• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3751-3758
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• 2014

This study was designed to evaluate the effects of arthritis and comorbid chronic conditions on the health-related quality of life (HRQoL) in the Korean older population. The study subjects were 2,708 Korean adults aged 65 and older from the $3^{rd}$ Korea National Health and Nutrition Examination Surveys data: 1,357 persons with a single chronic condition, such as arthritis, herniations of the intervertebral disc, osteoporosis, asthma, peptic ulcers, stroke, or cataract; 886 persons with arthritis and a second chronic condition described above; and 465 persons with no chronic condition. An analysis of covariance was performed to compare the EQ-5D index among the groups. The effects of arthritis, second chronic condition and their interactions were analyzed by multiple linear regression analysis. The results are as follows. Compared to men with arthritis only, men with stroke only, stroke and arthritis, or cataract and arthritis had a lower age adjusted EQ-5D index. Women with a stroke only, asthma only, cataract only, osteoporosis and arthritis, peptic ulcer and arthritis, stroke and arthritis, or cataract and arthritis had a lower age adjusted EQ-5D index than women with arthritis only. Arthritis and comorbid conditions had additive effects on the HRQol in both genders except for arthritis and stroke in women. In conclusion, comorbid chronic medical conditions in older people with arthritis may reduce the HRQoL in an additive manner.

• Journal of agricultural medicine and community health
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• v.37 no.4
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• pp.246-257
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• 2012

Objectives: To compare the self-rated health in chronic disease patients with depression, chronic disease patients, and depression patients, and to observe the related factors to the self-rated health of people age 65 and older. Methods: The subjects were 2,549 elderly people, over 65 years old in Busan Metropolitan City who participated in 2009 community health survey. Association between self-rated health and general characteristics, life style and disease status were observed. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Analysis of complex sample was done with SAS (ver. 9.2), using ${\chi}^2$-test and multiple logistic regression. Results: Among total 2,549, there were 740 normal people (29.8%), 50 people with depression (1.8%), 1,495 people with other chronic diseases (58.2%), and 264 people with the comobidity of depression and other chronic diseases (10.1%). Good self-related health accounted for 20.3% for the whole, 33.4% for normal, 16.7% for chronic disease, 16.1% for depression, and 3.2% for chronic diseases with depression. Disease, gender, education, income, alcohol drinking, regular exercise and regular walking were independent factors associated with the good self-related health. Conclusions: It is suggested that when the chronic disease control program for the elderly is developed, depression care should be considered along with the program. This program should be given priority to the women and the vulnerable classes and should also be related to the regular walking.

• Journal of Digital Convergence
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• v.19 no.8
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• pp.351-359
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• 2021

This study was conducted to analyze the relationship between the practice of aerobic exercise and the prevalence and risk of arthritis with comorbid chronic diseases. For this study, the National Health and Nutrition Examination Survey 2017-2019 data were used and 17,356 people were selected as subjects. The relationship between the practice of aerobic exercise and the prevalence and risk of arthritis according to demographic characteristics and chronic diseases was analyzed by the chi-square independence test and Breslow-Day test. While the rate of aerobic exercise was low among women, the elderly, the low-income group, the low-education group, and people living in rural areas, the prevalence and risk of arthritis were relatively high. And in the chronic disease-positive group, those who practiced aerobic exercise had a relatively lower prevalence and risk of arthritis than those who did not. In particular, the practice of aerobic exercise was an effective complement in reducing the prevalence and risk of arthritis in people with high blood pressure, diabetes, and dyslipidemia. Therefore, the practice of aerobic exercise such as walking, slow running, and aerobic dance should be recommended in terms of the preventive medicine and health care to people who are in the group with a high prevalence of arthritis in demographic characteristics and people who have comorbid chronic diseases.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.397-408
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• 2006

