• Journal of Medicine and Life Science
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• v.21 no.3
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• pp.62-71
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• 2024

The incidence of diabetes is continuously increasing worldwide, resulting in a considerable socioeconomic burden. Glycemic control using traditional diabetes medications prevents microvascular complications; however, there is no objective evidence that it prevents macrovascular complications. In the 21st century, concerns have arisen that strict glycemic control and the diabetes drug rosiglitazone might increase mortality. This led the United States Food and Drug Administration to establish guidelines that require that cardiovascular outcome trials (CVOTs) with 3-point major adverse cardiovascular events (3-P MACE) as the primary endpoints be performed for new diabetes drugs. Since then, 20 CVOTs have been reported. Dipeptidyl peptidase 4 inhibitors do not increase the incidence of cardiovascular disease; however, saxagliptin increases the risk of heart failure. Sodium-glucose cotransporter inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) not only have proven cardiovascular safety but also have shown results beyond expectations by reducing the incidence of cardiovascular diseases. Additionally, SGLT2is have been reported to markedly prevent heart failure and kidney disease. The reduction in 3-P MACE by GLP-1RAs was observed only with long-acting agents; long-acting GLP-1RAs also markedly reduced renal endpoints. However, no preventive effect against heart failure was observed with GLP-1RAs. The preventive effects of both drug types against cardiovascular and kidney diseases appear to be independent of glycemic control. In conclusion, based on CVOT results, it is necessary to actively prescribe SGLT2is and GLP-1RAs to prevent cardiovascular disease in patients with diabetes, regardless of glycemic control.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2022.09a
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• pp.3-3
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• 2022

배경: 독일 크나이프 요법을 국내에서 적용하기 위해 검증 연구가 필요하다. 목적: 국내 산림 환경에서 적용한 크나이프 요법이 자율 신경계 및 회복탄력성에 미치는 영향을 규명하기 위함이다. 방법: 크나이프 요법 중 4가지 요소('움직임', '삶의 질서', '음식 섭취', '치유 식물')를 고려한 중재 프로그램을 구성하여, 성인 40명을 대상으로 적용했다. 중재 전과 후에 맥파측정기(uBioMacpa)를 이용하여 HRV(TP, VLF, LF, HF, LF/HF, CSI: Cumulative Stress Index)와 회복탄력성 지수를 측정하고 비교 분석했다. 결과: HRV를 분석한 결과, 프로그램 중재 후 연구 대상자의 TP(8.64%, p<.001), VLF(6.96%, p<.05), LF(15.86%, p<.001), HF(8.46%, p<.01), LF/HF(5.77%, p<.05)는 유의하게 증가하였고, CSI는 유의하게 감소하였다(16.06% p<.001). KRQ-53 평균 점수는 191.56점에서 206.22점으로 14.66점 증가한 것으로 나타났다. 결론: 국내 산림 환경에서 적용한 크나이프 요법은 자율신경계를 전체적으로 활성화하고, 교감과 부교감신경의 활성도를 높여 심장 활동을 촉진시키며, 누적 스트레스를 감소시켜 주었다. 그리고 회복탄력성을 개선하는 것으로 나타났으며(p<.05), 특히 자기 조절 능력 요인에서 그 효과가 큰 것으로 확인되었다. 본 연구의 결과는 크나이프 요법이 국내 산림 환경에서 치유 프로그램으로 활용되어 스트레스 해소를 포함한 자율 신경계의 긍정적인 효과를 제시한 초기적인 최초의 증거라 할 수 있다.

• Health Policy and Management
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• v.34 no.1
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• pp.17-25
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• 2024

Background: This study aimed to assess the appropriate allocation of emergency medical beds across 17 provinces and presume the economic benefits associated with such allocation. Methods: To estimate the optimal allocation of emergency medical beds by province, data from the Statistics Korea's "cause of death statistics (2014-2021)," regional statistics on "area, population, gender, age," and "population projections" were utilized. The "number of emergency beds by city and district" provided by the Health Insurance Review and Assessment Service was also used. In estimating the economic benefits of preventing avoidable emergency deaths due to the expansion of emergency medical facilities, guidelines from the Korea Development Institute and the Korea Transport Institute were referenced to calculate the wage loss costs associated with emergency deaths and estimate the economic benefits. Results: The optimal ratio of emergency medical beds allocation by region was highest in Gyeonggi, Seoul, Gyeongnam, Gyeongbuk, and Busan, while Daejeon, Jeju, and Sejong showed lower ratios. Additionally, the prevention of avoidable deaths and economic benefits resulting from the increase in emergency medical facilities were highest in Gyeonggi, Seoul, Gyeongbuk, Gyeongnam, and Busan. However, when standardized by population, the prevention of avoidable deaths and economic benefits were analyzed to be highest in Gyeongbuk, Chungnam, Jeonnam, Gyeongnam, and Busan. Conclusion: The results of this study can serve as foundational data for future policy measures aimed at addressing the imbalance in the supply of emergency medical facilities across regions. Considering regional characteristics in the distribution of emergency medical facilities is expected to ultimately increase the efficiency of national finances and yield economic benefits.

