• Korea journal of population studies
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• v.29 no.2
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• pp.27-51
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• 2006

In this paper, I have tested various kinds of methods for mortality projection and chose Lee-Carter method for projection of Korean mortality by age and sex. I reviewed the trends of life tables and life expectancies by age and sex from 2005 to 2050 projected by Lee-Carter method and found that the method was very applicable for Korean mortality projection. The differences between reported and estimated data for the period of 1971-2003 were small enough for both sexes and for all of the age groups. The projected life expectancies in 2051 were 82.73 years for males and 89.41 for females, and the differences decreased from 7.06 years in 2005 to 6.68 years. Because of the limitation of Korean infant mortality rate, I adopted the Japanese estimated IMR in 2050 as Korean object level in 2051. When the time series of IMR become long enough, we can use Korean IMR directly for the mortality projection. In addition, if we can estimate the changes of the main cause of death correctly in future, the mortality projection will be more correct and reliable. This will be available when we can produce a long series of life tables by cause of deaths.

• Neonatal Medicine
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• v.16 no.2
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• pp.154-162
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• 2009

Purpose: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. Methods: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. Results: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. Conclusion: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.939-943
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• 2003

Neonatal herpes simplex virus(HSV) infections result in significant morbidity and mortality. Although acyclovir treatment has improved survival, severe neurological sequelae can occur in the majority of survivors. HSV infections limited to the skin, eyes and mouth(SEM) can cause neurologic impairment. A direct correlation exists between the development of neurologic deficits and the frequency of cutaneous HSV recurrences. National Institutes of Allergy and Infectious Diseases(NIAID) Collaborative Antiviral Study Group conducted a phase I/II trial of continuous oral acyclovir therapy for the suppression of cutaneous recurrences. We describe a preterm infant who had two recurrences after neonatal SEM disease had been treated with intravenous acyclovir, and there were no more recurrences after continuous oral acyclovir suppressive therapy for six months. We report this case with a review of related literature.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.1-7
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• 2006

Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

• Korea journal of population studies
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• v.29 no.2
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• pp.89-113
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• 2006

Over the past four decades reproductive behavior has changed rapidly in much of the developing countries. The average total fertility rate has fallen by half from six or more to near three today. Between 1960 and 2000 the largest fertility decline occurred in Asia and Latin America. The mortality rate has also decreased in most developing countries. The purpose of this study is to review the pattern and characteristic of demographic transition in developing countries. At first, this study focuses on the regional fertility and mortality transition. Africa, the total fertility rate is still high, can be match to the second stage of demographic transition. Similar case is found in Southern West Asia areas. However, the fertility rate has therd stage of demographic transition. The same pattern is found in Latin America. The mortality rate has also decreased in most of developing countries. It is interesting to find that there is a clear difference among developing countries. In terms of crude death rate, Latin American countries show the lowest rate. while African countries remain still high rate. About mortality, African countries show a high level in terms of both crude death rate and infant mortality rate. African countries also show the lowest level of life expectancy in the world. One of the reasons for low level of life expectancy in Africa is the widespread of AIDS in this areas. This study suggests that we should include 'AIDS' in the study of mortality in African countries.

• Journal of Nutrition and Health
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• v.31 no.8
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• pp.1338-1346
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• 1998

North Korea has been experiencing a serious food shortage. However, the extent and magnitude of malnutrition and health problems are virturally unknown because a nationwide food and nutritional survey has never been conducted. To get a better udnerstanding of the situation., an exhaustive literature search on the health and nutritiona conditions of North Koreans was performed. We also obtained anthropometric data on 274 North Korean Defectors who are recently resettlers in the South. Some(137) measurements were taken at the time of entry to the South, and the remaining data was from the health and nutrition mail survey conducted by us on North Korean refugeee re-settlers. Health and inutritional status of North Koreans was found to be less than desirable as shown in high infant mortality rates, high mortality and morbidity rates of malnutriton-related infectious deseases, and smaller body sizes. Striking differences were noted in all of the above health and nutrition indicators between north and South Koreans. Considering the fact that North and South Koreans are homogeneous in their genetic back-ground, ours study results clearly demonstrate that the health and nutrition of North Koreas has deteriorated with the dhronic food shortage, which might have sorsened with a recent food crissi. The smaller and thinner adult stature proevailing in North Korea could play a significant negative role in the country's economy, since lower lean body mass has been associated with reduced work productivity that could hinder economic growth and development.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.112-116
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• 2004

Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.

• Child Health Nursing Research
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• v.8 no.2
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• pp.129-140
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• 2002

The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.

• Health Policy and Management
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• v.29 no.3
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

• Korea journal of population studies
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• v.26 no.2
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• pp.1-32
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• 2003

An analysis on cause-specific mortality at the provincial level provides essential information for policy formulation and makes it possible to draw hypotheses regarding various diseases and causes of death. Although the mortality level and causes of death at the provincial level are determined by the multiple effects of socioeconomic, cultural, medical and ecological factors, this study primarily intends to examine similarities and differences of cause-specific mortality at the provincial level. Utilizing the registered death and the registered population as of 1998, the delayed death registration and unreported infant deaths were supplemented at the provincial level and age-standardized death rates and life tables were calculated. Regarding the mortality level due to all causes, major findings were as follow: (1) For both sexes as a whole, Seoul showed the lowest mortality level, and Jeonnam showed the highest mortality level; and (2) The differences of the mortality level among provinces were greater for males than females and for those less than 65 years than those 65 years and over. Regarding the cause-specific mortality level revealed in all indicators (cause-specific age-standardized mortality rates and the probability of dying at birth due to a specific cause for males, females, and both sexes combined respectively), the major findings were as follow: (1) The mortality level due to heart diseases was the highest in Busan and the lowest in Gangweon; (2) The mortality level due to liver diseases was the highest in Chonnam; and (3) The mortality level due to traffic accidents was the highest in Chungnam and the lowest in Inchon. As the mortality differentials at the provincial level are related to various factors, exploratory statistical analysis is attempted for the 25 explanatory variables including socioeconomic variables and 90 mortality variables. Mortality due to all causes are related to socioeconomic variables. Among cause-specific mortality, mortality due to liver diseases and traffic accidents is related to socioeconomic variables. Finally, the need to improve the quality of death certificate is discussed.