The purpose of this study was to investigate the displacements of cast framework by torch soldering and electric soldering techniques. Specimen had two cylinders and connecting bar that had sectioned with 0.3mm gap at mid point. 10 of total specimens were divided into two groups. In torch soldered group, soldering investment block was made and conventional torch soldering procedure was carried out. In electric soldered group, electric soldering was carried out on the master cast without soldering investment block by using electric soldering machine(Dentapunkt DP 7, Kulzer, Germany). After soldering procedure, three dimensional coordinates of two centroids of each cylinder were measured by three dimensional coordinate measuring machine. The intercentroidal displacement and global displacement were calculated and then, these values were compared and evaluated. The results were obtained as follows: 1. Intercentroidal distances of specimens decreased after both soldering procedures, and the decrease in intercentroidal distance was greater for torch soldered group than for electric soldered group 2. Global displacements of torch soldered group were greater than those of electric soldered group
Investments

Background: The absence of effective antiviral medications and vaccines increased the focus on non-pharmaceutical preventive behaviors for mitigating against the coronavirus disease 2019 (COVID-19) pandemic. To examine the current status of non-pharmaceutical preventive behaviors practiced during the COVID-19 outbreak and factors affecting behavioral activities, we compared to the 2015 Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in Korea. Methods: This was a serial cross-sectional population-based study in Korea with four surveys conducted on June 2 and 25, 2015 (MERS-CoV surveys), and February 4, and April 2, 2020 (COVID-19 surveys). Of 25,711 participants selected using random digit dialing numbers, 4,011 participants (aged ≥ 18 years) were successfully interviewed, for the 2020 COVID-19 (n = 2,002) and 2015 MERS-CoV (n = 2,009) epidemics were included. Participants were selected post-stratification by sex, age, and province. The total number of weighted cases in this survey equaled the total number of unweighted cases at the national level. We measured the levels of preventive behaviors (social distancing [avoiding physical contact with others]), and practicing transmission-reducing behaviors such as wearing face mask and handwashing. Results: Between the surveys, respondents who reported practicing social distancing increased from 41.9%–58.2% (MERS-CoV) to 83.4%–92.3% (COVID-19). The response rate for the four surveys ranged between 13.7% and 17.7%. Practicing transmission-reducing behaviors (wearing face masks and handwashing) at least once during COVID-19 (78.8%, 80.2%) also increased compared to that during MERS-CoV (15.5%, 60.3%). The higher affective risk perception groups were more likely to practice transmission-reducing measures (adjusted odds ratio, 3.24–4.81; 95 confidence interval, 1.76–6.96) during both COVID-19 and MERS-CoV. Conclusion The study findings suggest markedly increased proportions of non-pharmaceutical behavioral practices evenly across all subgroups during the two different novel virus outbreaks in Korea. Strategic interventions are needed to attempt based on preventive behavior works.

PURPOSE: The most important step for patients who come to the emergency department with ureter stones is acute pain management. There have been insufficient studies on what factors affect acute pain management for ureteral colic the most. In this study, patients with ureteral colic were divided into two groups: one group, in which the pain was first managed with an analgesic, and another group with unmanaged pain, to find factors that most affect additive analgesics administration for ureter stones. METHODS: There were 121 patients, eventually confirmed for the presence of ureter stones through a computed tomography CT scan, included in this study. When ureter stones were suspected after the initial patient evaluation, initial pain was assessed through numerical rating scale (NRS) and the first analgesic was administered once. Pain was reassessed through NRS after 30 minutes. At that time, if the pain was managed, the patient was assigned to Group 1. If the pain persisted, another analgesic was administered for the second and third time, and the patient was assigned to Group 2. Finally, ureter stones were identified through CT scan. RESULTS: There were 58 patients (47.9%) in Group 1 and 63 patients (52.1%) in Group 2. There were no statistically significant differences in average age, serum creatinine, size of ureter stone, and severity of hematuria between the two groups. The differences in NRS measured initially and after 30 minutes were statistically significant (7.6+/-1.4 vs. 8.6+/-1.2, p<0.001; 1.4+/-1.3 vs. 6.6+/-1.9, p<0.001, respectively). The presence of hydronephrosis and perirenal edema were also statistically significant (p<0.001, p=0.007). The affecting factor for the administration of additive analgesics was hydronephrosis (odds ratio 7.213, p<0.001). CONCLUSION: Hydronephrosis is an important factor in the treatment of patients with additive analgesics. It can also be used as a predictive index to assess the severity of pain in patients with ureter stones.
Acute Pain ; Analgesics ; Creatinine ; Edema ; Emergencies ; Hematuria ; Humans ; Hydronephrosis ; Renal Colic ; Ureter ; Urolithiasis

