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Clinical Efficacy of Erdosteine in Patients with Acute or Chronic Bronchitis -A Randomized, Double Blind, Comparative Study vs. Ambroxol- (급.만성 기관지염 환자에서 엘도스$^{(R)}$(Erdosteine)의 임상효과 -염산 암브록솔과의 무작위 이중맹검 비교시험-)

  • Kim, Seok-Chan;Lee, Sang-Hoak;Song, So-Hyang;Kim, Young-Kyoon;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1296-1307
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    • 1997
  • Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

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The Influence of Aging on Pulmonary Function Tests in Elderly Korean Population (한국에서 노화에 따른 폐기능지표의 변화양상)

  • Lee, Jae-Myung;Kim, Eun-Jung;Kang, Min-Jong;Son, Jee-Woong;Lee, Seung-Joon;Kim, Dong-Gyu;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.752-759
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    • 2000
  • Background : Many studies have shown that pulmonary function differs widely among race, age and geographical residency. By virtue of the improvement of nutrition and environment, the elderly population in Korea is markedly increasing and so are the ages of patients complaining respiratory symptoms. However, we do not have our own data on the pulmonary functional reserve of elderly persons in Korea. We evaluate the deterioration of pulmonary functional reserve and standardize the predictive values of pulmonary function in the elderly population. Method : Pulmonary function tests were conducted in 100 men and 100 women over the age of 65. We analyzed changes of FVC and $FEV_1$ according to age and height by linear regression. We compared our new multiple linear regression equation with other equations currently used in Korea. Results : In men, the mean age was $71.5{\pm}5.2$(mean${\pm}$SD) years and the mean height was $163.6{\pm}6.2$cm. The mean FVC was $3.42{\pm}0.49{\ell}$ and the mean $FEV_1, $2.72{\pm}v$. In women, the mean age was $72.0{\pm}5.1$ years and the mean height was $149.1{\pm}5.9$cm. The mean FVC was $2.22{\pm}0.42{\ell}$ and the mean $FEV_1$ $1.83{\pm}0.34{\ell}$. Multiple linear regression equation using age and height as an independent factors was as follows : FVC(${\ell}$)=1.857-0.0356$\times$age(year)+0.02517$\times$height(cm) (p<0.01, $R^2$=0.279), $FEV_1(${\ell}$)=1.340-0.02698$\times$age(year)+0.02021$\times$height(cm) (p<0.01, $R^2$=0.255) in men, FVC(${\ell}$) =-0.09765-0.03332$\times$age(year)+0.03164$\times$height(cm) (p<0.01, $R^2$=0.435), $FEV_1(${\ell}$)=-0.l69-0.02469$\times$age(year)+0.02539$\times$height(cm) (p<0.01, $R^2$=0.41) in women. Conclusion : We established prediction regressions for pulmonary functional tests in the elderly Korean population. We also confirmed that currently adopted equations do not exactly anticipate the expected pulmonary functional reserve in the aged person over 65 years old. We suggest that our new equations from this study should be applied to interpret the pulmonary function tests in the elderly population in Korea.

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The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

A comparative study on the correlation between Korean foods and the fractures of PFG and all ceramic crowns for posterior applications (구치용 도재소부금관과 전부도재관에 파절을 일으키는 한국음식에 관한 연구)

