• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.416-422
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• 2011

Background: Inhaled corticosteroids (ICSs) are the most essential medication for asthma control. Many reports suggest that the usage of ICSs improves not only the control of asthma symptoms but also prevents exacerbation. We investigated whether increases in ICS prescriptions are associated with decreases in asthma exacerbation in the clinical practice setting. Methods: We retrospectively analyzed the database of adult asthma patients who had visited a tertiary referral hospital, the Asan Medical Center between January 2000 and December 2009. The number of emergency department (ED) visits, admissions, intensive care unit (ICU) care, deaths, and ICS prescriptions were analyzed to evaluate the time trend of asthma exacerbation as a function of the ICS prescription rate during the ten years. Results: The numbers of ED visits, admissions, and episodes of ICU care decreased during the ten years (p<0.001, p=0.033, p=0.001, respectively) while the number of ICS prescriptions increased (p<0.001). We found a correlation between the number of ICS prescriptions and the number of ED visits, admissions, or ICU care. For these outcomes, the correlation coefficients were r=-0.952, p<0.001; r=-0.673, p=0.033; r=-0.948, p<0.001, respectively. Conclusion: The number of ICS prescriptions increased during the past ten years while the number of asthma exacerbations decreased. Our results also showed a negative correlation between the ICS prescription rate and asthma exacerbation in the clinical practice setting. In other words, an increase in ICS prescription may be a major cause of a decrease in asthma exacerbations.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.135-139
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• 2009

Human metapneumovirus (hMPV) is a recently recognized human respiratory pathogen, which is known to be associated with upper and lower respiratory tract infections mainly in children, immunocompromised patients, and the elderly. The clinical manifestations of hMPV infections are similar to those of the human respiratory syncytial virus infection, which range from mild upper respiratory tract infection to severe bronchiolitis and pneumonia. Recently, hMPV has come to be thought of as the cause a similar spectrum of disease in adults as that seen in children; however, most of the reports of hMPV infections have focused on infection in children. We report a case of severe hMPV pneumonia requiring mechanical ventilation in an immunocompetent adult in Korea.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.66-71
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• 2012

Purpose: We analyzed treatment result to examine the outcome for patients with sacral chordoma and to determine relevant prognostic factors. Materials and Methods: We retrospectively reviewed 19 patients with sacral chordoma seen at out institution between 1990 and 2010. There were 9 men and 10 women with mean age of 56 years. The average follow up was 63 months (range, 25-144 months). 15 patient received surgical treatment, six of these patient had wide, eight had marginal, one had intralesional margin and 4 patient treated with Radiation therapy only. Results: The disease free and overall survival rate for all 19 patients was 34.7% and 79.7% at 5-years, respectively. Statistical analysis using the log-rank test revealed no significant difference between the surgery and radiation therapy groups in overall survival (p=0.54). Nine of 19 patients had local recurrence at a median of 2.5 years postoperatively. Seven of these 9 patients had distant metastasis at a median of 4.5 years postoperatively. Among the variables, tumor size (p=0.033) and tumor involvement of above S3 (p=0.032) were independent prognostic factor for overall survival. Nine of 15 patients who received surgical treatment had postoperative complication such as voiding difficulty and incontinence. Conclusion: Careful consideration of the patient general condition and predictable complication of the treatment might be the best way to improve patient's survival and quality of life.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.291-299
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• 1999

This study was conducted to evaluate the health status including mainly cognitive function and activities of daily living of institutional elderly in a rural area. We studied 466 subjects dwelling in ten institutions at Chonnam province, Korea. The participants consist of 148 males(31.8%) and 318 females(68.2%). We collected the information of socioeconomic state, mini-mental state examination(MMSE), activities of daily living(ADL), instrumental activities of daily living(IADL), and Dartmouth Primary Care Cooperative Information Project(COOP) chart. The results were followed: 1. Severe cognitive function impairment was appeared in 45 males(30.4%) and 115 females(36.2%). 2. The percentage of fully independent in the six ADL items was 50.0% of males and 42.8% of females, but 31.1% of males and 26.1% of females were fully dependent. 3. Males had more impairment in mode of transportation among IADL, but females had most impairment in laundry. 4. Observing health status by COOP chart, both had more grade in feeling and social activity than physical fitness.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.34-46
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• 2009

Objectives: This study was conducted to estimate health service weight for resource allocation and performance monitoring using Basic Priority Rating System. Methods: The Health service would be classified according to New Health Plan 2010, and Burden of disease collected from preceding studies. The data of severity of health problem and effectiveness of intervention were collected through the survey of experts' suggestion. The health service weight was estimated in the formula which is Basic Priority Rating System. Results: In the result of analysis, the health service weight of Infectious disease was ranked highest at 58.97% followed by Anti-smoking campaign(14.07%), Hypertension(3.87%), Diabetes mellitus(3.40%), Cancer(2.90%), Cardiovascular-Cerebrovascular diseases(2.86%), Physical activity(2.10%), Moderate drinking(2.07%), Medical examination(1.92%), Mental health promotion(1.72%), Serious mental illnesses(1.62%), Nutrition(1.52%), Oral health promotion(1.15%), Oral diseases(1.10%), Addiction(0.73%). Conclusions: We think the result of this study provides a rational basis for resource allocation and performance monitoring of health service.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.251-259
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• 2012

Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053 (95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group, patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and long-term odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3% of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid, whereas intravenous corticosteroid also reported high rate of adverse reactions.

