• Health Policy and Management
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• v.24 no.1
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• pp.56-70
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• 2014

Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

• Journal of the Korean Geographical Society
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• v.49 no.6
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• pp.935-948
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• 2014

As chronic diseases have become more prevalent and problematic, effective cares for major chronic diseases have been a locus of the healthcare policy. In this regard, this study examines how region-specific characteristics affect the prevalence of hypertension in South Korea. To analyze, we combined a unique multi-year data set including key indicators of health conditions and health behaviors at the 237 small administrative districts. The data are collected from the Annual Community Health Survey between 2009 and 2011 by Korea Centers for Disease Control and Prevention and other government organizations. For the purpose of investigating regional variations, we estimated using Geographically Weighted Regression (GWR) and decision tree model. Our finding first suggests that using the multi-year data is more legitimate than using the single-year data for the geographical analysis of chronic diseases, because the significant annual differences are observed in most variables. We also find that the prevalence of hypertension is more likely to be positively associated with the prevalence of diabetes and obesity but to be negatively associated with population density. More importantly, noticeable geographical variations in these factors are observed according to the results from the GWR. In line with this result, additional findings from the decision tree model suggest that primary influential factors that affect the hypertension prevalence are indeed heterogeneous across regional groups. Taken as a whole, accounting for geographical variations of health conditions, health behaviors and other socioeconomic factors is very important when the regionally customized healthcare policy is implemented to mitigate the hypertension prevalence. In short, our study sheds light on possible ways to manage the chronic diseases for policy makers in the local government.

• The Korean Journal of Community Living Science
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• v.17 no.1
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• pp.123-139
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• 2006

The purpose of this study is to search how to promote health and improve nutrition and health care of the elderly people in rural area. Behaviors for health promotion and habits against health risk were surveyed. Dietary management was analyzed for surveyed nutrient intake by 24 hr -recall method. 242 subjects were collected in 12 cities or counties in Gyeonggi Province and 20 elderly people (10 male and 10 female) were selected out of 1 village in each district. Questionnaire for health behavior and dietary management was carried out by trained interviewers. Statistical analyses were made by SAS (version 8.1) and Chi-square tests and General Linear Models were used. Characteristics of the elderly people were 61-74 year-olds (68.2%), elementary school educated (78.4%), with spouse (51.7%), monthly living cost of 500-1,000 thousand won(43.4%), and monthly pocket money of 50-100 or 100-200 thousand won(33.5%, 26.5%). 41.4% of the subjects checked up medical examination regularly. The alcohol drinking status was significantly different according to gender: high no-drink rate of female (52.5%) and low no-drink rate of male (25.6%). Kinds of disease were different according to gender: higher proportion of cardiovascular disease(46.3%) and diabetes mellitus(8.1 %) in male and joint lumbago neuralgia(44.4%) and osteoporosis(8.6%) in female. Gastrointestinal complaints were nausea (69.0%) and chronic indigestion (17.8%). Constipation (12.0%) and vomiting (4.3%) were more frequent in female. Dietary management was good (3 meals per day: 93.4%., dining with family: 72.4%, regular mealtime: 72.4%, and 3-4 times of snacks per week: 44.9%) except side dish taking of 3-4 kinds only. However, almost one-third of the female elderly ate alone (30.6%) which was well compared with one-fifth of the male (19.7%). And food and nutrients intake were not significantly different according to gender except that male elderly's intake of energy and protein was lower than that of female's. The surveyed subjects had no difficulties in Activities of Daily Living (ADL), but some female elderly had some difficulties with Instrumental Activities of Daily Living (IADL) like working at home, using transport, and going shopping. These results suggest that low quality of life linked with low economic status of the rural elderly and that congregate meal at village hall would be required for the female elderly eating alone. For the undernourished male elderly, it would be needed to provide snacks and to establish nutrition and health surveillance system.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.3
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• pp.289-297
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• 2017

The objective of this study was to identify and compare the anti-diabetic effects of mulberry leave (ML), silkworm (SK), mulberry fruit (MF), and Cudrania tricuspidata BUREAU (CT) extracts in high fat diet (HFD)-induced obese and diabetic mice. C57BL/6N mice were assigned to six groups: normal diet (ND, n=7), HFD (n=10), HFD with 5% ML powder (ML, n=10), HFD with 2% SK powder (SK, n=10), HFD with 5% MF powder (MF, n=10), and HFD with 5% CT powder (CT, n=10). Mice were fed their assigned diet for 14 weeks. ML group showed significant reduction in levels of plasma glucose and insulin compared with the HFD group. Plasma total cholesterol (T-C) was significantly reduced by ML and SK compared with the HFD group. Plasma high-density lipoprotein cholesterol (HDL-C) and HTR (HDL-C to T-C ratio) levels of the ML, SK, MF, and CT groups were significantly elevated compared to the HFD group. Moreover, concentrations of hepatic T-C and triglycerides in the ML, SK, MF, and CT groups were significantly reduced in comparison to the HFD group. Levels of pAKT, pS6K, and pAMPK significantly increased in the ML group compared with the HFD group. Taken together, ML appears to be the most potent anti-diabetic and anti-dyslipidemic substance among sericultural products. ML could be developed as a potential agent for diabetes and its complication management.