  • Kim, Jeong-Ho;Lee, Jai-Bong
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.156-163
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    • 2009
  • Statement of problem: Recently, there have been increased esthetic needs for posterior dental restorations. The failure of posterior dental ceramic restoration are possible not only by the characters of the component materials but also by the type of food. Purpose: The research aim was to compare the in vitro fracture resistance of simulated first molar crowns fabricated using 4 dental ceramic systems, full-porcelain-occlusal-surfaced PFG, half-porcelain-occlusal-surfaced PFG, Empress 2, Ice Zirkon and selected Korean foods. Material and methods: Eighty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a Instron 4465, and the maximum load(N) was recorded. Afterwards, selected Korean foods specimens(boiled crab, boiled chicken with bone, boiled beef rib, dried squid, dried anchovy, round candy, walnut shell) were prepared. 15 specimens per each food were placed under the Instron and the maximum fracture loads for them were recorded. The 95% confidence intervals of the characteristic failure load were compared between dental ceramic systems and Korean foods. Afterwards, on the basis of previous results, 14Hz cyclic load was applied on the 4 systems of dental ceramic restorations in MTS. The reults were analyzed by analysis of variance and Post Hoc tests. Results: 95% confidence intervals for mean of fracture load 1. full porcelain occlusal surfaced PFG Crown: 2599.3 to 2809.1 N 2. half porcelain occlusal surfaced PFG Crown: 3689.4 to 3819.8 N 3. Ice Zirkon Crown: 1501.2 to 1867.9 N 4. Empress 2 Crown: 803.2 to 1188.5 N 5. boiled crab: 294.1 to 367.9 N 6. boiled chicken with bone: 357.1 to 408.6 N 7. boiled beef rib: 4077.7 to 4356.0 N 8. dried squid: 147.5 to 190.5 N 9. dried anchovy: 35.6 to 46.5 N 10. round candy: 1900.5 to 2615.8 N 11. walnut shell: 85.7 to 373.1 N under cyclic load(14Hz) in MTS, fracture load and masticatory cycles are: 1. full porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 4796.8-9321.2 cycles under 2224.8 N(round candy)load, no fracture under smaller loads. 2. half porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 881705.1-1143565.7 cycles under 2224.8 N(round candy). no fracture under smaller loads. 3. Ice Zirkon Crown fractured at 95% confidence intervlas of 979993.0-1145773.4 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. 4. Empress 2 Crown fractured at 95% confidence intervals of 564.1-954.7 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. Conclusion: There was a significant difference in fracture resistance between experimental groups. Under single load, Korean foods than can cause fracture to the dental ceramic restorations are boiled beef rib and round candy. Even if there is no fracture under single load, cyclic dynamic load can fracture dental posterior ceramic crowns. Experimental data with 14 Hz dynamic cyclic load are obtained as follows. 1. PFG crown(full porcelain occlusion) was failed after mean 0.03 years under fracture load for round candy(2224.8 N). 2. PFG crown(half porcelain occlusion) was failed after mean 4.1 years under fracture load for round candy(2224.8 N). 3. Ice Zirkon crown was failed after mean 4.3 years under fracture load for boiled chicken with bone(382.9 N). 4. Empress 2 crown was failed after mean 0.003 years under fracture load for boiled chicken with bone(382.9 N).

The micro-tensile bond strength of two-step self-etch adhesive to ground enamel with and without prior acid-etching (산부식 전처리에 따른 2단계 자가부식 접착제의 연마 법랑질에 대한 미세인장결합강도)

