Comparison of Services for Autism Spectrum Disorder in Massachusetts with Those in Seoul

BACKGROUND: This article intended to identify and describe areas in need of services and interventions for individuals with autism spectrum disorder (ASD) and their families in Seoul, Korea. METHODS: A descriptive comparison was made between available services and interventions in Seoul, Korea and Massachusetts, USA. Relevant information was obtained through sending phone/email inquiries to the governments and organizations, visiting their official websites, and searching for published articles or reports. RESULTS: In a few areas such as level of education, economy, and general quality of healthcare, Seoul was found to be similar to Massachusetts. However, in terms of services and interventions for individuals with ASD and their families, especially early identification and intervention, special education, care coordination, school-based programs, and transition to adulthood, Massachusetts was shown to have far more availability. CONCLUSION: The limited availability of services and interventions for individuals with ASD and their families in Seoul in comparison to Massachusetts, underlines target areas for further investment and development.

Musculoskeletal Disorders in Northeast Lobstermen

BACKGROUND: The objective of this study was to report on the prevalence of musculoskeletal pain in lobstermen in the northeast USA. METHODS: Crews were randomly selected from those licensed to fish in Maine and Massachusetts and followed prospectively. The survey used a Nordic Musculoskeletal Questionnaire format to characterize musculoskeletal disorders. RESULTS: A total of 395 individuals participated. One half of the respondents reported low back pain. Back pain was attributed to or exacerbated by lobstering. Low back pain was prevalent among both captains and sternmen, while sternmen reported more hand/wrist pain than captains. Multiple locations for pain were common in individual participants. CONCLUSION: Equipment or technology to assist material handling should be a priority, as the body segments with high prevalence of pain (back, hand/wrists, shoulders, knees) are all affected by the repetitive and forceful handling of the lobster traps.

Pretreatment with remifentanil protects against the reduced-intestinal contractility related to the ischemia and reperfusion injury in rat / Pré-tratamento com remifentanil protege contra a redução da contratilidade intestinal relacionada à lesão de isquemia e reperfusão em ratos

BACKGROUND AND OBJECTIVES: Serious functional and structural alterations of gastrointestinal tract are observed in failure of blood supply, leading to gastrointestinal dismotility. Activation of opioid receptors provides cardioprotective effect against ischemia-reperfusion (I/R) injury. The aim of the present study was to determine whether or not remifentanil could reduce I/R injury of small intestine. METHODS: Male Wistar Albino rats were subjected to mesenteric ischemia (30 min) followed by reperfusion (3 h). Four groups were designed: sham control; remifentanil alone; I/R control; and remifentanil + I/R. Animals in remifentanil + I/R group were subjected to infusion of remifentanil (2 ug kg-1 min-1) for 60 min, half of which started before inducing ischemia. Collecting the ileum tissues, evaluation of damage was based on contractile responses to carbachol, levels of lipid peroxidation and neutrophil infiltration, and observation of histopathological features in intestinal tissue. RESULTS: Following reperfusion, a significant decrease in carbachol-induced contractile response, a remarkable increase in both lipid peroxidation and neutrophil infiltration, and a significant injury in mucosa were observed. An average contractile response of remifentanil + I/R group was significantly different from that of the I/R group. Lipid peroxidation and neutrophil infiltration were also significantly suppressed by the treatment. The tissue samples of the I/R group were grade 4 in histopathological evaluation. In remifentanil + I/R group, on the other hand, the mucosal damage was moderate, staging as grade 1. CONCLUSIONS: The pretreatment with remifentanil can attenuate the intestinal I/R injury at a remarkable degree possibly by lowering lipid peroxidation and leukocyte infiltration.

