• Korea journal of population studies
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• v.12 no.2
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• pp.1-21
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• 1989

For the analysis of mortality differentials by socioeconomic factors based on death registration data, we have considered four variables : place of residence, educational attainment, marital status and occupation. The age range adopted were 5 to 64 years of age for place of residence, and 25 to 64 years of age for the other factors. The mortality differentials by socioeconomic variables were clear and in the expected direction: mortality levels among urban residents, better educated groups, and non- agricultural workers were lower than among the other sub- groups. The average mortality level in rural areas is much higher than in urban areas : the rural mortality levels were at least double the urban levels at ages below 40 years, but became smaller after age 40, and no clear differentials by urban I rural residence increased until 1974~76 for the both sexes, but since the then differentials have declined slowley for both sexes. This changing pattern of mortality differentials by place of residence can be explained by historical socioeconomic development : the development generally started in urban areas, and rural areas followed : in the course of socioeconomic development the differences between the death rates in the two areas became smaller and finally the mortality levels in the two areas became nearly the same, as is found in the developed countries nowadays. The inverse relationships between mortality and educational level became stronger between the periods 1970~72 and 1984~86, but showed the same atterns of mortality differentials in both period : larger differences among the younger age groups, and for males, than among the older age groups, and for females. The increasing mortality differentials in the fourteen-year period between 1970~72 and 1984~86 were caused by inadequate living standards of the non- educated, whose proportion in the total population, however, dropped sharply during that period. Also, the much lower proportions of low - educated groups or of persons with no formal education among males than females helped to establish the clearly pronounced differentials. The mortality differentials by marital status in Korea showed the usual pattern : the mortality rates of the married in each age and sex group were clearly lower than those of others during the fourteen-year period between 1970~72 and 1984~86. In Korean society which remotes universal marriage, the never married recorded especially high death rates, presumably mainly because of ill - health, but also possibly because of the stigma attached to celibacy. However, the mortality differentials by marital status changed with the changes in the proportionate distribution by marital status during the period : the differences between the death rates of the married and never married groups became smaller, the proportion of the never married group increased : in contrast, the differences between mortalities of the married and widowed / divorced / separated groups widened, with the decrease in the proportion of the later group ; this tendency was perticularly marked for females. Occupational groups also showed clear mortality differences : among four occupational groups mortality of males was highest among agricultural workers and lowest among 'professional, admi-nistrative and clerical workers, However, when the death rates were standardized by educational level, the death rates by occupation in age group 45~64 years were nearly the same (excet for the mixed group consisting of unemployed, students, military servicemen and unknown). Therefore, the clear mortality dfferentials by occupation in Korea resulted mainly from the differences in educational level between different occupation groups. Since socioeconomic characteristics are related to each other, the net effect of each variable was examined. Each of the three variables - ducational level, marital status and urban / rural residence affected significantly Korean adult mortality when the effects of the other variables were controlled. Among the three variables educational level was the most important factor for the determination of the adult mortality level. When male's occupation was added to the above three variables, the effects of occupation on adult mortality were notably smaller after control for the effects of the other three variables while the net effects of these three variables were nearly the same irrespectively whether occupation was included or not. Thus, the differences in educational level (mainly), place of residence and marital status bring out the clear differences in observed mortality levels by occupation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.194-201
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• 2005

Purpose: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. Methods: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. Results: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2 : 1 with the mean age of $6{\pm}4.3years$. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. Conclusion: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.57-64
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• 2007

Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.334-342
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• 2001