• Herbal Formula Science
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• v.26 no.1
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• pp.81-102
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• 2018

Objectives : I analysed daehwangmokdan-tang's compatibility principle by the system of chief, deputy, assistant, and envoy and investigated pharmacological activities by categorizing with chemical components, molecular level, cellular level, animal level and human level based on Korean and Chinese studies for this formula. Methods : Daehwangmokdan-tang's compatibiltity principle was examined by the system of chief, deputy, assistant, and envoy. I looked into studies that presented in Korea from 1956 to 2016 about daehwangmokdan-tang through KOREA INSTITUTE OF ORIENTAL MEDICINE, Korean medicine information system (OASIS) and in Chinese for 20 years about daehwangmokdan-tang through China National Knowledge Infrastructure, CNKI. Then classify into chemical components, molecular level, cellular level, animal level and human level to analyse. Results : According to the system of chief, deputy, assistant, and envoy, chief herb is Rhei Radix et Rhizoma and Moutan Cortex, deputy herb is Natrii Sulfas and Persicae Semen, assistant and envoy herbs are Trichosanthis Semen. The amount of extraction of paeonol, total anthraquinone, and conjugated anthraquinone from daehwangmokdan-tang with the formulation of the system of chief, deputy, assistant, and envoy was the highest, and in the formulation of chief herb and deputy herb, the extraction amount of paeonol and conjugated anthraquinone was the lowest. With other formulations, the amount of extraction of total anthraquinone and conjugated anthraquinone was improved, although the degree was different. In particular, when it is blended with Persicae Semen as a deputy herb, the extraction amount of total anthraquinone and conjugated anthraquinone of Rhei Radix et Rhizoma as a chief herb is greatly increased, and the extraction amount of paeonol is rather different, but it is lowered. It was found that the amount of Mg Ca K Na in daehwangmokdan-tang was the highest. Pharmacological activities can be detected in inflammatory mediators and enzymes for molecular level. For cellular level, it can be determined in lipopolysaccharide (LPS)-stimulated RAW 264.7 cell line. In mouse and rats for animal level and human level, in inflammatory diseases (acute appendicitis, acute pancreatitis, acute cholecystitis, acute abdominal disease, ect.), pharmacological activities was caught. Conclusions : From the above results, daehwangmokdan-tang is composed in line with the system of chief, deputy, assistant, and envoy, suggesting that there is certain rationality and scientific. Pharmacological activities of daehwangmokdan-tang are effective to anti-inflammation, improvement of sepsis, analgesic, muscle relaxation, and improvement of intestinal flora and its metabolites. Daehwangmokdan-tang is consistent with the action of diuresis and anti-inflammation in terms of the content of elements, suggesting that there is action of purging fire and removing blood stasis, defecation detoxification, cooling blood and clearing heat and activating blood and dispersing stasis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.435-445
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• 2018

This study was conducted to develop and apply the health conversation program to determine its effectiveness. The study employed a pretest-posttest nonequivalent control group design. There were 25 subjects in one intervention group and 22 subjects in the control group. The program included a 4-week, 12-session education program in health conversation for professionally retired elderly mentors and an 8-week, 24-session program for vulnerable elderly diabetics provided by mentors who were older persons trained in diabetes management. Data were collected from December 2015 to May 2016 and subsequently analyzed by an independent t-test using SPSS 20.0. Biochemical variables and physical variables were assessed by blood test and Inbody 230 (Biospace). Psychosocial variables were assessed by questionnaires. The health conservation program led to significantly decreased FBS (p<0.01), TC (p<0.01), TG (p=0.04), SBP (p=0.03), waist (p<0.01) and symptoms of depression (p=0.01), and significantly increased social support (p=0.02). These results indicated that the health conservation program is effective at increasing social support and decreasing FBS, TC, TG, SBP, waist, and symptoms of depression in community-dwelling vulnerable diabetic elderly; accordingly, health conservation programs should be applied to improve quality of life of vulnerable diabetic elderly.

• Journal of agricultural medicine and community health
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• v.42 no.4
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• pp.226-233
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• 2017

Objective: The purpose of this study was to describe and understand self-care status of the aged diabetic patients with noncompliance after hospital discharge. Methods: A qualitative research method was used for the study design. The participants were 15 diabetic patients aged 65 or older who had been admitted more than two times for hyperglycemia in the past 1 year in a general hospital in Daegu. Data were collected from November 1 2015 to March 1 2016 through in-depth personal interview. Results: Patients' knowledge level on causes and symptoms of diabetes was low. Most participants rarely and irregularly checked blood sugar at home. They were under a lot of stress from their family. Due to old age and illness they did not have sufficient physical activity and they have had rarely regular meals. They considered the self-care education program unnecessary and there was limitations of accessibility for education. Conclusions: The aged diabetic patients who had the repeat admission did not perform self-care activities properly and had problems especially in blood glucose check, support from their family, and health education after returning home. More personalized and community-based self-management education programs will be necessary.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.350-354
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• 1996

