• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.497-505
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• 2018

This study was conducted to investigate the characteristics of private health insurance subscribers and non-subscribers as they relate to severely ill patients, and to identify the factors of participation. The study was conducted using the National Health and Nutrition Examination Survey for 2015, and data were analyzed using SPSS ver. 23.0. The subjects were 417 patients with severe disease (cancer, heart disease, cerebrovascular disease) over 19 years of age. Crossover analysis was employed to identify differences between the state of private health insurance participation, while binary logistic regression analysis was used to confirm the factors affecting private health insurance subscription. Analysis of the effects of the subjects on the private health insurance participation rate revealed that the social and demographic characteristics were higher in younger individuals regardless of sex, residence, or marital status. Moreover, higher household income, regardless of the education level, was associated with a higher participation rate of health insurance target individuals compared to medical benefit target individuals. The private health insurance participation rate was low and the explaining power was 51.7%, regardless of subjective health awareness and walking practice. Therefore, efforts should be made to improve the living environment and support local governmental programs for the elderly, low income households, socially vulnerable groups with limited activities and groups with limited health behavior. It is also necessary to consider various health policies, such as providing government health education or programs to prevent severe illness.

• The Journal of the Korea Contents Association
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• v.14 no.6
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• pp.247-254
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• 2014

For the purpose of early diagnosis of the breast cancer, the attention on the screening mammography has been increasing-with supply of digital mammography day by day. Image quality is decided by target materials and filter combinations. Optimized selection by a glandular density and a thickness is needed, because these combinations change x-ray spectrum and effect to image quality. The purpose of this study is to find out optimized target and filter combinations through the evaluation of quantitative image quality and to suggest means which minimize patient dose through MCNPX. In results, spatial frequency resolution evaluation which is quantitative image quality evaluation method, MTF, NPS, DQE shows that we have to select Mo/Mo combinations or Mo/Rh combinations when compressed breast is thin. but in case of that when compressed breast is thick, we have to select Rh/Rh combinations or W /Rh combinations. In a comprehensive evaluation, W!Rh combinations which are not used in thin breasts in practice was superior to all image quality evaluation. This result is somewhat different-with clinical examination results. Secondary end point was organ dose evaluation, radiation dose of opposite breast was approximately 47 ~73% effectiveness when selecting standard breast. In conculsion, the most important point is that we have to select the optimal combinations-with considering dose evaluation and various thickness.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.315-322
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• 2009

Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

• Journal of the Korean Society of Food Science and Nutrition
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• v.31 no.6
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• pp.1043-1047
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• 2002

It is well known that soy isoflavones play beneficial roles in the prevention of chronic diseases such as breast cancer, cardiovascular disease and osteoporosis. However current data are not sufficient for estimating the level of isoflavone intake. To use the urinary isoflavone excretion as a maker of isoflavone intake,26 participants consumed the isoflavone extract capsule (90 mg soy isoplavones/capsule) daily for 3 months. The study compared effects of pre- and post-isoflavone supplement in the following parameters; physical examination, dietary recalls, and urinary isoflavon excretion. The average age, height and weight were 65.7 years, 149.4 cm, and 57.3 kg. Subjects maintained regular diet pattern, and average daily nutrient intakes between pre- and post- supplementation were not significantly different except vitamin A, carotene and vitamin C. There was no significant difference between pre- and post- supplementation in terms of daily isoflavone intake. The basal urinary isoflavone excretion was 8.37 mg/day (daidzein 6.23 mu genistein 2.14 mg), and average daily excretion rate was IS.8%. Urinary isoflavone excretion was significantly increased, after isoflavone supplementation for 3 months as compared the basal level (p<0.01). Our data suggest that urinary isoflavone level, especially daidzein and genistein, may be a useful maker to estimate isoflavone intake.

• Journal of Digital Convergence
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• v.15 no.5
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• pp.281-291
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• 2017

This study aimed to assess detection rate applying the mammographic imaging methods. The evaluation of the shape and margin of tumor was conducted by score oriented to 180 patients who had undergone FFDM, DBT and BMRI scans among breast cancer patients, and the number of calcification was classified by size. There was no significant difference between DBT and BMRI for tumors larger than 1 cm in low-density breasts and for tumors larger than 2 cm in high-density breasts. Moreover, as for the detection rate of number of fine calcification, the highest rate was observed in FFDM followed by DBT and BMRI in the order named regardless of size. In conclusion, DBT was able to be detected even without BMRI if the mass was larger than 1 cm in the low-density breast and larger than 2 cm in the high-density breast. The detection rate of calcification turned out to be the highest in FFDM followed by DBT regardless of size, and calcification was not observed by BMRI. The appropriate use of FFDM, DBT and BMRI with respect to mass tumor will contribute to serving as a guide to examination methods of reducing burden of patients.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.248-250
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• 2002

A 56 year-old man complaining of dry cough, dyspnea, chest pain, fever, and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy and subsequent radiotherapy because of an esophageal cancer. After the emergency echocardiography revealed a small amount of pericardial effusion and pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach and the pericardium, and an emergency operation was done under the diagnosis of gastropericardial fistula. The patient expired postoperative seven days later. Gastropericardial fistula caused by a peptic ulcer perforation after the esophagectomy and esophagogastrostomy operation is a very rare complication and brings forth a disastrous result. Early detection using the chest radiography, electrocardiogram, upper Gl study, echocardiography and a review of physical examination, and an immediate treatment are therefore mandatory.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.391-396
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• 1994

Carcinoembryonic Antigen is one of most frequently checked tumor markers in cancer management. We performed statistical analysis with serum CEA data of 2626 persons who received regular health examination and were thought to be free of active disease to determine the cutoff values of serum CEA level in normal Korean adults and to study the factors influencing serum CEA levels in normal subjects. 1) The cutoff values of serum CEA in normal Korean adults in general were 9.28ng/ml for men, 5.90 ng/ml for women. 2) Serum CEA level was influenced by age, present smoking history, sex, and abnormal findings in chest X ray. 3) Serum CEA level had no correlation with the history of amount of alcohol consumption or obesity. 4) Cutoff values of serum CEA in normal Korean adults were tabulated according to age, sex, and smoking history. Serum CEA level was influenced by age, sex, present smoking history and abnormal findings in chest X ray and cutoff values of serum CEA were tabulated according to age, sex, and smoking history.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.228-235
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• 1998

Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.

• Tuberculosis and Respiratory Diseases
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• v.53 no.2
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• pp.196-201
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• 2002

Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant. melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.