• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.58-64
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• 2006

Purpose: The purpose of this cross-sectional study was to assess the nutritional states and investigate the energy intake of tube-fed patients with severe neurodevelopmental disability. Methods: Eighty six tube-fed patients with severe neurodevelopmental disability were studied. Heights were measured by flexible scale segmentally. Nutritional parameters of weight, triceps skinfold thickness and mid-arm circumference were also measured. Total caloric intakes through the tube were calculated. Results: The anthropometric results showed that nutritional states of tube-fed patients with severe neurodevelopmental disability were poor. The mean daily caloric intake was much less than daily energy requirement (mean=45.2% of requirement). The caloric intake was 7.2 kcal/height (cm), 57.0 kcal/weight (kg). Height was more related with caloric intake (r=0.476) than weight (r=0.263). Conclusion: These results provide that tube-fed patients with severe neurodevelopmental disability were growth retarded and their energy intakes were much less than daily energy requirements. The preliminary evidence was that they need adequate nutritional supply.

• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.542-554
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• 1989

The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.

• Journal of Preventive Medicine and Public Health
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• v.39 no.2
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• pp.115-122
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• 2006

Objectives : This study was conducted to examine the relationships of the several socioeconomic position indicators with the mortality risk in a representative longitudinal study of South Korea. Methods : The 1998 National Health and Nutrition Examination Survey was conducted on a cross-sectional probability sample of South Korean households, and it contained unique 13-digit personal identification numbers that were linked to the data on mortality from the National Statistical Office of Korea. Of 5,607 males and females, 264 died between 1999 and 2003. Cox's regression was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) of mortality. Results: Socioeconomic differences in mortality were observed after adjustments were made for gender and age. Compared with those people having college or higher education, those people without any formal education had a greater mortality risk (RR=2.21, 95% CI=1.12-4.40). The mortality risk among manual workers was significantly greater than that for the non-manual workers (RR=2.73, 95% CI=1.47-5.06). A non-standard employment status was also associated with an increase in mortality: temporary or daily workers had a greater mortality risk than did the full-time workers (RR=3.01, 95% CI=1.50-6.03). The mortality risk for the low occupational class was 3.06 times greater than that of the high and middle occupational classes (95% CI=1.75-5.36). In addition, graded mortality differences according to equivalized monthly household income were found. A reduction of monthly household income by 500 thousand Korean Won (about 400 US dollars) was related with a 20% excess risk of mortality. Self-reported poor living standards were also associated with an increased risk of mortality. Those without health insurance had a 3.63 times greater risk of mortality than the insured (95% CI=1.61-8.19). Conclusions: This study showed the socioeconomic differentials in mortality in a national longitudinal study of South Korea. The existence of socioeconomic mortality inequalities requires increased social discussion on social policies in Korean society. Furthermore, the mechanisms for the socioeconomic inequalities of mortality need to be explored in future studies.

• Journal of Preventive Medicine and Public Health
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• v.29 no.4 s.55
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• pp.705-719
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• 1996

Since the 1960s, Korea has achieved rapid economic growth, longer life expectancy, accelerated urbanization and a westenization of diet. Cardiovascular disease has become the leading cause of death; however the prevalence of ischemic heart disease(IHD) remains low. A cross-sectional multiphasic screening service for 18,426 persons aged $30\sim64$ years in a Medical Aid Program in Kyonggi-do Province was conducted from 1991 to 1993. Total cholesterol(TC), fasting blood glucose(FBG), blood pressure(BP), and electrocardiographic(EKG) data were collected. The result as follows ; 1. On the EKG findings, the age-adjusted prevalence of myocardial ischemia and myocardial infarction was 1.45% in men and 2.06% in women. 2. The mean blood pressure was 122.9/78.8mmHg. The age-adjusted prevalence of hypertension was 11.05% in men and 9.02% in women. The prevalence of hypertension showed increasing tendency according to age increase. In all age group, the prevalence of hypertension was higher in men than women. 3. The mean total cholesterol level was 184.4mg/dl in men and 189.2mg/dl in women. The age-adjusted prevalence of hypercholesterolemia was 4.88% in men and 5.67% in women. The total cholesterol level showed increasing tendency according to age increase, except $55\sim64$ age group in men. 4. The prevalence of hyperglycemia is 5.8%. The age-adjusted prevalence of hyperglycemia is 6.72% in men and 4.50% in women. The prevalence of hyperglycemia showed increasing tendency according to age increase. 5. On the EKG findings, the prevalence of myocardial ischemia and myocardial infarction was higher in hypertension than normal, in all age group of men and women less than 40 years-old. Only in women more t]fan 40 years-old, the prevalence of myocardial ischemia and myocardial infarction was higher in hypercholesterolemia and hyperglycemia. Nevertheless there is not statistical association between ischemia heart disease and previous risk factors in other age group, the prevalence of myocardial ischemia and myocardial infarction was higher in hypertension, hypercholesterolemia and hyperglycemia than normal. The result of this study suggest that relationships between major risk factor of ischemic heart disease and ischemic heart disease is similar to existing theory.