• Journal of the Korea Convergence Society
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• v.9 no.1
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• pp.387-392
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• 2018

The aim of this study was to determine the statistical significance of heart rate variability(HRV) between sleep stages, Apnea-hypopnea index(AHI) and age in patients with obstructive sleep apnea(OSA). This study evaluated the main parameters of HRV over time domain and frequency domain in 40 patients with sleep apnea. The non-REM(sleep stage) was statistically validated by comparing the AHI degree of the three groups(mild, moderate, severe) of sleep apnea patients. The NN50(p=0.043), pNN50(p=0.044), VLF peak(p=0.022), LF/HF(p=0.028) were statistically significant in the R-R interval of patients with sleep apnea from the control group (p<0.05). The LF / HF (p = 0.045) and HF power (p = 0.0395) parameters between the non-RAM sleep (sleep 2 phase) and REM sleep in patients with sleep apnea were statistically significant in the control group(p<0.05). We may be able to provide a basis for understanding the correlation among AHI, sleep stage and age and heart rate variability in patients with obstructive sleep apnea.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.74-78
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• 2009

Objective: It has been reported that the sleep apnea syndrome in the asthmatic patients is prevalent, however, the systematic study in this field using polysomnography has rarely been performed. The aim of this study is to investigate the relationship between the apnea-hypopnea index (AHI) and the pulmonary function in asthmatic children. Methods: This study enrolled 19 male and 12 female asthmatic children aged 6-13 years (average $8.2{\pm}1.7$ years old). Complete overnight polysomnography and pulmonary function test were performed for the participants. Results: Of the 31 asthmatic children, 21 (67.7%) met the diagnostic criteria of the pediatric sleep apnea and the average AHI was $1.7{\pm}1.5/h$. The children with higher AHI showed poorer pulmonary function ($FEV_1$/FVC ratio: p=0.002, $FEV_1$%pred: p=0.047). Conclusion: These results suggest that the prevalence of the pediatric sleep apnea could be very high among the asthmatic children and the severity of the sleep apnea correlates with the pulmonary function. However, the case-control study to compare the AHI between the asthma and control groups is absolutely necessary because few normative data are available for the children.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.448-452
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• 2004

Trauma from occlusion(TFO) is injury to the periodontal tissue as a result of occlusal forces. Mobility is a common clinical sign of occlusal trauma. In acute occlusal trauma, this may be accomanied by pain, tenderness to percussion, thermal sensitivity, and pathologic tooth migration. Chronic occlusal trauma may be marked by excessive wear and gingival recession. Radiographic finding include a widened periodontal ligament space, radiolucence and condensation of the alveolar bone and root resorption. TFO is related to the pathogenesis of periodontal disease. It can cause increased tooth mobility TFO itself does not initate or aggravate marginal gingivitis or initiate periodontal pockets. Active trauma can accelerate bone loss, pocket formation and gingival recession depending on the presence of local irritants and inflammation. Gingival recession associated with occlusal forces includes traumatic crescent, McCall's festoon and Stillman's cleft. TFO plays a minor role in the pathogenesis of early to moderate periodontitis. A 5-year-old male visited Yonsei University Pedodontics clinic with a chief complaint about gingival recession. Mobility, excessive wear, gingival recession were detected by clinical exam on the both mandibular deciduous ca nine. On the radiographic view, vertical alveolar bone loss was observed on both mandibular deciduous canine.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.102-109
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• 2008

The aims of this study were to evaluate dental caries status and to analyze the dental caries related factors which could explain the relationship between dental caries and disabled type, severity of handicap, and oral health behaviors among disabled children and adolescent in Korea. A total of 677 subjects aged from 6 to 18 were finally selected by stratified cluster sampling. They were examined by 13 trained dentists and interviewed with questionnaire. For the crude and adjusted associations, bivariate and multivariate analysis were performed using SPSS program(SPSS Inc, Chicago, USA). DMFT index were 0.90(ages 6-8), 2.32(ages 9-11), 3.63(ages 12-14) and 4.93(ages 15-17), respectively. The DMFT index was significantly related to age, frequency and dependency of toothbrushing, and mastication and functional disorder. Specialized preventive care program which accounted the age and toothbrushing instruction be developed and adapted to promote oral health status and behaviors of disabled children and adolescent in Korea.