Reimbursement of Digital Therapeutics: Future Perspectives in Korea

Digital health is rapidly growing worldwide and its area is expanding from wellness to treatment due to digital therapeutics (DTx). This study compared DTx in the Korean context with other countries to better understand its political and practical implications. DTx is generally the same internationally, often categorized as software as a medical device. It provides evidence-based therapeutic interventions for medical disabilities and diseases.Abroad, DTx support entailed state subsidies and fundraising and national health insurance coverage. In the case of national health insurance coverage, most cases were applied to mental diseases. Moreover, in Japan, DTx related to hypertension will possibly be under discussion for national health insurance coverage in 2022. In overseas countries, coverage was decided only when the clinical effects were equivalent to those provided by existing technology, and in the UK, real usage data for DTx and associated evaluations were reflected by national health coverage determination. Prices were either determined through closed negotiations with health insurance operating agencies and manufacturers or established based on existing technology. Concerning the current situation, DTx dealing with various diseases including hypertension are expected to be developed near in the future, and the demand for use and compensation will likely increase. Therefore, it is urgent to define and prepare for DTx, relevant support systems, and health insurance coverage listings. Several support systems must be considered, including government subsidies, science/technology funds, and health insurance.

Shear Bonding Strength of Three Cements Luted on Pediatric Zirconia Crowns and Dentin of Primary Teeth / 대한소아치과학회지

The aim of this study was to evaluate the shear bond strength of three luting cements and to identify the effect of thermocycling.Zirconia discs were made similar to the inner surface of a preformed pediatric zirconia crown (NuSmile® ZR crown: ZRCr). The similarity between the zirconia discs and the inner surface of a ZRCr was confirmed by scanning electron microscope. Three luting cements were Ketac™ Cem Permanent Glass Ionomer Luting Cement (KGI), RelyX™ Luting Plus Cement (RLP), RelyX™ Unicem Self-Adhesive Universal Resin Cement (RUR). Three luting cements were bonded according to the manufacturer's instructions for 60 zirconia discs and 60 dentin of primary teeth. Total of 120 specimens were divided into two subgroups: One was not aged, and the other was tested with 5500 thermocycling. Shear bond strength was measured using a universal testing machine, and the fracture patterns were observed with SEM.On the zirconia discs and the dentin of primary teeth, shear bond strength of RUR was higher than that of KGI and RLP, and there were statistically significant differences by cement type. The shear bond strength differences for RUR were not statistically significant depending on thermocycling.

Study of Bacteria Associated with Dental Caries Using a 3 Tone Disclosing Agent / 대한소아치과학회지

The aim of this study was to determine the efficacy of a 3 tone plaque disclosing gel in assessing the risk of caries related to the population of Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus spp. quantified using a quantitative real-time polymerase chain reaction (qRT-PCR).15 healthy children of ages 9 – 12 years were randomly examined. The 3 tone plaque disclosing gel was applied on teeth surfaces, which changed the color to pink or red, blue or purple and light blue. Plaque was divided into 3 groups based on staining. Genomic DNA from each sample was subjected to a qRT-PCR assay for quantitative detection of target bacteria. The Kruskal-Wallis test was conducted for correlation between the color of plaque and the number of bacterial species.The levels of S. mutans, S. sobrinus, and Lactobacillus spp. were significantly different in the plaque samples of the 3 groups (p < 0.05). The proportion of S. sobrinus to S. mutans showed correlation to the color of plaque.The different color-dyed plaque was related to the number of acidogenic bacteria. The 3 tone plaque disclosing gel could be used as one of the indicators to assess the clinical risk of caries associated with the population of S. mutans, S. sobrinus, and Lactobacillus spp.

Erratum Announcement: Ecological Factors Affecting School Adjustment of Low-Income Adolescents Attending Community Child Care Center (Child Health Nursing Research Vol. 23 No. 2. p. 158~167)

The author's affiliation should be corrected.

Ecological Factors Affecting School Adjustment of Low-Income Adolescents Attending Community Child Care Center

PURPOSE: The purpose of this study was to investigate the ecological factors influencing school adjustment of adolescents from low-income families. METHODS: Secondary data analysis was performed using data of 1,321 low-income adolescents in 123 regions found on the Survey on Service Satisfaction with Community Child Care Center. RESULTS: The results of multi-level analysis identified the factors influencing school adjustment of low-income adolescents as follows: individual-level factors were gender, grade in school, and emotional problem; an interpersonal-level factor was family structure; organizational-level factors were length of time attending center and satisfaction with the service of the center; community-level factors were region and perception of community. CONCLUSION: The results suggest that low-income adolescents' adjustment to school is influenced not only by individual factors but also by diverse environmental factors. Community factors suggest that more education support systems and leisure facilities for adolescents need to be built in small and medium cities. Strategies to enhance positive perception of community are also needed for this population. Further, it is necessary to develop multi-level interventions to improve the school adjustment of adolescents from vulnerable social groups.

A novel BTK gene mutation, c.82delC (p.Arg28 Alafs*5), in a Korean family with X-linked agammaglobulinemia / 소아과

X-linked agammaglobulinemia (XLA) is a hereditary humoral immunodeficiency that results from Bruton’s tyrosine kinase (BTK) gene mutations. These mutations cause defects in B-cell development, resulting in the virtual absence of these lymphocytes from the peripheral circulation. Consequently, this absence leads to a profound deficiency of lg all isotypes, and an increased susceptibility to encapsulated bacterial infections. A 15-month-old Korean boy presented with recurrent sinusitis and otitis media after 6 months of age, and had a family history of 2 maternal uncles with XLA. Laboratory tests revealed a profound deficiency of Ig isotypes, and a decreased count of CD19⁺ B cells in the peripheral circulation. Based on his family history and our laboratory test results, he was diagnosed with XLA. We performed BTK gene analysis of peripheral blood samples obtained from family members to confirm the diagnosis. Mutational analysis revealed a novel hemizygous frameshift mutation (c.82delC, p.Arg28Alafs*5), in the BTK gene. His mother and maternal grandmother were heterozygous carriers of this mutation and his two maternal uncles were hemizygous at the same position. After XLA diagnosis, intravenous immunoglobulin (400 mg/kg, monthly) treatment was initiated; recurrent sinusitis and otitis media were subsequently brought under control. To our knowledge, this is the first reported case of a Korean pedigree with a novel mutation in the BTK gene.