• Journal of Preventive Medicine and Public Health
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• v.33 no.4
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• pp.449-458
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• 2000

Objectives : To determine the prevalence of prostatitis symptoms in the general population by questionnaire survey and to measure the effect of prostatitis symptoms on quality of life(QOL). Materials & Methods : A cross sectional community-based epidemiologic study was performed on 2,034 men, living in the Seoul metropolitan area using stepwise random sampling. Out of 2,034 interviewees, 1,356 men who were older than 40 and provided sufficient information were selected for this study. The questionnaires were completed by well trained interviewers. Contents of the questionnaires included demographic data, the Prostatitis Symptom Index(PSI), the International Prostate Symptom Score(IPSS), a general health questionnaire section and a sexual health questionnaire section. The PSI was composed of a sum of the scores from three questions about dysuria, penile pain and perineal pain and it ranged 0 to 12. Incidence of prostatitis symptoms was defined by a score of 4 or more and the reference group was defined as consisting of those with a score of 3 or less. The rate of incidence of prostatitis symptoms was assessed according to age and the difference of QOL between the prostatitis symptoms group and the reference group. Results : The overall positive rate of prostatitis symptoms measured by the PSI, in men older than 40, living in the Seoul metropolitan area, was 4.5%(61/1,356), adjusted to 4.8% by the relative proportion of this age group in the general population of the Seoul metropolitan area as compared to Korea and the World. The proportion of the group with prostatitis symptoms assessed by the PSI did not increase with age although the proportion of participants with moderate to severe lower urinary tract symptoms (LUTS) did increase with age. The group with prostatitis symptoms suffered from a much greater incidence of LUTS compared to the reference group (p<0.05). The QOL scores of the IPSS, and the general health and sexual health status of the group with prostatitis symptoms, were worse than those of the reference group.(p<0.05). Conclusions : The positive rate of prostatitis symptoms in men older than 40, living in the Seoul metropolitan area, was 4.8% and it didn't increase with age. The general QOL of the group with prostatitis symptoms was much worse than that of the reference group.

• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.623-629
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• 1997

This is cross-sectional study to evaluate a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measured hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles containing red cell number, hemoglobin, hematocrit. Blood viscosity are replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) are measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz. Grades of PTAs(pure-tone averages) are divided three groups that are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results shows significant association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).

• Molecules and Cells
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• v.37 no.1
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• pp.66-73
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• 2014

Myeloid-derived suppressor cells (MDSCs) play an important role in impairing the function of T cells. We characterized MDSCs in two chronic hepatitis C (CHC) cohorts: a cross-sectional group that included 61 treatment-naive patients with CHC, 14 rapid virologic response (RVR) cases and 22 early virologic response (EVR) cases; and a longitudinal group of 13 cases of RVR and 10 cases of EVR after pegylated-interferon-${\alpha}$/ribavirin treatment for genotype 1b HCV infection. Liver samples from 32 CHC patients and six healthy controls were subjected to immunohistochemical analysis. MDSCs frequency in treatment-naive CHC was significantly higher than in RVR, EVR, or healthy subjects and was positively correlated with HCV RNA. Patients infected with HCV genotype 2a had a significantly higher frequency of MDSCs than those infected with genotype 1b. Decreased T cell receptor (TCR) ${\zeta}$ expression on $CD8^+$ T cells was significantly associated with an increased frequency of MDSCs in treatment-naive CHC patients and was restored by L-arginine treatment in vitro. Increased numbers of liver arginase-$1^+$ cells were closely associated with the histological activity index in CHC. The TCR ${\zeta}$ chain was significantly downregulated on hepatic $CD8^+$ T cells in CHC. During antiviral follow up, MDSCs frequency in peripheral blood mononuclear cells was directly correlated with the HCV RNA load in the plasma and inversely correlated with TCR ${\zeta}$ chain expression in $CD8^+$ T cells in both RVR and EVR cases. Notably, the RVR group had a higher frequency of MDSCs at baseline than the EVR group. Collectively, this study provides evidence that MDSCs might be associated with HCV persistence and downregulation of CD8 ${\zeta}$ chain expression.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.39-43
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• 2007

