• 대한지역사회영양학회지
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• 제17권3호
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• pp.341-352
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• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• 핵의학기술
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• 제21권2호
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• pp.49-54
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• 2017

Purpose The high-dose administration of I-131 has been standing for the basic therapy method of thyroid cancer. In korea, it is not necessary for patients to be hospitalized if the administration dose are under 1.2 GBq. However, if the dose are over 1.2 GBq, the patients should be stay in special ward with radiation shield. In such cases, the radioactivity level upon release should be under a dose of $70{\mu}Sv/hr$ at a distance of approx. 1m. This regulation bring the patients to stay for about 2 to 3 days in ward before the release. Materials and Methods Using the inpatients' release data of severance hospital, an inpatient-days were retrospectively calculated and compared with practical data and estimate the inpatient-days with the conditions of korea ($70{\mu}Sv/hr$), Japan ($30{\mu}Sv/hr$), germany ($3.5{\mu}Sv/hr$ at a distance of approx. 2 m), and other european countries. Results When a effective half-life of 15.4 was used, the expected inpatient-days were calculated as 2.15 days in the condition of Japanese regulation and 1.37 days in the condition of korean regulation. The practical inpatient-days of patients in Severance hospital were 1.32 days. Conclusion As ICRP 94 has been mentioned that the release of patients administrated with I-131 for the therapy should be carefully considered because each patients has different thyroid uptake rate and their conditions with family members after the release from the ward. Nonetheless, efforts to bring more aquate data which is for getting closer to the practical data should be continuously studied.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.75-83
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• 2018

목적: 호스피스 완화의료에서 환자의 기대 여명 예측뿐 아니라 퇴원형태를 예측하여 적절한 치료를 제공할 필요가 있다. 이번 연구에서는 입원 초기 환자의 퇴원 형태 예측에 유의한 요소들을 알아보고 효율적인 완화의료의 방향에 대해 제시하고자 한다. 방법: 2016년 4월 1일부터 2017년 12월 31일까지 P병원 호스피스 병동에 입원한 말기암환자 568명 중 377명을 대상으로 하였으며 입원 시 사정한 환자의 수행 지수, 증상 및 징후, 사회 경제적 상태와 혈액검사 자료를 바탕으로 연구를 진행하였다. 결과: 입원 당시 높은 수행지수, 양호한 증상 및 징후, 정상에 가까운 혈액검사 수치를 보일 때 생존 퇴원할 가능성이 높았다. 결론: 환자의 퇴원형태 예측에 ECOG, KPS, Global health, Mental status와 같은 수행지수, dyspnea, anorexia, dysphagia, fatigue와 같은 증상 및 징후, CBC, LFT, BUN, CRP 혈액검사 수치가 유의한 지표임을 확인하였다.

• 대한화상학회지
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• 제22권2호
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• pp.66-70
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• 2019

Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

• 대한예방한의학회지
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• 제19권1호
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• pp.95-107
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• 2015

Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

• Tuberculosis and Respiratory Diseases
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• 제56권3호
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• pp.268-279
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• 2004

연구배경 : 결핵균 감염을 확인하는 방법으로 투베르쿨린 검사가 사용되고 있으나, 폐결핵을 진단하거나 배제하는데 유용성이 있는 지에 대해서는 아직까지 잘 알려져 있지 않았다. 본 연구는 폐결핵이 의심되지만 객담 도말 음성인 환자에서 투베르쿨린 검사가 폐결핵을 진단하거나 배제하는 것에 도움이 되는지와, 객담 도말 양성 환자에서 폐결핵과 NTM 폐질환을 감별하고자 할 때 도움이 되는 지를 알아보고자 하였다. 방 법 : 2002년 10월부터 2003년 8월까지 삼성서울병원 호흡기내과에 입원한 성인 환자 중 폐결핵이 감별진단에 포함된 환자 258명을 대상으로 투베르쿨린검사를 시행하여 그 결과를 분석하였다. 결 과 : 남자가 156명, 여자가 102명이었고 평균 연령은57.5세였다. 최종진단은 폐암 89명(34.5%), 폐결핵59명(22.9%), 폐렴 33명(12.8%), NTM 폐질환 24명(9.3%) 등이었다. 투베르쿨린 검사는 폐결핵 환자의 81.4%(48/59)와 비결핵성 폐질환 환자의 42.2%(84/199)에서 양성을 보였다(p<0.001). 객담 도말음성 환자 208명 중 결핵 환자의 69.4%(25/36)와 비결해성 폐질환 환자의 44.8%(77/172)에서 양성을 보여(p=0.007), 투베르쿨린 검사 양성이 폐결핵을 예측하는 민감도와 특이도는 각각 69.4%(25/36)와 55.2%(95/172)였고, 양성 예측치와 음성 예측치는 각각 24.5%(25/102)와 89.6%(95/106)였다. 폐결핵환자 31명과 NTM 폐질환 환자 19명 등 객담 도말 양성 환자 50명에서는 폐결핵 환자의 83.9%(26/31)와 NTM 폐질환 환자의 21.1%(4/15)에서 양성을 보여(p<0.001), 민감도와 특이도는 각각 83.9%(26/31)와 78.9%(15/19), 양성 예측치와 음성 예측치는 각각 86.7%(26/30)와 75.0%(15/20)였다. 결 론 : 투베르쿨린 검사는 폐결핵이 의심되지만 객담 도말 음성인 환자에서 폐결핵을 배제하는 데 그리고 도말 양성 환자에서는 폐결핵과 NTM 폐질환을 감별하는 데 임상적 유용성이 있을 것으로 사료된다.