JUSTIFICATIVA E OBJETIVOS: Alterações funcionais e estruturais sérias do trato gastrointestinal são observadas na insuficiência de irrigação sanguínea, levando a alterações da motilidade gastrointestinal. A ativação dos receptores opioides proporciona um efeito cardioprotetor contra a lesão de isquemia/reperfusão (I/R). O objetivo do presente estudo foi determinar se remifentanil pode ou não reduzir a lesão de I/R do intestino delgado. MÉTODOS: Ratos machos albinos, da linhagem Wistar, foram submetidos à isquemia mesentérica (30 minutos) seguida de reperfusão (3 horas). Quatro grupos foram designados: sham controle; remifentanil isolado; controle I/R; remifentanil + I/R. Os animais do grupo remifentanil + I/R foram submetidos à infusão de remifentanil (2 µg kg-1 min-1) por 60 min, metade dos quais iniciou antes da indução da isquemia. Coletando os tecidos do íleo, a avaliação dos danos foi baseada nas respostas contráteis ao carbacol, nos níveis de peroxidação lipídica e infiltração de neutrófilos e na observação das características histopatológicas no tecido intestinal. RESULTADOS: Após a reperfusão, uma diminuição significativa da resposta contrátil induzida por carbacol, um notável aumento tanto da peroxidação lipídica quanto da infiltração de neutrófilos e uma lesão significativa da mucosa foram observados. A média da resposta contrátil no grupo remifentanil + I/R foi significativamente diferente daquela do grupo I/R. A peroxidação lipídica e a infiltração de neutrófilos também foram significativamente suprimidas pelo tratamento. As amostras de tecido do grupo I/R apresentaram grau 4 na avaliação histopatológica. No grupo remifentanil + I/R, por outro lado, a lesão da mucosa foi moderada, apresentando estadiamento de grau 1. CONCLUSÕES: O pré-tratamento com remifentanil pode atenuar a lesão intestinal de I/R em um grau notável, possivelmente pela redução da peroxidação lipídica e da infiltração leucocitária.

Review of Suicide Prevention Programs: Massachusetts, United States, in Comparison with Seoul

Suicide is a tragedy that has massive impact on society. In order to prevent suicide, active government intervention is necessary. The suicide rate in Seoul is rapidly increasing and is more than five times higher than that in the state of Massachusetts (MA) during the last decade, especially in the elderly. The suicide prevention program of MA is one of the most effective suicide prevention programs in the United States. The program views suicide as a preventable public health problem, and emphasizes treatment of depression and de-stigmatization of mental health illnesses to prevent suicide. Also, through active collaboration with mental health professionals, they try to identify at-risk populations and help them to get medical interventions. The program also actively collaborates with the regional coalition program and the Samaritans in taking care of the elderly, and supports the elderly in feeling worthwhile after retirement by helping them to work for communities as volunteers. For its part, the Seoul suicide prevention program puts more emphasis on "life respect culture" and "emotional support to high risk individuals by regular visiting". The annual budget of the Seoul suicide prevention program is one-quarter and that for mental health is about one-twentieth that of MA. Considering the high suicide rate and lower mental health service usage in Seoul, it is crucial to raise awareness of depression and decrease the stigma on mental illnesses. Furthermore, educational efforts with long-term investment in research on suicide are necessary.

Measurement of FVIII:C Level by Clot Waveform Analysis / 임상소아혈액종양

BACKGROUND: By using ACL 9000 coagulation analyzer (Instrumentation Laboratory Co., Lexington, Massachusetts, USA), we tried to investigate the possibility that activated partial thromboplastin time (aPTT) clot waveform analysis (CWA) may provide additional information on patients with hemophilia A.METHODS: Plasma samples were obtained from 35 patients with hemophilia A. The factor VIII levels of those patients were measured by a conventional one-stage factor VIII:C clotting assay and a factor VIII antigen assay. The data were applied to a Microsoft excel program calculating the index of the second derivative, and the time at point b (Min2), the point in time that clotting is initiated was also calculated.RESULTS: The corresponding aPTT clotting times were prolonged in all 9 patients with severe hemophilia A. The CWA could further discriminate between different levels of FVIII:C in the patients (n=20), with a FVIII:C level <4 IU/dL by conventional assay. The correlation between FVIII:C and the recalculated aPTT using Min2 was very high in patients with FVIII:C < or =4 IU/dL (r=0.952). Among the 9 patients who showed a lot of discrepancy from the FVIII:C level, there was 8 patients with mild hemophilia and 1 patient with moderate hemophilia (FVIII:C level 4.5%).CONCLUSION: Our study suggested that CWA and Min2 values might have greater discriminatory power in assessing low clotting factor activity. Further study is needed, including more patients with hemophilia A using CWA, correlation according to the severity group, a lower limit of detection for VIII:C, and a multiple one-stage assay.

