the stimulations resulted in more pronounced differences in response between the two groups. Especially in normal animals, blue stimulation on a green background produced the largest b-wave and photopic negative response (PhNR) amplitudes and caused more pronounced oscillatory potential (OP) wavelets (individual components). In glaucomatous eyes, blue stimulation on a green background significantly reduced PhNR amplitudes and abolished the robust OP components. These results, by providing the usefulness of blue on green combination, suggest the applicable photopic ERG protocol that complements the conventional ERG methods of accessing the progression of glaucomatous damage in the rat retina.
Animals ; Cautery ; Complement System Proteins ; Diagnosis ; Electroretinography ; Glaucoma* ; Intraocular Pressure ; Models, Theoretical ; Rats* ; Rats, Sprague-Dawley ; Retina* ; Retinaldehyde ; Veins

Emphysematous pyelitis is uniquely characterized by gas-forming infection restricted to the renal collecting system. This disease entity is uncommon, and shows preferred occurrence in patients with diabetes mellitus or urinary tract obstruction. We report a case of bilateral emphysematous pyelitis in a diabetic end-stage renal disease patient undergoing peritoneal dialysis therapy. The patient was treated by medical treatment only and then recovered from infection, and she has maintained peritoneal dialysis until today. The authors report this case as a successful medical treatment for emphysematous pyelitis accompanying multiple risk factors, such as diabetes mellitus, amorphous medullary kidney stones, and even underlying maintaining peritoneal dialysis.
Diabetes Mellitus ; Humans ; Kidney Calculi ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Pyelitis ; Risk Factors ; Urinary Tract

STATEMENT OF PROBLEM: The titanium has advantages of a high biocompatibility, a corrosion resistence, low density, and cheep price, so it is focused as a substituted alloy. But it is quite difficult to cast with the tranditional method due to the high melting point, reacivity with element at elevated temperature. By using the CAD-CAM system for the crown construction, it is possible to reduce the errors while proceeding the wax-up, investing, and casting procedure. PURPOSE: The purposes of this study were to measure the marginal adaptation of the casting titanium coping and machine-milled titanium coping according to the casting methods and the marginal configurations. MATERIAL AND METHOD: The marginal configurations were used chamfer, shoulder,and beveled shoulder. The total 30 copings were used, and these are divided into 6 groups according to the manufacturing method and marginal configuration. The gap between margin of the model and the restoration was measured with 3-dimensional measuring microscope. RESULTS: The following results were obtained; 1. casting gold coping demonstrated the best marginal seal, followed by casting titanium coping finally machine-milled titanium copings. 2. In casting titanium coping, chamfer demonstrated the best marginal seal, followed by shoulder and beveled shoulder. There was no significantly difference in shoulder and beveled shoulder. But all margin form has clinically acceptable 3. In machine-milled titanium copings, chamfer demonstrated the best marginal seal, followed by shoulder and beveled shoulder. Beveled shoulder show large and uneven marginal gap. CONCLUSIONS: Above result revealed that marginal adaptation of the titanim coping is available in the clinical range, it can be used as an alternative metal and it is prefered especially in chamfer or shoulder margin during implant superstructure fabrication. But there should be more research on machine-milled titanium in order to use it in the clinics.
Alloys ; Computer-Aided Design ; Corrosion ; Crowns ; Freezing ; Shoulder ; Titanium*

STATEMENT OF PROBLEM: The titanium has advantages of a high biocompatibility, a corrosion resistence, low density, and cheep price, so it is focused as a substituted alloy. But it is quite difficult to cast with the tranditional method due to the high melting point, reacivity with element at elevated temperature. By using the CAD-CAM system for the crown construction, it is possible to reduce the errors while proceeding the wax-up, investing, and casting procedure. PURPOSE: The purposes of this study were to measure the marginal adaptation of the casting titanium coping and machine-milled titanium coping according to the casting methods and the marginal configurations. MATERIAL AND METHOD: The marginal configurations were used chamfer, shoulder,and beveled shoulder. The total 30 copings were used, and these are divided into 6 groups according to the manufacturing method and marginal configuration. The gap between margin of the model and the restoration was measured with 3-dimensional measuring microscope. RESULTS: The following results were obtained; 1. casting gold coping demonstrated the best marginal seal, followed by casting titanium coping finally machine-milled titanium copings. 2. In casting titanium coping, chamfer demonstrated the best marginal seal, followed by shoulder and beveled shoulder. There was no significantly difference in shoulder and beveled shoulder. But all margin form has clinically acceptable 3. In machine-milled titanium copings, chamfer demonstrated the best marginal seal, followed by shoulder and beveled shoulder. Beveled shoulder show large and uneven marginal gap. CONCLUSIONS: Above result revealed that marginal adaptation of the titanim coping is available in the clinical range, it can be used as an alternative metal and it is prefered especially in chamfer or shoulder margin during implant superstructure fabrication. But there should be more research on machine-milled titanium in order to use it in the clinics.
Alloys ; Computer-Aided Design ; Corrosion ; Crowns ; Freezing ; Shoulder ; Titanium*

A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.
Blister ; Bronchi ; Lung ; Stents ; Thoracic Surgery