• 한국간담췌외과학회지
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• 제27권2호
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• pp.180-188
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• 2023

Backgrounds/Aims: The present study looked at the role of radical surgery in gallbladder cancers (GBC) with limited metastatic disease. Methods: The retrospective observational study was conducted to screen the database from 1st January 2010 to 31st December 2019. Patients of GBC found to have low-volume metastatic disease upon surgical exploration were included. Results: Of the 1,040 patients operated for GBC, 234 patients had low-volume metastatic disease (microscopic disease in station 16b1 node or N2 disease isolated port-site metastases, or low burden peritoneal disease with deposits less than 1 cm, in adjacent omentum or adjacent diaphragm or Morrison's pouch or a solitary discontinuous liver metastasis in adjacent liver parenchyma) detected intraoperative. Of these, 62 patients underwent radical surgery for R-0 metastatic disease followed by systemic therapy, while the remaining 172 patients did not undergo radical surgery and were given palliative systemic chemotherapy. Patients who underwent radical surgery had significantly superior overall survival (19 months versus 12 months, p < 0.01) and superior progression-free survival (10 months versus 5 months, p < 0.01) when compared to the rest. This difference in survival was more significant amongst patients when operated on after neoadjuvant chemotherapy. Regression analysis showed that a sub-group of patients with incidental GBC with limited metastases showed more favorable outcomes with radical surgery. Conclusions: Authors suggest a possible role for radical treatment of advanced GBC with a limited metastatic burden. Neoadjuvant chemotherapy can be used for preferentially selecting patients of favorable disease biology for curative treatment.

• 정신신체의학
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• 제24권2호
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• pp.200-207
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• 2016

연구목적 알츠하이머병은 대표적인 증상인 인지 기능의 저하 외에도 다양한 행동심리증상(Behavioral Psychological Symptoms of Dementia, BPSD)을 흔히 동반하며, 이는 간병인들로 하여금 부양 부담을 야기한다. 본 연구에서는 한국의 치매 환자들과 그들의 간병인들을 대상으로 행동심리증상의 각 항목들과 간병인의 부양 부담에 대한 상관관계를 알아보고자 한다. 방 법 80명의 치매 환자들을 대상으로 행동심리증상을 한국형 신경정신행동검사(Korean neuropsychiatric inventory, K-NPI)를 통해서 평가하였고, 부양자들의 부양부담은 한국판 Zarit Burden Interview(ZBI)를 이용하여 평가하였다. 결 과 K-NPI의 망상, 환각, 초조/공격성, 우울/낙담, 불안, 탈억제, 과민/불안정 빈도와 간병인 부양부담의 평가척도인 ZBI 사이에 통계적으로 유의한 상관이 있었으며, K-NPI의 환각, 초조/공격성, 불안, 탈억제, 이상운동증상, 수면/야간행동의 심각도와 ZBI 척도 간에 유의한 상관이 있었다. K-NPI의 빈도${\times}$심각도 영역에서는 망상, 환각, 초조/공격성, 우울/낙담, 불안, 탈억제, 이상운동증상, 수면/야간행동과 ZBI가 유의한 상관관계를 보였다. 또한 인지기능척도(MMSE-KC, CDR, GDS)와 ZBI 척도 사이에 유의한 상관이 있었으며, 일상생활수행능력(Barthel-ADL, K-ADL)과 ZBI 척도 사이에도 유의한 상관관계를 보였다. 결 론 알츠하이머병 환자의 BPSD와 간병인의 부양부담과 상관관계가 있었다. 또한 간병인의 부양부담은 인지기능 및 일상생활수행능력과도 상관이 있었다. BPSD를 조기에 발견하고 적절하게 치료함으로써 치매 환자의 삶뿐만 아니라 보호자의 삶의 질도 개선시킬 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.191-199
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• 2001

Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

• Journal of Preventive Medicine and Public Health
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• 제54권2호
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• pp.103-109
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• 2021

Objectives: The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017. Methods: Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs). Results: The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively. Conclusions: The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

• Journal of Preventive Medicine and Public Health
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• 제54권4호
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• pp.251-258
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• 2021

Hepatitis C infection is responsible for high morbidity and mortality rates globally as well as for significant indirect costs. The disease burden caused by the hepatitis C virus (HCV) is comparable to the one caused by human immunodeficiency virus or tuberculosis. Today, simple detection methods, highly effective and easy to administer therapies and efficient preventative measures are available to combat hepatitis C. Nevertheless, in most countries around the world, the World Health Organization target of eliminating this infectious disease and its consequences by 2030 are not being met. Significant gaps in care for hepatitis C sufferers still exist, the shortcomings ranging from education and treatment to aftercare. Hepatitis C infection was and still is not on the radar of most politicians and health authorities. National programmes and strategies to combat the disease exist or are being developed in many countries. However, for these to be implemented efficiently and successfully, clear political commitment, strong civil society actors, well-functioning public health structures and the relevant support from global donors are needed.

