• Title/Summary/Keyword: Disease morbidity

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Evidence-based estimation of health care cost savings from the use of omega-3 supplementation among the elderly in Korea

  • Hwang, Ji-Yun;Kim, Wu Seon;Jeong, Sewon;Kwon, Oran
    • Nutrition Research and Practice
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    • v.9 no.4
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    • pp.400-403
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    • 2015
  • BACKGROUND/OBJECTIVES: By the year 2050, thirty-eight percent of the Korean population will be over the age of 65. Health care costs for Koreans over age 65 reached 15.4 trillion Korean won in 2011, accounting for a third of the total health care costs for the population. Chronic degenerative diseases, including coronary heart disease (CHD), drive long-term health care costs at an alarming annual rate. In the elderly population, loss of independence is one of the main reasons for this increase in health care costs. Korean heath policies place a high priority on the prevention of CHD because it is a major cause of morbidity and mortality. SUBJECTS/METHODS: This evidence-based study aims to the estimate potential health care cost savings resulting from the daily intake of omega-3 fatty acid supplementation. Potential cost savings associated with a reduced risk of CHD and the medical costs potentially avoided through risk reduction, including hospitalizations and physician services, were estimated using a Congressional Budget Office cost accounting methodology. RESULTS: The estimate of the seven-year (2005-2011) net savings in medical costs resulting from a reduction in the incidence of CHD among the elderly population through the daily use of omega-3 fatty acids was approximately 210 billion Korean won. Approximately 92,997 hospitalizations due to CHD could be avoided over the seven years. CONCLUSIONS: Our findings suggest that omega-3 supplementation in older individuals may yield substantial cost-savings by reducing the risk of CHD. It should be noted that additional health and cost benefits need to be revisited and re-evaluated as more is known about possible data sources or as new data become available.

Prevalence of Abdominal Obesity and Associated Factors among Korean Adults: The 2001 Korean National Health and Nutrition Examination Survey (한국 성인의 복부비만 빈도와 관련 인자: 2001 국민건강영양조사)

  • Chung, Hae-Rang
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.684-691
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    • 2006
  • Abdominal obesity (AO) is a strong risk factor for type 2 diabetes and cardiovascular disease, which has shown a remarkable increase in Korea. This study aimed to identify prevalence of AO and related risk factors in Korean adults. A total of 5,132 men and women aged 20-85 years old from the 2001 Korean National Health and Nutrition Examination Survey were included in the analyses. AO was defined as waist circumference >=90 cm in men and >=85 cm in women as proposed by Korean Society of Obesity. Multiple logistic regression was carried out to identify risk factors for AO. Three models were specified: (i) demographic and socioeconomic factors (model 1: age, education, poverty income ratio, employment), (ii) lifestyle factors and covariates (model 2: physical activity, cigarette smoking, alcohol consumption, dietary quality, type 2 diabetes, co-morbidity) and (iii) demographic, socioeconomic and lifestyle factors (model 3). The prevalence of AO was 24.1 % in men, 23.5% in women. High poverty income ratio in men and low education attainment in women were risk factors for AO in model. 1. There was a significant association of AO with alcohol consumption, physical inactivity and dietary quality in men, alcohol consumption and cigarette smoking in women. These factors except alcohol consumption in men became insignificant in model 3. This findings underscore the importance of developing AO prevention programs in Korea that target the at risk groups identified in this study. A program focusing on low income men or less educated women would be more efficient.

Mid-Term Results of Minimally Invasive Direct Coronary Artery Bypass Grafting

  • Seo, Dong Hyun;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong;Chung, Su Ryeun;Kim, Dong Jung
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.8-14
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    • 2018
  • Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data - including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention - were collected. Results: The mean age of the patients was $69.4{\pm}11.1years$ and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in the intensive care u nit and in the hospital were 1.5 and 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of $85.3%{\pm}0.09%$ and a 5-year MACCE-free survival rate of $72.8%{\pm}0.1%$. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at $9.7{\pm}10.8months$ postoperatively. Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.