Measurement of FVIII:C Level by Clot Waveform Analysis / 임상소아혈액종양

BACKGROUND: By using ACL 9000 coagulation analyzer (Instrumentation Laboratory Co., Lexington, Massachusetts, USA), we tried to investigate the possibility that activated partial thromboplastin time (aPTT) clot waveform analysis (CWA) may provide additional information on patients with hemophilia A. METHODS: Plasma samples were obtained from 35 patients with hemophilia A. The factor VIII levels of those patients were measured by a conventional one-stage factor VIII:C clotting assay and a factor VIII antigen assay. The data were applied to a Microsoft excel program calculating the index of the second derivative, and the time at point b (Min2), the point in time that clotting is initiated was also calculated. RESULTS: The corresponding aPTT clotting times were prolonged in all 9 patients with severe hemophilia A. The CWA could further discriminate between different levels of FVIII:C in the patients (n=20), with a FVIII:C level <4 IU/dL by conventional assay. The correlation between FVIII:C and the recalculated aPTT using Min2 was very high in patients with FVIII:C < or =4 IU/dL (r=0.952). Among the 9 patients who showed a lot of discrepancy from the FVIII:C level, there was 8 patients with mild hemophilia and 1 patient with moderate hemophilia (FVIII:C level 4.5%). CONCLUSION: Our study suggested that CWA and Min2 values might have greater discriminatory power in assessing low clotting factor activity. Further study is needed, including more patients with hemophilia A using CWA, correlation according to the severity group, a lower limit of detection for VIII:C, and a multiple one-stage assay.

Development of an attenuated vaccine strain from a korean respiratory type infectious bronchitis virus / 대한수의학회지

An attenuated vaccine strain AVR1/08 of Korean respiratory type of infectious bronchitis virus (IBV) was developed by 89th passages of IBV D85/06 strain in chicken eggs. The AVR1/08 strain had higher virus titer at least 20 times (10(1.3)) than the parent virus D85/06 by egg inoculation method. The AVR1/08 strain had a single point mutation (S to Y) at position 56 of spike protein of IBV compared to parent virus IBV D85/06 strain. The mutation was observed consistently at viruses after 47th passage in chicken eggs. The AVR1/08 strain showed no virulence even after 6 passages in chickens and all chickens inoculated induced anti-IBV antibody 14 days after vaccination. The AVR1/08 strain had broad protective efficacy against QX type Korean nephropathogenic virus (Q43/06 strain), KM91 type Korean nephropathogenic virus (KM91 strain) and Korean respiratory virus (D85/06 strain). In contrast, Massachusetts (Mass) type attenuated vaccine strain H120 showed protection of 37.5 to 50% against these three viruses. Our results indicate that the AVR1/08 strain has potential as an attenuated vaccine effective in controlling IBVs circulating in Korea.

Development of Compact Disks in Speech Audiometry and First Stage Verification for the New Speech Materials / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To standard test method of Korean speech audiometry, we developed an audio compact disk, the KsoM-07 (Korean Society of Otolaryngolgy, Monosyllabic, 2007) word lists and evaluated them for clinical usage. SUBJECTS AND METHOD: The monitored live voice (MLV) of a female talker was digitally recorded with a Beltone audiometer and the GoldWave program. The calibration for each word was done by calculating the root-mean-square (RMS) at the moving time of 300 ms using MATLAB(R) (7.0 version, The MathWorks, Inc. Natick, Massachusetts, USA) and the GoldWave (v 5.25 GoldWave Inc. St. John's, NL, Canada) program. The discrimination score was measured in 20 normal subjects to obtain psychometric function curve of each word and to compare the homogeneity of two lists. The first verification methods for new speech materials were done by comparing the discrimination scores of the flat type and the descending types at 150 sensorineural hearing loss with similar pure tone threshold. RESULTS: 44% of MLV recording was above +/-3 dB deviation and had to be recalibrated. Two lists showed equal difficulty or homogeneity in normal subjects. Discrimination scores were statistically different among the groups with respect to hearing level and the slope of audiogram. CONCLUSION: KsoM-07 word lists were relatively homogeneous and showed differences between the descending type and the flat type of hearing loss. Therefore, KsoM-07 word lists can be useful in evaluating the impairment found in the descending type of sensorineural hearing loss as well as in serving as a new speech test material for Korean monosyllabic words.

Distribution of heavy metals in vegetation surrounding the Blackstone River, USA: considerations regarding sediment contamination and long term metals transport in freshwater riverine ecosystems.

