Hourly wages of physicians within medical fees based on the Korean relative value unit system

Background/Aims@#It is difficult to reach a social agreement on the appropriatelevel of compensation for professionals. This study was performed to examine thephysician fee embedded in the relative value unit (RVU) system in comparisonwith the Korean hourly minimum wage. @*Methods@#The Health Insurance Service Price and the Korean Classification ofProcedural Terminology were used to obtain the hourly wages of physicians fordesignated health care services. In addition, the physician fee schedule at theUnited States Centers for Medicare and Medicaid Services and the Organisationfor Economic Co-operation and Development (OECD) report on minimal wagewere used. Health care service fees were selected based on laboratory, pathology,imaging, and procedure codes as well as examination fees. For calculation of physicianlabor costs per hour, physician workload × conversion factor was divided bythe time involved. To calculate the proportion of physician labor fee in the totalfee, the physician workload RVU for each service fee was divided by the total RVU. @*Results@#A total of 27 physician fee codes were selected. Compared to the Koreanhourly minimum wage in 2015, the average physician wages were greater by 2.80-fold for primary care and by 3.05-fold for tertiary care. The mean proportion ofphysician labor cost in the total cost was 0.19, which was significantly lower thanthat of corresponding procedures in the United States RVU (mean, 0.48). @*Conclusions@#The average Korean physician wages compared to the hourly minimumwage were disproportionately low compared to the USA and other referenceOECD countries.

Development and Application of an Education Program for Healthy Dietary Life for Elementary School Aftercare Class Children / 대한지역사회영양학회지

OBJECTIVES: This study aimed to develop a school-centered healthy eating environment for children in elementary care classrooms and prevent incorrect eating habits and obesity through the development and application of standardized healthy eating habit-forming educational materials.METHODS: Ten schools in eight districts of Gyeonggi-do and 400 students from 19 care classes were selected. Based on the developed educational materials, the program was applied to students once in two weeks. ‘Notices for Parents’ forms were also sent to the students' home to educate their parents. Pre and post-surveys were conducted to evaluate the effectiveness of the education. The pre-education, education, and aftercare were conducted from September 28 to September 31, 2016, from October 3 to November 30, 2016, and from December 5 to December 9, 2016, respectively.RESULTS: The healthy eating program for elementary care classes was designed to develop a school-centered healthy eating environment and provide standardized educational material for healthy eating habits. Twelve educational topics were developed: 〈Eat Evenly〉, 〈Eat Breakfast〉, 〈Eat vegetables and Fruits〉, 〈Clean Body, Strong Body〉, 〈Healthy and Tasty Snacks〉, 〈Keep Healthy Weight〉, 〈Food that enters our body〉, 〈What is safe food?〉, 〈Food selection and Storage〉, 〈Our land, Our grain〉, 〈Enjoy Traditional Food〉, and 〈Food manners〉. Moreover, the materials were produced in four forms: for students, for after school caring teachers, for external specialists, and for parents. The effectiveness evaluation was conducted to confirm the application of the program. The average eating habits score was 3.3 ± 0.6, with no significant difference between before and after application. The score of overall satisfaction of the education was 3.9 ± 0.9. The most satisfying content was ‘Did you get to know how to eat evenly?’. Significant increases were observed in two contents for parents regarding their children's knowledge changes after the education: ‘Five nutrients needed for growing children’ and ‘Knowing sugar foods and sugar-containing foods’. On the other hand, their educational satisfaction was 3.6 ± 0.6, which was lower than the children's satisfaction. This might be because their education was conducted only through the ‘Notices for Parents’ form.CONCLUSIONS: In the long term, the healthy eating habit-formation education for lower elementary school children is expected to be beneficial. To prevent obesity and establish healthy eating habits of children, it is important to develop healthy eating education programs centered on elementary school aftercare classes, including the development of educational materials and an application system through connection with the home and community.

A Case of Septic Shock caused by Achromobacter xylosoxidans in an Immunocompetent Female Patient after Extracorporeal Shock Wave Lithotripsy for a Ureteral Stone / 감염과화학요법

Achromobacter xylosoxidans can cause various types of infections, but its infection in humans is rare. A. xylosoxidans has been reported as a rare etiological agent of infections including primary bacteremia, catheter-related bloodstream infection, endocarditis, otitis, and pneumonia, particularly in immunocompromised hosts. We encountered a case of septic shock caused by A. xylosoxidans in a 52-year-old, immunocompetent woman with no underlying disease, who received extracorporeal shock wave lithotripsy to remove a left upper ureteral stone. She was treated with antibiotics to which the organism was susceptible but died as a result of septic shock.

