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Rehospitalization Rate and Medical Cost of Infants in the First Year after Discharge from Neonatal Intensive Care Units (신생아중환자실 입원자의 퇴원 후 재입원의 빈도와 의료비용)

  • Bae, Chong-Woo;Shim, Kye-Shik;Hahn, Won-Ho;Kim, Ki-Soo;Kim, Beyong-Il;Shin, Son-Moon;Lee, Sang-Lak;Lim, Baek-Keun;Choi, Young-Youn
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.13-20
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    • 2010
  • Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

Comparing Quality of Life following Liver Transplantation for Cadaveric versus Living Donor Liver Transplant Recipients: A Single-Center Study (사체간이식 환자와 생체간이식 환자들의 삶의 질 비교 연구)

  • Kim, Gum Hi;Yoon, Seok-Jun;Ahn, Hyeong-Sik;Lee, Jun-Young;Park, Hyeung-Keun;Suh, Kyung-Suk
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.32-45
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    • 2004
  • Objective : The aim of this study were to measure quality of life(QOL) in liver transplant recipients, to compare QOL between living donor liver transplant recipients and cadaveric liver transplant recipients and to investigate whether SF-36 may be used as a disease-specific instrument in liver transplant recipients. Methods : We conducted a single-center cross-sectional study of 133 LT recipients ages 13 to 65 years, all of whom had had Liver Transplantation(LT) at least 1 months previously. QOL was assessed using a self-completion questionnaire consisting of the Bang Whal Ran(1991) instruments and the 36-Item Short-Form Health Survey(SF-36) health status profile measure. We investigated whether the SF-36 instrument may be used as a disease-specific instrument in LT recipients. Individual scale scores range from 0 to 100, with higher score reflecting better health. Data on demographics, clinical status at pre transplantation 1 day, post transplantation clinical status, and graft function were collected to identify predictors of post transplantation QOL. Results : Standard measures for test-retest reliability, internal consistency, and discriminant and concurrent validity were examined. The reliability of the SF-36, as measured by test-retest correlation(Pearson coefficients: 0.729, p=0.002) and by internal consistency(Cronbach's alpha: 0.9431) exceeded conventional acceptability criteria. The correlation between domain scores of SF-36 and the Bang Whal Ran(l991) was clear and logical in that the clinical characteristics of SF-36 strongly correlated with the clinical component summary score of the Bang Whal Ran(l991)(r = 0.8155, P<.01). SF-36 scale scores were compared between Cadaveric Liver Transplant recipients and Living Donor Liver Transplant recipients. Donor types of post LT did not influence HRQOL(p>0.05). 87% of the liver transplant recipients were satisfied to get LT. Satisfaction of post LT showed significantly greater HRQOL(p<0.001). Conclusion : SF-36 is found reliable and valid. This study indicates thet Donor Type did not influence HRQOL after LT. The information gained from this study will help us to better define expectations and the clinical course after liver transplantation to patients and their families.

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Prevalence of soy allergy by cow milk-allergic infants in Korea (국내 우유알레르기 환아의 대두알레르기 발생 빈도)

  • Son, Dae-Yeul;Lee, Chan;Park, Ki-Hwan;Oh, Sang-Suk;Lee, Sang-Il;Ahn, Kang-Mo;Han, Young-Shin;Nam, Sung-Yeon;Yoon, Kwang-Ro
    • Korean Journal of Food Science and Technology
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    • v.33 no.4
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    • pp.501-505
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    • 2001
  • Soy protein formulas have been used as supplementary food for infants allergic to cow's milk as well as to prevent atopy since 1929. Though these formulas are used as alternative ways to nourish these infants, the effects of soy proteins are still controversial because they may cause soy allergies in infants. The state of Korean food allergic infants is not as well known as allergy eases in Europe or USA. The purpose of this study was to examine the prevalence of soy allergy in the case of Korean infants in concerning with milk allergy. Among 153 infants with clinical allergic symptoms that underwent tests, 21% and 51.6% of infants exhibited soy and milk allergies, respectively. Furthermore, some of the subjects (14%) possessed both soy protein and milk protein allergies. For cow milk allergic infants, only 27.8% of the tested infants were found exhibiting allergy symptoms related to soy protein, however, cow milk protein allergic reaction was detected in the serum of most soy allergic infants (68.8%).

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A Meta-analysis on the Association between Chronic Noise Exposure and Blood Pressure (만성적 소음노출과 혈압의 상관성에 관한 메타분석)

  • Kim, Chun-Bae;Kim, Jai-Young;Cha, Bong-Suk;Choi, Hong-Ryul;Lee, Jong-Tae;Nam, Chung-Mo;Lee, Sang-Yun;Wang, Seung-Jun;Park, Kee-Ho;Kim, Dae-Youl;Koh, Sang-Baek
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.343-348
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    • 2000
  • Objectives : This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. Methods : Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. Results : All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studios were accomplished in a resting stale, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. Conclusions : Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.