  • Kim, You-Lee;Kim, Jee-Hwan;Shim, June-Sung;Kim, Kwang-Mahn;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.148-156
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    • 2008
  • Statement of problems: Self-etch adhesives exhibit some clinical benefits such as ease of manipulation and reduced technique-sensitivity. Nevertheless, some concern remains regarding the bonding effectiveness of self-etch adhesives to enamel, in particular when so-called 'mild' self-etch adhesives are employed. This study compared the microtensile bond strengths to ground enamel of the two-step self-etch adhesive Clearfil SE Bond (Kuraray) to the three-step etch-and- rinse adhesive Scotchbond Multi-Purpose (3M ESPE) and the one-step self-etch adhesive iBond (Heraeus Kulzer). Purpose: The purpose of this study was to determine the effect of a preceding phosphoric acid conditioning step on the bonding effectiveness of a two-step self-etch adhesive to ground enamel. Material and methods: The two-step self-etch adhesive Clearfil SE Bond non-etch group, Clearfil SE Bond etch group with prior 35% phosphoric acid etching, and the one-step self-etch adhesive iBond group were used as experimental groups. The three-step etch-and-rinse adhesive Scotchbond Multi-Purpose was used as a control group. The facial surfaces of bovine incisors were divided in four equal parts cruciformly, and randomly distributed into each group. The facial surface of each incisor was ground with 800-grit silicon carbide paper. Each adhesive group was applied according to the manufacturer's instructions to ground enamel, after which the surface was built up using Light-Core (Bisco). After storage in distilled water at $37^{\circ}C$ for 1 week, the restored teeth were sectioned into enamel beams approximately 0.8*0.8mm in cross section using a low speed precision diamond saw (TOPMET Metsaw-LS). After storage in distilled water at $37^{\circ}C$ for 1 month, 3 months, microtensile bond strength evaluations were performed using microspecimens. The microtensile bond strength (MPa) was derived by dividing the imposed force (N) at time of fracture by the bond area ($mm^2$). The mode of failure at the interface was determined with a microscope (Microscope-B nocular, Nikon). The data of microtensile bond strength were statistically analyzed using a one-way ANOVA, followed by Least Significant Difference Post Hoc Test at a significance level of 5%. Results: The mean microtensile bond strength after 1 month of storage showed no statistically significant difference between all adhesive groups (P>0.05). After 3 months of storage, adhesion to ground enamel of iBond was not significantly different from Clearfil SE Bond etch (P>>0.05), while Clearfil SE Bond non-etch and Scotchbond Multi-Purpose demonstrated significantly lower bond strengths (P<0.05), with no significant differences between the two adhesives. Conclusion: In this study the microtensile bond strength to ground enamel of two-step self-etch adhesive Clearfil SE Bond was not significantly different from three-step etch-and-rinse adhesive Scotchbond Multi-Purpose, and prior etching with 35% phosphoric acid significantly increased the bonding effectiveness of Clearfil SE Bond to enamel at 3 months.

한강하류지형면의 분류와 지형발달에 대한 연구 (양수리에서 능곡까지)