• Journal of Preventive Medicine and Public Health
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• 제38권2호
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• pp.175-181
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• 2005

Objectives: This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. Methods: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). Results : The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100,000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. Conclusion: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.

• 한국환경보건학회지
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• 제48권2호
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• pp.123-129
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• 2022

Background: The Environmental Health Action Program was a national project carried out from 2012~2021. It was aimed at developing public technologies to protect people's health from various environmental hazards. Objectives: One of the final goals of the project was "creating health benefits worth more than 179.2 billion won by reducing the environmental burden of disease." This study aims to evaluate whether the program sufficiently achieved the planned benefits. Methods: In order to secure consistency in evaluation, we applied the same equation used in the goal-setting process. It is comprised of six parameters to estimate the benefit: 1. The amount of medical expenses for environmental diseases; 2. The attributable proportion of environmental risk factors' 3. The rate of reduction in medical expenses for environmental diseases; 4. R&D project contribution; 5. The proportion of successful policy reflection; and 6. The contributions of the project. The corresponding variables were estimated at the end of the project, and the health benefits of the project were recalculated using the newly estimated variables. Results: It was estimated that a total of 195 billion won in health benefits occurred or will occur from 2015 to 2026. The main contributors for achieving the target were an increase in medical expenses for environmental diseases, a high score in the R&D project contribution, and the proportion of successful policy reflection. Conclusions: Technically, the equation used in the project is about medical expenses for environmental diseases rather than about the environmental burden of disease. There are several benefits of using the environmental burden of disease in the evaluation of public health policies. In further studies, developing a policy evaluation framework using indicators such as population attributable fraction would be needed.

• 대한안전경영과학회지
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• 제25권1호
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• pp.39-50
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• 2023

This study analyzed the effect of workers' socio-psychological burden factors on musculoskeletal disorders. A survey was conducted targeting office and field workers in the Seoul metropolitan area. Analysis was performed using the results of 357 surveys out of 400 surveys. The analysis results were derived as follows. First, the socio-psychological burden factor did not show statistically significant results for musculoskeletal disorders. Second, it was found that job stress factors also had a positive effect on musculoskeletal disorders. Third, social psychological burden factors were found to be more positive than office workers than field workers. Fourth, there was a statistically significant correlation between job stress and musculoskeletal disease risk scores. From the above results, job stress factors affect musculoskeletal disease risk factors (work frequency, pain level, and duration) and the increase in musculoskeletal disorders and the number of accidents.

• 보건교육건강증진학회지
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• 제33권4호
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• pp.1-9
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• 2016

Objectives: This review is to suggest strategies to reduce risk factors of non-communicable diseases (NCD) in South Korea. Methods: Prior research findings on the burden of NCD and associated risk factors and the effectiveness of intervention programs were reviewed. Strategies regarding the control of NCD risk factors were conceived. Results: The author presented research findings from the Global Burden of Disease study on the burden of non-communicable disease (NCD) and associated risk factors in South Korea. Strengths and limitations of population and high-risk strategies for preventing NCDs were introduced. The author also reviewed the evidence on the effectiveness of multiple cardiovascular risk factor interventions and community-based intervention programs on cardiovascular diseases conducted in industrialized countries. Finally, strategies to reduce NCD risk factors in South Korea were suggested. Conclusions: The evidence-based interventions and the importance of population strategies in NCD prevention were highlighted. The author indicated that strategies employed by unhealthy commodity industries to undermine effective public health policies and programs should be actively monitored. It has been suggested that effective high-risk strategies with ecological models to address social risks rather than medical risks among disadvantaged population should be further developed in South Korea.

• 대한치과의료관리학회지
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• 제9권1호
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• pp.1-6
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• 2021

Measuring and quantifying the burden of disease (BoD) is crucial for healthcare policy-related decisions. For this purpose, summary measures of population health (SMPH) have been proposed to overcome the limitations of prevalence, incidence, and mortality. Oral health remains separated from the mainstream healthcare system, and the lack of reliable epidemiological data has been pointed out as the cause. In this study, we aimed to understand the flow of international and domestic BoD research related to oral disorders and the direction in which those studies should advance in the future. It is necessary to continuously revise the previously measured BoD of oral disorders and calculate the BoD by performing subdivisions, starting from the development of lay descriptions. Furthermore, developing elaborate BoD measurement methodologies that reflect the complexity of the oral cavity is essential.