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Preliminary Study on Performance Evaluation of a Stacking-structure Compton Camera by Using Compton Imaging Simulator (Compton Imaging Simulator를 이용한 다층 구조 컴프턴 카메라 성능평가 예비 연구)

  • Lee, Se-Hyung;Park, Sung-Ho;Seo, Hee;Park, Jin-Hyung;Kim, Chan-Hyeong;Lee, Ju-Hahn;Lee, Chun-Sik;Lee, Jae-Sung
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.51-61
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    • 2009
  • A Compton camera, which is based on the geometrical interpretation of Compton scattering, is a very promising gamma-ray imaging device considering its several advantages over the conventional gamma-ray imaging devices: high imaging sensitivity, 3-D imaging capability from a fixed position, multi-tracing functionality, and almost no limitation in photon energy. In the present study, a Monte Carlo-based, user-friendly Compton imaging simulator was developed in the form of a graphical user interface (GUI) based on Geant4 and $MATLAB^{TM}$. The simulator was tested against the experimental result of the double-scattering Compton camera, which is under development at Hanyang University in Korea. The imaging resolution of the simulated Compton image well agreed with that of the measured image. The imaging sensitivity of the measured data was 2~3 times higher than that of the simulated data, which is due to the fact that the measured data contains the random coincidence events. The performance of a stacking-structure type Compton camera was evaluated by using the simulator. The result shows that the Compton camera shows its highest performance when it uses 4 layers of scatterer detectors.

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The Association of Insulin Resistance with Cardiovascular Disease Risk and Dietary Factors in Korean Type 2 DM Patients (제2형 당뇨병 환자에서 인슐린저항성과 심혈관질환 위험요인 및 식이요인과의 관계)

  • Yu, So-Young;Hong, Hye-Sook;Lee, Hyun-Sook;Choi, Young-Ju;Huh, Kap-Bum;Kim, Wha-Young
    • Journal of Nutrition and Health
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    • v.40 no.1
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    • pp.31-40
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    • 2007
  • The purpose of this study was to investigate the association between insulin resistance and cardiovascular disease risk factors in Korean type 2 diabetes patients. The subjects were 429 (male: 218, female: 211) type 2 DM patients visited DM clinic, and they were classified into quartiles based on $K_{ITT}$ index (%/min, Insulin Tolerance Test). Anthropometric and biochemical characteristics, and dietary intakes by Food Frequency Questionnaire were assessed. The means of waist circumference, fat mass, percent body fat and abdominal fat thickness were significantly higher in the lowest quartile (the most insulin resistant group) than in the highest quartile (the least insulin resistant group) of $K_{ITT}$ index (%/min)(p<0.05), For hematological values, the lowest quartile showed significantly higher fasting blood glucose, HbA1c, C-peptide, insulin, triglyceride, ApoB/apoA-1 ratio and C-reactive protein compared to the highest quartile (p < 0.05). Moreover, $K_{ITT}$ index (%/min) was negatively correlated with waist circumference, fat mass, percent body fat, abdominal fat thickness and fasting blood concentrations of glucose, HbA1c, C-peptide, insulin, cholesterol, triglyceride, ApoB/apoA-1 ratio and C-reactive protein (p < 0.05). Nutrient intakes were not significantly different among the quartile groups of $K_{ITT}$ index (%/min) and also not correlated with insulin resistance, however, they showed correlation with obesity parameters (BMI, waist circumference, waist-hip ratio, vat mass, abdominal fat thickness), which were strongly associated with insulin resistance. In conclusion, cardiovascular disease risk would be higher as the insulin resistance grows in Korean type 2 DM patients, and nutrient intakes would affect to the insulin resistance through the effect on anthropometric parameters.

Korean Asthma Guideline 2014: Summary of Major Updates to the Korean Asthma Guideline 2014

  • Kim, Deog Kyeom;Park, Yong Bum;Oh, Yeon-Mok;Jung, Ki-Suck;Yoo, Ji Hong;Yoo, Kwang-Ha;Kim, Kwan Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.3
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    • pp.111-120
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    • 2016
  • Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

Investigation of Theileria sp. from Ticks and Roe Deer (Capreolus pygargus) in Jeju Island (제주 노루와 진드기에서 타일레리아 감염 조사)

  • Moon, Kyoung-Ha;Lee, Sang;Choi, Chang-Yong;Kim, So-Yeon;Kang, Chang-Wan;Lee, Kyoung-Kap;Yun, Young-Min
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.6-10
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    • 2014
  • Siberian Roe deer which inhabits Jeju Island is unique native species. Most of all the roe deer infect a lot of ticks, which can affect its population directly and can act as a vector to spread vector-borne diseases. The purposes of this study were to identify the ticks and detect the piroplamsosis on the roe deer in Jeju island. We collected ticks and blood samples in 23 roe deer rescued and treated at the Jeju Wildlife Rescue Center. As a result, we identified the one species of ticks, Haemaphysalis longicornis in roe deer and detected the closely related to Theileria luwenshuni in all blood samples (100%) and 8 pooled ticks (34.8%). These results indicate that there may be a high prevalence particularly of T. luwenshuni infection in Jeju wild roe deer and H. longicornis is a major vector of these diseases. It suggested that Jeju roe deer may act as reservoirs for these zoonotic pathogens.