  • Park, No-Sik
    • Journal of the Speleological Society of Korea
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    • no.68
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    • pp.23-73
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    • 2005
  • Purpose of study; The purpose of this study is specifically classified as two parts. The one is to attempt the chronological annals of Quaternary topographic surface through the study over the formation process of alluvial surfaces in our country, setting forth the alluvial surfaces lower-parts of Han River area, as the basic deposit, and comparing it to the marginal landform surfaces. The other is to attempt the classification of micro morphology based on the and condition premising the land use as a link for the regional development in the lower-parts of Han river area. Reasons why selected the Lower-parts of Han river area as study objects: 1. The change of river course in this area is very serve both in vertical and horizontal sides. With a situation it is very easy to know about the old geography related to the formation process of topography. 2. The component materials of gravel, sand, silt and clay are deposited in this area. Making it the available data, it is possible to consider about not oかy the formation process of topography but alsoon the development history to some extent. 3. The earthen vessel, a fossil shell fish, bone, cnarcoal and sea-weed are included in the alluvial deposition in this area. These can be also valuable data related to the chronological annals. 4. The bottom set conglometate beds is also included in the alluvial deposits. This can be also valuable data related to the research of geomorphological development. 5. Around of this area the medium landform surface, lower landform surface, pediment and basin, are existed, and these enable the comparison between the erosion surfaces and the alluvial surfaces. Approach : 1. Referring to the change of river beds, I have calculated the vertical and horizontal differences comparing the topographic map published in 1916 with that published in 1966 and through the field work 2. In classifying the landform, I have applied the method of micro morphological classification in accordance with the synthetic index based upon the land conditions, and furthermore used the classification method comparing the topographic map published in 1916 and in that of 1966. 3. I have accorded this classification with the classification by mapping through appliying the method of classification in the development history for the field work making the component materials as the available data. 4. I have used the component materials, which were picked up form the outcrop of 10 places and bored at 5 places, as the available data. 5. I have referred to Hydrological survey data of the ministry of Construction (since 1916) on the overflow of Han-river, and used geologic map of Seoul metropolitan area. Survey Data, and general map published in 1916 by the Japanese Army Survbey Dept., and map published in 1966 by the Construction Research Laboratory and ROK Army Survey Dept., respectively. Conclusion: 1. Classification of Morphology: I have added the historical consideration for development, making the component materials and fossil as the data, to the typical consideration in accordance with the map of summit level, reliefe and slope distribution. In connection with the erosion surface, I have divided into three classification such as high, medium and low-,level landform surfaces which were classified as high and low level landform surfaces in past. furthermore I have divided the low level landform surface two parts, namely upper-parts(200-300m) and bellow-parts(${\pm}100m$). Accordingly, we can recognize the three-parts of erosion surface including the medium level landform surface (500-600m) in this area. (see table 22). In condition with the alluvial surfaces I have classified as two landform surfaces (old and new) which was regarded as one face in past. Meamwhile, under the premise of land use, the synthetic, micro morphological classification based upon the land condition is as per the draw No. 19-1. This is the quite new method of classification which was at first attempted in this country. 2. I have learned that the change of river was most severe at seeing the river meandering rate from Dangjung-ni to Nanjido. As you seee the table and the vertical and horizontal change of river beds is justly proportionable to the river meandering rate. 3. It can be learned at seeing the analysis of component materials of alluvial deposits that the component from each other by areas, however, in the deposits relationship upper stream, and between upper parts and below parts I couldn't always find out the regular ones. 4. Having earthern vessel, shell bone, fossil charcoal and and seaweeds includen in the component materials such as gravel, clay, sand and silt in Dukso and Songpa deposits area. I have become to attempt the compilation of chronicle as yon see in the table 22. 5. In according to hearing of basemen excavation, the bottom set conglomerate beds of Dukso beds of Dukso-beds is 7m and Songpa-beds is 10m. In according to information of dredger it is approx. 20m in the down stream. 6. Making these two beds as the standard beds, I have compared it to other beds. 7 The coarse sand beds which is covering the clay-beds of Dukso-beds and Nanjidobeds is shown the existence of so-called erosion period which formed the gap among the alluvial deposits of stratum. The former has been proved by the sorting, bedding and roundness which was supplied by the main stream and later by the branch stream, respectively. 8. If the clay-beds of Dukeo-bed and Songpa-bed is called as being transgressive overlap, by the Eustatic movement after glacial age, the bottom set conglomerate beds shall be called as being regressive overlap at the holocene. This has the closest relationship with the basin formation movement of Seoul besides the Eustatic movement. 9. The silt-beds which is the main component of deposits of flood plain, is regarded as being deposited at the Holocene in the comb ceramic and plain pottery ages. This has the closest relationship with the change of river course and river beds.

Effect of Solvent Fractions from Doenjang on Antimutagenicity, Growth of Tumor Cells and Production of Interleukin-2 (된장 분획물의 항돌연변이 및 암세포 증식 억제효과와 interleukin-2 생성에 미치는 영향)