치주질환은 치아 지지조직의 파괴로 튿정 지어지는 감염성 질환으로서 이것은 주로 조직의 교원질 성분을 분해시키는 MMP(matrix metalloproteinase)에 의해 이루어진다. 한편, 여러 연구에서 당뇨병과 치주질환의 심도와의 관계에 대한 논의가 있어왔으며 당뇨병이 치주염을 포함한 구강 감염에 대한 감수성을 증가시키며 역으로 만성 치주염의 염증성 매개물질에 의해 인슐린 작용이 방해받을 수 있음을 보고하였다. 본 연구의 목적은 만성 치주염 환자와 제 2형 당뇨병을 동반한 만성 치주염 환자의 치은조직에서 MMP-13과 elastase의 발현 양상을 비교하여 병리 기전의 차이점을 규명하고, 두 단백질간의 상호관계를 알아보기 위한 것이다. 경북대 병원 치주과에 내원한 환자의 비당뇨 환자의 정상 치은 부위, 비당뇨 환자의 만성 치주염 부위, 제 2형 당뇨병 환자의 만성 치주염 부위에서 각각 8개의 변연 치은을 채득하여 액화 질소에 급속 동결시켰다. 모든 조직 샘플에서 동량의 단백질을 western blotting을 통해 분석하여였고, densitometer를 이용하여 정량한 후 ANOVA 분석으로 통계처리 하였다. 결과분석에서 MMP-13은 제 2형 당뇨를 가진 환자의 염증성 조직에서 가장 높게 발현되었고 전신적으로 건강한 환자의 염증성 조직과 정상 조직에서는 유사한 양상을 보였으며 그 차이는 통계적으로 유의하였다. 또한 elastas는 그룹간에 유의한 차이 없이 유사한 양상으로 발현되었고, 염증성 조직에서도 당뇨병의 유무에 관계없이 유사하게 나타났다. 한편 조직내 MMP-13과 elastase의 발현 양상간에 유의한 상관관계는 보이지 않았다. 결론적으로 MMP-13은 당뇨병을 동반한 환자의 치은 염증초직에서 유의하게 증가되어 나타났으며, 전신적으로 건강한 환자의 염증조직과 당뇨를 동반한 환자의 염증조직에서 MMP-13과 elastase의 발현양상은 큰 상관관계가 발견되지 않았다.

• Journal of Digital Convergence
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• v.13 no.12
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• pp.245-257
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• 2015

This study was to develop the predictive model for severity-adjusted mortality of inpatients with multiple chronic conditions and analyse the factors on the variation of hospital standardized mortality ratio(HSMR) to propose the plan to reduce the variation. We collect the data "Korean National Hospital Discharge In-depth Injury Survey" from 2008 to 2010 and select the final 110,700 objects of study who have chronic diseases for principal diagnosis and who are over the age of 30 with more than 2 chronic diseases including principal diagnosis. We designed a severity-adjusted mortality predictive model with using data-mining methods (logistic regression analysis, decision tree and neural network method). In this study, we used the predictive model for severity-adjusted mortality ratio by the decision tree using Elixhauser comorbidity index. As the result of the hospital standardized mortality ratio(HSMR) of inpatients with multiple chronic conditions, there were statistically significant differences in HSMR by the insurance type, bed number of hospital, and the location of hospital. We should find the method based on the result of this study to manage mortality ratio of inpatients with multiple chronic conditions efficiently as the national level. So we should make an effort to increase the quality of medical treatment for inpatients with multiple chronic diseases and to reduce growing medical expenses.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.555-563
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• 1999

Background: Chronic cough is a common symptom that requires the systematic diagnostic approach for proper evaluation. Postnasal drip syndrome(PNDS), bronchial asthma, gastroesophageal reflux disease(GERD), and chronic bronchitis are among the common causes. This study was conducted to evaluate the spectrum and the frequency of the causes of chronic cough. Methods: We prospectively evaluated 93 patients who had chronic cough despite normal chest radiographic finding. History and physical examination were done along with paranasal sinus radiograph, spirometry, bronchoprovocation test and 24-hours' ambulatory aesophageal pH monitoring as necessary. Results: Forty-nine(52%) of the 93 patients had PNDS, 15 patients(16%) bronchitis, 10 patients(11%) asthma, 4 patients (4%) GERD, 7 patients (8%) both PNDS and asthma, 4 patients (4%) undiagnosed condition and 4 patients(4%) were taking ACE inhibitor. Sixty-nine percent of the patients with PNDS improved after follow up, 73% patients with bronchitis, 80% patients with asthma, 50% patients with GERD, 100% patients with both PNDS and asthma, and 100% patients with ACE inhibitor. Conclusion: PNDS was the most common causes of chronic cough. Bronchitis was the second and asthma the third in frequency. The etiology of chronic cough can be determined easily by history and physical examination, successful therapy initiated in most patients. The response to specific therapy also was important in evaluation of chronic cough.