Phantom-Validated Reference Values of Myocardial Mapping and Extracellular Volume at 3T in Healthy Koreans

  • Lee, Eunjin;Kim, Pan Ki;Choi, Byoung Wook;Jung, Jung Im
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.3
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    • pp.141-153
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    • 2020
  • Purpose: Myocardial T1 and T2 relaxation times are affected by technical factors such as cardiovascular magnetic resonance platform/vendor. We aimed to validate T1 and T2 mapping sequences using a phantom; establish reference T1, T2, and extracellular volume (ECV) measurements using two sequences at 3T in normal Koreans; and compare the protocols and evaluate the differences from previously reported measurements. Materials and Methods: Eleven healthy subjects underwent cardiac magnetic resonance imaging (MRI) using 3T MRI equipment (Verio, Siemens, Erlangen, Germany). We did phantom validation before volunteer scanning: T1 mapping with modified look locker inversion recovery (MOLLI) with 5(3)3 and 4(1)3(1)2 sequences, and T2 mapping with gradient echo (GRE) and TrueFISP sequences. We did T1 and T2 mappings on the volunteers with the same sequences. ECV was also calculated with both sequences after gadolinium enhancement. Results: The phantom study showed no significant differences from the gold standard T1 and T2 values in either sequence. Pre-contrast T1 relaxation times of the 4(1)3(1)2 protocol was 1142.27 ± 36.64 ms and of the 5(3)3 was 1266.03 ± 32.86 ms on the volunteer study. T2 relaxation times of GRE were 40.09 ± 2.45 ms and T2 relaxation times of TrueFISP were 38.20 ± 1.64 ms in each. ECV calculation was 24.42% ± 2.41% and 26.11% ± 2.39% in the 4(1)3(1)2 and 5(3)3 protocols, respectively, and showed no differences at any segment or slice between the sequences. We also calculated ECV from the pre-enhancement T1 relaxation time of MOLLI 5(3)3 and the post-enhancement T1 relaxation time of MOLLI 4(1)3(1)2, with no significant differences between the combinations. Conclusion: Using phantom-validated sequences, we reported the normal myocardial T1, T2, and ECV reference values of healthy Koreans at 3T. There were no statistically significant differences between the sequences, although it has limited statistical value due to the small number of subjects studied. ECV showed no significant differences between calculations based on various pre- and post-mapping combinations.

Effects of Persimmon Leaf Tea Extract, Green Tea Extract and Oolong Tea Extract on the Frequencies of Mutagen-Induced Sister Chromatid Exchange in Chinese Hamster Ovary Cells (감잎차, 녹차, 우롱차 추출물이 돌연변이 물질로 유발된 Sister Chromatid Exchanges 빈도에 미치는 영향)

  • Song, Hyun-Soon;Lee, Hyun-Kul;Choi, Eon-Ho;Kang, Myung-Hee
    • Korean Journal of Food Science and Technology
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    • v.31 no.3
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    • pp.823-830
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    • 1999
  • The suppressing effects of crude extracts of three Korean teas, persimmon leaf tea extract (PLTE), green tea extract (GTE) and oolong tea extract (OTE), were studied on the induction of sister chromatid exchange (SCE) in cultured Chinese hamster ovary cells. When cells were treated with tea extract after mitomycin C (MMC) treatment, the frequency of MMC-induced SCEs were decreased at the high concentration $(1000\;{\mu}g/mL)$ of PLTE in the presence of S9 mix and at low concentrations $(20{\sim}80\;{\mu}g/mL)$ of PLTE in the absence of S9 mix, Whereas GTE and OTE showed suppressing effects on the MMC-induced SCEs at low concentrations $(10{\sim}20\;{\mu}g/mL)$ for OTE and $160\;{\mu}g/mL$ for GTE only in the presence of S9 mix. MMC-induced SCEs were decreased by post-treatment with each tea extracts with S9 mix in the G1 phase of the cell cycle. These results suggest that PLTE, GTE and OTE could have bio antimutagenic activities, and also suggest that PLTE might have unknown antimutagenic components which would be responsible for the inhibitory effect against direct acting mutagenicity.

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