• Health Policy and Management
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• v.21 no.2
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• pp.329-348
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• 2011

This research analyzed 168,010 cases of death of the aged over 65 from 244,867cases of death excluding 7 unknown age cases from 244,874 all age cases of death by using the death data of the National Statistical Office for 2007 to figure out factors affecting the quality of causes of death statistics of the aged and to suggest the ways of improving the quality of death statistics of the aged in korea. This research tried to derive factors affecting ill-defined cause of death category in acordance with WHO's guidelines and to find causes of lowering the accuracy of causes of death statistics of the aged. This research identified the problems of causes of death statistics of the aged by using both demographic characteristics such as sex, age, marital status, educational attainment, residential region, region size and factors of death items as independent variable to find causes of ill-defined cause of death of the aged. Logistic regression analysis was executed to calculate the hazard ratio about the ill-defined causes of death of the aged and multiple regression analysis was conducted to derive factors affecting the ill-defined cause of death by regional groups through using these independent variables such as the component ratio of over age 65, female death rates, doctors insitutions rate, medical institutions rate, attaching rates of death certificate by neighborhood. As a results of this research, R-code was the highest of ill-defined causes of death, accounting for 82.1%, and senility death(R54) of R-code was the highest, accounting for 91.2%. through subdivided order distribution of the ill-defined causes of death of the aged. As ill-defined causes of death by regional groups, attaching rates of death certificate by neighborhood was the most important factor(p<0.05) and also showed regression model's description with 83.8% ($R^2$=83.8%). Furthermore, Jeon-nam was the highest in the regional groups and these regions such as Je-ju, Jeon-buk, Chung-nam were not only attaching the death certificate by neighborhood but also were high at the rate of ill-defined causes of death. Therefore, this research found that both reconsideration about death certificate by neighborhood and education for doctors who write death certificate were needed the most.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.39-42
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• 1981

Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart diseases and atherosclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the deads occurred or the incomplete description on the cause of death reported suggests that statistical information of cause of death from the medically certified death records is meaningful in interpreting changing patterns.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.227-238
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• 1996

This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: $38.9\sim44.6%$, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.1%), injury and poisoning(7.1%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.90-96
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• 2015

Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4251-4254
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• 2014

Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.293-307
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• 1997

In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U. N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for work-men(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade, of work-men was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for' cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.

• Korean Circulation Journal
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• v.52 no.7
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• pp.544-555
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• 2022

Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

• Journal of The Association for Neo Medicine
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• v.2 no.1
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• pp.35-54
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• 1997

We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.