Pulmonary mucormycosis is a very rare but often fatal opportunistic fungal infection caused by the order Mucorales in class Zygomycetes. Reported overall mortality exceeds 70% and the diagnosis is often made post-mortem. We experienced 2 cases of typical form of pulmonary mucormycosis. One patient was a poorly controlled diabetic and the other suffered from acute Iymphocytic leukemia (ALL). The former was diagnosed by a bronchoscopic biopsy and the latter by a pathologic examination from the percutaneous drain of a subphrenic abscess. Both of them underwent a surgical excision of the involved lung tissue. The patient with diabetes mellitus was successfully treated by surgical resection and discharged without complications. The other with ALL underwent a second operation and was transferred to the department of internal medicine for further management of his relapse of lettkemia. Recent literat re suggests that early aggressive diagnostic effort and treatment including surgical resection in the case of localized forms of the disease results in a good prognosis.

• Journal of Life Science
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• v.22 no.5
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• pp.582-586
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• 2012

The purpose of this study was to examine the effect of 8 weeks of aerobic exercise on serum lipids and kidney function in middle-aged T2DM patients. Subjects participated in aerobic exercise training during 8 wk. They started with an exercise intensity of $HR_{max}$ 60-75%, 20~45 minutes per day, 3~5 times a week. The results were compared to the baseline after 8 weeks. After the 8-week aerobic exercise routine, the body fat percentage and fasting glucose were significantly decreased, and the total cholesterol (TC) andtriglycerides (TG) were significantly decreased. Additionally, kidney function (Blood Urea Nitrogen (BUN], uric acids, and creatinine) was not significantly changed. In conclusion, a regular 8-week aerobic exercise training routine may improve serum lipids; however, kidney function (BUN, uric acids, and creatinine) did not change in middle-age type 2 diabetes mellitus (T2DM) and T2DM in diabetic nephropathy patients.

• Herbal Formula Science
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• v.24 no.1
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• pp.17-30
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• 2016

Objectives Rehmanniae Radix Preparata was prepared in the traditional Rehmanniae Radix Preparata preparation method set forth in the 『Treasured Mirror of Eastern Medicine(Donguibogam)』 with a view to measuring the contents of 5-Hydroxymethyl-2-furaldehyde(5-HMF) at individual stages of steaming and sundrying and identifying new chemical components.Methods Based on the traditional Rehmanniae Radix Preparata preparation method set forth in the 『Treasured Mirror of Eastern Medicine』, Rehmanniae Radix Preparata steamed and sundried once through nine times was prepared. Thereafter, 5-HMF contents were analyzed and new chemical components were identified in the Rehmanniae Radix Preparata using Waters HPLC e2695, 2640 detectors, a Waters Acquity UPLC system, and a Micromass Q-TOF Premier mass spectrometer.Results The Rehmanniae Radix Preparata preparation method set forth in the 『Treasured Mirror of Eastern Medicine』 is a unique preparation method in Republic of Korea different from that in China. In the first stage of the method, fresh Rehmanniae Radix Crudus was divided into high quality, medium quality, and low quality ones named Rehmanniae Radix Crudus (Caelum)(天黃), Rehmanniae Radix Crudus (Homo)(人黃), and Rehmanniae Radix Crudus (Terra)(地黃) respectively to use Rehmanniae Radix Crudus (Caelum) and Rehmanniae Radix Crudus (Homo) for preparation of juice while using Rehmanniae Radix Crudus (Terra) to make Rehmanniae Radix Preparata. In the second stage, Rehmanniae Radix Crudus (Caelum) and Rehmanniae Radix Crudus (Terra) were made into juice and Rehmanniae Radix Crudus (Terra) was soaked in the juice. In the third stage, among auxiliary materials, rice wine named Purum Vinum Oryzae(淸酒) brewed from sticky rice was sprinkled on Rehmanniae Radix Crudus (Terra) to the extent that Rehmanniae Radix Crudus (Terra) became wet. In the fourth stage, Rehmanniae Radix Preparata steamed in earthenware steamer was dried under natural sunlight. The contents of 5-HMF in Rehmanniae Radix Preparata steamed and sundried once through nine times were shown to be below 0.1% in all cases. Pomolic acid was identified as a new chemical component.Conclusions In conclusion, the Rehmanniae Radix Preparata preparation method set forth in the 『Treasured Mirror of Eastern Medicine』 is thought to be a unique preparation method in South Korea in which Rehmanniae Radix Preparata is completed through the first stage in which fresh Rehmanniae Radix Crudus collected from fields is divided into high, medium, and low quality ones and fresh Rehmanniae Radix Crudus juice is made, the second stage in which the high quality fresh Rehmanniae Radix Crudus is soaked in the fresh Rehmanniae Radix Crudus juice, the third stage in which the fresh Rehmanniae Radix Crudus is steamed, and the fourth stage in which the steamed Rehmanniae Radix Crudus is dried.