The Blackstone River, a 74 km interstate stream located in South Central Massachusetts and Rhode Island (USA), has had a long history of problems due to high concentrations of metals such as copper and lead. The river has been subjected to metals load that include contributions from urban runoff, wastewater discharges, contaminated sediments, and also resuspension of contaminated sediments in the river-bed. All of these effects lead to elevated concentrations of metals such as lead, copper, zinc, chromium, cadmium and arsenic. Furthermore, the contaminated sediments located behind impoundments become especially important when higher flows cause resuspension of the previously deposited sediments and associated metals. While it is known that high metals concentrations in this river are found in the bottom sediments, the fate of the metals and impact on the ecosystem are not well known. This paper addresses the potential impacts that metals may have on vegetation and plant tissues in the vicinity of the river Plant tissues (primarily mosses), were collected from a number of sampling sites along a 14 km stretch of this river. At each site, samples were collected from multiple distances from the riverbank. Laboratory analyses made use of both wet digestion and dry ashing digestion methods, followed by analysis using an atomic absorption spectrophotometer. The wet and dry ashing digestion methods yielded similar results, although the results afforded by the dry ashing methods were slightly lower than the results obtained from the wet method. The results showed that the metals concentrations in vegetation (as determined from plant tissue analyses) were generally inversely related to the distance between the vegetation and the riverbank, with higher metals concentrations existing in plant tissues located close to the riverbank. In addition, it was found that the transport of metals concentrations to the terrestrial vegetation adjacent to this section of the Blackstone River was affected by the river morphology and flow characteristics (including velocity, flow rate and depth of flow, which can govern the potential for plant submergence, as well as the dynamics of flow and transport in the soil near the river). The analyses help to provide an improved understanding of metals transport and potential significance of metals contamination in a terrestrial ecosystem that is located adjacent to a river.

Risk factors of coronary heart disease.

Extensive clinical and statistical studies have identified several factors that increase the risk of coronary heart disease(CHD). This study is another attempt to identify the factors that increase the risk for CHD as it is an extremely important area in health sciences. Utilizing the Framingham data about a wide variety of risk factors associated with CHD,researchers are now working to develop better tools to assess overall risk. The incidence of CHD was recorded along with patients age, sex and cholesterol level in the study. Logistic regression was used to model the log odds of developing CHD as a function of cholesterol category (0: < 190 mg/100 ml, 1: 190-219 mg/ml, 2: 220-249 mg/100ml, 37 colon; 250 mg/100ml), adjusting for age, sex and their interaction. The analysis showed that serum cholesterol level is a risk factor of coronary heart disease, but its effect is modified by the age category of the subjects. Sex is also associated with CHD, and moreover the effect of age on the 12-year incidence of CHD is gender-dependent.

Effects of various silane coupling agents on the strength and the surface roughness of glass fiber-added PMMA resin / 대한치과보철학회지

STATEMENTS OF PROBLEM: The fracture of acrylic resin dentures remains an unsolved problem. Therefore, many investigations have been performed and various approaches to strengthening acrylic resin, for example, the reinforcement of heat-cured acrylic resin using glass fibers, have been suggested over the years. Silane is important for bonding between glass fiber and resin. PURPOSE: The aim of the present study was to investigate the effect of various silane on the strength of PMMA resin and roughness of resin-glass fiber complex after abrasion test. MATERIAL AND METHODS: 3mm glass fiber (Chopped strand, Hankuk fiber Co., Milyang, Korea) was treated with 3 kinds of silane (MPS, EPS, APS) (Sila-ace, Chisso chemical, Tokyo, Japan) and mixed with PMMA resin(Vertex RS, Vertex Dental B.V., Zeist, Netherlands). Transverse strength and Young's modulus was measured using Instron (Instron model 4466, Instron, Massachusetts, USA). After abrasion test (The 858 Mini Bionix II Test System, MTS System Co., Minnesota, USA) surface roughness was evaluated using tester (Form Talysurf plus, Taylor Hopson Ltd., Leicester, England). Examination of scanning electron microscope was also performed RESULTS: Within this study, the following conclusions were drawn. 1. Surface treatment of glass fiber with MPS and APS increased transverse strength of PMMA resin complex, but surface treatment with EPS decreased transverse strength of PMMA resin complex (p0.05).