• The Korean Journal of Medicine
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• v.99 no.3
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• pp.149-157
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• 2024

Background/Aims: Carbapenems are recommended for treating bacteremia caused by extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae (ESBL-E). However, this has resulted in a significant rise in the utilization of carbapenems in cases of ESBL-E infection. We evaluated the clinical outcomes of patients with ESBL-E bacteremia treated with non-carbapenem antimicrobials. Methods: We conducted a retrospective case-control study of a cohort of patients with documented ESBL-E bacteremia from January 2021 to December 2021. The patients were divided into two groups according to whether they received non-carbapenem or carbapenem therapy. The rates of treatment failure, 30-day mortality and microbiologic failure, and the durations of hospitalization and of antimicrobial therapy were compared between the two groups. Antimicrobial susceptibility testing and phenotypic identification of ESBL-E were performed using the Vitek 2 system. Results: Of 118 patients with ESBL-E bacteremia, 54 received non-carbapenem drugs (non-carbapenem group [NCG]) and 64 received carbapenems (carbapenem group [CG]). Treatment failure at 30 days occurred in 16.7% of the patients in the NCG and in 18.8% in the CG (p = 0.65). The 30-day mortality rate was 14.8% in the NCG and 17.2% in the CG (p = 0.63). Extra-urinary tract infection and prior antimicrobial therapy within 30 days were risk factors for treatment failure in patients with ESBL-E bacteremia. The clinical outcomes did not differ significantly between the two groups, challenging the prevailing preference for carbapenems in the treatment of ESBL-E bacteremia. Conclusions: Non-carbapenem antimicrobials such as piperacillin/tazobactam are recommended for patients with mild ESBL-E bacteremia in South Korea.

• Parasites, Hosts and Diseases
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• v.32 no.2
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• pp.85-92
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• 1994

A seroepidemiologic observation of anti-Spirometrc erinacei plerocercoid (sparganum) antibody (IgG) in serum was made in normal adult and epileptic patients in Korea from february, 1987 to September, 1990. Sera were tested by enzyme-linked immunosorbent assay (ELISA) for anti-sparganum antibody together with anti-Taenic soEiun metacestode, and anti-Parusonimus westermcni antibodies. Sera reacted positively to sparganum antigen only were considered. Positive rate for anti-sparganum antibody in 850 normal adults was 1.9% (standardized rate by provincial population was 1.7%). In 2,667 randomly selected patients of epilepsy at 28 local centers of the Changmi Club, positive rate was 2.5% (standardized rate: 2.3%). In both normal adult and patient groups, the higher antibody rates were observed in Kangwon and Chonnam Provinces. Positive rates were 10 times higher in male than in female in normal adults and 4.5 times in male epileptic patients. The rates were elevated especially with age over 30-year. odd ratio of the antibody was 1.32 which indicated an ambiguous etiologic factor for epilepsy.

• Journal of Naturopathy
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• v.11 no.1
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• pp.1-8
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• 2022

Background: A validation study is needed to make domestic applications of German Kneipp therapy. Purpose: The study aims to test the effect of a Kneipp therapeutic program in a domestic forest environment on the autonomic nervous system. Methods: The program was made considering the 4 key elements ('exercise', 'regulative therapy', 'nutrition', and 'phytotherapy') of the Kneipp therapy. Total 3 sessions (once a week for 5 hours in each session) were performed to 40 domestic adults divided into four groups (10 in each group). HRV was measured on the subjects before and after the intervention, and its 6 characteristic parameters (TP, VLF, LF, HF, LF/HF, CSI: Cumulative Stress Index) were compared for statistical analysis. Results: For 33 subjects excluding 7 who were disturbed by interrupt factors during measurements, significant improvements after the intervention, were observed in TP(8.64%, p < ..001), VLF(6.96%, p < .05), LF(15.86%, p < .001), HF(8.46%, p < .01), LF/HF(5.77%, p < .05) and CSI(-16.06%, p < ..001). Conclusions: The Kneipp therapy performed in the forest environment was shown to activate the autonomic nervous system and in particular the sympathetic and parasympatheric nervous to promote heart activity, and was also shown to most significantly reduce cumulative stress. The present observations would be the first preliminary evidence that the Kneipp therapeutic interventation in a domestic forest environment results in positive responses of the autonomic nervous system including stress relief.