Background and Objectives: There are few studies reported that specifically examine the phonetic characteristics and voice handicap index (VHI) in patients with Allergic Rhinitis. This study was designed to examine phonetic characteristics and VHI in adult patients with allergic rhinitis. Materials and Methods: Forty-two male patients diagnosed as allergic rhinitis were given skin-prick test and others, aged from 20 to 56 years, and were compared with a 16 male control group with no pathology and in the same age group. The VHI was used to measure the changes of patient's perception. Acoustic and aerodynamic analysis test were done, and a nasalance test performed to measure rabbit, baby, and mother passage. Acoustic rhionometry (AR) was performed to evaluate nasal volume and nasal crosssectional area. Statistical analysis was done using independent sample t-test. Results: VHI showed significantly different score in the studied group, higher than that of control group. AR graph showed that there was no significant differences of nasal volume and nasal cross-sectional area. The Shimmer and SFF value in the group of allergic patients were higher than in the control group. MPT value in the group of allergic patients was lower than in the control group. Nasalance in allergic patients showed hypernasality all passage. Conclusion: We suggest that patients with allergic rhinitis have considerable voice problems. Most of them have hypernasality, which may be a compensatory mechanism by nasal obstruction.

• Health Policy and Management
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• v.25 no.3
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• pp.162-173
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• 2015

Background: The aim of the current study was to investigate the factors related to the non-practice of cancer screening in cancer survivors, who are at high risk of developing second cancers. Methods: This study is a cross-sectional analysis of 1,125 cancer survivors ${\geq}19$ years old who participated in the Korean National Health and Nutrition Examination Surveys IV and V (2007-2012). A Rao-scott chi-square test and a survey logistic regression analysis were employed respectively to analyze the difference of cancer survivors in cancer screening by each characteristic and the factors related to the non-practice of cancer screening in cancer survivors. Results: Among total subjects, 33.5% did not participate in cancer screening in the last two years. Results from a fully adjusted logistic model showed that the non-practice of cancer screening in cancer survivors was significantly associated with variables such as sex, age, marital status, education level, monthly income, and drinking a alcoholic beverage Specifically, the odds ratio of non-practice of cancer screening was higher in males than in females, in the younger group than in older group, in the group with no spouse than in the group with a spouse; in a group with a low level of education than in a group with a high level of education; in a group with the lowest income level than in a group with the other levels of income; or in non-drinkers than in drinkers. Conclusion: Health policies to reduce the non-practice rate of cancer screening in cancer survivors should be designed and implemented with close attention to cancer survivors' socio-economic characteristics such as sex, age, marital status, education, and income, along with a health behavioral characteristic as drinking.

• Health Policy and Management
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• v.28 no.1
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• pp.3-14
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• 2018

Background: Both objective body shape and perceived body image have been known to influence the mental health. The purpose of this study was to explore the relationship of a combination between actual body mass index (BMI) status and perceived body image with anxiety depressive condition (ADC) in Korean men and women. Methods: This cross-sectional study analyzed data of 26,239 subjects ${\geq}20$ years old from the National Health and Nutrition Examination Survey (2010-2014). This study performed a Rao-Scott chi-square and multivariate logistic regression analyses reflecting survey characteristics and used a variety of independent variables such as socio-demographics and health behavior factors. Results: With all independent variables considered, people with normal weight who perceived themselves as overweight were more likely associated with ADC than a referent group with normal weight who perceived themselves as normal weight, as shown for both men (odds ratio [OR], 1.52; confidence interval [CI], 1.07-2.15) and women (OR, 1.25; CI, 1.06-1.48). Meanwhile, compared to the referent group, men with underweight who perceived themselves as underweight showed a lower association with ADC (OR, 0.63; CI, 0.41-0.97), whereas women with underweight who perceived themselves as underweight showed its higher association (OR, 1.47; CI, 1.10-1.96). Conclusion: A certain group of people categorized as a combination between actual BMI status and perceived body image showed a relatively high likelihood of having ADC, and the gender difference in the likelihood of having the condition for a group was clear. Therefore, this study suggests the need to identify the group at a high risk of ADC on the basis of actual BMI status and perceived body image and to develop an appropriate mental health management program for the group.