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases / 대한소화기학회지

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.

Diabetic Ketoacidosis with Spontaneous Pneumomediastinum: A Case Report / 임상당뇨병

Spontaneous pneumomediastinum (SPM) is defined as the presence of extraluminal gas in the mediastinal space without any clear traumatic cause. It has been reported in association with asthma exacerbation, emesis, childbirth, seizure, excessive shouting, drug inhalation and diabetic ketoacidosis (DKA). SPM complicated by DKA is infrequently accompanied with chest pain and DKA can lead to changes in respiratory rate and depth; this complication might be underestimated. Here, we report a 21-year-old male with throat pain on swallowing due to SPM complicated by DKA. Clinicians need to consider this complication in differential diagnoses.

Surgically assisted rapid palatal expansion with tent screws and a custom-made palatal expander: a case report / 대한악안면성형재건외과학회지

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

Three-dimensional cone-beam computed tomography based comparison of condylar position and morphology according to the vertical skeletal pattern / 대한치과교정학회지

OBJECTIVE: To compare condylar position and morphology among different vertical skeletal patterns. METHODS: Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. RESULTS: The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. CONCLUSIONS: Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.

Three-dimensional cone-beam computed tomography based comparison of condylar position and morphology according to the vertical skeletal pattern / 대한치과교정학회지

OBJECTIVE: To compare condylar position and morphology among different vertical skeletal patterns. METHODS: Diagnostic cone-beam computed tomography images of 60 adult patients (120 temporomandibular joints) who visited the orthodontic clinic of Hallym University Sacred Heart Hospital were reviewed. The subjects were divided into three equal groups according to the mandibular plane angle: hypodivergent, normodivergent, and hyperdivergent groups. Morphology of the condyle and mandibular fossa and condylar position were compared among the groups. RESULTS: The hypodivergent and hyperdivergent groups showed significant differences in superior joint spaces, antero-posterior condyle width, medio-lateral condyle width, condyle head angle, and condylar shapes. CONCLUSIONS: Condylar position and morphology vary according to vertical facial morphology. This relationship should be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.

A Case of Primary Leiomyosarcoma of the Femur / 대한내과학회지

Primary leiomyosarcoma rarely occurs in bone; when it occurs, it is more frequent in middle-aged individuals and frequently metastasizes to the lung. Here, we report a case of primary leiomyosarcoma of the femur in a 47-year-old woman who complained of pain in the left hip. The plain x-ray revealed an osteolytic lesion in the greater trochanter of the femur. The histopathological and immunohistochemical evaluation revealed a moderately differentiated leiomyosarcoma. Computed tomography of the chest and abdomen revealed no other potential primary lesions. The patient was diagnosed with primary leiomyosarcoma of the bone. Although surgical removal was recommended, the patient refused surgery. As an alternative, she was given radiotherapy and chemotherapy. No local progression or distant metastasis has been observed during the 4-year follow-up period.

The effect of bonded resin surface area on the detachment force of lingual bonded fixed retainers: An in vitro study / 대한치과교정학회지

OBJECTIVE: The aims of this study were to evaluate the relationship between the detachment force and bonding resin surface are and to determine the resin bonding surface area that would provide adequate bonding strength with minimum resin volume. METHODS: One hundred and sixty human premolars were randomly divided into 4 groups of 40 teeth each. The diameter of the resin surface area in each group was as follows: group 1, 1.5 mm; group 2, 2.5 mm; group 3, 3.5 mm; and group 4, 4.5 mm. Respond Dead Soft straight (length 0.0175 inch) was used to fabricate the retainers, and Transbond(TM) XT was used to fix the retainers to the tooth surfaces. A pair of teeth was embedded in acrylic blocks for each specimen. Thus, each group comprised 20 samples. Fixed retainers were bonded to the teeth, and vertical force was applied at the middle of wire. The force was measured using a universal testing machine. RESULTS: The mean value of detachment force was the highest for group 4 (102.38 +/- 2.92 N), followed by group 3 (63.54 +/- 2.21 N), group 2 (51.95 +/- 1.61 N), and group 1 (24.14 +/- 1.38 N). CONCLUSIONS: The detachment force of lingual fixed retainers was significantly affected as the area of the resin bonding surface increased. Considering the minimum bonding strength of brackets, a resin bonding surface area with a diameter of 3.5 mm would provide adequate bonding strength.