Background : RpoB gene mutations have been found in about 96-98% of rifampicin (RMP)-resistant Mycobacterium tuberculosis. Recent reports confirm that the in laboratory settings a rpoB gene mutation can be used as a surrogate marker for multi-drug resistant tuberculosis. However, its usefulness in clinical applications has not been evaluated. This study was performed to confirm whether mutation analysis of the rpoB gene of M. tuberculosis is useful in clinical settings. Methods : The medical records of 33 patients in whom rpoB gene analysis was conducted using an INNOLiPA Rif. TB assay (LiPA) from June, 1998, to July, 2000, at the Asan Medical Center were retrospectively reviewed in 33 patients. The clinical characteristics in addition to the drug susceptibility and LiPA results were analyzed. The drug susceptibility test was considered as a gold standard method for M. tuberculosis susceptibility and these results were compared with those of the rpoB gene study and sequencing analysis. Sequencing analysis of the rpoB gene was done in cases where there was a discrepancy between the results of the drug susceptibility an d rpoB gene study. Results : The mean age and sex ratio was $42{\pm}18$, and 24:9 (M:F), respectively. There were 19 RMP susceptible (58%) and 14 RMP-resistant cases (42%) according to the rpoB gene study. The mean time from the request to reporting the results of the rpoB gene study was $5.2{\pm}2.6$ days. The mean gap from reporting the rpoB gene study to reporting the susceptibility was $56{\pm}35$ days. Twenty-eight cases (85%) showed identical results compared with the drug susceptibility results, whereas five cases (15%) showed contradictory results. When compared with the sequencing analysis, of the five cases that showed contradictory results, two had LiP A analysis errors and the remaining three were identical to the sequencing results. The rpoB gene study was of assistance in choosing the appropriate drugs in 28 cases (85%). Conclusions : An rpoB gene study using an LiP A assay was useful in rapidly diagnosing RMP-resistant tuberculosis, which enabled a proper choice of the appropriate drugs in clinical practices. However, an LiPA assay always should be performed in conjunction with microscopy, culture, and susceptibility tests.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.295-299
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• 2009

Background: There are various etiologies causing bronchiectasis, but the cases without definite causes account for a quite high proportion. It is also uncertain that immunoglobulin G subclass deficiency (IgGSD) is associated with bronchiectasis. Therefore, we tried to measure the frequency of IgGSD in patients with bronchiectasis of unclear etiology, and to observe the clinical features of those patients with bronchiectasis and IgGSD. Methods: For the outpatients of a university hospital who were diagnosed as bronchiectasis by chest CT, we produced comprehensive history taking and physical examinations, and finally selected 31 patients with bronchiectasis of unclear etiology. Results: Two patients had total immunoglobulin G deficiency. The frequency of IgGSD was comparatively high (n=14). When we compared IgGSD group to normal immunoglobulin G subclass group, there were no significant differences in sex, age, and the frequency of sinusitis, bronchial asthma, and the abnormal lung function. Conclusion: In cases of bronchiectasis without definite causes, it can be considered to measure the level of immunoglobulin G subclass. It is also probably worthwhile to further evaluate the relationship between IgGSD and bronchiectasis.

• Journal of agricultural medicine and community health
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• v.35 no.2
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• pp.151-164
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• 2010

Objective:Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. Methods: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. Results: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. Conclusion:In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.

• The Journal of Pediatrics of Korean Medicine
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• v.14 no.2
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• pp.149-168
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• 2000