  • Kim, Kwang-Hyuk;Park, Kun-Young;Lee, Sook-Hee;Lim, Sun-Young
    • Journal of Life Science
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    • v.17 no.6 s.86
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    • pp.791-797
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    • 2007
  • We studied the inhibitory effect of solvent fractions from doenjang on mutagenicity using Salmonella typhimurium TA100 in Ames test. We also investigated the effect of solvent fractions from doenjang on the growth of tumor cells and the production of interleukin-2 (IL-2). The treatment of dichlorormethane and ethylacetate fractions (2.5 mg/assay) from doenjang to Ames test system inhibited aflatoxin B$_1$ (AFB$_1$) induced mutagenicity by 96% and 97%, respectively, and showed a higher antimutagenic effect than other solvent fractions. In case of N-methyl-N'-nitro-N-nitrosoguamidine (MNNG) induced mutagenicity, the ethylacetate fraction showed the highest inhibitory effect (by 75%) among the other sol-vent fractions, although the inhibitory effect was not stronger compared to AFB$_1$ induced mutagenicity. The treatment of dichloromethane and ethylacetate fractions markedly inhibited the growth of Yac-1 (by 80% and 94%, respectively) and sacroma-180 cancer cells (by 60% and 96%, respectively) after 4 days of incubation at 37${\circ}$C. To elucidate the immunological mechanism of antitumor activity of doenjang, spleen cells of Balb/c mouse were exposed to the dichloromethane and ethyl-acetate fractions for 24 hours at 37${\circ}$C . The culture supernatants following the treatment of djchloromethane and ethylacetate factions to spleen cells increased the production of IL-2. These results indicated that the anticarcinogenic effect of doenjang was mediated by the production of IL-2.

A Survey on Child Battering among Elementary School Children and Related Factors in Urban and Rural Areas (도시 및 농어촌 아동의 가정내 구타발생률 및 관련요인 조사)

  • Jeon, Kae-Soon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.232-242
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    • 1991
  • To determine the incidence rate of child battering and related factors, a questionnaire survey was Conducted on 1,255 children in 4th and 5th grades of two elementary schools (one in the upper economic class area with 519 students and the other in the lower economic class area with 504 students) in Taegu and two schools in rural areas of Kyungpook province (120 and 112 students, respectively) from 1st May to 10th May 1990. Total number of children who were battered during one-month period (1-30 April 1990) prior to the survey was 918 (73.1%). Among the battered children 87 (6.9%) were severely battered (twice or more in a month by kicking or more severe method) and 831 children (66.2%) were moderately battered (all other battering than severe battering). The percentage of battered children and degree of battering were not significantly different between two schools in Taegu and between urban and rural areas. Common reasons for battering were disobediance (61.9%), making troubles (34.9%), and poor school performance (33.3%). However, 16.1% of severely battered children responded that the perpetrators battered them to wreak their anger and 5.7% of them did not know the reason why they were battered. A majority of the battered children (65%) regretted their fault after being battered but 20.7% of the severely battered children wanted to run away and 9.2% of them had an urge to commit suicide. While most of the physical injuries due to battering were minor as bruise (52.7%) but some of them were severe, e.g., bone fracture (2.5%), skin laceration (1.5%), and loss of consciousness. (0.2%). The common psycho-behavioral complaints of the severely battered children were unwillingness to study (31%), unwillingness to live (17.2%), and reluctance to go home (13.8%). The incidence rate of severe battering was significantly higher (p=0.018) among the children living in a quarter attached to a store (14.0%) than the children living in an apartment (6.6%) and individual house (6.2%). The incidence rate of severe battering was higher among children living in a rental house (8.4%) than children living in their own house 6.3%) (p=0.005). The children of father only working (5.1%) and mother only working (4.5%) had a lower incidence rate of severe battering than the children of both parents working (9.1%) and both parents unemployed (20.7%) (p=0.006). More children were battered when there was a sick family member (80.8%) compared with the children without a sick family member (71.4%) (p=0.001). The incidence rates of severe and moderate battering increased as the frequency of quarreling between mother and father increased (P=0.000). The percentage of unbattered children was higher among children whose father's occupation was professional (39.4%) than that of the total study subjects (26.9%) (p<0.001).

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Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents (성장기 청소년의 혈압변화와 결정요인)

  • Suh, Il;Nam, Chung-Mo;Jee, Sun-Ha;Kim, Suk-Il;Kim, Young-Ok;Kim, Sung-Soon;Shim, Won-Heum;Kim, Chun-Bae;Lee, Kang-Hee;Ha, Jong-Won;Kang, Hyung-Gon;Oh, Kyung-Won
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.308-326
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    • 1997
  • Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

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Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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