A Comparison of Management Conditions in Japan's Dental Clinics and Medical Clinics

In recent years, national medical expenditures have continued to increase in Japan, and have now reached 39 trillion yen. In contrast, dental clinic expenditures have been slow to grow over the past few years, totaling 2.7132 trillion yen. At the same time, the number of dentists continues to increase, with a total of 102,551 dentists in 2012, surpassing the 100,544 physicians at medical clinics. Objective: Given this, we compared management conditions at dental clinics and medical clinics over time to determine whether management conditions of dental clinics are really as harsh as often claimed. Methods: we used the relevant data provided in the Central Social Insurance Medical Council's Survey on Economic Conditions in Health Care for statistics, which depicts management conditions at clinics, and analyzed the causes. Results: Annual fluctuations in the revenue/expense gap (revenue less expense) show that the gap for dentists far undercut that for physicians at medical clinics. The main reason for this decline in revenue is that the number of dental patients declined more that the unit price rose compared to the medical clinic. Conclusion: We determined that management conditions are harsh for dental clinics.DOI: 10.14693/jdi.v22i2.50

Clinical Study on Plasma Fibronectin Level and Cellular Fibronectin Localization in Gastric Cancer

Plasma fibronectin (pFN) in patients with gastric cancer was measured by ELISA method in the aspect of clinical significance. And also cellular fibronectin (cFN) was detected by means of immunochemical staining to clarify the localization of the basal membran and stroma. pFN was a significantly reduced in patients with gastric cancer and hepatocelllular carcinoma. In the postoperative course, a peak reduction was observed on day 1 and recovery was retarded in patients with gastric cancer. It was ascertained in this study that pFN indicated the patient\u27s nutritional states and also reflected the function of the reticuloendothelial system. A few carcinomas showed discontinuous staining on the surface in some of papillary adenocarcinomas, well differentiated and moderately differentiated carcinomas and on the basement membrane of metastatic lymphnodes. It is certified that cFN localization correlated well with local invasion and node metastasis, and there was nothing to show cFN localization at the sites of deep invasion and involved lumen of lymph vessels

New Casemix Classification as an Alternative Method for Budget Allocation in Thai Oral Healthcare Service: A Pilot Study

This study aimed to develop a new casemix classification system as an alternative method for the budget allocation of oral healthcare service (OHCS). Initially, the International Statistical of Diseases and Related Health Problem, 10th revision, Thai Modification (ICD-10-TM) related to OHCS was used for developing the software “Grouper”. This model was designed to allow the translation of dental procedures into eight-digit codes. Multiple regression analysis was used to analyze the relationship between the factors used for developing the model and the resource consumption. Furthermore, the coefficient of variance, reduction in variance, and relative weight (RW) were applied to test the validity. The results demonstrated that 1,624 OHCS classifications, according to the diagnoses and the procedures performed, showed high homogeneity within groups and heterogeneity between groups. Moreover, the RW of the OHCS could be used to predict and control the production costs. In conclusion, this new OHCS casemix classification has a potential use in a global decision making

Action and Function of ASB Proteins in Compartment Size Regulation

One of the most important and defining processes during development is the pattern formation of the various compartments in embryos. In an effort to discover the participants involved in regulating compartment size, we identified, in Danio rerio (zebrafish) embryos, the ankyrin repeat and SOCS box-containing protein 11 (d-asb11) gene. We first showed that d-Asb11 is a key mediator of Delta-Notch Signaling, acting at the level of DeltaA ubiquitylation, important in fine-tuning the lateral inhibition gradients between DeltaA and Notch. We, then, isolated a zebrafish having a germline deletion of the d-Asb11 cullin box subdomain and showed that this deletion resulted in loss of d-Asb11 activity. As a consequence, the animals were defective for Notch signaling and proper cell fate specification within the neurogenic regions of zebrafish embryos. We also provided evidence that d-Asb11 is important in maintaining myogenic proliferation in the stem cell compartment of zebrafish embryos and muscle regenerative responses in adult animals. This finding is supported by the highly specific d-Asb11 expression found in proliferating satellite cells in zebrafish muscle. In addition, we have applied immunoaffinity chromatograpy followed by tandem mass spectrometry to identify human ASB11 interacting proteins. The data confirmed the role of ASB11 as a subs