PURPOSE: Alarm interventions are effective and safe treatments for nocturnal enuresis when compared with the other treatments. However, the rate of doctors prescribing enuresis alarms is quite low in Korea. This study evaluated the application conditions and treatment results of an enuresis alarm in children with enuresis in Korea. MATERIALS AND METHODS: 147 out of 316 patients who purchased an enuresis alarm through a alarm sales agency in Korea were evaluated retrospectively. The questionnaire had two main categories: items of enuresis(number of episodes during the night, enuresis frequency during a week, etc.) and the items of the enuresis alarm(previous treatment history, a motivation of using enuresis alarm treatment, the period of using the enuresis alarm, initial success, continued success, dropout of using enuresis alarm, nocturia after treatment, etc.). RESULTS: A total 147 children participated in this study. The initial success rate was 30.6% whereas the continued success rate was 34.0%. In addition, the dropout rate was 27.2%. 46.2% of patients purchased the enuresis alarm with a doctor's prescription and 53.8% purchased the alarm without a prescription. Among the factors, the success and dropout rate were affected by only whether the patient visited the hospital. Thirty five patients who took combination therapy with medicine had a significantly lower initial success rate. CONCLUSIONS: In Korea, without a doctor's prescription, 53.7% patients attempt to treat enuresis alarm directly. The initial and continued success rate with the enuresis alarm was approximately 30% and the dropout rate was approximately 30%.
Child ; Commerce ; Enuresis ; Humans ; Korea ; Motivation ; Nocturia ; Nocturnal Enuresis ; Patient Dropouts ; Prescriptions ; Retrospective Studies

OBJECTIVES: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. METHODS: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. RESULTS: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. CONCLUSIONS: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.
Adult ; Aged ; Colorectal Neoplasms/*mortality/surgery ; Databases, Factual ; Female ; Hospital Mortality ; Hospitals, Teaching ; Humans ; Logistic Models ; Male ; Middle Aged ; Models, Psychological ; *Models, Theoretical ; Neoplasm Staging ; Odds Ratio ; Quality of Health Care ; Risk Adjustment

OBJECTIVE: There are currently limited treatment options for rheumatoid arthritis (RA) patients with chronic hepatitis B (CHB). In the process of pursuing further treatment strategies for this subgroup of patients, it is prudent to study what medications have been commonly prescribed, particularly for disease modifying anti-rheumatic agents (DMARDs) in Korea. METHODS: We analyzed the Korean National Health Insurance claims database (2007~2009) of RA patients through co-working with the Clinical Research Center for RA (CRCRA). Patients with CHB were defined by an algorithm including prescription information, blood tests, and the ICD-10 code. RESULTS: There were 8,677 CHB patients (3.8%) among 226,592 RA patients in the database. The age distribution or gender difference in CHB patients was comparable to the general RA population. Hydroxychloroquine was the most frequently (66.2%) prescribed DMARD. Thirty four percent of CHB patients had been prescribed with methotrexate (MTX) during the study period; most of them without concomitant anti-viral treatment. About 3% of RA patients with CHB were prescribed with TNF inhibitors. CONCLUSION: Apart from the published expert recommendations, MTX still seems to be one of the main DMARDs prescribed to Korean RA patients with CHB. This is most likely due to the lack of evidence-based, effective treatment strategies for this subgroup of patients.
Age Distribution ; Antirheumatic Agents ; Arthritis, Rheumatoid ; Hematologic Tests ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hydroxychloroquine ; International Classification of Diseases ; Methotrexate ; National Health Programs ; Prescriptions

OBJECTIVE: There are currently limited treatment options for rheumatoid arthritis (RA) patients with chronic hepatitis B (CHB). In the process of pursuing further treatment strategies for this subgroup of patients, it is prudent to study what medications have been commonly prescribed, particularly for disease modifying anti-rheumatic agents (DMARDs) in Korea. METHODS: We analyzed the Korean National Health Insurance claims database (2007~2009) of RA patients through co-working with the Clinical Research Center for RA (CRCRA). Patients with CHB were defined by an algorithm including prescription information, blood tests, and the ICD-10 code. RESULTS: There were 8,677 CHB patients (3.8%) among 226,592 RA patients in the database. The age distribution or gender difference in CHB patients was comparable to the general RA population. Hydroxychloroquine was the most frequently (66.2%) prescribed DMARD. Thirty four percent of CHB patients had been prescribed with methotrexate (MTX) during the study period; most of them without concomitant anti-viral treatment. About 3% of RA patients with CHB were prescribed with TNF inhibitors. CONCLUSION: Apart from the published expert recommendations, MTX still seems to be one of the main DMARDs prescribed to Korean RA patients with CHB. This is most likely due to the lack of evidence-based, effective treatment strategies for this subgroup of patients.
Age Distribution ; Antirheumatic Agents ; Arthritis, Rheumatoid ; Hematologic Tests ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hydroxychloroquine ; International Classification of Diseases ; Methotrexate ; National Health Programs ; Prescriptions

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

Aortic rupture caused by migration of a clavicular pin is a rare complication sometimes seen after clavicular fracture. There are many reviews of the complications of pin migration following surgery on the shoulder girdle. It is uncommon, though, for clavicular pin migration to result in aortic rupture and a subsequent cardiac tamponade. This unusual injury can be presented as acute shock symptoms after the previous pinning operation of a clavicle fracture, and it manifests characteristics that can be detected through computed tomography (CT) and focused by abdominal sonography for trauma (FAST). We report a case in which a patient suffered an aortic rupture induced cardiac tamponade caused by clavicular pin migration following surgery for a clavicular midshaft fracture.
Aortic Rupture ; Bone Wires ; Cardiac Tamponade* ; Clavicle* ; Emergencies* ; Emergency Service, Hospital* ; Fracture Fixation ; Humans ; Shock ; Shoulder

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.
Benchmarking ; Hospitals ; Humans ; *National Health Programs ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration ; Republic of Korea