Patterns of Childhood Cancer Incidence in Saudi Arabia (1999-2008)

  • Al-Mutlaq, Hind M.;Bawazir, Amen Ahmed;Jradi, Hoda;Al-Dhalaan, Zeyad Abdulaziz;Al-Shehri, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.431-435
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    • 2015
  • Background: Although childhood cancer is a rare disease, 100,000 children younger than 15 years of age die from cancer each year, the majority of them in developing countries. More data need to be gathered and published particularly in developing countries to better understand the scale of the problem. Aims: This study aimed to describe the patterns of childhood cancers in Saudi Arabia over a period of ten years (1999-2008). Materials and Methods: This descriptive retrospective study was based on secondary data from the Saudi Cancer Registry from 1999 to 2008. All Saudi cases (both genders), under the age of 15 years, who were diagnosed with cancer during the study period, were included in this study. Results: Childhood cancer in Saudi Arabia, in the period between 1999 and 2008, accounted for about 8% of total cancer cases. The most common encountered cancers were leukemia (34.1%), followed by lymphoma (15.2%), brain (12.4%), and kidney cancers (5.3%). The overall incidence of childhood cancers increased from 8.8 per 100,000 in 1999 to 9.8 per 100,000 in 2008. The incidence rates of cancers per 100,000 in the years 1999 and 2008 were generally higher among males, (9.4 and 11.5 in males vs. 8.3 and 8.1 in females). The highest incidence rate in the surveyed years was apparent in the birth to age 4 years group. Conclusions: Cancer is an important public health problem in Saudi Arabia and a major ascending contributor to mortality and morbidity in children. More studies are required to describe the patterns of childhood cancers and related risk factors in Saudi Arabia.

DPPA2 Protein Expression is Associated with Gastric Cancer Metastasis

  • Shabestarian, Hoda;Ghodsi, Mohammad;Mallak, Afsaneh Javdani;Jafarian, Amir Hossein;Montazer, Mehdi;Forghanifard, Mohammad Mahdi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8461-8465
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    • 2016
  • Gastric cancer (GC) as the fourth most common cause of malignancies shows high rate of morbidity appropriating the second leading cause of cancer-related death worldwide. Developmental pluripotency associated-2 (DPPA2), cancer-testis antigen (CT100), is commonly expressed only in the human germ line and pluripotent embryonic cells but it is also present in a significant subset of malignant tumors. To investigate whether or not DPPA2 expression is recalled in GC, our aim in this study was to elucidate DPPA2 protein expression in gastric cancer. Fifty five GC tumor and their related margin normal tissues were recruited to evaluate DPPA2 protein expression and its probable associations with different clinicopathological features of the patients. DPPA2 was overexpressed in GC cases compared with normal tissues (P < .005). While DPPA2 expression was detected in all GC samples, its high expression was found in 23 of 55 tumor tissues (41.8%). Interestingly, 50 of 55 normal samples (90.9%) were negative for DPPA2 protein expression and remained 5 samples showed very low expression of DPPA2. DPPA2 protein expression in GC was significantly correlated with lymph node metastasis (p = 0.012). The clinical relevance of DPPA2 in GC illustrated that high level expression of this protein was associated with lymph node metastasis supporting this hypothesis that alteration in DPPA2 was associated with aggressiveness of gastric cancer and may be an early event in progression of the disease. DPPA2 may be introduced as a new marker for invasive and metastatic GCs.

Knowledge, Perception and Attitude Towards Human Papillomavirus among Pre-university Students in Malaysia

  • Kwang, Ng Beng;Yee, Choy Mun;Shan, Lim Pei;Teik, Chew Kah;Chandralega, Kampan Nirmala;Abdul Kadir, Abdul Karim
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9117-9123
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    • 2014
  • Background: To evaluate the knowledge, perception and attitudes towards human papilloma virus (HPV) among pre-university students in Malaysia. Study design : In this cross sectional study, between November 2013 to March 2014, in a public university, a convenient sampling method was used. A total of 716 respondents were recruited and interviewed with a set of standard questionnaires for assessment of knowledge, perception and attitudes towards HPV and predictor variables associated with level of knowledge. Results: Almost half (48.9%) of the respondents scored less than 5 and were categorised as having poor knowledge. Three hundred and twelve (43.6%) respondents had moderate knowledge and only 54 (7.5%) respondents exhibited good knowledge with the score of 11 and above. Only 142 (20%) students perceived themselves to be vulnerable to HPV infection though 560 (78.2%) students thought that HPV infection is a serious disease. Perceived benefits and desire to be vaccinated were significantly associated with gender (p=0.000) and knowledge of HPV vaccine and cervical cancer (p=0.000). Conclusions: The level of knowledge regarding HPV among the pre-university students was low. However, student intention for vaccination increased with increasing level of knowledge. Thus, efforts to improve knowledge and awareness should be prioritised to increase uptake of the HPV vaccination programme and hence reduce morbidity and mortality from consequences of HPV infection, including cervical carcinoma.