• Journal of Convergence for Information Technology
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• v.11 no.1
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• pp.183-190
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• 2021

The purpose of this study was to determine the change trend of emergency department visits among elderly patients with chronic diseases. Using the National Emergency Department Information System data, from January 1, 2014 to December 31, 2019, the selected patient data were evaluated for the emergency department discharge main diagnosis codes for eight chronic diseases. The incidence of elderly chronic diseases, emergency department visits, and admission rates were analyzed. Since 2014, there has been a consistent increase in the number of elderly patients visiting the emergency department, especially among those aged over 85 years. The number of emergency department visits among the elderly chronically ill patients also increased, with a significant increase in ischemic heart disease and arthrosis cases. Furthermore, there was a significant difference in the number of chronically ill patients in each year from 2014-2019 (P<0.001). With respect to the trend of admission rates to the emergency department by chronic disease, most diseases showed an increasing trend (P<0.001). however, hyperlipidemia showed a continuous decreasing trend in all age groups since 2014 (P<0.001). Among the elderly chronically ill patients, a greater increase in the admission rate following emergency department visits was noted in those over 85 years of age, with a significant difference in all diseases, except for hyperlipidemia, hypertension, and tuberculosis (P<0.001). As the aging population grows, the emergency department admission rates among the elderly chronically ill patients will rise rapidly. This could create issues with respect to the use and consumption of emergency medical resources. Hence, it is necessary to manage chronic diseases effectively in the elderly.

• The Korean Chronic Disease News
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• no.311
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• pp.1-18
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• 2006

경기도 평택시 송탄 보건소 김보섭 소장/만성질환 관리 중추적 단체 위상제고/“앞으로 국민연금 덜 받는다”/건강보험료 환급 사기‘주의’/전공의 보조수당 민간병원 확대/65세이상 60%에 월8만9천원 지급/“의료용 혈액이 부족하다”/남‘암’-여‘순환기’사망확률 높아/수면무호흡증, 남성 발기부전초래/독감백신 국내 생산기반 구축/정부 의약품 가격 정책‘위헌소송’/차별화 된 고품격 보건서비스 제공/보건소 의료기관 서비스 만족도‘1위’/초고령사회 대응, 본격 시동 걸었다/노인의료“의료적 접근 동반돼야”/겨울철 어르신 건강관리 수칙 발표/비영리 의료기관 M&A 근거 마련/병원 서비스산업 주요 육성방안/고령친화 모델지역 기본구상/

• The Monthly Diabetes
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• s.289
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• pp.60-63
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• 2013

우리는 스트레스의 연속인 일상에서 생활하고 있다. 때로는 부정적인 면 뿐 아니라 우리를 긴장하게 함으로써 하나의 자극제로 삶의 활력소 같은 긍정적인 면도 가지고 있다. 그러나 만성질환인 당뇨병은 당뇨병 진단 자체뿐 아니라 합병증 예방을 위해 평생 지속적으로 약물요법, 식이요법, 규칙적인 운동수행 등을 동반하기에 갑작스러운 개인적, 환경적 변화에 대한 중압감과 함께 일상에서의 스트레스가 가중된다.

• Korean Journal of Human Ecology
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• v.22 no.1
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• pp.181-188
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• 2013

노인에게서 두드러지게 나타나고 있는 저근육형 비만은 근육감소를 동반한 체지방의 증가로 신체상의 뚜렷한 체성분의 변화를 야기 시킨다. 이때 골감소증을 동반하여 신체기능의 감소 및 골절장애 그리고 대사성 관련 질환의 위험도가 올라가는 것으로 보고되고 있다. 노화로 인한 체성분의 변화는 단순한 저근육형일 경우와 비만일 때 보다 급격히 증가된 복부내장 지방조직에서 분비되는 염증성 사이토카인, C-반응성 단백질(CRP), 인터루킨(IL)-6, IL-8 및 종양 괴사 인자(TNF-${\alpha}$)들이 단백질 대사를 저해하여 근육량의 감소를 더욱 촉진시키며, 염증관련 대사질환의 유병률에 중요한 요인이다. 본 연구에서는 DNA 메틸화가 당뇨병, 심혈관질환, 암과 같은 만성염증성 질환에 관계하고 있다는 최근 연구 결과를 기초로 하여 항염증 영양소와 생리활성을 갖는 식품인자들의 충분한 섭취가 염증조절에 중요하게 기여할 것으로 생각되며, 또한 염증성 질환의 주요 표식자인 DNA 메틸화와 히스톤 변형을 유발하는 효소의 활성 또는 비 암호화된 RNA의 발현을 조절함으로써 근육량 증가와 체지방 감소에 중요한 역할을 하는 것을 살펴보았다. 따라서 최근 새롭게 인식되는 후생유전학적 연구의 중심에 있는 항염증 영양소의 효과와 체성분 변화와의 긍정적 관계를 중심으로 저근육형 비만의 예방 및 인구고령화에 건강한 노화를 위한 효과적인 방법을 제시하였다.