• Journal of Naturopathy
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• v.10 no.2
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• pp.77-85
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• 2021

Background: It is necessary to verify the resilience of the newly improved Kneipp psychotherapy. Purpose: This study assesses whether Kneipp Lebensordnung psychotherapy; KnLP program improves resilience. Methods: The KnLP program, including salutogenesis, logotherapy, meditation, and resilience training, is reorganized in consideration of Korean culture and sentiments. It was conducted 4 times for 25 adults (once a week, 3 hours a time), and data, KRQ-53 (Korean Resilience Quotient-53) measured intervention, before, and after was compared and analyzed. Results: The data for 9 adults were selected to draw reliable analysis, and it concluded that participants' KRQ-53 mean score increased by 14.66 from 191.56 to 206.22 during and after the program. The score increase by factor in resilience training is 5.89 points for self-regulation skills, 4.89 points for in interpersonal skills, and 3.89 points for positive capacity. Conclusions: KnL program improves participants' resilience skill (p<.05), and especially in self-regulation skill. Subsequent studies with more participants are required to achieve statistically significant and generalized results in the future.

• Journal of agricultural medicine and community health
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• v.46 no.1
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• pp.12-22
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• 2021

Backgrounds: Proper distribution and supply of physicians are factors that affect national health care systems. This study investigated the payment distribution levels and the determinants that influence the salary levels of hospital hired physicians. Methods: We analyzed 4,014 job advertisements posted on an internet invitation information site about physician recruitment from May 2016 to May 2019. We used univariate analysis to determine the relationship between average monthly salary and the other related variables. Multiple regression analysis was used to determine the predictors of physician salary level. Results: The average monthly salary for the service physician was 15.4 million won, highest for orthopedic surgeons with 22.24 million won, and lowest for diagnostic laboratory physician with 11.4 million won. The factors significantly associated with average monthly salary were; non-major specialty, housing provision, no severance pay, and incentives(p<0.05). Non-major specialty, incentives, and the regions were predictors of the average standardized monthly salary(p<0.05). Conclusion: Factors associated with average monthly salary as revealed by this study were; medical specialty, hospital regional location, housing provision, payment of retirement allowance, and payment of other incentives respectively. However, this study was a cross-sectional study, and further studies will be required.

• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.73-79
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• 2009

Purpose : We undertook this study to improve our understanding of the epidemiologic and clinical features of nonpolioenterovirus (NPEV) infections, especially enterovirus 71 (EV71) infections, in Korean children. Methods : Between April and June 2000, NPEVs were detected by RT-PCR and cultures of specimens obtained from patients with aseptic meningitis, acute respiratory disease, and acute gastroenteritis which were associated with enteroviral exanthem and vesicular pharyngeal enanthem, such as herpangina, and hand, foot, and mouth disease (HFMD). EV71 was identified by sequencing the VP1 gene. The clinical and epidemiologic data were analyzed retrospectively after all 87 NPEV-positive patients were divided into 4 groups, according to the clinical manifestations. Sixteen patients who mainly had symptoms of acute gastroenteritis were in group A, 21 patients with symptoms and signs of lower respiratory tract infections were in group B, 42 patients with a HFMD rash only were in group C with or without fever, and 8 patients with aseptic meningitis or paralysis were in group D. For the 11 EV71-positive patients, 1 was in group A, 2 were group B, 7 were in group C, and 1 was in group D. Results : There were 87 NPEV infections, including 11 EV71 infections. The mean age of the patients was 2 years and 11 months, ranging from 1 day to 15 years. There were no fatal cases among a total of 87 NPEV infections and no significant differences in clinical severity between the EV71 and other NPEV infections. Conclusion : NPEV infections in children were common during the 3 months in the spring of 2000. Unlike in southeast Asia, where fatal EV71 infection outbreaks have occurred since 1997, the clinical features of EV71 infection in Korean children are mild.

• Journal of Convergence for Information Technology
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• v.12 no.2
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• pp.174-183
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• 2022

This study was conducted to investigate the effect of the active exercise program using sling on the pain and balance of total knee replacement patients. Subjects were 20 patients who received total knee replacement and are hospitalized, 10 patients in each group were randomly assigned to a group (CPM group) that applied only CPM (Continuous passive motion) and a group (CSG) that combined CPM with a active exercise program using sling. CG was performed CPM 5 days a week, CSG performed CPM 2 days a week and a active exercise program using sling 3 days a week, and each intervention was performed for 40 minutes a day for a total of 4 weeks. Pain was evaluated using VAS (Visual analog scale), and balance was measured using BT4 (Balance training 4) to measure C90 area, trace length, and Sway average velocity with eyes open and closed. As a result, there was a significant decrease in pain in both groups, and there was also a significant difference in the amount of change between groups. In balance, all variables except C90 of CG showed significant changes after intervention, and there was a significant difference between C90 and Vel with eyes closed in the amount of change between groups. Therefore, we believe that CPM and active exercise program using sling are effective interventions to reduce pain and improve balance in total knee replacement patients.