Clinical Experience of Cardiac Myxoma (심장점액종의 임상적 경험)

  • 김종원;전상협
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.311-314
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    • 1996
  • Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

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Long-Term Outcomes and Feasibility with Laparoscopy-Assisted Gastrectomy for Gastric Cancer

  • Kim, Ki-Han;Kim, Min-Chan;Jung, Ghap-Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.12 no.1
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    • pp.18-25
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    • 2012
  • Purpose: Recently, laparoscopy-assisted gastrectomy (LAG) has been widely accepted modality for early gastric cancer in Korea. The indication of LAG may be extended in an experienced institution. In our institution, the first case of laparoscopy-assisted gastrectomy (LAG) for gastric cancer was performed in May 1998. We retrospectively reviewed the long-term oncologic outcomes over 12 years to clarify the feasibility of LAG for gastric cancer. Materials and Methods: The authors retrospectively analyzed 753 patients who underwent LAG for gastric cancer, from May 1998 to August 2010. We reviewed clinicopathological features, postoperative outcomes, mortality and morbidity, recurrence, and survival of LAG for gastric cancer. Results: During the time period, 3,039 operations for gastric cancer were performed. Among them, 753 cases were done by LAG (24.8%). There were 69 cases of total gastrectomy, 682 subtotal gastrectomies, and 2 proximal gastrectomies. According to TNM stage, 8 patients were in stage 0, 619 in stage I, 88 in stage II, and 38 in stage III. The operation-related complications occurred in 77 cases (10.2%). Median follow-up period was 56.2 months (range 0.7~165.6 months). Twenty-five patients (3.3%) developed recurrence, during the follow-up period. The overall 5-year and disease free survival rates were 97.1% and 96.3%, respectively. Conclusions: The number of postoperative complications and survival rates of our series were comparable to the results from that of other reports. The authors consider LAG to be a feasible alternative for the treatment of early gastric cancer. However, rationale for laparoscopic surgery in advanced gastric cancer has yet to be determined.

A Case of Empyema Caused by Streptococcus Constellatus (Streptococcus Constellatus에 의한 농흉 1예)

  • Ryu, Yong Suc;Lee, Jae Hyung;Lee, Byung Hoon;Kim, Sang Hoon;Yang, Dong Jin;Ryu, Sang Ryol;Yu, Yun Hwa;Cheong, Mi Youn;Chae, Jeong Don
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.463-466
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    • 2009
  • Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.

Post-Transcriptional Control of Tropoelastin in Aortic Smooth Muscle Cells Affects Aortic Dissection Onset

  • Qi, You-Fei;Shu, Chang;Xiao, Zhan-Xiang;Luo, Ming-Yao;Fang, Kun;Guo, Yuan-Yuan;Zhang, Wen-Bo;Yue, Jie
    • Molecules and Cells
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    • v.41 no.3
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    • pp.198-206
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    • 2018
  • Aortic dissection (AD) is a catastrophic disease with high mortality and morbidity, characterized with fragmentation of elastin and loss of smooth muscle cells. Although AD has been largely attributable to polymorphisms defect in the elastin-coding gene, tropoelastin (TE), other undermined factors also appear to play roles in AD onset. Here, we investigated the effects of post-transcriptional control of TE by microRNAs (miRNAs) on elastin levels in aortic smooth muscle cells (ASMC). We found that miR-144-3p is a miRNA that targets TE mRNA in both human and mouse. Bioinformatics analyses and dual luciferase reporter assay showed that miR-144-3p inhibited protein translation of TE, through binding to the 3'-UTR of the TE mRNA. Interestingly, higher miR-144-3p levels and lower TE were detected in the ASMC obtained from AD patients, compared to those from non-AD controls. In a mouse model for human AD, infusion of adeno-associated viruses (serotype 6) carrying antisense for miR-144-3p (asmiR-144-3p) under CAG promoter significantly reduced the incidence and severity of AD, seemingly through enhancement of TE levels in ASMC. Thus, our data suggest an essential role of miR-144-3p on the pathogenesis of AD.