Tensile bond strength between elastomeric impression materials and tray resins depending on the thickness of the tray adhesive / 대한치과보철학회지

STATEMENT OF PROBLEM: Elastomeric impression materials have been widely used to obtain an accurate impression. However there have not been enough studies on the influence of the thickness of the tray adhesives on the bonding strength between the trays and the elastomeric impression materials. PURPOSE: In order to understand the relationship between the thickness of the tray adhesive and the tensile bond strength and to suggest the thickness at which the bonding strength is strongest, tensile bond strength related to the thickness of adhesives of 3 different elastomeric impression materials were tested. MATERIALS AND METHODS: 3 impression materials, Permlastic(R) Regular Set(Kerr Corp., Romulus, Michigan, U.S.A.), Impregum(TM) Penta(TM)(3M ESPE, Seefeld, Germany), and Aquasil Ultra Monophase Regular Set Smart Wetting(R) (Dentsply Caulk, Milford, Delaware, U.S.A.), were used in this study, and tray adhesives from the same manufacturers of the impression materials were used, which were Rubber Base Adhesive, Polyether Adhesive, and Silfix, respectively. The tray specimens were prepared by autopolymerizing the tray material(Instant Tray Mix, Lang, Wheeling, Illinois, U.S.A.), and a PVC pipe was used to house the impression material. In group A, tray adhesives were applied in multiple thin layers of 1 to 5 and in group B, adhesives were applied only once, in the thickness equivalent to several applications. Lightness(L*) of the adhesion surface was measured with a spectrophotometer (CM-3500d, Konica Minolta, Sakai, Osaka, Japan). The tensile bond strength of the elastomeric impression material and the tray resin was measured with universal materials testing machines(Instron, Model 3366, Instron Corp, Nowood, Massachusetts, U.S.A.). A formula between the number of adhesive application layers and the lightness of the adhesion surface was deduced in group A, and the number of adhesive layers in group B was estimated by applying the lightness(L*) to the deduced formula. RESULTS: 1. In group A, a statistically significant increase in tensile bond strength appeared when the number of application layers increased from 1 to 2 and from 4 to 5, and no significant difference was present between 2, 3, and 4 layers in Permlastic. In Impregum, the tensile bond strength was significantly increased when the number of adhesive layers increased from 1 to 3, but no significant difference after 3 layers. In Aquasil, the tensile bond strength significantly increased as the number of application layers increased up to 4 but showed no significant difference between 4 and 5. 2. In group B, the tensile bond strength was decreased when the thickness of the adhesive increased in Permlastic. Impregum showed an increased tensile bond strength when the thickness of the adhesive was increased. In Aquasil, the tensile bond strength increased as the number of adhesive application layers increased up to approximately 2.5 layers but it sharply decreased after approximately 4.5. CONCLUSION: From the study, the common idea that it is better to apply a thin and single coat of tray adhesive needs correction in more detailed ways, and instructions on some of the tray adhesives should be reconsidered since there were several cases in which the tensile bond strength increased according to the increase in the thickness of the adhesives.

Comparison of Motor Function between Old and Young Age Group after the Rehabilitation Management in Stroke Patients

OBJECTIVE: This study was designed to make a comparison of motor function according to the age group after the rehabilitation management in poststroke hemiplegic patients. METHOD: We examined 23 cases of young age stroke with hemiplegia aged or =70 years. Motor power of affected side was measured by Motricity Index (MI) and Trunk Control Test (TCT). Level of ambulation was determined by Massachusetts General Hospital Functional Ambulation Classification (MGHFAC). Scores of each scale at admission and reassessment were obtained after rehabilitation management to compare the level of motor function in each age group and according to the age group. RESULTS: Scores of MI, TCT and MGHFAC scale were significantly increased after rehabilitation management in each group. Although both groups differed regarding to those of MGHFAC, there was no difference for the increment of MI and TCT according to the age group after rehabilitation. CONCLUSION: Both age group showed significant improvement of the motor function and ambulation level after rehabilitation management. Ambulation level improvement of younger patient was greater than that of older patients. However, there was no difference in the extent of motor function improvement of affected side according to the age groups.

Expanded newborn screening by tandem mass spectrometry: the Massachusetts and New England experience.