The Purpose of this study was to investigate the new effective oriential medicine tretments in pediatric disease and its clinical applicability The study was composed of 1245 new patients who had been treated at the all unit in the Dong-Seo oriential Medicine Hospitial for 1 year, from 1 April 1999 to 31 March 2000, and aged between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. Result 1. The numbers of children who involved in this study is total 1245: Male children are 668 and female children are 577 children. The sex rate between male and female is 1.15 to 1. 2. Most of the above patients came to the hospital at first time from diseases such as musculoskelectal disease, weakness, asthma, cough, anorexia, common cold, rhiorrhea, sweating, dyspepsia, dematitis, night terror, obesity, stomach, short stature, Besides, they also came to the hospital at first time from various diseases such as epistasxis, pyrexia. Bell's palsy, nocturia, contipation, cerebral palsy, disorder, CVA. diarrhea. stress disease, Allergic disease, Tic disorder. Visual disorder, Kawasaki disease, Pierre Robin's syndrom, hematuria, edema and so on. 3. Looking at the frequent diseases, Respiratory dis. children including asthma, cough, rhiorrhea, sweating, common cold, pyrexia covers 36%, in 399 numbers. digestive dis. children including anorexia, dyspepsia, stomach, diarrhea, constipation, indigestion covers 19%, in 211 numbers. cadiovasculary disease children including arrthymia, terror in frequency, night crying, sediation, Tic disorder covers 8%, in 85 numbers. Hepatobiliary disease children including short stature, dizziness, visual difficulty, sprain, disorder of nail covers 21%, in 238 numbers. renal disease. children including nocturia, hematuria, hemation, disorder of hair, menorrhea, cerebral palsy, edema in 44 numbers. Fatigue children covers 13%. in 143 numbers. 4. In case of respatory disease children. total number is 399 children. dematitis children are 108 numbers and asthma children are 96 numbers. These show that children seem to the best have dematitis and asththma. The age from 0 to 6 is 290 numbers, covering 73 percentage. The others are covering 27 percentage. These data demonstrate that the age from 0 to 6 age could easily get these kinds - of diseases. The 29 percent of children had these kinds of diseases in spring. The 28 percent of children had these kinds of diseases in autumn. These show that children seem to frequently have these kinds of diseases in both spring and autumn season.(inter-season) 5. In case of digestive disease, anorexia covers 39%, in 83 numbers, dyspepsia covers 28%, in 59 numbers, anorexia and dyspepsia were the lagest group in digestive disease and the age from 0 to 6 covers 59%, in 125 numbers and the other age covers 39%. According to these data, infant seems to be vulnerable to these kinds of diseases. The 24 percent of children had these kinds of diseases in spring and summer. The 33 percent of children had these kinds of diseases in winter, which means that children mostly had winter. but decreased significant in autumn. 6. In case of cadiovasculary diseases, it can be divided into two categories: night covers 73% and nervous characteristics covers 27%. The age from 0 to 6 occupies 75%, and the other age occupies 25%. These data also show that infants can easily infected with these kinds of diseases. Analyzing by the season, summer could be the most frequent season that children have these kinds of diseases. but decreased in autumn. 7. In case of hepatobiliary children, sprains covers 166 numbers, fatigue covers 32 numbers, epistasxia covers 24 members, the reasion which sprain occupyied most of % were sprain covered ages. The age from 0 to 14 covers 59% and from 15 to 18 covers 41%. In the conclusion the adolescent seems to be vulnerable to sprains. In spring 29%, insummer 31%, in autumn 23%, and in winter 28% of children got these kinds of diseases, which show that children seems to have this kinds of disease in summer season. and decreased in autumn. 8. In case of renal disease. nocturia and hematuria covers 52%(occupied overhalf). The age from 0 to 6 covers 52%(occupied overhalf). Analyzing by season, in spring increased in summer(59%), decreased in autumn(45%) Conclusion 1. The chief complant in pediatric diseases that needed an oriental medical tretment was mainly the disease that tends to take iong time and the weakness. and appeared frequency in respiratory disease : 2. The oriential medical tretment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In paticular, the study shows that the oriental medical tretment should be emphasized in terms of preventing the disease 3, The new disease, which were developed with the change of human life and envir oment(just like seual disorder, short stature, obesity, dynamic disorder, examinee disease), should be in vestigated as a new field of oriental medical tretment.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.495-502
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• 2010