In February 1999, Massachusetts introduced expanded newborn screening for 20 rare metabolic disorders by MS/MS. Medium chain acyl-CoA dehydrogenase deficiency (MCADD) was mandated, in addition to 9 previously screened disorders, while the remaining 19 were offered as an optional pilot. Approximately 98% of parents have elected to participate in the optional program. Maine added MCAD in September 1999, and the optional disorders in July 2001. The other New England states are currently studying the benefits of adding additional testing. Expanded MS/MS screening in Massachusetts has thus far yielded a prevalence of approximately 1: 10,000 [200,000 screened--22 total cases--MCAD (7), VLCAD (1), SCAD (5), PA (2), 3-MCC (1), citrullinemia (1), ASA (1), argininemia (1), CPT11 (1) and 2 patients (argininemia and CPT11) with a severe neonatal presentation who died in the immediate newborn period]. All surviving patients have normal developmental outcomes so far. To evaluate the benefit of expanded newborn screening in the New England Region, the New England Consortium of Metabolic Centers has undertaken a prospective 3 year study, comparing the outcomes of patients identified by MS/MS with those diagnosed clinically. To date 22 screened patients (10 MCAD, 4 SCAD, 1 VLCAD, 1 CPT11, 13-MCC, 2 PA, 1 ASA, 1 citrullinemia and 1 argininemia) have been enrolled along with 24 clinically identified patients (7 MCAD, 1 SCAD, 1 VLCAD, 1 LCHAD, 1 argininemia, 1 tyrosinemia type 1, 6 PA, 3 GA 1, 2 GA 11, 1 MMA). Studies include: medical exam, neuropsychological assessment (Bayley Test and Stanford-Binet Test of Intelligence) and medical record review. Preliminary data suggest that the screened patients have an improved clinical outcome with fewer hospitalizations and so far, no neurological complications.

An Analysis of Neurosurgical Resources on the Internet / 대한의료정보학회지

To know recent research works in neurosurgical fields and to analyze neurosurgery related sites on the internet, authors have been searching sites on the web offering the neurosurgical resources. From December 1995 to October 1996 we used a modem(28.8Kbps) and thereafter connected to a LAN(local area network). Under the environment of Windows 95, we used web browsers with Netscape 2.02 and Netterm 2.89. We got an medical information with PC journals or seminars and graded the neurosurgical center/institutes from A to E according to the quality of web sites. We could use the internet resources more rapidly in the early morning than noon or evening. Best sites for neurosurgeon were MedMark(http://www.medmark.bit.co.kr/neurosur.html) and Neurosource (http://www.neurosource.com/). The more comprehensive academic neurosurgical site among all web were the Massachusetts General Hospital(http://neurosurgery.mgh.harvard.edu/) and the University North California (http://sunsite.unc.edu/Neuro/uncns/home.html). In 89 neurosurgical center/institutes, 72 sites(80.9%) couldn't supply sufficient information. In conclusion, there are many webs related to neurosurgery on the internet, but useful sites for neurosurgeon are not common. It is necessary to make an effort to find available sites offering more information in the future.

A Study on the Ratio Analysis as a Tool for Evaluating Financial Performance / 예방의학회지

Ratio analysis allows a hospital to evaluate its own performance over time and to compare its performance with that of other hospitals. For this study, three types of ratio analysis were conducted based on some data on hospitals in Massachusetts. First, Key ratios influencing financial performance were identified using discriminant analysis. Second, the financial structures of the teaching and the non-teaching hospitals were compared using ratios and multiple comparison method. Third, the effects of the prospective reimbursement law of the state on financial performance were examined using ratios and paired t-test. The purpose of the law is to reduce hospital costs by setting the revenue ceiling prior to the effective budget year. The findings of this study were as follows: 1) When hospitals were divided into three groups, according to their operating income, only profitability ratios showed a consistent difference among the groups. 2) In the discriminant analysis, five ratios were selected: current ratio, operating margin, return on assets, fixed assets turnover, and inventory turnover. They are the key ratios to be monitored periodically for the purpose of evaluating the financial performance of hospitals. 3) When teaching hospitals were compared with non-teaching hospitals, acid ratio, days of cash on hand, and inventory turnover were statistically significant before the law went into effect, whereas only fixed assets turnover and inventory turnover were significant afterward. Contrary to previous studies, profitability ratios of teaching hospitals were higher than those of non-teaching hospitals, although the differences were not statistically significant. 4) When the ratios between the two periods (before and after the law) were compared, three profitability ratios (operating margin, return on assets, and return on equity) were significant for teaching hospitals, whereas three activity ratios (total assets turnover, fixed assets turnover, current assets turnover) were significant for non-teaching hospitals. Furthermore, while both total operating revenue and expenses were decreased, net operating income was increased, due to a greater decrease in total operating expenses. This shows that the law can indeed, simultaneously, achieve both a reduction in costs as well as improvement in the financial situation of hospitals.