Purpose : Sepsis is a significant cause of morbidity and mortality in the newborn, particularly in preterm. The objective of this study was to analyze the incidence rate, causative pathogens and clinical features of neonatal sepsis in one neonatal intensive care unit (NICU) for 6 years. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics including sex, gestational age, birth weight, Apgar score, length of hospitalization, length of total parenteral nutrition, presence of central venous catheter, underlying diseases, laboratory findings, microorganisms isolated from blood culture, complications and mortality in 175 patients between January 2003 and December 2008. Results : 1) Sepsis was present in 175 of 3,747 infants for 6 years. There were more gram-positive organisms. 2) The gram-negatives were more prevalent in preterm. There were no significant differences of other clinical features between two groups. 3) Underlying diseases were found in 73.7%, and the most common disease was cardiovascular disease. The most common organisms of gram-positives and gram-negatives were methicillin resistant Staphylococcus aureus (MRSA) and Serratia marcescens. 4) There was statistically significant difference on platelet counts between two groups (P<0.05). 5) Complications were found in 18.3% and septic shock was the most common. MRSA was the most common pathogen in sepsis with complication. 6) The mortality rate was 7.4%. 7) There were differences in monthly blood stream infection/1,000 patient-days. Conclusion : The studies about the factors that can influence neonatal sepsis will contribute to decrease the infection rates in NICUs.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.97-102
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• 1993

A retrospective analysis of various characteristics in 32 limited stage small cell lung cancer patients treated at the Department of Therapeutic Radiology in Kangnam St. Mary's Hospital, Catholic University Medical College from April 1983 to September 1991, was carried out to identify factors which had prognostic significance for survival from initiation of radiation therapy. There were 26 men and 6 women. Median age was 63 years (range: 24-78 years). The follow up duration was 1.5 to 44 months (median: 9 months). External radiation therapy was done with daily 160-180 cGy,5 fraction/week, total of 1000-6660 cGy (median: 4500 cGy) to the mediastinum by 6 MV linear accelerator. Of 32 Patients, 27 ($84.4{\%}$) patients were treated with combined modality (chemotherapy plus radiation therapy), and 5 ($15.6{\%}$) patients were treated with radiation therapy only. Complete responders were 12 patients ($37.5{\%}$), partial responders were 11 ($34.4{\%}$), and no responders were 9($28.1{\%}$). Karnofsky performance status over 70 (p<0.04), chemotherapy regimen (CAV, PV, and CAV+PV) (p<0.04),6 or more cycles of chemotherapy (p<0.007), radiation therapy over 4500 cGy (p<0.03), and radiation therapy responder (CR+PR) (p<0.003) showed a significantly favorable influence on 1 year survival rate. Age (p=0.545), sex (p=0.666), presence of superior vena cava syndrome (p=0.719), prophylactic cranial irradiation (p=0.217), and radiation therapy duration (p=0.491) had no effect on survival. Radiation induced side effects were transient esophagitis in 11 ($34{\%}$), general weakness in 9($28{\%}$), gastrointestinal symptoms in terms of nausea, vomiting and indigestion in 5 ($15{\%}$) and leukopenia in 1 ($3{\%}$).

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.101-108
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• 1997

Purpose : The clinical characteristics of renovascular hypertension (RVHT) in children were analyzed. Methods : Medical records of 16 children diagnosed as RVHT on the basis of angiography during Jan. '86 to Jun. 94 in our hospital were reviewed retrospectively. Results : The mean age at the onset was 8.5 yrs and the sex ratio(M:F) was 7:9. The causes of RVHT were Takayasu arteritis in 6, Moyamoya disease in 5, and fibromuscular dysplasia in 3 patients. Abdominal bruit was noted in 6 patients (38%). Peripheral renin activity was raised in all tested patients. Bilateral renal arterial involvemnent was found in 9 patients (56%). Captopril renal scans showed good correlation with angiographic findings. Five patients were treated with antihypertensives only, and blood pressure was controlled completely in 2 and incompletely in 3. Percutaneous transluminal angioplasty was performed in 10 patients with 50% of success rate. However, hypertension was recurred due to restenosis or accompaning aortic stenosis in 3 patients. Surgical treatment was performed in 4 patients, and the blood pressure was controlled partially in 1 and poorly in the remaining 3. Conclusions : Takayasu arteritis, Moyamoya disease and fibromuscular dysplasia are the major causes of childhood RVHT in our country. The diagnosis of RVHT in children should be based on a set of tests individually selected for case by case. For the low curability of the current treatment modalities available, RVHT in children should not be regarded as 'curable' so far. We expect, however, that the outcome will be improved by more extensive application of the newly developed surgical technique.